Anti-acne Products Research Articles

Development and Evaluation of Herbal Antiacne Gel Formulation Using Curcumin Phytosomes .

Acne vulgaris is a persistent inflammatory condition affecting the pilosebaceous unit that manifests as various skin lesions, including papules, comedones, cysts, pustules, and abscesses. Curcumin, extracted from Curcuma longa rhizomes (Family: Zingiberaceae), is identified for its potent antioxidant, wound-healing, and anti-inflammatory properties. This study aimed to develop an herbal antiacne gel formulation incorporating bioactive curcumin in phytosomes. The formulated gel was evaluated for several physicochemical properties, including pH, spreadability, viscosity, drug content, etc. Additionally, the optimized gel formulation was tested for its in-vitro antiacne action against Propionibacterium acnes. Results showed that developed antiacne gel containing curcumin phytosomes was comparable to a commercially available antiacne product. Stability studies demonstrated that the formulated product remained stable for three months under accelerated stability conditions as per ICH guidelines.

Knowledge, Attitude and Practice towards the Appropriate Use of Anti-Acne Products amongst Youths and Adults

Acne is the most common skin disorder, especially in youths and adults, regardless of gender. However, with the wide range of ages and education, people's knowledge, attitudes, and practices might be diverse. Therefore, it is essential to understand the correct treatment. This study aimed to identify the knowledge, attitude, and practice towards the appropriate use of anti-acne in the community. The study was carried out in the neighbouring area of Universitas Airlangga, Surabaya, using a validated questionnaire. The data were analyzed with nonparametric correlation using Spearman Correlation. According to the data collected from 103 participants, about 62.1 % (n=64) had a moderate level of knowledge, 50.5 % had a positive attitude toward using anti-acne products, and 61.2 % (n=63) had positive responses in the practice of using anti-acne products. There was a positive correlation between the participant's knowledge and practice (p<0.001; r= 0.388). This study concludes that a health promotion program is a warranty to increase the public's level of knowledge.

Reevaluation of methanol extract from Phoenix dactylifera var. sukkari fruit’s potential against acne-inducing bacteria

<p>One of the natural ingredients that is often developed as an antibacterial product is the date palm (<em>Phoenix dactylifera</em>). However, scientific evidence regarding the effectiveness of the antibacterial compounds contained in dates needs to be evaluated, considering that several previous studies have reported that dates are more dominant as antioxidants than as antibacterials. Therefore, it is necessary to reevaluate the antibacterial ability of the methanolic extract of the sukkari variety date palm against the three test bacteria that cause acne, namely <em>P. acnes</em>, <em>S. epidermidis</em> and <em>S. aureus</em>. This research aimed to determine the sensitivity of the three bacteria tested in response to the methanol extract of the sukkari dates. This research design is experimental. The samples tested were sukkari and the tested bacteria were <em>P. acnes, S. epidermidis </em>and<em> S. aureus</em>. Dates were extracted by maceration method and made in concentrations of 50%, 60%, 70%, 80% and 90%. Positive control was chloramphenicol antibiotic while negative control was sterile distilled water. All treatments including control (+) and (-) were given to the test bacteria using the Kirby Baeur method to see the diameter of the zone of inhibition of the test bacteria growth. The data was processed in tabular form and compared with the 2016 CLSI standard to see the sensitivity response of the test bacteria. Results of this research is<strong> </strong>the sukkari dates extract with concentrations of 50%, 60%, 70%, 80% and 90% was able to inhibit the growth of <em>P. acnes, S. epidermidis</em> and <em>S. aureus</em> bacteria with an interval of 7.0-10.0 mm in diameter of the zone of inhibition. All the tested bacteria showed a sensitivity response in the resistant category, so the sukkari dates fruit extract is not the main choice to be developed as a natural anti-acne product.</p>

