Acne Research Articles

Awareness, beliefs, and self-medication practice of acne vulgaris among medical and pharmacy students in Yemen: A cross-sectional study

Background: Acne is a prevalent global skin condition, impacting around 9.4% of the population. This chronic inflammatory disease is commonly observed in the adolescent age group. The practice of self-medication for acne is widespread among medical and pharmacy students. This study aimed to evaluate self-medication practices and explore medical and pharmacy students’ awareness, beliefs, and attitudes towards acne vulgaris. Methods: A questionnaire-based cross-sectional study was conducted among medical and pharmacy students in four colleges in the capital city of Yemen. All students attending the selected colleges during the study period (June and July 2023) were eligible to participate. Results: The findings revealed that 58.7% of students had acne. The overall rate of correct answers to the knowledge statements was 58.9%. The majority of students reported negative effects, including psychological and social impact. However, only a small proportion (23.9%) believed that acne negatively affected job performance. Slightly more than half of the students (54.5%) expressed willingness to use over-the-counter (OTC) drugs. Regarding effective practices, most students (61.4%) believed that maintaining a proper diet was crucial. Conclusion: The study reveals the widespread use of self-medication for acne and highlights the need to raise awareness about the effective management and control of acne.

METFORMIN THERAPY FOR ACNE VULGARIS AMONG MALES AND FEMALES WITHOUT POLYCYSTIC OVARY SYNDROME: A SYSTEMATIC REVIEW AND META-ANALYSIS

Objectives: There is an association between Acne vulgaris and insulin resistance and metabolic syndrome. Although metformin was effective in polycystic ovary syndrome (PCOS) patients, its effects on acne vulgaris among males and females without PCOS are scarce. The study aimed to assess the impact of metformin on acne vulgaris among males and females without PCOS. Methods: We searched seven databases including Scopus, Web of Science, PubMed, Google Scholar, MEDLINE, EBSCO, and Cochrane Library. We conducted the literature search during October and November of 2024 and the articles were included from inception up to the most recently published research. We used the keywords metformin, doxycycline, tetracycline, isotretinoin, acne vulgaris, acne severity, inflammatory lesions, non-inflammatory lesions, and Global Acne Grading System. A checklist was used to collect the information analyzed by the RevMan System 5.4 (United Kingdom). Results: Out of a hundred and forty-eight studies identified, we screened 27 full texts, and only five studies were found eligible to be included in the meta-analysis. The studies included 214 patients with study duration of 2–6 months. Metformin was effective in reducing global acne severity scores. However, it was inferior to doxycycline, tetracycline, and isotretinoin, odd ratio, 1.16, 95% CI, 0.37–1.94, Chi-square, 3.95, and p=0.004, and odd ratio, 3.75, 95% CI, 1.85–5.65, Chi-square, 98.32, and p<0.001, respectively. Conclusion: Metformin was effective in acne vulgaris treatment among males and females without PCOS, p<0.05, but not superior to other systemic therapies. p>0.05. Furthermore, extensive controlled trials are recommended.

An Overview of Malaysian Rainforest Herbs with Potential Anti-acne Activity

Background: Acne vulgaris, a common dermatological disorder that affects around 85% of individuals and is characterized by inflammation and infection. Natural products and traditional medicines have been used as alternative treatments to chemical-based products due to negative side effects and drug resistance. Objective: This review aims to provide an overview of the anti-inflammatory, antioxidant, and antibacterial properties of Malaysian medicinal plants for use in acne. Methodology: The databases used were the National Center for Biotechnology (NCBI), PubMed, Google Scholar, Scopus, and Science Direct. At least one keyword or combination of the following terms: i) antibacterial, ii) anti-inflammatory, iii) antioxidant, iv) anti-acne, v) antimicrobial, vi) Malaysia, and vii) medicinal plants, were used for the search. Results: Eurycoma longifolia Jack, Quercus infectoria, Strobilanthes crispus, Aquilaria crassna, Ficus deltoidea Jack, Phyllanthus emblica, Barringtonia racemosa, Boesenbergia rotunda L, Rhinacanthus nasutus, Tacca integrifolia rhizome, Clinacanthus Nutans, Labisa pumila Benth. Morinda citrifolia with Psidium guajava L. leaves, Cinnamomum verum, Moringa oleifera, Salix alba, Gaultheria fragrantissima, Garcinia mangostana, Azadirachta indica, and Aloe barbadensis miller have been linked to the use as potential anti-acne agents. Conclusion: Malaysia's rainforest herbs have the potential to be used in formulations for adjunct treatment to currently available anti-acne agents due to their antiinflammatory and antibacterial bioactivities.

