Resurfacing of Facial Acne Scars With a New Variable-Pulsed Er:YAG Laser in Fitzpatrick Skin Types IV and V.

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Chathra, Namitha; Mysore, Venkataram

2018-01-01

The Er:YAG laser, considered to be less effective than CO 2 laser in its traditional form, in its new modulated version has variable pulse technology that is claimed to be superior to the earlier versions of the laser. The aim of the study was to check efficacy and safety of the new variable square pulse (VSP) Er:YAG laser in the management of acne scar in patients with Fitzpatrick skin types IV and V. This retrospective study consisted of 80 patients (Fitzpatrick skin types IV and V) with atrophic and hypertrophic facial acne scars. Records of the patients who had undergone four treatment sessions with VSP technology equipped with Er:YAG laser were extracted. Each patient had undergone a minimum of four sessions. Fractional mode at medium laser pulse (SP) and long pulse (LP) was employed for the depressed center of the scars to stimulate neocollagenogenesis. Short laser pulse (MSP) in nonfractionated mode was used for ablating the raised scar border and hypertrophic scars. Goodman and Baron global scarring grading system was used for qualitative and quantitative assessments. Patient's satisfaction to the treatment and observer's assessment of improvement (based on photographs) was graded as poor (75% improvement). At the end of the four sessions, the number of patients in grade IV postacne scarring reduced from 16 to 2 and that in grade III from 47 to 29. The mean score significantly dropped from 36.94 to 27.5. Subjective assessment revealed that 78 of 80 patients had noticed more than 25% improvement, with 50 of them showing more than 50% improvement at the end of four sessions. Eight patients perceived an excellent response and 42 reported a good response. This is notably higher than the observer's grading, which showed an excellent response in only 2 patients and a good response in 35. Adverse effects were limited to prolonged erythema (two patients), prolonged crusting (one patient), and postinflammatory hyperpigmentation (one patient). Ninety-seven percent of

Nonablative Fractional Laser Resurfacing for Acne Scarring in Patients With Fitzpatrick Skin Phototypes IV-VI.

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Alexis, Andrew F; Coley, Marcelyn K; Nijhawan, Rajiv I; Luke, Janiene D; Shah, Sejal K; Argobi, Yahya A; Nodzenski, Michael; Veledar, Emir; Alam, Murad

2016-03-01

There is a paucity of studies investigating laser resurfacing in Fitzpatrick skin phototypes (SPT) IV to VI. To assess the efficacy and safety of fractional nonablative laser resurfacing in the treatment of acne scarring in patients with SPT IV to VI. The authors conducted a randomized, investigator-blinded and rater-blinded, split-face comparative study of adults with SPT IV to VI and facial acne scars treated with 2 different density settings and the same fluence. Quantitative global scarring grading system (QGSGS) scores were significantly improved from baseline at 16 and 24 weeks (p = .0277). Improvements in QGSGS scores after higher and lower density treatments were statistically similar (p = .96). The live-blinded dermatologist, the blinded dermatologist photoraters, and the patients rated scars as being significantly more improved by visual analog scale at weeks 16 and 24 compared with baseline (p skin types IV to VI. Self-limited postinflammatory hyperpigmentation was a common occurrence, especially with higher treatment densities.

Combination therapy in the management of atrophic acne scars

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Shilpa Garg

2014-01-01

Full Text Available Background: Atrophic acne scars are difficult to treat. The demand for less invasive but highly effective treatment for scars is growing. Objective: To assess the efficacy of combination therapy using subcision, microneedling and 15% trichloroacetic acid (TCA peel in the management of atrophic scars. Materials and Methods: Fifty patients with atrophic acne scars were graded using Goodman and Baron Qualitative grading. After subcision, dermaroller and 15% TCA peel were performed alternatively at 2-weeks interval for a total of 6 sessions of each. Grading of acne scar photographs was done pretreatment and 1 month after last procedure. Patients own evaluation of improvement was assessed. Results: Out of 16 patients with Grade 4 scars, 10 (62.5% patients improved to Grade 2 and 6 (37.5% patients improved to Grade 3 scars. Out of 22 patients with Grade 3 scars, 5 (22.7% patients were left with no scars, 2 (9.1% patients improved to Grade 1and 15 (68.2% patients improved to Grade 2. All 11 (100% patients with Grade 2 scars were left with no scars. There was high level of patient satisfaction. Conclusion: This combination has shown good results in treating not only Grade 2 but also severe Grade 4 and 3 scars.

Clinical evaluation of the SmartSkin fractional laser for the treatment of photodamage and acne scars.

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Gold, Michael H; Heath, Amanda D; Biron, Julie A

2009-11-01

Fractional photothermolysis with a CO2 laser shows promise in the treatment of photodamaged skin. The purpose of this study was to evaluate a fractional CO2 laser device (SmartSkin, Cynosure, Westford, MA) for the treatment of facial photodamage. Twelve subjects seeking treatment of facial hyperpigmentation, skin laxity, wrinkles and fine lines, enlarged pores and acne scars enrolled in the study. Each subject was treated twice with the SmartSkin device at three- to five-week intervals. Results were evaluated at one week, one month and three months after the final treatment. All 12 subjects completed the study. Physician and subject assessments both indicated that clinical improvements in all photodamage parameters were apparent at one month and persisted at least three months. Improvements in acne scars were noted but not graded. Eleven subjects would recommend the treatment to family and friends. The median pain scores during the initial and final treatments were 2.00 and 2.00, respectively, on a scale of 0-5. Only one adverse effect, facial edema, was judged "probably related to treatment." The SmartSkin fractional laser device improves photodamaged skin for at least three months. The treatment was well tolerated and adverse effects were limited to transient facial edema.

Automated facial acne assessment from smartphone images

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Amini, Mohammad; Vasefi, Fartash; Valdebran, Manuel; Huang, Kevin; Zhang, Haomiao; Kemp, William; MacKinnon, Nicholas

2018-02-01

A smartphone mobile medical application is presented, that provides analysis of the health of skin on the face using a smartphone image and cloud-based image processing techniques. The mobile application employs the use of the camera to capture a front face image of a subject, after which the captured image is spatially calibrated based on fiducial points such as position of the iris of the eye. A facial recognition algorithm is used to identify features of the human face image, to normalize the image, and to define facial regions of interest (ROI) for acne assessment. We identify acne lesions and classify them into two categories: those that are papules and those that are pustules. Automated facial acne assessment was validated by performing tests on images of 60 digital human models and 10 real human face images. The application was able to identify 92% of acne lesions within five facial ROIs. The classification accuracy for separating papules from pustules was 98%. Combined with in-app documentation of treatment, lifestyle factors, and automated facial acne assessment, the app can be used in both cosmetic and clinical dermatology. It allows users to quantitatively self-measure acne severity and treatment efficacy on an ongoing basis to help them manage their chronic facial acne.

Fractional CO2 laser resurfacing for atrophic acne scars

DEFF Research Database (Denmark)

Hedelund, Lene; Haak, Christina Skovbølling; Togsverd-Bo, Katrine

2012-01-01

The treatment of acne scars with fractional CO(2) lasers is gaining increasing impact, but has so far not been compared side-by-side to untreated control skin.......The treatment of acne scars with fractional CO(2) lasers is gaining increasing impact, but has so far not been compared side-by-side to untreated control skin....

Comparison of fractional microneedling radiofrequency and bipolar radiofrequency on acne and acne scar and investigation of mechanism: comparative randomized controlled clinical trial.

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Min, Seonguk; Park, Seon Yong; Yoon, Ji Young; Suh, Dae Hun

2015-12-01

Fractional microneedling radiofrequency (FMR) is one of the promising methods in acne treatment. Moreover, bipolar radiofrequency (BR) generates heat thereby which induces neocollagenosis. FMR may have the potential to be a safe and effective treatment for the patients both with acne and acne scar. This study was performed to compare the efficacy and safety of FMR and BR in acne and acne scar treatment. Furthermore, mechanism of the FMR treatment was investigated through skin tissues obtained from subjects. Twenty subjects with mild-to-moderate acne and acne scars were treated in a split-face manner with FMR and BR. Two sessions of treatment was done 4 weeks apart in a total 12-week prospective single-blind, randomized clinical trial. Clinical assessment and sebum measurement were carried out for the evaluation of efficacy and safety. Skin tissues were acquired for investigation of molecular changes. FMR was more effective for acne scar especially in icepick and boxcar scar compared to BR. Both inflammatory and non-inflammatory acne lesions decreased by 80 and 65 % in the FMR-treated side at the final visit of 12 weeks, respectively. FMR treatment resulted in significant reduction of sebum excretion. Both treatments showed no severe adverse effects other than erythema. The FMR showed superior efficacy in acne and acne scar compared with BR. Increased expression of TGFβ and collagen I and decreased expression of NF-κB, IL-8 are suggested to involve in the improvement of acne scar and acne lesion by FMR.

Use of radiofrequency in cosmetic dermatology: focus on nonablative treatment of acne scars

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Simmons BJ

2014-12-01

Full Text Available Brian J Simmons, Robert D Griffith, Leyre A Falto-Aizpurua, Keyvan Nouri Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, University of Miami, Miami, FL, USA Abstract: Acne is a common affliction among many teens and some adults that usually resolves over time. However, the severe sequela of acne scarring can lead to long-term psychological and psychiatric problems. There exists a multitude of modalities to treat acne scars such as more invasive surgical techniques, subcision, chemical peels, ablative lasers, fractional lasers, etc. A more recent technique for the treatment of acne scars is nonablative radiofrequency (RF that works by passing a current through the dermis at a preset depth to produce small thermal wounds in the dermis which, in turn, stimulates dermal remodeling to produce new collagen and soften scar defects. This review article demonstrates that out of all RF modalities, microneedle bipolar RF and fractional bipolar RF treatments offers the best results for acne scarring. An improvement of 25%–75% can be expected after three to four treatment sessions using one to two passes per session. Treatment results are optimal approximately 3 months after final treatment. Common side effects can include transient pain, erythema, and scabbing. Further studies are needed to determine what RF treatment modalities work best for specific scar subtypes, so that further optimization of RF treatments for acne scars can be determined. Keywords: acne scarring, radiofrequency treatments, nonablative radiofrequency treatments, scars

Lactic acid peeling in superficial acne scarring in Indian skin.

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Sachdeva, Silonie

2010-09-01

Chemical peeling with both alpha and beta hydroxy acids has been used to improve acne scarring with pigmentation. Lactic acid, a mild alpha hydroxy acid, has been used in the treatment of various dermatological indications but no study is reported in acne scarring with pigmentation. To evaluate the efficacy and safety of full strength pure lactic acid 92% (pH 2.0) chemical peel in superficial acne scarring in Indian skin. Seven patients, Fitzpatrick skin type IV-V, in age group 20-30 years with superficial acne scarring were enrolled in the study. Chemical peeling was done with lactic acid at an interval of 2 weeks to a maximum of four peels. Pre- and post-peel clinical photographs were taken at every session. Patients were followed every month for 3 months after the last peel to evaluate the effects. At the end of 3 months, there was definite improvement in the texture, pigmentation, and appearance of the treated skin, with lightening of scars. Significant improvement (greater than 75% clearance of lesions) occurred in one patient (14.28%), good improvement (51-75% clearance) in three patients (42.84%), moderate improvement (26-50% clearance) in two patients (28.57%), and mild improvement (1-25% clearance) in one patient (14.28%). © 2010 Wiley Periodicals, Inc.

Improvement of Atrophic Acne Scars in Skin of Color Using Topical Synthetic Epidermal Growth Factor (EGF) Serum: A Pilot Study.

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Stoddard, Marie Alexia; Herrmann, Jennifer; Moy, Lauren; Moy, Ronald

2017-04-01

BACKGROUND: Atrophic scarring in skin of color is a common, permanent, and distressing result of uncontrolled acne vulgaris. Ablative lasers and chemical peels are frequently used to improve the appearance of atrophic scars, primarily through the stimulation of collagen and elastin; however, these treatment modalities are associated with risks, such as dyspigmentation and hypertrophic scarring, especially in patients with darker skin. OBJECTIVE: We evaluated the efficacy of topically applied synthetic epidermal growth factor (EGF) serum in reducing the appearance of atrophic acne scars in skin of color. METHODS: A single-center clinical trial was performed on twelve healthy men and women (average age 32.5) with Fitzpatrick Type IV-V skin and evidence of facial grade II-IV atrophic acne scars. Subjects applied topical EGF serum to the full-face twice daily for 12 weeks. Scar improvement was investigated at each visit using an Investigator Global Assessment (IGA), a Goodman grade, clinical photography, and patient self-assessment. RESULTS: Eleven subjects completed the trial. Compared to baseline, there was an improvement in mean IGA score from 3.36 (SEM = 0.15) to 2.18 (SEM = 0.33). Mean Goodman grade was reduced from 2.73 (SEM = 0.19) to 2.55 (SEM = 0.21). Of the eleven pairs of before and after photographs, nine were correctly chosen as the post-treatment image by a blind investigator. On self-assessment, 81% reported a "good" to "excellent" improvement in their scars compared to baseline (P = 0.004). CONCLUSION: Topical EGF may improve the appearance of atrophic acne scars in skin of color. Additional, larger studies should be conducted to better characterize improvement. J Drugs Dermatol. 2017;16(4):322-326..

The impact of post-acne scars on the quality of life among young adults in Singapore

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Sai Yee Chuah

2015-01-01

Full Text Available Background and Objectives: Post-acne scarring is a common and well-known sequelae of acne vulgaris. We aim to study the impact of post-acne scarring on the quality of life (QOL among young adults in Singapore. Settings and Design: This was a non-interventional prospective study. Materials and Methods: Patients aged 21-40 years with atrophic and hypertrophic acne scars who attended the National Skin Centre, Singapore were recruited in the study. They answered a simple questionnaire and the clinical severity of their acne scars were assessed by the doctor. Statistical Analysis Used: Descriptive analyses using absolute and percentage frequencies were performed on all data. The test of significance was two-sided and was set at 5% (P ≤ 0.05. Differential analyses were conducted using the parametric, independent two-sample t-test and non-parametric Mann-Whitney U-test. The statistical assessments were performed using SPSS version 18.0. Results: A total of 100 patients were studied. The mean patients′ subjective self-scoring on the severity of their post-acne scars was 5.78/10 and the mean Dermatology Life Quality Index (DLQI for post-acne scars was 5.61. Many (36%, n = 36 were self-conscious of their acne scars and 24%, (n = 24 felt that their acne scars was affecting their social activities. Conclusions: Our study showed that post-acne scars have a significant negative effect on the QOL of young adults. It highlights the need to increase public awareness of acne vulgaris and its sequelae through education programs and advocating early treatment to reduce the risk of scarring.

Split face comparative study of microneedling with PRP versus microneedling with vitamin C in treating atrophic post acne scars

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Simran Chawla

2014-01-01

Full Text Available Introduction: Acne scars are largely preventable complications of acne. 95% of the scars occur over the face thus impacting the quality of life. Correction of scars is the priority for acne patients. Materials and Methods: Thirty patients with post acne atrophic facial scars attending the OPD during the period from April to October 2013 were offered four sittings of microneedling with PRP on one side and microneedling with vitamin C on other side of the face at an interval of 1 month. Results: Twenty-seven out of the total 30 patients completed the treatment schedule. Two patients were lost to follow up and one dropped out of the study due to severe PIH. Mean age of the patients was 27.5 years. Out of 30 patients, 23 achieved reduction in scarring by one or two grades. Excellent response was seen in five (18.5% patients with platelet-rich plasma (PRP as compared to two (7% patients who received treatment with vitamin C according to physician′s assessment. As far as up gradation by 1 score is considered, i.e., good response, it was similar in both cases. Vitamin C did not prove to be as efficacious as PRP since 10 (37% patients had poor response in vitamin C-treated area compared to only 6 (22.2% patients who underwent PRP therapy, but vitamin C proved to be efficacious in dealing with post inflammatory hyper-pigmentation secondary to acne. Patients were more satisfied with PRP as compared to vitamin C. The results were evaluated and statistical analysis was done using SPSS 16.0.2. Conclusions: Overall results were better with microneedling and PRP. Vitamin C combined with microneedling also showed improvement with respect to firmness and smoothness of skin; as well as post inflammatory hyper-pigmentation. Microneedling combined with PRP proved to be good in treating boxcar and rolling scars but had limited efficacy in dealing with ice pick scars.

Combined Fractional Treatment of Acne Scars Involving Non-ablative 1,550-nm Erbium-glass Laser and Micro-needling Radiofrequency: A 16-week Prospective, Randomized Split-face Study

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Hyuck Hoon Kwon

2017-06-01

Full Text Available An optimized therapeutic regimen involving a non-ablative fractionated laser or radiofrequency therapy for acne scars has not yet been established. To evaluate whether the combination of a non-ablative fractional laser (NAF and fractional micro-needling radiofrequency (FMR has clinical advantages for the treatment of atrophic acne scars compared with NAF alone, a 16-week prospective, randomized split-face study was performed. Each facial side of a patient was treated with 3 sessions of either NAF with FMR or NAF alone, with a 4-week interval between each session. Although both sides demonstrated significant decreases in the échelle d’évaluation clinique des cicatrices d’acné (ECCA score, the facial side treated using the combination regimen demonstrated greater improvement in ECCA score regarding degree and onset time than the NAF-treated side. Histopathological and immunohistochemical results confirmed the clinical findings. This study demonstrated that a combination regimen involving NAF and FMR could be a viable option with satisfactory efficacy.

Fractional ablative CO2 laser treatment versus scar subcision and autologous fat transfer in the treatment of atrophic acne scars: New technique

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Laila Mohammad

2016-04-01

Full Text Available There are different modalities for management of atrophic acne scars which include lasers. Ablative fractional CO2 laser was developed to address the shortcomings of traditional ablative lasers, with superior results to non-ablative fractional lasers. Autologous fat transfer has been utilized for nearly a decade in tissue augmentation and reconstruction.Present studies were designed to compare ablative fractional CO2 laser treatment with scar subcision and autologous fat transfer in the treatment of atrophic acne scars. 20 patients with atrophic acne scars were recruited: 10 patients were treated by three sessions of ablative fractional CO2 laser therapy, and 10 patients treated by subcision and autologous fat transfer. All patients were followed up for three months, and were assessed by digital photograph before and after treatment through the application of Goodman and Baron quantitative and qualitative grading systems, in addition to reports by three physicians committees and reports of patients’ satisfaction. Analysis of both groups showed significant improvements in all types of atrophic acne scars. The mean percentage of total quantitative improvement was more significant in the case of autologous fat transfer with regard to ice-pick and total number of scars. Therefore, scar subcision with autologous fat transfer proved to be as effective as, or even more effective than, ablative fractional CO2 laser in the treatment of atrophic acne scars with regard to the total number of scars as well as ice-pick type.

Treatment of acne scarring using a dual-spot-size ablative fractionated carbon dioxide laser: review of the literature.

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Tierney, Emily P

2011-07-01

Fractional photothermolysis has been reported in the literature to improve pigmentary and textural changes associated with acne scarring. To review the literature for the treatment of acne scarring using nonablative fractional laser (NAFL) and ablative fractional laser (AFL) resurfacing. Review of the Medline literature evaluating NAFL and AFL for acne scarring. NAFL and AFL are safe and effective treatments for acne scarring. It is likely that the controlled, limited dermal heating of fractional resurfacing initiates a cascade of events in which normalization of the collagenesis-collagenolysis cycle occurs. We present the results of a patient treated using a novel dual-spot-size AFL device. Three months after the final treatment, the patient reported 75% improvement in acne scarring and 63% overall improvement in photoaging. Fractionated resurfacing for the treatment of acne scarring is associated with lesser risks of side effects of prolonged erythema and risks of delayed-onset dyspigmentation and scarring which complicate traditional ablative laser resurfacing approaches. We present herein preliminary data suggesting that a dual-spot-size AFL device presents novel advantages of improving texture and pigmentation in acne scarring and photoaging. © 2011 by the American Society for Dermatologic Surgery, Inc.

Facial Scar Revision: Understanding Facial Scar Treatment

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... keep the head elevated when lying down, to use cold compresses to reduce swelling, and to avoid any activity that places undue stress on the area of the incision. Depending on the surgery performed and the site of the scar, the facial plastic surgeon will explain the types of activities to ...

New Atrophic Acne Scar Classification: Reliability of Assessments Based on Size, Shape, and Number.

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Kang, Sewon; Lozada, Vicente Torres; Bettoli, Vincenzo; Tan, Jerry; Rueda, Maria Jose; Layton, Alison; Petit, Lauren; Dréno, Brigitte

2016-06-01

Post-acne atrophic scarring is a major concern for which standardized outcome measures are needed. Traditionally, this type of scar has been classified based on shape; but survey of practicing dermatologists has shown that atrophic scar morphology has not been well enough defined to allow good agreement in clinical classification. Reliance on clinical assessment is still needed at the current time, since objective tools are not yet available in routine practice. Evaluate classification for atrophic acne scars by shape, size, and facial location and establish reliability in assessments. We conducted a non-interventional study with dermatologists performing live clinical assessments of atrophic acne scars. To objectively compare identification of lesions, individual lesions were marked on a high-resolution photo of the patient that was displayed on a computer during the clinical evaluation. The Jacob clinical classification system was used to define three primary shapes of scars 1) icepick, 2) boxcar, and 3) rolling. To determine agreement for classification by size, independent technicians assessed the investigators' markings on digital images. Identical localization of scars was denoted if the maximal distance between their centers was ≤ 60 pixels (approximately 3 mm). Raters assessed scars on the same patients twice (morning/afternoon). Aggregate models of rater assessments were created and analyzed for agreement. Raters counted a mean scar count per subject ranging from 15.75 to 40.25 scars. Approximately 50% of scars were identified by all raters and ~75% of scars were identified by at least 2 of 3 raters (weak agreement, Kappa pairwise agreement 0.30). Agreement between consecutive counts was moderate, with Kappa index ranging from 0.26 to 0.47 (after exclusion of one outlier investigator who had significantly higher counts than all others). Shape classifications of icepick, boxcar, and rolling differed significantly between raters and even for same raters at

Combination of microneedling and glycolic acid peels for the treatment of acne scars in dark skin.

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Sharad, Jaishree

2011-12-01

  Acne scars can cause emotional and psychosocial disturbance to the patient. Various modalities have been used for the treatment of acne scars like punch excision, subcision, peels, microdermabrasion, unfractionated and fractioned lasers. The latest in the treatment armamentarium is microneedling. Acne scars commonly coexist with postinflammatory hyperpigmentation. A combination of microneedling and glycolic acid (GA) peels was found to give excellent results in the treatment of such scars. The aim was to study the efficacy of a combination of microneedling with glycolic peel for the treatment of acne scars in pigmented skin.   Thirty patients in the age group of 20-40 years with atrophic box type or rolling scars with postinflammatory hyperpigmentation were chosen for the study. Two groups were made. The first group comprised of 30 patients in whom only microneedling was performed once in 6 weeks for five sessions. In the second group of 30 patients, a combination of microneedling and 35% GA peels was carried out. Patients from both groups were evaluated on the basis of Echelle d'Evaluation clinique des Cicatrices d'acné classification.   Based on the objective scoring and its statistical analysis, there was significant improvement in superficial and moderately deep scars (grade 1-3). There was also improvement in skin texture, reduction in postacne pigmentation in the second group.   Microneedling is a simple, inexpensive office procedure with no downtime. It is safe in Indian skin (skin types III-IV). The combined sequential treatment with GA peel caused a significant improvement in the acne scars without increasing morbidity. © 2011 Wiley Periodicals, Inc.

The effect of a daily facial cleanser for normal to oily skin on the skin barrier of subjects with acne.

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Draelos, Zoe D

2006-07-01

Acne vulgaris is a common skin disorder that affects many people every year, especially the teenaged population. People with acne find the condition especially difficult to manage because of the disease's chronicity and variability in response to treatment. Acne is the result of pores clogged with shed skin cells combined with sebum in the hair follicle. Successful treatment of acne is important because acne has the potential to result in lasting physical and emotional scarring. For many years, physicians have agreed that although cleansing is not effective on its own, effective cleansing is an important part of any acne treatment regimen. However, patients have not been satisfied with the types of cleansers available. In addition to containing dyes and perfumes that can irritate and exacerbate acne, these cleansers often are too harsh and can result in excessive drying of the skin, which leads to overcompensation by the oil glands and ultimately to more oil on the surface of the skin. This study examined the use of a daily facial cleanser formulated for normal to oily skin in subjects with mild facial acne. The cleanser was studied for 2 weeks in the absence of additional treatments to eliminate the confounding effects of various treatments. Subjects were monitored for skin barrier function through transepidermal water loss (TEWL) and corneometry, sebum level, and lesion counts. The results of the study indicate that the facial cleanser is gentle and does not damage the skin barrier or result in sebum overcompensation; additionally, the cleanser is effective at deep-pore cleansing, which may help to manage some acne-associated symptoms.

Efficacy of Modified Jessner's Peel and 20% TCA Versus 20% TCA Peel Alone for the Treatment of Acne Scars.

