Pathogenesis Of Acne Vulgaris Research Articles

The assessment of the minimum inhibitory concentration of Botulinum toxin on Staphylococcal bacteria isolated from Acne vulgaris and validating its impact through Polymerase Chain Reaction analysis

Acne vulgaris (AV) is an inflammation of pilosebaceous unit which commonly occurs in adolescence. Staphylococcus aureus is also involved in AV pathogenesis. This study included isolating and diagnosing 35 samples of bacteria isolated from acne by the aerobic method and dividing them according to their sensitivity to methicillin,10 samples were used in determining the extent of the effect of different concentrations of Botulinum toxin on bacteria using PCR technology. The results obtained 2.5mg/ml as the MIC for the bactria. Botox treatment at 2.5mg/ml demonstrated molecular effects, causing a lack of PCR binding in selected samples. This suggests a potential disruption in gene transcription or DNA degradation, aligning with international studies showcasing Botox's molecular impact on acne-related Staphylococcus aureus, supporting its role in combination therapy for bacterial control. Botox, renowned for cosmetic use, is also under investigation for medical applications like treating acne. Research suggests that Botox may reduce acne by minimizing sebum production and inhibiting bacteria associated with acne, particularly Staphylococcus aureus. Global studies support these findings, revealing potential applications beyond cosmetics, expanding into acne treatment.

Acne: role of Cutibacterium acnes and possibilities of using bacteriophages

BACKGROUND: The role of Cutibacterium acnes in the pathogenesis of acne vulgaris and its adverse effect on follicular hyperkeratosis, inflammation and the skin microbiome have now been established. Their excessive colonization contributes to the loss of microbial diversity of the skin, activates the innate immune system, leads to the appearance of skin rash elements and chronic inflammation. Bacteriophages are considered as a new promising direction in the treatment of patients with acne, as they have an antimicrobial effect against C. acnes; contribute to the preservation of the skin microbiome; have an indirect effect on the innate and adaptive immune response. AIM: To evaluate the effectiveness and safety of topical therapy with cosmetic gel with bacteriophages Fagoderm in the complex treatment of patients with moderate to severe acne. MATERIALS AND METHODS: In the design of a simple open prospective study in parallel groups, the effect of cosmetic gel with bacteriophages on the number of comedones, pupules and pustules was assessed in 35 adult patients with moderate acne. During therapy, possible adverse events were simultaneously recorded. RESULTS: During therapy, similar dynamics were noted in the form of a decrease in non-inflammatory elements of acne both in the group of people receiving a combination of adapalene and phagoderm, and in the comparison group, where monotherapy with adapalene was carried out. The number of inflammatory elements of acne decreased in both groups, but in the main group this happened at an earlier time. Compared to the initial data, already in the 2nd week the number of inflammatory elements decreased by 50% (in comparison ― by 32%); by the end of the 4th ― by 95% (respectively in the comparison group ― by 74%). CONCLUSION: Cosmetic gel with bacteriophages with bacteriophages helps reduce the inflammatory manifestations of moderate acne.

Serum Catestatin Levels in Patients with Acne Vulgaris: Single-Center Prospective Study

Introduction: Recent studies showed that antimicrobial peptides have an essential role in the pathogenesis of acne vulgaris. This study aims to investigate serum catestatin levels in acne vulgaris patients and focuses on the change in serum levels after systemic isotretinoin therapy. Methods: This prospective study includes 101 acne vulgaris patients and 28 healthy controls. Serum catestatin levels were measured and compared between acne vulgaris and control group patients. Also, serum catestatin levels were measured again at the 24th week of isotretinoin therapy. Results: The serum catestatin levels in patients with acne vulgaris were statistically higher than in the control group (p < 0.001). In addition, serum catestatin levels were associated with the severity of acne vulgaris. A significant decrease in serum catestatin levels was detected after 24 weeks of systemic isotretinoin treatment. Conclusion: Catestatin was found to be significantly higher in the serum of patients with acne vulgaris compared to the control group. Although, the demonstration that catestatin levels decrease with isotretinoin treatment may indicate that it may have an important role in the pathogenesis of acne and could be used as a biomarker, future studies are needed to establish the role of catestatin in the pathogenesis of acne vulgaris.

Poly-β-(1→6)-N-acetyl-D-glucosamine mediates surface attachment, biofilm formation, and biocide resistance in Cutibacterium acnes.

