Ocular surface changes in moderate-to-severe acne vulgaris

AIM:To investigate ocular surface disorders and tear function changes in patients with acne vulgaris and explore the potential relationship between acne vulgaris and dry eye.METHODS:This cross-sectional study included right eyes of 53 patients with acne vulgaris and 54 healthy controls.The participants completed the Ocular Surface Disease Index(OSDI)questionnaire.The following ocular surface-related parameters were measured:tear meniscus height(TMH),noninvasive tear breakup time(NIBUT),Schirmer I test(SIT),lipid layer thickness(LLT)score of the tear film,meibum score,meibomian gland orifice obstruction score,the ratio of meibomian gland loss,conjunctival hyperemia score,and corneal fluorescein staining(CFS)score.RESULTS:The stability of the tear film decreased in acne vulgaris patients.In the acne group,the TMH and NIBUT were lower,whereas the OSDI,meibum score,meibomian gland orifice obstruction score,ratio of meibomian gland loss,and conjunctival hyperemia score were higher compared with controls(P<0.05).There were no significant differences in the CFS score,SIT,or LLT score between the groups(P>0.05).In two dry eye groups,the TMH,NIBUT,and LLT score were lower in the acne with dry eye(acne-DE)group,and the meibum score,meibomian gland orifice obstruction score,ratio of meibomian gland loss and conjunctival hyperemia score in the acne-DE group were higher(P<0.05).There were no significant differences between OSDI,SIT,and CFS score(P>0.05).CONCLUSION:Patients with moderate-to-severe acne vulgaris are more likely to experience dry eye than those without acne vulgaris.Reduced tear film stability and meibomian gland structure dysfunction are more pronounced in patients with moderate-to-severe acne and dry eye.

Serum level changes of inflammatory cytokines in patients with moderate to severe acne vulgaris treated with dual-wavelength laser

Background:Acne vulgaris(AV)is a common inflammatory skin disease.Although various mechanisms have been indicated in the etiopathogenesis of AV,the exact pathophysiology remains unknown.Various lasers have been used to treat AV;however,the serum level changes of inflammatory cytokines after laser therapy have not been elucidated.We aimed to investigate the relationship between inflammatory changes and remission on the opposite side in patients with moderate to severe AV after treating half of the face with 595-and 1064-nm dualwavelength laser.Methods:In total,18 patients(9 male and 9 female)between 16 and 35 years of age with moderate to severe AV were evaluated in the study.Disease severity was classified according to the Pillsbury grading system of acne.Patients were randomized to receive a series of two treatment sessions at intervals of 2 weeks and followed up at 2 weeks after the final treatment.A 3 mL blood sample was drawn from every subject each time,and serum levels of inflammatory cytokines such as interleukin(IL)-6,IL-8,and IL-22 were determined using enzyme-linked immunosorbent assay at baseline and 2 weeks after each treatment.Improvement was determined by a blinded assessment of photographs taken before and after the final evaluation.Results:Inflammation was significantly reduced on both the treated and untreated sides,and symptoms of AV lesions were alleviated.All patients showed a significant increase in serum IL-22 levels after the first laser therapy,with no significant difference in serum IL-6 and IL-8 levels.After the second laser therapy,serum IL-6,IL-8,and IL-22 levels were significantly decreased.No significant side effects such as bruising,edema,hyperpigmentation,hypopigmentation,or scarring were reported.Conclusion:Half-face treatment with 595-and 1064-nm dual-wavelength laser for moderate and severe AV showed a significant effect of full-face remission,which was associated with a gradual decrease in IL-6,IL-8,and IL-22 levels after half-face topical treatment.This suggests that reducing inflammatory cytokine levels in the serum can relieve inflammation in non-therapeutic sites.This laser treatment is effective,economical,and painless.

