Examining Quality of Life After Treatment with Azelaic and Pyruvic Acid Peels in Women with Acne Vulgaris

Physiological and Psychological Effects of Isotretinoin in the Treatment of Patients with Acne: A Narrative Review

Isotretinoin (ISO) is a powerful vitamin A derivative that offers the potential for treatment of permanent remission of acne; however, its potential side effects on both physiological and psychological aspects limit its application. This article reviews the side effects of ISO from physiological and psychological aspects in detail, to better screen the suitable population of ISO and improve the efficiency of clinical treatment. Our findings indicate that ISO may cause teratogenicity, skin reactions, ocular reactions, changes in blood indicators, and occasional acne fulminans. To optimize clinical treatment, more attention should be paid to identifying the specific conditions under which these reactions occur, how severe they are, and how they subside to alleviate patient concerns. Regarding the controversial issue of psychological side effects caused by ISO, researchers should shift their focus to the psychological problems that acne itself may cause.

The Effectiveness of Pyruvic Acid Peeling in Improving the Quality of Life of Patients with Acne Vulgaris

Improving the quality of life (QoL) of patients with various chronic diseases has become a challenge and priority of contemporary medicine. The aim of this study was to assess the impact of pyruvic acid peeling on the QoL of patients with acne vulgaris. The study group consisted of 200 young patients (mean age 23.04 ± 4.71) with acne vulgaris of mainly mild or moderate severity. Basic data about the patient were collected using a self-reported questionnaire. The assessment of QoL was carried out using standardized questionnaires: CADI (Cardiff Acne Disability Index), DLQI (Dermatology Life Quality Index), SWLS (Satisfaction With Life Scale), and BDI (Beck Depression Inventory). The cosmetic intervention consisted of chemical peeling with 35% pyruvic acid for acne lesions on the body and included four series repeated at 7-day intervals. This study demonstrated that acne vulgaris impairs the quality of life of young people. There were no significant differences between the severity of acne and the lifestyles of the subjects. The applied cosmetic procedure significantly decreased the severity of the acne and improved the quality of life of the patients.

Prospective Evaluation of a Topical Botanical Skin Care Regimen on Mild to Moderate Facial and Truncal Acne and Mood

Acne vulgaris is a common inflammatory condition that can be associated with profound psychosocial impacts. Conventional treatment includes topical retinoids, benzoyl peroxide, and antimicrobials, and some may cause irritation and skin dryness. In this 8-week open-label study, we examined the effects of a botanical skin care regimen (Codex Labs Shaant Balancing regimen) on mild to moderate facial and truncal acne. Twenty-four male and female subjects between the ages of 12 and 45 years were assessed for eligibility, 20 were enrolled, and 15 completed all study visits. Facial and truncal acne lesion counts, skin hydration, sebum excretion rate, and mood were assessed at baseline, week 4, and week 8. Total facial lesion counts (inflammatory and non-inflammatory lesions) decreased by 20.5% at week 4 (p = 0.06) and by 25.2% at week 8 (p < 0.05). Inflammatory lesion counts on the trunk were found to decrease at week 8 relative to baseline by 48% (p < 0.05). Forehead sebum excretion rate decreased by 40% at week 4 (p = 0.07) and 22% at week 8 (p = 0.08), and cheek skin hydration increased by 27.6% at week 4 (p = 0.14) and 65% at week 8 (p = 0.10). Participants also experienced significant improvement in components of a positive effect, such as feeling "strong" and "inspired", and a decrease in negative effects, such as feeling "irritable." Overall, the botanical skin care regimen was found to be well-tolerated. Our study suggests that a botanical skin care regimen may reduce facial and truncal acne lesion counts, increase skin hydration, reduce sebum production, and augment positive effects and moods in those with mild to moderate facial and truncal acne.

Use of Patient-Reported Outcomes in Acne Vulgaris and Rosacea Clinical Trials From 2011 to 2021: A Systematic Review

Importance

Acne and rosacea have substantial implications for quality of life, and it is therefore important to ensure the patient's voice is being captured in pivotal randomized clinical trials (RCTs). Although patient-reported outcome measures (PROMs) are a valuable tool to capture the patient perspective, little is known about use of PROMs in RCTs on acne and rosacea.

