Acne Research Articles

Efficacy of diluted botulinum toxin type A (Microbotox) in treatment of mild to moderate acne vulgaris.

Acne vulgaris is a common and challenging condition to treat. To assess the effect of botulinum toxin type A (BTX-A) in the treatment of mild to moderate acne vulgaris. This study included 30 patients with mild to moderate acne vulgaris treated with intradermal injections of diluted BTX-A (microbotox) on the cheek in a regular grid pattern using very small droplets (microbotox). Cases were assessed by acne grading of severity by Investigator's Global Assessment of acne (IGAs) at baseline, at 1month and after 4months follow-up. IGA of acne at baseline ranged between 2 to 3 with a mean of 2.77 ± 0.430 and decreased significantly to 0.93 ± 0.868 after 4months. There were highly statistically significant differences between different follow-up periods according to Investigator's Global Assessment of acne. IGA on acne showed that 6 (20.0%) had fair improvement, 11 (36.7%) had good improvement and 9 (30.0%) demonstrated excellent improvement. Microbotox presents an approach to oily skin and acne vulgaris management. The multifaceted actions of BTX-A offer promising avenues for addressing the complex pathophysiology of this inflammatory condition pending verification by larger controlled multicenter studies.

Photodynamic Therapy Effects with Curcuma longa L. Active Ingredients in Gel and Blue LED on Acne: A Randomized, Controlled, and Double-Blind Clinical Study

Photodynamic therapy (PDT) using the photosensitizer curcumin and blue light has a relevant effect on bacteriological decontamination caused by C. acne. The aim is to verify PDT’s effectiveness with curcumin in individuals diagnosed with moderate to severe acne. This study was carried out on a total of 35 volunteers of both genders (12–32 years old), with moderate to severe acne vulgaris. The volunteers were randomized into five groups: L (LED), V (Vehicle), C (Curcumin), L + V (LED + Vehicle), and L + C (LED + Curcumin). The curcumin gel and LED with blue wavelength (450 nm ± 10 nm) were used. Qualitative and quantitative evaluations were used to verify the efficacy of the treatment by counting inflamed and non-inflamed lesions. The L + C group until day 30 showed a lower percentage of inflammatory lesions than the Vehicle group for the same period. On day 60, the L + C group showed lower inflammatory lesion values compared to the other groups. Intragroup analysis of hydration in the Vehicle group (V) showed a difference on days 30 and 60 compared to day zero. In an intragroup analysis, the L + C group showed a decrease in the mean scores on day 30, and day 60 compared to day zero, showing an improvement in the psychosocial status of these volunteers. Taken together, our results showed that the combination of blue LED therapy and curcumin proved to be an effective and safe treatment for reducing inflamed acne lesions in individuals with moderate to severe acne, while also enhancing their quality of life from a psychosocial perspective.

The Role of Fractional Radiofrequency in Long-term Acne Remission and Reduction of Acne Scar Load.

Acne is an inflammatory skin disease afflicting the majority of the world's population at some point in their lifetime, and is seen to be chronic in about 50% of cases. Acne leads to significant social withdrawal, depression, and disfiguring scars in many cases. Available treatments are characterized by high rates of relapse, dangerous side effects, and social stigma, which often leads to poor patient compliance and treatment failure. The aim of this article was to discuss and share the authors' experiences utilizing fractional radiofrequency (RF) (Morpheus8; InMode Ltd., Lake Forest, CA) in the treatment of both active acne and acne scars. A retrospective review was conducted comparing 3 treatment modalities. In total, 356 patients received acne scar treatments. The cohort comprised a high-dose isotretinoin topical therapy series (n = 128, 36%), a 6-session ablative laser series (n = 89, 25%), and a 3-session fractional RF microneedling series (n = 139, 44). Of the patients with extended 3-year follow-up, the relapse rates were: isotretinoin group, 36 of 54 (67%); laser group, 12 of 16 (75%), and fractional RF microneedling group, 7 of 29 (24%). In treating older acne scars, fractional RF microneedling technology has served as an effective tool to tighten skin and fill in atrophic scars when used in conjunction with other techniques. This technology is very effective and very safe for treating all skin types with acne and acne scars.

