Moderate Inflammatory Acne Research Articles

Clinical evaluation of efficacy of intralesional platelet-rich plasma injection versus 1064 nm long-pulsed Neodymium:YAG laser in the treatment of inflammatory acne vulgaris in adolescent and post-adolescent patients: a prospective randomized split-face comparative study

Large numbers of local and systemic therapies are available for acne treatment. Common oral or topical retinoids, antibiotics, or keratolytics are used but sometimes are inconvenient, and side effects caused by these conventional therapies prompted a search for effective and safe treatments. This study aimed to evaluate the efficacy of intralesional platelet-rich plasma injection versus 1064 nm long-pulsed Nd:YAG laser in the treatment of moderate inflammatory acne vulgaris in both adolescents and post-adolescent patients. This split-face comparative study was carried out on thirty patients who suffered from moderate inflammatory and non-inflammatory acne vulgaris. The patients were classified into two groups: group I: adolescent (≤ 25 years) and group II: post-adolescent (< 25 years). Each group received four sessions of intralesional PRP injection on one side of the face and a long-pulsed Nd:YAG (1064 nm) laser on the other side with 2 weeks interval. Evaluation was done by blinded dermatologists using photographs and lesions counting and by patient satisfaction. Side effects were also noted. Both groups (adolescents and post-adolescent) showed a high statistically significant improvement of inflammatory as well as non-inflammatory lesions either in PRP or Nd:YAG laser–treated side with no significant difference between the two sides. The intralesional PRP injection and 1064 nm long-pulsed Nd:YAG laser are safe and effective methods for controlling inflammatory as well as non-inflammatory acne vulgaris in both adolescents and post-adolescent patients.

Transcriptomics Analysis Indicates Trifarotene Reverses Acne-Related Gene Expression Changes.

Background and Objectives: Trifarotene is a topical retinoid selective for retinoic acid receptor gamma that was recently approved for treatment of acne vulgaris. We performed a gene expression analysis to identify the molecular and cellular impact of trifarotene treatment on acne papules.Methods: In this open-label prospective study, subjects with moderate inflammatory acne of the back were treated with trifarotene 0.005% or vehicle cream on dedicated areas for 27 days, and 4 biopsies were collected from each subject (1 from skin without a visible acne lesion and three at the site of an acne papule: one baseline, one after vehicle treatment, and one after trifarotene treatment). Large scale gene expression profiling of the biopsies was performed using Affymetrix technology, treatment-specific gene expression profiles were generated using statistical modeling, and pathway analysis was performed. Using single-cell RNAseq data, in silico deconvolution of transcriptomics data was performed to identify cellular signatures.Results: We discovered a unique set of 67 genes modulated by trifarotene that are primarily involved in cellular migration, inflammation, and extracellular matrix reorganization. Changes in cellular expression were similar in both trifarotene-treated and spontaneously-resolving lesions. However, only trifarotene treatment impacted SPP1+ macrophages, a subset of highly proliferative macrophages recently identified in fibrotic tissue.Conclusions: These results show that trifarotene has a novel action in acne treatment by affecting epidermal and immune components of acne pathogenesis.

27862 Trifarotene transcriptomics analysis and acne-related gene expression

Trifarotene cream, 0.005% is an FDA approved topical retinoid indicated for treatment of facial and truncal acne and has received positive outcome through the European Decentralized Procedure. Trifarotene is the first novel topical retinoid molecule approved for acne treatment in 20 years, and the only approved retinoid that specifically acts through retinoic acid receptor gamma. This study investigated new potential pathways through which trifarotene exerts its efficacy in acne by analyzing the changes in gene expression in the skin of acne patients. Subjects with moderate inflammatory acne of the back were treated with trifarotene 0.005% or vehicle cream on dedicated back areas for 27 days, and 4 biopsies were collected on each subject (non-involved skin, acne papule, trifarotene, and vehicle-treated site). Large-scale gene expression profiling of the biopsies was performed using Affymetrix technology, and treatment specific gene expression profiles were generated using statistical modeling. This analysis highlighted a specific gene expression profile, comprising of 67 genes uniquely driven by Trifarotene treatment with most of these genes known to affect immune responses as well as extracellular matrix reorganization. Interestingly, those genes were downregulated as compared with the papule signature suggesting that trifarotene reverses some inflammatory processes of the papule. Altogether, these results show that trifarotene has a unique action in acne treatment by acting on epidermal differentiation and proliferation (Aubert et al., 2018) as well as on innate and adaptive immune cells in acne pathogenesis.