The commensal skin bacterium Cutibacterium acnes plays a role in the pathogenesis of acne vulgaris and also causes opportunistic infections of implanted medical devices due to its ability to form biofilms on biomaterial surfaces. Poly-β-(1→6)-N-acetyl-D-glucosamine (PNAG) is an extracellular polysaccharide that mediates biofilm formation and biocide resistance in a wide range of bacterial pathogens. The objective of this study was to determine whether C. acnes produces PNAG, and whether PNAG contributes to C. acnes biofilm formation and biocide resistance in vitro. PNAG was detected on the surface of C. acnes cells by fluorescence confocal microscopy using the antigen-specific human IgG1 monoclonal antibody F598. PNAG was detected in C. acnes biofilms by measuring the ability of the PNAG-specific glycosidase dispersin B to inhibit biofilm formation and sensitize biofilms to biocide killing. Monoclonal antibody F598 bound to the surface of C. acnes cells. Dispersin B inhibited attachment of C. acnes cells to polystyrene rods, inhibited biofilm formation by C. acnes in glass and polypropylene tubes, and sensitized C. acnes biofilms to killing by benzoyl peroxide and tetracycline. C. acnes produces PNAG, and PNAG contributes to C. acnes biofilm formation and biocide resistance in vitro. PNAG may play a role in C. acnes skin colonization, biocide resistance, and virulence in vivo.

Macrophages in acne vulgaris: mediating phagocytosis, inflammation, scar formation, and therapeutic implications.

Macrophages serve as a pivotal nexus in the pathogenesis of acne vulgaris, orchestrating both the elimination of Cutibacterium acnes (C. acnes) and lipid metabolic regulation while also possessing the capacity to exacerbate inflammation and induce cutaneous scarring. Additionally, recent investigations underscore the therapeutic potential inherent in macrophage modulation and challenge current anti-inflammatory strategies for acne vulgaris. This review distills contemporary advances, specifically examining the dual roles of macrophages, underlying regulatory frameworks, and emergent therapeutic avenues. Such nuanced insights hold the promise of guiding future explorations into the molecular etiology of acne and the development of more efficacious treatment modalities.

Association of different cell types and inflammation in early acne vulgaris.

Acne vulgaris, one of the most common skin diseases, is a chronic cutaneous inflammation of the upper pilosebaceous unit (PSU) with complex pathogenesis. Inflammation plays a central role in the pathogenesis of acne vulgaris. During the inflammatory process, the innate and adaptive immune systems are coordinately activated to induce immune responses. Understanding the infiltration and cytokine secretion of differential cells in acne lesions, especially in the early stages of inflammation, will provide an insight into the pathogenesis of acne. The purpose of this review is to synthesize the association of different cell types with inflammation in early acne vulgaris and provide a comprehensive understanding of skin inflammation and immune responses.

ANTIBACTERIAL ACTIVITY OF DR. RIDZ ANTI-ACNE NANOSERUM® AGAINST SKIN BACTERIA THAT CAUSE ACNE VULGARIS

Cutibacterium acnes, Staphylococcus epidermidis, and Staphylococcus aureus are commonly associated with the pathogenesis of acne vulgaris. Skincare products that contain natural ingredients have become a trend to treat acne. Dr.Ridz Anti-Acne Nanoserum® product was formulated with the extract of Cassia alata leaf and Piper betle. The aim of this study was to determine the antibacterial activity of this formulated product against against C. acnes, S. epidermidis, and S. aureus. The minimum inhibitory concentration (MIC) value and the minimum bactericidal concentration (MBC) were determined using a broth microdilution and a streak plate method, respectively. The rate of killing by this product was tested using time-kill assay (TKA) at 0.5x MIC, 1x MIC, and 2x MIC with incubation periods of 2, 4, 6, 8 10, 12, and 24 hours. The MIC values showed that this product inhibited S. epidermidis and S. aureus better than C. acnes. From the calculation of the MBC/MIC ratio, this product showed bactericidal effects against all tested bacteria. The time-kill studies showed that the killing effect of this product was concentration-dependent, and the highest antibacterial activity was observed at the concentration of 2x MIC against all tested bacteria. In conclusion, Dr.Ridz Anti-Acne Nanoserum® exhibits the best antibacterial activities against S. epidermidis and showed a bactericidal effect towards all tested bacteria. .

