Mild Acne Research Articles

Adapalene-Benzyl Peroxide Combination as an Option for Acne Vulgaris Treatment: A Systematic Literature Review

Background: Acne vulgaris affect 9,4% of the world population, especially in teenage age. Treatment of acne is based on severity; mild acne is treated with a topical agent, whereas moderate and severe acne is treated with topical and systemic agents. Topical therapy, including retinoids, antibiotics, and benzoyl peroxide, is the foundation of acne treatment. Adapalene-benzoyl peroxide therapy can be used in treatment to avoid antibiotic resistance. This study aimed to evaluate the efficacy and tolerance of adapalene/benzoyl peroxide topical treatment in mild to moderate acne vulgaris.
 Methods: This systematic review conducted a literature search through 3 databases, following PRISMA 2020 guidelines. Inclusion criteria were written in English or Indonesian, published in 2016-2020, a randomized controlled trial (RCT) study designed using human samples, and discussed the efficacy of topical adapalene-benzoyl peroxide in mild and moderate acne vulgaris. Studies that were unavailable in full text and based on secondary data were excluded.
 Results: Acne vulgaris lesions and scars decreased significantly with adapalene/benzoyl peroxide topical therapy. The addition of moisturizer to therapy can reduce the side effects of retinoate.
 Conclusion: The combination of adapalene/benzoyl peroxide can be an alternative treatment for mild to moderate acne.

Efficacy of Oxybrasion in the Treatment of Acne Vulgaris: A Preliminary Report.

There are many cosmetic methods to reduce skin eruptions in people with acne vulgaris. As oxybrasion is a safe method of exfoliating dead epidermis, our objective was to investigate its effectiveness in young women with acne vulgaris. The Global Acne Grading System (GAGS) and Derma Unit SSC 3 device (Sebumeter SM 815, Corneometer CM 825) were used to assess acne vulgaris and skin properties. Twenty-four women aged 19–21 years (M = 19.50, SD = 0.66) with diagnosed mild acne vulgaris and a high level of sebum (more than 100 μg/cm2) participated in the study. Women on any dermatological treatment within the last 12 months and/or hormonal contraception were excluded. Probands were randomly assigned to two equal groups. Group A (experimental) was oxybrased with 0.9% sodium chloride solution simultaneously with compressed oxygen. Group B (placebo) was the group treated with non-carbonated mineral water and oxygen from the device (not pure). A series of five treatments was performed at 10-day intervals. Skin parameters were measured before and 30 days after the end of treatment. As a result, in group A (experimental), skin hydration and GAGS improved, while sebum on the epidermis was reduced. No side effects were noted. We concluded that oxybrasion is effective in women with acne and safe, as it improved skin parameters; however, further research is needed.

THE INFLUENCES OF KNOWLEDGE LEVEL BEHAVIOUR AND ATTITUDE IN SELECTING TYPE OF POWDER ON THE INCIDENCE OF ACNE VULGARIS IN BANYUMAS REGENCY

Background: Acne vulgaris is a chronic obstructive and inflammatory skin disease. It occurs in almost all adolescents with a prevalence of 90%. Pathogenesis of Acne vulgaris is estimated to be related to several triggering factors such as food by 23.2%, stress by 26.4%, hormones by 32.7% and use of cosmetics by 47.3%. Powder is the most widely used cosmetic in the long term and one of the causes of Acne vulgaris which causes occlusion of pores on the skin surface. In the content of powder that causes acne vulgaris because there are comedogenic ingredients such as lanolin. Methods: This study was an observational study with data collection techniques using cluster sampling and sampling technique by accidental sampling. Results: The level of knowledge of women in the Banyumas Regency was dominated by the high category as many as 64 respondents (64.0%). The incidence of acne vulgaris out of 100 respondents, 67 (67.0%) of respondents had mild acne vulgaris, 22 respondents (22.0%) had moderate acne vulgaris and 1 respondent (1.0%) had severe acne vulgaris and the rest had no acne vulgaris. Chi-square analysis showed that there was a relationship between knowledge with behavior and attitude in choosing the type of powder to the incidence of acne vulgaris as evidenced by the p value of each variable, namely 0.044 and 0.028 (p <0.05). Conclusion: the level of knowledge with behavior and attitude in choosing the powder type had a significant relationship to the incidence of acne vulgaris in women in Banyumas Regency.