Acne vulgaris: advances in pathogenesis and prevention strategies.

The aim is to encourage the creation of innovative prevention and treatment measures and to help readersin selecting the most effective ones. Acne vulgaris is the most prevalent skin condition of adolescents, affecting approximately 9% of theglobal population. Patients becomemore prone to mental and psychological problems because of it. Severalstrategies have been established to effectively improve acne vulgaris. However, the complexity of its pathogenesisand the limitations of the existing strategies to control it in terms of bacterial resistance, patient compliance, andsafety have made the development of new control strategies a hot topic in skin health research. This review systematically summarizes the pathogenesis and prevention strategies of acne vulgarisaccording to the most recent studies. The limitations of the current research on acne vulgaris and future researchdirections are presented based on the analysis of the strengths and weaknesses of the existing prevention andtreatment strategies.

Current perspectives for metabolomics and lipidomics in dyslipidemia of acne vulgaris: a mini review

Acne vulgaris (AV) is a common inflammatory disorder involving the pilosebaceous unit. Many studies have reported that people with AV have higher levels of total cholesterol (TC), triglycerides (TG), and low-density lipoprotein cholesterol (LDL-c) compared to healthy controls. Hence, they concluded that an unhealthy lipid profile is an independent risk factor for AV. Recent research in metabolomics and lipidomics has been propelled by rapid advancements in technologies including computational methods and mass spectrometry. Using metabolomics and lipidomics approach, a broad range of structurally diverse lipid species were detected and important lipid biomarkers were identified that are vital to the pathogenesis of AV. In this review, we will describe the recent progress in dyslipidemia of AV using metabolomics and lipidomics advances. We will begin with a literature overview of dyslipidemia of AV, followed by a short introduction of metabolomics and lipidomics. Finally, we will focus on applying metabolomics and lipidomics in dyslipidemia of AV.

Additive Effects of Natural Plant Extracts/Essential Oils and Probiotics as an Antipathogenic Topical Skin Patch Solution for Acne and Eczema.

This work leverages the additive antipathogenic effects of natural extracts/essential oils (EOs) and probiotics for the treatment of acne vulgaris associated with Cutibacterium acnes (C. acnes) and eczema complicated by secondary infections with Staphylococcus aureus (S. aureus). Six probiotic strains and various extracts/EOs were evaluated in a large screening to evaluate their potential against both pathogens. Lacticaseibacillus paracasei PCB003 was able to inhibit the growth of both pathogens. For extracts/EOs, Oregano EO had the best antipathogenic effects on both pathogens and did not show any adverse impact on the growth of probiotics, making it suitable for simultaneous use. Using Lactiplantibacillus plantarum PCB011 as a probiotic model, five material formulations were assessed for their suitability to protect probiotic cells within freeze-dried topical patches. Alginate and trehalose (ALG+TRE) and thermoplastic starch (TPS) had the highest probiotic survivability, with ALG+TRE chosen as the final patch material as it was more robust. PCB003 and PCB011 were individually incorporated into the ALG+TRE freeze-dried matrix to form a 6 mm patch; both ALG+TRE (PCB003) and ALG+TRE (PCB011) patches, when used individually, successfully inhibited C. acnes growth by 4.7 and 6.0 mm, respectively, surpassing the performance of commercially available acne patches. The additive effect with 30% Oregano EO further improved pathogen inhibition. For S. aureus, the incorporation of 30% Oregano EO to ALG+TRE (PCB003) increased the size of the inhibition zone more than 10-fold. For C. acnes, the ALG+TRE (PCB003) patch with 30% Oregano EO demonstrated an inhibition zone of 16.3 mm, and the ALG+TRE (PCB011) patch with 30% Oregano EO achieved a 14.3 mm inhibition zone. Genomic analysis confirmed that PCB003 and PCB011 lack antimicrobial resistance determinants, ensuring safety. This study successfully combined probiotics and natural agents to create effective dermatological antipathogenic patches.