Comparison of efficacy &amp; safety of Blue Light vs topical application of 1% Clindamycin solution in the treatment of mild to moderate inflammatory Acne Vulgaris

Aim: To compare the efficacy &amp; safety of blue light vs topical application of 1% clindamycin solution in the treatment of mild to moderate inflammatory acne vulgaris. Study Design: Comparative interventional study done in Dermatology Outpatient Department Unit-II, KEMU/ Mayo Hospital, Lahore six months i.e. 1-06-2014 – 30-11-2014 Methodology: After an informed and written consent, 130 patients fulfilling the selection criteria were enrolled in the study and divided in two study groups A &amp; B by balloting method. At first visit, a detailed history and clinical examination was recorded on a specially designed proforma. The acne was graded according to the acne grading scale of American Academy of Dermatology.4,13 Group A was exposed to blue light for twenty minutes twice weekly for eight weeks. Group B was given 1% clindamycin to apply twice daily for a period of eight weeks. Post- treatment follow up was done for next four weeks. Patients were assessed at 2nd, 4th, 6th, 8th, 10th, and 12th week. All findings and side effects were recorded on a predesigned proforma. To determine the efficacy of treatment, Acne Severity Index (ASI) was used.5 Result: Efficacy of treatment [≥ 50% improvement in ASI score] was seen in 39(60%) patients in blue light group while in clindamycin group it was achieved in 8 (12.3%) patients only. Blue light group had significantly less number of side effects observed in 35 (37.23%) patients while clindamycin group had a higher number of side effects observed in 59 (62.77%) patients, p-value= 0.013. Conclusion: Blue light is more efficacious and safer than topical 1% clindamycin in the treatment of mild to moderate inflammatory acne vulgaris. Keywords: Blue light, 1% Clindamycin, Acne vulgaris

Efficacy and safety of a novel water-soluble herbal patch for acne vulgaris treatment: A randomized, assessor-blinds controlled, intra-individual split-face comparative study.

Acne vulgaris is a chronic inflammatory skin disease. Antibiotics, particularly clindamycin and erythromycin, are used for the treatment of acne vulgaris. However, emerging antibiotic-resistant strains have been an important problem. This study aims to evaluate the efficiency and safety of a novel water-soluble herbal acne patch (WHAP) compared with the hydrocolloid acne patch (HAP) in mild to moderate inflammatory acne patients. The randomized, assessor-blind controlled, intra-individual split-face study was performed on 49 acne patients. The clinical outcomes were evaluated on day 2, 4, 7, 9, and 11 of treatment. It was shown that the median time to resolution of the inflammatory acne treated with WHAP was shorter than HAP with a statistically significant difference (WHAP was 4 days, whereas HAP was 6 days) (P value <.001). Moreover, WHAP had a more significant decrease in the rate of inflammatory diameter, erythema scores (by clinical and colorimetry), and a more increase in the rate of lightness scores (by colorimetry) than HAP (P value <.05). No adverse effects were reported in both groups. It is safe to use WHAP as an alternative treatment for inflammatory acne.

Two is better than one: The combined effects of glycolic acid and salicylic acid on acne-related disorders.