Objective

To characterize the use of PROMs in RCTs on acne and rosacea.

Evidence Review

A systematic literature search was conducted using the search terms acne vulgaris and rosacea in the following databases: MEDLINE through PubMed, Embase, Cochrane Central Register of Controlled Trials, and Cochrane Database of Systematic Reviews. A modified search hedge for RCTs from the McGill Library was applied. All phase 2, 3, and 4 RCTs published between December 31, 2011, through December 31, 2021, that evaluated the efficacy and safety of therapies for acne and rosacea vs any comparator were eligible for inclusion.

Findings

A total of 2461 publications describing RCTs were identified, of which 206 RCTs met the inclusion criteria (163 trials [79%] on acne and 43 [21%] on rosacea). At least 1 PROM was used in 53% of trials (110) included; PROM use was more common in rosacea RCTs (67% [n = 29]) compared with acne RCTs (50% [n = 81]). At least 1 dermatology-specific (13% [n = 27]) or disease-specific (14% [n = 28]) PROM was included in the RCTs analyzed. Only 7% of trials (14) included a PROM as a primary outcome measure. There was no statistically significant increase in PROM inclusion over the study period (11 of 21 trials in 2011 vs 5 of 12 trials in 2021).

Conclusions and Relevance

In this systematic review, PROMs were included in approximately one-half of acne and rosacea RCTs performed over the study period. In addition, PROMs were rarely used as a primary outcome measure, and inclusion of PROMs has not increased substantially over the past 10 years. Increasing use of PROMs in RCTs can ensure that the patient's perspective is captured during the development of new treatments for acne and rosacea.

Efficacy of Hydrogen Purification and Cosmetic Acids in the Treatment of Acne Vulgaris: A Preliminary Report

Acne and skin lesions that appear in its course deteriorate the quality of life of patients, cause depression and the emergence of suicidal thoughts. Cosmetic treatments can have a positive effect on improving skin condition by cleaning up skin eruptions, thus improving the well-being of affected people. Hydrogen purification is a treatment that uses alkaline water generated by a device, which reduces sebum from the surface of the epidermis. This is a novel treatment that has recently been introduced to beauty salons. On the other hand, cosmetic acids have been used for many years for treating people with acne vulgaris and give spectacular results in terms of improving the skin condition. In this study, skin condition was evaluated with a Derma Unit SSC 3 device. The Global Acne Grading System (GAGS) was used to check acne severity. Twenty-four women aged 19-21 years (M = 20.13, SD = 0.80) diagnosed with mild acne vulgaris and a high sebum level participated in the study. Group A underwent a hydrogen purification treatment using an H2jet manipulator, which ejected alkaline water from the manipulator under pressure. Group B underwent a hydrogen purification treatment with the use of a phytic, pyruvic, lactic and ferulic acids at 40% mixture (pH 1.4). A series of four treatments was performed at 14-day intervals in both groups. Skin parameters were measured before and 30 days after the series of treatment. Very good results were obtained in both groups. The skin eruptions in patients were reduced and we also observed lower amounts of sebum on the surface of the epidermis, and an improvement in skin hydration. However, in group B, the results were better than in group A. The study showed that the synergy of the treatments produced much better effects than those obtained by completing the hydrogen purification treatment alone.

A Split Face Comparative Study to Evaluate the Efficacy of 40% Pyruvic Acid vs. Microdermabrasion with 40% Pyruvic Acid on Biomechanical Skin Parameters in the Treatment of Acne Vulgaris

The synergy of cosmetic acids, with their keratolytic and antibacterial properties, with the mechanical exfoliation of the epidermis brings faster and better treatment results. The aim of the study was to compare the effects of using only pyruvic acid and the synergy of microdermabrasion and chemical exfoliation. In total, 14 women diagnosed with acne took part in the study. Two areas were marked on the participants' faces: the right side (microdermabrasion treatment and a preparation containing pyruvic acid 40%) and the left side (preparation containing pyruvic acid 40%) without mechanical exfoliation. A series of four treatments was performed at 2-week intervals. Skin parameters such as stratum corneum hydration and sebum secretion were measured. Before the treatments, all patients had moderate acne according to GAGS (Min: 19, Max: 22, Md: 20), and after the treatments, it decreased to mild acne according to GAGS (Min: 13, Max: 17, Md: 140). On the right side of the face, there was a statistically significant reduction in sebum secretion in all the examined areas of the face and increase in the hydration of the stratum corneum. On the left side of the face, the differences were also observed in the decrease of sebum value and increase of hydration level; however, they were smaller than on the right side. The use of microdermabrasion in combination with pyruvic acid led to better results in the case of increased hydration and reduction of sebum secretion than using only pyruvic acid treatment.

