Improvement Of Acne Lesions Research Articles

Assessment of efficacy and safety of clindamycin with nicotinamide in mild to moderate acne vulgaris: a prospective study

Background: Acne vulgaris is a very common skin disease that is usually treated with topical products, systemic medications, or a combination of both. Acne vulgaris affects approximately 9% of the population worldwide causing permanent physical scarring, negatively affects the quality of life and self-image, and has been associated with increased rates of anxiety, depression, and suicidal ideation. Methods: This was a prospective study conducted at BMCRI including thirty-five subjects who were diagnosed with mild to moderate acne vulgaris. Patients were treated with topical clindamycin 1% with nicotinamide 4%. Efficacy was assessed by mean change in acne severity index (ASI) and total lesion count (TLC) from baseline and at the end of 4, 8 and 12 weeks. Safety was assessed by adverse events reported. Results: There was statistically significant improvement noted at the end of each visit. Baseline ASI was 88.05±4.02 and end of 12 weeks was 14.17±2.7. Baseline TLC was 30.17±1.33 and at the end of 12 weeks was 4.25±0.99. Both the ASI and TLC results were statistically significant at the end of fourth, eighth and twelfth-week p value <0.0001. Conclusions: Combination topical formulations are the most broadly used treatment regimen for Acne vulgaris to target one or more steps in the pathogenesis of acne. From the results of the present study the participants on combination of clindamycin with nicotinamide had a significant improvement in acne lesions at end of 12th week of topical application and were satisfied with the therapy with no major adverse effects.

Efficacy of Low-Level Laser Versus Topical Erythromycin 2% in the Treatment of Inflammatory Acne Vulgaris.

Acne vulgaris is a skin problem affecting many people of different ages. Despite many options that are available for treatment of acne vulgaris, many patients still respond inadequately to treatment. Phototherapy is one of the best acne treatment options. It was to compare the efficacy of low-level laser therapy in treatment of inflammatory acne versus topical erythromycin 2% cream. This study included 40 patients (18 males, 22 females) with different clinical severities of acne vulgaris. All the participants underwent split-face treatment: one side with 8 treatments (twice per week) of a low-level continuous infrared diode laser (808 nm) wavelength and (500 Hz) frequency and the other side with topical erythromycin 2% twice daily (aknemycin cream 2%). Evaluation was done at start of sessions, 2 weeks after the end of sessions and 3 months after stoppage of treatment depending on: photographs, global evaluation of acne scale, and Indian acne association grading. There was improvement of acne lesions on laser side and antibiotic side (assessed as non-inflammatory and inflammatory lesion counts). Laser side showed better results than antibiotic side. Patients were more satisfied with laser treatment due to minimal side effects and less relapse. A series of 8 treatments using low level continuous infrared diode laser represents a cheap, safe and effective non-invasive therapeutic option for acne vulgaris.

A pilot study on the efficacy of topical lotion containing anti-acne postbiotic in subjects with mild -to -moderate acne.

Acne can compromise facial esthetics and become a mental burden, especially when it occurs in puberty. Skincare cosmetics with anti-acne efficiency is more convenient than other treatment modalities, such as dietary supplements, in certain circumstances. The purpose of this study was to investigate the efficacy of an anti-acne lotion in alleviating acne. In our study, an anti-acne lotion containing ferment lysate produced by Lactiplantibacillus plantarum VHProbi® E15 were applied to subjects with mild -to -moderate acne over 4 weeks. The efficacy was evaluated based on instrumental measurements using Visia®-CR and CK-MPA® system. The anti-acne lotion exhibited favorable safety, meeting the stringent criteria for the detection of microbes, heavy metals, toxicity, and irritation. After 2 weeks of treatment, a statistically significant improvement in acne lesions was observed compared to baseline (P < 0.01), and this continued to the end of the study. After 4 weeks of treatment, the transepidermal water loss (P < 0.05) and sebum production (P < 0.05) were significantly decreased in subjects compared to baseline. In addition, the pore/area of interest (AOI) and stratum corneum hydration displayed slightly positive changes throughout treatment. Thus, we conclude that applying topical anti-acne lotion may be safe and confer effective benefits in people with mild -to -moderate acne and represents a promising therapeutic option for acne.

Application of red light therapy for moderate-to-severe acne vulgaris: A systematic review and meta-analysis.