Acne Relapse and Isotretinoin Retrial in Patients With Acne

Isotretinoin is the only medical acne treatment capable of inducing acne remission; however, some patients experience acne relapse and require retrials of isotretinoin. There is a need to understand who is most at risk and how daily dose and cumulative dosage can influence outcomes. To assess rates of acne relapse and isotretinoin retrial and to identify associated factors among patients with acne who received an isotretinoin treatment course. This cohort study used data from the MarketScan commercial claims database from January 1, 2017, to December 31, 2020, to identify patients with acne who were 12 years or older and had received isotretinoin for 4 months or longer, with at least 1 year of continuous enrollment after completion of isotretinoin. Data analyses were performed from June 30, 2024, to August 1, 2024. Multivariable Cox proportional hazards regression was used to quantify associations of patient demographic and treatment characteristics with acne relapse and isotretinoin retrial. A total of 19 907 patients (mean [SD] age, 20.6 [7.8] years; 10 504 females [52.8%]) were included, among whom 4482 (22.5%) had acne relapse and 1639 (8.2%) had isotretinoin retrial. Female sex (hazard ratio [HR], 1.43; 95% CI, 1.35-1.52) was significantly associated with increased rates of acne relapse, and isotretinoin cumulative dosage (mg/kg) was associated with a decreased rate of acne relapse (HR, 0.996; 95% CI, 0.995-0.997). Furthermore, daily dose was not associated with decreased risk of acne relapse or isotretinoin retrial among those with conventional and high cumulative dosages. Female sex (HR, 0.68; 95% CI, 0.62-0.76) and isotretinoin cumulative dosage (HR, 0.99; 95% CI, 0.98-0.99) were associated with decreased rates of isotretinoin retrial. Stratification by cumulative dosage indicated that higher cumulative dosage was associated with decreased rates of retrial among patients with low (<120 mg/kg) and conventional (120-220 mg/kg), but not high (>220 mg/kg) cumulative dosage. Maximum daily dose (mg/kg/d) was not negatively associated with acne relapse or isotretinoin retrial in patients with cumulative dosage of 120 mg/kg or more. The findings of this cohort study suggest that higher cumulative dosage may potentially reduce risk of acne relapse and isotretinoin retrial. Furthermore, daily dose was not associated with decreased risk of the outcomes for conventional and high cumulative dosage; therefore, daily dosing could be individualized to patient goals and preferences.

Assessment of inflammatory markers in Acne vulgaris patients: serum IL-17, IL22, and IL-10

One of the four main factors in the pathophysiology of acne vulgaris (AV) is inflammation, which may be a primary or secondary process caused by Propionibacterium acnes. To counteract inflammatory mediators, the immune system possesses a variety of anti-inflammatory mechanisms. The data supporting the early involvement of the inflammatory pathway in the etiology of AV, a chronic, complex, inflammatory skin condition, has become more clear. This cell line's activators, Th17 cells, and the cytokines that follow are all probably important in initiating and maintaining the disease. The aim of this study is to determine the degree to which acne vulgaris is influenced by the interleukins IL-10, IL-17, and IL-22. Individualized patients in our study, sex-matched controls were included, and there were 42 male and 58 female AV patients, aged 12 to 30. An enzyme-linked immunosorbent assay (ELISA) was used to measure the serum levels of IL-10, IL-17, and IL-22. The levels were then connected with the severity of acne. In cases, the serum levels of IL-10, IL-17, and IL-22 were 0.34±0.080, 0.13, 0.14±0.0035, 0.136-0.233, and 0.24±0.0142, 0.126-0.243 pg/ml, respectively, while in controls, they were 0.13±0.028, 0.10±0.0085, 0.14±0.0035, 0.117-0.126, and 0.22±0.0089, 0.114-0.127 pg/ml. For IL-10 and IL-17, there was a substantial difference in levels between patients and controls; however, for IL-22, the difference was negligible. The levels of IL-10 and IL-17 showed an extremely strong positive connection. This study came to the conclusion that IL-10 and IL-17 are important effectors in the pathophysiology of AV. In acne lesions, Th17 cells activated by IL-22 are probably the main source of IL-37.