Correlation between Serum Levels of Thyroid Peroxidase-Antibody and Severity of Acne Vulgaris

The aim of the study was to estimate serum levels of thyroid peroxidase-antibody (TPO-Ab) in individuals with acne vulgaris and subjects who appeared to be healthy, to compare TPO-Ab between the two groups and to correlate severity of acne vulgaris with serum levels of TPO-Ab. A total number of 120 participants of both genders with age range between 15 to 45 years were selected in this study according to inclusion and exclusion criteria. Among them, 60 individuals with acne vulgaris were assigned to group A. Group A was again sub-divided into mild, moderate and severe acne on the basis of the severity of acne vulgaris. For comparison, 60 persons who appeared healthy and were matched by age and gender were considered as group B. The serum level of TPO-Ab was estimated. The study revealed significantly higher (p<0.001) levels of TPO-Ab (463.80±532.55 U/mL, median 122.9) of group A in comparison to group B (184.1±375.1 U/mL, median 40.8). TPO-Ab levels were significantly (p <0.001) more positive in group A 38/60(63.3%) compared with group B 14/60(23.3.%). TPO-Ab were positively correlated (r-+0.168) with the severity of the acne vulgaris but was not statistically significant (p-0.200).

Analysis of global trends and hotspots of skin microbiome in acne: a bibliometric perspective

BackgroundAcne is a chronic inflammatory condition affecting the hair follicles and sebaceous glands. Recent research has revealed significant advances in the study of the acne skin microbiome. Systematic analysis of research trends and hotspots in the acne skin microbiome is lacking. This study utilized bibliometric methods to conduct in-depth research on the recognition structure of the acne skin microbiome, identifying hot trends and emerging topics.MethodsWe performed a topic search to retrieve articles about skin microbiome in acne from the Web of Science Core Collection. Bibliometric research was conducted using CiteSpace, VOSviewer, and R language.ResultsThis study analyzed 757 articles from 1362 institutions in 68 countries, the United States leading the research efforts. Notably, Brigitte Dréno from the University of Nantes emerged as the most prolific author in this field, with 19 papers and 334 co-citations. The research output on the skin microbiome of acne continues to increase, with Experimental Dermatology being the journal with the highest number of published articles. The primary focus is investigating the skin microbiome’s mechanisms in acne development and exploring treatment strategies. These findings have important implications for developing microbiome-targeted therapies, which could provide new, personalized treatment options for patients with acne. Emerging research hotspots include skincare, gut microbiome, and treatment.ConclusionThe study’s findings indicate a thriving research interest in the skin microbiome and its relationship to acne, focusing on acne treatment through the regulation of the skin microbiome balance. Currently, the development of skincare products targeting the regulation of the skin microbiome represents a research hotspot, reflecting the transition from basic scientific research to clinical practice.

A Single-Center, Open Label, Study to Evaluate the Effectiveness of Acne Scar Gel (ASG) in Improving Acne Scar Appearance and Reducing Hyperpigmentation in Subjects With Mild-To-Moderate Acne Scars.