Many companies capitalized on treatable skin conditions by providing expensive prescription medications or high-end over-the-counter cosmetics. However, patients have become more apprehensive toward these medications in lieu of their often-detrimental side effect profile and reactivity with sensitive skin. We developed a serum was created to counteract this budding problem. Our goal was to bring an alternative prescription acne medication that was superior in controlling acne when compared to several OTC and prescription-strength medications. We created a new formulary comprising primarily of all natural glycolic acid and salicylic acid. We designed a prospective study to assess the efficacy of our serum composed of glycolic and salicylic acid for patients suffering from mild to moderate inflammatory and cystic acne, rosacea, folliculitis, and keratosis pilaris. Sixty-six patients were selected ranging in age from 17 to 46. They were asked to apply the wake-up serum at night for 2 weeks. At the follow-up appointment, the patients were asked to fill out a questionnaire regarding the changes they have noticed with their skin. Over 90% of the patients reported they had significant overall improvement in acne with decrease in comedonal and cystic acne. 70%-80% of the patients stated decrease in oiliness, even texture, and smoother looking skin. Physical examination findings were consistent with patient-reported assessment. A glycolic and salicylic acid combination serum may be considered an alternative treatment method for patients who wish to opt out of the typical prescription medication treatment.

Clinical assessment of topical erythromycin gel with and without zinc acetate for treating mild-to-moderate acne vulgaris

Purpose: Erythromycin is an effective topical antibiotic for treating mild-to-moderate inflammatory acne vulgaris, especially papules acne during puberty as well as papules - pustular acne in adult women. Erythromycin is a macrolide antibiotic that has long been used as a topical dosage form to treat acne. It has favorable effects in resolving inflammatory acne lesions not only by reducing Propioni bacterium acnes density, but also by directly inhibiting neutrophil chemotactic factors and reactive oxygen species (ROS) production. Zinc, a metallic element has bacteriostatic activity against Propioni bacterium acnes. Combining zinc with antibiotic (erythromycin) can reduce antibiotic resistance and increase antibiotic absorption in-to the skin.Material and methods: In the present study, erythromycin (2% w/v) with zinc acetate (1.2% w/v) as ‘topical gel’ and erythromycin (2% w/v) gel alone were evaluated for treating mild to moderate inflammatory acne vulgaris. This double-blind study was carried out on 102 patients 13–25 years of age, divided into two groups. The group A received erythromycin and group B received erythromycin with zinc acetate topical gels during 3 weeks. Acne grading and lesion counts for comedones, papules and pustules were performed during each visit zero, first, second and third weeks.Results: Erythromycin treatment (with zinc acetate) gel showed to be more effective than erythromycin (alone) gel with respect to reducing the number of acne lesions and severity grade of acne.Number of lesions and severity of acne were significantly reduced at the end of 3rd week in both groups (p < .001). Conclusions: In conclusion, it can be stated that erythromycin with and without zinc acetate was clinically effective, and both formulations produced a significant reductions in acne grading as well as inflamed and noninflamed lesion counts (p < .000). Statistically, there was no significant difference between formulation A and B.

Complementary and Alternative Methods for Treatment of Acne Vulgaris: a Systematic Review

To review the current literature regarding complementary and alternative treatment options for acne vulgaris. Acne vulgaris is an increasingly prevalent disease worldwide. While conventional methods of treatment are still primarily used to treat acne, complementary and alternative methods of treatment are becoming utilized in conjunction or in place of prescription medications. Studies have shown comparable benefit of Complementary and Alternative Medicine (CAM) therapies to conventional treatment. Oral green tea extract was a moderately effective treatment of inflammatory acne without significant side effects. Nicotinamide oral and topical preparations demonstrated efficacy in the treatment of moderate inflammatory acne without significant side effects. Oral zinc gluconate was not as effective as oral minocycline in the treatment of inflammatory acne. CAM therapy has relatively few reported side effects for acne vulgaris, and is mildly effective in treatment of inflammatory and comedonal acne. More studies are needed for further comparison of CAM modalities with each other as well as with conventional treatment.

Adverse effects of isotretinoin: A large, retrospective review.