Development of Anti-Acne Topical Gel Formulation Containing Herbal Extract

Systemic and topical antimicrobials are effective in the treatment of inflammatory acne vulgaris; however, widespread use of these agents is becoming increasingly associated with the emergence of resistant pathogens raising concerns about microorganism resistance and highlighting the need for alternative non-antimicrobial agents for the treatment of acne. Several multinational companies like Lakme Cosmetics Ltd., Lotus Ltd., Ayur Healthcare Ltd., Patanjali Ayurveda, etc. have started developing anti-acne products which contain multiple extracts of common Indian plants. The study aims to develop herbal gel formulations containing Bougainvillea glabra extract (aqueous, methanol, ethyl acetate, and petroleum ether) for the treatment of acne. The formulations were comprehensively evaluated for Physical evaluation, Washability, Skin irritation test, Spreadability, pH, Viscosity, Extrudability, Swelling index, and Accelerated stability studies as per the standard methods. Amongst all the formulations studied, batch F2 was found optimum for all the parameters. The extraction yield was found to be 11.21%. Bougainvillea glabra aqueous extract showed low anti-bacterial activity whereas both Bougainvillea glabra methanol extract and Bougainvillea glabra ethyl acetate extract expressed moderate anti-bacterial activity with average MIC value against E. coli and B. subtilis. In contrast to them, the petroleum ether extract of Bougainvillea glabra presented highest anti-bacterial activity, however, the activity was less pronounced than the standard drug Clindamycin. The formulations (F1-F4) represented alike results with that of the extracts and expressed lesser activity as compared to the marketed herbal product.

The potential of selected plant extracts in anti-acne skincare formulations

Consumer awareness and the desire to reach for cosmetics with natural ingredients are still growing. The active ingredients of plants can reduce acne lesions and skin redness accompanying them. Specialised cosmetic formulations should support Anti-acne products containing therapeutic agents, reducing visible skin inflammation. These products should act simultaneously, ensuring proper skincare due to the content of plant metabolites exhibiting desired biological activity. In this study, the application of a selected plant extract in cosmetic preparations for acne skincare containing selected plant extracts was prepared: Arnica montana flower, Sambucus nigra and Rosmarinus officinalis leaf, Saponaria officinalis root, Aloe barbadensis leaf juice and Silybum marianum seed oil and then their effects were compared. The extracts were applied as active ingredients in face cream, serum and micellar solution forulations. The physicochemical properties (pH value, stability, dispersed phase particle size and type of emulsion) were evaluated; moreover, rheological tests of the samples were carried out, and the skin cleansing ability of the micellar solution was examined. In addition, all the formulations were subject to various tests, which allowed for the evaluation of their organoleptic properties. It was noticed that the used plant raw materials affect the care of the skin with acne tendencies. Both extracts (Arnica montana flower extract and Sambucus nigra extract) were used in the same concentrations in the cosmetics so that differences in results were easy to compare. Importantly, during the consumer tests, the probants discontinued usage of other anti-acne agents normally applied, which allowed for an objective assessment of the effect of the tested extracts on the acne skin. The formulations tested were proven to be effective cosmetics supporting anti-acne therapy.

Irritation Test of Bawang Dayak (Eleutherine Bulbosa (Mill.) Urb.) Loose Powder for Acne Vulgaris

Several studies revealed that the ethanolic extract, cream, and loose powder of Bawang Dayak bulbs (Eleutherine bulbosa (Mill.) Urb.) are effective in inhibiting the growth of different acne-causing bacteria, including S. aureus, S. epidermidis, and P. acne. Several product series have also been developed using the plant for the treatment of acne-prone skin. Therefore, this study aims to carry out a primary irritation test of E. bulbosa loose powder using the patch test method on rabbits and humans to determine its safety before it is marketed. The results showed that the primary irritation index of E.bulbosa loose powder on rabbits was 0.125, which was classified in the negligible category, and there were no signs of erythema or edema in humans. This indicates that it does not cause irritation and has the potential to be developed into anti-acne products.

Kaempferia parviflora Rhizome Extract as Potential Anti-Acne Ingredient.

Kaempferia parviflora (Black ginger) is used widely in medical fields as an anti-microorganism and anti-inflammation. In this study, the aim was to evaluate the in vitro and in vivo anti-acne efficacy of black ginger extract. The results indicate that the methanol and ethanol extracts showed the highest total phenolic contents, without a significant difference, whereas the n-hexane extract showed the highest total flavonoid content. Nine flavones were detected using UPLC−QTOF−MS, and the ethyl acetate extract showed the highest amount of 5,7-dimethoxyflavone (DMF) according to HPLC. Antibacterial activity against Staphylococcus aureus, S. epidermidis, and Cutibacterium acnes was observed. All the extracts showed antimicrobial activity against C. acnes, revealing MICs in the range of 0.015 to 0.030 mg/mL, whereas the ethyl acetate extract inhibited the growth of S. epidermidis with a MIC of 3.84 mg/mL. In addition, the ethyl acetate extract showed the highest activity regarding nitric oxide inhibition (IC50 = 12.59 ± 0.35 µg/mL). The ethyl acetate extract was shown to be safe regarding cell viability at 0.1 mg/mL. The anti-acne efficacy was evaluated on volunteers. The volunteers were treated in two groups: one administered a 0.02% ethyl acetate extract gel-cream (n = 9) and one administered a placebo (n = 9) for 6 weeks. The group treated with the gel-cream containing the extract showed 36.52 and 52.20% decreases in acne severity index (ASI) after 4 and 6 weeks, respectively, and 18.19 and 18.54% decreases in erythema, respectively. The results suggest that K. parviflora could be a potent active ingredient in anti-inflammatory and anti-acne products.