Acne vulgaris affects up to 80% of individuals aged 11 to 30 years and is one of the most common diseases in the world. Acne and its sequelae, such as redness, hyperpigmentation, irritation, and scarring, can have a deleterious effect on quality of life. Topical therapies are the standard of care, and compliance is central to success. The purpose of the study was to evaluate the efficacy of a novel topical formulation (TASG) for the improvement of acne scar appearance and for reducing hyperpigmentation. This single-center, open-label clinical trial included healthy subjects (n = 27, age range 18 to 45 years) presenting with mild to moderate acne scarring and hyperpigmentation. Study duration was 4 visits over a 12-week period. Product was to be applied twice daily. No significant treatment-related adverse events were noted. Data show that 72.5% of subjects had smoother skin and reduced hyperpigmentation (as per observer grading of photographs) and redness at the final week 12 follow-up visit; subjective questionnaire results showed high patient satisfaction, with overall positive impressions of the product itself and its regular use. The data show that TASG is a safe and effective therapeutic option for improving the appearance of acne scars and related hyperpigmentation.

Measurement of Acne Severity, Dietary Habits, and Blood Zonulin Levels in Acne Patients.

Zonulin is a signaling protein secreted by enterocytes that can reversibly open tight junctions. Blood zonulin levels are elevated in disorders characterized by increased intestinal permeability. The aim of this study is to compare blood zonulin levels and dietary habits between acne vulgaris patients and healthy controls, as well as to investigate the relationship between blood zonulin levels, diet, disease severity, age at onset, and duration in the acne group. Additionally, we aimed to explore the relationship between diet and blood zonulin levels in both groups. Seventy-five patients with acne vulgaris over the age of 18 years and 75 healthy controls were included in the study. Blood zonulin levels in both groups were analyzed using the sandwich ELISA method. Demographic data, habits, and dietary preferences were recorded. In the acne group, the mean blood zonulin level was significantly higher than in the control group (195.54 ± 49.05 ng/mL vs. 158.45 ± 85.07 ng/mL, p = 0.001). Additionally, milk and high glycemic index food consumption were significantly higher in the acne group. Our results support the hypothesis that increased intestinal permeability may be involved in the pathogenesis of acne vulgaris. Moreover, our study confirms the relationship between diet and acne. Future studies are warranted to elucidate the impact of acne-promoting and acne-preventive foods on the pathogenesis of acne through intestinal permeability.

Performance and Safety of the Medical Device Ialuxid Gel in the Treatment of Mild-Moderate Acne Vulgaris: An Open-Label, Noncomparative Multicentre Interventional Clinical Trial.

Medical literature shows there is no ideal treatment for acne, but topical therapies like benzoyl peroxide, retinoids, and antibiotics have proven to improve mild-moderate cases. Replacing benzoyl peroxide (potentially irritating) with hydrogen peroxide has already been suggested in the medical literature. We investigated a medical device, a proprietary combination of hyaluronic acid, hydrogen peroxide, and glycine in mild-moderate acne vulgaris. Patients of both sexes between ≥ 18 and ≤ 45 years old, with a Global Acne Grading System score ≤ 30, were included. Exclusion criteria were dermal systemic or infectious diseases; allergy to the tested product; pregnant or lactating women; treatment for acne 30 days before baseline; and previous facial aesthetic surgery. Forty patients were treated for 8 weeks several times a day with the tested product and visited at baseline, week 2, week 4, and week 8. Outcomes were decreasing the total number of lesions and the Global Acne Grading System Severity Score, Investigator Global Assessment of Performance with photographs evaluation in blind, Dermatology Life Quality Index, and the Treatment Satisfaction Questionnaire. Adverse events were collected for safety. A 2-fold decrease in the number of lesions at the final visit (-56.3%, p < 0.001). The remaining outcomes evidenced a statistically significant reduction at the final visit. Only 8 adverse events (all mild and related to the tested device) were reported. Results and optimal safety demonstrate that the tested product has a clinical benefit and could be associated with retinoids, as first choice for mild to moderate acne. Clinicaltrial.gov as NCT05345093.