Calprotectin may be positively associated with the severity of acne vulgaris

Background and objective: Acne vulgaris (AV) is a common skin disease of sebaceous hair follicles. Many factors are associated with the occurrence and severity of acne, while the exact etiology remains incompletely understood. The current study was aimed to investigate the association between the severity of acne and serum zinc, copper, and calprotectin. Methods: Fifty patients with AV were recruited in the study as well as 25 healthy age and sex-matched individuals as controls. The acne severity was classified into mild (n=21), moderate (n=16), and severe acne (n=14) according to the global acne grading system (GAGS). Serum levels of zinc, acne and calprotectin were evaluated by enzyme-linked immunosorbent assay (ELISA). The gained data were analyzed using GraphPad Prism software. Results: Insignificant difference was found in zinc and copper levels between controls and AV patients, except in severe AV, where the patients displayed significant elevation in serum copper level (p<0.05) as compared to that of mild AV. The calprotectin concentration was significantly higher (p<0.001) in all AV patients, when compared with healthy subjects, which was positively correlated with the disease severity. No gender difference was noted for all measured biomarkers. Conclusions: Our study suggests a possible association between calprotectin and acne inflammation, which requires validation in large-scale studies.

Evaluation of topical remedies in the treatment of acne available in the Republic of Moldova

Introduction. A lot of research and studies are currently being carried out in the field of elaboration and optimization of topical pharmaceutical forms used in the treatment of various types of acne. Acne vulgaris is a disease with a complex etiopathogenesis with potential negative psychosocial effects on the quality of life of patients, and its prevention is based on the successful management of risk factors. There are currently many topical and systemic treatment options available, so the choice of therapy depends on the form and severity of the condition. The advantage of topical pharmaceutical forms is the ability to target early stages of acne lesions. Material and methods. Statistical, systemic, informational and sociological analysis were used as methods of analysis. Documentation with the State Drug Nomenclature and Classification, evaluation of topical prescription for acne treatment, dispensed in the Vasile Procopisin University Pharmaceutical Center (UPhC), the study of active pharmaceutical ingredients (API) and technological characteristics of topical pharmaceutical forms. Results. Topical treatment for acne should be based on its type and severity. The basic therapy for the treatment of mild acne refers to external applications, due to their action to prevent lesions. Treatment should be maintained over time to prevent recurrence. For domestic patients are accessible drugs with keratolytic, bacteriostatic and anti-inflammatory properties for topical treatments as benzoyl peroxide, salicylic acid, sulfur, azelaic acid, zinc oxide and antibiotic. The analysis of the use of anti-acne medications, in treating mild to moderate acne, by the age group, identified that for adolescents treatment is being focused on combating the causative agent of sebum production using salicylic acid in 32.5% cases and with age increase, the aim is to suppress inflammatory processes requiring retinoids, and in case of absence, can be substituted by benzoyl peroxide. Conclusions. The therapeutic approach in clinical practice must be done individually, considering the severity and shape of acne lesions.

Demodex Mites in Relation to the Degree of Acne Vulgaris among Egyptian Patients.