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Puri, Neerja

2015-01-01

There is a paucity of studies on the use of chemical peels for acne scars among the Asian population. A trichloroacetic acid (TCA) and Jessner's combination chemical peel, originally described by Monheit, is said to be better than a TCA peel alone. The aim of the study was to compare the efficacy of 20% TCA and Jessner's solution versus 20% TCA alone for the treatment of acne scars. : The patients were divided into two groups of 25 patients each. Chemical peeling was done in both the groups. In Group I, chemical peeling with Jessner's peel followed by 20% TCA was done and in Group II patients chemical peeling with 20% TCA peel alone was done. In Group I (Jessner's peel and 20% TCA), mild improvement of acne scars was seen in 8% cases, moderate improvement in 32% cases and marked improvement of acne scars was seen in 60% patients. In Group II (20% TCA), mild improvement of acne scars was seen in 32% cases, moderate improvement in 40% cases and marked improvement of acne scars was seen in 28% patients. But, the difference in improvement of acne scars was not statistically significant in both the groups (P value > 0.05).

The efficacy of conditioned media of adipose-derived stem cells combined with ablative carbon dioxide fractional resurfacing for atrophic acne scars and skin rejuvenation.

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Zhou, Bing-Rong; Zhang, Ting; Bin Jameel, Afzaal Ahmed; Xu, Yang; Xu, Yan; Guo, Shi-Lei; Wang, Ying; Permatasari, Felicia; Luo, Dan

2016-06-01

To evaluate the effects of conditioned medium of adipose-derived stem cells (ADSC-CM) on efficacy and side effects after fractional carbon dioxide laser resurfacing (FxCR) when treating subjects with facial atrophic acne scars or with skin rejuvenation needs. Twenty-two subjects were enrolled in the study and divided into two groups. Nine subjects were included in skin rejuvenation group and thirteen subjects were included in acne scar group, and all subjects underwent three sessions of FxCR. ADSC-CM was applied on FxCR site of one randomly selected face side. Evaluations were done at baseline, 1 week after first treatment, and 1 month after each treatment. The outcome assessments included subjective satisfaction scale; blinded clinical assessment; and the biophysical parameters of roughness, elasticity, skin hydration, transepidermal water loss (TEWL), and the erythema and melanin index. Biopsies taken from one subject in skin rejuvenation group were analyzed using hematoxylin and eosin, Masson's Trichrome, and Gomori's aldehyde fuchsin staining. ADSC-CM combined with FxCR increased subject satisfaction, elasticity, skin hydration, and skin elasticity and decreased TEWL, roughness, and the melanin index in both acne scars and skin rejuvenation groups. Histologic analysis showed that ADSC-CM increased dermal collagen density, elastin density, and arranged them in order. ADSC-CM with FxCR is a good combination therapy for treating atrophic acne scars and skin rejuvenation. JSPH2012-082 - Registered 14 Feb 2012.

Fractional ablative carbon dioxide laser resurfacing for skin rejuvenation and acne scars in Asians.

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Chan, Nicola P Y; Ho, Stephanie G Y; Yeung, Chi K; Shek, Samantha Y N; Chan, Henry H

2010-11-01

Ablative fractional resurfacing (AFR) is a new modality for photorejuvenation and acne scars which combines carbon dioxide (CO₂) laser ablation with fractional photothermolysis. The objective is to evaluate the efficacy and side effects of a new fractional CO₂ ablative device (Fraxel Re:pair) for skin rejuvenation and acne scars in Asians. Nine patients underwent one full-face treatment. The energy levels ranged from 30-70 mJ with coverage between 30% and 45%. Improvement in skin texture, laxity, wrinkles, enlarged pores, overall pigmentation irregularity, and adverse effects were assessed up to 6 months post-treatment. Standardized photographs using the Canfield Visia CR system® were assessed by two independent observers. Subjective improvement was assessed by patient questionnaires. Nine Chinese patients (skin types III and IV, mean age 44.8) were included. Statistically significant improvements were seen for skin texture, skin laxity, wrinkles, enlarged pores, and acne scars. The post-inflammatory hyperpigmentation rate was 55.5% and 11.1% at 1 and 6 months post-treatment, respectively. Eighty-six percent of patients were overall satisfied to very satisfied with the treatment. Ablative fractional CO₂ laser resurfacing was overall safe and effective for skin rejuvenation and acne scars in Asians. However, in view of the high post-inflammatory rate and the statistically significant but only mild to moderate improvement after a single treatment as observed in this study, there is a need to review the current role of fractional ablative CO₂ laser treatment as compared to fractional non-ablative for skin rejuvenation and acne scar treatment in Asians. © 2010 Wiley-Liss, Inc.

Efficacy of modified Jessner′s peel and 20% TCA versus 20% TCA peel alone for the treatment of acne scars

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Neerja Puri

2015-01-01

Full Text Available Introduction: There is a paucity of studies on the use of chemical peels for acne scars among the Asian population. A trichloroacetic acid (TCA and Jessner′s combination chemical peel, originally described by Monheit, is said to be better than a TCA peel alone. Aims: The aim of the study was to compare the efficacy of 20% TCA and Jessner′s solution versus 20% TCA alone for the treatment of acne scars. Materials and Methods : The patients were divided into two groups of 25 patients each. Chemical peeling was done in both the groups. In Group I, chemical peeling with Jessner′s peel followed by 20% TCA was done and in Group II patients chemical peeling with 20% TCA peel alone was done. Results: In Group I (Jessner′s peel and 20% TCA, mild improvement of acne scars was seen in 8% cases, moderate improvement in 32% cases and marked improvement of acne scars was seen in 60% patients. In Group II (20% TCA, mild improvement of acne scars was seen in 32% cases, moderate improvement in 40% cases and marked improvement of acne scars was seen in 28% patients. But, the difference in improvement of acne scars was not statistically significant in both the groups (P value > 0.05.

A Report of Two Cases of Solid Facial Edema in Acne.

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Kuhn-Régnier, Sarah; Mangana, Joanna; Kerl, Katrin; Kamarachev, Jivko; French, Lars E; Cozzio, Antonio; Navarini, Alexander A

2017-03-01

Solid facial edema (SFE) is a rare complication of acne vulgaris. To examine the clinical features of acne patients with solid facial edema, and to give an overview on the outcome of previous topical and systemic treatments in the cases so far published. We report two cases from Switzerland, both young men with initially papulopustular acne resistant to topical retinoids. Both cases responded to oral isotretinoin, in one case combined with oral steroids. Our cases show a strikingly similar clinical appearance to the cases described by Connelly and Winkelmann in 1985 (Connelly MG, Winkelmann RK. Solid facial edema as a complication of acne vulgaris. Arch Dermatol. 1985;121(1):87), as well as to cases of Morbihan's disease that occurs as a rare complication of rosacea. Even 30 years after, the cause of the edema remains unknown. In two of the original four cases, a potential triggering factor was identified such as facial trauma or insect bites; however, our two patients did not report such occurrencies. The rare cases of solid facial edema in both acne and rosacea might hold the key to understanding the specific inflammatory pattern that creates both persisting inflammation and disturbed fluid homeostasis which can occur as a slightly different presentation in dermatomyositis, angioedema, Heerfordt's syndrome and other conditions.

The microsponge delivery system reduces facial oiliness and shine during acne therapy.

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Kircik, Leon H

2013-11-01

Acne therapies that are able to show efficacious treatment of acne lesions as well as to address the issues of oiliness and shine control may be particularly appropriate for the treatment of patients with acne vulgaris that is accompanied by oily skin and facial shine. The microsphere delivery system (MDS), a novel delivery technology for topical therapy, can be customized to optimize product attributes, including oil absorption. Clinical trials have clearly established the efficacy and tolerability of such MDS formulations in the treatment of acne. In addition, studies have shown that the use of products formulated with an MDS provides a more significant reduction in facial shine than non-MDS acne therapy, as well as a reduction in facial sebum accumulation relative to control. Future clinical research should aim to further delineate the effect of individual topical acne treatment formulations on oiliness and shine.

A Report of Two Cases of Solid Facial Edema in Acne

OpenAIRE

Kuhn-R?gnier, Sarah; Mangana, Joanna; Kerl, Katrin; Kamarachev, Jivko; French, Lars E.; Cozzio, Antonio; Navarini, Alexander A.

2017-01-01

Introduction Solid facial edema (SFE) is a rare complication of acne vulgaris. To examine the clinical features of acne patients with solid facial edema, and to give an overview on the outcome of previous topical and systemic treatments in the cases so far published. Methods We report two cases from Switzerland, both young men with initially papulopustular acne resistant to topical retinoids. Results Both cases responded to oral isotretinoin, in one case combined with oral steroids. Our cases...

Comparative study of the efficacy of Platelet-rich plasma combined with carboxytherapy vs its use with fractional carbon dioxide laser in atrophic acne scars.

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Al Taweel, Abdul-Aziz Ibrahim; Al Refae, Abdul-Aziz Abdul-Salam; Hamed, Ahmed Mohamed; Kamal, Asmaa Mostafa

2018-04-22

Acne scars are a major concerning problem to all acne patients affecting their quality of life. Platelet-rich plasma (PRP) and fractional CO 2 laser are innovative treatment modalities for acne scars. Carboxytherapy can also be used to improve scar tissue through the increase in collagen deposition and reorganization, and the improvement in skin texture and tone. The aim of this work was to compare the efficacy, safety, and complications of the intradermal injection of PRP combined with carboxytherapy and PRP combined with fractional CO 2 laser, in the treatment of atrophic acne scars. Forty patients with atrophic acne scars were divided into 2 groups. Group A included 20 patients and was subjected to three fractional CO 2 laser sessions combined with PRP injection. Group B included 20 patients and was subjected to three sessions of carboxytherapy combined with PRP injection. Both fractional CO 2 laser and carboxytherapy combined with PRP showed improvement in acne scars and patients' satisfaction but the improvement with fractional CO 2 laser was significantly better than carboxytherapy but with more side effects. Improvement of acne scars was noted in both treatment modalities with obvious higher and statistically significant results in favor of fractional CO 2 laser but with more side effects. Carboxytherapy is a promising tool in treatment of acne scars with less complication. © 2018 Wiley Periodicals, Inc.

Sebum, acne, skin elasticity, and gender difference - which is the major influencing factor for facial pores?

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Kim, B Y; Choi, J W; Park, K C; Youn, S W

2013-02-01

Enlarged facial pores have been esthetic problems and have become a matter of cosmetic concern. Several factors are supposed to be related to the enlargement of facial pores, although scientific evaluations were not performed yet. To assess the correlation between facial pores and possible relating factors such as age, gender, sebum secretion, skin elasticity, and the presence of acne, using objective bioengineering instruments. Sixty volunteers, 30 males and 30 females, participated in this study. Various parameters of facial pores were assessed using the Robo Skin Analyzer. The facial sebum secretion and skin elasticity were measured using the Sebumeter and the Cutometer, respectively. These data were compared and correlated to examine the possible relationship between facial pores and age, sebum secretion and skin elasticity, according to gender and the presence of acne. Male gender and the existence of acne were correlated with higher number of facial pores. Sebum secretion levels showed positive correlation with facial pores. The R7 parameter of skin elasticity was negatively correlated with facial pores, suggesting increased facial pores with decreased skin elasticity. However, the age and the severity of acne did not show a definite relationship with facial pores. Male, increased sebum and decreased skin elasticity were mostly correlated with facial pore development. Further studies on population with various demographic profiles and more severe acne may be helpful to elucidate the potential effect of aging and acne severity on facial pores. © 2011 John Wiley & Sons A/S.

Medical makeup for concealing facial scars.

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Mee, Donna; Wong, Brian J F

2012-10-01

Surgical, laser, and pharmacological therapies are all used to correct scars and surgical incisions, though have limits with respect to how well facial skin can be restored or enhanced. The use of cosmetics has long been a relevant adjunct to all scar treatment modalities. In recent years, technical advancements in the chemistry and composition of cosmetic products have provided the patient with a broader range of products to employ for concealing scars. This review will provide an overview of contemporary methods for concealing facial scars, birthmarks, and pigmentary changes without the use of traditional/dated, heavy appearing camouflage products. Additionally, general guidelines and information will be provided with respect to identifying competent makeup artists for care of the medical patient. The article by no means is meant to be a tutorial, but rather serves as a starting point in this allied field of medicine. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Fractional nonablative 1,540-nm laser resurfacing of atrophic acne scars. A randomized controlled trial with blinded response evaluation

DEFF Research Database (Denmark)

Hedelund, Lene; Moreau, Karen Estell R; Beyer, Ditte M

2010-01-01

The efficacy of nonablative fractional laser resurfacing of acne scars has been described in case reports and uncontrolled trials. The present study is the first randomized controlled trial in this field. The aim of this study was to examine the efficacy and adverse effects of 1,540-nm nonablative...... fractional laser treatment of acne scars. Ten patients with acne scars were included. Two intraindividual areas of similar size and appearance within contralateral anatomical regions were randomized to (1) 3-monthly laser treatments with a StarLux 1,540-nm fractional handpiece, and (2) no treatment. Blinded...... appeared more even and smooth than untreated control areas (4.5, 2-6.5, versus 6.5, 4.5-8, P=0.0156, at 4 weeks; 4.5, 2.5-6.5, versus 6.5, 4.5-8, at 12 weeks; P=0.0313). Patients were satisfied with the treatment (5.5, 1-7, after 12 weeks) and five of the ten patients evaluated their acne scars...

Expanded flap to repair facial scar left by radiotherapy of hemangioma.

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Zhao, Donghong; Ma, Xinrong; Li, Jiang; Zhang, Lingfeng; Zhu, Baozhen

2014-09-01

This study explored the feasibility and clinical efficacy of expanded flap to repair facial scar left by radiotherapy of hemangioma. From March 2000 to April 2011, 13 cases of facial cicatrices left by radiotherapy of hemangioma have been treated with implantation surgery of facial skin dilator under local anesthesia. After water flood expansion for 1-2 months, resection of facial scar was performed, and wound repairing with expansion flap transfer was done. Thirteen patients were followed up from 5 months to 3 years. All patients tolerated flap transfer well; no contracture occurred during the facial expansion flap transfer. The incision scar was not obvious, and its color and texture were identical to surrounding skin. In conclusion, the use of expanded flap transfer to repair the facial scar left by radiotherapy of hemangioma is advantageous due to its simplicity, flexibility, and large area of repairing. This method does not affect the subsequent facial appearance.

The Psychosocial Impact of Acne Vulgaris

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Hazarika, Neirita; Archana, M

2016-01-01

Background: Acne vulgaris causes erythematous papulopustular lesions in active stage and often leave behind residual scarring and pigmentation. Its onset in adolescence may add to the emotional and psychological challenges experienced during this period. Aims: To assess the impact of acne on the various psychosocial domains of daily life. Materials and Methods: This was a prospective, cross-sectional study done in the dermatology out-patient department of a tertiary care hospital from January to March 2015. A total of 100 consecutive, newly diagnosed patients of acne vulgaris, aged 15 years and above were included in this study. The relationship between acne vulgaris and its sequelae was analyzed with ten different domains of daily life by using dermatology life quality index (DLQI) questionnaire. Results: Females (56%), 15–20 year olds (61%), facial lesions (60%), and Grade II acne (70%) were most common. Acne scars were noted in 75% patients, whereas 79% cases had post-acne hyperpigmentation. Thirty-seven percent patients had DLQI scores of (6–10) interpreted as moderate effect on patient's life. Statistically significant correlation (P acne; embarrassment with site and grade of acne; daily activities with grade of acne and post-acne pigmentation; choice of clothes with site of acne; social activities with gender, site and grade of acne; effect on work/study with grade of acne; interpersonal problems with site and post-acne pigmentation; sexual difficulties with grade of acne. Limitation: It was a hospital-based study with small sample size. Conclusion: Significant impact of acne and its sequelae was noted on emotions, daily activities, social activities, study/work, and interpersonal relationships. Assurance and counseling along with early treatment of acne vulgaris is important to reduce disease-related psychosocial sequelae and increase the efficacy of treatment. PMID:27688440

The Psychosocial Impact of Acne Vulgaris.

Science.gov (United States)

Hazarika, Neirita; Archana, M

2016-01-01

Acne vulgaris causes erythematous papulopustular lesions in active stage and often leave behind residual scarring and pigmentation. Its onset in adolescence may add to the emotional and psychological challenges experienced during this period. To assess the impact of acne on the various psychosocial domains of daily life. This was a prospective, cross-sectional study done in the dermatology out-patient department of a tertiary care hospital from January to March 2015. A total of 100 consecutive, newly diagnosed patients of acne vulgaris, aged 15 years and above were included in this study. The relationship between acne vulgaris and its sequelae was analyzed with ten different domains of daily life by using dermatology life quality index (DLQI) questionnaire. Females (56%), 15-20 year olds (61%), facial lesions (60%), and Grade II acne (70%) were most common. Acne scars were noted in 75% patients, whereas 79% cases had post-acne hyperpigmentation. Thirty-seven percent patients had DLQI scores of (6-10) interpreted as moderate effect on patient's life. Statistically significant correlation (P < 0.05) found were as follows: Physical symptoms with grade of acne; embarrassment with site and grade of acne; daily activities with grade of acne and post-acne pigmentation; choice of clothes with site of acne; social activities with gender, site and grade of acne; effect on work/study with grade of acne; interpersonal problems with site and post-acne pigmentation; sexual difficulties with grade of acne. It was a hospital-based study with small sample size. Significant impact of acne and its sequelae was noted on emotions, daily activities, social activities, study/work, and interpersonal relationships. Assurance and counseling along with early treatment of acne vulgaris is important to reduce disease-related psychosocial sequelae and increase the efficacy of treatment.

The psychosocial impact of acne vulgaris

Directory of Open Access Journals (Sweden)

Neirita Hazarika

2016-01-01

Full Text Available Background: Acne vulgaris causes erythematous papulopustular lesions in active stage and often leave behind residual scarring and pigmentation. Its onset in adolescence may add to the emotional and psychological challenges experienced during this period. Aims: To assess the impact of acne on the various psychosocial domains of daily life. Materials and Methods: This was a prospective, cross-sectional study done in the dermatology out-patient department of a tertiary care hospital from January to March 2015. A total of 100 consecutive, newly diagnosed patients of acne vulgaris, aged 15 years and above were included in this study. The relationship between acne vulgaris and its sequelae was analyzed with ten different domains of daily life by using dermatology life quality index (DLQI questionnaire. Results: Females (56%, 15–20 year olds (61%, facial lesions (60%, and Grade II acne (70% were most common. Acne scars were noted in 75% patients, whereas 79% cases had post-acne hyperpigmentation. Thirty-seven percent patients had DLQI scores of (6–10 interpreted as moderate effect on patient's life. Statistically significant correlation (P < 0.05 found were as follows: Physical symptoms with grade of acne; embarrassment with site and grade of acne; daily activities with grade of acne and post-acne pigmentation; choice of clothes with site of acne; social activities with gender, site and grade of acne; effect on work/study with grade of acne; interpersonal problems with site and post-acne pigmentation; sexual difficulties with grade of acne. Limitation: It was a hospital-based study with small sample size. Conclusion: Significant impact of acne and its sequelae was noted on emotions, daily activities, social activities, study/work, and interpersonal relationships. Assurance and counseling along with early treatment of acne vulgaris is important to reduce disease-related psychosocial sequelae and increase the efficacy of treatment.

Comparative Study of the Use of Trichloroacetic Acid and Phenolic Acid in the Treatment of Atrophic-Type Acne Scars.

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Dalpizzol, Mariana; Weber, Magda B; Mattiazzi, Anna Paula F; Manzoni, Ana Paula D

2016-03-01

Many therapies involving varying degrees of complexity have been used to treat acne scars, but none is considered the gold standard treatment. A comparative evaluation of 88% phenol and 90% trichloroacetic acid (TCA) applied using the chemical reconstruction of skin scars (CROSS) technique. A nonrandomized, single-blinded self-controlled clinical trial was conducted among patients with ice pick-type and boxcar-type atrophic acne scars. Using 88% phenol on the left hemiface and 90% TCA on the right hemiface was adopted as the standard practice of the CROSS technique. The dermatological quality of life index (DLQI) questionnaire, acne scar grading scale Échelle d´Evaluation Clinique des Cicatrices d'Acne (ECCA), and evaluation of improvement were performed pretreatment and post-treatment. Regarding ECCA, significant differences were found in pretreatment and post-treatment (p < .001). Regarding tolerance to pain, it was found that the discomfort felt with 90% TCA was significantly less than that felt with 88% phenol (p = .020). Regarding the quality of life measured with the DLQI, the results showed that the mean score in post-treatment assessment was significantly lower than that in the pretreatment assessment (p < .05). Hypochromia and enlargement scar were only seen after the use of 90% TCA. This study confirmed the efficacy of both TCA and phenol for treating such scars, with less severe complications from the use of phenol.

An Automatic Diagnosis Method of Facial Acne Vulgaris Based on Convolutional Neural Network.

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Shen, Xiaolei; Zhang, Jiachi; Yan, Chenjun; Zhou, Hong

2018-04-11

In this paper, we present a new automatic diagnosis method for facial acne vulgaris which is based on convolutional neural networks (CNNs). To overcome the shortcomings of previous methods which were the inability to classify enough types of acne vulgaris. The core of our method is to extract features of images based on CNNs and achieve classification by classifier. A binary-classifier of skin-and-non-skin is used to detect skin area and a seven-classifier is used to achieve the classification task of facial acne vulgaris and healthy skin. In the experiments, we compare the effectiveness of our CNN and the VGG16 neural network which is pre-trained on the ImageNet data set. We use a ROC curve to evaluate the performance of binary-classifier and use a normalized confusion matrix to evaluate the performance of seven-classifier. The results of our experiments show that the pre-trained VGG16 neural network is effective in extracting features from facial acne vulgaris images. And the features are very useful for the follow-up classifiers. Finally, we try applying the classifiers both based on the pre-trained VGG16 neural network to assist doctors in facial acne vulgaris diagnosis.

Effects of a phasic oral contraceptive containing desogestrel on facial seborrhea and acne.

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Prilepskaya, V N; Serov, V N; Zharov, E V; Golousenko, I J; Mejevitinova, E A; Gogaeva, E V; Yaglov, V V; Golubeva, O N

2003-10-01

The combined oral contraceptive containing ethinylestradiol and the selective progestogen, desogestrel, in a phasic regimen (DSG-OC, Tri-merci) has been shown to reduce facial oiliness. This study was designed to evaluate further the effects of this OC on the skin of women with facial seborrhea and mild or moderate acne. This was an open, noncomparative, bicenter study in 60 healthy Russian women, aged 18-30 years, with facial seborrhea and mild or moderate facial acne, who wished to use oral contraception. All women received the OC containing desogestrel (50/100/150 microg) and ethinylestradiol (35/30/30 microg) for three phases of 7 days followed by a 7-day pill-free interval, for six cycles. Seborrhea was assessed using the Sebutape technique, in which strips of adhesive microporous polymeric film pressed onto facial sites are used to assess sebaceous activity. Acne was assessed by counting facial lesions. Subjective evaluations of skin and hair condition, patients' feelings to them and satisfaction with the OC were made using a visual analogue scale (VAS). Assessments were made at baseline, and after one, three and six treatment cycles. Sebutape assessments of seborrhea were significantly improved, on the right and left cheeks, after one treatment cycle, and on the forehead after three treatment cycles. These improvements increased steadily and were much larger at the end of Cycle 6. Acne grades were significantly improved after three and six treatment cycles. VAS scores in response to questions dealing with self-esteem and self-confidence were significantly improved after three cycles and in some cases after just one cycle. The women's views of their skin and hair (greasiness) were correspondingly significantly improved. Subjective assessments indicated that after one, three and six cycles, 69%, 93% and 98%, respectively, of women were satisfied or very satisfied with the DSG-OC. In women with facial seborrhea and mild or moderate acne, the use of DSG

Inhibitory effects of Cheongsangbangpoong-tang on both inflammatory acne lesions and facial heat in patients with acne vulgaris: A randomized controlled trial protocol.

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Kim, Kyuseok; Kim, Kwan-Il; Lee, Junhee

2016-01-22

Due to increasing interest from acne patients concerned about the side effects associated with conventional therapies, complementary and alternative medicine (CAM) has been suggested as a new therapeutic modality for acne vulgaris. Herbal medicine is one of these CAM treatments. Cheongsangbangpoong-tang (CBT) is a common herbal formula used in patients with acne vulgaris in the clinical practice of Korean Medicine (KM). However, despite the common use of CBT in clinical practice, the current level of evidence is insufficient to support an inhibitory effect of CBT on inflammatory acne lesions and facial heat. Therefore, this study was designed to assess the inhibitory effect of CBT on both inflammatory acne lesions and facial heat. A randomized, double-blind, parallel-group, and placebo-controlled trial will be conducted. Fifty-six participants with acne vulgaris will be randomized into one of two groups: the CBT or placebo groups. After randomization, participants will be prescribed either CBT or placebo three times a day at a dose of 5 g after meals for 8 weeks. The following outcome measurements will be used in the examination of subjects: the mean percentage change and the count change of the inflammatory and non-inflammatory acne lesions, the temperature of facial points on digital infrared thermal imaging (DITI), serum cortisol, serum dehydroepiandrosterone-sulfate (DHEA-S), visual analogue scale (VAS), investigator global assessment (IGA), and severity score on the Korean Acne Grading System (KAGS) from baseline to the end of the trial. This trial will provide evidence regarding the inhibitory effect of CBT on inflammatory acne lesions and facial heat. The findings of this trial may have important implications for the more widespread use of CBT for the treatment of acne vulgaris. The trial is registered with the Clinical Research Information Service (CRiS), Republic of Korea: KCT0001468 .