PDO screw threads versus fractional CO2 laser, after subcision, for atrophic acne scar remodelling: a randomized group-based comparative study.

Atrophic acne scars present a significant therapeutic challenge. While subcision with various adjunctive treatments, including fractional CO₂ lasers and polydioxanone (PDO) threads, has been employed for scar remodeling, comparative evidence on their efficacy remains limited. This study aims to compare the clinical efficacy and patient satisfaction between subcision with fractional CO₂ laser and subcision with PDO screw threads in managing atrophic acne scars. A randomized, controlled study was conducted on 40 patients with atrophic acne scars. Patients were assigned to two groups: Group A underwent subcision with PDO screw threads insertion, and Group B underwent subcision followed by fractional CO₂ laser resurfacing. Outcomes were assessed using the Goodman and Baron grading system, Antera 3D imaging, and patient satisfaction. Significant scar improvement was observed in both groups, with Group B demonstrating greater reduction in scar severity and depth (p = 0.022). While Group A showed faster recovery and lower downtime, Group B yielded higher patient satisfaction scores. Subcision combined with fractional CO₂ laser resulted in superior long-term scar improvement, although PDO threads provided quicker recovery. The choice of treatment may depend on patient preferences and scar characteristics.

The Safety Profile of Acne Supplements: Analysis of Active Ingredients

Introduction: Acne treatment options vary widely, with many patients using dietary supplements. Despite their popularity, these products pose safety concerns due to lack of FDA approval for safety or efficacy before release. The US Institute of Medicine sets Tolerable Upper Intake Levels (ULs) for nutrients, but there are no regulatory limits to prevent supplements from exceeding these ULs. Methods: On March 3, 2024, active ingredients from the top 50 best-selling acne supplements were collected from Amazon. Data were analyzed to identify ingredients and the frequency at which their dosages surpassed the ULs for different age groups. Results: The most prevalent active ingredients were zinc (40%), vitamin A (30%), diindolylmethane (DIM) (26%), vitamin E (26%), and selenium (24%). Thirty percent of all supplements contained at least one ingredient exceeding its UL for ages 9 to 13, 20% for ages 14-18, and 16% for ages 19 and older. Twenty-five percent of zinc-containing supplements and 33% of vitamin A-containing supplements exceeded the UL for any all groups. Discussion: Acne supplements frequently contain ingredients that surpass ULs, particularly zinc and vitamin A. Chronic toxicity from these nutrients can lead to significant health issues. Dermatologists should inquire about supplement use when prescribing treatments like isotretinoin to prevent toxicity risks.

Hypocrellin A-Mediated Photodynamic Antibacterial Activity Against Cutibacterium acnes: An In Vitro Study.

Skin dysbiosis caused by Cutibacterium acnes contributes greatly to the complex pathogenesis of acne, and antimicrobial photodynamic therapy has emerged as a promising treatment option for acne treatment. Hypocrellin, a photosensitizer extracted from a traditional Chinese medicinal fungus, has showed effective antimicrobial activity. This study aimed to evaluate the antibacterial ability of hypocrellin mediated PDT against Cutibacterium acnes. Using modified broth dilution method and morphological observation, the antibacterial effects was tested under a series of experimental conditions. The results showed that hypocrellin initiates type II photodynamic reactions by inducing amount of reactive oxygen species, particularly singlet oxygen. Within a certain concentration range, hypocrellin effectively maintained the antibacterial efficacy with minimal damage to keratinocyte cells. These results provide new insights into the use of PDT for acne treatment.

Treatment of Acne With a 1726 nm Laser, Air Cooling, and Real-Time Temperature Monitoring, Software-Assisted Power Adjustment to Achieve a Temperature Endpoint With Selective Sebaceous Gland Photothermolysis.