Decoding Acne Vulgaris: Insights into Pathogenesis, Treatment Modalities, Diagnosis and Recent Advancements

Background: Acne vulgaris, an alternative term for acne, is a persistent inflammatory skin condition affecting the pilosebaceous unit. Its development involves a combination of factors, including increased sebum production, changes in keratinization leading to comedone formation, colonization of hair follicles by Propionibacterium acnes (P. acnes), and the release of inflammatory mediators in the vicinity of the pilosebaceous unit. Objective: This review provides a concise overview of acne, covering its pathogenesis, epidemiology, diagnosis, treatment options, and recent advancements involved in acne. Discussion: Various therapeutic approaches, encompassing topical, systemic, combination, and hormonal treatments, are employed to address acne. Prolonged use of synthetic medications is common in acne therapy, but their potential for severe side effects prompts a preference for herbal- based treatments. Herbal remedies utilizing extracts of natural origin are considered safer due to their lower toxicity and reduced likelihood of adverse drug reactions. Recent advancements, particularly in personalized medicine and microbiome research have enhanced our understanding and opened new avenues for more effective management. Conclusion: Decoding acne vulgaris has provided insights into its pathogenesis, treatment modalities, diagnostics, and recent advancements. Integrating synthetic and herbal treatments, personalized medicine, microbiome research, and advanced modeling techniques offer promising acne management strategies.

Novel transethosome coencapsulated combination for acne treatment: in-vitro efficacy and ex-vivo biodistribution studies.

Acne vulgaris is a skin condition affecting approximately 85% of young adults. It is influenced by androgens and primarily occurs in the pilosebaceous unit, where inflammation and obstruction happen. Hyperseborrhea and hyperkeratinization lead to increased levels of fatty acids and necrotic keratinocytes, promoting the proliferation of C. acnes phylotype IA1. Here, the in-vitro efficacy of a novel combination on the main processes involved in acne was studied. Furthermore, the combination was coencapsulated in transethosomes to target the pilosebaceous unit, and the biodistribution was analyzed ex vivo by fluorescence microscopy. The combination of compounds reduced inflammatory markers levels, sebum production and 5α-Reductase levels while it induced autophagy and FOXO1 nuclear levels in sebocytes. The compounds coencapsulated in transethosomes reached the pilosebaceous unit as proven by the ex vivo analysis. The proposed combination of compounds is a promising approach to be included in topical products for the treatment of acne vulgaris.

Platelet Rich Plasma as a Potential Treatment for Melasma: A Review

Melasma impacts millions of individuals globally. It is characterized by hyperpigmented macules that predominantly affect the centrofacial region. Although not medically dangerous, melasma can significantly diminish quality of life and overall well-being. Current therapeutic approaches offer varying degrees of efficacy, tolerance, and outcomes, underscoring the need for further research to identify treatments that are both effective and safe. Platelet-rich plasma (PRP), an autologous plasma enriched with a high concentration of platelets, has gained attention in the medical field for its regenerative properties and favorable benefit-risk profile. In dermatology and aesthetic medicine, PRP has demonstrated efficacy in applications such as wound healing, skin rejuvenation, alopecia, acne scarring, and, more recently, pigmentation disorders. This review explores the potential of PRP as a treatment modality for melasma, suggesting that PRP, whether used as an adjunctive or standalone therapy, may significantly enhance treatment outcomes. Nevertheless, despite promising evidence supporting its use, further research is required to establish robust biomolecular mechanisms and evaluate the long-term safety and efficacy of PRP in managing melasma.

Antihistamines reduce initial flaring and speed improvement during isotretinoin treatment for acne: A systematic review and meta-analysis

Antihistamines reduce initial flaring and speed improvement during isotretinoin treatment for acne: A systematic review and meta-analysis

Effectiveness and Safety of the Use of 1470 nm Laser Therapy in Patients Suffering From Acne Scarring of the Facial Skin

Effectiveness and Safety of the Use of 1470 nm Laser Therapy in Patients Suffering From Acne Scarring of the Facial Skin

The Effectivity of 15% TCA Superficial Chemical Peeling to Treat Comedos and Papulo-Pustules Acne Vulgaris