Polymorphism of Rs1800629 Gene of TNF-Α in the Pathogenesis of Acne Vulgaris

Background: The study of the association between acne vulgaris and the TNF-gene polymorphism rs1800629 in the Uzbek population is discussed in this article. Methodology: The research was conducted on 165 patients with various clinical forms of acne vulgaris and 161 healthy donors. Findings: During this research, allele frequencies and genotypes of rs1800629 polymorphism of TNF-α gene were found with statistically significant differences between the control group and subgroups of patients with acne vulgaris. As a result of the investigation, it was discovered that heterozygous genotype G/A should be a genetic marker for an increased risk of acne development, whereas homozygous genotype G/G should be a marker for a reduced risk of acne formation.

Skin Barrier Parameters in Acne Vulgaris versus Normal Controls: A Cross-Sectional Analytic Study.

Data of objective skin barrier parameters in acne patients with and without therapy compared with normal controls are limited. This information could provide more insight into the pathogenesis of acne vulgaris and optimal acne treatment. To measure and compare skin barrier parameters in a large cohort of acne patients with and without therapy compared with normal controls. This cross-sectional analytic study was conducted on healthy Thai volunteers. After completing a questionnaire on their general information and skincare routine, volunteers received a full skin examination and were divided into subjects with and without acne. Skin barrier parameters, including the transepidermal water loss (TEWL), skin hydration and sebum production were measured and compared between the two groups. Factors that may affect each parameter were analysed and adjusted for in a multivariate regression analysis. In addition, data from acne patients with and without treatment were evaluated. The study included 316 volunteers (164 acne patients, 152 controls), mostly female (79% acne, 78% controls). The mean age of the acne group was considerably lower than that of the control group (34 vs 48.6 years (p < 0.001)). Acne patients showed significantly higher TEWL (13.16 vs 10.63 g/m²/day, p < 0.001), sebum production (median 3 vs 0 A.U, p = 0.002), and skin hydration (244.60 vs 222.60 uS, p = 0.001). These differences remained significant after adjusting for confounding factors. Additionally, significant differences were observed between controls, acne. Patients receiving and not receiving acne medications. The highest TEWL was observed in acne patients receiving treatment, followed by untreated acne patients and normal controls (p = 0.0003). Skin hydration exhibited a comparable pattern (p = 0.03). There were significantly higher TEWL, sebum production and hydration in acne patients. Acne treatment further impaired the skin barrier. These findings support the possible benefits of moisturisers with barrier-enhancing properties in patients receiving acne medications.

Effects of oral isotretinoin treatment for acne vulgaris patients on anger responses and the relationship with temperament.

Isotretinoin is the only medication against all the factors involved in acne vulgaris pathogenesis. The aim of our study was to verify whether patients with acne vulgaris receiving isotretinoin therapy exhibit elevated anger levels and to observe the correlation between age, temperament traits, and anger. The study group comprised a sum of 100 cases, involving 50 individuals with acne vulgaris-required high-dose retinol therapy and 50 controls who did not start any medication. Our study showed that anger levels increased with drug use. A positive correlation between cyclothymic temperament, the anxiety-related behavior subdimension, and the introvert and passive-aggressive subdimension of interpersonal anger reactions has been recognized. In addition, a positive one was observed between hyperthymic temperament and the introvert subdimension, which is one of the anger-related thoughts and interpersonal anger reactions. This study elucidates anger dimensions such as anger-related thoughts, behaviors, and reactions in individuals who received retinol treatment for acne vulgaris. In addition to anger and its dimensions, temperament was also investigated. Although several studies have investigated the relationship between acne vulgaris and psychiatric symptoms, to the best of our knowledge, no research has been reported in the English-language literature regarding the relationship between anger dimensions and temperament after retinol treatment that might make our study an original and valuable contribution to the literature.

Serum Interleukin-19 Levels in Acne Vulgaris Patients of Varying Clinical Severity in Erbil City.