Treatment of a traumatic atrophic depressed scar with hyaluronic acid fillers: a case report

Directory of Open Access Journals (Sweden)

Hussain SN

2017-08-01

Full Text Available Syed Nazim Hussain,1 Greg J Goodman,2,3 Eqram Rahman4 1Royal Lush Skin Hair & Laser Clinic, Saket, New Delhi, India; 2Department of Primary Care, Monash University, Clayton, 3Skin and Cancer Foundation Inc, Carlton, VIC, Australia; 4Faculty of Medical Science, Postgraduate Medical Institute, Anglia Ruskin University, Chelmsford, UK Background: Hyaluronic acid filler has been documented in the treatment of atrophic depressed acne scars relatively frequently in the literature but rarely in chronic depressed traumatic atrophic facial scars.Methods: This case report discusses the use of hyaluronic acid fillers in the correction of a post-traumatic facial atrophic scar on the right cheek.Results: The right cheek scar was substantially corrected with one session of two different hyaluronic acids injected in a deep and superficial plane.Conclusion: Relatively accurate, simple and effective correction of this atrophic traumatic scar may suggest that fillers are a suitable alternative to surgery for such scars. Keywords: scarring, scar correction, filler, hyaluronic acid, facial scar

Acne Scarring—Pathogenesis, Evaluation, and Treatment Options

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Connolly, Deirdre; Vu, Ha Linh; Mariwalla, Kavita

2017-01-01

Acne vulgaris is a ubiquitous problem affecting 80 percent of people ages 11 to 30 years, with many patients experiencing some degree of scarring. This review focuses on atrophic scars, the most common type of acne scar. We briefly address the cellular sequelae that lead to scar formation and the initial evaluation of patients with acne scars. We then discuss an algorithmic approach to the treatment of acne scarring based on the classification of scars into erythematous and atrophic types. Lastly, we discuss the future treatment of acne scars and ongoing clinical trials. PMID:29344322

Treatment of acne scars and wrinkles in asian patients using carbon-dioxide fractional laser resurfacing: its effects on skin biophysical profiles.

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Hwang, Young Ji; Lee, Yu Na; Lee, Yang Won; Choe, Yong Beom; Ahn, Kyu Joong

2013-11-01

Although ablative fractional resurfacing is known to be effective against photoaging and acne scars, studies on its efficacy, safety and changes in the skin characteristics of Asians are limited. The aim of this study is to assess the efficacy and safety of carbon dioxide fractional laser (CO2FL) in Koreans treated for wrinkles and acne scars, and to define the changes in skin characteristics during recovery period. We administered one session of CO2FL on 10 acne scar patients and 14 wrinkles patients with skin types IV and V. The surveillance of efficacy and side effects along with the measurement of biophysical properties was carried out before 1 day, 1 week, 1 month and 3 months after treatment. Using a non-invasive method, skin barrier damage, erythema and bronzing of skin during the recovery period were assessed, and all of the items eventually returned to the pre-treatment level. Skin elasticity was measured in the wrinkle group, and the statistically significant effect was sustained throughout the next three months. The outcome of treatment was found to be better than 'moderate improvement' in both the acne scar and wrinkle groups. Further, there were no serious side effects three months post-procedure. CO2 FL is thought to be an effective and safe method for treating moderate to severe acne scars and wrinkles in Asians.

Impact of facial burns: relationship between depressive symptoms, self-esteem and scar severity.

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Hoogewerf, Cornelis Johannes; van Baar, Margriet Elisabeth; Middelkoop, Esther; van Loey, Nancy Elisa

2014-01-01

This study assessed the role of self-reported facial scar severity as a possible influencing factor on self-esteem and depressive symptoms in patients with facial burns. A prospective multicentre cohort study with a 6 months follow-up was conducted including 132 patients with facial burns. Patients completed the Patient and Observer Scar Assessment Scale, the Rosenberg Self-esteem Scale and the Hospital Anxiety and Depression Scale. Structural Equation Modeling was used to assess the relations between depressive symptoms, self-esteem and scar severity. The model showed that patient-rated facial scar severity was not predictive for self-esteem and depressive symptoms six months post-burn. There was, however, a significant relationship between early depressive symptoms and both patient-rated facial scar severity and subsequent self-esteem. The variables in the model accounted for 37% of the variance in depressive symptoms six months post-burn and the model provided a moderately well-fitting representation of the data. The study suggests that self-esteem and depressive symptoms were not affected by self-reported facial scar severity but that earlier depressive symptoms were indicative for a more severe self-reported facial scar rating. Therefore, routine psychological screening during hospitalisation is recommended in order to identify patients at risk and to optimise their treatment. Copyright © 2014 Elsevier Inc. All rights reserved.

Fractional nonablative 1,540-nm laser resurfacing of atrophic acne scars. A randomized controlled trial with blinded response evaluation

DEFF Research Database (Denmark)

Hedelund, Lene; Moreau, Karen Estell R; Beyer, Ditte M

2010-01-01

as moderately or significantly improved. No differences were found in skin redness or pigmentation between before and after treatment. Patients experienced moderate pain, erythema, oedema, bullae, and crusts. No adverse effects were seen in untreated control areas. The nonablative 1,540-nm fractional laser......The efficacy of nonablative fractional laser resurfacing of acne scars has been described in case reports and uncontrolled trials. The present study is the first randomized controlled trial in this field. The aim of this study was to examine the efficacy and adverse effects of 1,540-nm nonablative...... fractional laser treatment of acne scars. Ten patients with acne scars were included. Two intraindividual areas of similar size and appearance within contralateral anatomical regions were randomized to (1) 3-monthly laser treatments with a StarLux 1,540-nm fractional handpiece, and (2) no treatment. Blinded...

Fractional Carbon Dioxide Laser and its Combination with Subcision in Improving Atrophic Acne Scars.

Science.gov (United States)

Nilforoushzadeh, Mohammad Ali; Faghihi, Gita; Jaffary, Fariba; Haftbaradaran, Elaheh; Hoseini, Sayed Mohsen; Mazaheri, Nafiseh

2017-01-01

Acne is a very common skin disease in which scars are seen in 95% of the patients. Although numerous treatments have been recommended, researchers are still searching for a single modality to treat the complication due to its variety in shape and depth. We compared the effects of fractional carbon dioxide (CO 2 ) laser alone and in combination with subcision in the treatment of atrophic acne scars. This clinical trial study was performed in Skin Diseases and Leishmaniasis Research Center (Isfahan, Iran) during 2011-2012. Eligible patients with atrophic acne scars were treated with fractional CO 2 laser alone (five sessions with 3-week interval) on the right side of the face and fractional CO 2 laser plus subcision (one session using both with four sessions of fractional CO 2 laser, with 3-week interval) on the left side. The subjects were visited 1, 2, and 6 months after the treatment. Patient satisfaction rate was analyzed using SPSS 20 software. The average of recovery rate was 54.7% using the combination method and 43.0% using laser alone ( P < 0.001). The mean patient satisfaction was significantly higher with the combination method than laser alone (6.6 ± 1.2 vs. 5.2 ± 1.8; P < 0.001). Bruising was only seen with the combination method and lasted for 1 week in 57.0% and for 2 weeks in 43.0%. Erythema was seen in both methods. Postinflammatory pigmentation and hyperpigmentation were associated with combination method. No persistent side effects were seen after 6 months. Using a combination of subcision and laser had suitable results regarding scar recovery and satisfaction rate.

Values of a Patient and Observer Scar Assessment Scale to Evaluate the Facial Skin Graft Scar.

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Chae, Jin Kyung; Kim, Jeong Hee; Kim, Eun Jung; Park, Kun

2016-10-01

The patient and observer scar assessment scale (POSAS) recently emerged as a promising method, reflecting both observer's and patient's opinions in evaluating scar. This tool was shown to be consistent and reliable in burn scar assessment, but it has not been tested in the setting of skin graft scar in skin cancer patients. To evaluate facial skin graft scar applied to POSAS and to compare with objective scar assessment tools. Twenty three patients, who diagnosed with facial cutaneous malignancy and transplanted skin after Mohs micrographic surgery, were recruited. Observer assessment was performed by three independent rates using the observer component of the POSAS and Vancouver scar scale (VSS). Patient self-assessment was performed using the patient component of the POSAS. To quantify scar color and scar thickness more objectively, spectrophotometer and ultrasonography was applied. Inter-observer reliability was substantial with both VSS and the observer component of the POSAS (average measure intraclass coefficient correlation, 0.76 and 0.80, respectively). The observer component consistently showed significant correlations with patients' ratings for the parameters of the POSAS (all p -valuesskin graft scar assessment in skin cancer patients, the POSAS showed acceptable inter-observer reliability. This tool was more comprehensive and had higher correlation with patient's opinion.

Efficacy of a new fractional CO2 laser in the treatment of photodamage and acne scarring.

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Katz, Bruce

2010-01-01

This study evaluates the efficacy and safety of a novel fractional CO(2) laser device for improving facial rhytids, hyperpigmentation, enlarged pores, skin laxity, and acne scarring. Subjects (n= 15) were treated three to five times at 3-week intervals. Biopsy specimens were used to evaluate healing response and neocollagenesis. Clinical improvement was rated on a quartile rating scale from digital photographs. Subject discomfort during treatment was evaluated on a scale of 0 to 5. Fourteen subjects who completed the study achieved good to excellent improvement in overall appearance, with 60% rated excellent. Improvement in photodamage was good to excellent in 92% of subjects, and reduction in rhytids was good to excellent in 85%. A total of 79% of subjects achieved good to excellent improvement in pore sizes and skin laxity. Subject discomfort during treatment was 3.0 +/- 0.7. Erythema persisted for 2-3 days, and subjects resumed normal activities 1-2 days after the procedure. Histological slides after a single treatment showed new collagen formation. The SmartSkin fractional CO(2) system (Cynosure, Inc., Westford, MA, USA) provides significant improvement for the treatment of facial wrinkles, hyperpigmentation, pore size, and skin laxity associated with photodamage.

The impact of acne and facial post-inflammatory hyperpigmentation on quality of life and self-esteem of newly admitted Nigerian undergraduates.

Science.gov (United States)

Akinboro, Adeolu Oladayo; Ezejiofor, Ogochukwu Ifeanyi; Olanrewaju, Fatai Olatunde; Oripelaye, Mufutau Muphy; Olabode, Olatunde Peter; Ayodele, Olugbenga Edward; Onayemi, Emmanuel Olaniyi

2018-01-01

Acne and facial post-inflammatory hyperpigmentation are relatively common clinical conditions among adolescents and young adults, and inflict psychosocial injuries on sufferers. To document the psychosocial and self-esteem implications of acne and facial hyperpigmentation on newly admitted undergraduates. A cross-sectional survey was conducted among 200 undergraduates. Demographics and clinical characteristics were obtained and acne was graded using the US Food and Drug Administration 5-category global system of acne classification. Participants completed the Cardiff Acne Disability Index (CADI) and the Rosenberg self-esteem scale (RSES), and data were analyzed using SPSS 20. Mean age of acne onset was 16.24 ± 3.32 years. There were 168 (84.0%) cases categorized as almost clear, 24 (12.0%) as mild acne, 4 (2.0%) as moderate acne and 4 (2.0%) as severe acne. Acne with facial hyperpigmentation, compared to acne without hyperpigmentation, was associated with significant level of anxiety in 30 participants (26.5% vs 10.3%, p =0.004) and emotional distress in 40 (35.4% vs 10.3%, p self-esteem and perception of worse disease. There was no association between gender and QoL but acne was related to a reduction of self-worth. Low self-esteem was present in 1.5%, and severe acne was associated with an occasional feeling of uselessness in the male gender. Acne with facial hyperpigmentation induces poorer QoL and self-esteem is impaired only in severe acne. Beyond the medical treatment of acne, dermatologists should routinely assess the QoL and give attention to treatment of facial post-inflammatory hyperpigmentation among people of color.

Acne Scars

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... or scrubbing scarred areas can further reduce skin elasticity and heighten the appearance of the scar. Pick ... technique or procedure is appropriate for my skin type? Did the doctor show me before-and-after ...

Standard guidelines of care for acne surgery

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Khunger Niti

2008-03-01

Full Text Available Acne surgery is the use of various surgical procedures for the treatment of postacne scarring and also, as adjuvant treatment for active acne. Surgery is indicated both in active acne and post-acne scars. Physicians′ qualifications: Any Dermatologist can perform most acne surgery techniques as these are usually taught during postgraduation. However, certain techniques such as dermabrasion, laser resurfacing, scar revisions need specific "hands-on" training in appropriate training centers. Facility: Most acne surgery procedures can be performed in a physician′s minor procedure room. However, full-face dermabrasion and laser resurfacing need an operation theatre in a hospital setting. Active acne: Surgical treatment is only an adjunct to medical therapy, which remains the mainstay of treatment. Comedone extraction is a process of applying simple mechanical pressure with a comedone extractor, to extract the contents of the blocked pilosebaceous follicle. Superficial chemical peel is a process of applying a chemical agent to the skin, so as to cause controlled destruction of the epidermis leading to exfoliation. Glycolic acid, salicylic acid and trichloroacetic acid are commonly used peeling agents for the treatment of active acne and superficial acne scars. Cryotherapy: Cryoslush and cryopeel are used for the treatment of nodulocystic acne. Intralesional corticosteroids are indicated for the treatment of nodules, cysts and keloidal acne scars. Nonablative lasers and light therapy using Blue light, non ablative radiofrequency, Nd:YAG laser, IPL (Intense Pulsed Light, PDT (Photodynamic Therapy, pulse dye laser and light and heat energy machines have been used in recent years for the treatment of active inflammatory acne and superficial acne scars. Proper counseling is very important in the treatment of acne scars. Treatment depends on the type of acne scars; a patient may need more than one type of treatment. Subcision is a treatment to break the

The impact of acne and facial post-inflammatory hyperpigmentation on quality of life and self-esteem of newly admitted Nigerian undergraduates

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Akinboro AO

2018-05-01

Full Text Available Adeolu Oladayo Akinboro,1 Ogochukwu Ifeanyi Ezejiofor,2 Fatai Olatunde Olanrewaju,3 Mufutau Muphy Oripelaye,3 Olatunde Peter Olabode,4 Olugbenga Edward Ayodele,4 Emmanuel Olaniyi Onayemi3 1Dermatology Unit, Department of Internal Medicine, Ladoke Akintola University of Technology, Ogbomoso and LAUTECH Teaching Hospital, Ogbomoso, Nigeria; 2Dermatology Unit, Department of Medicine, Nnamdi Azikiwe University, Nnewi, Nigeria; 3Department of Dermatology and Venereology, Obafemi Awolowo University and OAUTHC, Ile-Ife, Nigeria; 4Department of Internal Medicine, Ladoke Akintola University of Technology, Ogbomoso and LAUTECH Teaching Hospital, Ogbomoso, Nigeria Background: Acne and facial post-inflammatory hyperpigmentation are relatively common clinical conditions among adolescents and young adults, and inflict psychosocial injuries on sufferers.Objective: To document the psychosocial and self-esteem implications of acne and facial hyperpigmentation on newly admitted undergraduates.Materials and methods: A cross-sectional survey was conducted among 200 undergraduates. Demographics and clinical characteristics were obtained and acne was graded using the US Food and Drug Administration 5-category global system of acne classification. Participants completed the Cardiff Acne Disability Index (CADI and the Rosenberg self-esteem scale (RSES, and data were analyzed using SPSS 20.Results: Mean age of acne onset was 16.24 ± 3.32 years. There were 168 (84.0% cases categorized as almost clear, 24 (12.0% as mild acne, 4 (2.0% as moderate acne and 4 (2.0% as severe acne. Acne with facial hyperpigmentation, compared to acne without hyperpigmentation, was associated with significant level of anxiety in 30 participants (26.5% vs 10.3%, p=0.004 and emotional distress in 40 (35.4% vs 10.3%, p<0.001. Acne severity correlated with total CADI score but not with total RSES score. Quality of life (QoL was significantly reduced among acne patients with facial

Patient reported facial scar assessment: directions for the professional

NARCIS (Netherlands)

Hoogewerf, C.J.; van Baar, M.E.; Middelkoop, E.; van Loey, N.E.

2014-01-01

Background The face is central to our identity and provides our most expressive means of communication. Currently, the role of facial scarring in relation to self-esteem is unclear and the value of self-reported scar assessment is insufficiently understood. The aim of this study was twofold: (1) to

Patient reported facial scar assessment : directions for the professional

NARCIS (Netherlands)

Hoogewerf, Cornelis J; van Baar, Margriet E; Middelkoop, Esther; Van Loey, N.E.E.

BACKGROUND: The face is central to our identity and provides our most expressive means of communication. Currently, the role of facial scarring in relation to self-esteem is unclear and the value of self-reported scar assessment is insufficiently understood. The aim of this study was twofold: (1) to

Imaging inflammatory acne: lesion detection and tracking

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Cula, Gabriela O.; Bargo, Paulo R.; Kollias, Nikiforos

2010-02-01

It is known that effectiveness of acne treatment increases when the lesions are detected earlier, before they could progress into mature wound-like lesions, which lead to scarring and discoloration. However, little is known about the evolution of acne from early signs until after the lesion heals. In this work we computationally characterize the evolution of inflammatory acne lesions, based on analyzing cross-polarized images that document acne-prone facial skin over time. Taking skin images over time, and being able to follow skin features in these images present serious challenges, due to change in the appearance of skin, difficulty in repositioning the subject, involuntary movement such as breathing. A computational technique for automatic detection of lesions by separating the background normal skin from the acne lesions, based on fitting Gaussian distributions to the intensity histograms, is presented. In order to track and quantify the evolution of lesions, in terms of the degree of progress or regress, we designed a study to capture facial skin images from an acne-prone young individual, followed over the course of 3 different time points. Based on the behavior of the lesions between two consecutive time points, the automatically detected lesions are classified in four categories: new lesions, resolved lesions (i.e. lesions that disappear completely), lesions that are progressing, and lesions that are regressing (i.e. lesions in the process of healing). The classification our methods achieve correlates well with visual inspection of a trained human grader.

An assessment of the efficacy and safety of cross technique with 100% TCA in the management of ice pick acne scars

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Deepali Bhardwaj

2010-01-01

Full Text Available Background : Chemical reconstruction of skin scars (CROSS is a technique using high concentrations of trichloroacetic acid (TCA focally on atrophic acne scars to induce inflammation followed by collagenisation. This can lead to reduction in the appearance of scars and cosmetic improvement. Aims : The aim of this pilot study is to investigate the safety of the CROSS technique, using 100% TCA, for atrophic ice pick acne scars. Settings and Design : Open prospective study. Materials and Methods : Twelve patients with predominant atrophic ice pick post acne scars were treated with the CROSS technique, using 100% TCA, applied with a wooden toothpick, at two weekly intervals for four sittings. Efficacy was assessed on the basis of the physician′s clinical assessment, photographic evaluation at each sitting and patient′s feedback after the fourth treatment, and at the three-month and six-month follow-up period, after the last treatment. Results : More than 70% improvement was seen in eight out of ten patients evaluated and good results (50 - 70% improvement were observed in the remaining two patients. No significant side effects were noted. Transient hypopigmentation and hyperpigmentation was observed in one patient each. Physician′s findings were in conformity with the patient′s assessment. Three months after the last treatment, one patient noted a decrease in improvement with no further improvement even at the six-month follow-up period. Conclusion : The CROSS technique with 100% TCA is a safe, efficacious, cost-effective and minimally invasive technique for the management of ice pick acne scars that are otherwise generally difficult to treat. In few patients the improvement may not be sustained, probably due to inadequate or delayed collagenisation.

Skin needling as a treatment for acne scarring: An up-to-date review of the literature

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Adam G. Harris, MBChB

2015-06-01

Conclusion: There is moderate evidence to suggest that skin needling is beneficial and safe for the treatment of acne scarring. However, double-blinded, randomized controlled trials are required to make more definitive conclusions.

Facial fluid synthesis for assessment of acne vulgaris using luminescent visualization system through optical imaging and integration of fluorescent imaging system

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Balbin, Jessie R.; Dela Cruz, Jennifer C.; Camba, Clarisse O.; Gozo, Angelo D.; Jimenez, Sheena Mariz B.; Tribiana, Aivje C.

2017-06-01

Acne vulgaris, commonly called as acne, is a skin problem that occurs when oil and dead skin cells clog up in a person's pores. This is because hormones change which makes the skin oilier. The problem is people really do not know the real assessment of sensitivity of their skin in terms of fluid development on their faces that tends to develop acne vulgaris, thus having more complications. This research aims to assess Acne Vulgaris using luminescent visualization system through optical imaging and integration of image processing algorithms. Specifically, this research aims to design a prototype for facial fluid analysis using luminescent visualization system through optical imaging and integration of fluorescent imaging system, and to classify different facial fluids present in each person. Throughout the process, some structures and layers of the face will be excluded, leaving only a mapped facial structure with acne regions. Facial fluid regions are distinguished from the acne region as they are characterized differently.

Treatment of facial atrophic scars with Esthélis, a hyaluronic acid filler with polydense cohesive matrix (CPM).

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Hasson, Ariel; Romero, William A

2010-12-01

The treatment of atrophic scars is difficult and dermal filler materials provide a simple alternative with immediate results. Esthélis® is an injectable non-animal crosslinked hyaluronic acid of Swiss origin characterized by a polydense cohesive matrix (CPM®) which produces a gel of uniform consistency with better biointegration to the tissues and a longer duration. To evaluate Esthélis in the treatment of atrophic scars. Twelve patients aged 18-56 years with facial atrophic scars caused by acne vulgaris, dog bite, piercing, basal cell carcinoma and leishmaniasis were treated with Esthélis. The injection technique was linear threading, serial puncture or a combination of both. Clinical efficacy was assessed independently by the authors and by patients immediately, one week and one month after the injection. Adverse events were registered. Authors described the results as moderate (27%), good (57%) and excellent (17%), immediately, one week and one month after the injection. Patients evaluated the cosmetic improvement as good (42%) or excellent (58%) one month after the treatment. Pain during the injection was described as slight or moderate. Only mild erythema was observed immediately after injection, which spontaneously resolved within few hours. Esthélis showed good or excellent results in most patients with atrophic scars, and these were perceived as even better when patients evaluated the cosmetic improvement. The best results were observed in patients with more deforming scars such as surgical scars or trauma.

The efficacy of autologous platelet rich plasma combined with ablative carbon dioxide fractional resurfacing for acne scars: a simultaneous split-face trial.

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Lee, Jin Woong; Kim, Beom Joon; Kim, Myeung Nam; Mun, Seog Kyun

2011-07-01

Ablative carbon dioxide (CO(2) ) fractional resurfacing is a promising therapeutic intervention for the treatment of acne scars, although this technique is associated with prolonged surgical site erythema and edema, which may affect the daily lives of patients. Autologous platelet-rich plasma (PRP) is known to enhance wound healing and has applications in many areas of medicine. To evaluate the synergistic effects of autologous PRP with CO(2) fractional resurfacing for acne scars. A split-face trial was conducted in 14 Korean participants with acne scars. All participants received one session of ablative CO(2) fractional resurfacing. Immediately after resurfacing, facial halves were randomly assigned to receive treatment with autologous PRP injections on one side (experimental side) and normal saline injections on the other side (control side). The participants were monitored for degree of recovery and resurfacing-associated adverse events, including prolonged erythema, edema, and other effects on days 0, 2, 4, 6, 8, 15, and 30. The intensity of erythema was objectively measured using a chromometer at the same time intervals. After one additional treatment session using the same protocol, two independent dermatologists evaluated clinical improvement using a quartile grading scale. All participants completed the study. Erythema on the experimental side improved faster than on the control side and was significantly less at day 4 (p=.01). This difference was confirmed using a chromometer (p=.049). Total duration of erythema was an average of 10.4±2.7 days on the control side and 8.6±2.0 days on the experimental side (p=.047). Edema also improved faster on the experimental side than on the control side. The total duration of edema was an average of 7.1±1.5 days on the control side and 6.1±1.1 days on the experimental side (p=.04). Participants were also assessed for duration of post-treatment crusting, with a mean of 6.8±1.0 days on the control side and 5.9±1

Comparison of a long-pulse Nd:YAG laser and a combined 585/1,064-nm laser for the treatment of acne scars: a randomized split-face clinical study.