A split face study on the effect of an anti-acne product containing fermentation products of Enterococcus faecalis CBT SL-5 on skin microbiome modification and acne improvement.

Antibiotic-resistant Cutibacterium acnes and dysbiosis of the skin microbiome are of increasing concern in acne treatment. Enterococcus faecalis, a widely used probiotic, has shown benefits for acne treatment by exerting antimicrobial activity against C. acnes. Therefore, this study aimed to investigate the efficacy and safety of an E. faecalis CBT SL-5-extract-containing lotion in patients with mild-to-moderate acne. Twenty patients were enrolled in this randomized, placebo-controlled, split-face comparative study. Patients were treated with E. faecalis lotion on one side of the face and a vehicle lotion on the other side for 4 weeks. The efficacy outcome measures included improvement in the investigators' assessment of acne severity, patient satisfaction, changes in skin parameters and diversity of the skin microbiome. The investigators' assessment score was significantly improved on the test side compared to the control side, after 2 weeks (p = 0.009) and 6 weeks (p < 0.0005). However, TEWL and skin hydration were not significantly different between the two groups. The phylogenetic diversity of the skin microbiota decreased over time in the skin samples of test side. In conclusion, E. faecalis CBT SL-5 extract can be a feasible and well-tolerated option for improving acne severity and skin microbiome dysbiosis in mild-to-moderate acne patients.

Preparation of Nanostructured Lipid Carriers (NLCs) Loading Violacein Extract for Anti-Acne Products

The objective of this research is to evaluate the antimicrobial activity of Nanostructured Lipid Carriers (NLCs) loading violacein extract. The extract was tested for the antimicrobial activities against 3 strains of pathogenic bacteria; namely Cutibacterium acnes ATCC 6919, Staphylococcus aureus ATCC 6538 and Staphylococcus epidermidis ATCC 12228 by agar well diffusion assay. The result indicated that the violacein extract from Chromobacterium violaceum ATCC 12472 has strongest antibacterial effect against C. acnes, S. aureus and S. epidermidis with MIC values in range of 0.0146-0.4688 mg/mL with the lowest MBC value of 0.0146 mg/mL against C. acnes. Violacein extract loaded Nanostructured Lipid Carriers (NLCs) for anti-acne products were prepared by using melt-emulsification technique. The studied factors are the ratio of liquid lipid and solid lipid (LL:SL), surfactant concentration and sonication time. The Ratio of Oleic acid and Compritol® 888 ATO (3:1) with Tween 20 (1.5% w/w) and sonication time of 10 minute (F8 formulation) are an optimizing condition for NLC-Base. The resulted formulations showed the NLC-Base had average particle size of 213.7±2.42 nm with a polydispersity index of 0.239±0.003 and Zeta potential of -26.6±0.45 mV. After that, violacein extract (2% w/w) was loaded into the NLCs (VIO-NLCs). Antibacterial activity of VIO-NLCs 2 % was determined by using agar dilution. The result showed that VIO-NLCs 2 % can inhibit the growth of C. acnes for 60 days during storage. Furthermore, VIO-NLCs 2 % can also act as S. aureus and S. epidermidis inhibitor within 30 days shelf life.

Bioactivities of Karanda (Carissa carandas Linn.) fruit extracts for novel cosmeceutical applications.