Background: Acne vulgaris was very common self limitting disease, affected approximately 85% of adolesence, that was defined as a chronic inflammation of pilosebaceous units. It was characterized by the formation of comedones (as primarily acne lession), erythemathous papules and pustules, less frequently nodules and pseudocyst, and was accompanied by scarring in some cases that caused psychosocial problems. TCA 15% was superficial chemical peeling, involved an application of exfoliating agents to the skin, resulting in controlling wound and destructing the portion of the epidermis with subsequent regeneration and reepithelialization within 3-5 days.TCA was the first line therapy for acne scar and skin rejuvenation. Objective/Aim Study: To know the effectivity of 15% TCA superficial chemical peeling to treat comedos and papulepustules in acne vulgaris. Research Design &amp; Statistical Analysis: Cohort experimental Study - Wilcoxon Sign Rank Sum Test statistical analysis methods. Material &amp; Methods: One layer of 15% TCA superficial chemical peelings was applied. Clinical improvements were judged by counting acne lessions and classified the acne severity according to Global Acne grading System before and after treatment. Result: There was statistically significant difference in clinical improvement of all type acne lessions before after therapy with 15% of TCA chemical peeling. The mean of difference of papulepustules before-after peelings was 5,14 (81,66%), comedos was 83,92 (85,23%) and the total acne lessions was 77,07 (86,79%). The mean of difference of GAGS acne score before-after peeling was 13,07 (74,75%). Discussion: This research proved that one layer of 15% TCA superficial chemical peeling was statistically and clinically effective and good to treat all type of acne vulgaris. It was the best comedolytic activity and good to treat inflammatory/papulepustules acne lession. The goal therapy of acne vulgaris: removed plugging of the pilar drainage, reduced sebum production, treated bacterial and fungal colonization, and prevented from scarring could be solved by 15% TCA superficial chemical peeling. It improved the depth contour and caused softening associated scars by their action on collagen remodelling and stimulation of new collagen activity, reepithelialization, regenerated compact epidermis that improved light reflection, eliminated dermal melanin and prevented transfer melanin to keratinocytes that improved skin textural and fine line, glowed, rejuvenated, lightened and minimized PIH. It decreased skin pH and TEWL and improved skin barrier permeability. 15% TCA superficial chemical peeling was good and well tolerated methods for acne therapy, now considered as the single main acne therapy or could be combined with other therapy to treat acne chronicity and solved resistance problems to antibiotics and antifungi.

From Monotherapy to Adjunctive Therapies: Applicationof Dermocosmetics in Acne Management Across Australia and New Zealand.

Acne vulgaris is a globally prevalent dermatological disease, with its severity ranging from mild to severe. While moderate to severe acne often requires topical or systemic pharmaceutical therapy, mild to moderate acne may be managed with dermocosmetics, which are over-the-counter skincare agents with active ingredients that target acne pathophysiology. Dermocosmetics can also be effective as adjunct therapy for the management of more severe acne. For example, they can be used to complement the mode of action of pharmaceuticals or to mitigate side effects and improve treatment compliance. This review discusses the roles of commonly available dermocosmetics in the context of both mild and severe acne management protocols.

Exploring the Incidence and Risk Factors of Dyslipidemia in Patients with Severe Acne Vulgaris on Systemic Isotretinoin Therapy: Findings from a Prospective Study

Background and Objectives: Oral isotretinoin has revolutionized the treatment of severe acne vulgaris. Isotretinoin is associated with multiple adverse effects, one of which is dyslipidemia (DLP). Materials and Methods: This single-center prospective study recruited 498 patients who were eligible for isotretinoin for severe acne. Risk factors for hyperlipidemia and serum lipids were assessed at baseline. Patients received daily doses ranging from 0.25 to 1 mg/kg of their body weight, and their fasting serum lipids were checked regularly until they reached a cumulative dose of 120–150 mg/kg. Our primary objective is to investigate dyslipidemia incidence and predictors, while the secondary objective is to assess the impact of dose reduction on lipid panels. Results: Our sample was primarily female (n = 380, 76.3%), with a normal Body Mass Index (23.2 ± 4.0) and a mean age of 20.7 (±4.1) years. About 72.5% had a family history of acne, 17.1% a family history of dyslipidemia. Around 17.3% reported tobacco use. A total of 57 (11.4%) patients on isotretinoin developed DLP. Smoking was independently associated with a higher risk of dyslipidemia (OR 1.97, 95% CI [1.01, 3.82], p = 0.046). The mean onset of DLP was at 3.23 (±2.13) months. A total of 52 patients out of the 57 had a dose reduction of 10 mg (n = 5) or 20 mg (n = 47). A dose reduction of 50% was found to significantly improve triglyceride levels. Conclusions: More than 1 out of 10 patients on isotretinoin developed DLP. Tobacco use was significantly associated with developing DLP. Dose reduction significantly impacted a decrease in triglyceride levels.