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Min, Seong U K; Choi, Yu Sung; Lee, Dong Hun; Yoon, Mi Young; Suh, Dae Hun

2009-11-01

Nonablative laser is gaining popularity because of the low risk of complications, especially in patients with darker skin. To compare the efficacy and safety of a long-pulse neodymium-doped yttrium aluminium garnet (Nd:YAG) laser and a combined 585/1,064-nm laser for the treatment of acne scars. Nineteen patients with mild to moderate atrophic acne scars received four long-pulse Nd:YAG laser or combined 585/1,064-nm laser treatment sessions at fortnightly intervals. Treatments were administered randomly in a split-face manner. Acne scars showed mild to moderate improvement, with significant Echelle d'évaluation clinique des cicatrices d'acné (ECCA) score reductions, after both treatments. Although intermodality differences were not significant, combined 585/1,064-nm laser was more effective for deep boxcar scars. In patients with combined 585/1,064-nm laser-treated sides that improved more than long-pulse Nd:YAG laser-treated sides, ECCA scores were significantly lower for combined 585/1,064-nm laser treatment. Histologic evaluations revealed significantly greater collagen deposition, although there was no significant difference between the two modalities. Patient satisfaction scores concurred with physicians' evaluations. Both lasers ameliorated acne scarring with minimal downtime. In light of this finding, optimal outcomes might be achieved when laser treatment types are chosen after considering individual scar type and response.

The Efficacy and Safety of Azelaic Acid 15% Foam in the Treatment of Facial Acne Vulgaris.

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Hashim, Peter W; Chen, Tinley; Harper, Julie C; Kircik, Leon H

2018-06-01

Azelaic acid demonstrates anti-inflammatory, anti-oxidative, anti-comedogenic, and anti-microbial effects. Azelaic acid 20% cream is currently approved for the treatment of acne vulgaris, and azelaic acid 15% foam has recently been approved for rosacea. Given the favorable tolerability profile of foam preparations, it is reasonable to assume that azelaic acid 15% foam could serve as a viable treatment option for facial acne. To examine the efficacy and safety of azelaic acid 15% foam in the treatment of moderate-to-severe facial acne Methods: Twenty subjects with moderate-to-severe facial acne vulgaris were enrolled in this two-center, open-label pilot study. All study subjects were treated with azelaic acid 15% foam for 16 weeks. Efficacy analyses were based on the change in facial investigator global assessment (FIGA) and changes in total, inflammatory, non-inflammatory lesion counts between baseline and week 16. There was a significant reduction in FIGA scores from baseline to week 16 (p = .0004), with 84% of subjects experiencing at least a 1 grade improvement, and 63% of subjects achieving a final grade of Clear or Almost Clear. All subjects experienced reductions in inflammatory and total lesion counts by week 16, and 89% of subjects experienced reductions in non-inflammatory lesions. Azelaic acid 15% foam was well tolerated, with almost all instances of erythema, dryness, peeling, oiliness, pruritus, and burning being of mild or trace degree, and most adverse effects resolving by the end of the study. Azelaic acid 15% foam is effective and safe in the treatment of facial acne vulgaris. Given the convenience of foam vehicles, azelaic acid 15% foam should be considered as a viable treatment option for this condition. J Drugs Dermatol. 2018;17(6):641-645.

Fractional carbon dioxide laser for the treatment of facial atrophic acne scars: prospective clinical trial with short and long-term evaluation.

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Elcin, Gonca; Yalici-Armagan, Basak

2017-12-01

The aim of this study was to evaluate the efficacy and safety of fractional carbon dioxide laser for the treatment of acne scars. Thirty-one participants, 15 female and 16 male, whose mean age was 34.84 ± 10.94 years, were included in this prospective study. The study took place between 2012 and 2016. Participants were evaluated with the "ECCA Grading Scale" before the first session, 3 months (short-term evaluation) and 3 years after the last session (long-term evaluation). Participants received two or three treatment sessions at 4-week intervals, with a 10,600 nm fractional carbon dioxide laser with pulse energies ranging between 100 and 160 mJ, 120 spot type, 75-100 spot/cm 2 density, and 30 W power. Self-assessments by the participants were done 3 months and 3 years after the last session. The mean ECCA score was 107.90 ± 39.38 before the first session, and 82.17 ± 36.23 at the time of short-term evaluation (p = 0.000). The grade of improvement at the short-term evaluation was as follows: no improvement, mild, moderate, and significant improvement for 7 (22.6%), 11 (35.5%), 9 (29%), and 4 (12.9%) of the participants, respectively. Regarding self-assessments, 80.6 and 61.3% of the participants rated themselves as having at least mild improvement at the short-term and the long-term follow-up periods, respectively. The results of this study suggest that fractional carbon dioxide laser is an efficient treatment option for acne scars. Furthermore, self-assessment results show that more than half of the participants still experience at least mild improvement at the end of 3 years.

Prosthodontist contribution in treating post-burn hypertrophic facial scars

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Padmanabhan T

2010-01-01

Full Text Available The formation of hypertrophic scars is common following healing of the burn wound, particularly in children. The face is one of the areas of the body most frequently affected by burns. Scar formation as a result of burn wounds leads to contraction of the formed granulation tissue, which causes both aesthetic and functional impairment for the patient. Scarring has major psychological and physical repercussions. Scarring on the face and visible regions of the body can be very distressing for the patient. Prevention of scars involves early and continuous use of a compressive orthesis. However, their efficacy is often limited to the facial region because of the contours of this area of body. This paper describes a clinical case of post-burn hypertrophic scars treated with silicone gel sheeting applied with pressure under custom made auto-polymerizing resin stent.

Ablative Fractional 10 600 nm Carbon Dioxide Laser Versus Non-ablative Fractional 1540 nm Erbium-Glass Laser in Egyptian Post-acne Scar patients.

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Elsaie, Mohamed L; Ibrahim, Shady M; Saudi, Wael

2018-01-01

Introduction: Non-ablative fractional erbium-doped glass 1540 nm and fractional ablative 10600 nm carbon dioxide lasers are regarded as effective modalities for treating acne atrophic scars. In this study, we aimed to compare the effectiveness of fractional CO 2 laser and fractional nonablative 1540 nm erbium doped glass laser in treating post acne atrophic scars in Egyptian patients. Methods: Fifty-eight patients complaining of moderate and severe acne atrophic scars were randomly divided into 2 groups of 29 patients each. Both groups were subjected to 4 treatment sessions with 3 weeks interval and were followed up for 3 months. In group A, enrolled patient sreceived C2 laser, while in group B, patients were treated with 1540 nm erbium glass fractional laser. Results: Clinical assessment revealed that the mean grades of progress and improvement were higher with fractional 10600 nm CO2 laser but with non-significant difference between both treatments ( P = 0.1). The overall patients' satisfaction with both lasers were not significantly different ( P = 0.44). Conclusion: Both fractional ablative CO2 and fractional non-ablative erbium glass lasers are good modalities for treating acne scars with a high efficacy and safety profile and good patient satisfaction. The fractional ablative laser showed higher efficacy while non-ablative laser offered less pain and shorter downtime.

Efficacy of autologous platelet-rich plasma combined with fractional ablative carbon dioxide resurfacing laser in treatment of facial atrophic acne scars: A split-face randomized clinical trial

OpenAIRE

Gita Faghihi; Shima Keyvan; Ali Asilian; Saeid Nouraei; Shadi Behfar; Mohamad Ali Nilforoushzadeh

2016-01-01

Background: Autologous platelet-rich plasma has recently attracted significant attention throughout the medical field for its wound-healing ability. Aims: This study was conducted to investigate the potential of platelet-rich plasma combined with fractional laser therapy in the treatment of acne scarring. Methods: Sixteen patients (12 women and 4 men) who underwent split-face therapy were analyzed in this study. They received ablative fractional carbon dioxide laser combined with intradermal ...

Autologous fat transplantation for depressed linear scleroderma-induced facial atrophic scars.

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Roh, Mi Ryung; Jung, Jin Young; Chung, Kee Yang

2008-12-01

Facial linear scleroderma results in depressed atrophic scars. Autologous fat transplantation has been widely used, and fat appears to be an ideal material for filling depressed atrophic scars and contour deformities, but long-term results for autologous fat transplantation are controversial. To review the short- and long-term results of 20 patients who underwent multiple autologous fat transplantations for depressed atrophic scar correction. Twenty patients with clinically inactive facial linear scleroderma were included. They received at least two transplantations and had a 12-month follow-up evaluation. On the forehead, 51% to 75% improvement (average grading scale: 2.4) was achieved when observed at least 12 months after the last treatment. For the chin, correction was poor (average grading scale: 0.7) with less than 25% improvement. The infraorbital area showed fair correction, but the nose showed poor correction. Two of three patients with scalp reduction surgery showed excellent results, showing only slight scar widening. Autologous fat transplantation is an effective method for long-term correction of depressed atrophic scars left by linear scleroderma on the forehead but is less effective for corrections on the nose, infraorbital area, and chin.

3D-printed transparent facemasks in the treatment of facial hypertrophic scars of young children with burns.

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Wei, Yating; Li-Tsang, Cecilia W P; Liu, Jun; Xie, Lihua; Yue, Shukai

2017-05-01

Facial burns could create serious scar problems resulting disfigurement particularly on children. The conventional methods of producing transparent face masks for scar control remains complex and require dexterous skills of experienced clinician and patients' compliance during fitting. In this study, we adopted a portable 3D scanning and Computer-Aided Design (CAD) to produce 3D-printed transparent facemasks. Its efficacy was tested on two children with facial burns resulting hypertrophic scars. This study adopted a longitudinal case follow up research design. Two children with facial burns were recruited in the study upon consent. Their facial features were scanned with a portable 3D scanner and then edited and converted to the target files: the customized printable facemask files. The transparent facemask was directly printed out on the transparent biocompatible material followed by adding the medical grade silicone gel to provide extra pressure on the scar site. The facemasks were fitted to the patients with elastic straps connecting the printed anchoring bolts. Both children and family were instructed to wear the facemask for at least 20h per day and they were assessed before treatment, one month and three months after treatment on the facial scar conditions. At the one-month and three-month assessments after treatment, a decrease in average scar thickness was shown and the facial appearance was satisfactory. The 3D-printed facemasks were well fitted on both patients. The treatment was well-tolerated and no complication was reported. 3D-printed transparent facemask is convenient and efficient to fabricate, and is suitable for treating pediatric facial hypertrophic scars after burn. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

Sonography of acne vulgaris.

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Wortsman, Ximena; Claveria, Pedro; Valenzuela, Fernando; Molina, Maria Teresa; Wortsman, Jacobo

2014-01-01

The purpose of this study was to assess the sonographic morphology of the clinical and subclinical pathology of facial acne vulgaris. We studied patients with facial acne vulgaris diagnosed by certified dermatologists, and using a standardized protocol for sonographic examinations, we sequentially described the sonographic pathomorphologic characteristics. Lesions of particular interest to the referring clinician were also analyzed separately. Additionally, acne involvement was staged clinically and sonographically (SOS-Acne) using morphologic definitions of the relevant lesions and predefined scoring systems for gradation of the severity of acne lesions. A total of 245 acne lesions in 20 consecutive patients were studied. Sonographic abnormalities consisted of pseudocysts, folliculitis, fistulas, and calcinosis. Most conditions were subclinical and mostly due to lesion extensions deep into the dermis and hypodermis (52% of pseudocysts and 68% of fistulas). The statistical concordance between acne severity scores assigned by two separate clinicians was strong (κ = 0.8020), but the corresponding sonographic scores generally showed more severe and clinically occult involvement. Facial acne vulgaris often involves deeper tissues, beyond the reach of the spatially restricted clinical examination; these subclinical conditions can be detected and defined with sonography. Additionally, acne vulgaris is amenable to sonographic scoring.

Efficacy of intense pulsed light therapy in the treatment of facial acne vulgaris: Comparison of two different fluences

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Monika V Patidar

2016-01-01

Full Text Available Background: Acne vulgaris is the most common disease of the skin affecting adolescents and young adults causing psychological distress. The combination of antibiotic resistance, adverse effects of topical and systemic anti acne medications and desire for high tech approaches have all led to new enthusiasm for light based acne treatment. Intense pulse light (IPL therapy has three modes of action in acne vulgaris i.e., photochemical, photo thermal and photo immunological. Aims: (1 to study efficacy of IPL therapy in facial acne vulgaris. (2 To compare two fluences - one normal and other subnormal on right and left side of face respectively. Methods: (Including settings and design and statistical analysis used. Total 45 patients in age group 16 to 28 years with inflammatory facial acne vulgaris were included in prospective study. Baseline data for each patient was recorded. All patients were given 4 sittings of IPL at 2 weeks interval and were followed for 2 months every 2 weeks. Fluence used was 35J/cm2 on right and 20J/cm2 on left side. Percentage reduction in lesion count was calculated at each sitting and follow up and graded as mild (0-25%, moderate (26-50%, good (51-75% and excellent (76-100%. Side effects were noted. The results were analysed using Mann-Whitney Test. Results: On right side, excellent results were achieved in 10(22%, good in 22(49% and moderate in 13(29% patients. On left side excellent were results achieved in 7(15%, good in 19(42% and moderate in 16(43% patients. There was no statically significant difference noted in efficacy of two fluences used in treatment of facial acne vulgaris. Conclusions: IPL is a effective and safe option for inflammatory acne vulgaris with minimal reversible side effects. Subnormal fluence is as effective as normal fluence in Indian skin.

Zonun’s regime (35% glycolic acid peel with microneedling followed by tretinoin 0.05% plus glycolic acid 12% application followed by salicylic acid 30% peeling for treatment of acne scars: a pilot study

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Zonunsanga

2015-01-01

Full Text Available Introduction: Acne scars are the result of inflammation within the dermis brought on by acne. The scar is created by the wound trying to heal itself resulting in too much collagen in one spot. Current treatment available are not much satisfactory. Microneedling injure the dermis, thereby stimulating collagen formation. Glycolic acid acts as vehicle for delivery of drugs to dermis: in addition to that, it also has a role in collagen induction. Tretinoin helps in collagen formation. Salicylic acid remodel the superficial skin after the treatment. Material and Methods: A total of 4 patients in which 3 out of 4 patient, grade 3 acne scars and 1 out of 4 had grade 2 scar were treated with the regime. After taking consent 35% Glycolic acid peeling was done followed by microneedling. From the next day 12% Glycolic acid plus 0.05% Tretinoin is applied once a day for 2 months. After 2 months 30% Salicylic acid peeling is done. Photographs were taken before treatment, after 1 month and after 2 months of completion of the therapy and compared. Objective assessment was done according to Global Acne Scarring Classification. Result: subjectively 2 patients reported excellent response and 2 patients reported good response. Objectively, all patients showed good to excellent response. Conclusion: Zonun’s regime may be effective for treatment of acne scars.

Assessment of Life Quality Index Among Patients with Acne Vulgaris in a Suburban Population.

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Hazarika, Neirita; Rajaprabha, Radha K

2016-01-01

Acne vulgaris affects about 85% of adolescents, often extending into adulthood. Psychosocial impact of acne on health-related quality of life (QoL) has been identified, but it remains under-evaluated, especially in Indian patients. This study was aimed to assess the impact of acne and its sequelae on the QoL. This was a hospital-based, prospective, cross-sectional study done between June and November 2014 on 114 consenting patients above 15 years of age with acne vulgaris. Acne vulgaris and its sequelae were graded, and QoL was assessed by using Dermatology Life Quality Index (DLQI) questionnaire. Most cases (64%) were between 15 and 20 years. Females (57%) outnumbered males. Facial lesions (61.4%) and grade II acne were most common. Mean DLQI score was 7.22. DLQI scores were statistically influenced by the age of the patient, duration and grade of acne, acne scar, and postacne hyperpigmentation. This study showed significant impairment of QoL in acne patients. Assurance and counseling along with early treatment of acne vulgaris are important to reduce disease-related psychosocial sequelae and increase the efficacy of treatment.

The application of 3D-printed transparent facemask for facial scar management and its biomechanical rationale.

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Wei, Yating; Wang, Yan; Zhang, Ming; Yan, Gang; Wu, Shixue; Liu, Wenjun; Ji, Gang; Li-Tsang, Cecilia W P

2018-03-01

Deep facial burns leave conspicuous scar to the patients and affect their quality of life. Transparent facemask has been adopted for the prevention and treatment of facial hypertrophic scars for decades. Recently, with the advancement of 3D printing, the transparent facemask could facilitate the fitting of the facial contour. However, the effectiveness of the device and its biomechanical characteristics on pressure management of hypertrophic scar would need more objective evaluation. A biomechanical model of the transparent 3D-printed facemask was established through finite element analysis. Ten patients with extensive deep facial burns within 6 months were recruited for clinical study using 3D-printed facemask designed according to biomechanical model, and the interface pressure was measured on each patient. The patients in the treatment group (n=5) was provided with the 3D-printed transparent face mask soon after initial scar assessment, while the delayed treatment group (n=5) began the treatment one month after the initial scar assessment. The scar assessment was performed one month post intervention for both groups. The biomechanical modeling showed that the 3D, computer-generated facemask resulted in unbalanced pressure if design modifications were not incorporated to address these issues. The interface pressure between the facemask and patient's face was optimized through individualized design adjustments and the addition of silicone lining. After optimization of pressure through additional lining, the mean thickness and hardness of the scars of all 10 patients were decreased significantly after 1-month of intervention. In the delayed treatment group, the mean thickness of the scars was increased within the month without intervention, but it was also decreased after intervention. Facemask design and the silicone lining are important to ensure adequate compression pressure of 3D-printed transparent facemask. The intervention using the 3D-printed facemask

Evaluating Platelet-Rich Therapy for Facial Aesthetics and Alopecia: A Critical Review of the Literature.

Science.gov (United States)

Motosk O, Catherine C; Khouri, Kimberly S; Poudrier, Grace; Sinno, Sammy; Hazen, Alexes

2018-05-01

Despite the growing popularity of platelet-rich plasma, existing evidence supporting its efficacy remains controversial due to the lack of large-scale studies and standardized protocols for preparation and application. This article reviews its use in facial rejuvenation, fat grafting, acne scarring, and androgenic alopecia. Emphasis is placed on comparing methods of platelet-rich plasma preparation and application across studies. A systematic review was performed for articles published between 2006 and 2015. All clinical studies and case reports that addressed platelet-rich plasma alone and/or in combination with fat grafting for facial rejuvenation, acne scarring, or androgenic alopecia were included. Of the 22 articles included in the analysis, seven studies used platelet-rich plasma alone for facial rejuvenation, seven in combination with fat grafting, two for treatment of acne scarring, and six for treatment of androgenic alopecia. Individual study procedures, means of evaluation, and significant results are summarized. Although the majority of studies in this review report positive results, significant variation exists in preparation protocols and in the number and frequency of clinical treatments. The majority of studies report positive results for all indications evaluated in this review, but the procedure is limited by the lack of a standardized method for preparation and application of platelet-rich plasma. The extent to which significant variability in platelet-rich plasma preparation and/or application methods may affect clinical outcomes is not completely clear. In the interim, we present a consolidation of platelet-rich plasma treatment techniques and outcomes currently in use to help guide physicians in their clinical practice.

Impact of facial burns: relationship between depressive symptoms, self-esteem and scar severity

NARCIS (Netherlands)

Hoogewerf, C.J.; van Baar, M.E.; Middelkoop, E.; van Loey, N.E.

2014-01-01

Objective: This study assessed the role of self-reported facial scar severity as a possible influencing factor on self-esteem and depressive symptoms in patients with facial burns. Method: A prospective multicentre cohort study with a 6 months follow-up was conducted including 132 patients with

Impact of facial burns : relationship between depressive symptoms, self-esteem and scar severity

NARCIS (Netherlands)

Hoogewerf, Cornelis Johannes; van Baar, Margriet Elisabeth; Middelkoop, Esther; Van Loey, N.E.E.

2014-01-01

OBJECTIVE: This study assessed the role of self-reported facial scar severity as a possible influencing factor on self-esteem and depressive symptoms in patients with facial burns. METHOD: A prospective multicentre cohort study with a 6 months follow-up was conducted including 132 patients with

Acne image analysis: lesion localization and classification

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Abas, Fazly Salleh; Kaffenberger, Benjamin; Bikowski, Joseph; Gurcan, Metin N.

2016-03-01

Acne is a common skin condition present predominantly in the adolescent population, but may continue into adulthood. Scarring occurs commonly as a sequel to severe inflammatory acne. The presence of acne and resultant scars are more than cosmetic, with a significant potential to alter quality of life and even job prospects. The psychosocial effects of acne and scars can be disturbing and may be a risk factor for serious psychological concerns. Treatment efficacy is generally determined based on an invalidated gestalt by the physician and patient. However, the validated assessment of acne can be challenging and time consuming. Acne can be classified into several morphologies including closed comedones (whiteheads), open comedones (blackheads), papules, pustules, cysts (nodules) and scars. For a validated assessment, the different morphologies need to be counted independently, a method that is far too time consuming considering the limited time available for a consultation. However, it is practical to record and analyze images since dermatologists can validate the severity of acne within seconds after uploading an image. This paper covers the processes of region-ofinterest determination using entropy-based filtering and thresholding as well acne lesion feature extraction. Feature extraction methods using discrete wavelet frames and gray-level co-occurence matrix were presented and their effectiveness in separating the six major acne lesion classes were discussed. Several classifiers were used to test the extracted features. Correct classification accuracy as high as 85.5% was achieved using the binary classification tree with fourteen principle components used as descriptors. Further studies are underway to further improve the algorithm performance and validate it on a larger database.

Comparative Study Using Autologous Fat Grafts Plus Platelet-Rich Plasma With or Without Fractional CO2 Laser Resurfacing in Treatment of Acne Scars: Analysis of Outcomes and Satisfaction With FACE-Q.

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Tenna, S; Cogliandro, A; Barone, M; Panasiti, Vincenzo; Tirindelli, M; Nobile, Carolina; Persichetti, Paolo

2017-06-01

with fractional CO 2 laser resurfacing. The FACE-Q module confirmed the impact of treatment of facial acne scars in social life and relationships. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

367 cases of CO2 laser therapy on facial acne

Science.gov (United States)

Gao, Yunqing; Liu, Songhao; Zhang, You; Liu, T. C.

1996-09-01

Since 1989, we have cured 367 persons of facial acne of different course by using direct irradiation of high-power CO2 laser combing with operative therapy of low-power CO2 laser. The cure rate is 100 percent. In this paper, we stated the therapeutic approach. It was shown that this therapeutic approach is simple and effective, and its recurrence rate is zero. There are no cicatrices after healing. It is easy to accept it, and is worthy of extension.

Periauricular Keloids on Face-Lift Scars in a Patient with Facial Nerve Paralysis

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Masayo Aoki, MD, PhD

2017-07-01

Full Text Available Summary:. Keloids are caused by excessive scar formation that leads to scar growth beyond the initial scar boundaries. Keloid formation and progression is promoted by mechanical stress such as skin stretch force. Consequently, keloids rarely occur in paralyzed areas and areas with little skin tension, such as the periauricular region. Therefore, periauricular incision is commonly performed for face lifts. We report a rare case of keloids that arose from face-lift scars in a patient with bilateral facial nerve paralysis. A 51-year-old Japanese man presented with abnormal proliferative skin masses in bilateral periauricular scars. Seventeen years before, he had a cerebral infarction that resulted in permanent bilateral facial nerve paralysis. Three years before presentation, the patient underwent face-lift surgery with periauricular incisions. We diagnosed multiple keloids. We removed the masses surgically, closed the wounds with sutures in the superficial musculoaponeurotic system layer to reduce tension on the wound edges, reconstructed the earlobes with local skin flaps, and provided 2 consecutive days of radiotherapy. The wounds/scars were managed with steroid plasters and injections. Histology confirmed that the lesions were keloids. Ten months after surgery, the lesions did not exhibit marked regrowth. The keloids appeared to be caused by the patient's helmet, worn during his 3-hour daily motorcycle rides, which placed repeated tension on the periauricular area. This rare case illustrates how physical force contributes to auricular and periauricular keloid development and progression. It also shows that when performing surgery with periauricular incisions, care should be taken to eliminate wound/scar stretching.

Acne, vulgaris on the back (image)

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Acne frequently occurs on the back. Here, there are 2 to 6 millimeter wide erythematous (red) pustules ... Permanent scarring may follow a severe case of acne. Men are more often affected on their shoulders ...

Acne, cystic on the face (image)

Science.gov (United States)

The face is the most common location of acne. Here, there are 4 to 6 millimeter red ( ... scars and fistulous tract formation (connecting passages). Severe acne may have a profound psychological impact and may ...