Efficacy of Oxybrasion in the Treatment of Acne Vulgaris: A Preliminary Report

There are many cosmetic methods to reduce skin eruptions in people with acne vulgaris. As oxybrasion is a safe method of exfoliating dead epidermis, our objective was to investigate its effectiveness in young women with acne vulgaris. The Global Acne Grading System (GAGS) and Derma Unit SSC 3 device (Sebumeter SM 815, Corneometer CM 825) were used to assess acne vulgaris and skin properties. Twenty-four women aged 19–21 years (M = 19.50, SD = 0.66) with diagnosed mild acne vulgaris and a high level of sebum (more than 100 μg/cm²) participated in the study. Women on any dermatological treatment within the last 12 months and/or hormonal contraception were excluded. Probands were randomly assigned to two equal groups. Group A (experimental) was oxybrased with 0.9% sodium chloride solution simultaneously with compressed oxygen. Group B (placebo) was the group treated with non-carbonated mineral water and oxygen from the device (not pure). A series of five treatments was performed at 10-day intervals. Skin parameters were measured before and 30 days after the end of treatment. As a result, in group A (experimental), skin hydration and GAGS improved, while sebum on the epidermis was reduced. No side effects were noted. We concluded that oxybrasion is effective in women with acne and safe, as it improved skin parameters; however, further research is needed.

The Burden on Cohabitants of Patients with Chronic Spontaneous Urticaria: A Cross-Sectional Study

Chronic Spontaneous Urticaria (CSU) has been associated with patients’ poor quality of life. Despite being a chronic disease that could alter the quality of life of the people who live with patients, the potential burden on their cohabitants has not been studied to date. The aim of this study is to analyze the relationship between the patient’s quality of life, disease control, disease duration and family quality of life and the cohabitant’s mood disturbances, sexual dysfunction, type D personality and sleep quality. A cross-sectional study including patients suffering from CSU and their cohabitants was performed. Sociodemographic variables and disease activity, quality of life, sleep, sexual disfunction, anxiety, depression and type D personality were collected using validated questionnaires. Sixty-two subjects, 31 CSU patients and 31 cohabitants, were included in the study. Worse disease control and poorer quality of life in patients were associated with poorer family quality of life and higher rates of anxiety among the cohabitants (p < 0.05). Patients’ poor quality of life was associated with reduced sexual satisfaction among the cohabitants (p < 0.05). Long disease duration (>10 years) was associated with an increased prevalence of type D personality among the cohabitants (prevalence ratio: 2.59, CI 95% 1.03−7.21). CSU seems to have an impact on the quality of life of cohabitants, especially in terms of increased rates of anxiety, poorer quality of life and reduced sexual satisfaction. The prolonged course of the disease could be associated with the increased presence of non-adaptative personality traits.

Methods for the Improvement of Acne Scars Used in Dermatology and Cosmetology: A Review

Acne vulgaris is a chronic skin disease that, depending on its course, is characterized by the occurrence of various skin eruptions such as open and closed comedones, pustules, papules, and cysts. Incorrectly selected treatment or the presence of severe acne vulgaris can lead to the formation of atrophic scars. In this review, we summarize current knowledge on acne scars and methods for their improvement. There are three types of atrophic scars: icepick, rolling, and boxcar. They are of different depths and widths and have different cross-sections. Scars can combine to form clusters. If acne scars are located on the face, they can reduce the patient’s quality of life, leading to isolation and depression. There are multiple effective modalities to treat acne scars. Ablative lasers, radiofrequency, micro-needling, and pilings with trichloroacetic acid have very good treatment results. Contemporary dermatology and cosmetology use treatments that cause minimal side effects, so the patient can return to daily functioning shortly after treatment. Proper dermatological treatment and skincare, as well as the rapid implementation of cosmetological treatments, will certainly achieve satisfactory results in reducing atrophic scars.

