A single-blinded, randomized, controlled clinical trial evaluating the effect of face washing on acne vulgaris

Foundations first: the unchanging significance of cleansing in the era of fourth-generation retinoids

The onset of fourth-generation retinoids such as trifarotene marks an advancement in acne therapy, and applications are still being elucidated. However, clinicians should not dismiss the importance of simple, nonpharmacological measures such as regular skin cleansing and the use of moisturizers, reaffirming their crucial place in the holistic management of both acne and other dermatological conditions.

Smart Watches Lack Skin Smarts: Current and Future Dermatologic Applications in Device Metrics

INTRODUCTION

Smartwatches have proven life-saving in medical specialties such as cardiology. Smartwatches actively warn us of arrhythmia risk and loud noise exposure. However, dermatologic health metrics are rarely monitored, and users are never alerted of potential skin health issues. Furthermore, the role of these devices within dermatology has not been evaluated in the literature. This study aims to analyze the current data points monitored by smartwatches and discuss potential adaptations to support dermatologic patient education and improve clinical management.  Methods: The top three smartwatches per global market share were identified and analyzed to determine the health data points they monitor and the alerts they provide. These data points were grouped and compared based on their corresponding body systems.  Results: Cardiovascular health comprises the highest percentage of data points collected with an average of 41% while dermatologic health averaged only 11%.  Conclusion: Dermatology is grossly underrepresented in current smartwatch devices. There is an important need to expand the dermatologic health metrics tracked by adapting existing smartwatch technology. From proactive cancer prevention to disease-specific reactive interventions, smartwatches can play a significant role in improving dermatological health and reducing healthcare costs.

Efficacy of the continuous use of a lotion with carbon dioxide on male subjects with mild acne

OBJECTIVE

Acne vulgaris is caused by dyslipidemia, dyskeratosis and/or abnormal bacterial growth. The obstruction of skin pores due to hyperkeratosis of the infundibulum contributes to the formation of comedones. Thus, normalizing keratinization of epidermal cells in skin pores might be useful to improve acne. Recently, it has been found that the transcutaneous application of carbon dioxide (CO₂ ) regulates imbalances of the desquamatory process. In this study, we evaluated the efficacy of a skin lotion containing CO₂ on mild acne.

METHODS

Twenty-four healthy Japanese males (20-29 years old) with mild acne attended this evaluation. The subjects were divided into 2 groups, one group used a skin lotion containing CO₂ and the other group used a skin lotion without CO₂ . Following facial washing, each subject topically applied the skin lotion with or without CO₂ twice a day for 4 weeks. Prior to the start of the evaluation (week 0) and following 2 and 4 weeks of treatment, acne symptoms were assessed by a dermatologist and by instrumental measurements.

RESULTS

Topical application of the skin lotion with CO₂ for 4 weeks significantly improved acne symptoms, which was recognized by the subjects. However, treatment with the skin lotion without CO₂ did not improve acne symptoms. This improvement of acne symptoms by CO₂ was not accompanied by changes in sebum levels, skin surface pH, skin capacitance, or porphyrin levels.

CONCLUSION

The transcutaneous application of a lotion with CO₂ improves acne symptoms by normalizing keratinization without affecting skin surface conditions.

Advances in the human skin microbiota and its roles in cutaneous diseases

Skin is the largest organ in the human body, and the interplay between the environment factors and human skin leads to some skin diseases, such as acne, psoriasis, and atopic dermatitis. As the first line of human immune defense, skin plays significant roles in human health via preventing the invasion of pathogens that is heavily influenced by the skin microbiota. Despite being a challenging niche for microbes, human skin is colonized by diverse commensal microorganisms that shape the skin environment. The skin microbiota can affect human health, and its imbalance and dysbiosis contribute to the skin diseases. This review focuses on the advances in our understanding of skin microbiota and its interaction with human skin. Moreover, the potential roles of microbiota in skin health and diseases are described, and some key species are highlighted. The prevention, diagnosis and treatment strategies for microbe-related skin diseases, such as healthy diets, lifestyles, probiotics and prebiotics, are discussed. Strategies for modulation of skin microbiota using synthetic biology are discussed as an interesting venue for optimization of the skin-microbiota interactions. In summary, this review provides insights into human skin microbiota recovery, the interactions between human skin microbiota and diseases, and the strategies for engineering/rebuilding human skin microbiota.