Acne is a very common and disfiguring disease that affects mostly adolescents and, to some extent, adults. The objective of our study was to estimate the adverse effects after isotretinoin by treatment of 3,525 patients due to acne vulgaris in a 5-year observation. Retrospective, comparative study was carried out in Poland and Romania from January 2012 to August 2016. Inclusion criteria into this study were moderate, severe, and nodulocystic inflammatory acne vulgaris. Exclusion criteria were mild acne, pregnant, and lactating women. Statistical analysis was carried out using T test and Chi square. All patients were treated with oral isotretinoin. Patient age ranged from 13-35 years. Dry lips was the most commonly reported adverse effect, affecting 100% of users, followed by xerosis (94.97%) and facial erythema (66.21%). Of all adverse effects, psychiatric symptoms accounted for 25.16%; eye lesions accounted for 8.96%. In lab investigations an increase in the level of total cholesterol and serum triglycerides was observed. This study documents the adverse effect profile of isotretinoin in a large number of patients collected over a period of 4 years. Side effects were mild and well tolerated and did not necessitate stopping the treatment. However, it is important to educate patients about this potential consequence.

Adapalene 0.1%/benzoyl peroxide 2.5% gel reduces the risk of atrophic scar formation in moderate inflammatory acne: a split-face randomized controlled trial.

The efficacy of current topical acne treatments in mitigating the potential for acne scarring is not known. To evaluate the effect of adapalene 0.1%/benzoyl peroxide 2.5% (A/BPO) gel compared to vehicle in reducing the risk of acne scarring. Multicentre, randomized, investigator-blinded, vehicle-controlled, split-face study conducted over 6 months. Subjects were adults with active moderate facial acne vulgaris and at least 10 atrophic acne scars at baseline. Efficacy evaluations included counts of atrophic acne scars and primary acne lesions as well as a Scar Global Assessment (SGA; 5-point scale). After 6 months treatment, scar counts remained stable with A/BPO while increasing by approximately 25% with vehicle (mean scar count 11.58 vs. 13.55, respectively, at Month 6; P = 0.036). The percentage of subjects with a SGA of 'almost clear' (hardly visible scars) increased from 9.7% to 45.2% with A/BPO, whereas it did not change with vehicle (P = 0.0032). Total acne lesion counts decreased by 65% with A/BPO and 36% with vehicle (mean lesion count 8.5 vs. 16.1, respectively, at Month 6; P < 0.001). Relatively small study group (31 subjects). Topical long-term treatment with A/BPO is effective in reducing the risk of atrophic scars and improving the global severity of scarring.

A multicenter, randomized, split-face clinical trial evaluating the efficacy and safety of chromophore gel-assisted blue light phototherapy for the treatment of acne.

Although a variety of laser/light-based devices have been reported to be effective for the treatment of acne, long-term data on efficacy and safety in the management of moderate and severe inflammatory acne is lacking. The objective of this 12-week clinical trial was to evaluate the efficacy and safety of the KLOX BioPhotonic System, a LED blue light device using specific photo-converter chromophores, in the treatment of moderate to severe acne vulgaris. One patient hemiface was randomly selected to receive 6 weeks of treatment (twice weekly) with the LED light and the photo-converter chromophores whereas the contralateral hemiface was not treated with the BioPhotonic System. All patients were provided with a skin cleanser and a non-comedogenic cream with ultraviolet protection to be used on the entire face during the treatment period. Following completion of the 6-week treatment period, the patient was followed for an additional 6 weeks. Efficacy was assessed through changes in acne severity using the Investigator's Global Assessment (IGA) scale and inflammatory acne lesion counts, both evaluated against baseline at weeks 6 and 12. Safety was assessed through physical exam, vital signs, laboratory evaluations, and physician and patient reporting of adverse events. A reduction of at least two grades in IGA scale severity was demonstrated in 51.7% of patients at week 12. Furthermore, at week 12, subjects with a baseline IGA grade of 3 (moderate) demonstrated a success rate (2 or greater grade drop) of 45.3% whereas patients with a baseline IGA grade of 4 (severe) demonstrated a success rate of 61.1%. Acne inflammatory lesion counts confirmed these results, with a reduction of at least 40% of lesions in 81.6% of treated hemifaces after 12 weeks. Treatment was considered as safe and well tolerated, with no serious adverse event and no patient discontinuation from the study from any adverse event. Patients' quality of life was also improved with a decrease of pain linked to acne after the 6-week treatment period. The BioPhotonic System comprised of LED blue-light phototherapy and photo-converter chromophores was found to be efficacious and safe, with a sustained clinical response at 12 weeks for the management of moderate to severe facial inflammatory acne.