<b>Background and Objective:</b> <i>Demodex</i> mites are considered to play a pathogenic role in facial dermatoses as <i>Acne vulgaris</i>. In this study the association between <i>Acne vulgaris</i> and <i>Demodex</i> spp. intensity, kind and activity were investigated. <b>Materials and Methods:</b> Two degrees of acne was included, mild acne (30 cases) and moderate to severe acne (30 cases), besides 30 healthy subjects as a control. Deep skin scraping followed by direct microscopic detection was applied to diagnose demodicosis. <b>Results:</b> All the detected mites in moderate to severe acne were <i>D. folliculorum</i> which was observed in a highly dynamic status with their entire life cycle stages with intensity >5 mites per cm<sup><a href="2246157_ja">2</a></sup>. While very few inactive <i>D. brevis</i> mites were detected in the 2 subjects related to the control group<i>. </i>Despite that females comprised the majority of acne cases, males encompassed a statistically higher number than females among positive demodicosis cases. Itching and hair loss were the significant clinical signs within positive cases. Regarding risk factors, oily skins, repeated exposure to the sun, stressful lifestyle plus defective use of facial cleansers were found to be statistically significant. <b>Conclusion:</b> These results attained an association between moderate to severe acne and energetic <i>D. folliculorum</i> entire population. Thus, this study recommended lifestyle's modification for those cases suffering from <i>Acne vulgaris</i> with deep facial cleaning to avoid such infestation that worsens acne condition. Accordingly, once acne treatments are ineffective, consideration of <i>Demodex</i> mites with the needed acaricidal therapy is necessary.

New Normal Mask-Wearing and Its Impact on Underneath Skin Microbiome: A Cross-Sectional Study in Mild Acne Vulgaris Patients

Introduction: Prolonged mask-wearing could modulate the skin microenvironment resulting in several facial dermatoses. Microbial dysbiosis is proposed to be linked with these changes; however, data regarding the association is still limited. Accordingly, we aimed to explore the impact of face masks on the skin’s bacterial microbiota. Methods: We classified participants into short (<4 h/day) and long (≥4 h/day) mask-wearing time (SMWT and LMWT) groups according to mask-wearing time per day in the previous 2 weeks. Specimens were swabbed from the cheek and forehead of 45 mild acne vulgaris patients, representing mask-covered area (MCA) and mask-uncovered area (MUA), respectively. The 16S rRNA gene sequencing and QIIME2 were used to characterize bacterial communities. Results: There were 12 (26.7%) and 33 (73.3%) participants in SMWT and LMWT, respectively. There were no significant differences in beta diversity across MCA/MUA or LMWT/SMWT groups. In alpha-diversity, the evenness on MCA was significantly lower in LMWT than in SMWT (p value = 0.049). Among all groups, the relative abundance of bacterial taxa was similar, showing Actinobacteriota and Firmicutes, and Cutibacterium and Staphylococcus as the most predominant phyla and genera, respectively. Conclusion: Our results showed no significant impact of mask-wearing on the skin microbiota in mild acne vulgaris participants.

The Relationship Between Anxiety Level with the Onset of Acne Vulgaris in Medical Faculty of Universitas Sumatera Utara 2016 – 2018

Acne vulgaris (AV) is a chronic inflammation of the follicle pilosebaceous induced by Propionibacterium acnes. Anxious circumstances increase the androgen hormones. This increases the production of sebum and the proliferation then activates Propionibacterium acnes, resulting in AV. To find out the relationship between levels of anxiety and the onset of AV to the Faculty of Medicine, Universitas Sumatera Utara (FK USU) 2016 – 2018 conducted observational research with cross sectional design. This research samples as many as 66 students of FK USU Group 2016 – 2018 and using stratified random sampling method. The result of anxiety level of FK USU students indicates that there are mild anxiety (92.4%) moderate anxiety (6.1%) and severe anxiety (1.5%). The AV event of FK USU students indicates that there are mild acne (51.5%) moderate acne (40.9%) severe acne (6.1%) and normal results (1.5%). With the chi square test there is a significant link between the level of anxiety and the onset of the vulgaris (p = 0.026). There is a significant relationship between the levels of anxiety with the onset of AV on student of FK USU 2016-2018.