Maskne: The Epidemic within the Pandemic: From Diagnosis to Therapy

Maskne, a newly coined term deriving from the contraction of mask-related acne, is a form of mechanical acne resulting from continuous textile–skin adherence and friction. Prolonged mask use heats up the face environment, thus modifying skin microbiota and sebum production. Although effective prevalence is unknown, since the pandemic began and the prolonged use of masks was extended to the general population, maskne has been a frequent topic of consultation among dermatologists. This term has been successfully introduced into common language, with more than 200,000 hashtags on social media, where it is also possible to find “home remedies” that can worsen this dermatosis. The aim of this paper is to discuss the pathogenesis, address clinicians on the correct differential diagnoses among facial dermatoses, and move towards the correct therapy.

Cell Phone Acne: New Acne Clinical Features in the Coronavirus Disease-19 Era

Technological developments in telecommunications, especially cell phone, enable us to keep communicate without meeting each other. Especially during the latest coronavirus outbreak, when people need to keep up social distance. Meanwhile, electronic devices such as smartphone, tablets, laptops, and light-emitting diode screens are the sources of visible lights that can emit high levels of short-wavelength visible light (blue region in the light spectrum). Prolonged exposure to high-energy blue light, heat dissipation from cell phone, friction, trapped sweat and oil, accumulation of dust, and increased bacterial growth can cause cell phone acne. Management of cell phone acne from prevention to combination therapy based on the results of the evaluation of the severity of acne is needed.

Association between exposure to ambient air pollution and occurrence of inflammatory acne in the adult population

Background

Acne vulgaris is one of the most prevalent skin diseases responsible for dermatological consultations. Several internal and external factors can affect acne occurrence and severity. Outdoor air pollution is an external factor discussed to trigger inflammation of the skin. The objective of this study was to find a link between the exposure to ambient air pollution and inflammatory acne occurrence in the Lebanese adult population.

Methods

A cross-sectional study was conducted, using an online questionnaire to collect the required data from different Lebanese regions. The survey covered pollution exposure questions as well as queries on several factors known to have a role on acne occurrence.

Results

A total of 372 participants were included in the study, aged 18 to 55 years old. The results of a logistic regression taking the presence/absence of acne as the dependent variable, showed that female gender (aOR = 4.39), younger age (aOR = 1.05), using hydrating cream (aOR = 4.30), working near a power plant vs not (aOR = 3.07), having a severe NO2 exposure compared to none (aOR = 8.24), a higher number of family members with acne or history of acne (aOR = 1.48) were significantly associated with higher odds of having acne, whereas having a dry skin compared to normal (aOR = 0.20) was significantly associated with lower odds of having acne.

Conclusion

The occurrence of inflammatory acne in Lebanese adults was found to be associated with ambient exposure to high levels of NO₂ and employment near a power plant known to emit CO₂, CO, SO₂, NO₂ and PM. Therefore, our findings can serve as a first step towards implementing awareness on a skin care routine suitable for highly polluted areas.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-11738-0.

Knowledge about, attitude toward, and practices in skin care among Thai adolescents

BACKGROUND

Skin care for maintaining skin integrity includes cleansing, skin product use, and photoprotection. Inappropriate skin care can lead to skin problems.

AIMS

To evaluate the knowledge, attitude, and practices in skin care among Thai adolescents.

PATIENTS/METHODS

Questionnaire-based, descriptive, cross-sectional study.