ABSTRACTThe aim of this research was to determine the total phenolic content (TPC), antioxidation, antiaging, and antibacterial activities of Carissa carandas Linn., and aims at the novel plant sources which is utilized for their cosmeceutical applications. The two conditions (fresh and dried) and three stages (unripe, ripe, and fully ripe) of C. carandas were extracted by ethanolic maceration. Folin–Ciocalteu assay was used for determining the TPC. 2,2-diphenyl-1-picrylhydrazyl (DPPH) and 2,2′-azinobis(3-ethylbenzothiazoline-6-sulfonic acid) (ABTS) assays were used for estimating antioxidant activity. The inhibitory tyrosinase activities were measured using the modified dopachrome assay. Antiaging was evaluated by inhibition of collagenase and elastase, and antibacterial activities. The result of six extracts from C. carandas showed that the highest phenolic content and elastase inhibition of the fresh fruit in fully ripe stage were 100.31 ± 2.64 mg GAE/g extract and 14.11% ± 0.95%, respectively. The fresh fruit in the unripe stage showed that the strongest percentage of DPPH IC50 and collagenase inhibitory activity were 29.11 ± 0.23 μg/mL and 85.94% ± 2.21%, respectively. The ethanolic extract of unripe dried fruit exhibited the highest antioxidant activity in the of ABTS assay, with an IC50 of 0.17 ± 0.01 μg/mL. The MBC displayed the dried fruit ripe stage anti Cutibacterium acnes, Staphylococcus epidermidis, and Staphylococcus aureus strains were 25.0, 25.0, and 16.25 mg/mL, respectively. The fresh fruit in the ripe stage showed that the strongest inhibition tyrosinase was 93.88% ± 5.64%. The conclusion of this research indicates that the fresh fruit of C. carandas fruit extracts has high potential as a novel cosmeceuticals’ applications to antiaging and skin whitening. The dried fruit in ripe stage extract has the most effective ingredient for antiacne products.

Simultaneous determination of 18 chlorinated hydrocarbon organic solvents in cosmetics by gas chromatography-mass spectrometry

建立了同时测定化妆品中18种氯代烃类有机溶剂的气相色谱-质谱(GC-MS)检测方法。样品在饱和氯化钠溶液中由正十四烷振荡提取后,以Agilent J&W DB-624超高惰性毛细管柱(30 m×0.25 mm×1.4 μm)为分离色谱柱进行分析,以电子轰击(EI)源、SIM模式进行质谱监测,外标法定量。结果表明,18种化合物在19 min内完成色谱分离分析,检出限(LOD, S/N=3)和定量限(LOQ, S/N=10)分别为0.033~0.049 mg/L和0.10~0.15 mg/L, 18种氯代烃类有机溶剂在0.2~100 mg/L线性范围内线性关系良好,相关系数(R2)均不小于0.9992。以阴性样品口红(固体)和漱口水(液体)为样品基质,在不同添加水平下,18种氯代烃类有机溶剂的平均回收率分别为92.4%~103.1%和93.3%~102.4%,相对标准偏差(RSD, n=6)分别为3.1%~5.3%和2.8%~5.4%。采用该方法对115个化妆品样品进行测定,3个指甲油样品均检测出四氯乙烯,测定值为11.4~42.0 g/kg。研究建立的方法采用高沸点溶剂作为进样溶剂,取消溶剂延迟时间,使只能在溶剂延迟时间出峰的化合物得到有效色谱分离,分析时间短,且重复性好,灵敏度高,可同时检测各种化妆品中多种氯代烃类有机溶剂。该方法的建立为我国化妆品中氯代烃类有机溶剂检测标准的制订和质量安全监控提供了参考。

Treatment-seeking behavior, knowledge and beliefs about acne vulgaris among adolescents: A cross-sectional study in high school students in Tirana, Albania.

Acne vulgaris is a common adolescents' disorder. Nevertheless, there is lack of knowledge about acne among adolescents. To evaluate the adolescents' knowledge and beliefs about acne, to investigate help-seeking behavior and treatment preferences. A cross-sectional study conducted in 10 public high schools in Tirana. A total of 2036 students enrolled. All participants were asked about socio-demographic data, knowledge and beliefs about acne, treatment-seeking behaviors and clinical preferences. Of participants 45.3% thought acne is a medical problem, 23.1% thought it's a cosmetic problem, and less than 10% thought acne is a normal condition for their age. Of adolescents 30% did not know that acne is not contagious, 49.7% believed acne is curable with prescribed medication, 33.4% thought acne heals by itself, and only 0.9% believed acne is non-curable. Male adolescents were more likely to have lower level of knowledge and misconceptions about acne compared to females. Only 18.5% had consulted a dermatologist. The majority (54.7%) were using anti-acne products recommended by their friends or pharmacists. Only minority of Albanian adolescents with acne consults a dermatologist. Age, gender and acne severity play a significant role in determining help-seeking behavior. Patient and parent education can significantly improve the treatment outcome.