Treatment of Active Acne Vulgaris by Chemical Peeling Using 88% Lactic Acid

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Khalifa E. Sharquie

2014-10-01

Full Text Available Introduction: The etiopathogenesis of acne vulgaris is multifactorial, and its therapy is prolonged course that might be not accepted by many patients. Most recently TCA 35% one session peeling gave complete clearance and full remission for active acne vulgaris. Lactic acid has been used effectively as therapeutic topical agents for many skin diseases. Aim: To evaluate the efficacy and safety of chemical peeling using 88% lactic acid solution in the treatment of active acne vulgaris. Material and Methods: This clinical, interventional, therapeutic study was done at the Department of Dermatology, Baghdad Teaching Hospital, during the period from October 2012 to October 2013. Twenty five patients with active acne vulgaris were included, 15 (60% females and 10 (40% males and their ages ranged from 16-36 (21.5000± 5.46279 years. Fifteen patients were associated with acne scars. Three chemical peels using 88% lactic acid solution was carried out two weeks apart for patients with active acne vulgaris with or without scarring. Scoring for active acne vulgaris and acne scar was done for each case before and after operation to evaluate the severity of acne and the degree of scar before and after treatment. All patients were with Fitzpatrick’s skin types III and IV. Patients were followed up every two weeks during period of therapy and monthly for 3 months after stopping the treatment. Results: Twenty five patients with active acne vulgaris were treated with 3 sessions of lactic acid, fifteen patients had associated acne scar. Scoring for active acne vulgaris including papules and pustules showed highly statistically significant reduction after 2 weeks of therapy (p=0.0001, after 4 weeks (p=0.0001and after 6 weeks (p=0.0001, with percent reduction 87.2% for papules and 94% for pustules after end of sessions while after 3 months follow up the reduction rate for papules 93.8% and p-value (p=0.001 and for pustules 97.6% and (p=0.0001. While the scarring

Efficacy of autologous platelet-rich plasma combined with fractional ablative carbon dioxide resurfacing laser in treatment of facial atrophic acne scars: A split-face randomized clinical trial.

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Faghihi, Gita; Keyvan, Shima; Asilian, Ali; Nouraei, Saeid; Behfar, Shadi; Nilforoushzadeh, Mohamad Ali

2016-01-01

Autologous platelet-rich plasma has recently attracted significant attention throughout the medical field for its wound-healing ability. This study was conducted to investigate the potential of platelet-rich plasma combined with fractional laser therapy in the treatment of acne scarring. Sixteen patients (12 women and 4 men) who underwent split-face therapy were analyzed in this study. They received ablative fractional carbon dioxide laser combined with intradermal platelet-rich plasma treatment on one half of their face and ablative fractional carbon dioxide laser with intradermal normal saline on the other half. The injections were administered immediately after laser therapy. The treatment sessions were repeated after an interval of one month. The clinical response was assessed based on patient satisfaction and the objective evaluation of serial photographs by two blinded dermatologists at baseline, 1 month after the first treatment session and 4 months after the second. The adverse effects including erythema and edema were scored by participants on days 0, 2, 4, 6, 8, 15 and 30 after each session. Overall clinical improvement of acne scars was higher on the platelet-rich plasma-fractional carbon dioxide laser treated side but the difference was not statistically significant either 1 month after the first treatment session (P = 0.15) or 4 months after the second (P = 0.23). In addition, adverse effects (erythema and edema) on the platelet-rich plasma-fractional carbon dioxide laser-treated side were more severe and of longer duration. Small sample size, absence of all skin phototypes within the study group and lack of objective methods for the evaluation of response to treatment and adverse effects were the limitations. This study demonstrated that adding platelet-rich plasma to fractional carbon dioxide laser treatment did not produce any statistically significant synergistic effects and also resulted in more severe side effects and longer downtime.

Tolerance and safety of superficial chemical peeling with salicylic acid in various facial dermatoses

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Iqbal Zafar

2005-03-01

Full Text Available BACKGROUND: Chemical peeling is a skin-wounding procedure that may have some potentially undesirable side-effects. AIMS: The present study is directed towards safety concerns associated with superficial chemical peeling with salicylic acid in various facial dermatoses. METHODS: The study was a non-comparative and a prospective one. Two hundred and sixty-eight patients of either sex, aged between 10 to 60 years, undergoing superficial chemical peeling for various facial dermatoses (melasma, acne vulgaris, freckles, post-inflammatory scars/pigmentation, actinic keratoses, plane facial warts, etc. were included in the study. Eight weekly peeling sessions were carried out in each patient. Tolerance to the procedure and any undesirable effects noted during these sessions were recorded. RESULTS: Almost all the patients tolerated the procedure well. Mild discomfort, burning, irritation and erythema were quite common but the incidence of major side-effects was very low and these too, were easily manageable. There was no significant difference in the incidence of side-effects between facial dermatoses (melasma, acne and other pigmentary disorders. CONCLUSION: Chemical peeling with salicylic acid is a well tolerated and safe treatment modality in many superficial facial dermatoses.

Comparison of a fractional microplasma radio frequency technology and carbon dioxide fractional laser for the treatment of atrophic acne scars: a randomized split-face clinical study.

Science.gov (United States)

Zhang, Zhen; Fei, Ye; Chen, Xiangdong; Lu, Wenli; Chen, Jinan

2013-04-01

No studies have compared fractional microplasma radio frequency (RF) technology with the carbon dioxide fractional laser system (CO2 FS) in the treatment of atrophic acne scars in the same patient. To compare the efficacy and safety of fractional microplasma RF with CO2 FS in the treatment of atrophic acne scars. Thirty-three Asian patients received three sessions of a randomized split-face treatment of fractional microplasma RF or CO2 FS. Both modalities had a roughly equivalent effect. Échelle d'Évaluation Clinique Des Cicatrices d'Acné scores were significantly lower after fractional microplasma RF (from 51.1 ± 14.2 to 22.3 ± 8.6, 56.4% improvement) and CO2 FS (from 48.8 ± 15.1 to 19.9 ± 7.9, 59.2% improvement) treatments. There was no statistically significant difference between the two therapies. Twelve subjects (36.4%) experienced postinflammatory hyperpigmentation (PIH) after 30 of 99 treatment sessions (30.3%) on the CO2 FS side and no PIH was observed on the fractional microplasma RF sides. Both modalities have good effects on treating atrophic scars. PIH was not seen with the fractional microplasma RF, which might make it a better choice for patients with darker skin. © 2013 by the American Society for Dermatologic Surgery, Inc. Published by Wiley Periodicals, Inc.

Efficacy of photodynamic therapy combined with minocycline for treatment of moderate to severe facial acne vulgaris and influence on quality of life.

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Xu, Xinghua; Zheng, Yi; Zhao, Zigang; Zhang, Xin; Liu, Pengxiang; Li, Chengxin

2017-12-01

Acne vulgaris is a prevalent skin disorder impairing both physical and psychosocial health. This study was designed to investigate the effectiveness of photodynamic therapy (PDT) combined with minocycline in moderate to severe facial acne and influence on quality of life (QOL). Ninety-five patients with moderate to severe facial acne (Investigator Global Assessment [IGA] score 3-4) were randomly treated with PDT and minocycline (n = 48) or minocycline alone (n = 47). All patients took minocycline hydrochloride 100 mg/d for 4 weeks, whereas patients in the minocycline plus PDT group also received 4 times PDT treatment 1 week apart. IGA score, lesion counts, Dermatology Life Quality Index (DLQI), and safety evaluation were performed before treatment and at 2, 4, 6, and 8 weeks after enrolment. There were no statistically significant differences in characteristics between 2 treatment groups at baseline. Minocycline plus PDT treatment led to a greater mean percentage reduction from baseline in lesion counts versus minocycline alone at 8 weeks for both inflammatory (-74.4% vs -53.3%; P minocycline plus PDT achieved IGA score minocycline plus PDT got significant lower DLQI at 8 weeks (4.4 vs 6.3; P minocycline alone, the combination of PDT with minocycline significantly improved clinical efficacy and QOL in moderate to severe facial acne patients. Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

Use of a Cutaneous Body Image (CBI) scale to evaluate self perception of body image in acne vulgaris.

Science.gov (United States)

Amr, Mostafa; Kaliyadan, Feroze; Shams, Tarek

2014-01-01

Skin disorders such as acne, which have significant cosmetic implications, can affect the self-perception of cutaneous body image. There are many scales which measure self-perception of cutaneous body image. We evaluated the use of a simple Cutaneous Body Image (CBI) scale to assess self-perception of body image in a sample of young Arab patients affected with acne. A total of 70 patients with acne answered the CBI questionnaire. The CBI score was correlated with the severity of acne and acne scarring, gender, and history of retinoids use. There was no statistically significant correlation between CBI and the other parameters - gender, acne/acne scarring severity, and use of retinoids. Our study suggests that cutaneous body image perception in Arab patients with acne was not dependent on variables like gender and severity of acne or acne scarring. A simple CBI scale alone is not a sufficiently reliable tool to assess self-perception of body image in patients with acne vulgaris.

Efficacy of autologous platelet-rich plasma combined with fractional ablative carbon dioxide resurfacing laser in treatment of facial atrophic acne scars: A split-face randomized clinical trial

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Gita Faghihi

2016-01-01

Full Text Available Background: Autologous platelet-rich plasma has recently attracted significant attention throughout the medical field for its wound-healing ability. Aims: This study was conducted to investigate the potential of platelet-rich plasma combined with fractional laser therapy in the treatment of acne scarring. Methods: Sixteen patients (12 women and 4 men who underwent split-face therapy were analyzed in this study. They received ablative fractional carbon dioxide laser combined with intradermal platelet-rich plasma treatment on one half of their face and ablative fractional carbon dioxide laser with intradermal normal saline on the other half. The injections were administered immediately after laser therapy. The treatment sessions were repeated after an interval of one month. The clinical response was assessed based on patient satisfaction and the objective evaluation of serial photographs by two blinded dermatologists at baseline, 1 month after the first treatment session and 4 months after the second. The adverse effects including erythema and edema were scored by participants on days 0, 2, 4, 6, 8, 15 and 30 after each session. Results: Overall clinical improvement of acne scars was higher on the platelet-rich plasma-fractional carbon dioxide laser treated side but the difference was not statistically significant either 1 month after the first treatment session (P = 0.15 or 4 months after the second (P = 0.23. In addition, adverse effects (erythema and edema on the platelet-rich plasma-fractional carbon dioxide laser-treated side were more severe and of longer duration. Limitations: Small sample size, absence of all skin phototypes within the study group and lack of objective methods for the evaluation of response to treatment and adverse effects were the limitations. Conclusion: This study demonstrated that adding platelet-rich plasma to fractional carbon dioxide laser treatment did not produce any statistically significant synergistic effects

Treatment of acne vulgaris with fractional radiofrequency microneedling.

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Kim, Sang Tae; Lee, Kang Hoon; Sim, Hyung Jun; Suh, Kee Suck; Jang, Min Soo

2014-07-01

Fractional radiofrequency microneedling is a novel radiofrequency technique that uses insulated microneedles to deliver energy to the deep dermis at the point of penetration without destruction of the epidermis. It has been used for the treatment of various dermatological conditions including wrinkles, atrophic scars and hypertrophic scars. There have been few studies evaluating the efficacy of fractional radiofrequency microneedling in the treatment of acne, and none measuring objective parameters like the number of inflammatory and non-inflammatory acne lesions or sebum excretion levels. The safety and efficacy of fractional radiofrequency microneedling in the treatment of acne vulgaris was investigated. In a prospective clinical trial, 25 patients with moderate to severe acne were treated with fractional radiofrequency microneedling. The procedure was carried out three times at 1-month intervals. Acne lesion count, subjective satisfaction score, sebum excretion level and adverse effects were assessed at baseline and at 4, 8 and 12 weeks after the first treatment as well as 4, 8 and 12 weeks after the last treatment. Number of acne lesions (inflammatory and non-inflammatory) decreased. Sebum excretion and subjective satisfaction were more favorable at every time point compared with the baseline values (P acne vulgaris. © 2014 Japanese Dermatological Association.

Acne vulgaris.

Science.gov (United States)

Moradi Tuchayi, Sara; Makrantonaki, Evgenia; Ganceviciene, Ruta; Dessinioti, Clio; Feldman, Steven R; Zouboulis, Christos C

2015-09-17

Acne vulgaris is a chronic inflammatory disease - rather than a natural part of the life cycle as colloquially viewed - of the pilosebaceous unit (comprising the hair follicle, hair shaft and sebaceous gland) and is among the most common dermatological conditions worldwide. Some of the key mechanisms involved in the development of acne include disturbed sebaceous gland activity associated with hyperseborrhoea (that is, increased sebum production) and alterations in sebum fatty acid composition, dysregulation of the hormone microenvironment, interaction with neuropeptides, follicular hyperkeratinization, induction of inflammation and dysfunction of the innate and adaptive immunity. Grading of acne involves lesion counting and photographic methods. However, there is a lack of consensus on the exact grading criteria, which hampers the conduction and comparison of randomized controlled clinical trials evaluating treatments. Prevention of acne relies on the successful management of modifiable risk factors, such as underlying systemic diseases and lifestyle factors. Several treatments are available, but guidelines suffer from a lack of data to make evidence-based recommendations. In addition, the complex combination treatment regimens required to target different aspects of acne pathophysiology lead to poor adherence, which undermines treatment success. Acne commonly causes scarring and reduces the quality of life of patients. New treatment options with a shift towards targeting the early processes involved in acne development instead of suppressing the effects of end products will enhance our ability to improve the outcomes for patients with acne.

Comparison between Er:YAG laser and bipolar radiofrequency combined with infrared diode laser for the treatment of acne scars: Differential expression of fibrogenetic biomolecules may be associated with differences in efficacy between ablative and non-ablative laser treatment.

Science.gov (United States)

Min, Seonguk; Park, Seon Yong; Moon, Jungyoon; Kwon, Hyuck Hoon; Yoon, Ji Young; Suh, Dae Hun

2017-04-01

Fractional Er:YAG minimizes the risk associated with skin ablation. Infrared diode laser and radiofrequency have suggested comparable improvements in acne scar. We compared the clinical efficacy of Er:YAG laser and bipolar radiofrequency combined with diode laser (BRDL) for the treatment of acne scars. Moreover, acute molecular changes of cytokine profile associated with wound healing have been evaluated to suggest mechanisms of improvement of acne scar. Twenty-four subjects with mild-to-moderate acne scars were treated in a split-face manner with Er:YAG and BRDL, with two treatment sessions, 4 weeks apart. Objective and subjective assessments were done at baseline, 1, 3, 7 days after each treatment and 4 weeks after last treatment. Skin biopsy specimens were obtained at baseline, 1, 3, 7, 28 days after one session of treatment for investigation of molecular profile of acute skin changes by laser treatment. Investigator's Global Assessment representing the improvement degree shows 2.1 (50%) in fractional Er:YAG and 1.2 (25%) in BRDL. Er:YAG induced the later and higher peak expression of TGFβs and collagenases, whereas BRDL induced earlier and lower expression of TGFβ and collagenases, relatively. PPARγ dropped rapidly after a peak in Er:YAG-treated side, which is associated with tissue inhibitor of metalloproteinase (TIMP) expression. We observed higher expression of TIMP after Er:YAG treatment compared with BRDL by immunohistochemistry, which may be associated with the expression of upregulation of collagen fibers. The superior efficacy of Er:YAG to BRDL in the treatment of acne scars may be associated with higher expression of collagen which is associated with differential expression of TGFβs, collagenases, PPARγ, and TIMP. Lasers Surg. Med. 49:341-347, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Isotretinoin in acne agminata

International Nuclear Information System (INIS)

Daneshpazhooh, M.; Ehsani, A.; Toosi, S.; Robati, Reza M.

2007-01-01

Acne agminata is an asymptomatic papulopustular eruption. This condition typically occurs in young adults. The eruption generally runs a self-limited course, but disfiguring scars can occur. Histological examination shows scattered dermal granulomas composed of epitheloid and some giant cells with central caseation. A variety of agents such as wide spectrum antibiotics, oral steroids, dapsone and clofazimine have been used with varying degrees of success. Herein, we report 2 Caucasian males with acne agminata successfully treated with isotretinoin. (author)

Management strategies for acne vulgaris

Science.gov (United States)

Whitney, Kristen M; Ditre, Chérie M

2011-01-01

Clinical question: What are the most effective treatment(s) for mild, moderate, severe, and hormonally driven acne? Results: Mild acne responds favorably to topical treatments such as benzoyl peroxide, salicylic acid, and a low-dose retinoid. Moderate acne responds well to combination therapy comprising-topical benzoyl peroxide, antibiotics, and/or retinoids, as well as oral antibiotics in refractory cases and oral contraceptive pills for female acne patients. Severe nodulocystic acne vulgaris responds best to oral isotretinoin therapy. In female patients with moderate to severe acne, facial hair, loss of scalp hair and irregular periods, polycystic ovarian syndrome should be considered and appropriate treatment with hormonal modulation given. Adjunctive procedures can also be considered for all acne patients. Implementation: Pitfalls to avoid when treating acne: treatment of acne in women of child-bearing age; familiarization of all acne treatments in order to individualize management for patients; indications for specialist referral. PMID:21691566

1,213 Cases of Treatment of Facial Acne Using Indocyanine Green and Intense Pulsed Light in Asian Skin

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Kui Young Park

2015-01-01

Full Text Available Background. Photodynamic therapy (PDT has been used for acne, with various combinations of photosensitizers and light sources. Objective. We evaluated the effectiveness and safety of indocyanine green (ICG and intense pulsed light (IPL in the treatment of acne. Materials and Methods. A total of 1,213 patients with facial acne were retrospectively reviewed. Patients received three or five treatments of ICG and IPL at two-week intervals. Clinical response to treatment was assessed by comparing pre- and posttreatment clinical photographs and patient satisfaction scores. Results. Marked to excellent improvement was noted in 483 of 1,213 (39.8% patients, while minimal to moderate improvement was achieved in the remaining 730 (60.2% patients. Patient satisfaction scores revealed that 197 (16.3% of 1,213 patients were highly satisfied, 887 (73.1% were somewhat satisfied, and 129 (10.6% were unsatisfied. There were no significant side effects. Conclusion. These results suggest that PDT with ICG and IPL can be effectively and safely used in the treatment of acne.

Pilot Study of Topical Copper Chlorophyllin Complex in Subjects With Facial Acne and Large Pores.

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Stephens, Thomas J; McCook, John P; Herndon, James H

2015-06-01

Acne vulgaris is one of the most common skin diseases treated by dermatologists. Salts of copper chlorophyllin complex are semi-synthetic naturally-derived compounds with antioxidant, anti-inflammatory and wound healing activity that have not been previously tested topically in the treatment of acne-prone skin with enlarged pores. This single-center pilot study was conducted to assess the efficacy and safety of a liposomal dispersion of topically applied sodium copper chlorophyllin complex in subjects with mild-moderate acne and large, visible pores over a course of 3 weeks. Subjects were supplied with the test product, a topical gel containing a liposomal dispersion of sodium copper chlorophyllin complex (0.1%) with directions to apply a small amount to the facial area twice daily. Clinical assessments were performed at screening/baseline and at week 3. VISIA readings were taken and self-assessment questionnaires were conducted. 10 subjects were enrolled and completed the 3-week study. All clinical efficacy parameters showed statistically significant improvements over baseline at week 3. The study product was well tolerated. Subject questionnaires showed the test product was highly rated. In this pilot study, a topical formulation containing a liposomal dispersion of sodium copper chlorophyllin complex was shown to be clinically effective and well tolerated for the treatment of mild-moderate acne and large, visible pores when used for 3 weeks.

Clay jojoba oil facial mask for lesioned skin and mild acne--results of a prospective, observational pilot study.

Science.gov (United States)

Meier, Larissa; Stange, Rainer; Michalsen, Andreas; Uehleke, Bernhard

2012-01-01

External application of clay facial masks is a cosmetic procedure generally used to reduce skin lesions and to improve overall skin condition. Collecting pilot data about self-treatment with clay jojoba oil masks on participants with acne-prone, lesioned skin and acne. Open, prospective, observational pilot study: Participants received written information, instructions, and questionnaires without direct contact with the study physician. For 6 weeks, they applied the masks 2-3 times per week. The primary outcome is the difference of skin lesions: baseline vs. after 6 weeks. 194 participants (192 female, 2 male, mean age (± SE) (32.3 ± 0.7 years) returned questionnaires and diaries. 133 of these participants returned complete and precise lesion counts (per-protocol (PP) collective). A 54% mean reduction in total lesion count was observed after 6 weeks of treatment with clay facial mask. Both inflammatory and non-inflammatory skin lesions were reduced significantly after treatment compared to baseline: Median counts (MC) of pustules per affected participant were reduced from 7.0 ± 0.9 to 3.0 ± 0.5 (mean individual reduction (MIR) = 49.4%), the MC of the papules from 3.5 ± 2.2 to 1.0 ± 0.4 (MIR = 57.3%), the MC of cysts from 2.0 ± 0.8 to 0.5 ± 0.4 (MIR = 68.6%) and the MC of comedones from 26.5 ± 6.3 to 16.0 ± 4.0 (MIR = 39.1%). DLQI-average score decreased from 5.0 ± 4.5 (mean ± SE) before to 2.1 ± 2.8 after treatment. The present study gives preliminary evidence that healing clay jojoba oil facial masks can be effective treatment for lesioned skin and mild acne vulgaris. Copyright © 2012 S. Karger AG, Basel.

Evaluation of Azithromycin in Treatment of Acne Vulgaris Compared to

African Journals Online (AJOL)

Introduction: Acne vulgaris is the most common dermatological disorder in adolescence. Treatment is essential to prevent physical and psychological scarring. Although many treatments for acne are available, effective management has become increasingly challenging with the emergence of antibiotic-resistant strains of ...

Comparison of salicylic acid 30% peel and pneumatic broadband light in the treatment of mild to moderately severe facial acne vulgaris.

Science.gov (United States)

Thuangtong, Rattapon; Tangjaturonrusamee, Chinmanat; Rattanaumpawan, Pinyo; Ditre, Chérie M

2017-07-01

Acne patients experience not only a medical disease but also an aesthetic condition, and this latter complication greatly motivates patients to seek out the best treatment regimen to hasten improvement in their appearance. The available clinical procedures for acne treatment include salicylic acid 30% peel and pneumatic broadband light (PBBL). The objective of this study was to compare the efficacy of salicylic acid 30% peel and PBBL treatments in patients with mild to moderately severe facial acne vulgaris. Twelve patients were recruited for a 12-week prospective, single-blind, randomized, split-face study. Patients were treated with a salicylic acid 30% peel on one side of the face and PBBL treatment was administered on the opposite side of the face for 6 consecutive weeks without other acne treatments. At every visit, treatment evaluations were performed using a modified Global Acne Grading Score (mGAGS), acne quality of life (QOL) questionnaire, Wong-Baker FACES Pain Rating Scale (WBPRS) assessments, and clinical photography. Improvement in acne symptoms was observed for both treatment procedures without significant differences and with minimal side effects. Salicylic acid 30% peel and PBBL were well tolerated in our study, and both clinical procedures were efficacious and well-tolerated by the patients.

Superficial chemical peeling with salicylic acid in facial dermatoses

International Nuclear Information System (INIS)

Bari, A.U.; Iqbal, Z.; Rahman, S.B.

2007-01-01

To determine the effectiveness of salicylic acid chemical peeling in common dermatological conditions affecting face in people with predominant Fitzpatrick skin type IV and V. A total of 167 patients of either gender, aged between 13 to 60 years, having some facial dermatoses (melasma, acne vulgaris, postinflammatory hyperpigmentations, freckles, fine lines and wrinkles, post-inflammatory scars, actinic keratoses, and plane facial warts) were included. A series of eight weekly hospital based peeling sessions was conducted in all patients under standardized conditions with 30% salicylic acid. Clinical improvement in different disorders was evaluated by change in MASI score, decrease in the size of affected area and % reduction in lesions count. McNemar test was applied for data analysis. Majority of the patients showed moderate to excellent response. There was 35% to 63% improvement (p< 0.05) in all dermatoses. Significant side effects, as feared in Asian skins were not observed. Chemical peeling with salicylic acid is an effective and safe treatment modality in many superficial facial dermatoses. (author)

Depressive symptoms, suicidal ideation and acne: a study of male Finnish conscripts.

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Rehn, L M H; Meririnne, E; Höök-Nikanne, J; Isometsä, E; Henriksson, M

2008-05-01

To investigate the association among acne, depressive symptoms and suicidal ideation in Finnish male military conscripts. Consecutive 165 acne patients and 150 patients with mild knee symptoms for comparison were enrolled in the study conducted in the Central Military Hospital, Helsinki, Finland. They filled out the following questionnaires: General Health Questionnaire (GHQ-12), Beck Depression Inventory (BDI), Alcohol Use Disorders Identification Test and Rosenberg Self-Esteem Scale. The Leeds acne grading scale was used to estimate the severity of acne. Sixteen (9.7%) acne patients and 20 (13.3%) comparison patients had at least moderate level of depressive symptoms (BDI score 10; P > 0.05, between groups). Suicidal ideation (BDI suicidal item score 1) was reported by 24 (14.5%) acne patients and 16 (10.7%) comparison patients (P > 0.05, between groups). When comparing the mild facial acne patients (Leeds score 0-3) with those with moderate-severe facial acne (Leeds score 4), there were no statistical differences in depressive symptoms (9.5% vs. 10.0%) or suicidal ideation (13.7% vs. 15.7%). No linear relationship was observed between the BDI and facial Leeds scores (P > 0.05). Risk factors for suicidal ideation among the acne patients were depression and alcohol risk use. Young male patients with acne do not suffer more depressive symptoms or suicidal ideation than patients with mild knee symptoms, and the severity of acne is not associated with the presence of depressive symptoms. The risk factors for suicidal ideation among acne patients seem to be similar to those found in the general population.

