Use of Oral Contraceptives for Management of Acne Vulgaris

The efficacy of Topical Clascoterone versus systematic spironolactone for treatment of acne vulgaris: A systematic review and network meta-analysis

OBJECTIVES

This study aimed to evaluate the effectiveness of topical clascoterone (TC) compared to oral spironolactone for acne vulgaris treatment.

METHODS

A computerized search through PubMed/MEDLINE, SCOPUS, and the Cochrane Library was conducted to find relevant papers. We used the "netmeta" and "meta" packages for network meta-analysis (NMA) in RStudio 1.2.5019 (2009-2019 RStudio, Inc.) to conduct all of our statistical tests.

RESULTS

Seven articles (n = 2,006 patients) were included. The fixed-effect size showed that TC 1% bis in die (BID) showed potential effectiveness in reducing the inflammatory and non-inflammatory lesion count compared to placebo (Standardized mean difference, SMD = -0.27, 95% CI: -0.36 to -0.17) and (SMD = -0.31, 95% CI: -0.41 to -0.22), respectively. The random-effect size showed that TC 1% BID was significantly associated with a 12-week treatment success compared to placebo (Odds ratio, OR = 2.44, 95% CI: 1.12 to 5.30). Spironolactone 200 mg was associated with a significant reduction in total lesion count (SMD = -4.46, 95% CI: -5.60 to -3.32).

CONCLUSION

TC appears to reduce both inflammatory and non-inflammatory lesion count and may lead to treatment success. Spironolactone at 200 mg showed potential effectiveness in terms of total lesion count reduction. These results suggest that both TC and Spironolactone could be beneficial in treating patients with acne vulgaris.

Nanomedicine-fortified cosmeceutical serums for the mitigation of psoriasis and acne

Cosmetics have a long history of use for regenerative and therapeutic purposes that are appealing to both genders. The untapped potential of nanotechnology in cosmeceuticals promises enhanced efficacy and addresses the issues associated with conventional cosmetics. In the field of cosmetics, the incorporation of nanomedicine using various nanocarriers such as vesicle and solid lipid nanoparticles significantly enhances product effectiveness and promotes satisfaction, especially in tackling prevalent skin diseases. Moreover, vesicle-fortified serum is known for high skin absorption with the capacity to incorporate and deliver various therapeutics. Additionally, nano-embedded serum-based cosmeceuticals hold promise for treating various skin disorders, including acne and psoriasis, heralding potential therapeutic advancements. This review explores diverse nanotechnology-based approaches for delivering cosmetics with maximum benefits.

Efficacy and tolerability of low-dose spironolactone and topical benzoyl peroxide in adult female acne: A randomized, double-blind, placebo-controlled trial

Effective therapies for adult female acne (AFA) are limited. Oral spironolactone (SPL), 100-200 mg/day, is currently used off-label to treat AFA. However, high-dose SPL results in clinically significant side-effects which prevent widespread use in clinical practice. The efficacy of low-dose spironolactone in AFA is unknown. We examined the efficacy and tolerability of low-dose (25-50 mg/day) oral SPL in Thai women with moderate AFA. A randomized, double-blind, placebo-controlled trial was conducted for 12 weeks. Moderate AFA patients aged between 25 and 45 years received a combination of daily topical benzoyl peroxide (BP) 2.5% plus either SPL 25 mg (SPL25 group), SPL 50 mg (SPL50 group) or placebo. We performed total acne counts and Adult Female Acne Scoring Tool (AFAST) grading at 4-week intervals. The success rate, defined as the proportion of participants achieving a "clear/almost clear" AFAST grade by the end of week 12, was considered as the main outcome. Treatment-related adverse events (TRAE) were recorded. We enrolled 63 participants in the study. The total acne counts decreased significantly in all three groups (P < 0.05) as compared with baseline. Participants in the SPL50 group had a significantly higher success rate than those in the placebo group (P < 0.05). Serum potassium and creatinine levels showed no significant changes with treatment or between groups. A small number of participants in SPL25 and SPL50 reported mild and temporary TRAE, such as menstrual irregularities, breast tenderness and dizziness. The combination of SPL 50 mg/day and topical BP proved effective in improving moderate AFA in Thai women, with an acceptable side-effect profile. We propose this regimen as an option for treating moderate AFA.

Use of Short Acting Reversible Contraception in Adolescents: The Pill, Patch, Ring and Emergency Contraception

Long acting reversible contraception (LARC) is the recommend form of birth control for adolescents by both the American Academy of Pediatrics and the American Congress of Obstetrics and Gynecology, but the majority of adolescents continue to use short acting reversible contraception (SARC) such as the oral contraceptive pill, vaginal ring, and transdermal patch. For this reason, it is important for medical providers to be familiar with how to prescribe and manage SARC in adolescents, paying particular attention to which patients are eligible to use them, which benefits the methods have outside of contraception, what side effects to be aware of, and special considerations for adolescents. Many adolescents will choose not to use any form of hormonal contraception-thus having a knowledge about and comfort with use of emergency contraception is of equal importance.

In Vitro Antimicrobial Activity of Essential Oils from Sardinian Flora against Cutibacterium (Formerly Propionibacterium) acnes and Its Enhancement by Chitosan

The in vitro antibacterial activity of some essential oils from Sardinian flora, both alone and in combination with chitosan, was investigated against a strain of Cutibacterium acnes, a bacterium involved in pathogenesis of acne. The composition of the essential oils was determined by gas chromatography and gas chromatography/mass spectrometry. The results of this investigation demonstrated that some of the oils examined, characterised by different chemical profiles, possessed some activity against C. acnes. Interestingly, this antibacterial effect was enhanced by sub-inhibitory concentrations of chitosan. These observations suggest the potential application of this synergy in the development of innovative topical formulations useful in the management of acne.

Hormonal treatment of acne vulgaris: an update

Acne vulgaris is a common skin condition associated with multiple factors. Although mostly presenting alone, it can likewise present with features of hyperandrogenism and hormonal discrepancies. Of note, hormonal therapies are indicated in severe, resistant-to-treatment cases and in those with monthly flare-ups and when standard therapeutic options are inappropriate. This article serves as an update to hormonal pathogenesis of acne, discusses the basics of endocrinal evaluation for patients with suspected hormonal acne, and provides an overview of the current hormonal treatment options in women.