Non-inflammatory Acne Lesions Research Articles

A Novel Treatment of Acne Vulgaris Using a 1927 nm Fractional Thulium Laser: A Case Series.

Acne vulgaris remains one of the most common and problematic dermatological conditions. Recently, a fractional 1927 nm thulium laser has been developed with specific water absorption characteristics which may be of interest in the treatment of acne. Nine consecutive Korean subjects, 6 females and 3 males, ages ranging from 13 to 33 yr, presented with a mixture of inflammatory and noninflammatory acne. Baseline clinical photography, image analysis and lesion counts were performed. A fractional 1927 nm thulium laser (FTL) delivered 6 treatment sessions in 5 subjects and 5 sessions in 4 subjects, 4 weeks between sessions. Pain during treatment was assessed. At 32 weeks after the last treatment session, an independent Investigator Global Assessment (IGA) performed lesion counts and graded the severity of the acne at baseline and the final assessment on a quintile scale. Data were analyzed statistically. All 9 subjects completed the study with significant reductions in the inflammatory and noninflammatory lesions (P values 0.0012 and 0.0081, respectively) with overall lesion counts at the final assessment ranging from 60% to 97.1%, and acne grades in the IGA dropping by an average of 1.67 (range 1 to 3 grades). There was no significant difference in lesion counts or acne grades between the subjects who had 6 treatments and those who had 5 (P = 0.7695). Mild pain was reported during treatment, and no adverse events were reported by either the subjects or investigator. The FTL at the parameters used in the present study caused disruption to the upper portion of the affected follicles and sebaceous glands under an intact stratum corneum, thereby destroying or damaging the causative Cutibacterium acnes. The superficial controlled coagulation additionally induced follicular remodeling and tissue regeneration, potentially contributing to the noticeable results in inflammatory and noninflammatory acne lesions.

A Clinical Study on the Improvement of Acne Skin by Differences in AHA Concentration Ratio of Body peeling Mist Containing Hydroxy Acids

The purpose of this study was to compare the improvement of acne skin according to the difference in AHA concentration ratio of body peeling mist containing Hydroxy Acids in 30 healthy people with acne in the body. We observed back acne and skin conditions for 6 weeks with three comparison groups containing 21.65% AHA, 24.00% AHA, and 26.50% AHA. As a result of observing acne skin improvement after 6 weeks, the difference between the three groups was not statistically significant, but the change in the ratio to the baseline of inflammatory and non-inflammatory acne lesions and the change in Michaelson’s Acne Severity Index (ASI) were significantly reduced according to the measurement time of each group. As a result of observing skin improvement in Sebum, Flakiness, Moisture after 6 weeks, the L group showed statistically related changes in skin moisture, the M group showed skin sebum, skin flakiness, skin moisture, and the H group showed statistically related changes in skin flakiness, skin moisture. In addition, the subjective skin irritation was the highest in the H group, and the subjective feeling of usage was the highest in the M group. Collectively, the results indicated that acne skin improvement rate and subjective satisfaction were the highest in group M using HA’s 32.00% product (AHA 24.00%), which is useful for the production and development of acne care cosmetics.

A Randomized Clinical Trial to Evaluate the Efficacy of an Oral Probiotic in Acne Vulgaris.

The relevance of the gut microbiota in some skin inflammatory diseases, including acne vulgaris, has been emphasized. Probiotics could play a role in the modulation of the microbiota, improving the clinical course of this disease. A 12-week randomized, double-blind, placebo-controlled, clinical trial with patients aged 12 to 30 years with acne vulgaris was conducted. The study product was a capsule composed of the probiotic Lacticaseibacillus rhamnosus (CECT 30031) and the cyanobacterium Arthrospira platensis (BEA_IDA_0074B). Patients with improvement in the Acne Global Severity Scale were 10/34 (29.41%) in the placebo group compared with 20/40 (50%) in the probiotic group (p = 0.03). A significant reduction (p = 0.03) in the number of non-inflammatory acne lesions was observed in the probiotic group (-18.60 [-24.38 to -12.82]) vs the placebo group (-10.54 [-17.43 to -3.66]). Regarding the number of total lesions, a reduction almost reaching statistical significance (p = 0.06) was observed in the probiotic group (-27.94 [-36.35 to -19.53]) compared with the placebo group (-18.31 [-28.21 to -8.41]). In addition, patients with improvement attending the Global Acne Grading System were 7/34 (20.58%) in the placebo group vs 17/40 (42.50%) in the probiotic group (p = 0.02). The number of adverse events was similar in both groups. The probiotic used in this study was effective and well tolerated, and it should be considered for acne vulgaris patients.