Photodynamic therapy had made great progress in the treatment of acne vulgaris. However, there is no meta-analysis on the effectiveness and safety of red light therapy for acne vulgaris. To assess the efficiency and safety of red light therapy for acne vulgaris. PubMed, Cochrane Library, EMBASE, and Web of Science were retrieved to identify related studies. The outcomes were expressed as improvement in the average percentages of inflammatory acne lesions (MPRI) and non-inflammatory acne lesions (NMPRI), as well as the improvement of acne lesions respectively after treatment. 13 randomized controlled trials (RCTs) consisting of 422 participants were included. There was no significant difference in the average number of non-inflammatory lesions (weighted mean difference (WMD=-0.527; 95% CI,-3.055~2.001; p=0.683). Moreover, there was no statistically significant difference in the average number of inflammatory lesions (WMD =0.701; 95% CI, -0.809~2.212; p =0.363). In the subgroup analysis of the outcome changes in comedones, pustules, papules, and total lesions, it was found that red light therapy elicited no significant superiority compared with other conventional treatment methods (WMD=-1.125; 95% CI, -3.122~0.873; p=0.270). Adverse events of the red light group were generally mild or even completely non-existent. There was no statistically significant difference between red light therapy and traditional therapies in terms of efficacy. However, due to the heterogeneity of the researches and the lack of large sample size, the result of this study needs to be interpreted with caution.

The efficacy of intense pulsed light and heat energy therapy compared to benzoyl peroxide gel 2.5% in the treatment of mild and moderate acne vulgaris

The use of technology-based light therapies such as intense pulsed light and heat energy (IPL) provides an alternative therapy for patients with acne. However, clinical evidence is required to evaluate the efficacy and safety of the IPL. This study aimed to evaluate the efficacy of IPL compared to benzoyl peroxide (BP) as standard therapies in patients with acne vulgaris. The study was conducted with randomized controlled trial parallel design involving patients with mild and moderate acne vulgaris. Acne severity was determined by the method of Combined Acne Severity Classification (CASC). Statistical analysis using repeated measurement analysis of variance was conducted to assess the reduction in lesions and number of P. acnes in each group followed by independent t-test to compare of both groups. A p value <0.05 was considered significant. Sixty-two patients with mild and moderate acne vulgaris were enrolled in this study and treated with IPL (32 patients) and with BP gel 2.5% (30 patients). Two patients from the IPL were dropped out. All subjects showed improvement in acne lesions. Reduction of the number of non-inflammatory lesions at IPL therapy group was not significantly different than the BP gel 2.5% at week 2 (p=0.705) and 4 (p=0.186). Reduction in the number of inflammatory lesions in the IPL treatment group was not significantly different than BP gel 2.5% at week 2 (p=0.604) but significantly higher at week 4 (p=0.003). The reduction of P. acnes colonization in the IPL group was significantly higher than BP gel 2.5% group at week 2 (p=0.000) and 4 (p=0.000). In conclusion, the efficacy of IPL in the reduction of the number of inflammatory lesions and the P. acnes colonization is better than BP on patients with acne vulgaris.

Retrospective Study of the Use of a Fractional Radio Frequency Ablative Device in the Treatment of Acne Vulgaris and Related Acne Scars

Background: Acne vulgaris (AV) is a common disease that often results in disfiguring facial scarring that carries into adulthood. Here we report our experience with fractional radiofrequency (FRF) device in treatment of patients with acne and acne related scarring. Materials & Methods: We retrospectively reviewed the charts of all patients with acne scarring who completed a four treatment regimen in our clinic. Results: We identified eight patients who completed four treatments with median age of 20.5 years (range 17 - 41). All patients demonstrated significant improvement of acne lesions and acne scarring. Skin biopsies demonstrated reduction of scar depth and increased new collagen production, and repopulation of the scar tissue by elastic fibers and adnexal structures after the fourth treatment. Conclusion: FRF emerges as a safe and effective treatment modality for AV and acne related scars. Further randomized controlled studies are required to fully evaluate the magnitude of this positive effect and more basic science studies are needed in order to better characterize its mechanism of action on acne lesions.