A Case Report of Concurrent Acne-Related Occurrence Complications: Telangiectasia, Post-Inflammatory Erythema, Post-Inflammatory Hyperpigmentation, and Atrophic and Hypertrophic Scars

Prior to his initial diagnosis, a 21-year-old male had been experiencing facial acne for two years and had been treated by a doctor in private practice. The patient visited our department because the clinical manifestations of mandibular acne did not improve. At the time of initial examination, telangiectasia (TE), post-inflammatory erythema (PIE), post-inflammatory hyperpigmentation (PIH), atrophic scars (ASs), and a hypertrophic scar (HS) with induration were observed on the right neck. We diagnosed this as an acne vulgaris complication. HS lesions were topically treated by injecting triamcinolone acetonide, and the patient was prescribed 8.1 g/day of oral Saireito (Japanese herb). Adapalene benzoyl peroxide gel and topical tacrolimus hydrate ointment were used to treat PIE and TE. Both HSs and PIE improved;however, TE and AS did not improve. Currently, the patient is under observation. We consider this to be a very rare concurrent occurrence of diverse complications of acne vulgaris, and present the following case study.

Effective Skin Care Guidance for Patients with Acne Vulgaris after Standard Treatment

With the introduction of new drugs, the treatment of acne vulgaris has improved dramatically;however, there remains a considerable gap between treatment outcomes and patients’ treatment goals. This study aimed to determine whether dermatologists’ guidance on appropriate skincare for skin symptoms such as post-inflammatory erythema and post-inflammatory hyperpigmentation (PIH), which are not covered by acne treatment, leads to an improvement in patients’ skin condition and patient satisfaction. Japanese women who had completed standard treatment for acne vulgaris and those with mild symptoms not requiring treatment were included in the study. The participants received instructions about skin care at the beginning of the study, which they continued to apply for 6 weeks. At the start and end of the study, participants were examined by a dermatologist;afterward, skin measurements, including skin color, skin surface lipid content, and image analysis by VISIA® Evolution, analysis of stratum corneum obtained from the skin surface, and Skindex-16 questionnaire for assessing quality of life (QOL), were performed. The following showed significant improvements: PIH score, number of inflammatory acne lesions, and number of non-inflammatory acne lesions observed via skin examination;skin surface lipid content and values of L* and a* obtained via instrumental measurement;n number of pore, texture, red spot, and pigmented spot obtained via by image analysis;and degree of multilayer exfoliation and interleukin-1α determined by analysis of epidermal stratum corneum. QOL measurement using Skindex-16 also improved significantly. Appropriate skin care guidance following standard acne vulgaris treatment is helpful in achieving patients’ treatment goals. .

Effects of cosmetics containing purified honeybee(Apis mellifera L.) venom on acne vulgaris

Acne vulgaris is a chronic dermatologic problem with multiple factors involved in its pathogenesis. Alternative solutions to acne treatment were instigated by antibiotic resistance despite of its extensive use. Purified bee venom （PBV） has been proposed as a promising candidate for that purpose. The present study was designed to confirm the antibacterial effect of PBV and access the efficacy of cosmetics containing PBV in subjects with acne vulgaris. METHODS： The skin bacterium Propionibacterium acnes was incubated with PBV at various concentrations and bacterial growth was evaluated using the colony forming unit （CFU） assay. The mechanism of PBV employed in killing P. acnes was examined by scanning electron microscopy （SEM） and transmission electron microscopy （TEM）. In addition, a total of 12 subjects were randomized in a double-blind, controlled trial to receive either cosmetics containing PBV or cosmetics without PBV for two weeks. Evaluations included lesion counts and skin microorganism. RESULTS： PBV exhibited antimicrobial activity in a concentration-dependent manner, reducing the number of P. acnes CFU by approximately 6 logs at a concentration of 0.5 mg. When PBV concentration was higher than 1.0 mg, no P. acnes colonies were spotted on an agar. TEM and SEM of untreated P. acnes illustrated the normal pleomorphic structure, whereas the PBV- treated bacterium lost the integrity of surface architecture. Significant difference （P=0.027） in the grading levels based on numbers of lesion counts for inflammatory and noninflammatory was observed in favour of the PBV group compared with the control group. In terms of average decrement of skin microorganism, subjects receiving cosmetics containing PBV experienced a significant 57.5% decrease of adenosine triphosphate levels, whereas participants receiving cosmetics without PBV experienced a nonsignificant decrease of 4.7%. CONCLUSION： These results show that the in vitro actions of antimicrobial activity of PBV were translated in vivo. Cosmetics containing PBV provided a certain degree of efficacy in terms of lesion counts and skin microorganism concentration compared with cosmetics without PBV in subjects with acne vulgaris. PBV may be a good candidate compound for developing therapeutic drua for the treatment of acne vulaaris.