Formulation of anti-acne concealer containing cinnamon oil with antimicrobial activity against Propionibacterium acnes.

This study aimed to develop an anti-acne concealer containing essential oil with anti-Propionibacterium acnes activity. Antimicrobial activity of cinnamon oil, galangal oil, and eucalyptus oil against P. acnes DMST 14916 was assayed using agar disc diffusion and the broth dilution method. Cinnamon oil showed the maximum inhibitory activity against P. acnes with a clear zone diameter of 36.75 ± 1.06 mm, compared to 14.67 ± 0.58 and 41.83 ± 1.04 mm for tea tree oil and clindamycin, respectively. The minimum inhibitory concentration value of cinnamon oil was 5 mg/mL. Among five formulations of concealer incorporating 0.5% w/w cinnamon oil, F4 provided good texture, coverage, and spreadability with anti-P. acnes activity and stable under determined storage conditions. Cinnamon oil could be a promising cosmetic ingredient for anti-acne products, and F4 concealer may be useful for both covering skin imperfections and the management of acne.

Safety and efficacy of two botanical based topical anti-acne products in treatment of mild to moderate acne subjects

Safety and efficacy of two botanical based topical anti-acne products in treatment of mild to moderate acne subjects

Renewable sources: applications in personal care formulations.

A global tendency for products considered environmentally sustainable, and ecologically obtained led the industry related to personal care formulations to fund the research and the development of personal care/cosmetics containing ingredients from natural resources. Furthermore, consumers are aware of environmental and sustainability issueans, thus not harming the environment represents a key consideration when developing a new cosmetic ingredient. In this study we review some examples of active ingredients or raw materials used in cosmetics/personal care/biomedical products that are coming from either through biotechnological systems, or as byproducts of several industries. A skin formulation containing biosynthetic actives, prepared by us and the study regarding its dermocosmetic properties are also described. The need for the standardization processes, the safety assessment tools, the improvement of the exploitation methods of these renewable sources in order the production to be ecologically and economically better are also discussed.

EFEKTIVITAS BEBERAPA PRODUK PEMBERSIH WAJAH ANTIACNE TERHADAP BAKTERI PENYEBAB JERAWAT Propionibacterium acnes

The purpose of this study was to determine the effectiveness of some antiacne facial cleanser products against bacteria that cause acne Propionibacterium acnes, which conducted experimentally using 6 product against of antiacne facial cleanser bacteria cause Propionibacterium acnes with three replication. The parameters observed were the inhibitory zone diameters. The results showed that of some antiacne facial cleanser products that are most effective in inhibiting the growth of acne-causing bacteria Propionibacterium acnes is the product CCA code, with a 35 mm inhibit zone, because CCA products were contain 6 combinations of natural ingredients from Hamamelis virginia, Melaleuca alternifolia, Cinnamomum zeylanicum, Cedrus atlantica, Portulaca oleracea and olive oil All antiacne products are shown to have effectiveness against the bacteria Propionibacterium acnes.

FORMULATION AND EVALUATION OF ANTI ACNE GEL CONTAINING CITRUS AURANTIFOLIA FRUIT JUICE USING CARBOPOL AS GELLING AGENT

Objective: The objective of this study was to design a product of anti-acne gel containing Citrus aurantifolia fruit juice as an effective antibacterial to treat acne caused by Propionibacterium acne and Staphylococcus epidermidis using carbopol as a gelling agent.Methods: The fresh juice of C. aurantifolia fruit was obtained by juicer and pasteurized for 30 min at 65-70 °C. The minimum inhibitory concentration (MIC) of the fruit juice was determined using the microdilution method. Then, carbopol in different concentration was incorporated in a gel base formula to obtain a stable gel base. The fresh juice in different formulas (F1, F2 and F3) was evaluated for 28 d. The color, pH and viscosity of each formula were observed. In addition, the antibacterial potency of each formula was analyzed using the agar diffusion method against both tested bacteria. Results: The citrus MIC values of both test bacteria showed different results, 20-40 % v/v for P. acne and 5-10 % v/v for S. epidermidis. The MIC values were converted into in vivo concentration and the resulted concentrations for each formula were 25, 50 and 75 % v/v. For supporting the formula, the most stable base gel was achieved using carbopol 1 % as the gelling agent. Among three formulas, the anti-acne gel formula containing 75 % fruit juice with carbopol 1% was the best formula based on the physical and microbiological parameter.Conclusion: Thus, it was concluded that the antiacne gel of fruit juice of C. aurantifolia with carbopol as a gelling agent could produce the effective and stable gel of anti-acne product.