RESULTS

A total of 588 Thai adolescent students (mean age: 15.6 ± 1.8 years, 50.5% female) were included. Of those who responded, 99.5% knew the benefits of cleansing, and 95.9% knew the benefits of skin care products. Skin products, moisturizer, and sunscreen were used by 87.8%, 80.8%, and 71.5% of students, respectively. Female teenagers used moisturizers, cosmetics, and sunscreen significantly more than males (p = 0.001, p = 0.001, and p < 0.001, respectively). High school teenagers applied cosmetics more than junior high school teenagers (p = 0.004). Ninety-three percent of adolescents knew the effects of sunlight, but only 27.4% regularly applied sunscreen. The sources of knowledge were from person, online social media, print media, and television/radio in 88.5%, 77.5%, 30.7%, and 26.1%, respectively. Data from physicians and parents were trusted by 65.3% and 64.2%, respectively. Most (74.1%) adolescents searched for data from more than 1 source. Adolescent females and high school adolescents demonstrated significantly more accurate knowledge and practice in cleansing and photoprotection (p < 0.001) compared with adolescent males and junior high school adolescents. Knowledge and practices did not significantly correlate with underlying skin diseases or monthly allowance.

CONCLUSION

Gender and education level were found to significantly influence knowledge and practice in skin care among adolescents in Thailand.

Identifying the Impacts of Acne and the Use of Questionnaires to Detect These Impacts: A Systematic Literature Review

BACKGROUND

Acne (syn: acne vulgaris) ranks as the most common inflammatory dermatosis treated worldwide. Acne typically affects adolescents at a time when they are undergoing maximum physical and social transitions, although prevalence studies suggest it is starting earlier and lasting longer, particularly in female patients. According to global burden of disease studies, acne causes significant psychosocial impact. Hence, identifying mechanisms to accurately measure the impact of the disease is important. Adopting an approach to harmonize and standardize measurements is now recognized as an essential part of any clinical evaluation and allows for better comparison across studies and meta-analyses.

OBJECTIVE

The Acne Core Outcome Research Network (ACORN) has identified relevant domains as part of a core outcome set of measures for use in clinical studies. One of these is health-related quality of life (HRQoL). The aim of this systematic review was to provide information to inform the identification of the impacts most important to people with acne.

METHODS

A synthesis of available evidence on acne impacts was constructed from a systematic review of the literature, with searches conducted in the MEDLINE, EMBASE and PsychInfo databases.

RESULTS

We identified 408 studies from 58 countries using 138 different instruments to detect the impacts of acne. Four of the five most commonly used instruments (Dermatology Life Quality Index [DLQI], Cardiff Acne Disability Index [CADI], Acne Quality of Life scale [Acne-QoL], Hospital Anxiety and Depression Scale [HADS] and Skindex-29) do not identify specific impacts but rather quantify to what extent acne affects HRQoL. Other studies identified one or more impacts using open-ended questions or tailor-made questionnaires.

CONCLUSION

This review serves as a rich data source for future efforts by groups such as ACORN (that include patients and health care providers) to develop a core set of outcome measurements for use in clinical trials.

Topical dermocosmetics and acne vulgaris

Acne is a highly common skin disease especially among teenagers. Modern acne treatments are based also on the use of moisturizers, cleansers and sunscreens. In choosing the right cleanser, it is important to consider some aspects: the interaction between skin type and the cleanser, the optimal time and method of cleaning and the cosmetic perception of the patient. The aim of our review is to highlight the importance of choosing the most suitable topical dermocosmetics for the different skin types, as well as the most effective timing and method to combine dermocosmetics with the standard acne treatment. A search in literature for selected key words was performed using PubMed. Additional papers were identified based on author expertise. Treatment of acne patients should include education for proper daily skin hygiene, including protection from environmental damage. However, given the low number of clinical studies on cleansers, it is difficult to make reliable recommendations. The correct choice and use of topical dermocosmetics are fundamental in the management of acne patients. Daily use of moisturizers, cleansers and sunscreens can reduce both inflammatory and non-inflammatory acne lesion counts and may be helpful for acne treatment if combined with specific drugs.