Retrospective Study of the Use of a Fractional Radio Frequency Ablative Device in the Treatment of Acne Vulgaris and Related Acne Scars

Background: Acne vulgaris (AV) is a common disease that often results in disfiguring facial scarring that carries into adulthood. Here we report our experience with fractional radiofrequency (FRF) device in treatment of patients with acne and acne related scarring. Materials & Methods: We retrospectively reviewed the charts of all patients with acne scarring who completed a four treatment regimen in our clinic. Results: We identified eight patients who completed four treatments with median age of 20.5 years (range 17 - 41). All patients demonstrated significant improvement of acne lesions and acne scarring. Skin biopsies demonstrated reduction of scar depth and increased new collagen production, and repopulation of the scar tissue by elastic fibers and adnexal structures after the fourth treatment. Conclusion: FRF emerges as a safe and effective treatment modality for AV and acne related scars. Further randomized controlled studies are required to fully evaluate the magnitude of this positive effect and more basic science studies are needed in order to better characterize its mechanism of action on acne lesions.

Long Term Follow-Up Results of a Fractional Radio Frequency Ablative Treatment of Acne Vulgaris and Related Acne Scars

Introduction: Acne vulgaris and acne scarring are prevalent conditions that can have a negative effect on a patient’s quality of life. Fractional radiofrequency technologies have been shown to be clinically safe and effective in managing acne scars through dermal remodeling without causing direct damage to the epidermis. In a recently published study, we presented our clinical and histological results in the treatment of patients with active acne and acne related scarring using a Fractional RF (FRF) device. In the current article we demonstrate long term follow-up results, up to two years post last fractional treatment. Methods: Four out of the eight patients who completed a four treatment regimen were invited for long term follow-up visit to document treatment results. In some cases, touch-up treatments were conducted to optimize clinical results. Results: Patients demonstrated significant improvement of acne lesions, acne scarring, pores and skin texture. Long term photos demonstrated that clinical improvement progressed with time. Conclusion: The current study further supports the previous findings that FRF is a safe and effective treatment modality for active acne and acne related scars. Treatment protocol can be customized according to patient needs and clinical results last for long term.

TNFR 2 M196R Polymorphism and Acne Vulgaris in Han Chinese:A Case-control Study

In this case-control study,the relationship between M196R(676 T→G) variant in exon 6 of tumor necrosis factor receptor type 2(TNFR2) gene and genetic susceptibility of acne vulgaris in Han Chinese was investigated.A total of 93 acne vulgaris patients and 90 healthy subjects from Han Chinese ethnic group were enrolled in this study.Polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP) technique was adopted to analyze the single nucleotide polymorphisms(SNPs) of TNFR2 M196R gene,and to examine the association between acne vulgaris and the polymorphisms in TNFR2 M196R gene.The relationship between different genotypes and the susceptibility of acne vulgaris was analyzed.The results showed that there was significant difference in the frequency of the genotype M/R+R/R in the TNFR2 M196R genetic polymorphisms between acne vulgaris patients and healthy controls(χ2=4.343;P=0.037;OR=1.899;95% CI:1.036-3.445);and there was significant difference in the allele(R) frequency between acne vulgaris patients and healthy controls(χ2=5.588;P=0.018;OR=1.838;95% CI:1.105-3.057).It was concluded that the high frequency of 196R allele in the functional M196R polymorphism of TNFR2 is a risk factor for acne vulgaris in Han Chinese.