The Effects of Green Tea (Camellia sinensis), Bamboo Extract (Bambusa vulgaris) and Lactic Acid on Sebum Production in Young Women with Acne Vulgaris Using Sonophoresis Treatment

People struggling with acne vulgaris, not only experience skin eruptions and skin pain, but also report that their quality of life is worse compared with healthy people. This study examined, for the first time, the effect of sonophoresis on select skin parameters (sebum level) in young women suffering from acne vulgaris. The study included 60 women 19–23 years of age (M = 21.45, SD = 0.91) with mild and moderate facial acne. The inclusion criteria were 19–23 years of age, female or male gender, mild to moderate acne, no dermatological treatment within last 12 months, and no hormonal contraception (women). No men volunteered for the study, so the group was homogeneous. The patients were divided into two groups. Group A underwent a sonophoresis procedure using ultrasound and ultrasound gel combined with a green tea, bamboo extract ampule, and 5% lactic acid. Group B was the placebo group, where sonophoresis was performed using only ultrasound gel (no ampules). The members of the placebo group were told that they were undergoing sonophoresis with a green tea, bamboo extract, and 5% lactic acid ampule. Before and after the series of procedures, sebum levels were measured in the skin. Each patient underwent a series of five procedures using sonophoresis equipment at one-week intervals. Sonophoresis with green tea, bamboo extract, and 5% lactic acid contributed to the reduction of skin eruptions and sebum levels in the participants of the study (group A). The study results demonstrated that the combined use of plant preparations, lactic acid, and ultrasound had a positive effect on the skin of people suffering from acne vulgaris, including reduction of skin eruptions and sebum levels on the surface of the skin.

Topical antimicrobial peptides in combined treatment of acne patients

BACKGROUND

Acne vulgaris (AV) is a chronic inflammatory disorder of the pilosebaceous unit that affects over 80% of adolescents and young adults. This study aimed to compare the therapeutic efficacy and tolerability of an isotretinoin treatment course with GDP-20 (granulysin-derived peptides) versus the conventional isotretinoin monotherapy prescribed to patients with mild-to-moderate acne.

METHODS

Our study included 60 Russian subjects affected with AV of mild-to-moderate severity divided into two therapeutic groups. Half of the patients were female; mean age was 19.5 ± 5.6 years. Group 1 was treated with topical GDP-20 twice daily to the affected skin of the face combined with systemic isotretinoin in a fixed low dose of 0.3 mg/kg/day. Group 2 was treated with systemic isotretinoin as a monotherapy.

RESULTS

The assessment of the changes of AV lesion count on the 12th week of the treatment showed that in Group 1, the mean value of open comedo number reduced from 21.4 ± 6.1 at day 0 to 4.4 ± 2.5 (p < 0.05), the mean number of closed comedo reduced from 7.6 ± 3.5 to 2.4 ± 1.05 (p < 0.05), and those of papules-pustules reduced from 6.1 ± 1.03 to 1.4 ± 0.2 (p < 0.05).

CONCLUSIONS

Topical antimicrobial peptides (GDP-20) combined with low doses of systemic isotretinoin mild-to-moderate resulted in considerable improvement of clinical manifestations of mild-to-moderate AV and threefold reduction in the disease severity with IGA score 0-1 after 12 weeks. Topical application of GDP-20 antimicrobial peptides can improve the efficacy of low-dose systemic isotretinoin in combined treatment of mild-to-moderate AV.

Effects of Topical Hydrogen Purification on Skin Parameters and Acne Vulgaris in Adult Women

BACKGROUND

Acne vulgaris is a prevalent dermatological disease characterized by skin eruptions, which may decrease the sufferer's quality of life. Hydrogen purification treatment is a new procedure used in cosmetology to improve the skin parameters of the face. This study examined the effectiveness of hydrogen purification treatment to improve women's skin conditions with regard to acne vulgaris.