Efficacy of adapalene/benzoyl peroxide combination in moderate inflammatory acne and its impact on patient adherence

Adapalene 0.1 %/benzoyl peroxide (BPO) 2.5 % (Epiduo®) is the first, fixed-dose topical combination gel developed for the once-daily treatment of acne. The objective of this observational study was to assess efficacy and patient adherence under daily clinical practice conditions in a large population of young adults and adolescents (12 to 20 years) with moderate inflammatory acne. A total of 2 780 patients receiving adapalene-BPO were evaluated in this multicenter, open-label, prospective non-interventional observational study. Observation time per patient was approximately 12 weeks. Assessment parameters included changes in acne severity, treatment success, safety, and therapeutic adherence. After 12 weeks, the majority of patients (91.5 %) showed improvement of acne under adapalene-BPO treatment, with an initial therapeutic response noted after a median time of 14 days. Overall, 21.8 % of participants displayed complete resolution of visible acne lesions. Treatment adherence was assessed as good in 63.2 % of patients. The majority of individuals (69.5 %) experienced no or only mild local skin irritations. No serious adverse drug reactions (ADR) were reported during the course of the study. Adapalene-BPO is effective and safe in the treatment of moderate inflammatory acne. The fixed-dose combination and easy application simplifies the therapeutic regimen, leading to good treatment adherence in the majority of patients.

Topical erythromycin-zinc acetate complex lotion versus topical erythromycin gel in treatment of mild to moderate acne vulgaris

Introduction: Topical antibiotics are the main step in the treatment of mild to moderate acne vulgaris. Erythromycin is one of the effective topical therapies for this disease. Zinc sulfate 5% solution was reported to be effective in treatment of acne vulgaris and rosacea. Aim: To compare the effectiveness and side effects of topical erythromycin in combination with zinc and erythromycin alone in treatment of mild to moderate acne vulgaris. Material and Methods: This single, blind, therapeutic, comparative study was done in the Department of Dermatology – Baghdad Teaching Hospital, Baghdad, Iraq; from May 2012 August 2013.Scoring of acne was carried out and the patients were examined every two weeks for 10 weeks of treatment. One month after stopping drugs, patients were evaluated for drug complications and disease recurrence. Eighty patients fulfilling enrollment criteria were included in this study. Patients were divided into two groups: Group A (40 patients) treated twice daily with topical erythromycin-zinc complex lotion and Group B (40 patients) treated twice daily with topical 2% erythromycin gel. Results: Both topical erythromycin-zinc lotion and erythromycin gel were statistically an effective therapy starting after 6 weeks treatment and up to 4 weeks after stopping treatment. Erythromycin-zinc lotion was more effective and act earlier than erythromycin gel starting from 4 weeks of therapy till the end of treatment (after 10 week) and even after 4 weeks after stopping the treatment (p value <0.0001). Conclusions: Erythromycin-zinc complex lotion was an effective and well tolerated topical therapy for mild to moderate inflammatory acne vulgaris and was more effective than erythromycin gel alone.