A prospective study on the efficacy and safety of fractional carbon dioxide laser in the treatment of post-acne scars

Introduction Acne scars can play havoc with the social functioning of the patient leading to severe depression with reduced quality of life. Fractional CO2 laser provides a fine balance between the undesirable side effects of ablative lasers and the limited efficacy of nonablative lasers. Objective The present study was conducted to evaluate the efficacy and safety of fractional CO2 laser in the treatment of acne scars. Patients and methods Fractional CO2 laser treatment performed on 30 patients with atrophic acne scar by different protocols depending on the type and its depth. Results were assessed based on serial photographs, clinical improvement, and physician’s global assessment scale. Results Of the 30 participants, 27 completed all three sessions. Out of the 27 patients in the final follow-up, three (10%) had excellent improvement of which two had mild acne scar and one had moderate scar before treatment; 16 (59.2%) had good response of which 13 had moderate acne scar and three had mild scar and eight (29.7%) had fair response of which six had moderate scars and two had mild scars. Conclusion Fractional CO2 laser as monotherapy in the treatment of mild-to-moderate post-acne scars seems to be effective with good patient satisfaction and reduced side effect profile. In case of severe acne scars, fractional CO2 laser can be used as a combined procedure along with other therapeutic modalities like subcision, platelet-rich plasma, and TCA CROSS (chemical reconstruction of skin scars using trichloroacetic acid) techniques.

Citral의 여드름성 피부에서 염증 개선 효과

As clinical trials on acne, this study aimed to assess the potential of citral in easing acne inflammation by inhibiting and unveiling the inflammatory activity of citral. For this, a total of 36 testees with high acne occurrence (age 19-23) were chosen and administered citral (0.5%, 1%) twice a day over 12 weeks. Then, the size and severity of inflammatory acne and amount of sebum production were investigated. In addition, inflammation images were analyzed. According to clinical trials, inflammation improvements were confirmed in all experimental groups (both 0.5% and 1% citral contents) (p＜0.05). When the size and shape of a pustule, which are critical indicators for in inflammation improvements, were observed, in particular, both size and shape diminished by 52% in the 1% citral group (p＜0.05). In terms of sebum production, T-zone revealed a significant decrease in the 1% citral group (p＜0.05) while U-zone showed a decrease in the 0.5% citral group (p＜0.05). According to analysis of inflammation images, considerable inflammation improvements were found in both 0.5% and 1% citral groups. After inflammation, pigmentation also improved, resulting in skin brightening. The above results confirm that citral is more effective in easing mild acne symptoms. In terms of inflammation improvements, it appears that the 1% citral group is more effective.

The Effects of Green Tea (Camellia sinensis), Bamboo Extract (Bambusa vulgaris) and Lactic Acid on Sebum Production in Young Women with Acne Vulgaris Using Sonophoresis Treatment.

People struggling with acne vulgaris, not only experience skin eruptions and skin pain, but also report that their quality of life is worse compared with healthy people. This study examined, for the first time, the effect of sonophoresis on select skin parameters (sebum level) in young women suffering from acne vulgaris. The study included 60 women 19–23 years of age (M = 21.45, SD = 0.91) with mild and moderate facial acne. The inclusion criteria were 19–23 years of age, female or male gender, mild to moderate acne, no dermatological treatment within last 12 months, and no hormonal contraception (women). No men volunteered for the study, so the group was homogeneous. The patients were divided into two groups. Group A underwent a sonophoresis procedure using ultrasound and ultrasound gel combined with a green tea, bamboo extract ampule, and 5% lactic acid. Group B was the placebo group, where sonophoresis was performed using only ultrasound gel (no ampules). The members of the placebo group were told that they were undergoing sonophoresis with a green tea, bamboo extract, and 5% lactic acid ampule. Before and after the series of procedures, sebum levels were measured in the skin. Each patient underwent a series of five procedures using sonophoresis equipment at one-week intervals. Sonophoresis with green tea, bamboo extract, and 5% lactic acid contributed to the reduction of skin eruptions and sebum levels in the participants of the study (group A). The study results demonstrated that the combined use of plant preparations, lactic acid, and ultrasound had a positive effect on the skin of people suffering from acne vulgaris, including reduction of skin eruptions and sebum levels on the surface of the skin.

