Acne Medications

Altern Med Rev. 2009 Mar; 14(1): 67-71Vitex agnus-castus (chaste tree) is a deciduous shrub that is native to Europe and Asia. Medicinally, the berries have been used for centuries for conditions such as acne, constipation, infertility, lactation support, and libido control. Current clinical uses for chaste tree are menstrual irregularities, premenstrual syndrome, and mastalgia. These indications are supported by the German Commission E reports and a recent survey of practitioners. Recent clinical research identified a dopaminergic effect of chaste tree on the pituitary, with central prolactin inhibition. Hormone modulation by Vitex is seen through dopamine antagonism, not by stimulation of FSH and LH, as was originally reported by early clinical studies. Due to its high degree of safety and efficacy, Vitex is widely used by German physicians, herbalists, and naturopathic physicians for many gynecological conditions.

Zhongguo Zhen Jiu. 2009 Mar; 29(3): 247-51Li B, Chai H, Du YH, Xiao L, Xiong JOBJECTIVE: To evaluate the therapeutic effect and safety of acupuncture and moxibustion for treatment of acne, and to analyze the current situation of clinical studies at present. METHODS: Retrieve PubMed, Cochrane library, CBM databank, CNKI databank, etc., and collect the randomized and controlled trials of treatment of acne with acupuncture and moxibustion, and select clinical trials conforming with the enrolled criteria, and conduct evaluation of quality with Cochrane systematic manual 5.0, and RevMan 4.2.8 was used for statistical analysis. RESULTS: Seventeen papers, including 1,613 cases, conformed with the enrolled criteria. Seventeen studies adopted the cured rate as the evaluation index, Meta-analysis showed treatment of acne by acupuncture and moxibustion with routine western medicine as control, significant difference for inter-group comparison [combined RR (random efficacy model) = 2.96, 95% CI (1.63, 4.91), Z=4.08. P

J Drugs Dermatol. 2009 Apr; 8(4): 383-8Leyden J, Wortzman M, Baldwin EKBACKGROUND: Newer agents and formulations seek to improve the tolerability of topical retinoid therapy. Recently, a gel containing crystalline clindamycin 1.2% and tretinoin 0.025% (CLIN/RA) was approved by the U.S. Food and Drug Administration (FDA) for the treatment of treating mild-to-moderate acne. OBJECTIVE: This single-center, randomized, evaluator-blind phase 1 study compared the tolerability of CLIN/RA to 0.1% tretinoin gel or 0.1% adapalene gel. RESULTS: Forty-five patients applied CLIN/RA once daily to one side of their face every day for 21 days. Patients were randomized to either tretinoin 0.1% (n = 23) or adapalene 0.1% (n = 22) on the contralateral side. A clinical evaluator assessed degree of erythema and scaling; patients provided subjective evaluations of burning, stinging, and itching. CONCLUSION: CLIN/RA was significantly better tolerated than was 0.1% tretinoin gel, as evidenced by significantly reduced erythema (P < 0.04), scaling (P < 0.03), itching (P < 0.02), burning (P < 0.03) and stinging (P < 0.04). A trend for greater erythema, scaling, and subjective discomfort for 0.1% adapalene gel compared to CLIN/RA was also evident.

Australas J Dermatol. 2009 May; 50(2): 107-12Tang MB, Tan ES, Tian EA, Loo SC, Chua SHOral isotretinoin is a highly effective treatment for refractory nodulocystic acne. However, it can be associated with serious adverse effects such as teratogenicity and hepatitis. Inadequate cumulative dosing may also result in reduced therapeutic efficacy and higher disease relapse. A preliminary audit had previously revealed a poor and inconsistent adherence to local isotretinoin prescribing guidelines by physicians. To achieve greater than 90% adherence to isotretinoin guidelines for all acne patients prescribed systemic isotretinoin at the National Skin Centre, Singapore, key areas and the reasons for non-adherence were identified. A specifically designed 'one-stop' electronic isotretinoin chart was launched within the electronic medical records (EMR) system to address important safety areas; namely, informed patient consent, pregnancy testing, baseline laboratory tests, and automatic calculation of cumulative and target doses of isotretinoin. Physician adherence to prescribing guidelines improved from a baseline of 50-60% to greater than 90% (range 95-100%) for 30 consecutive months post intervention. The e-isotretinoin chart has resulted in significant improvement in physicians' adherence to isotretinoin prescription guidelines and highlights the utility of EMR technology in influencing safe prescribing behaviour among doctors.