This work highlights the methods used to develop a multi-pulse 1726 nm laser system combined with bulk air-cooling for selective sebaceous gland (SG) photothermolysis using thermal imaging and software algorithms. This approach enables treating to a desired tissue temperature and depth to provide a safe, effective, reproducible, and durable treatment of acne. We designed and built a 1726 nm laser system with a 40 W maximum power output, a highly controlled air-cooling device, and a thermal camera in the handpiece, which permits real-time temperature monitoring of the epidermis. IRB-approved safety and efficacy trials demonstrated SG damage at depth, resulting in safe, efficacious, and durable clinical outcomes. Bioheat transfer and light transport modeling confirmed that the pulsing protocols could produce therapeutic temperatures at various SG depths, while protecting the epidermis and dermis with bulk air-cooling. Similarly, we employed clinical observations and photothermal modeling to identify pain mitigation opportunities while maintaining therapeutic efficacy. Biopsies were subsequently taken for histological evaluation. Clinical and histological data, confirmed with modeling, demonstrated that multi-pulse laser delivery with bulk air-cooling selectively increased SG temperature compared to surrounding dermis and at depths unachievable by a single pulse. Subjects showed an average 71% ILC reduction at 3 months posttreatment. We identified two different pulsing protocols with similar selective photothermolysis (SP) of the SG with very different pain responses. Thus, changing the pulsing protocols allowed for pain mitigation and eliminated the need for injectable anesthetic. Histology confirmed the selective damaging of the SG at depth and the preservation of the surrounding dermis and the epidermis. The multi-pulse 1726 nm laser with bulk air-cooling, thermal monitoring, treat-to-temperature (and depth) control, and a unique pulsing protocol, is capable of selectively damaging SGs at depth without damage to the surrounding dermis or the epidermis. The system offers two different protocols that were developed with different levels of discomfort allowing for two different methods for pain mitigation (injectable vs. topical anesthesia).

Efficacy and Safety of Punch Elevation with Microneedling In the Treatment of Atrophic Acne Scars

Efficacy and Safety of Punch Elevation with Microneedling In the Treatment of Atrophic Acne Scars

Do patients with severe acne vulgaris prefer the evening chronotype more? A case-control study.

This study aimed to investigate sleep quality, chronotype preferences, anxiety, and depression levels in patients diagnosed with acne vulgaris and compare them with healthy controls. This cross-sectional case-control study included 92 patients with acne vulgaris and 59 age- and sex-matched healthy controls. Acne severity was assessed using the Global Acne Grading System (GAGS); sleep quality using the Pittsburgh Sleep Quality Index (PSQI); chronotype preferences using the Morningness-Eveningness Questionnaire (MEQ); and anxiety and depression levels using the Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI). There were no significant differences in the MEQ, BDI, or BAI scores between the two groups. The PSQI score was significantly higher in the patient group than that in the control group. Acne severity was negatively correlated with the MEQ scores and positively correlated with the PSQI scores. When the patient group was divided into three subgroups according to acne severity (mild, moderate, and severe), significant differences in MEQ and BAI scores were observed between the groups. According to the post-hoc analysis, the severe acne group had higher BAI scores, while the mild acne group had higher MEQ scores. It would be more appropriate to be aware of the potential psychiatric comorbidities of acne vulgaris and adopt a multidisciplinary approach to the treatment and management process.