Development of Anti-Acne Film from Bio-Cellulose Incorporating Punica granatum Peel Extract

The aim of this study was to formulate bio-cellulose film incorporating Punica granatum (pomegranate) peel extract for application as anti-acne product. The dried pomegranate peels were extracted by water (PPEwater), 50 % (PPE50E), 70 % (PPE70E) or 95 % (PPE95E) (v/v) ethanol. The extracts were total phenolic content (TPC) and free radical scavenging activity. PPE50E had highest TPC (55.95±1.44 gGAE/100g of dried peel extract), highest free radical scavenging activity with IC50 of 18.77±1.73 µg/ml and exerted the activity of bactericidal against Staphylococcus aureus, Staphylococcus epidermidis and Propionibacterium acne (P. acne). The PPE50E was selected for formulating anti-acne bio-cellulose (BC) film. The BC film prepared from bacteria Acetobacter xylinum. It showed a strong film with the tensile strength in range of 5 - 15 MPa and the elongation at break about 5 %. The simple soaking method was used to combine BC with 5 or 10 mg/ml of PPE50E. By the SEM, the assemble nano-fibrils and the layer structure of the BC combining with the PPE50E (BCP) was found. The BCP had higher tensile strength and lower elongation at break than the BC. The BCP at wet state showed a soft and flexible film. The anti-bacterial efficacy of the BCP against tested bacteria was observed, according to the disc diffusion assay. The P. acne inhibition zones of the BCP at the concentration of 5 and 10 mg/ml were 27.7 and 35.5 mm which closed to the clindamycin (45.5 mm) as positive control. From the remarkable results, the BCP is interestingly natural device for acne treatment.

The relationship between container colors and the beauty benefits of skin care products

AbstractThis study explored the best color selections to match the benefits of beauty products based on rankings obtained from an experimental perception of different skin care product containers. Gender (64 males, 75 females) and cultural (76 Taiwanese, 63 Malaysians) differences were also compared, aiming to explore color associations and emotional bonding by using psychophysical testing methods. A survey of 205 market samples showed that nearly half of the existing skin care product containers had a white body color. White appeared frequently on containers for skin whitening, firming, exfoliating, antiaging, and antiacne products. However, skin moisturizing products used an equal amount of white and blue on their containers. The psychophysical experiment results showed that participants felt that white best matched skin whitening products, red matched skin firming and antiaging products, blue matched skin moisturizing products, black matched exfoliating products, and green matched antiacne products. Neither gender nor cultural differences were found to be significant. Comparing the results with color emotion studies, it was found that (1) for color emotion weight, firming products were related to heaviness, whereas whitening products were connected to lightness; (2) for color emotion heat, whitening, moisturizing, exfoliating and antiacne products were aligned with coolness; and (3) for color emotion activity, product container colors were not related, except slightly for firming products. These findings suggest that psychological responses to color meaning are context‐ and experience‐dependent, meaning that selection of colors to match beauty benefits is based more on people's expectations of the products than their color emotion response.

In vivo monitoring of topical therapy for acne with reflectance confocal microscopy.

Acne vulgaris is a common disease of the pilosebaceous unit. The aim of the study was to evaluate compartment-specific treatment action through the microscopic non-invasive imaging of skin changes. Mild-moderate acne patients, that were prescribed a topical anti-acne product, were followed by clinical and reflectance confocal microscopy (RCM) imaging every 14 days to 6 weeks. Mean and standard deviation of the scores were analyzed for each time point. After 2 weeks, the RCM count of papules/pustules and the RCM scores of exocytosis and dermal inflammation, decreased substantially. After 4 weeks, the RCM number of comedos was reduced. After 6 weeks, the number of regular follicles increased, while the infundibula with thickened bright border decreased significantly. The progressive reduction in the clinical scores was correlated with the improvement of the RCM parameters. RCM study of acne skin showed a different timing for inflammatory and hyperkeratotic components to achieve a significant reduction during topical therapy with the association of retinoid and antibacterial molecules. The microscopic changes observed showed the regularization of the skin and the improvement of acne related features. RCM may represent a useful tool for the objective assessment of treatment efficacy and individual response evaluation.