Background Acne vulgaris (AV) is a common multifactorial disorder affecting the pilosebaceous units. Research has shown that inflammation plays a crucial role in the pathogenesis of AV, including both inflammatory and non-inflammatory acne. Several studies have linked proinflammatory cytokines to AV; however, only a few have explored the correlation between interleukin-19 (IL-19) and AV. Our aim is to estimate the level of IL-19 in patients with AV compared to matched controls and to investigate the role of IL-19 in the pathogenesis of acne. Materials and methods This prospective cross-sectional case and control study includes 80 patients and 40 matched controls. Patients were divided into mild (20), moderate (40), and severe (20) groups based on their global acne score severity index. Detailed history and complete general and dermatological examinations were taken from each patient. Furthermore, 5 ml of blood was taken from all participants to assess the level of IL-19. Results IL-19 levels were significantly higher in patients with AV compared to matched controls. Furthermore, IL-19 concentrations were found to be proportional to the severity of acne, with the highest levels detected in patients with severe AV (p-value <0.005). Conclusion IL-19 levels in AV were significantly higher than in matched control. The difference was proportional to its severity. This might indicate IL-19 as an inflammatory marker and could potentially be related to AV.

DNA methylation profiling and integrative multi-omics analysis of skin samples reveal important contribution of epigenetics and immune response in the pathogenesis of acne vulgaris

The regulatory effect of DNA methylation on the pathogenesis of acne vulgaris is completely unknown. Herein we analyzed the DNA methylation profile in skin samples of acne vulgaris and further integrated it with gene expression profiles and single-cell RNA-sequencing data. Finally, 31,134 differentially methylated sites and 770 differentially methylated and expressed genes (DMEGs) were identified. The multi-omics analysis suggested the importance of DNA methylation in inflammation and immunity in acne. And DMEGs were verified in an external dataset and were closely related to early inflammatory acne. Additionally, we conducted experiments to verify the mRNA expression and DNA methylation level of DMEGs. This study supports the significant contribution of epigenetics to the pathogenesis of acne vulgaris and may provide new ideas for the molecular mechanisms of and potential therapeutic strategies for acne vulgaris.

Evaluation of serum adiponectin and lipid profile in patients with acne vulgaris

Background Acne vulgaris is a chronic inflammatory disease of the pilosebaceous unit and is among the most common dermatological conditions worldwide. Adipokines are bioactive molecules secreted by adipocytes. Adiponectin is the most abundant adipokine. It has multiple properties, which includes sensitization of insulin, anti-inflammatory, and antiatherogenic effect. Objectives This study aims to evaluate serum adiponectin and lipid profile levels in patients with acne vulgaris and their correlation with each other and disease severity. Patients and methods This is a case-control study, conducted on a total of 90 patients with acne vulgaris and matched age, sex, and body mass index 70 healthy controls. Serum adiponectin and lipid profile levels were evaluated in all subjects. Results Total cholesterol (TC), total triglycrides (TG) and low density lipoprotein (LDL) were significantly higher in acne vulgaris cases, while high density lipoprotein (HDL) was statistically significant lower in cases compared to controls. Adiponectin concentration was significantly higher in acne vulgaris cases when compared to control group with positive correlations with female gender, disease severity, TC, LDL and significant negative correlation with HDL. Conclusions Adiponectin may play a role in the pathogenesis of acne vulgaris and may affect its severity. Evaluation of all acne patients for lipid profile and advice for healthy diets as an adjuvant method to acne treatment.

A cross-sectional study examining the prevalence of antibiotic-resistant Cutibacterium acnes isolated from patients with acne in Bangkok, Thailand.

Cutibacterium acnes is associated with the pathogenesis of acne vulgaris (AV). The relationship between antibiotic-resistant C. acnes and AV remains unclear. The authors aimed to determine the prevalence of antibiotic-resistant C. acnes and investigate the association of acne severity with topical and systemic treatments in patients with acne. Samples were collected of inflammatory and noninflammatory acne, including closed and open comedones and erythematous papules/pustules from the face of patients with mild to severe acne. The samples were cultured under anaerobic conditions for the isolation of C. acnes. Antibiotic susceptibility tests for erythromycin, tetracycline, doxycycline, clindamycin, and trimethoprim/sulfamethoxazole were performed using the agar dilution method. From 153 patients, 143 viable C. acnes samples were isolated (93.5%). They were found resistant to trimethoprim/sulfamethoxazole (143/143, 100%), clindamycin (108/143, 75.5%), erythromycin (105/143, 73.4%), tetracycline (74/143, 51.7%), and doxycycline (73/143, 51.1%). There was no significant correlation between the prevalence of antibiotic resistance and acne severity. High-level resistant C. acnes correlated with higher clinical severity of acne in patients taking doxycycline (τb = 0.3). The present prevalence of antibiotic-resistant C. acnes was high in Thailand. Antibiotic stewardship in AV treatment should be encouraged to prevent further antibiotic resistance crises.