The application of skin care product in acne treatment

Acne is a kind of chronic inflammatory skin disease, which is common in the hair follicle and sebaceous gland of teenagers. It often recurs and affects the quality of life of patients. Acne itself can cause the damage of skin barrier function. On the other hand, common acne treatment methods, such as external drugs, systemic drugs, physical, and chemical treatment, can also lead to the damage of skin barrier function and affect the treatment effect. The application of skin care in the adjuvant treatment of acne has been widely concerned. Due to their high safety, good tolerance, and the effect of improving the damaged skin barrier, medical skin care products are a hot spot in the treatment of cosmetic skin diseases in recent years. It can not only increase the curative effect, reduce the side effects, but also increase the compliance of patients when combined with conventional acne treatment. In this article, skin care products and their application in acne treatment were reviewed.

Truncal acne, what do we know?

Truncal acne is frequently overlooked in dermatological practice, even though it may result in scars and impact on self-esteem and body image. Therefore, it is important to identify the disease early in order to initiate treatment in time and, thus, to prevent it from worsening and resulting in physical and psychological sequelae. The aim of this review is to provide an overview of what is currently known about truncal acne, its prevalence, aetiology and physiopathology, how its severity is currently evaluated, how to differentiate it from other skin afflictions and current treatment options. A review of literature considering the issue of truncal acne published up to 2019 and available from PubMed was conducted, and in total, 76 articles were selected from PubMed. Currently, only little information about truncal acne is available. Considered as having the same pathophysiology as facial acne, the clinical picture and treatment response seem to differ. Specific acne severity grading systems and quality of life questionnaires as well as a specific treatment algorithm are still lacking. Filling this gap should allow clinicians to assess truncal acne in the best possible way, choosing suitable treatment options, helping patients to improve treatment adherence and quality of life and finally allowing a better management of truncal acne. In conclusion, more knowledge is required to treat more efficiently truncal acne.

Adolescents' self perceived acne-related beliefs: from myth to science

BACKGROUND

Acne vulgaris is recognized as the third most prevalent skin disease worldwide, with highest prevalence among adolescents. Beliefs and perceptions of adolescents about acne are incoherent in the literature.

OBJECTIVES

To assess the most frequently reported acne-related beliefs in adolescents in order to focus on misconceptions and develop proper recommendations.

METHODS

A cross-sectional community-based study on representative sample of 2516 schoolchildren was conducted in six randomly selected secondary schools in Belgrade, Serbia. Only schoolchildren with present or past acne history participated. Factors believed to aggravate or ameliorate acne were recorded and analyzed, and the comparisons between girls and boys were evaluated using Pearson's chi-squared test.

RESULTS

A total of 1452 schoolchildren with acne participated, aged 14-18 years, among them 801 (55.2%) girls and 651 (44.8%) boys. Boys significantly more frequently believed that sweating, exercise, and dairy foods aggravate acne, whereas girls significantly more frequently blamed emotional stress, sweets, fatty foods, sun, and lack of sleep. The top four amelioration factors were as follows: comedone extraction, healthy diet, sun exposure, and increased water consumption. Acne regression was more frequently perceived to be linked with cigarettes in boys, but with sun exposure and weight loss in girls.

STUDY LIMITATIONS

The narrow age span of adolescents (14-18 years) and exclusion of acne-free adolescents are limitations due to study design.

CONCLUSION

This survey is part of the first epidemiological study on a representative sample in the Western Balkan region. The significance of the most frequent acne-related beliefs is discussed and myths about acne are highlighted.

Clinical significance of neutrophil gelatinase-associated lipocalin and galectin-7 in tape-stripped stratum corneum of acne vulgaris

The usefulness of stratum corneum neutrophil gelatinase-associated lipocalin and stratum corneum galectin-7 as biomarkers of acne vulgaris was studied. A comparison of neutrophil gelatinase-associated lipocalin levels on the cheeks of patients with acne vulgaris at the start of the study and at the time of symptom improvement showed a significant decrease. On the other hand, the galectin-7 levels at the time of symptom improvement were significantly higher than those at the start of the study. Therefore, because the inflammation in the epidermis and hair follicles was reduced after therapy, as a result of the solution of the inflammatory eruptions caused by acne vulgaris, the neutrophil gelatinase-associated lipocalin level also showed a significant decrease after therapy. These results suggest that stratum corneum neutrophil gelatinase-associated lipocalin may be useful as an objective biomarker of changes in acne vulgaris symptoms.