The clinical effectiveness and cost-effectiveness of fractional CO2 laser in acne scars and skin rejuvenation: A meta-analysis and economic evaluation.

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Ansari, Fereshteh; Sadeghi-Ghyassi, Fatemeh; Yaaghoobian, Barmak

2018-01-31

Fractional CO 2 has many indications in medicine including in treatment of acne scars and rejuvenation. The aim of this study was to evaluate the safety, efficacy, and cost-effectiveness of Fractional CO 2 Laser in comparison with other methods of rejuvenation and acne scar treatment. Several databases including Medline, OVID, EMBASE, CINHAL, SCOPUS, Web of science, CRD, and Cochrane were searched. After conducting the search and evaluation of selected publications, critical appraisal was done and eligible studies were accepted for inclusion in the systematic review. From 2667 identified publications two of the trials were eligible. The effectiveness and complications of Fractional CO 2 laser were comparable with Er:YAG but Fractional CO 2 laser was 14.7% (p = 0.01) more effective than Q-Switched ND:YAG laser. Cost affectivity of this method was the same as other alternative lasers. In conclusion Fractional CO 2 laser is an effective and safe method for curing of several kinds of skin diseases. Nevertheless there was not sufficient evidence to support its advantage. This device has equal or lower price in comparison to competent technologies except for the non- fractional ablative CO 2 laser that has the same or lower price and comparable effects.

Psychological status as a function of residual scarring and facial asymmetry after surgical repair of cleft lip and palate.

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Millar, Keith; Bell, Aileen; Bowman, Adrian; Brown, Denise; Lo, Tsz-Wai; Siebert, Paul; Simmons, David; Ayoub, Ashraf

2013-03-01

Objective : Objective measure of scarring and three-dimensional (3D) facial asymmetry after surgical correction of unilateral cleft lip (UCL) and unilateral cleft lip (UCLP). It was hypothesized that the degree of scarring or asymmetry would be correlated with poorer psychological function. Design : In a cross-sectional design, children underwent 3D imaging of the face and completed standardized assessments of self-esteem, depression, and state and trait anxiety. Parents rated children's adjustment with a standard scale. Setting : Glasgow Dental School, School of Medicine, College of Medical, Veterinary and Life Sciences. Patients : Fifty-one children aged 10 years with UCLP and 43 with UCL were recruited from the cohort treated with the surgical protocol of the CLEFTSIS managed clinical network in Scotland. Methods : Objective assessment to determine the luminance and redness of the scar and facial asymmetry. Depression, anxiety, and a self-esteem assessment battery were used for the psychological analysis. Results : Cleft cases showed superior psychological adjustment when compared with normative data. Prevalence of depression matched the population norm. The visibility of the scar (luminance ratio) was significantly correlated with lower self-esteem and higher trait anxiety in UCLP children (P  =  .004). Similar but nonsignificant trends were seen in the UCL group. Parental ratings of poorer adjustment also correlated with greater luminance of the scar. Conclusions : The objectively defined degree of postoperative cleft scarring was associated with subclinical symptoms of anxiety, depression, and low self-esteem.

Infantile acne treated with oral isotretinoin

DEFF Research Database (Denmark)

Miller, Iben Marie; Echeverría, Begoña; Torrelo, Antonio

2013-01-01

In contrast to adolescent acne, infantile acne (IA) is a rare condition with only a limited body of available literature. In this descriptive, retrospective study, we reviewed six cases from 2002 to 2010 treated with oral isotretinoin. The average age of onset was 6.16 months (range 0-21 mos......). Consistent with the previous, limited literature, we found predominantly boys are affected, a predilection for the cheeks, and a polymorphic inflammatory morphology. Two patients had a family history of acne. All cases were successfully and safely treated with oral isotretinoin. The suggested treatment...... of childhood acne is similar to that of adolescents (graded according to the severity of the skin disease and risk of scarring). Oral isotretinoin appears to be an effective and safe treatment for severe IA....

Comparing the role of subcision suction method with and without the injection of platelet-rich plasma in the treatment of depressed scars

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Nouran Abd El-Aziz Abou Khedr

2017-02-01

Full Text Available Among wound-healing modalities, platelet-rich plasma (PRP has been used for wound healing, through the release of multiple growth factors. The platelets mediate wound healing by initiating the clotting pathway and the subsequent matrix remodelisation. The aim of the work was to study the role of injection of platelet-rich plasma in the treatment of scars. This study was conducted on thirty patients who were divided into two groups (A and B. Each group included fifteen patients. The two groups were randomly distributed by using individual sealed envelopes. Group A was subjected to subcision of their acne scars using Nokor needle, followed by suction. Group B patients were subjected to the same treatment but followed by an injection of platelet-rich plasma once per month over three months. In Group A, 6 patients (40% showed moderate improvement, 5 patients (33.3% showed slight improvement and 4 patients (26.7% showed significant improvement. In Group B, 7 patients (46.7% showed moderate improvement, 5 patients (33.3% showed marked improvement and 3 patients (20% showed significant improvement. There was a statistically significant difference on the independent observer’s after-treatment assessment between the groups (P=0.014. In conclusion, subcision suction leads to a persistent improvement of acne scars in a short time, and the coupling with injection of PRP is the most effective in the treatment of depressed facial scars.

Combination of platelet rich plasma in fractional carbon dioxide laser treatment increased clinical efficacy of for acne scar by enhancement of collagen production and modulation of laser-induced inflammation.

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Min, Seonguk; Yoon, Ji Young; Park, Seon Yong; Moon, Jungyoon; Kwon, Hyuck Hoon; Suh, Dae Hun

2018-04-01

Platelet-rich plasma (PRP) which contains large amounts of growth factors has been tried to enhance therapeutic efficacy of laser treatment for acne scar with unknown underlying mechanism. The present study was conducted to investigate the molecular mechanism of increased clinical efficacy of PRP when combined with fractional laser treatment for treating acne scars. Subjects with mild to moderate acne scars were treated with two sessions of fractional CO 2 laser therapy given with and without co-administration of PRP. Skin biopsy specimens were obtained at baseline, 1, 3, 7, and 28 days for investigation of molecular profiles associated with skin changes produced by laser plus PRP treatment. The PRP treatment increased clinical efficacy with decreased severity of adverse effects such as erythema, swelling and oozing. Productions of TGFβ1 and TGFβ3 proteins were more highly elevated on the PRP-treated side of the face compared to the control side at day 28. Furthermore, PRP-treated side showed significant increase of c-myc, TIMP, and HGF expression. Experimental fibroblast culture model was also used. PRP administration after laser irradiation increased expressions of p-Akt, TGFβ1, TGFβ3, β-catenin, collagen 1, and collagen 3 in both dose-dependent and time dependent manners in fibroblast. Moreover, we acquired clinical and histological data through randomized control clinical trial. Taken together with human study results combined with the data from cell experiments we suggest that PRP treatment increased fibrogenetic molecules induced by fractional CO 2 laser, which have association with clinical effect. Lasers Surg. Med. 50:302-310, 2018. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

Use of makeup, hairstyles, glasses, and prosthetics as adjuncts to scar camouflage.

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Sidle, Douglas M; Decker, Jennifer R

2011-08-01

Scars after facial trauma or surgery can be a source of distress for patients, and facial plastic surgeons are frequently called upon to help manage them. Although no technique can remove a scar, numerous treatment modalities have been developed to improve facial scar appearance with varying levels of invasiveness. This article reviews techniques that camouflage scars without surgical intervention. Topical scar treatments, camouflage cosmetics, use of hairstyling and glasses, and facial prosthetics are discussed. In addition, professional counseling is provided on selection and application of topical cosmetics for use as part of an office practice. 2011 Elsevier Inc. All rights reserved.

Management strategies for acne vulgaris

Directory of Open Access Journals (Sweden)

Whitney KM

2011-04-01

Full Text Available Kristen M Whitney1, Chérie M Ditre21Philadelphia College of Osteopathic Medicine, Philadelphia, PA, USA; 2Skin Enhancement Center and Cosmetic Dermatology, Department of Dermatology, University of Pennsylvania School of Medicine, Philadelphia, PA, USADate of preparation: 30th November 2010Conflicts of interest: None declaredClinical question: What are the most effective treatment(s for mild, moderate, severe, and hormonally driven acne?Results: Mild acne responds favorably to topical treatments such as benzoyl peroxide, salicylic acid, and a low-dose retinoid. Moderate acne responds well to combination therapy comprising-topical benzoyl peroxide, antibiotics, and/or retinoids, as well as oral antibiotics in refractory cases and oral contraceptive pills for female acne patients. Severe nodulocystic acne vulgaris responds best to oral isotretinoin therapy. In female patients with moderate to severe acne, facial hair, loss of scalp hair and irregular periods, polycystic ovarian syndrome should be considered and appropriate treatment with hormonal modulation given. Adjunctive procedures can also be considered for all acne patients.Implementation: Pitfalls to avoid when treating acne: treatment of acne in women of childbearing age; familiarization of all acne treatments in order to individualize management for patients; indications for specialist referral.Keywords: acne vulgaris, benzoyl peroxide, retinoids, antibiotics, light and laser therapy, photodynamic therapy, photopneumatic therapy, chemical peels

Propionibacterium acnes endophthalmitis in Ahmed glaucoma valve.

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Gutiérrez-Díaz, E; Montero-Rodríguez, M; Mencía-Gutiérrez, E; Fernández-González, M C; Pérez-Blázquez, E

2001-01-01

To report a case of Propionibacterium acnes endophthalmitis in a patient with an Ahmed glaucoma valve. A nine-year-old boy with bilateral congenital glaucoma, with an Ahmed glaucoma valve implanted in the left eye, had recurrent conjunctival dehiscence and endophthalmitis. Vitreous cultures demonstrated the presence of Propionibacterium acnes. This is the first reported case of Propionibacterium acnes endophthalmitis in an Ahmed glaucoma valve and the second one in a glaucoma drainage device. We strongly recommend using a patch graft to prevent and treat tube exposure. Conjunctival grafts may be useful to close the conjunctiva when there is marked scarring to prevent patch exposure and melting or extrusion.

Efficacy and Safety of Tazarotene 0.1% Plus Clindamycin 1% Gel Versus Adapalene 0.1% Plus Clindamycin 1% Gel in Facial Acne Vulgaris: A Randomized, Controlled Clinical Trial.

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Maiti, Rituparna; Sirka, Chandra Sekhar; Ashique Rahman, M A; Srinivasan, Anand; Parida, Sansita; Hota, Debasish

2017-11-01

Acne vulgaris is a multifactorial disorder which is ideally treated with combination therapy with topical retinoids and antibiotics. The present study was conducted to compare the efficacy and safety of tazarotene plus clindamycin against adapalene plus clindamycin in facial acne vulgaris. This study is a randomized, open-label, parallel design clinical trial conducted on 60 patients with facial acne at the outpatient dermatology department in a tertiary healthcare center. The main outcome measures were change in the acne lesion count, Investigator's Static Global Assessment (ISGA) score, Global Acne Grading System (GAGS) score, and Acne-Specific Quality of Life Questionnaire (Acne-QoL) at the end of 4 weeks of therapy. After randomization one group (n = 30) received tazarotene 0.1% plus clindamycin 1% gel and another group (n = 30) received adapalene 0.1% plus clindamycin 1% gel for 1 month. At follow-up, all the parameter were reassessed. In both treatment regimens the total number of facial acne lesions decreased significantly. The difference in the change in the total count between the two combination regimens was also significant [6.51, 95% confidence interval (CI) 1.91-11.09, p = 0.007]. A ≥50% reduction in the total lesion count from the baseline levels was achieved by 71% of patients in the tazarotene plus clindamycin group and 22% of patients in the adapalene plus clindamycin group (p = 0.0012). The difference in the change of inflammatory (p = 0.017) and non-inflammatory (p = 0.039) lesion counts in the tazarotene plus clindamycin group were significantly higher than the adapalene plus clindamycin group. The difference in change of the GAGS score was also significantly higher in the tazarotene plus clindamycin group (p = 0.003). The ISGA score improved in 17 patients in the tazarotene plus clindamycin group versusnine patients in the adapalene plus clindamycin group (p = 0.04). The change of total quality-of-life score was found to be

The Efficacy and Safety of Azelaic Acid 15% Foam in the Treatment of Truncal Acne Vulgaris.

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Hoffman, Lauren K; Del Rosso, James Q; Kircik, Leon H

2017-06-01

INTRODUCTION: Truncal acne is often associated with facial acne, but there are fewer options for an effective topical treatment on the trunk. Given the advent of foam formulations with enhanced percutaneous absorption and convenient application due to easy spreadability on skin, the previously held idea that effective treatment of truncal acne requires oral treatment is challenged. Azelaic acid cream has been previously approved for acne vulgaris, thus azelaic acid foam may be a viable treatment option for truncal acne. STUDY DESIGN: A single-center, open label pilot study was conducted to investigate the efficacy and safety of azelaic acid 15% foam as a treatment modality for moderate truncal acne. Use for facial acne was also allowed and monitored during the study. RESULTS: Twice-daily application of azelaic acid 15% foam to affected areas resulted in a 1-grade reduction in truncal investigator global assessment (IGA) scores in nearly all patients (16/18). Eight out of 18 patients (44%) were rated as Clear or Almost Clear in the trunk by the end of the study. There were also improvements in facial IGA scores; 9 of 18 patients (50%) exhibited a 1-grade improvement in IGA scores and 11 of 18 were Clear or Almost Clear by the end of the study. A significant reduction in lesion counts was found throughout the study and the medication was well tolerated. CONCUSION: Azelaic acid 15% foam was effective in treating moderate truncal acne and facial acne in this pilot study. Given the efficacy and convenience of the foam vehicle, azelaic acid may be considered as a viable option for treatment of acne vulgaris, including on the trunk. Further studies are suggested in a larger population of patients, including adult females with acne. J Drugs Dermatol. 2017;16(6):534-538..

The Subunit Principle in Scar Face Revision.

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Elshahat, Ahmed; Lashin, Riham

2017-06-01

Facial scaring is considered one of the most difficult cosmetic problems for any plastic surgeon to solve. The condition is more difficult if the direction of the scar is not parallel to relaxed skin tension lines. Attempts to manage this difficult situation included revisions using geometric designs, Z plasties or W plasties to camouflage the straight line visible scaring. The use of long-lasting resorbable sutures was tried too. Recently, the use of botulinum toxin during revision improved the results. Fractional CO2 lasers, microfat grafts, and platelet-rich plasma were added to the armamentarium. The scar is least visible if placed in the junction between the facial subunits. The aim of this study is to investigate the use of the subunit principle to improve the results of scar revision. Four patients were included in this study. Tissue expansion of the intact part of the subunit allowed shifting the scar to the junction between the affected subunit and the adjacent one. Tissue expansion, delivery of the expanders, and advancement of the flaps were successful in all patients. The fact that this is a 2-stage procedure and sacrifices some of the intact skin from the affected facial subunit, makes this technique reserved to patients with ugly facial scars who are ambitious to improve their appearance.

Light/laser therapy in the treatment of acne vulgaris.

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Nouri, Keyvan; Villafradez-Diaz, L Magaly

2005-12-01

Acne vulgaris is one of the most prevalent skin diseases known. As common as this condition is, the social and psychological consequences are limitless. Although current treatments are available and include topical or oral antibiotics, it is crucial to develop a less risky and more effective therapy such as light/laser therapy. This article focuses specifically on the benefits of the light/laser treatment on acne vulgaris. Porphyrins accumulated in the bacteria, Propionibacterium acnes, one of the etiologic factors involved in the pathogenesis, allows phototherapy to be a successful modality. They have specific absorption peaks at which lasers have optimal effects. The longer the wavelength of the light is, the deeper its penetration and thus the greater its damage to the sebaceous glands. Although blue light is best for the activation of porphyrins, red light is best for deeper penetration and an anti-inflammatory effect. Ultraviolet (UV) light, although it may have initial an anti-inflammatory effects, has been proven to be potentially carcinogenic and have adverse effects such as aging (by UV-A) and burning (by UV-B). Previous studies indicate successful long-term intervention and selective damage of the sebaceous glands by using a diode laser with indocyanine green (ICG) dye. Mid-infrared lasers have been found to decrease lesion counts while also reducing the oiliness of skin and the scarring process. Nonablative laser treatment of acne scars using the Er:YAG laser with a short-pulsed mode has been successful in reducing the appearance of scars by stimulating neocollagenesis. The light/laser therapy has started to be explored with promising results in highly selected patients that require further investigation in greater populations and well-designed protocols.

Before and After Photos: Treatment of Hypertrophic Scars

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... Back Injectable Deoxycholic Acid Injectable Hyaluronic Acid Injectable Poly-l-lactic Acid Injectable Polymethylmethacrylate + Bovine Collagen Filler ... Does acne scar removal hurt? What are my pain management and anesthesia options? How long is the ...

Profile of acne vulgaris-A hospital-based study from South India

Directory of Open Access Journals (Sweden)

Adityan Balaji

2009-01-01

Full Text Available Background: Acne vulgaris is believed to be the most common disease of the skin. There is no Indian study on the profile of acne vulgaris, markers of severe forms of acne vulgaris and a possible correlation between acne vulgaris and markers of androgenicity in females. Aim: To study the profile of acne vulgaris, its seasonal variation, relationship with smoking and possible correlation between acne vulgaris and markers of androgenicity in females. Methods: The study was conducted between August 2006 and June 2008. All patients with acne vulgaris who consented to participate in the study were included. The parameters evaluated included age, gender, age of onset, duration of lesions, site of lesions, grade, relation with menstrual cycle, markers of androgenicity, number of acne lesions such as comedones, papules pustules and nodules, number and site of post-acne scarring, post-acne hyperpigmentation, seasonal variation and history of smoking. Results: A total of 309 patients with acne vulgaris were included in the study. The frequency of acne vulgaris in our study was 1.068%. Mean age of the study group was 19.78 years. Male to female ratio was 1.25:1. The most common age group involved was 16 to 20 years (59.8%. Mean age of onset was 15.97 years. Face was involved in all the patients, followed by back (28.2%, chest (20.1%, neck (9.4% and arms (10%. In the older age groups, women were more likely to report having acne vulgaris than men ( P = 0.01. The closed comedones outnumbered open comedones by a factor of 4.9:1. A total of 186 patients (60.2% had grade 1 acne vulgaris, 85 (27.5% had grade 2 acne, 8 (2.6% had grade 3 acne and 30 (9.7% had grade 4 acne vulgaris. There was a higher incidence of scarring (39.5% and post-acne hyperpigmentation (24.6% in our study. In female patients, 57.7% had premenstrual flare and 12.4% had cutaneous markers of androgenicity. There was no association between severity of acne vulgaris and other markers of

Efficacy and safety of superficial chemical peeling in treatment of active acne vulgaris.

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Al-Talib, Hassanain; Al-Khateeb, Alyaa; Hameed, Ayad; Murugaiah, Chandrika

2017-01-01

Acne vulgaris is an extremely common condition affecting the pilosebaceous unit of the skin and characterized by presence of comedones, papules, pustules, nodules, cysts, which might result in permanent scars. Acne vulgaris commonly involve adolescents and young age groups. Active acne vulgaris is usually associated with several complications like hyper or hypopigmentation, scar formation and skin disfigurement. Previous studies have targeted the efficiency and safety of local and systemic agents in the treatment of active acne vulgaris. Superficial chemical peeling is a skin-wounding procedure which might cause some potentially undesirable adverse events. This study was conducted to review the efficacy and safety of superficial chemical peeling in the treatment of active acne vulgaris. It is a structured review of an earlier seven articles meeting the inclusion and exclusion criteria. The clinical assessments were based on pretreatment and post-treatment comparisons and the role of superficial chemical peeling in reduction of papules, pustules and comedones in active acne vulgaris. This study showed that almost all patients tolerated well the chemical peeling procedures despite a mild discomfort, burning, irritation and erythema have been reported; also the incidence of major adverse events was very low and easily manageable. In conclusion, chemical peeling with glycolic acid is a well-tolerated and safe treatment modality in active acne vulgaris while salicylic acid peels is a more convenient for treatment of darker skin patients and it showed significant and earlier improvement than glycolic acid.

Microneedling combined with platelet-rich plasma or trichloroacetic acid peeling for management of acne scarring: A split-face clinical and histologic comparison.

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El-Domyati, Moetaz; Abdel-Wahab, Hossam; Hossam, Aliaa

2018-02-01

Minimally invasive procedures provide effective, safe, relatively long-lasting, and natural results without large damage to the skin. A combination treatment is considered an approach that includes at least 2 different and unrelated modalities. This study aims to evaluate the use and effectiveness of some combined minimally invasive procedures for management of acne scarring. Twenty-four volunteers with postacne atrophic scars were randomly divided into 3 equal groups according to performed procedure on each side of the face (microneedling by dermaroller alone or combined with platelet-rich plasma [PRP] or trichloroacetic acid [TCA] 15% peeling) and received 6 bi-weekly sessions of treatment. Photography and punch biopsies were taken before and after 3 months of treatment for clinical, histological, and histometrical evaluation. Combined treatment of dermaroller and PRP or dermaroller and TCA 15% showed significant improvement when compared with dermaroller alone (P = .015 and .011 respectively). Epidermal thickness showed statistically significant increase in studied groups, mainly after dermaroller and TCA 15%. Moreover, the 3 studied groups showed more organized collagen bundles and newly formed collagen formation and markedly decreased abnormal elastic fibers. Based on the clinical, histometrical, and histochemical assessment, inspite that most volunteers showed significant improvement after treatment, however, the combined use of dermaroller and TCA 15% was more effective in postacne atrophic scars than the use of dermaroller and PRP or dermaroller only. © 2017 Wiley Periodicals, Inc.

Treatment of hypertrophic scars and keloids using intense pulsed light (IPL).

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Erol, O Onur; Gurlek, Ali; Agaoglu, Galip; Topcuoglu, Ela; Oz, Hayat

2008-11-01

Keloids and hypertrophic scars are extremely disturbing to patients, both physically and psychologically. This study prospectively assessed the safety and efficacy of intense pulsed light (IPL) on scars originating from burns, trauma, surgery, and acne. Hypertrophic scars in 109 patients, originating from surgical incisions (n = 55), traumatic cuts (traffic accidents) (n = 24), acne scars (n = 6), keloids (n = 5), and burns (n = 19), were treated using an IPL Quantum device. Treatment was administered at 2-4-week intervals, and patients received an average of 8 treatments (range = 6-24). Using digital photographs, Changes in scar appearance were assessed by two physicians who were blinded to the study patients and treatments. The photographs were graded on a scale of 0 to 4 (none, minimal, moderate, good, excellent) for improvement in overall clinical appearance and reduction in height, erythema, and hardness. An overall clinical improvement in the appearance of scars and reductions in height, erythema, and hardness were seen in the majority of the patients (92.5%). Improvement was excellent in 31.2% of the patients, good in 25.7%, moderate in 34%, and minimal in 9.1%. Over half the patients had good or excellent improvement. In the preventive IPL treatment group, 65% had good to excellent improvement in clinical appearance. Patient satisfaction was very high. This study suggests that IPL is effective not only in improving the appearance of hypertrophic scars and keloids regardless of their origin, but also in reducing the height, redness, and hardness of scars.

Steroid acne vs. Pityrosporum folliculitis: the incidence of Pityrosporum ovale and the effect of antifungal drugs in steroid acne.

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Yu, H J; Lee, S K; Son, S J; Kim, Y S; Yang, H Y; Kim, J H

1998-10-01

Steroid acne is a folliculitis that can result from systemic or topical administration of steroid, and has been described as showing a similar clinical picture to Pityrosporum folliculitis, but there have been few reports about the incidence of Pityrosporum ovale and the effect of antimycotic drugs in steroid acne and other acneiform eruptions. Our purpose was to describe the association between steroid acne and P. ovale, and to confirm the superior efficacy of oral antifungal drugs over anti-acne drugs in the treatment of steroid acne. The history, clinical features direct microscopy, histopathologic analysis, and therapeutic results of 125 cases with steroid acne or other acneiform eruptions were described and compared. Over 80% of patients with acneiform eruption receiving systemic steroid revealed significant numbers of P. ovale in the lesional follicle. Furthermore, oral antifungal drug (itraconazole) showed significantly better clinical and mycologic effects than any other group of medications used in this study. Steroid acne and other acneiform eruptions showing discrete follicular papules and/or pustules localized to the upper trunk and acneiform facial skin lesions associated with multiple acneiform lesions on the body in the summer period should be suspected as Pityrosporum folliculitis. In addition, oral antifungal drugs recommended for Pityrosporum folliculitis; however, it will require a larger case-control study to confirm the superiority of antifungal therapy over anti-acne treatment.