An Open-label Study to Investigate the Efficacy and Tolerability of Dapsone Gel, 7.5% in the Treatment of Acne Vulgaris in Men and Women With Skin of Color

Acne vulgaris is a common skin disease prevalent in skin of color patients. Studies have demonstrated that dapsone gel, 7.5% (Aczone) used once daily is effective, safe, and well-tolerated for the treatment of acne in both men and women. However, minimal data are available in skin of color populations. This single-center, open-label clinical study investigated the efficacy and safety of dapsone gel, 7.5% in the treatment of moderate to severe acne vulgaris in patients with Fitzpatrick skin types IV-VI. Twenty (20) adult subjects with moderate to severe acne and Fitzpatrick skin types IV-VI were enrolled in this study and treated with dapsone gel, 7.5% once daily for 24 weeks. Dapsone gel, 7.5% applied daily for 24 weeks reduced acne severity, post-inflammatory hyperpigmentation, and decreased new inflammatory and noninflammatory acne lesions in skin of color patients with moderate to severe acne vulgaris. Treatment resulted in improved acne health-related quality of life and patient symptoms related to acne, including patient-reported post-inflammatory hyperpigmentation, especially with a treatment duration of 18 weeks or longer.  Limitations: The sample size was small and underpowered to detect statistically significant changes in some endpoints. Dapsone gel 7.5% was safe, well-tolerated, and efficacious in treating acne vulgaris and post-inflammatory hyperpigmentation in skin-of-color patients. Larger studies involving skin-of-color populations with acne vulgaris are warranted. J Drugs Dermatol. 2024;23(6):410-417. doi:10.36849/JDD.7897.

Fractional CO2 laser versus 1064-nm long-pulsed Nd:YAG laser for inflammatory acne vulgaris treatment: a randomized clinical trial

Acne vulgaris is challenging to treat for several individuals. Laser therapy may be a desirable alternative to traditional therapies with limited success. This study aimed to assess efficacy of fractional CO2 laser versus Nd:YAG laser for acne vulgaris therapy. Thirty cases with acne vulgaris underwent both fractional CO2 laser and Nd: YAG laser treatments in a randomized split face design at a 14-day interval for four sessions. The clinical efficacy was evaluated by counting acne lesions and utilizing the Global Acne Severity Scale (GEA Scale). GEAs decreased significantly after both fractional CO2 and Nd:YAG modalities after treatment and at a 3-month follow-up; fractional CO2 demonstrated significant more decrease in GEAs with (P = 0.006, 0.00 (respectively. Moreover, fractional CO2 showed a significantly higher satisfaction level (P = 0.004) and a better clinical improvement percentage regarding inflammatory and noninflammatory acne lesions (P = 0.007 and 0.000, respectively) after 3 months of follow-up. Apart from transient erythema, there were insignificant adverse effects concerning both treated sides. Fractional CO2 and Nd:YAG lasers are efficient physical modalities of acne treatment. However, fractional CO2 laser was more effective and more satisfying to the patients.

Effect of various types of photodynamic therapy on inflammatory and non-inflammatory lesions in patients with acne: A network meta-analysis of randomized controlled trials