The Potential Role of Survivin in The Pathogenesis and Severity of Acne and Post-Acne Scars

The Potential Role of Survivin in The Pathogenesis and Severity of Acne and Post-Acne Scars

Acne Conglobata: Insights into Severe Nodulocystic Acne and Novel Therapeutic Approaches

Background: Acne Conglobata (AC) is a rare and severe form of nodulocystic acne, primarily affecting adolescents and young adults. Characterized by deep nodules, abscesses, and interconnected sinus tracts, AC often leads to significant scarring and psychological distress. Despite its rarity, it presents a unique challenge in resource-limited settings like Bangladesh, where awareness and specialized dermatological care are insufficient. The multifactorial etiology includes hormonal imbalances, genetic predisposition, and environmental factors, complicating both diagnosis and treatment. Objective: This study aims to provide comprehensive insights into the clinical characteristics, risk factors, comorbidities, and treatment outcomes of Acne Conglobata in Bangladesh, with a focus on emerging therapeutic modalities. Methods: A cross-sectional observational study was conducted at a tertiary hospital in Dhaka, Bangladesh, from January to December 2024. A total of 50 patients diagnosed with Acne Conglobata were included, with data collected through clinical evaluations, patient interviews, and medical records. Descriptive statistics were employed to analyze demographic variables, risk factors, comorbidities, and treatment outcomes. Results: The majority of patients were aged 17-30 years, with a higher prevalence in males (70%). Hormonal imbalances (especially during puberty) and a family history of acne were the most common risk factors. Comorbidities such as depression/anxiety (40%), obesity (30%), and insulin resistance (20%) were prevalent. Treatment regimens primarily involved oral isotretinoin (80%), oral antibiotics (60%), and steroids (50%). Scar revision procedures were used in 30% of cases. Conclusion: Acne Conglobata significantly impacts young adults in Bangladesh, with genetic, hormonal, and environmental factors playing key roles in its pathogenesis. Depression, obesity, and insulin resistance were common comorbidities. Oral isotretinoin remains the most effective treatment, but a multimodal approach, including psychological support and scar revision, is essential. This study highlights the need for increased awareness and access to advanced therapies, especially in resource-limited settings like Bangladesh.

Effects of Light and Laser Therapies on the Microecosystem of Sebaceous Glands in Acne Treatment.

Acne vulgaris (acne) is one of the most common skin diseases with complex pathogenesis. Numerous studies have shown that the microecosystem of sebaceous glands and Cutibacterium acnes play key roles in its pathogenesis. Antibiotics targeting C. acnes have been widely used in acne treatment, but the growing prevalence of antibiotic resistance has become alarming. Further research into the microecosystem of sebaceous glands and the role of specific C. acnes phylotypes in acne pathogenesis has led to a paradigm shift in acne treatment. Currently, non-antibiotic therapies such as light therapy and laser therapy are becoming increasingly popular, opening up new opportunities in acne management. Studies on the microecosystem of sebaceous glands associated with acne and the effects of light and laser therapies on the microecosystem in acne treatment were retrieved from the PubMed database. Dysbiosis of the microecosystem of the pilosebaceous unit is closely related to the pathogenesis of acne. Light and laser therapies have an impact on the microecosystem of the pilosebaceous unit in acne treatment. Light and laser therapies are the popular alternative options in acne treatment. The mechanisms of their effect on the microecosystem of sebaceous glands are not completely clear and require further research, especially for laser therapy.

Efficacy of Probiotic Supplements and Topical Applications in the Treatment of Acne: A Scoping Review of Current Results.

Acne vulgaris is a prevalent dermatological condition characterized by comedones, papules, and pustules, with significant physical and psychological implications. Conventional treatments for this condition, including antibiotics and retinoids, face challenges, such as side effects and antibiotic resistance, necessitating alternative treatments. Recent studies show the potential of probiotics to modulate skin microbiome and alleviate acne symptoms. Therefore, this study aimed to consolidate evidence from randomized controlled trials (RCTs) and clinical investigations, evaluating the efficacy of probiotics in acne management. A comprehensive literature search was conducted across PubMed, Scopus, and Cochrane databases using several keywords, such as "probiotic", "microbiome", and "acne vulgaris". Inclusion criteria are RCTs and clinical studies from 2009 to 2024 examining probiotics for acne treatment. Studies were selected, screened, and analyzed based on population, intervention, design, and results. Descriptive statistics were used to summarize study characteristics. Fifteen studies including 811 participants met the inclusion criteria. The studies tested various oral and topical probiotics, including Lactobacillus, Bifidobacterium, Bacillus, and Enterococcus strains, over treatment periods ranging from 4 to 12weeks. The results showed that probiotics, reduced acne lesions, improved skin barrier function, and decreased inflammatory markers. Both oral and topical probiotics showed potential in balancing skin microbiome and reducing acne severity. Some studies reported outcomes comparable to conventional acne treatments, such as antibiotics and benzoyl peroxide. However, there is variability in individual responses to different probiotic strains, and potential side effects, though rare, have been reported in some cases. Probiotics presented a natural, effective alternative to conventional acne treatment. However, future studies are needed to determine optimal treatment protocols.