The influence of exposome on acne

BACKGROUND

Acne vulgaris is one of the main reasons for dermatological consultations. Severity and response to treatment may be impacted by various external factors or exposome.

AIM

To assess the impact of environmental factors on acne and to provide a comprehensive overview of the acne exposome.

METHODS

Two consensus meetings of five European dermatologists and a comprehensive literature search on exposome factors triggering acne served as a basis for this review.

RESULTS

Acne exposome was defined as the sum of all environmental factors influencing the occurrence, duration and severity of acne. Exposome factors impact on the response and the frequency of relapse to treatments by interacting with the skin barrier, sebaceous gland, innate immunity and cutaneous microbiota. They may be classified into the following six main categories: nutrition, psychological and lifestyle factors, occupational factors including cosmetics, as well as pollutants, medication and climatic factors. Moreover, practical considerations for the dermatologist's clinical practice are proposed.

CONCLUSION

Exposome factors including nutrition, medication, occupational factors, pollutants, climatic factors, and psychosocial and lifestyle factors may impact on the course and severity of acne and on treatment efficacy. Identifying and reducing the impact of exposome is important for an adequate acne disease management.

Quality of life measurement in acne. Position Paper of the European Academy of Dermatology and Venereology Task Forces on Quality of Life and Patient Oriented Outcomes and Acne, Rosacea and Hidradenitis Suppurativa

Acne causes profound negative psychological and social effects on the quality of life (QoL) of patients. The European Dermatology Forum S3-Guideline for the Treatment of Acne recommended adopting a QoL measure as an integral part of acne management. Because of constantly growing interest in health-related QoL assessment in acne and because of the high impact of acne on patients' lives, the European Academy of Dermatology and Venereology Task Force on QoL and Patient Oriented Outcomes and the Task Force on Acne, Rosacea and Hidradenitis Suppurativa have documented the QoL instruments that have been used in acne patients, with information on validation, purposes of their usage, description of common limitations and mistakes in their usage and overall recommendations.

Meeting the Challenges of Acne Treatment in Asian Patients: A Review of the Role of Dermocosmetics as Adjunctive Therapy

Conventional acne treatment presents several challenges such as intolerable side effects and antibiotic resistance. Dermocosmetic products may be used to reduce these unwanted effects. Dermocosmetics include skin cleansers, topical sebum-controllers, skin antimicrobial/anti-inflammatory agents, moisturizers, sunscreens, and camouflage products. Appropriate use of these products may help augment the benefit of acne treatment, minimize side effects, and reduce the need for topical antibiotics. In Asia, there is currently limited scientific data on the application and recommendations for dermocosmetic use in acne vulgaris (AV). This article reviews the evidence on dermocosmetics for AV and provides practice recommendations as discussed during the 4^th Asia-Pacific Acne Leaders' Summit held in Bangkok, Thailand, on 7 and 8 February 2015. Through a premeeting survey, a series of plenary lectures, a stepwise program of discussion sessions, and Medline article review, the Expert Panel set forth relevant recommendations on the role of dermocosmetics as adjunct for treating AV in Asian patients.

Role of cleansers in the management of acne: Results of an Italian survey in 786 patients

BACKGROUND

Modern therapy of acne is based also on moisturizers, cleansers and sunscreens. However, a few studies have been published on cleansers, and never in Italy.

OBJECTIVE

We decided to carry out an epidemiological study on the knowledge, beliefs and perceptions of acne patients regarding cleansers.

METHODS

The survey has been carried out in Italy in 2013-2014. A group of patients with acne completed a questionnaire which included 10 questions.