Radiofrequency waves with filling and peeling substances: An innovative minimally invasive technique for facial rejuvenation.

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Savoia, Antonella; Vannini, Fulvio; Baldi, Alfonso

2011-09-01

This study describes a pivotal clinical trial of a new minimally invasive cosmetic procedure for facial rejuvenation and for the treatment of scars and wrinkles. The procedure consisted of a combination of techniques such as fillers, biorevitalization, peeling, and intradermal radiofrequency, emitted from a new device denominated by Spherofill Medical Plus (SMP; Spherofill MD, PromoItalia Group S.p.A., Pozzuoli, Italy), for treating cutaneous regeneration, depressions, and striae. One hundred and twelve patients, divided into five groups, were treated. The results produced were statistically analyzed and resulted in significant and long-lasting effects for facial rejuvenation. Indeed, the analysis of the Global Aesthetic Improvement Scale (GAIS) scores in the five groups demonstrated statistically significant results between 3 and 9 months after the treatments. Evaluating the patients included in the study, it is possible to conclude that the treatment with SMP represents a safe and efficient solution for the treatment of wrinkles, acne lesions, striae, and of degenerated tissues caused by aging.

Acne and skin bleaching in Lomé, Togo.

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Kombaté, Koussake; Mouhari-Toure, Abas; Saka, Bayaki; Akakpo, Abla Séfako; Maboudou, Akouavi; Pitché, Palokinam; Tchangaï-Walla, Kissem

2012-11-01

This study aims at describing the clinical characteristics of patients with acne using skin bleaching (SB) products. This is a prospective study conducted over 8 months in three dermatology departments and one private clinic. All patients examined for acne were included in the study. The study included 119 patients examined for acne from March to October 2010. Among them 48 (40.7%) did SB. Hydroquinone was the first product used for SB (26 of 48), followed by topical corticosteroids (17 of 48). The elementary lesions were papules (99.2%), comedos (36.1%), pustules (63.9%), pigmentation (26.1%), scars (21%), and nodules (20.2%). The extent of acne on the face was observed in all patients (100%). The lesions were extensive among 43.7% of the patients. The extent of acne lesions was not statistically associated with SB. Other body areas concerned were the chest (20.2%), back, and shoulders (41.2%). The relative risk of having lesions on the back and/or shoulders when the patient practiced SB was 2.71 (CI: 1.08-6.84), which is significant. The study suggests that the back and shoulders can be the main areas for acne lesions associated with the practice of SB. The influence of different types of product is unclear. © 2012 The International Society of Dermatology.

An innovative approach to the topical treatment of acne

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Sparavigna A

2015-04-01

Full Text Available Adele Sparavigna, Beatrice Tenconi, Ileana De Ponti, Laura La PennaDermIng srl, Clinical Research and Bioengineering Institute, Monza, MB, ItalyAbstract: Acne is characterized by primary lesions on the face, chest, and back, and by a variety of other signs and symptoms. In particular, acne inflammatory lesions result from Propionibacterium acnes colonization and are of particular relevance as they can cause permanent scarring. Acne also causes significant psychological morbidity in affected patients. Products currently available for the treatment of acne include systemic and topical treatments. As these products can cause severe side effects, new, innovative therapies are needed. Farmaka Acne Cream (FAC is a novel, film-forming cream developed to treat mild and moderate acne. In vitro studies have demonstrated that FAC is as effective as 5% benzoyl peroxide in inhibiting growth of P. acnes. In 32 subjects with mild or moderate acne, FAC reduced all the major signs and symptoms of the disease. These included itching, erythema, and scaling, as well as reductions in the numbers of papules, pustules, and open and closed comedones. Acne severity improved in 38% of subjects, while none worsened. FAC was found to be effective in controlling sebum secretion, and was non-comedogenic. Most subjects (90% reported tolerability as good or very good, while clinical efficacy and cosmetic acceptability were judged as good. For assessment of contact sensitization and photosensitization, FAC was applied daily to the backs of 29 subjects in two symmetric areas for 10 days. Using a solar stimulator, one minimal erythema dose was delivered to one side of the back from days 11 to 13. The four different subareas of treated/untreated and irradiated/nonirradiated and combinations thereof were compared. No cases of contact sensitization or photosensitization were observed, and FAC is considered safe for use in intense sunlight. In vitro and in vivo studies provide

Clinical characteristics and epidermal barrier function of papulopustular rosacea: A comparison study with acne vulgaris.

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Zhou, Maosong; Xie, Hongfu; Cheng, Lin; Li, Ji

2016-01-01

To evaluate the clinical characteristics and epidermal barrier function of papulopustular rosacea by comparing with acne vulgaris. Four hundred and sixty-three papulopustular rosacea patients and four hundred and twelve acne vulgaris patients were selected for the study in Xiangya Hospital of Central South University from March 2015 to May 2016. They were analyzed for major facial lesions, self-conscious symptoms and epidermal barrier function. Erythema, burning, dryness and itching presented in papulopustular rosacea patients were significantly higher than that in acne vulgaris patients ( P acne vulgaris patients ( P acne vulgaris patients ( P acne vulgaris patients in comparison with that of healthy subjects ( P >0.05, P acne vulgaris patients and healthy subjects ( P acne vulgaris patients than that of healthy subjects ( P acne vulgaris. The epidermal barrier function was damaged in papulopustular rosacea patients while not impaired in that of acne vulgaris patients.

Validation of the Spanish Acne Severity Scale (Escala de Gravedad del Acné Española--EGAE).

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Puig, Lluis; Guerra-Tapia, Aurora; Conejo-Mir, Julián; Toribio, Jaime; Berasategui, Carmen; Zsolt, Ilonka

2013-04-01

Several acne grading systems have been described, but consensus is lacking on which shows superiority. A standardized system would facilitate therapeutic decisions and the analysis of clinical trial data. To assess the feasibility, reliability, validity and sensitivity to change of the Spanish Acne Severity Scale (EGAE). A Spanish, multicentre, prospective, observational study was performed in patients with facial, back or chest acne assessed using EGAE, Leeds Revised Acne Grading system (LRAG) and lesion count. Clinicians answered 4 questions regarding EGAE use and time employed. Patients were evaluated at baseline and after 5±1 weeks. Four additional blinded observers, all dermatologists, evaluated patients' pictures using EGAE and LRAG. In total, 349 acne locations were assessed in 328 patients. Of the dermatologists, 95.6% (CI: 92.9-97.5%) reported that EGAE was easy to use, and 75% used it in 0.85; p<0.001). EGAE mean score in treatment-compliant patients was significantly lower at follow-up than at baseline (2.14 vs. 1.57, p<0.001, Cohen's d=0.35).The pre-post-treatment difference in EGAE mean score in non-compliant patients was not significant (1.44 vs. 1.32, p<0.102) and Cohen's d was lower (0.19) than in compliant patients. The use of EGAE to evaluate acne grade in daily clinical dermatological practice in Spanish centres has shown feasibility, high interobserver reliability, concurrent validity and sensitivity to detect treatment effects.

Fluorescence digital photography of acne using a light-emitting diode illuminator.

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Ahn, Hyo Hyun; Kim, Soo Nam; Kye, Young Chul

2006-11-01

The fluorescence findings of several dermatological diseases, such as erythrasma, tinea versicolor, and acne are helpful for diagnosis and follow-up. However, many experience difficulty taking photographic images of fluorescence. The aim of this study was to develop a 405 nm light-emitting diode (LED) system for fluorescence digital photography of acne and to determine whether such a diode can be used to evaluate acne. Eight healthy acne patients were compared with controls by fluorescence digital photography using a digital camera equipped with a 405 nm LED illuminator. Digital photographs were taken by two different ways of exposure, i.e. appropriate exposure level and longer exposure. One side of the nose, cheek, and glabella was compared. The numbers and extents of fluorescence dots were counted and measured. As normal controls, seven individuals with apparent oiliness and no acne were enrolled. Red fluorescent facial dots were observed and photographed digitally using the 405 nm LED illuminator. These were more numerous and extensive on the glabella and cheeks of acne patients. Fluorescence digital photography of acne was successfully performed using a 405 nm LED illuminator. This illuminator could be used for acne evaluations.

Use of organic acids in acne and skin discolorations therapy

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Alicja Kapuścińska

2015-03-01

Full Text Available Acne is one of the most frequent skin disorders that occurs in puberty, but often adults also have acne. The most important factors responsible for acne are elevated production of sebum by hyperactive sebaceous glands and blockage of the follicle because of hyperkeratosis [14]. The third etiopathogenic factor of acne is excessive microflora reproduction [8]. The most significant bacterium that is responsible for formation of skin lesions is Propionibacterium acnes, a rod-shaped Gram-positive and aerotolerant anaerobic bacterium. It is estimated that P. acnes is responsible for acne in approximately 80% of people aged 11 to 30 [27,40]. Even healed skin lesions can often cause skin discolorations and scar formation [51]. Exfoliating chemical substances that are commonly used in dermatology and cosmetology are organic acids. Exfoliating treatment using organic acids is called “chemical peeling” and consists of controlled application of those substances on the skin [38]. The depth of exfoliation depends on organic acid concentration, type of substance and contact time with the skin [41]. Using exfoliating agents seems to be helpful in excessive keratinization – one of several factors responsible for acne. Moreover, epidermis exfoliation is a popular method of removing skin discoloration [22]. Considering chemical structure, exfoliating substances that are most often used in cosmetology contain alpha-hydroxyacids (glycolic acid, lactic acid, mandelic acid and citric acid, beta-hydroxyacids (salicylic acid and other organic acids, such as trichloroacetic acid and pyruvic acid [47]. In this article, a literature review of use of organic acids in acne and skin discoloration therapy is presented.

Assessment of treatment efficacy and sebosuppressive effect of fractional radiofrequency microneedle on acne vulgaris.

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Lee, Kyung Real; Lee, Eo Gin; Lee, Hee Jung; Yoon, Moon Soo

2013-12-01

A minimally invasive fractional radiofrequency microneedle (FRM) device has been used in skin rejuvenation and acne scars, and a recent pilot study demonstrated the positive therapeutic effect on acne. We evaluated the efficacy of FRM device for acne vulgaris in Asians and conducted objective measurement to assess its effect on sebum production. Twenty Korean patients with acne vulgaris received a single full-face FRM treatment. Outcome assessments included standardized photography, physician's global assessment, patient's satisfaction scores, acne lesion count, and objective measurements of casual sebum level (CSL) and sebum excretion rate (SER). They were evaluated at baseline and 2, 4, 8 weeks after the treatment. After a single FRM treatment, the CSL and the SER showed 30-60% and 70-80% reduction, respectively, at week 2 (P acne severity and acne lesion count also revealed clinical improvement with maximum efficacy at week 2, but returned to the baseline in most patients by week 8. Patients' satisfaction scores (0-4) were above 2 on average, and adverse effects were minimal. This prospective study demonstrated the sebosuppressive effect from a single FRM treatment, but its therapeutic efficacy in acne requires further evaluation. © 2013 Wiley Periodicals, Inc.

Antimicrobial efficacy of granulysin-derived synthetic peptides in acne vulgaris.

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Lim, Hee-Sun; Chun, Seung-Min; Soung, Min-Gyu; Kim, Jenny; Kim, Seong-Jin

2015-07-01

Antimicrobial peptides are considered as a potential alternative to antibiotic treatment in acne vulgaris because the development of a resistant strain of Propionibacterium acnes is problematic. Granulysin can be regarded as an ideal substance with which to treat acne because it has antimicrobial and anti-inflammatory effects. This study was performed to explore the effectiveness of granulysin-derived peptides (GDPs) in killing P. acnes in vitro under a standard microbiologic assay and to evaluate their potential use in a topical agent for the treatment of acne vulgaris. Twenty different peptides based on the known sequence of a GDP were synthesized and tested in vitro for antimicrobial activity. Thirty patients with facial acne vulgaris were instructed to apply a topical formulation containing synthetic GDP to acne lesions twice per day for 12 weeks. A newly synthesized peptide in which aspartic acid was substituted with arginine, and methionine was substituted with cysteine, showed the highest antimicrobial activity against P. acnes. Moreover, it was effective against both Gram-positive and Gram-negative bacteria in vitro. After treatment with the topical formulation containing 50 ppm of synthetic peptide for 12 weeks, a significant reduction in the number of pustules was observed, regardless of the increase in the number of comedones. In addition, a significant reduction in the clinical grade of acne based on the Korean Acne Grading System (KAGS) was evident. Synthesized GDP shows strong antimicrobial activity against P. acnes in vitro. The clinical improvement observed suggests a topical formulation containing the GDP has therapeutic potential for the improvement of inflammatory-type acne vulgaris by its antimicrobial activity. © 2015 The International Society of Dermatology.

A CLINICAL STUDY OF ACNE VULGARIS

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Melathil Sadanandan Sadeep

2017-11-01

Full Text Available BACKGROUND Acne vulgaris is a highly prevalent chronic inflammatory disease of pilosebaceous unit affecting teenagers and young adults. Prognosis of acne is generally good, especially in mild acne. But, this disease reduces the self-esteem, their sense of identity and can severely compromise quality of life. All clinicians caring for children and adolescents should be familiar with this problem. Early diagnosis, proper treatment and timely counselling reduce the overall impact of disease to individuals. MATERIALS AND METHODS This is a prospective study conducted in the Department of Dermatology at Government Medical College, Kottayam, Kerala, in 200 patients who presented to the outpatient clinic with a clinical diagnosis of acne vulgaris who have not yet received any medical treatment for the disease and consented to participate in the study. RESULTS Male-to-female ratio of 1.43:1. 61.5% patients were in the 2nd decade. 4% were more than 30 years old. Duration of the disease at the time of presentation ranged from 3 weeks to 30 years. 42.5% complained of mild itching and 18.5% had burning sensation. 48.5% attribute exacerbation of disease after food intake. 72.5% acne patients had seborrhoea. Hirsutism and Acanthosis nigricans were present in 7.31% and 4.87% female patients, respectively. 50% with hirsutism and 25% with Acanthosis nigricans had polycystic ovarian disease and severe grades of acne. 25.6% females complained of premenstrual exacerbation of the disease. 26% of the patients showed exacerbation in summer. Smokers had severe grades of acne vulgaris compared to nonsmokers. Comedones were present in all and they were the predominant lesions in majority. Inflammatory papules were the 2nd most common lesions. Severe grades of acne were more common in patients with age ≥20 years. Severity of the disease increases with long duration of the disease. Relatively high incidence of post-acne scarring and post-inflammatory hyperpigmentation was

Expert opinion and review article: The timing of comedone extraction in the treatment of premenstrual acne--a proposed therapeutic approach.

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Steventon, K

2011-04-01

The face is the most exposed part of our body, and deterioration of facial appearance, through disease or ageing, causes psychological distress. Acne lesions and subsequent pigmentation changes contribute to the unevenness of skin colour that is detrimental to facial attractiveness and leads to rejection and stigmatization in our society. The purpose of this review is to look at the root causes of premenstrual acne and, for the first time ever, propose that the specific timing of treatment can, at least in part, resolve the acne lesions. We postulate that it is the timing of the manual extraction that matters in resolving premenstrual acne and that the effectiveness of this therapy could be improved. Based on the reviewed evidence, we propose that it is important to remove the comedones at the time of ovulation, prior to the reduction of the size of the sebaceous orifice and epidermal barrier function, to counteract the onset of increased sebum production, prevent blockage of the pores and subsequent bacterial colonization and inflammation. If performed successfully, the extraction may contribute to a reduction in inflamed acne lesions and thus benefit women by increasing their facial attractiveness, well-being, social function and thereby decrease psychological stress. © 2010 The Author. ICS © 2010 Society of Cosmetic Scientists and the Société Française de Cosmétologie.

Keratosis pilaris and prevalence of acne vulgaris: a cross-sectional study.

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Schmitt, Juliano Vilaverde; Lima, Brunno Zeni de; Souza, Monique Carolina Meira do Rosário de; Miot, Hélio Amante

2014-01-01

Acne vulgaris has an important genetic predisposition, as well as keratosis pilaris. Clinical observations suggest that patients with keratosis pilaris have less frequent or less severe acne breakouts; however, we found no studies on this regard To determine if the presence of keratosis pilaris is associated with lower prevalence and severity of acne. A cross-sectional study was conducted with dermatology outpatients aged between 14 and 35 years. We evaluated history and clinical grade of acne, demographic variables, history of atopy, smoking, and use of hormonal contraceptives. Two groups were defined by the presence or absence of moderate to severe keratosis pilaris on the arms and were compared by bivariate analysis and by conditional multiple logistic regression. We included 158 patients (66% women), with a median age of 23 ± 11 years. Twenty-six percent of them had keratosis pilaris, which was associated with a history of atopy (odds ratio [OR]=2.80 [1.36 to 5.75]; pkeratosis pilaris had a less frequent history of acne (OR=0.32 [0.14 to 0.70]; pkeratosis pilaris on the arms was associated with lower prevalence of acne vulgaris and lower severity of facial lesions in adolescents and young adults.

Tretinoin microsphere gel pump 0.04% versus tazarotene cream 0.05% in the treatment of mild-to-moderate facial acne vulgaris.

Science.gov (United States)

Kircik, Leon H

2009-07-01

This 12-week, single-center, investigator-blinded, randomized, parallel-design study assessed the safety and efficacy of tretinoin microsphere gel 0.04% delivered by pump (TMG PUMP) to tazarotene cream 0.05% (TAZ) in mild-to-moderate facial acne vulgaris. Efficacy measurements included investigator global assessment (IGA), lesion counts, and subject self-assessment of acne signs and symptoms. Efficacy was generally comparable between treatment groups, although TMG PUMP provided more rapid results in several parameters. IGA showed a more rapid mean change from baseline at week 4 in the TMG PUMP group (-0.18 versus -0.05 in the TAZ subjects). TMG PUMP yielded more rapid improvement in papules. At week 4, the mean percentage change from baseline in open comedones was statistically significant at -64% in the TMG PUMP group (P=0.0039, within group) versus -19% in the TAZ group (not statistically significant within the group; P=0.1875). Skin dryness, peeling and pruritus were significantly less in the TMG PUMP group as early as week 4. Adverse events related to study treatment were rare in both groups and all resolved upon discontinuation of study medication.

[Facial injections of hyaluronic acid-based fillers for malformations. Preliminary study regarding scar tissue improvement and cosmetic betterment].

Science.gov (United States)

Franchi, G; Neiva-Vaz, C; Picard, A; Vazquez, M-P

2018-02-02

Cross-linked hyaluronic acid-based fillers have gained rapid acceptance for treating facial wrinkles, deep tissue folds and sunken areas due to aging. This study evaluates, in addition to space-filling properties, their effects on softness and elasticity as a secondary effect, following injection of 3 commercially available cross-linked hyaluronic acid-based fillers (15mg/mL, 17,5mg/mL and 20mg/mL) in patients presenting with congenital or acquired facial malformations. We started injecting gels of cross-linked hyaluronic acid-based fillers in those cases in 2013; we performed 46 sessions of injections in 32 patients, aged from 13-32. Clinical assessment was performed by the patient himself and by a plastic surgeon, 15 days after injections and 6-18 months later. Cross-linked hyaluronic acid-based fillers offered very subtle cosmetic results and supplemented surgery with a very high level of satisfaction of the patients. When injected in fibrosis, the first session enhanced softness and elasticity; the second session enhanced the volume. Cross-linked hyaluronic acid-based fillers fill sunken areas and better softness and elasticity of scar tissues. In addition to their well-understood space-filling function, as a secondary effect, the authors demonstrate that cross-linked hyaluronic acid-based fillers improve softness and elasticity of scarring tissues. Many experimental studies support our observations, showing that cross-linked hyaluronic acid stimulates the production of several extra-cellular matrix components, including dermal collagen and elastin. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

Keratosis pilaris and prevalence of acne vulgaris: a cross-sectional study*

Science.gov (United States)

Schmitt, Juliano Vilaverde; de Lima, Brunno Zeni; de Souza, Monique Carolina Meira do Rosário; Miot, Hélio Amante

2014-01-01

BACKGROUND Acne vulgaris has an important genetic predisposition, as well as keratosis pilaris. Clinical observations suggest that patients with keratosis pilaris have less frequent or less severe acne breakouts; however, we found no studies on this regard OBJECTIVE To determine if the presence of keratosis pilaris is associated with lower prevalence and severity of acne. METHODS A cross-sectional study was conducted with dermatology outpatients aged between 14 and 35 years. We evaluated history and clinical grade of acne, demographic variables, history of atopy, smoking, and use of hormonal contraceptives. Two groups were defined by the presence or absence of moderate to severe keratosis pilaris on the arms and were compared by bivariate analysis and by conditional multiple logistic regression. RESULTS We included 158 patients (66% women), with a median age of 23±11 years. Twenty-six percent of them had keratosis pilaris, which was associated with a history of atopy (odds ratio [OR]=2.80 [1.36 to 5.75]; pkeratosis pilaris had a less frequent history of acne (OR=0.32 [0.14 to 0.70]; pkeratosis pilaris on the arms was associated with lower prevalence of acne vulgaris and lower severity of facial lesions in adolescents and young adults. PMID:24626653

Enlarged facial pores: an update on treatments.

Science.gov (United States)

Dong, Joanna; Lanoue, Julien; Goldenberg, Gary

2016-07-01

Enlarged facial pores remain a common dermatologic and cosmetic concern from acne and rosacea, among other conditions, that is difficult to treat due to the multifactorial nature of their pathogenesis and negative impact on patients' quality of life. Enlarged facial pores are primarily treated through addressing associative factors, such as increased sebum production and cutaneous aging. We review the current treatment modalities for enlarged or dense facial pores, including topical retinoids, chemical peels, oral antiandrogens, and lasers and devices, with a focus on newer therapies.

Acne keloidalis nuchae: prevalence, impact, and management challenges

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Ogunbiyi A

2016-12-01

Full Text Available Adebola Ogunbiyi Dermatology Unit, Department of Medicine, College of Medicine, University of Ibadan, University College Hospital Ibadan, Oyo State, Nigeria Abstract: Acne keloidalis nuchae (AKN also known as folliculitis keloidalis nuchae (FKN is a chronic form of scarring folliculitis seen mostly in men of African descent. The term AKN is commonly used even though the condition is not a keloid, and the affected individuals do not have a tendency to develop keloids in other areas of the body. It is seen in post pubertal men and is rare after the age of 55 years. A few cases have been reported in females. which has been classified as a primary cicatricial alopecia since the exact cause of acne keloidalis (AK remains unknown. However, a few inciting agents have been suggested which include androgens, inflammation, infection, trauma, genetics, and ingrowing hairs. AK shares some similar features with other forms of cicatricial alopecia and may occur together. Papules, pustules, and sometimes tumorous masses in the nuchal or occipital regions of the scalp hence the name “bumps” evolved in the environment. Despite its common occurrence, only a few seek help in hospital when lesions start to unsightly affect the individual’s quality of life. The presences of the keloidal lesions are more stressful compared to the resulting alopecia. Various attempts to reduce the bumps with corrosives, acids, and car engine oils lead to larger lesions or unsightly scars. Active lesions produce bleeding during haircuts. This is worrisome as a couple of individuals with active AK share shaving instruments at the barber shop and are at risk of acquiring or transmitting blood-borne infections. There is an urgent need to encourage safe shaving habits and treatment of lesions at onset so as to prevent unsightly lesions. Keywords: scarring alopecia, clinical features, treatment challenges 

Tolerability and camouflaging effect of corrective makeup for acne: results of a clinical study of a novel face compact cream.

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Monfrecola, Giuseppe; Cacciapuoti, Sara; Capasso, Claudia; Delfino, Mario; Fabbrocini, Gabriella

2016-01-01

A novel face compact cream (FCC) containing a new patented formulation was recently developed to provide acne patients with cosmetic camouflage for their lesions and to have beneficial effects on the multifactorial components of the disease. This pilot investigation aimed to evaluate the real-life tolerability, potential for comedogenicity and covering effect provided by this FCC. This single-center study evaluated the FCC applied once daily for 28 days in 20 females with facial acne. Tolerability was assessed by rating skin reactions on a scale from 1 =absent to 4 =evident. Comedogenicity potential was evaluated by determining the number of facial acne lesions before and after use of the FCC. The covering effect was rated in ten patients 30 minutes after application on a scale from 1 =none to 5 =excellent. Patients rated their opinions on the FCC on day 28 using a questionnaire. Assessment of tolerability on days 0, 14, and 28 showed that skin reactions, including erythema, edema, dryness, desquamation, tight feeling, itching, and burning, were absent in all patients. The FCC was noncomedogenic and provided a significant 15.8% reduction in facial acne lesions after 28 days ( P <0.001). The FCC provided a good covering effect 30 minutes after application in 80% of patients. All patients (100%) were satisfied with the FCC, with 90% agreeing that the FCC was effective and 80% stating that the FCC improved their skin. The FCC was positively perceived, well tolerated, noncomedogenic, and provided an effective covering of acne in this small group of female patients with 1 month of follow-up.