Comparison of acne vulgaris patients and healthy controls in terms of autistic features and 2D:4D ratio

Objective In the pathogenesis of acne vulgaris; androgen hormones are mentioned as an important factor for affecting sebaceous gland differentiation. Intrauterine exposure to androgen hormones is associated with autism and autistic features. An important indicator of androgen exposure is the 2D:4D ratio. In this study, we aimed to compare acne vulgaris patients with healthy controls in terms of autistic features and 2D:4D ratio. Method The study was carried out in the outpatient unit of the Department of Dermatology and Venereology, Atatürk Training and Research Hospital, Ankara Yıldırım Beyazıt University School of Medicine. 104 patients aged between 18-40 years old diagnosed with acne vulgaris and 123 healthy controls were included in the study. The sociodemographic data form was completed by the researcher and 2D:4D ratios were measured. Autistic features were measured with the Autism Spectrum Quotient. Informed consent was obtained from all participants. Results In the analysis, 2D:4D ratios were found to be significantly lower in male gender than female gender. Both hands analyzed separately for 2D:4D ratio. There were no significant differences between the two groups in terms of 2D:4D ratios. In addition, in terms of mean 2D:4D ratios, no significant difference was found both the whole sample and the male and female gender between patient and control group. There was no significant difference between patient and control group in terms of autism spectrum quotient scores when evaluated the whole sample and male and female separately. Conclusion As a result of this study; new data on the relationship between acne and 2D:4D ratios, which are rarely associated with previous studies, have been obtained. The relationship between acne and autistic features, which were not previously examined, was assessed with this study. According to our knowledge, this is the first study to evaluate the relationship between acne and autistic features.

Assessment of plasma testosterone, estradiol, and progesterone levels in Vietnam female patients with moderate to severe acne vulgaris

Introduction: Acne is a chronic inflammatory disorder of the pilosebaceous unit with differential pathogenesis. To elucidate the roles of hormones in acne pathogenesis, we conducted a study to evaluate the plasma testosterone, estradiol, and progesterone levels in women with acne vulgaris. Methods: We conducted a cross-sectional descriptive study, and 140 women with acne vulgaris were examined; their plasma estradiol, progesterone, and testosterone were analyzed by chemiluminescence technique and compared with the healthy control group. Results: Increased plasma hormone levels in women with acne vulgaris accounted for 33.57%, and hyperandrogenism accounted for 20.71% of cases. We found significant differences in testosterone levels (mean value, 56.92 ± 27.64ng/dL, 60.71± 25.85ng/dL versus 38.35 ± 10.09ng/dL, p&lt;0.01), respectively, in the moderate to severe acne group and the control group. However, the estradiol level of the moderate and severe acne groups (325.12 ± 91.79 and 305.26 ± 83.01pmol/l) was lower than the control group (368.6 ± 58.34pmol/l), with p-value under 0.05. No statistically significant differences were found for progesterone levels. Conclusion: Female patients with moderate to severe acne vulgaris had abnormalities in plasma testosterone and estradiol levels. These abnormalities might be part roles in the pathogenesis of acne vulgaris, even when the mean levels were in the normal range.

The impact of physical activity, diet and stress on acne vulgaris. Pathogenesis and therapeutic procedures

Introduction Acne vulgaris is the most common skin disease that affects the majority of the population. Concepts on the pathogenesis of this disease have been changing over the years, as evidenced by the current indication of the precedence of inflammatory or immunological processes over disorders of keratinization of the outlets of hair and sebaceous units during the formation of acne lesions. Due to the complexity of the etiopathogenesis of acne vulgaris, the selection of appropriate therapeutic management is sometimes complicated. In addition, the process of treating the disease is multifaceted and time-consuming. Purpose The purpose of this review is to present the current state of knowledge on the effects of physical activity, diet and stress on acne vulgaris, as well as on the pathogenesis of acne vulgaris and the therapeutic management of patients suffering from this disease. Methods Literature was searched in PubMed and Google Scholarship databases. Publicly available books were searched. Results There is a proven precedence of inflammatory or immune processes over disorders of the keratinization of the estuaries of hair and sebaceous units during the formation of acne lesions. Conclusions Specialists should delve into the mechanism of the problem visible on the patient's skin to effectively and permanently cure the disease.