High dose niacin in the treatment of acne vulgaris:a pilot study

Introduction Acne patients are frequently associated with abnormal lipid profile. It may be useful to apply high doseof niacin that regulates the lipid profile along with acne treatment. There is no report about high dose of niacin in treatment ofacne. Objective To evaluate the therapeutic effect and safety of high-dose niacin in acne vulgaris. Methods Acne patientswere randomly allocated to two treatment groups. Both groups were treated orally with the tablets for 12 weeks; the niacingroup at an increasing dose of niacin tablet: 2000 mg (40 mg/kg/d). The control group (nicotinamide group) at a dose ofnicotinamide tablet: 600 mg (10 mg/kg/d). All patients were asked not to consume certain foods such as milk and alcohol.A high-protein, low-fat and low-glycemic-load diet was recommended in both groups. Results A total of 108 patients werefinished the study. Niacin group: 56 patients; control group: 52 patients. After 12 weeks of treatment, niacin and nicotinamidecaused improvement in acne patients. Percentage Improvement in the niacin group (82.37±7.837) %was significantly higherthan in the nicotinamide group (63.19±10.18)%, P <0.01. The number of successful cases in the niacin group was significantlyhigher than in the nicotinamide group after 12 weeks of treatment, (χ2 = 10.55, P <0.01). Conclusions High dose niacin canreally do it work in treatment of acne vulgaris. The therapeutic effcct of High dose of niacin in treatment of acne vulgaris ismore effective than nicotinamide.

Clinical Observation in 86 Cases of Acne Vulgaris Treated with Compound Oldenlandis Mixture

86 cases of acne vulgaris were treated with Fu Fang She She Cao He Ji (复方蛇舌草合剂Compound Oldenlandis Mixture), with the other 34 cases treated with Dang Gui Ku Shen Wan (当归苦参丸Pills Prepared from Chinese Angelica and Flavescent Sophora Root) as the controls, to observe the therapeutic effect of the former. The results showed that the cure plus markedly effective rate was 73.26% in the treatment group, and 47.06% in the control group, with a significant difference in the cure plus markedly effective rate between the two groups (P<0.01), and also in the total effective rate between the two groups significant (P<0.05). It may be concluded that the Compound Oldenlandis Mixture is a better agent for the illness.

Acne Vulgaris in Jeddah Medical Students: Prevalence, Severity, Self-Report, and Treatment Practices

Acne is a common skin disorder of teenagers and continues into adulthood. Research has been limited regarding acne prevalence, perception and health care utilization in Saudi Arabia. The objective of this study was to assess acne prevalence in final year female medical students in Jeddah, Saudi Arabia using the global acne grading system (GAGS) compared with student’s self-report of their acne. This is a cross-sectional study conducted among 151 students during 2016, in which students were interviewed subjectively and examined objectively by a trained physician. This study showed that acne was reported subjectively by 83.4% of female students compared to 98% of students assessed objectively by the global acne grading system. 14.6% of students claimed having no acne while it was objectively present, which was statistically significant (Χ2 = 15.4, P 2 months in 39.1% of students. Acne was present in 41.1% of the students parents compared to 83.4% in their siblings. A total of 41.7% of student had trunk acne. 60.9% of students had scarring and 72.8% of them had pigmentation. Moderate to severe acne students had higher siblings acne history of 95.2% (Χ2 = 5.85, P 2 = 4.05, P 2 = 4.87, P < 0.05) which was statistically significant. Our study confirms that acne is very common in female medical students in Jeddah, Saudi Arabia with a prevalence rate of 98%. Knowledge regarding acne treatment was inadequate demonstrating the need for educational and awareness programs about early treatment that will prevent suffering from acne scarring or pigmentation.