BackgroundRecent studies have demonstrated that photodynamic therapy (PDT) is safe and effective in treating acne vulgaris. The present study aimed to evaluate various PDTs on inflammatory and non-inflammatory lesions in patients with acne by a network meta-analysis (NMA) of randomized controlled trials (RCTs). MethodsThe researchers of this paper searched PubMed, Embase, Web of Science, and the Cochrane Central Register of Controlled Trials (CENTRAL) databases from inception to March 2022 to identify suitable RCTs. The included studies were evaluated for methodological quality using the Cochrane bias risk assessment tool. Twenty-one RCTs were included, with a total sample size of 898 participants. ResultsNetwork meta-analysis (NMA) revealed that indocyanine green (ICG) + near-infrared (NIR) diode laser, ICG+830 nm light-emitting diode (LED), indole-3-acetic acid (IAA) + 520 nm LED, and 5-aminolevulinic acid (ALA) + sunlight demonstrated obvious curative effects in patients with acne vulgaris. Importantly, ICG+NIR diode laser provided the greatest improvement in both inflammatory and non-inflammatory acne lesions (surface under the cumulative ranking curve [SUCRA]: 84.4% and 93.5%, respectively). ConclusionsBased on the NWM and SUCRA ranking, ICG + NIR diode laser can be considered more effective in treating acne than the other PDTs of the RCTs. However, this conclusion should be interpreted with caution due to the limitations of the present study.

The Role of Herbal Medicine in the Treatment of Acne Vulgaris: A Systematic Review of Clinical Trials.

Over the past few decades, interest in medicinal plants and phytochemicals for the treatment of skin disorders, including acne vulgaris, has progressively increased. Acne vulgaris is a chronic inflammatory disease of the pilosebaceous unit, which mainly occurs in adolescents and young adults. The treatment focuses on the four main factors involved in its pathogenesis: increased sebum production, hyperkeratinization, overgrowth of Cutibacterium acnes, and inflammation. The treatment includes topical retinoids, benzoyl peroxide, antibiotics, and oral isotretinoin. In this regard, the use of herbal medicine as a complementary and alternative medicine is a promising strategy. The main objective of this study was to systematically evaluate the efficacy and safety of medicinal plants and phytochemicals in the treatment of acne vulgaris. Three scientific databases (PubMed, Web of Science, and Scopus) were searched from inception to January 2021. Clinical trials comparing herbal therapies with placebo or other medicines for the treatment of acne vulgaris were included and analyzed. Outcome measures of interest comprised acne lesions (inflammatory and noninflammatory), sebum production, acne severity, and quality of life. The risk of bias in the included randomized controlled trials (RCTs) was assessed using the Cochrane risk-of-bias tool. A total of 34 clinical trials involving 1753 participants met the inclusion criteria for this systematic review. Most trials showed that herbal medicine significantly reduces inflammatory and noninflammatory acne lesions and has a relevant effect on acne severity. Some medicinal plants revealed equal or higher efficacy to standard treatments. No significant difference between groups in sebum production and quality of life was observed and no severe adverse events were reported. This systematic review provides evidence that medicinal plants and phytochemicals are promising treatments for mild to moderate acne vulgaris. However, more quality of evidence and standardized methodologies are needed to support their effectiveness and safety claims.

Role of Lactium™ in Psychodermatology: The CERTAIN Trial# on Patients with Acne Vulgaris.

Stress plays an important role in the causation and aggravation of psychodermatological conditions such as acne vulgaris. Alpha casein hydrolysate (αs1-casein hydrolysate; Lactium) has been shown to decrease serum cortisol levels, reduce stress-related symptoms, and promote relaxation. “This study aimed to compare the efficacy and safety of Lactium™ plus standard care to those of standard of care alone in reducing stress levels and acne severity in patients with acne vulgaris.” The C.E.R.T.A.I.N trial (Name registered with Clinical Trials Registry-India-No. CTRI/2019/01/017172) is a randomized, controlled, multicenter, open-label, two-arm, investigator-initiated clinical trial. A total of 100 patients with moderate-to-severe acne vulgaris were enrolled and randomly assigned to one of the two groups: Lactium™ plus standard care or standard care alone. Stress levels were assessed using serum cortisol levels, Investigator's Global Assessment (IGA) acne severity scale scores, Perceived Stress Scale (PSS) scores, and the Hamilton Anxiety Rating Scale (HAM-A) scores. The Dermatology Life Quality Index (DLQI) was also used to assess the impact of the skin disease on patients' quality of life. At 12 weeks, stress levels were significantly lower in group A (Nixiyax plus standard of care) than that in group B(only standard care), as measured by the change in serum cortisol levels (4.75 ± 4.46 vs. −0.24 ± 5.22). Furthermore, the mean change in PSS scores (3.09 ± 2.04 vs. 0.90 ± 2.76) and HAM-A scores (5.11 ± 1.94 vs. 1.25 ± 3.13) was significant. Patients in both arms had a significant decrease in total, inflammatory, and noninflammatory acne lesions, as well as a significant improvement in DLQI and IGA scores. In patients with moderate-to-severe acne vulgaris, Lactium™ was found to be both safe and well-tolerated. Lactium™ plus standard care is more effective than standard care alone in reducing acne severity through stress reduction.