Comparison of the Efficacy of Topical Clindamycin versus Niacinamide in the Treatment of Mild to Moderate Acne Vulgaris: a Systematic Review

Background: Acne vulgaris (AV) is one of the most common skin diseases among teenagers and is treated based on its severity. Mild acne is treated with topical agents, while moderate and severe acne are treated with a combination of topical and systemic agents. Topical agents that are often used for acne are antibiotics, such as topical clindamycin. Widespread use of antibiotics to treat AV causes resistance problems. Therefore, alternative therapies are needed to prevent resistance to topical clindamycin, such as topical niacinamide, which has anti-inflammatory effects without inducing resistance problems. Purpose: To compare the efficacy of topical clindamycin and topical niacinamide in mild to moderate AV. Methods: In this systematic review, a literature search was carried out through 6 databases, following PRISMA 2020 guidelines. Inclusion criteria were written in English or Indonesian, published in 2010-2020, randomized controlled trial (RCT) study design, conducted on human samples, and discussed the efficacy comparison of topical clindamycin and niacinamide in mild to moderate AV. Studies that were not accessible in full-text and based on secondary data were excluded. Quality and risk of bias assessments were done using The Jadad Scale and Risk of Bias 2 (RoB 2). Result: Acne severity was reduced significantly in both topical clindamycin and niacinamide groups, and there was no efficacy difference between these groups. Both topical clindamycin and topical niacinamide can cause mild side effects. Conclusion: Topical niacinamide can be an alternative therapy to topical clindamycin because they are both effective in treating mild to moderate AV.

Teledermatology in São Paolo, Brazil

Background There are places in the world where access to dermatologists can be very challenging and general practitioners may not be well trained in the diagnosis and treatment of skin conditions. Store-and-forward teledermatology may improve access to specialty care, provide accurate diagnoses, and reduce time to treatment, resulting in high patient satisfaction. The early detection and timely treatment of severe skin diseases could prevent adverse health outcomes and death. On the other hand, some skin conditions such as mild atopic dermatitis, acne, and fungal infections could be managed within primary care using teledermatology. Objective We aimed to (1) evaluate the proportion of individuals who could be assessed in primary care using teledermatology and how this affects the waiting time for an in-person dermatologist appointment and (2) assess the most frequent dermatoses according to demographic data and referrals made by the teledermatologist. Methods A cross-sectional retrospective study, involving 30,976 individuals and 55,624 skin lesions, was conducted from July 2017-July 2018 in the city of São Paulo. We assessed the frequency of diagnoses and referrals to biopsy, in-person dermatologists, or primary care, and compared the waiting time for an in-person dermatologist appointment before and after the teledermatology implementation. Results We found that 53% of the patients were managed by the primary care physician, 43% were referred to in-person dermatologists, and 4% were referred directly to biopsy, leading to a reduction in waiting time for in-person appointments of 78% when compared to the previous period (from 6.7 months to 1.5 months). The most frequent diseases were melanocytic nevus, seborrheic keratosis, acne, benign neoplasms, onychomycosis, atopic dermatitis, solar lentigo, melasma, xerosis, and epidermoid cyst, with significant differences according to sex, age, and referrals (Multimedia Appendix 1A,B). Conclusions The use of teledermatology as a triage tool significantly reduced the waiting time for in-person visits, improving health care access and using public resources wisely. Knowledge of sex, age, diagnoses, and treatment of common skin conditions can enable the creation of public policies for prevention and orientation of the population, as it can be used to train general physicians to address such cases. Conflicts of Interest None declared.