The Epidemiology of Acne Vulgaris among Adolescents and Young Adults in Jordan University Hospital

Background: Acne vulgaris is a widely prevalent distressing problem among young adults and adolescents. Almost one-third of young people consider acne to be a major problem/burden. Less than half of acne diagnoses are made by a physician, and acne is often self-managed. Objective: We aim to find the prevalence of acne among different age groups, treatment seeking behaviors and sources of knowledge about acne treatment. We also aim to determine impact of acne vulgaris on quality of life and psychology of patients. Design: A cross-sectional study. Setting: Jordan university hospital, Amman, Jordan. Subjects: Patients aged 15 - 35 years old who attended the family medicine clinic in Jordan University Hospital. Intervention: A self-administered questionnaire, consisted of three major parts, distributed during the period between August 2019 and October 2019. Results: Upon analyzing the data, 153 out of the 300 participants were found to have suffered or were still suffering from acne with a prevalence of 45%. The mean age at which the acne started was 16.20. There was a significant correlation between severity of acne and impact on life. More than half of the affected participants sought doctor help to treat their acne;patients depended on many sources of information to manage their acne. The majority of them reported the dermatologist as their source of information. Patients tended to use different methods of treatment to manage their acne. The cleanser was the most commonly used methods of treatment. Conclusion: Our article demonstrates that acne is a prevalent distressing problem among adolescents;it affects patients’ quality of life. Different modalities of treatment and sources of information were sought by patients. As family doctors, we emphasize the need for accessible, accurate, community-based education on the modalities of treatment of acne, and the importance of prompt medical attention toward its effect on quality of life.

PHOTOTHERAPY FOR MILD TO MODERATE ACNE VULGARIS WITH PORTABLE BLUE AND RED LED

In this paper,we studied portable blue and red light-emitting-diode(LED)light sources in phototherapy for mild to moderate acne vulgaris to evaluate the efficacy and tolerance of patients.Patients,randomly divided into blue and red groups,received either blue or red LED phototherapy twice a week for four weeks.After complete treatment,the number of lesions reduced by 71.4% in the blue group,in contrast to 19.5% in the red group.No obvious side effects were observed during and one month after the treatment,except for some mild dryness mentioned by several patients.

COMPARATIVE TREATMENT OF ACNE VULGARIS USING PALOMAR LUX APPLIQU´E TECHNIQUE AND DIRECT INTRALESIONAL INJECTION

Intralesional injection of triamcinolone(TMC)preparations is an effective therapy for cystic acne lesions.However,invasive delivery techniques limit the use of this modality to a relatively narrow class of cases.Skin permeability can be enhanced through creating a lattice of microzones(islets)of light-induced limited thermal damage in the upper layers of epidermis.In this paper,we directly compared safety and efficacy of delivering TMC acetonide with this novel technique versus conventional intralesional injection for treatment of inflammatory acne lesions.A combination of an intense pulsed light system and a specially designed appliqu´e with a pattern of absorbing centers has been used to create the lattice of islets of damage(LID).Quantitative analysis has included estimation of the following parameters:redness,diameter,and height of acne lesions.Clinical photography has been used to document dynamics of lesion development at successive visits(two hours,24 hours and one week post-treatment).Seven subjects have participated in the study.No difference in lesion dynamics between the treatment and control groups was observed at two-hours follow-up.At 24-hours/one-week follow-ups,TMC-injected and TMC-LID-delivered groups have demonstrated 82%/93%and 80%/89%improvement in height of lesions in comparison to control(60%/68%).Delivery of TMC with the newly proposed LID technique is at least as effective as intralesional injection for treating inflammatory acne lesions.Enhancement of skin permeability using LID approach is a promising technique for accelerating delivery of various compounds to their target areas in the skin.