Tazarotene 0.045% Lotion: A Novel Retinoid Formulation.

The aim of this study is to review the available data on efficacy and tolerability of tazarotene 0.045% lotion. A literature search of MEDLINE (PubMed) and EMBASE databases was completed in November 2021. Articles that discussed efficacy, tolerability, and pharmacology of tazarotene 0.045% lotion, written in English and published before mid-November 2021, were assessed. In two, 12-week phase III clinical trials, tazarotene 0.045% lotion had higher rates of treatment success (study 1: 25.5% and study 2: 29.6%) than individuals who received the vehicle (study 1: 13.0% and study 2: 17.3%) (both Ps < 0.001). Participants treated with tazarotene 0.045% lotion had greater least squares mean reduction in inflammatory (study 1: 55.5% and study 2: 59.5%) and noninflammatory (study 1: 51.4% and study 2: 60%) acne lesions when compared with vehicle (inflammatory acne lesions, study 1: 45.7% and study 2:49%; noninflammatory acne lesions, study 1: 41.5% and study 2: 41.6%) (P < 0.001 for studies 1 and 2). Tazarotene 0.045% lotion was well tolerated. Retinoids are first-line therapy in the treatment of acne vulgaris. However, many patients experience cutaneous irritation, which can decrease patient adherence and efficacy. Tazarotene 0.045% lotion is the first retinoid to utilize polymeric emulsion technology (PET) to efficiently distribute the medication across the skin, decreasing adverse effects while maintaining efficacy. Tazarotene 0.045% lotion is an effective and well-tolerated retinoid recently approved by the US Food and Drug Administration (FDA) for treating acne vulgaris in individuals 9 years of age and older.

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.

A topical gel of tea tree oil nanoemulsion containing adapalene versus adapalene marketed gel in patients with acne vulgaris: a randomized clinical trial.

Adapalene is used for treatment of acne vulgaris, a common dermatological disease. Nano-based carriers have been developed to improve solubility and bioavailability of adapalene and other acne treatment drugs. In our previous report, tea tree oil nanoemulsion containing adapalene gel (TTO NE + ADA Gel) showed appropriate physical and biological properties such as stability, viscosity, pH, size, morphology and biocompatibility in an animal model. The present study was designed to assess efficacy and safety of the TTO NE + ADA Gel in comparison with 0.1% adapalene marketed gel (ADA Marketed Gel). A total of 100 patients were randomized to receive TTO NE + ADA Gel or ADA Marketed Gel, once daily at night, for 12weeks. Analysis for efficacy was conducted by acne lesion count (total, inflammatory and non-inflammatory) and acne severity index at weeks 4, 8 and 12 using generalized estimating equation along with the safety assessments in each measurement for assessing dryness, erythema, burning sensation and irritation. Significantly better reduction in total, inflammatory, and non-inflammatory acne lesions were reported for TTO NE + ADA Gel as compared to the ADA Marketed Gel overall and on each measurement occasion (p value < 0.001 for all). Mean acne severity index also reduced with TTO NE + ADA Gel significantly in comparison with ADA Marketed Gel (p value < 0.001). Dryness was the most common adverse effect reported in both groups and it was higher in TTO NE + ADA Gel group. In conclusion, TTO NE + ADA Gel compared to ADA Marketed Gel appears more effective in the treatment of acne vulgaris, with no important change in adverse effects.

Asynchronous Teledermatology Assessment of Young Adult Acne Likely Concordant With In-Person Evaluation.