METHODS

In this study, 30 women participated who suffered from a high level of sebum and acne. The control group was comprised of 30 healthy women with a low level of sebum. The Hellgren-Vincent Scale and Derma Unit SSC 3 device were used to assess acne vulgaris severity and skin properties, respectively. Four hydrogen purification sessions were carried out at 7-day intervals, using the Hebe Hydrogenium+ generating alkaline water.

RESULTS

At baseline and 7 and 14 days after finishing the series of treatments, the levels of oiliness, moisture, and skin pH were tested. The main effects of treatment were significant in the following parameters: pH around the bottom lip, moisture between the eyebrows and around the nose, and oily skin in all three face sites.

CONCLUSIONS

The level of sebum decreased and moisture levels increased during hydrogen purification. Topical hydrogen purification is an effective and safe treatment for acne vulgaris.

Association between Satisfaction with Life and Personality Types A and D in Young Women with Acne Vulgaris

People with acne vulgaris report a lower level of satisfaction with life and are more frequently classified as having Type D personalities than those without acne. This research examined, for the first time, the moderating and mediating role of personality type in the relationship between acne severity and satisfaction with life. Among 300 female nursing and cosmetology students ranging in age from 19 to 24 years (M = 21.28, SD = 1.39), 150 individuals (50%) presented with symptoms of acne vulgaris (AV group), while the other 150 (50%) were categorized as controls without acne vulgaris (WAV sample). A cross-sectional study was conducted using three self-report questionnaires: The Satisfaction with Life Scale (SWLS), the Framingham Type A Scale (FTAS), and the Type D Scale (DS14). Acne vulgaris was clinically diagnosed using the Hellgren–Vincent Scale (HVS). The AV group scored significantly higher on the FTAS and DS14 and lower on the SWLS than the WAV sample. Life satisfaction correlated negatively with both the negative affectivity (NA) and social inhibition (SI) subscales of the DS14. The moderating role of the Type A behavioral pattern (TABP) and the mediating role of both NA and SI subscales of the DS14 were observed in the relationship between acne severity and satisfaction with life. The type of personality may explain the mechanism of the relationship between acne disease and subjective well-being. Therefore, psychological interventions and strategies focused on managing stress and mood may effectively improve satisfaction with life in people with acne.

(+)-Erythro-Δ8'-7S,8R-Dihydroxy-3,3',5'-Trimethoxy-8-O-4'-Neolignan, an Anti-Acne Component in Degreasing Myristica fragrans Houtt

Acne is a common skin condition observed in adolescents. Nutmeg (Myristica fragrans Houtt) (MF) is a well-known traditional Chinese medicine; its major toxic components, safrole and myristicin, are rich in essential oils. Essential oils of MF (MFO) were extracted by hydrodistillation; the residue was extracted using 50% methanol (MFE-M). The minimum inhibitory concentration (MIC) of MFE-M against Cutibacterium acnes and Staphylococcus aureus was 0.64 mg. Four compounds were obtained from MFE-M: myristicin (1), (+)-erythro-Δ^8′-7S,8R- dihydroxy-3,3,5′-trimethoxy-8-O-4′-neolignan (2), (+)-erythro-Δ^8’-7-hydroxy-3,4,3’,5’-tetramethoxy 8-O-4-neolignan (3), and erythro-Δ^8′-7-acetoxy-3,4,3′,5′-tetramethoxy-8-O-4′-neolignan (4). Compound 2 exerted the strongest antimicrobial activity, with MICs of 6.25 and 3.12 μg/mL against C. acnes and S. aureus, respectively. Moreover, 2 inhibited NO, PGE₂, iNOS, and COX-2 levels in RAW 264.7 cells induced by LPS or heat-killed C. acnes; NO production at 50% inhibitory concentrations (IC₅₀) was 11.07 and 11.53 μg/mL, respectively. Myristicin and safrole content was higher in MFO than in MFE-M. MFO and MFE-M caused no skin irritation after a single topical application in Wistar rats. MFE-M, with low safrole and myristicin content, did not cause skin irritation and exhibited an anti-acne effect; moreover, 2 was identified as the active substance. Therefore, MFE-M could be employed to develop anti-acne compounds for use in cosmetics.