Efficacy and Safety of 30% Supramolecular Salicylic Acid Peeling Combined with Isotretinoin Erythromycin Gel in the Treatment of Moderate-to-Severe Acne Vulgaris: A Comparative Study

Background: Both 30% supramolecular salicylic acid (SA) and isotretinoin erythromycin gel (IEG) have proven efficacy with good safety profiles in the treatment of acne vulgaris. Objectives: This study compared the clinical efficacy and safety of 30% SA peeling and IEG in the treatment of moderate-to-severe acne vulgaris. Methods: Patients with moderate-to-severe acne vulgaris were randomized into 3 groups of 30 persons each, and treated with SA peel, or IEG, or SA combine with IEG (SA + IEG group). Evaluation of acne was done by effective rate and individual lesion counts. And the adverse effects and recurrence were recorded. Results: The SA + IEG group was better in clinical efficacy and treating noninflammatory and inflammatory lesions than that of single treatment group (P 0.05). Conclusion: 30% SA combined with IEG had a significant effect in the treatment of moderate-to-severe acne lesions.

Treatment of Active Acne Vulgaris by Chemical Peeling Using TCA 35%

Background: The pathogenesis of acne vulgaris is multifactorial, and therapy can be directed at many of these factors, singly or in combination. There are different modalities of treatment of active acne vulgaris but they are often long lasting which could not be accepted by many patients. Objective: To evaluate the effectiveness, long term efficacy and safety of chemical peeling using 35% TCA solution in the treatment of active acne vulgaris. Patients and Methods:This clinical, interventional, therapeutic study was done at the Department of Dermatology—Baghdad Teaching Hospital during the period from January 2012 to March 2013. Eighteen patients with active acne vulgaris were included in this study, 10 (55.6%) females and 8 (44.4%) males. Their ages ranged from 15 to 35 (21.56 ± 5.501) years. Twelve patients were associated with acne scars. History and dermatological examination were performed for all patients regarding all demographic points related to the disease. Chemical peeling with 35% TCA used one session regarding active acne vulgaris and three sessions in patients with associated scarring. Scoring for active acne vulgaris and acne scar was done for each case before and after peeling to evaluate the severity of acne lesions and scarring. All patients were with Fitzpatrick’s skin types III and IV. Patients were followed up every two weeks for 12 weeks after starting therapy and every 4 weeks for 12 weeks after stopping the treatment to watch improvement, side effects and relapse. Results: Scoring for active acne vulgaris including papules and pustules showed highly statistically significant reduction after 2 weeks of therapy (p Conclusions: Chemical peeling by TCA 35% is a cost-effective mode of therapy for active acne vulgaris and acne scar with low down time in patients with dark complexion.

A Comparative Study of Topical Azailic Acid Cream 20% and Active Lotion Containing Triethyl Citrate and Ethyl Linoleate in the Treatment of Mild to Moderate Acne Vulgaris

Background: Acne vulgaris is a common disorder affecting 79% - 95% of the adolescent population. The choice of treatment depends on the severity, patients with mild to moderate acne should receive topical therapy such as azelaic acid. Rising antibiotic drug resistance consequent to the widespread use of topical antibiotics is causing concern and effective non-antibiotic treatments are needed. Objective: To compare the efficacy and side effects of topical azelaic acid cream 20% versus active lotion containing triethyl citrate and ethyl linoleate (TCEL) in treatment of mild to moderate acne vulgaris. Patients and Methods: This single, blinded, comparative, therapeutic study was done in the Department of Dermatology-Baghdad Teaching Hospital, Baghdad, Iraq;from May 2013-July 2014. Scoring of acne was carried out and the patients were examined every 2 weeks for 10 weeks of treatment. One month after stopping drugs, patients were evaluated for drug complications and disease recurrence. Sixty patients fulfilling enrollment criteria were included in this study. Patients were divided into 2 groups: Group A (30 patients) treated twice daily with TCEL lotion and Group B (30 patients) treated twice daily with topical azelaic acid cream 20%. Results: Both topical TCEL lotion and azelaic acid cream were statistically an effective therapy for treatment of mild to moderate acne vulgaris. TCEL lotion was more effective and act earlier than azelaic acid cream starting from 4 weeks of therapy till the end of treatment (after 10 weeks) and even after 4 weeks after stopping the treatment (P-value < 0.04). No systemic side effect for both groups was noted while the following side effects were reported;burning, pruritus and erythema, all these side effects disappeared after 8 weeks from starting treatment. After one month of follow up there was no significant relapse in both groups. Conclusion: The TCEL is non-antibiotic based, it had quicker onset of action and observable improvement of both inflammatory and non-inflammatory acne lesions. Its use would reduce the risk of antibiotic resistance developing within the skin flora.