Clinical and usability study to determine the safety and efficacy of the Silk'n Blue Device for the treatment of mild to moderate inflammatory acne vulgaris

Introduction: Home devices for acne vulgaris have emerged as a way to utilize our current light based technology for the care of our patients suffering from acne vulgaris. Materials and methods: Patient received eight treatments with the Silk'n Blue device over a 4-week period. Follow-up visits were at 1 month and 3 months. Results: Seventeen subjects were entered into this institutional review board (IRB) approved clinical research project. There was a statistically significant decrease in mean acne counts from baseline through the follow-up visits, p = 0.002. Percent reduction was also statistically significant, p = 0.041. The study also showed that 36.4% of the patients had complete clearance with the study device. 100% of the patients showed full comprehension with the label for the device. There were no adverse events. Photos were captured. Discussion: The Silk'n Blue device has an array of 24 LEDs emitting a spectrum of light in the blue-violet range of light (405–460 nm). Subjects enrolled in this clinical trial clearly were able to understand the labeling for the device. Conclusions: The Silk'n Blue device is a safe efficacious at home device for the treatment of mild to moderate inflammatory acne vulgaris.

Investigator-blind, placebo-controlled, randomized comparative study on combined vacuum and intense pulsed light versus intense pulsed light devices in both comedonal and papulopustular acne

Introduction: The aim was to compare the treatment effectiveness of intense pulsed light (IPL) and vacuum versus IPL with placebo for mild to moderate comedonal and inflammatory acne. Patients and methods: We randomized 180 patients with mild to moderate comedonal and inflammatory acne into three groups: Group A – 60 patients treated with vacuum and IPL, Group V – 60 patients treated with IPL, and Group 0 (control group) – 60 patients who received topical treatment with Sebium H2O Micellaire Solution. We evaluated the results using the Leeds revised acne-grading system and Cardiff Acne Disability Index. Results: There was a significant reduction in the number of papules, pustules, and comedones in Groups A and V compared with those in the control group (p < 0.001) with a more rapid decrease of the papules from Group A compared with that from Group V. We found an improvement in the clinical aspect (p < 0.001) when we compared Groups A and V with controls. Patients belonging to Group A were more satisfied compared with those belonging to Group V (p = 0.004) and significantly more satisfied compared with those belonging to Group 0 (p < 0.001). In conclusion, we consider that both the devices are efficient, the combination of vacuum and IPL representing a therapeutic option for the comedonal acne.

Topical 4% nicotinamide vs. 1% clindamycin in moderate inflammatory acne vulgaris

Nicotinamide and clindamycin gels are two popular topical medications for acne vulgaris. This study aimed to compare efficacy of the topical 4% nicotinamide and 1% clindamycin gels in these patients. In this randomized, double-blind clinical trial, patients with moderate inflammatory facial acne vulgaris were randomly allocated to receive either topical 4% nicotinamide (n=40) or 1% clindamycin gels (n=40) twice daily. In each group, they were further categorized in two subgroups with oily and non-oily types of facial skin. The Cook's acne grade was determined at baseline and at weeks 4 and 8 post treatment. Acne grade decreased from an average of 5.93±0.83 at baseline to 4.03±1.33 at week 4 and 2.08±1.59 at week 8 in nicotinamide receivers, and from an average of 5.70±0.94 at baseline to 3.85±1.66 at week 4 and 2.03±1.53 at week 8 in the clindamycin group (within-group P<0.001, between-group P>0.05). Comparing with each other, nicotinamide and clindamycin gels were significantly more efficacious in oily and non-oily skin types, respectively. No major side effect was encountered by any patient. Skin type is a significant factor in choosing between topical nicotinamide and clindamycin in patients with acne vulgaris.

Glycolic acid peeling in the treatment of mild to moderate inflammatory facial acne vulgaris