“THE STUDY OF CORRELATION OF SEVERITY OF ACNE VULGARIS AND ITS IMPACT ON QUALITY OF LIFE AMONGST MEDICAL STUDENTS IN WESTERN MAHARASHTRA”

Background : Acne vulgaris is one of the most common skin diseases amongst teenagers and young adults. affecting all ethnicities and races and has a considerable impact on quality of life. Aim and objectives : The study was undertaken to observe the clinical prole of acne vulgaris and its impact on quality of life amongst young adolescents using Cardiff Acne Disability Index (CADI) . Materials and methods : It was a hospital based cross sectional, questionnaire based study. A total of 156 medical students were involved in this study. Their clinical acne grading was done using Global Acne Grading System and its impact on quality of life was compared using Cardiff Acne Disability Index (CADI). Results : The study group included 156 students with male to female ratio of 1.29 : 1. According to Global Acne Grading System, 73.07% of participants had mild acne (1-18). The median CADI score is found out to be 4, which indicates mild psychological impact of acne on quality of life. The most common aggravating factor was exam stress (70.51%) in our study. Conclusion : There was low psychological impact of acne on quality of life amongst the study population owing to its mild clinical presentation. Global Acne Grading System and Cardiff Acne Disability Index (CADI) are the simple tools that can be incorporated in the routine management of patients with acne, in order to assess the severity of acne and its impact on quality of life.

Monopolar radiofrequency versus pulsed dye laser for treatment of acne scars: a randomized clinical trial

IntroductionThe main aim of the current study was to compare the effect of monopolar radiofrequency (MRF) and pulsed dye laser (PDL) in reducing acne scars and improving the cosmetic appearance.MethodsOverall, 30 patients suffering from mild or severe acne scars evaluated with the échelle d’évaluation clinique des cicatrices d’acné (ECCA) grading scale were randomly distributed into 2 groups. Group A (MRF group) was subjected to 1 session (8 minutes for each cheek) per month of MRF for 4 months. Group B (PDL group) received 1 session (5 minutes for each cheek) per month of PDL for 4 months. Pre- and post-treatment acne scar severity was assessed by using the ECCA grading scale and the self-assessment of clinical acne-related scars (SCARS) scale. Quality of life and the emotional impact of acne scars were evaluated by the facial acne scar quality of life (FASQoL) scale.ResultsBoth groups presented a significant decrease in ECCA scale, SCARS scale, and FASQoL scale after the treatment compared with the pre-treatment status (&lt;i&gt;p&lt;/i&gt; &lt; 0.001). There was a significant reduction in scores of ECCA scale, SCARS scale, and FASQoL scale in group B compared with group A after the treatment (&lt;i&gt;p&lt;/i&gt; &lt; 0.001).ConclusionsPDL is highly more effective than MRF in patients with acne scars.

Serum level of substance P and stress in acne-vulgaris patients

ObjectiveThe aim of the study was to evaluate the relationship between stress and serum concentration of substance P (SP) in acne-vulgaris patients.BackgroundAcne vulgaris is a multifactorial disorder of the pilosebaceous unit. The clinical picture can vary significantly, from mild comedonal acne to fulminant systemic disease. Although all age groups may be affected by its many variants, the peak incidence is during adolescence. Various studies have proved that neuropeptides affect the activity of the pilosebaceous unit by stimulating proliferation and differentiation of sebaceous glands, lipid synthesis, and induction of neutral endopeptidase expression in sebaceous cells, especially SP.Patients and methodsA case–control study included 40 patients with acne vulgaris and 40 age-matched and sex-matched controls. Emotional stress was analyzed with the use of Social Readjustment Rating Scale, whereas the methods of coping with stress were assessed with the Coping Inventory for Stressful Situation questionnaire, followed by taking blood samples to assess SP serum levels using the enzyme-linked immunosorbent-assay method.ResultsSP was significantly higher in the acne-patient group versus the control group (P < 0.05). A statistically significant difference was observed between acne patients and control groups regarding the Social Readjustment Rating Scale (P < 0.05).ConclusionThere was a statistically significant relation between stress scale and serum SP level in acne vulgaris.