Effects of Makeup Application on Diverting the Gaze of Others from Areas of Inflammatory Lesions in Patients with Acne Vulgaris

Skin manifestations can be major sources of stress for patients with skin diseases;hence, the effective use of makeup and cosmetic products for these patients has been established. The objective of this study was to determine if makeup can divert observers’ gaze from areas of inflammatory acne lesions. Both base and point makeup were applied to two Japanese female patients with mild to moderate acne vulgaris to hide skin manifestations, as well as to accentuate the eyes and lips. Photographs of their faces were shown, at various stages of makeup application, to 22 observers (11 men and 11 women). The effects of makeup application, and other eye-diverting strategies (e.g., clothing, accessories, and hairstyle), used to draw observers’ gaze away from acne lesions, were evaluated by analyzing observers’ eye movements. As base makeup application proceeded, time to first fixation, total fixation duration, and fixation count changed. Compared to “no makeup”, the time to first fixation, total fixation duration, and fixation count also decreased significantly after point makeup application. The additional eye-diverting strategies used also had significant gaze-diverting effects. Therefore, makeup can be useful for patients with acne to divert others’ gaze from lesions. Therefore, it should be actively integrated into acne management.

Efficacy of He-Ne Laser in Combination with Topical Clindamycin in the Treatment of Acne Vulgaris (AV)

Objective: To evaluate the efficacy of He-Ne laser in combination with topical clindamycin in the treatment of AV at 108 Military Central Hospital from Oct 2015 to Aug 2016. Subjects and Methods: 61 patients with AV were divided into 2 groups: Group 1: 31 patients were treated with He-Ne laser in combination with topical Clindamycin, Group 2: 30 patients were only treated with topical clindamycin. Laser HE-NE was applied 2 times/week for 6 weeks. Result: After 3 months of treatment Group 1: very good—51.6%, good—48.4%. Group 2: very good—30%, good—50% and moderate—20%. Conclusion: The combination of He-Ne laser with topical clindamycin shows more rapid clinical improvement compared to topical clindamycin alone in the treatment of mild and moderate AV.

Antibacterial,Anti-Keratinized and Anti-Inflammatory Effects of the GMP,A Multi-Herb Extraction on Acne Vulgaris

Recently reports showed that the pathobiology of acne vulgaris was arising from the exploration of sebaceous gland biology, hormonal factors, hyper-keratinization, and the role of bacteria, sebum, nutrition, cytokines and toll-like receptors (TLRs). Propionibacterium acnes (P.acnes) has a strong proinflammatory activity and targets molecules involved in the innate cutaneous immunity on keratinocytes by acting on TLR-2, leads to the development of comedones. GMP, a multi-herb extraction, targeted most of the major pathogenic features of acne with desired physicochemical traits. It strongly suppressed P.acnes growth, and reduced inflammation by suppressing the TLR-2/NF- kB pathway in SZ-95 sebocytes and HaCaT keratinocytes. GMP exhibited a marginal effect on cell viability and may have modulated hyper-keratinization of the epidermis. These results demonstrate the clinical feasibility of applying GMP for the treatment of acne.