Telemedicine, defined as practicing medicine at a distance, has grown in popularity over the past ten years, as advances in consumer technology have permitted its expansion. Dermatology is a field that especially lends itself to this method of care, as many common dermatological diagnoses can be made upon visual inspection. With social distancing becoming the new standard in this age of COVID-19, telemedicine emerges as a key tool in continuing patient care without interruption. In this pilot study, we examine the reliability of acne vulgaris diagnostic assessments made via patient-taken photos compared to in-office assessments in patients between the ages of 16 and 23 with mild to moderate acne. Fourteen patient encounters were clinically examined for three outcomes: inflammatory lesions, noninflammatory acne lesions, and facial nodules. On the same day patient outcomes were counted and recorded in-person, patients were instructed to photograph their faces. These images were reviewed 8&ndash;12 weeks later by investigators for the same assessment. Initial findings suggest strong concordance between in-person and digital diagnosis, with a Spearman&rsquo;s correlation coefficient of 0.96 across all lesion and nodule scores. These data support further research on the expansion and implementation of telemedicine for dermatology. J Drugs Dermatol. 20(4):432-435. doi:10.36849/JDD.5688.

Assessment of serum interleukin-19 in acne vulgaris patients of different clinical severities.

Acne vulgaris (AV) is a common chronic inflammatory disorder of the pilosebaceous unit among adolescents and young adults. Inflammation does have a central role in formation of both inflammatory and noninflammatory acne lesions with production of proinflammatory cytokines. To measure serum levels of interleukin 19 (IL-19) in acne vulgaris patients with different severities, and compare it with healthy controls, to evaluate its role in pathogenesis of acne vulgaris and correlate it with acne severity. This study included 120 subjects, aged 18-30years, divided into four groups, 30 in each; mild, moderate, and severe AV patients groups according to acne severity as well as apparently healthy controls group of matched age and sex with no previous history of acne or active acne. Each patient was subjected to history taking, general and dermatological examination with assessment of acne severity. Serum IL-19 levels of both patients and controls were also measured using quantitative enzyme-linked immunosorbent assay (ELISA). Results revealed significant difference in serum IL-19 levels between acne patients and controls, being higher in the former group (P value is<0.001). Moreover, the rise in serum IL-19 levels was significantly proportional to the increased acne severity (P value<0.001). IL-19 is related to the etiopathological inflammatory process of acne vulgaris and correlates with acne severity. It could be proposed as a prognostic inflammatory marker for acne vulgaris.

Topical dermocosmetics and acne vulgaris.

Acne is a highly common skin disease especially among teenagers. Modern acne treatments are based also on the use of moisturizers, cleansers and sunscreens. In choosing the right cleanser, it is important to consider some aspects: the interaction between skin type and the cleanser, the optimal time and method of cleaning and the cosmetic perception of the patient. The aim of our review is to highlight the importance of choosing the most suitable topical dermocosmetics for the different skin types, as well as the most effective timing and method to combine dermocosmetics with the standard acne treatment. A search in literature for selected key words was performed using PubMed. Additional papers were identified based on author expertise. Treatment of acne patients should include education for proper daily skin hygiene, including protection from environmental damage. However, given the low number of clinical studies on cleansers, it is difficult to make reliable recommendations. The correct choice and use of topical dermocosmetics are fundamental in the management of acne patients. Daily use of moisturizers, cleansers and sunscreens can reduce both inflammatory and non-inflammatory acne lesion counts and may be helpful for acne treatment if combined with specific drugs.

The effects of green tea on acne vulgaris: A systematic review and meta-analysis of randomized clinical trials.

Green tea extract (GTE) has been studied for the treatment of acne based on its anti-inflammatory/antioxidant properties. This systematic review and meta-analysis aimed to examine the effects of GTE on acne. Electronic databases, including PubMed, Embase, and the Cochrane Library were systematically searched up to August 2019. The effect size of acne lesion counts is presented as mean differences and 95% confidence intervals (CIs). Five randomized-controlled studies were included in the meta-analysis (N; experimental = 125, control = 122). GTE significantly reduced the number of inflammatory lesions (-9.38; 95% CI: -14.13 to -4.63). In subgroup analysis, topical GTE application significantly reduced the inflammatory lesion counts (-11.39; 95% CI: -15.91 to -6.86) whereas oral GTE intake showed minimal effect (-1.40; 95% CI: -2.50 to -0.30). Although GTE did not significantly reduce the number of non-inflammatory lesions (-21.65; 95% CI: -47.52 to 4.22), when stratified by the route of admission, non-inflammatory acne lesions were significantly reduced by topical GTE application (-32.44; 95% CI: -39.27 to -25.62) but not with oral GTE administration (0.20; 95% CI: 0.00 to 0.40). This systematic review and meta-analysis suggest that topical GTE application is beneficial for the treatment of acne without causing significant adverse events while oral GTE intake has limited effects. Further high-quality clinical trials are warranted.