Clinical efficacy of a cosmetic formulation with vitamin B3 for the treatment of oily skin

Oily skin has special needs, as the treatment and prevention of non-inflammatory acne and sebum control, maintaining skin barrier function and hydration. In this context, the importance of the development of specific and innovative cosmetics formulations to to fulfill the needs of this type of skin is evident. In this view, the aim of this study was the evaluation of the clinical efficacy of a cosmetic formulation containing Vitamin B3 in the treatment of oily skin using biophysical and skin imaging techniques. Female volunteers (n=40) between 18 to 30 years old with oily skin and/or mild inflammatory acne were recruited and received a formulation containing, or not (vehicle), 3% of Vitamin B3. Stratum corneum water content, transepidermal water loss (TEWL), sebum content and quantity of porphyrins were analyzed before (baseline) and after 28 days of application. Finally, an efficacy perception questionnaire was applied at the study end. The formulation with vitamin B3, showed a significant reduction of sebum and porphyrin content. The study participants in the assessment of perceived efficacy also reported these results. The studied formulation with Vitamin B3 was effective for oily skin care, acting on important parameters, such as controlling oiliness and improving skin appearance. Keywords: cosmetics, Niacinamide, skin physiology, oily skin, biophysical and skin imaging

Efficacy of a Retinoid, Keratolytic, Anti-Inflammatory and Antibacterial Gel and Spray Formulations in Mild Common Acne

Background and Objectives: For the treatment of mild/moderate acne, topical retinoids and antibacterial molecules are used in monotherapy or in combination. An exfoliating and anti-inflammatory action can increase the clinical efficacy of this therapeutic approach. A topical product in Gel and Spray Formulations (GF and SF) with retinoids (hydroxypinacolone retinoate and encapsulated retinol), with anti-inflammatory (niacinamide), antibacterial (biopep15) and keratolytic (glycolic and salicylic acids) activity has recently been developed. Topical retinoids have anti-inflammatory, anti-seborrheic and anticomedone-formation properties. Biopep15 is an oligopeptide with antibacterial action that can interfere with lipoteichoic acid, a component of the wall of Cutibacterium acnes. In addition, Biopep15 can perform also an antagonistic action against the Toll-Like-Receptor 2, involved in the pathogenesis of acne. Niacinamide has a well-known anti-inflammatory action. Salicylic and glycolic explain keratolytic and exfoliating activities. In this study the objective was to determine the efficacy and tolerability of GF and SF in mild/ moderate comedogenic acne. Methods: In a 4-week, open-label, prospective trial, 32 patients between the ages of 15 and 30 have been evaluated. All participants gave their written consent. Treatment with gel (for facial lesions) and spray (for lesions located on thorax, back and shoulder) applied twice daily were used. To assess clinical efficacy, a count of comedogenic lesions (open and closed comedones; non-inflammatory lesions: NIL) and inflammatory lesions (IL; papules, and pustules) was performed and the reduction in the number of lesions after 2 and 4 weeks of treatment was evaluated. An evaluation of Total lesions count (TL; NIL+IL) was also performed.The lesion count data were analysed with a paired Student's t test.We evaluated also the exfoliating/keratolytic activity and the effect on sebum production assessed at baseline, after 2 and 4 weeks of treatment. Finally, to evaluate Cutibacterium acnes (C. acnes) skin colonization, we performed a fluorescence detection of skin porphyrin content at baseline and at day 28, by mean of Visiopor PP 34 camera. Results: All patients completed the trial. At baseline the NIL, IL and TL count were 14.3, 8.7 and23, respectively. After 2 weeks of GF/SF treatment, NIL, IL and TL significantly decreased to 9.7 (-32%), 6.8 (-22%) and 16.5 (-29%), respectively. At the end of the treatment, a significant reduction in comparison with baseline was observed for NIL (-49%) IL (-63%) and TL (-54%). The exfoliating index evaluated in comparison with baseline value improved not significantly by 13% at day 14, and significantly (p=0.05) by 18% at day 24. The Cutibacterium acnes skin colonization area was significantly (p=0.02) reduced by 28% in comparison with baseline. Treatment was well tolerated, and local tolerability was assessed as optimal by all patients. Conclusion: This new anti-acne combination formula based on retinoids, antibacterial oligopeptide, keratolytic and anti-inflammatory agents have shown high clinical efficacy and good tolerability in patients with mild to moderate acne. The treatment shows also a keratolytic effect and a significant reduction of C. acnes skin colonization.