RESULTS

One hundred and eighteen dermatologists and 786 evaluable acne patients attended the survey. Approximately 70% of patients use a specific anti-acne cleanser. This cleanser is suggested in 57% of cases by a dermatologist. The patients buy this cleanser at the pharmacy (77% of cases). More than 62% of patients are satisfied about this cleanser. More than 66% of patients use the cleanser twice daily. The length of washing is less than one minute in 48% of patients. More than 66% of patients believe that the cleanser has a therapeutical role.

CONCLUSION

The results of this survey cannot be compared with other studies because of the lack of similar studies about this topic. These results suggest that a sample of Italian acne patients consider cleansers as an important adjuvant treatment in acne.

South-East Asia study alliance guidelines on the management of acne vulgaris in South-East Asian patients

The management of acne in South-East Asia is unique, as Asian skin and local variables require a clinical approach unlike that utilized in other parts of the world. There are different treatment guidelines per country in the region, and a group of leading dermatologists from these countries convened to review these guidelines, discuss current practices and recent advances, and formulate consensus guidelines to harmonize the management of acne vulgaris in the region. Emphasis has been placed on formulating recommendations to impede the development of antibiotic resistance in Propionibacterium acnes. The group adopted the Acne Consensus Conference system for grading acne severity. The group recommends that patients may be treated with topical medications including retinoids, benzoyl peroxide (BPO), salicylic acid, a combination of retinoid and BPO, or a combination of retinoids and BPO with or without antibiotics for mild acne; topical retinoid with topical BPO and a oral antibiotic for moderate acne; and oral isotretinoin if the patient fails first-line treatment (a 6- or 8-week trial of combined oral antibiotics and topical retinoids with BPO) for severe acne. Maintenance acne treatment using topical retinoids with or without BPO is recommended. To prevent the development of antibiotic resistance, topical antibiotics should not be used as monotherapy or used simultaneously with oral antibiotics. Skin care, comprised of cleansing, moisturizing and sun protection, is likewise recommended. Patient education and good communication is recommended to improve adherence, and advice should be given about the characteristics of the skin care products patients should use.

Effects of washing of the face with a mild facial cleanser formulated with sodium laureth carboxylate and alkyl carboxylates on acne in Japanese adult males

BACKGROUND/PURPOSE

Washing the face with a mild cleanser is generally recommended for acne care. Occasionally, the general public has the misconception that acne is exacerbated by cleansers and furthermore it has concerns about inducing skin irritation and xerosis by intensive washing. Recently, we developed a new cleanser based on sodium laureth carboxylate and alkyl carboxylates (AEC/soap) that cleans sebum well without penetrating the stratum corneum.

METHODS

We designed a controlled clinical trial conducted on adult Japanese males with moderate or less acne. Twenty subjects washed their faces with AEC/soap base cleanser twice a day for 4 weeks. Assessment of the efficacy was conducted prior to the start of the study, and at the end of weeks 2 and 4.

RESULTS

Significant improvement of the acne was observed within 2 weeks, and acne lesions were not detectable in 25% of the subjects at week 4. Sebum secretion levels on the skin significantly increased on the forehead, but significantly decreased on the cheek which correlated with the improvement. No complaints of dryness or irritation occurred during the study.

CONCLUSION

Washing the face twice a day with facial cleanser based on AEC/soap is an effective care for moderate or less grade facial acne.

Frequency of acne vulgaris and its exacerbation in facial and periorbital area after septorhinoplasty

BACKGROUND

High prevalence of rhinoplasty, controversies about its cutaneous complications and lack of structured studies about relationship between acne vulgaris and rhinoplasty, point out the necessity for performing this study.

PURPOSE

To determine the frequency of acne and its exacerbation after rhinoplasty.

MATERIALS AND METHODS

In a longitudinal controlled study at a tertiary referral university hospital, the degree of acne before and 1 and 3 months after surgery was measured in 110 patients (30 Male, 80 Female, Mean age: 26.3 ± 6.8) with rhinoplasty and 80 patients (35 Male, 45 Female, Mean age: 24.5 ± 4.6) with septoplasty, based on Global Acne Grading System (GAGS). The data were analyzed by SPSS 16 software.