Antiandrogenic therapy with ciproterone acetate in female patients who suffer from both androgenetic alopecia and acne vulgaris

Background.Androgenetic Alopecia in Women (AGA) occurs due to an underlying susceptibility of hair follicles to androgenic miniaturization, caused by androgens. Clinically, AGA is characterized by progressive hair loss, with a marked hair thinning in the fronto-parietal area so that the scalp can be easily seen.Acne vulgaris is androgen-dependent and often affects the skin that has an increased number of oil glands: face, back and chest. Although the sebaceous glands are present on the scalp too, it is very rare to get acne at this site, as the hair acts as a wig and allows the sebum to drain and does not block the pores.Both AGA and Acne Vulgaris are signs of hyperandrogenism. Cyproterone acetate/ethinyl estradiol (2mg/0.035mg) products are authorized for the treatment of androgenetic symptoms in women, such as acne, seborrhea, mild forms of hirsutism and androgenetic alopecia.Our study had a double purpose: - To evaluate the result of the study regimen Melleva 35 (one pill per day, for 3 consecutive months) in patients with moderate to severe acne, suffering also from Androgenetic Alopecia;- To establish the efficacy of the drug on acne and alopecia improvement, both from the doctor’s and patient’s point of view.Patients and methods.After being informed of the aims and procedures of the study, participants provided a written informed consent. A number of 35 female subjects with moderate to severe acne vulgaris remained in the study. The subjects had also been diagnosed as suffering from AGA, on the basis of clinical criteria, including the pattern of hair loss and trichoscopy assessment.Results83% of study subjects reported that their hair did not continue to fall after 3 months of antiandrogen therapy. The females were evaluated using trichoscopy and the doctor noticed hair regrowth in 77% of the cases. Regarding the improvement of acne lesions after the treatment, 40% of study subjects recorded good improvement and 26% recorded excellent results with Melleva 35.The acceptance of the treatment was very high, 86% patients were compliant with the study therapy. The rate of adverse events (5 cases) was within the limits of the treatment tested by the study.Almost a third of the total number of subjects (28.5%) reached a good satisfaction level after the treatment, while 37.1% claimed moderate satisfaction.ConclusionThere was no correlation between the age of the subjects and the treatment for acne therefore our first hypothesis was rejected.As a conclusion, antiandrogenic therapy with Melleva 35, 1 pill per day, for 3 consecutive months, shows good results for patients who suffer from both Androgenetic Alopecia and Acne Vulgaris.

Complementary, Holistic, and Integrative Medicine

Complementary, Holistic, and Integrative Medicine

Complementary, Holistic, and Integrative Medicine: Acne

1. Anju Sawni, MD* 2. Amritpal Singh, MD† 1. *Pediatric Education, Hurley Children’s Hospital/Hurley Medical Center, Flint, MI. 2. †Department of Dravyaguna (Medicinal Plants), Sri Dhanwantry Ayurvedic College, Chandigarh, India. * Abbreviations: EFAs: : essential fatty acid LTB4: : leukotriene B4 Acne vulgaris is a common skin disorder that affects ∼70% to 87% of adolescents and young adults. (1) The pathogenesis of acne is multifactorial and complex, and is thought to be due to androgen-stimulated sebum production. This production leads to follicular occlusion and hyperkeratinization, with comedo formation, as well as microbial colonization of pilosebaceous follicles by Propionibacterium acnes , leading to inflammatory papules and pustules. Conventional treatments for acne include salicylic acid, benzoyl peroxide, retinoids, and antibiotics (topical and systemic). However, symptoms may not always improve, and patients may have adverse reactions to conventional treatments and thus seek alternative treatments. Antibiotic resistance in P acnes also has been rising, thus promoting the need to look at alternative therapies. (2) The influence of diet on acne has been debated for decades. One review of the literature looking at the evidence for diet, face washing, and sunlight exposure in acne management concluded that the evidence is incomplete at best. (3) Another review did not support any link between acne and foods such as dairy products, chocolate, and fatty foods. (4) However, with more recent focus on diet and nutritional supplements, emerging research suggests that diet may be a factor, particularly in mediating the inflammation and oxidative stress of the acne process. (5)(6)(7) Western diets, with characteristically high glycemic indices, can elevate insulin and insulin-like growth factor 1 levels acutely and chronically. (5) These hormones stimulate adrenal and gonadal androgen production, leading to increased sebum production and acne. Frequent consumption of high-glycemic-index carbohydrates may repeatedly expose adolescents to acute hyperinsulinemia. Therefore, a low-glycemic-load diet may have a beneficial effect on acne. (6) A review …