Polyphenol Microneedles for Dermatological Therapy.

Dermatological diseases represent one of the most prevalent health concerns globally, with associated care and treatment costs having consistently increased over the past decade. Current therapeutic modalities, including topical medications, oral pharmaceuticals, and physical therapies, frequently face challenges such as inadequate drug absorption and substantial adverse effects. Microneedles, recognized as minimally invasive drug delivery systems, effectively penetrate the cutaneous barrier to enhance drug permeability and therapeutic efficacy. Polyphenols-abundant in botanical and marine sources-demonstrate diverse pharmacological properties encompassing anti-inflammatory and antioxidant activities. The integration of polyphenols with microneedle technology has emerged as a promising therapeutic strategy for dermatological conditions, demonstrating significant clinical potential. This review examines the multifunctional capabilities of polyphenol-incorporated microneedles and elucidates their mechanisms of action in managing dermatological disorders. Furthermore, it synthesizes recent progress in polyphenol-based microneedle applications for various cutaneous pathologies, including acne vulgaris, psoriasis, and atopic dermatitis. Finally, current challenges is discussed and proposed future research directions for optimizing polyphenol microneedle systems in dermatological therapeutics.

Linoleic Fatty Acid from Rwandan Propolis: A Potential Antimicrobial Agent Against Cutibacterium acnes

Acne is a very common skin condition that causes pimples in 80% of adolescents despite the many effective treatments developed. Various compounds have been employed in the treatment of acne, including erythromycin ointments and antiseptics, yielding mixed results. The rise in erythromycin-resistant C. acnes strains has driven the pursuit of new antimicrobial agents, especially those obtained from natural sources. Propolis that was collected in Rwanda was extracted, fractioned, and analyzed for its activity against C. acnes growth in accordance with NCLSI guidelines. Our work revealed that linoleic acid has a significant effect on C. acnes growth at a low concentration (16 µg/mL). A comparison of the antimicrobial activities of a broad panel of well-known fatty acids revealed a specific mode of action for linoleic acid, characterized by a significant membranotropic effect on Bacillus cereus established by measuring extracellular ATP levels as an indicator of membrane permeability. Our data suggest that linoleic acid is effective against C. acnes and could be a promising candidate for developing a propolis-based ointment for acne treatment.

Betaine-salicylic acid cocrystal for enhanced skincare and acne treatment.

Salicylic acid (SA) is a natural lipophilic active ingredient commonly used in cosmetics and skin disease treatments, offering benefits such as exfoliation, anti-inflammation effects, antibacterial properties, oil control, and acne alleviation. However, its poor water solubility, low bioavailability, and potential side effects, such as allergies, irritation, and dryness, hinder its widespread application. In this study, we prepared a betaine-salicylic acid (BeSA) cocrystal and systematically characterized its crystal structure, biological activity, and clinical efficacy. The results showed that BeSA has significantly lower irritancy and cytotoxicity than SA, but exhibits excellent anti-inflammatory and antioxidant properties as well as high moisturizing and anti-acne efficacy, making it a potential alternative to SA. Further, quantum chemical calculations and molecular docking simulations were conducted to investigate the intrinsic mechanisms underlying the excellent bioactivity of BeSA cocrystals. This study introduces an innovative solution for safer and more effective skincare formulations based on SA and offers theoretical guidance regarding material engineering and further material optimization, which has crucial implications for both industry and academia.

An Assessment of Current Clinician- and Patient-Reported Outcome Measures for Acne Scarring and Dyspigmentation: A Scoping Review.

An Assessment of Current Clinician- and Patient-Reported Outcome Measures for Acne Scarring and Dyspigmentation: A Scoping Review.