Acne Medications

Cutis. 2009 May; 83(5): 265-72Dhawan SSCombination therapy for the topical treatment of acne vulgaris using benzoyl peroxide (BPO) and an antibiotic is more efficacious and better tolerated than treatment with either component alone. Moreover, the addition of BPO to antibiotic therapy is recommended as a means of preventing the development of Propionibacterium acnes antibiotic resistance. However, BPO is an irritant, and the dryness and irritation experienced by some patients using topical therapy containing BPO can negatively impact compliance. Historically, once-daily treatment application has enhanced compliance versus twice daily. The current 12-week study aimed to compare the efficacy of a clindamycin 1%-BPO 5% topical gel with the hydrating excipients dimethicone and glycerin (C/BPO HE) and a clindamycin 1%-BPO 5% topical gel that does not contain hydrating excipients (C/BPO) applied once daily for the treatment of 20 participants with facial acne vulgaris and to determine if there were differences in product preference and participant acceptability between the treatments. Both C/BPO HE and C/BPO were effective in the treatment of acne, with substantive reductions (-60.8% and -61.3%, respectively) in total inflammatory lesions at week 4 in both treatment groups. Participants receiving C/BPO HE demonstrated a more consistent treatment response than with C/BPO, with incremental reductions in total inflammatory lesions at each time point, whereas the response to C/BPO waned at week 8. As a result, greater percentage reductions in inflammatory and noninflammatory lesions were observed with C/BPO HE treatment than C/BPO treatment at week 8 (papules: -71.9% vs -49.4%, P=.053; pustules: -64.8% vs -28.0%, P=.134; open comedones: -44.5% vs 2.6%, P=.480; closed comedones: -35.5% vs -26.3%, P=.501). With the exception of papules, greater reductions in all lesion subtypes also were observed at week 12. None of the between-group differences reached statistical significance. Both treatment groups displayed similar disease signs and symptoms throughout the study period. However, scaling, erythema, dryness, and pruritus occurred more frequently in participants using C/BPO. Treatment satisfaction was greatest with C/BPO HE; participants reported that this formulation was easy to apply and 100% (9/9) of participants reported that they would continue using C/BPO HE compared with 80% (8/10) of participants using C/BPO. Both treatments were well-tolerated. In this pilot study, both formulations were effective in the treatment of inflammatory and noninflammatory acne lesions, but C/BPO HE produced a more consistent reduction in total inflammatory lesions over 12 weeks. The addition of hydrating excipients in the C/BPO HE formulation appears to improve patient tolerance and acceptance, which will likely help patients to comply with therapy.

Eur J Dermatol. 2009 Jun 15; Cesko E, Körber A, Dissemond JAcne inversa is a chronic, recurring acneiform skin disease with inflammation of the follicular epithelium of the sebaceous glands and the terminal hair follicle. It primarily manifests in the intertriginous areas. So far, the aetiology of acne inversa is unknown. Smoking, amongst others, is being discussed and should be evaluated as a possible aetiological factor. In this study a retrospective investigation was carried out in 100 patients with acne inversa. The parameters; age, BMI, sex, weight, height, location of acne inversa, quantity of smoking, smoking behaviour and the date of initial diagnosis of acne inversa were considered. In most cases, the acne inversa is located in the axillary and inguinal areas. Overall, 96% of the 100 patients had a positive, long standing, on average almost 20-year, smoking history. On average, over 20 cigarettes are smoked daily. Over 50% of the patients are overweight. Merely 26.1% fall into the normal weight category. Our results suggest that especially smoking, but also obesity, may present an aetiologically relevant factor in the origin of acne inversa.

J Cosmet Dermatol. 2009 Jun; 8(2): 152-8Tochio T, Tanaka H, Nakata S, Ikeno HBackground Previous studies reported that lipid peroxide (LPO) caused by oxidation of sebum is associated with the progression of acne vulgaris, and that therapy with antioxidative ingredients is efficacious for treatment. In this study, we hypothesized that lipid accumulation in comedones induces progression of comedogenesis and inflammatory changes in comedones, and investigated the possible role of accumulated LPO in comedogenesis and its inflammatory changes. Methods We first sampled comedones and the stratum corneum from patients with acne vulgaris. The quantities of LPO, interleukin-1-alpha (IL-1alpha), and NF-kappa-B (NF-kappaB) in comedones and in the stratum corneum from each patient were measured for comparison. Next, comedones were sampled again from the same patients and classified into five groups: microcomedo (MC), noninflammatory open comedo (NIOC), noninflammatory closed comedo (NICC), inflammatory open comedo (IOC), and inflammatory closed comedo (ICC). We measured quantities of LPO in each group. Results The quantities of LPO, IL-1alpha, and NF-kappaB were significantly higher in the content of comedones than those in the stratum corneum. The quantities of LPO in the content of IOC and ICC were significantly higher than those of MC, NIOC, and NICC; however, there were no significant differences in quantities of LPO between the content of MC, NIOC, and NICC. Conclusions We conclude that the accumulation of a certain amount of LPO in the content of comedones may play an important role in the progression of comedogenesis and the excessive accumulation of LPO may be involved in inflammatory changes in comedones.

Fitoterapia. 2009 Jun 11; Pothitirat W, Chomnawang MT, Supabphol R, Gritsanapan WContents of bioactive components, free radical scavenging and anti-acne producing bacteria activities of young and mature fruit rind extracts of mangosteen were compared. The young fruit rind extract contained significantly higher contents of phenolics and tannins and promoted higher free radical scavenging activity than the mature fruit rind extract, while the later extract contained higher contents of flavonoids and alpha-mangostin xanthone and gave higher anti-acne producing bacteria activity than the young fruit rind extract. Thus, the young and mature stages of mangosteen fruit rind should be beneficial for further development of antioxidant and anti-acne pharmaceutical preparations, respectively.