Chemical peeling of the skin involves the topical application of a chemical agent in order to produce a controlled injury to a desired depth, thus allowing subsequent regeneration of the skin which can result in improved texture, more homogeneous pigmentation and less wrinkling. Acne vulgaris is one of the most common skin diseases. The aim of the actual study was to examine and compare the efficiency, skin tolerance and side effects of a 35% glycolic acid combined with antibiotic therapy in patients with inflammatory aspects of acne. The sample consisted of 120 subjects, divided into two experimental sub-samples of 60 subjects each. The first sub-sample consisted of patients with acne papulosa, while the second sub-sample consisted of patients with acne papulopustulosa.The patients from both sub-samples were additionally divided into two groups of 30 patients each. To the first group of 30 patients (within each sub-sample, respectively), glycolic acid in a concentration of 35% was applied after adjusted antibiotic therapy, while to the second group of 30 patients (within each sub-sample, respectively) glycolic acid in a concentration of 35% was applied without previous adjustment of antibiotic therapy. In each sub-sample, the differences in the manifested symptoms of the ailment and the side effects were analyzed. Glycolic acid had a significant effect in the treatment of acne papulosa and acne papulopustulosa, as a monotherapy, as well as combined therapy, that is, after adjusted antibiotic therapy. Side-effects were experienced by patients treated only by glycolic acid, that is, without previously adjusted antibiotic therapy. Glycolic acid chemical peels in concentration of 35% had overall efficiency and a superior therapeutic effect and are recommended by the authors after adjusted antibiotic therapy. The appearance and intensity of side effects in patients after adjusted monotherapy, adduced us to the choice of combined therapeutic treatment. Key words: Acne papulosa, acne papulopustulosa, chemical peeling, glycolic acid.

Clinically relevant advances in acne management with adapalene 0.1%/benzoyl peroxide 2.5% gel

Adapalene 0.1%/benzoyl peroxide 2.5% (adapalene/BPO) gel is a fixed-dose gel combining a topical retinoid and benzoyl peroxide. It is efficacious in moderate inflammatory acne and the combination provides efficacy greater than the sum of its active components for all relevant outcome measures for acne. In particular, this effect is maximal early in the course of therapy. While there was a range of lesion counts associated with moderate acne severity, adapalene/BPO was of greatest efficacy in those with higher lesion counts. The adjunctive use of adapalene/BPO with oral doxycycline increases the rate of global success fourfold beyond that of oral doxycycline alone. While this agent can be associated with an increased incidence of local intolerability, practical measures to address these issues can maintain patient acceptability.

Changing the topography of acne with topical medications

Acne vulgaris is a common skin condition that affects approximately 40-50 million Americans annually. The peak incidence of acne occurs during adolescence and young adulthood, with approximately 80% of persons aged 11-30 years having at least minor acne. Because the onset of acne is typically in early adolescence, pediatricians are often at the front-lines in terms of caring for patients with this chief complaint. Over the last 2 years, new acne therapies have become available. These include new combination fixed-dose products, which may allow for greater flexibility in treatment and greater patient compliance. New topical antibiotics have also come to the market, providing more therapeutic options for mild to moderate inflammatory acne. Lastly, acne therapies involving the use of light sources and photosensitizers are currently being developed, which may provide a whole new modality for managing complicated patients. Successful management of acne requires the physician to make a thorough assessment of the patient's acne severity, predominant lesion type, skin type, and lifestyle in order to pair each individual patient's needs with the appropriate anti-acne therapy. This article provides an overview of the pathophysiology of acne and pre-existing topical therapies. It then discusses some novel acne therapies and outlines how they might fit into a physician's treatment strategy.

Topical nadifloxacin 1% cream vs. topical erythromycin 4% gel in the treatment of mild to moderate acne

Topical antibiotics are the mainstay of therapy in mild to moderate inflammatory acne. Topical erythromycin is one of the most common prescribed topical antibiotics. Nadifloxacin, another topical antibiotic for acne, was recently introduced into the market in our country. In this study, we compared the efficacies and safety of topical nadifloxacin 1% cream and erythromycin 4% gel in acne. A total of 86 patients with mild to moderate facial acne were randomized into two treatment groups. The efficacies of the drugs were assessed by lesion counts. An acne severity index (ASI) was also calculated. In both groups, there was a significant reduction in lesion counts and ASI scores beginning from the first visit at week 4. This reduction continued throughout the 12-week study period. Both treatments were well tolerated. We conclude that when topically applied, both nadifloxacin 1% cream and erythromycin 4% gel are equally effective and safe treatments for mild to moderate facial acne.