Fractional Radiofrequency Microneedling as a Monotherapy in Acne Scar Management: A Systematic Review of Current Evidence.

Fractional radiofrequency microneedling (FRM) is a popular, minimally invasive skin rejuvenation modality for treating acne scarring. In this study, we aimed to systematically evaluate the current literature on the efficacy and safety of FRM as a monotherapy to treat different types of facial acne scarring. We systematically reviewed all available literature on FRM techniques used for acne scarring by searching the PubMed and EBSCO databases up to July 2024. 16 studies involving 481 patients, comprising six prospective studies, six randomized clinical trials, three retrospective studies, and one comparative trial, were included. FRM is likely an effective treatment for acne scarring when used as a monotherapy. Further randomized controlled trials are needed to establish appropriate treatment parameters.

In vitro and In vivo Activity of a New N-Oxide Derivative for Acne Vulgaris Treatment.

Furoxan and benzofuroxan are compounds containing an N-oxide function, known for their diverse pharmacological properties, including antimicrobial and antiinflammatory effects. This study aimed to investigate these activities using an in-house library of N-oxide compounds. Twenty compounds were tested against both Gram-positive and Gram-negative bacteria, including Cutibacterium acnes (C. acnes), a microorganism implicated in the development of acne vulgaris. One compound, (E)-4-(3-((2-(3-hydroxybenzoyl)hydrazone)methyl)phenoxy)-3- (phenylsulfonyl)-1,2,5-oxadiazol-2-N-oxide (compound 15), exhibited selective antimicrobial activity against C. acnes, with a Minimum Inhibitory Concentration (MIC) value of 2 μg/mL. Indirect measurement of Nitric Oxide (NO) release showed that compound 15 and isosorbide dinitrate, when treated with L-cysteine, produced nitrite levels of 20.1% and 9.95%, respectively. Using a NO scavenger (PTIO) in combination with compound 15 in a culture of C. acnes resulted in reduced antimicrobial activity, indicating that NO release is part of its mechanism of action. Cytotoxicity assessments using murine macrophages showed cellular viability above 70% at concentrations up to 0.78 μg/mL. Measurements of Interleukin-1 beta (IL1-β) and Tumor Necrosis Factor-alpha (TNF-α) indicated that compound 15 did not reduce the levels of these pro-inflammatory cytokines. Sustained NO production by inducible Nitric Oxide Synthase (iNOS) in macrophages or neutrophils has been found to be involved in the inflammatory process in acne vulgaris and lead to toxicity in surrounding tissues. Nitrite levels in the supernatant of murine macrophages were found to be decreased at a concentration of 0.78 μg/mL of compound 15, indicating an anti-inflammatory effect. In vivo studies were conducted using Balb/c nude mice inoculated subcutaneously with C. acnes. Cream and gel formulations of compound 15 were applied to treat the animals, along with commercially available anti-acne drugs, for 14 days. Animals treated with a cream base containing 5% of compound 15 exhibited less acanthosis with mild inflammatory infiltration compared to other groups, highlighting its anti-inflammatory properties. Similar results were observed in the benzoyl peroxide group, demonstrating that compound 15 presented comparable anti-inflammatory activity to the FDA-approved drug. These promising results suggest that compound 15 has a dual mechanism of action, with selective antimicrobial activity against C. acnes and notable anti-inflammatory properties, making it a potential prototype for developing new treatments for acne vulgaris.