Evaluation of Serum Levels of Interleukins 6, 8, 17 and 22 in Acne Vulgaris: A Cross-Sectional Study.

Acne vulgaris (AV) is a chronic, multifactorial, inflammatory skin disease, and it is now becoming increasingly clear that the inflammatory pathway is involved at a very early in the pathogenesis of acne. The Th17 cells, the activators of this cell line and its downstream effector cytokines, are all likely to have a critical role in inducing and maintaining the disease. To analyse the role of interleukins (ILs) 6, 8, 17 and 22 in the pathogenesis of acne. Sixty patients of AV and thirty age- and sex-matched controls were included in our study. Serum levels of interleukins 6, 8, 17 and 22 were determined using an enzyme-linked immunosorbent assay (ELISA), and thereafter, levels were correlated with the severity of acne. Serum levels of IL-6, IL-8, IL-17 and IL-22 were 0.15 ± 0.0174 pg/ml, 0.38 ± 0.080 pg/ml, 0.19 ± 0.0075 pg/ml and 0.23 ± 0.0152 pg/ml in cases, respectively, and 0.13 ± 0.0095 pg/ml, 0.14 ± 0.034 pg/ml, 0.13 ± 0.0033 pg/ml and 0.21 ± 0.0099 pg/ml in controls, respectively. The difference in levels between cases and controls was significant for IL-8 and IL-17, while for IL-6 and IL-22 the difference was insignificant. There was a highly significant positive correlation between IL-8 and IL-17 levels. IL-6 and IL-8 showed a significant positive correlation with the severity of disease. IL-8 and IL-17 play a critical effector role in the pathogenesis of AV. IL-6-stimulated Th17 cells are likely the major producers of IL-8 in acne lesions.

In vivo cytogenotoxicity testing of isotretinoin by the micronucleus assay in the blood of male Sprague-Dawley rats Isotretinoin is cytotoxic and genotoxic

Isotretinoin (ISO), one of vitamin A-derived retinoids, is comparatively the most widely prescribed drug in acne vulgaris pathogenesis. Despite its excellent therapeutic success, the systemic use of this drug showed undesirable serious side effects such as teratogenesis, oxidative stress, and genotoxicity. The uses of retinoids in cancer therapy are limited due to severe adverse reactions. This has led the scientific community to ask for further studies qualifying ISO features and comparing their efficacy and safety. The purpose of this study was to evaluate the cytogenotoxicity of multiple oral doses (5, 10, 15, and 20 mg/kg, daily for seven consecutive days) of ISO in male Sprague-Dawley rats. The micronucleus assay was used to investigate genotoxicity biomarkers such as the percentage of micronucleated polychromatic erythrocytes (%MNPCEs) and the percentage of aberrant cells (%Abc). Another goal was to test the cytotoxicity of the drug by measuring the ratio between PCEs and normochromatic erythrocytes (NCEs) (PCEs/NCEs). In comparison with the control, the three cytogenetic endpoints: %MNPCEs, P/N, and %Abc significantly (P ≤ 0.0017) dose-dependent increase. This suggested genotoxicity and cytotoxicity of the tested ISO doses. Therefore, the therapeutic uses of ISO should be restricted to a very narrow range border. Further studies are needed to shed more light on the safety profile of ISO therapy.

OXIDATIVE STRESS IN ACNE VULGARIS

Objective: Acne vulgaris is a common dermatological disease characterized by sebaceous hyperplasia, follicular hyperkeratinization, Immune reactions, and Inflammation. Our study aims to determine the role of oxidative stress in the pathogenesis of acne vulgaris. Methods: 35 acne patients and 35 healthy people were selected and their serum levels of superoxide dismutase SOD and Malondialdehyde MDA were estimated and the results are compared with the control group. Also, the relationship between the duration and severity of acne with the parameters is assessed. Results: The activity of SOD is found to be decreased and the level of MDA is found to be increased in acne patients compared to healthy people, suggesting increased oxidative stress in Acne vulgaris patients. Conclusion: Our study concludes that oxidative stress plays a role in the pathogenesis of Acne vulgaris and antioxidants can be used as a part of treatment.