Flutamide versus a cyproterone acetate-ethinyl estradiol combination in moderate acne: a pilot randomized clinical trial

BackgroundThe use of oral flutamide is rarely investigated in acne therapy. The aim of this study was to compare the efficacy of oral flutamide with that of a cyproterone-estradiol combination in treating acne lesions.MethodsA randomized clinical trial enrolled patients with moderate acne into two equal groups to receive either oral flutamide or the cyproterone-estradiol combination for 6 months. Lesion count, Acne Severity Index, and Global Acne Grading system (GAGS) scores were used to assess improvement in acne lesions. The dichotomous measurement scale for primary endpoint assessment was defined as improvement from moderate to mild acne based on GAGS score. Patient satisfaction and dermal fat were also assessed. Intention to treat and per protocol analyses were done, reporting related effect sizes.ResultsBoth treatments resulted in substantial improvement in acne lesions. Although flutamide seemed to have higher efficacy, an intention to treat analysis did not find the two treatment protocols to be different. The relative risk in intention to treat analysis was 1.8 (95% confidence interval [CI] 0.89–1.6), and was 1.33 (95% CI 1.03–1.72) for the per protocol analysis. The number needed to treat for flutamide compared with the cyproterone-estradiol combination was 7.7 and 4.2 in the intention to treat and per protocol analyses, respectively.ConclusionFlutamide appears to be more effective than a cyproterone-estradiol combination in some aspects of acne treatment, but this requires confirmation in a larger trial.

420 nm intense continuous light therapy for acne

BACKGROUND: Topical antibiotics, isotretinoin or systemic antibiotics are usually used for acne therapy. However, isotretinoin cannot be used during pregnancy because it can cause significant birth defects while systemic antibiotics can have adverse side effects such as gastrointestinal irritation, photosensitivity and tetracycline sensitivity. Describe here is a high-intensity, narrow-band, blue light (ClearLight) system, and its therapeutic clinical effect is investigated on acne using cutaneous measurements, bacterial observations and ultrastructural changes. MATERIALS AND METHODS: A total of 28 adult healthy volunteers with facial acne (mean age 28.1 years, range 16-56 years) were recruited for this study. They were treated with a total of eight serial biweekly 15-minute treatment sessions. Clinical counts of acne, as well as moisture, sebum and pH measurements were taken between each session. Nine of the 28 patients were followed for 2-3 months after the last treatment. Detection of bacteria in acne pustules was analyzed by culture and by polymerase chain reaction (PCR). Ultrastructural changes were examined in eight patients after four sessions of the light therapy. RESULTS: All patients completed the study. Overall, there was a 64.7% improvement in acne lesions. There were no bacterial changes before or after the therapy, although damaged Propionibacterium acnes were observed at the ultrastructural level. CONCLUSIONS: ClearLight performed eight times over 4 weeks can be useful in the treatment of acne. Further investigation will be needed to elucidate the mechanism of action of ClearLight.

Treatment of Inflammatory Acne with a Combination Therapy with Lymecycline and Adapalene Followed by Maintenance Treatment with Adapalene

Oral antibiotics, especially tetracyclines, are commonly used to treat moderate to moderately severe acne vulgaris. There are hints suggesting that a combination treatment with oral tetracyclines and topical retinoids can cause a greater and prompter improvement of acne than monotherapy with tetracyclines. We evaluated the clinical activity of a 12-week combined therapy with oral lymecycline (300mg/day for 2 weeks and then 150mg/day) and topical adapalene (gel or cream) in 419 patients with inflammatory acne. A significant reduction in the number of acne lesions was noted at 4 and 12 weeks (P&lt;0.0001). Thereafter, 400 patients underwent a maintenance treatment with adapalene alone for 12 weeks. At week 24 a relevant improvement of acne lesions still persisted (P&lt;0.0001) in most patients. Only 16 patients relapsed and required additional use of oral lymecycline which proved again successful. No substantial differences were noted in the magnitude of clinical response between patients treated with adapalene gel and those treated with cream formulation. Treatment was well tolerated. Local adverse reactions occurred in 11.7 % of patients and resulted in premature discontinuation of treatment in 1.4 %. Systemic (gastrointestinal) untoward effects developed in 1.2 % of patients and caused treatment interruption in 0.7 % of cases. No serious adverse events occurred.