Efficacy of IPL therapy for the treatment of acne vulgaris: A meta-analysis.

Intense pulse light (IPL) has been adopted by numerous patients. However, no existing study has analyzed the efficiency and safety of IPL in the treatment of acne vulgaris. To assess the efficiency and safety of IPL in the treatment of acne vulgaris. Electronic databases, including Embase, Cochrane Library, and MEDLINE, were retrieved to identify related studies. In this study, the primary and secondary outcomes were the mean percentage reduction of inflammatory acne lesion improvement (MPRI) and the mean percentage reduction of noninflammatory acne lesion improvement (NMPRI), respectively. Between-study heterogeneities were assessed using theI2 statistic. Eight randomized controlled trials (RCTs) including 450 patients were enrolled into the present analysis. With regard to MPRI, the result of IPL group was poorer than that of control group [mean deviation (MD)=-4.37 (95% confidence interval CI: -7.83, -0.91), P=.01]. In addition, the efficiency of IPL was poor among African and Asian populations [MD=-3.87 (95% CI: -7.36, -0.37), P=.03; MD=-28.37 (95% CI: -52.26, -4.18), P=.02]. Meanwhile, difference in the efficiency between IPL and 1064nm Nd:YAG was not statistically significant [MD=-3.25 (95% CI: -7.01, -0.51). P=.09]. Besides, the efficiency of IPL was lower than that of PDL [MD=-28.37 (95% CI: -52.26, -4.18), P=.02]. There was no statistically significant difference in the efficiency between IPL and other treatments for NMPRI. With regard to adverse effects, erythema (46.73%) and pain (39.13%) were the most common. IPL is not so efficient as other supplementary therapies. For inflammatory acne lesions, the efficiency of IPL is poorer than that of PDT. Difference in geographic regions may affect the IPL efficiency. However, the results obtained in this study should be cautiously interpreted due to the heterogeneities and the lack of studies with a large sample size.

Evaluation of Efficacy and Safety of AHPL/AYCAP/0413 Capsule and AHPL/ AYTOP/0213 Cream in Patients Suffering from Acne Vulgaris

Background: Available treatments for acne vulgaris are associated with various adverse effects, which necessitate patients to opt for alternative treatment options. Objectives: To evaluate efficacy and safety of AHPL/AYCAP/0413 capsule and AHPL/AYTOP/0213 cream in subjects suffering from Acne Vulgaris. Method: A total of 62 subjects completed the study. Subjects were advised to take 2 capsules of AHPL/AYCAP/0413 twice daily orally after meals with water and apply AHPL/AYTOP/0213 cream all over the face twice a day for two months or complete resolution of acne whichever was earlier. The primary objective was to assess changes in total number of inflammatory acne lesions on face. Secondary objectives were to assess changes in total numbers of noninflammatory acne lesions, total lesion count (inflammatory and non-inflammatory), acne severity, acne scarring, signs and symptoms, skin lightening effect, post acne dark spots, adverse events and laboratory investigations. Results: The mean inflammatory acne lesion count reduced significantly from 7.94 ± 5.91 (baseline visit) to 1.89 ± 3.06 (p=0.001) at the end of treatment. Significant reduction in total numbers of non-inflammatory acne lesions, total lesion count, acne severity and signs and symptoms of acne were observed at the end of treatment. Also improvement in skin colour, severity of post acne dark spot and reduction in numbers of post acne dark spots were observed at the end of treatment. Laboratory parameters were within normal limits both at pre and post treatment. Conclusion: AHPL/AYCAP/0413 capsule and AHPL/AYTOP/0213 cream is safe and significantly effective for treatment of acne vulgaris.

A Correlation between Serum Level of Alkaline Phosphatase and Acne Severity in Children and Adolescents: A Retrospective Cross-Sectional Study.