RESULTS

The frequency of acne exacerbation in first post-surgical visit was 27% in case and 3.5% in control subjects (P<0.007). In case group, 42.9% of those who had no acne before surgery, developed mild acne and 14.5% of those with mild acne, turned into moderate acne. In second post-surgical visit 91.7% of those who had moderate acne in first visit, turned into mild acne and 80% of those with severe acne in first post-surgical visit changed into moderate acne without any specific therapy (P<0.0001 and P<0.001, respectively).

CONCLUSIONS

Rhinoplasty has significant relationship with acne exacerbation. The severity of acne decreases gradually during 3 months after surgery. For determining the exact course and risk factors of this complication, further studies are needed.

Skin microbiota: overview and role in the skin diseases acne vulgaris and rosacea

As the first barrier to environmental exposures, human skin has developed an integrated immune system to protect the inner body from chemical, physical or microbial insults. Microorganisms inhabiting superficial skin layers are known as skin microbiota and include bacteria, viruses, archaea and fungi. The microbiota composition is crucial in the instruction and support of the skin's immune system. Changes in microbiota can be due to individual, environmental or behavioral factors, such as age, climate, hygiene or antibiotic consumption, which can cause dysbiosis. The contribution of skin microbiota to disease development is known in atopic dermatitis, where there is an increase in Staphylococcus aureus. Culture-independent studies have enabled more accurate descriptions of this complex interplay. Microbial imbalance is associated with the development of various diseases. This review focuses on microbial imbalances in acne vulgaris and rosacea.

Knowledge and practice of primary healthcare physicians for management of acne vulgaris in Qassim region, Saudi Arabia

BACKGROUND

The management of acne in its early stages is important for disease prognosis. Patients with acne usually present at the primary healthcare (PHC) centers during the early stages of their disease. Assessment of the current knowledge and practice of the physicians treating these patients is required.

OBJECTIVE

The aim of our study was to assess the knowledge and practice of physicians working at PHC centers in the Qassim region of Saudi Arabia on the management of acne vulgaris.

SUBJECTS AND METHODS

A cross-sectional survey was conducted on 142 physicians working at PHC centers of the Qassim province, Saudi Arabia. Physicians were asked to answer a pretested specially-designed questionnaire on the management of acne vulgaris that comprised questions evaluating the knowledge on disease causes, aggravating or relieving factors, and treatment practices.

RESULTS

This survey revealed that physicians working at PHC centers had inadequate knowledge on disease management; 38.7% of doctors had a low level of knowledge, whereas only 11.3% had a high level of knowledge. Participating physicians indicated that the main causes of acne are (a) hormonal factors (58.5%), (b) infections (16.9%), and (c) genetic abnormalities (12%). Lack of sufficient knowledge of physicians reflected on their treatment practices; only one-third of them independently dealt with acne cases without referral, and 23.9% referred the cases without medication. Physicians with a low level of knowledge showed six times more referrals than those with a high level of knowledge (P<0.001; odds ratio: 6.0).

CONCLUSION AND RECOMMENDATIONS

This study revealed that physicians practicing at PHC centers have inadequate knowledge and practice for management of acne. Steps should be taken to improve and update the dermatological knowledge of physicians working at PHC centers. Lectures, workshops, and other training activities should be arranged for them by dermatologists with expertise in acne. Further studies are required to analyze the current situation of practice for other common dermatological disorders.

Acne: prevalence and relationship with dietary habits in Eskisehir, Turkey

BACKGROUND

Acne vulgaris is a common disease affecting adolescents. There is not comprehensive data on acne prevalence in the Central Anatolia Region in particular. Etiology of acne is not clarified yet. Acne might be related to environmental factors. There is increasing evidence supporting acne and diet relationship.

OBJECTIVES

The aim of the study was to determine the acne prevalence in adolescents in the city of Eskisehir, located in the Central Anatolia, Turkey in addition to evaluate factors affecting acne and its relationship with dietary habits.