Evaluation of psychological well-being and social impact of atrophic acne scarring: A multinational, mixed-methods study

BackgroundMost people with acne are at risk of developing acne scars, but the impact of these scars on patients' quality of life is poorly researched.ObjectiveTo assess the perspective of patients with acne scars and the impact of these scars on their emotional well-being and social functioning.MethodsA 60-minute interview of 30 adults with acne scars informed and contextualized the development of a cross-sectional survey of 723 adults with atrophic acne scars.ResultsThe main themes identified in the qualitative interviews included acceptability to self and others, social functioning, and emotional well-being. In the cross-sectional survey, 31.6%, 49.6%, and 18.8% of the participants had mild, moderate, and severe/very severe acne scarring. The survey revealed that 25.7% of the participants felt less attractive, 27.5% were embarrassed or self-conscious because of their scars, 8.3% reported being verbally and/or physically abused because of their scars on a regular basis, and 15.9% felt that they were unfairly dismissed from work. In addition, 37.5% of the participants believed that their scars affected people's perceptions about them, and 19.7% of the participants were very bothered about hiding their scars daily. Moreover, 35.5% of the participants avoided public appearances, and 43.2% felt that their scars had negatively impacted their relationships.LimitationsThe temporal evaluation of the impact was not estimated.ConclusionEven mild atrophic acne scarring can evoke substantial emotional, social, and functional concerns.

Cultural and Linguistic Adaptation for the Romanian Language Version of the Cardiff Acne Disability Index: A Pilot Study on the Web-Based Experience of Cognitive Debriefing

Background The Cardiff Acne Disability Index (CADI) is a validated measurement instrument for quality of life evaluation in young patients with acne. The original version was designed in English, and it has been translated to other languages. An adaptation for the Romanian language was lacking. Objective The main objective of this study was to evaluate the comprehensibility of the Romanian language adaptation of the CADI in a small sample of patients with acne. Methods Guided by the team at Cardiff University, we conducted the stages of the standardized translation process—forward translation, the reconciliation of translated versions, back translation, and cognitive debriefing. The cognitive debriefing stage involved applying the CADI to a small sample of patients. This was followed by individual interviews in which each question was discussed. Ethical approval was obtained for the cognitive debriefing stage. We administered this measure as a web-based form. The completion times for each individual question and for the entire survey were automatically recorded. The interviews for assessing comprehensibility and suitability for the Romanian language and culture were also held as live, web-based meetings. Results A total of 7 patients with acne—4 females and 3 males—aged between 19 and 34 years were included. All subjects were native speakers of the Romanian language. They had mild or moderate acne. The mean completion time for the survey was 3.28 minutes. The mean score for the CADI was 5.4286. All participants agreed that the language used in this quality of life measurement instrument was simple, clear, and adequate for their native language. Conclusions Despite the epidemiologic restrictions against COVID-19, through teledermatology, we achieved cultural adaptation for the CADI in a language that previously lacked a specific tool for assessing quality of life impairment in patients with acne. Conflicts of Interest CMS receives royalties from Springer Nature, consulting fees from Vichy International, and support for attending meetings from Leo Pharma. SC has no conflicts of interest.