BackgroundAcne is a chronic inflammatory disease of the pilosebaceous unit and usually affects adolescents when the peak concentrations of growth hormone, insulin-like growth factor 1, and androgen are demonstrated. The activity of alkaline phosphatase (ALP), which increases physiologically in growing children and adolescents, in the pilosebaceous unit has been reported. However, the correlation between the serum level of ALP and the number of acne lesions has not been studied.ObjectiveThe present cross-sectional study was designed to evaluate the correlation between serum level of ALP and the numbers of non-inflammatory and inflammatory acne lesions in children and adolescents.MethodsFor this study, 202 pediatric and adolescent patients clinically diagnosed with acne vulgaris were included. Age, sex, serum level of ALP, number of non-inflammatory acne lesions, number of inflammatory acne lesions, and number of total acne lesions were evaluated. Additionally, the serum level of dehydroepiandrosterone sulfate was evaluated in 117 patients. Multiple regression analysis was performed. Multicollinearity was quantified using the variance inflation factor.ResultsIn the 202 patients, serum level of ALP was the only independent factor that significantly affected both the number of non-inflammatory acne lesions and of total acne lesions (regression coefficient=0.089 and 0.086, respectively, p<0.001).ConclusionThere was a significant correlation between serum level of ALP and the extent of acne (non-inflammatory acne lesions and total acne lesions).

Nd:YAG laser vs IPL in inflammatory and noninflammatory acne lesion treatment.

Several topical and systemic therapies are available for the treatment of acne vulgaris but are associated with several limitations, and recently, intense pulse light (IPL) and long-pulsed 1064nm Nd: YAG laser have shown efficacy. The current study aimed to compare the efficacy of Nd:YAG laser and IPL in inflammatory and noninflammatory acne lesions. Thirty patients with inflammatory and noninflammatory facial acne were assigned randomly and equally into two groups, the Nd:YAG and IPL groups. The patients received three sessions of laser 2weeks apart, and the clinical improvement was assessed by the reduction in the number of lesions. At baseline, the two groups showed a nonsignificant difference as regards total number (P=.476), inflammatory (P=.457), and noninflammatory lesions (P=.420). The improvement in total lesions was significant in the Nd:YAG Group but nonsignificant in the IPL Group (P<.001, P=.13, respectively). Three patients (20%) in the IPL Group showed exacerbation after the first and second sessions. One month after the last session, the difference in improvement between noninflammatory and inflammatory lesions showed a significant difference in the Nd:YAG Group (P=.017) and a nonsignificant difference in the IPL Group (P=.823). Nd:YAG, compared to the IPL Group, showed a significant difference as regards the improvement score in noninflammatory lesions (P=.0099) and a nonsignificant difference in inflammatory lesions (P=.4295). The significant improvement in noninflammatory lesions and the absence of a significant flare-up of acne as seen among patients treated with IPL make Nd:YAG a better therapeutic modality for acne.

Clinical efficacy of herbal extracts in treatment of mild to moderate acne vulgaris: an 8-week, double-blinded, randomized, controlled trial

Background Herbal extracts with fewer adverse effects can be an alternative to these drugs because they can target various molecular pathways of acne pathogenesis. Objectives To evaluate the clinical efficacy of herbal extracts (mangosteen, Lithospermum officinale, Tribulus terrestris L., Houttuynia cordata Thunb) for the treatment of mild to moderate acne vulgaris. Methods Sixty patients were randomized in a 1:1 ratio to receive blinded treatment with herbal extracts or vehicle for 8 weeks. Inflammatory and non-inflammatory acne lesion counts, Investigator’s Global Assessment, patient’s satisfaction and safety profiles were assessed. We also performed skin biopsy at baseline and week 8 to confirm immunological changes with immunohistochemistry staining. Results By the end of the study period, both inflammatory and non-inflammatory acne lesion counts were significantly decreased in herbal extracts group (p< .05). In immunohistochemistry staining, expressions of IL-1α, IL-8, and keratin 16 were significantly decreased in herbal extracts group compared to vehicle group from baseline to week 8. There was no serious adverse events in both groups. Conclusions This herbal extracts can be a new therapeutic option for patients with mild to moderate acne vulgaris who are reluctant to use drugs.