METHODS

A cross-sectional study was conducted on 2300 participants aged 13-18 years. The participants were asked to complete a questionnaire form consisting information about acne and a questionnaire form consisting information about dietary habits (The Adolescent Food Habits Checklist). In addition an objective evaluation of acne was determined.

RESULTS

The mean age of students with acne was 15.10±1.53. The current acne prevalence was 60.7%. Although 21% of the participants had severe acne (grade 3-4) and 25% developed sequelaes, only 11.5% of all participants consulted a doctor. The participants without acne had healthier dietary habits than participants with acne (P<0.05). Frequent fat intake (OR=1.39, 95% CI: 1.06-1.82), frequent sugar intake (OR=1.30, 95% CI: 1.05-1.60), frequent eating sausages, burgers (OR=1.24, 95% CI: 1.03-1.48), frequent eating pastries, cakes (OR=1.20, 95% CI: 1.01-1.43) were associated with increased risk for acne.

CONCLUSIONS

Acne prevalence is high among adolescents in Eskisehir but the rate of consulting doctor is low. Increasing public awareness is critical for convincing adolescents to seek medical help earlier. Acne was related with dietary habits. Fat, sugar and fast food consumption is found to be positively correlated with acne prevalence.

Acne vulgaris: pathogenesis, treatment, and needs assessment

Acne vulgaris is a common skin condition with substantial cutaneous and psychologic disease burden. Studies suggest that the emotional impact of acne is comparable to that experienced by patients with systemic diseases, like diabetes and epilepsy. In conjunction with the considerable personal burden experienced by patients with acne, acne vulgaris also accounts for substantial societal and health care burden. The pathogenesis and existing treatment strategies for acne are complex. This article discusses the epidemiology, pathogenesis, and treatment of acne vulgaris. The burden of disease in the United States and future directions in the management of acne are also addressed.

New insights into adolescent acne

PURPOSE OF REVIEW

Acne vulgaris remains one of the most common conditions affecting adolescents. The pediatric practitioner is the first to evaluate adolescent acne, making familiarity with the condition and its management essential. This review covers some of the recent literature regarding acne to help practitioners stay current on the issues regarding this topic.

RECENT FINDINGS

The pathogenesis of acne is multifactorial and complex, but recent advances in molecular genetics have provided additional information on the actions of Proprionibacterium acnes. Nutritional studies have reevaluated a possible role for diet and lifestyle factors in acne development. Many therapies are available to control acne and to limit associated scarring. Their appropriate use requires an understanding of not only the benefits but also the possible risks and adverse effects involved. Recent concerns regarding the use of antibiotics and isotretinoin will be addressed.

SUMMARY

This study reviews the recent literature regarding teenage acne, focusing on pathogenesis, associations, and controversies and considerations in therapy.

Male skin care needs

Male skin care has undergone significant development over the past decade, with many companies now marketing skin care products directly to the male consumer. Despite the claims of many of these companies, few over-the-counter products have data to support their efficacy at a clinical level. A basic, effective regimen for preventive male skin care should include twice-daily facial cleansing and twice-daily moisturizer application, which should include sunscreen during the day. This article focuses on topical therapies directed at the maintenance and repair of photoaged male skin. The future holds promise for new developments in skin care. However, in the absence of significant scientific breakthroughs, the most cost-effective intervention will continue to be prevention.

Practical considerations in acne treatment and the clinical impact of topical combination therapy

Acne vulgaris is a highly prevalent, multifactorial disease process affecting the pilosebaceous units of the dermis. The effects of acne are profound both physically and psychosocially across all age groups and ethnicities; therefore, prompt recognition and appropriate treatment are critical. Pharmacotherapeutic approaches range from simple monotherapy to multimodal treatments with a variety of topical and systemic agents. Optimal patient outcomes in acne management, however, are based both on treatment efficacy as well as overall patient satisfaction. In an effort to comprehensively address these key clinical considerations in acne management, we examine the diverse nature of acne patients, the factors in optimizing treatment outcomes, and the clinical impact of current medications, particularly topical combination therapy.