Propionibacterium acnes in the pathogenesis and immunotherapy of acne vulgaris.

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Liu, Pei-Feng; Hsieh, Yao-Dung; Lin, Ya-Ching; Two, Aimee; Shu, Chih-Wen; Huang, Chun-Ming

2015-01-01

Acne vulgaris, a multi-factorial disease, is one of the most common skin diseases, affecting an estimated 80% of Americans at some point during their lives. The gram-positive and anaerobic Propionibacterium acnes (P. acnes) bacterium has been implicated in acne inflammation and pathogenesis. Therapies for acne vulgaris using antibiotics generally lack bacterial specificity, promote the generation of antibiotic-resistant bacterial strains, and cause adverse effects. Immunotherapy against P. acnes or its antigens (sialidase and CAMP factor) has been demonstrated to be effective in mice, attenuating P. acnes-induced inflammation; thus, this method may be applied to develop a potential vaccine targeting P. acnes for acne vulgaris treatment. This review summarizes reports describing the role of P. acnes in the pathogenesis of acne and various immunotherapy-based approaches targeting P. acnes, suggesting the potential effectiveness of immunotherapy for acne vulgaris as well as P. acnes-associated diseases.

Tolerability and camouflaging effect of corrective make-up for acne: results of a clinical study of a novel face compact cream

Directory of Open Access Journals (Sweden)

Monfrecola G

2016-10-01

Full Text Available Giuseppe Monfrecola, Sara Cacciapuoti, Claudia Capasso, Mario Delfino, Gabriella Fabbrocini Department of Clinical Medicine and Surgery, Section of Dermatology, University of Naples Federico II, Naples, Italy Background: A novel face compact cream (FCC containing a new patented formulation was recently developed to provide acne patients with cosmetic camouflage for their lesions and to have beneficial effects on the multifactorial components of the disease. This pilot investigation aimed to evaluate the real-life tolerability, potential for comedogenicity and covering effect provided by this FCC.Methods: This single-center study evaluated the FCC applied once daily for 28 days in 20 females with facial acne. Tolerability was assessed by rating skin reactions on a scale from 1 =absent to 4 =evident. Comedogenicity potential was evaluated by determining the number of facial acne lesions before and after use of the FCC. The covering effect was rated in ten patients 30 minutes after application on a scale from 1 =none to 5 =excellent. Patients rated their opinions on the FCC on day 28 using a questionnaire.Results: Assessment of tolerability on days 0, 14, and 28 showed that skin reactions, including erythema, edema, dryness, desquamation, tight feeling, itching, and burning, were absent in all patients. The FCC was noncomedogenic and provided a significant 15.8% reduction in facial acne lesions after 28 days (P<0.001. The FCC provided a good covering effect 30 minutes after application in 80% of patients. All patients (100% were satisfied with the FCC, with 90% agreeing that the FCC was effective and 80% stating that the FCC improved their skin.Conclusion: The FCC was positively perceived, well tolerated, noncomedogenic, and provided an effective covering of acne in this small group of female patients with 1 month of follow-up. Keywords: acne, comedones, dermatocosmetic, tolerability

Acne severity grading: determining essential clinical components and features using a Delphi consensus.

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Tan, Jerry; Wolfe, Barat; Weiss, Jonathan; Stein-Gold, Linda; Bikowski, Joseph; Del Rosso, James; Webster, Guy F; Lucky, Anne; Thiboutot, Diane; Wilkin, Jonathan; Leyden, James; Chren, Mary-Margaret

2012-08-01

There are multiple global scales for acne severity grading but no singular standard. Our objective was to determine the essential clinical components (content items) and features (property-related items) for an acne global grading scale for use in research and clinical practice using an iterative method, the Delphi process. Ten acne experts were invited to participate in a Web-based Delphi survey comprising 3 iterative rounds of questions. In round 1, the experts identified the following clinical components (primary acne lesions, number of lesions, extent, regional involvement, secondary lesions, and patient experiences) and features (clinimetric properties, ease of use, categorization of severity based on photographs or text, and acceptance by all stakeholders). In round 2, consensus for inclusion in the scale was established for primary lesions, number, sites, and extent; as well as clinimetric properties and ease of use. In round 3, consensus for inclusion was further established for categorization and acceptance. Patient experiences were excluded and no consensus was achieved for secondary lesions. The Delphi panel consisted solely of the United States (U.S.)-based acne experts. Using an established method for achieving consensus, experts in acne vulgaris concluded that an ideal acne global grading scale would comprise the essential clinical components of primary acne lesions, their quantity, extent, and facial and extrafacial sites of involvement; with features of clinimetric properties, categorization, efficiency, and acceptance. Copyright © 2011 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

Evidence-based approach to the treatment of hidradenitis suppurativa/acne inversa, based on the European guidelines for hidradenitis suppurativa

NARCIS (Netherlands)

W.P. Gulliver (Wayne P.); C.C. Zouboulis (Christos C.); E.P. Prens (Errol); G.B.E. Jemec (Gregor); T. Tzellos (Thrasivoulos)

2016-01-01

textabstractHidradenitis suppurativa/acne inversa (HS) is a chronic inflammatory skin disease characterized by painful, recurrent nodules and abscesses that rupture and lead to sinus tracts and scarring. To date, an evidence-based therapeutic approach has not been the standard of care and this is

Erythema-directed digital photography for the enhanced evaluation of topical treatments for acne vulgaris.

Science.gov (United States)

Micali, G; Dall'Oglio, F; Tedeschi, A; Lacarrubba, F

2018-01-31

Erythema-directed digital photography is a novel method for evaluating the efficacy and tolerability of topical acne treatments. Here, we describe three case reports in which erythema-directed digital photography was used to evaluate acne before and after up to 12 weeks of treatment with clindamycin 1%/tretinoin 0.025% (Clin-RA). Erythema-directed digital photography was used to evaluate acne in three patients with mild-to-moderate facial acne, two of whom had refused to continue previous topical acne treatment (benzoyl peroxide 5% and clindamycin 1%/benzoyl peroxide 5%) due to persistent irritation. Acne lesions and erythema were evaluated using standard clinical photography and erythema-directed digital photography (VISIA-CR ™ system) before and after 8-12 weeks of treatment with Clin-RA. Erythema-directed digital photography revealed background erythema from previous topical acne treatments that was not evident from standard clinical photographs and allowed a better visualization of both inflammatory and non-inflammatory lesions. In all patients, there was a clear improvement in background erythema and a reduction in acne lesions following treatment with Clin-RA. This study has demonstrated for the first time that erythema-directed digital photography can enhance the evaluation of the efficacy and tolerability of topical acne treatments. These cases show that Clin-RA was associated with improved efficacy and tolerability vs previous treatments with topical monotherapy (benzoyl peroxide 5%) or a topical fixed-dose combination (clindamycin 1%/benzoyl peroxide 5%). © 2018 The Authors. Skin Research and Technology Published by John Wiley & Sons Ltd.

Is acne caused by colonization with the "wrong" strain of Propionibacterium acnes? A review of the role of Propionibacterium acnes in acne

DEFF Research Database (Denmark)

Lomholt, Hans Bredsted; Kilian, Mogens

2008-01-01

Acne is still a major problem, and treatment options are far from ideal. A number of studies suggest that the species Propionibacterium acnes plays an important role in the pathogenesis, and new data point towards molecular mechanisms by which the organism is able to trigger the host inflammatory...... response. The current knowledge on P. acnes in relation to acne is reviewed....

Evidence-based approach to the treatment of hidradenitis suppurativa/acne inversa, based on the European guidelines for hidradenitis suppurativa

DEFF Research Database (Denmark)

Gulliver, Wayne; Zouboulis, Christos C.; Prens, Errol

2016-01-01

Hidradenitis suppurativa/acne inversa (HS) is a chronic inflammatory skin disease characterized by painful, recurrent nodules and abscesses that rupture and lead to sinus tracts and scarring. To date, an evidence-based therapeutic approach has not been the standard of care and this is likely due...

Modified Lengthening Temporalis Myoplasty Involving an Extended Lazy-S Incision to Avoid Facial Scar Formation.

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Oji, Tomito; Hayashi, Akiteru; Ogino, Akihiro; Onishi, Kiyoshi

2018-05-01

Lengthening temporalis myoplasty is a faster and less invasive alternative to free muscle transfer for smile reconstruction. However, it requires a nasolabial fold incision, which leaves a midfacial scar. Based on esthetic considerations, a modified approach, involving an extended lazy-S (parotidectomy) incision instead of a nasolabial fold incision, was developed. A cadaveric study involving 10 hemifaces was conducted. From February 2013 to March 2016, the modified lengthening temporalis myoplasty procedure was employed in 10 patients. The results were graded from 1 (poor) to 5 (excellent) according to the Terzis grading system. The excursion of the oral commissure was also measured. The extended lazy-S incision provides easy and safe access to the coronoid process and good visibility. The patients' mean age was 56.5 years, and the mean duration of the postoperative follow-up period was 22.2 months. The patients' underlying conditions included acoustic neuroma (n = 2), Bell palsy (n = 3), congenital conditions (n = 2), brain infarction (n = 1), Ramsay Hunt syndrome (n = 1), and malignant parotid lymphoma (n = 1). One patient suffered a surgical site infection, which was successfully treated with irrigation. All the patients achieved improvements in smile symmetry: 2, 5, and 3 patients obtained excellent, good, and moderate results, respectively. The excursion of the oral commissure ranged from 5 to 10 mm. The modified lengthening temporalis myoplasty procedure provides satisfactory functional outcomes without causing significant complications. It does not leave a facial scar and is a preferable option, especially for young and female patients, and patients who have undergone ablative surgery involving the parotid region.

Epidemiology of acne vulgaris in adolescent male students in Arar, Kingdom of Saudi Arabia.

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Abo El-Fetoh, Nagah M; Alenezi, Naif G; Alshamari, Nasser G; Alenezi, Omar G

2016-09-01

Acne vulgaris is the most common cutaneous disorder affecting adolescents and young adults. Small, noninflamed acne lesions may not be more than a slight nuisance, but, in individuals with more severe inflammatory disease, pain, social embarrassment, and both physical and psychological scarring can be life altering. Despite its high prevalence, no previous community-based studies have been conducted in Arar, northern border of Kingdom of Saudi Arabia, addressing this issue. The aim of this study was to estimate the prevalence of acne vulgaris, to describe the sociodemographic characteristics of cases, and to determine the aggravating factors and the psychological impact of acne vulgaris in a representative sample of secondary school male students in Arar city, Kingdom of Saudi Arabia. This was a cross-sectional study. A multistage systematic random sampling technique was followed. A total of 400 male students during the academic year 2015-2016 were included in the study. Data were collected by means of personal interview and filling-in a questionnaire. The overall prevalence of acne vulgaris was 53.5%. The mean age of onset was 15.0±1.2 years. Positive family history of acne vulgaris was found in 46.7% of cases. The skin was greasy in 61.7% of cases. Acne site was the face in 67.3%, the back in 4.7%, and both in 28% of the cases. More than half (54.2%) of the cases had first-degree acne. Students mentioned several factors affecting the appearance of acne; 59.8% of cases reported a relation of increased acne appearance with the cleanliness of the skin, 35.5% reported relation with consumption of fatty meals, 24.2% with eating chocolate, 23.3% with consumption of spicy food, 12.1% with excess intake of cola drinks, 31.8% with heavy smoking, and 60.7% reported increased acne appearance in summer months. Acne was highly prevalent among secondary school male students in Arar city, Kingdom of Saudi Arabia. Several risk factors increased the appearance of acne, including

Acne keloidalis nuchae: prevalence, impact, and management challenges.

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Ogunbiyi, Adebola

2016-01-01

Acne keloidalis nuchae (AKN) also known as folliculitis keloidalis nuchae (FKN) is a chronic form of scarring folliculitis seen mostly in men of African descent. The term AKN is commonly used even though the condition is not a keloid, and the affected individuals do not have a tendency to develop keloids in other areas of the body. It is seen in post pubertal men and is rare after the age of 55 years. A few cases have been reported in females. which has been classified as a primary cicatricial alopecia since the exact cause of acne keloidalis (AK) remains unknown. However, a few inciting agents have been suggested which include androgens, inflammation, infection, trauma, genetics, and ingrowing hairs. AK shares some similar features with other forms of cicatricial alopecia and may occur together. Papules, pustules, and sometimes tumorous masses in the nuchal or occipital regions of the scalp hence the name "bumps" evolved in the environment. Despite its common occurrence, only a few seek help in hospital when lesions start to unsightly affect the individual's quality of life. The presences of the keloidal lesions are more stressful compared to the resulting alopecia. Various attempts to reduce the bumps with corrosives, acids, and car engine oils lead to larger lesions or unsightly scars. Active lesions produce bleeding during haircuts. This is worrisome as a couple of individuals with active AK share shaving instruments at the barber shop and are at risk of acquiring or transmitting blood-borne infections. There is an urgent need to encourage safe shaving habits and treatment of lesions at onset so as to prevent unsightly lesions.

What Is Acne?

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... Topics Acne English Español 繁體中文 한국어 tiếng Việt Acne Basics In-Depth Download Download EPUB Download PDF What is it? Points To Remember About Acne Doctors don’t know what causes acne, but ...

Evaluation of Acne Quality of Life and Clinical Severity in Acne Female Adults

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Amal Kokandi

2010-01-01

Full Text Available Acne is a common disease especially among teenagers. It has a considerable psychological impact on affected individuals. The aim of this paper was to assess if the effect of acne on acne-related quality of life is correlated to acne clinical severity. 112 university female students attending the university medical clinics with acne complaints were examined. Cardiff Acne Disability Index (CADI was used to assess acne-related quality of life, and global acne grading system (GAGS was used to assess clinical severity of acne. There was no correlation between acne severity (GAGS scoring system and quality of life impairment as assessed by CADI score (=0.145, =.127. Additionally, CADI score did not correlate with disease duration or age of patients. We therefore conclude that acne clinical severity alone does not affect acne-related quality of life changes. Many other factors might play a role.

Acne in women.

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Ramos-e-Silva, M; Ramos-e-Silva, S; Carneiro, S

2015-07-01

This review focuses on the subject of acne in women, a disease that is increasingly common and that can also affect men. Adult acne differs from the type of acne that occurs in teenagers, and it may persist beyond adolescence or have its onset at an older age (adult-onset acne or late acne). Acne can have a negative impact on the quality of life of patients at any age, leading to a negative body image and decrease in self-esteem, and in older patients it can result in discrimination in the workplace and in other social environments. Acne in women must be understood as a specific problem, and here we discuss the pathogenesis, clinical presentation, psychology and treatment of this very prevalent problem. © 2015 British Association of Dermatologists.

Acne

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Acne is a common skin disease that causes pimples. Pimples form when hair follicles under your skin ... neck, back, chest, and shoulders. Anyone can get acne, but it is common in teenagers and young ...

Can I Prevent Acne?

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... for Educators Search English Español Can I Prevent Acne? KidsHealth / For Teens / Can I Prevent Acne? Print en español ¿Puedo prevenir el acné? What Causes Acne? Contrary to what you may have heard, acne ...

Use of lipidomics to investigate sebum dysfunction in juvenile acne[S

Science.gov (United States)

Sinagra, Jo-Linda; Capitanio, Bruno

2016-01-01

Acne is a multifactorial skin disorder frequently observed during adolescence with different grades of severity. Multiple factors centering on sebum secretion are implicated in acne pathogenesis. Despite the recognized role of sebum, its compositional complexity and limited analytical approaches have hampered investigation of alterations specifically associated with acne. To examine the profiles of lipid distribution in acne sebum, 61 adolescents (29 males and 32 females) were enrolled in this study. Seventeen subjects presented no apparent clinical signs of acne. The 44 affected individuals were clinically classified as mild (13 individuals), moderate (19 individuals), and severe (12 individuals) acne. Sebum was sampled from the forehead with SebutapeTM adhesive patches. Profiles of neutral lipids were acquired with rapid-resolution reversed-phase/HPLC-TOF/MS in positive ion mode. Univariate and multivariate statistical analyses led to the identification of lipid species with significantly different levels between healthy and acne sebum. The majority of differentiating lipid species were diacylglycerols (DGs), followed by fatty acyls, sterols, and prenols. Overall, the data indicated an association between the clinical grading of acne and sebaceous lipid fingerprints and highlighted DGs as more abundant in sebum from adolescents affected with acne. PMID:27127078

Minimally invasive brow suspension for facial paralysis.

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Costantino, Peter D; Hiltzik, David H; Moche, Jason; Preminger, Aviva

2003-01-01

To report a new technique for unilateral brow suspension for facial paralysis that is minimally invasive, limits supraciliary scar formation, does not require specialized endoscopic equipment or expertise, and has proved to be equal to direct brow suspension in durability and symmetry. Retrospective survey of a case series of 23 patients between January 1997 and December 2000. Metropolitan tertiary care center. Patients with head and neck tumors and brow ptosis caused by facial nerve paralysis. The results of the procedure were determined using the following 3-tier rating system: outstanding (excellent elevation and symmetry); acceptable (good elevation and fair symmetry); and unacceptable (loss of elevation). The results were considered outstanding in 12 patients, acceptable in 9 patients, and unacceptable in only 1 patient. One patient developed a hematoma, and 1 patient required a secondary adjustment. The technique has proved to be superior to standard brow suspension procedures with regard to scar formation and equal with respect to facial symmetry and suspension. These results have caused us to abandon direct brow suspension and to use this minimally invasive method in all cases of brow ptosis due to facial paralysis.

The effect of probiotics on immune regulation, acne, and photoaging

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Mary-Margaret Kober

2015-06-01

Full Text Available Probiotics are live micro-organisms that provide a health benefit to the host. The role of probiotics in the management of disease, as well as immune modification, has recently experienced a renewed interest in society, as probiotics can be found in products ranging from yogurt to facial creams. In this article, we discuss the role of probiotics in the development of the immune system, the treatment of acne and rosacea, and protection against aging and photodamage.

Perceived functional impact of abnormal facial appearance.

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Rankin, Marlene; Borah, Gregory L

2003-06-01

Functional facial deformities are usually described as those that impair respiration, eating, hearing, or speech. Yet facial scars and cutaneous deformities have a significant negative effect on social functionality that has been poorly documented in the scientific literature. Insurance companies are declining payments for reconstructive surgical procedures for facial deformities caused by congenital disabilities and after cancer or trauma operations that do not affect mechanical facial activity. The purpose of this study was to establish a large, sample-based evaluation of the perceived social functioning, interpersonal characteristics, and employability indices for a range of facial appearances (normal and abnormal). Adult volunteer evaluators (n = 210) provided their subjective perceptions based on facial physical appearance, and an analysis of the consequences of facial deformity on parameters of preferential treatment was performed. A two-group comparative research design rated the differences among 10 examples of digitally altered facial photographs of actual patients among various age and ethnic groups with "normal" and "abnormal" congenital deformities or posttrauma scars. Photographs of adult patients with observable congenital and posttraumatic deformities (abnormal) were digitally retouched to eliminate the stigmatic defects (normal). The normal and abnormal photographs of identical patients were evaluated by the large sample study group on nine parameters of social functioning, such as honesty, employability, attractiveness, and effectiveness, using a visual analogue rating scale. Patients with abnormal facial characteristics were rated as significantly less honest (p = 0.007), less employable (p = 0.001), less trustworthy (p = 0.01), less optimistic (p = 0.001), less effective (p = 0.02), less capable (p = 0.002), less intelligent (p = 0.03), less popular (p = 0.001), and less attractive (p = 0.001) than were the same patients with normal facial

Effects of herbal medicine for dysmenorrhea treatment on accompanied acne vulgaris: a study protocol for a randomized controlled trial.

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Kim, Kwan-Il; Nam, Hae Jeong; Kim, Mia; Lee, Junhee; Kim, Kyuseok

2017-06-17

The incidence of preadolescent acne among women is increasing. Acne deteriorates the quality of life; conventional treatment options are limited and have not been effective against acne, particularly acne associated with menstruation. Despite evidence that acne associated with menstruation abnormalities naturally improves when menstruation recovers to normal, there have only been few studies on the effects of dysmenorrhea treatment on acne. Therefore- we designed this study to assess the effects of gyejibokryung-hwan (GBH) and dangguijagyag-san (DJS), which are widely used in dysmenorrhea treatment, on acne associated with menstruation cycle. This is a protocol for a randomized, double-blind, parallel-group, placebo-controlled and multicenter trial. One hundred and sixteen participants with dysmenorrhea accompanied by acne vulgaris will be recruited at three centers and randomized into two groups, the herbal treatment group and placebo group. The participants will receive GBH or DJS based on pattern identification or placebo granules thrice daily for 8 weeks, with an 8-week follow up. The primary outcome will be the mean percentage change in the count of inflammatory acne lesions. The secondary outcomes would be based on dysmenorrhea numeric rating scale, verbal multidimensional scoring system for dysmenorrhea, acne numeric rating scale, investigator's static global assessment scale of facial acne vulgaris, and safety testing. Adverse events will also be reported. The effects of GBH or DJS used in dysmenorrhea treatment on acne associated with the menstrual cycle will be evaluated. The findings of this trial will provide evidence regarding the effect of herbal medicine in improving acne vulgaris associated with menstruation in women. Korean Clinical Trial Registry ( http://cris.nih.go.kr ; registration number: KCT0002259). Date of registration: March 10, 2017.

Facial reconstruction for radiation-induced skin cancer

International Nuclear Information System (INIS)

Panje, W.R.; Dobleman, T.J.

1990-01-01

Radiation-induced skin cancers can be difficult to diagnose and treat. Typically, a patient who has received orthovoltage radiotherapy for disorders such as acne, eczema, tinea capitis, skin tuberculosis, and skin cancer can expect that aggressive skin cancers and chronic radiodermatitis may develop subsequently. Cryptic facial cancers can lead to metastases and death. Prophylactic widefield excision of previously irradiated facial skin that has been subject to multiple recurrent skin cancers is suggested as a method of deterring future cutaneous malignancy and metastases. The use of tissue expanders and full-thickness skin grafts offers an expedient and successful method of subsequent reconstruction

Hidradenitis suppurativa/acne inversa: bilocated epithelial hyperplasia with very different sequelae.

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von Laffert, M; Stadie, V; Wohlrab, J; Marsch, W C

2011-02-01

Hidradenitis suppurativa/acne inversa is a chronic, inflammatory, scarring disease in the terminal hair follicle and apocrine gland-bearing areas (skin folds). There is considerable histological evidence that perifolliculitis and follicular hyperkeratosis precede the rupture of the follicle. The timing of the epithelial hyperplasia at the infundibula of inflamed terminal follicles has not yet been clarified. To clarify the early histopathological life of lesions ('chronology') in hidradenitis suppurativa/acne inversa, focusing on the terminal follicle structure and its surrounding tissue (hyperkeratosis, hyperplasia of follicular epithelium, perifolliculitis and rupture). In total, 485 operative specimens obtained from 128 patients with diagnosed hidradenitis suppurativa/acne inversa (all surgically treated by wide excision) were examined histologically. Two to five histological preparations (total 485) per operation area (total 196) were prepared by multiple slicing. Hidradenitis suppurativa/acne inversa showed a heterogeneous histological pattern: hyperkeratosis of the terminal follicles (89%), hyperplasia of follicular epithelium (80%), pronounced perifolliculitis (68%) and follicle rupture (24%). Perifolliculitis, follicular hyperkeratosis and hyperplasia occurred prior to the rupture of the follicle. Other histological criteria were: subepidermal cellular inflammatory infiltrate (82%), epidermal psoriasiform hyperplasia (56%), pronounced acute dermal inflammation (28%), pronounced chronic dermal inflammation (49%), and involvement of apocrine glands (52%) and subcutis (31%). Infundibular hyperkeratosis, hyperplasia of the follicular epithelium and perifolliculitis are major histopathological characteristics of hidradenitis suppurativa/acne inversa. These apparently precede rupture of the follicle. In particular, hyperplasia of the follicular epithelium probably marks the beginning of sinus formation, which usually spreads horizontally. Psoriasiform hyperplasia

Diseño y desarrollo de dos mascarillas faciales para el acné con quitina como sustancia bioactiva

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Jessy Pavón Pérez

2011-06-01

Full Text Available La industria cosmética brinda importancia al logro de un cosmético más completo, un cosmecéutico, que represente seguridad en el mantenimiento de la salud y la belleza. En este trabajo se diseñaron y desarrollaron 2 mascarillas faciales para el acné con quitina al 2 % como sustancia activa. Este polímero de origen marino posee propiedades hidratantes, filmógenas, ha sido demostrada su acción cicatrizante y antimicrobiana. Se realizaron 2 diseños de experimentos con mezcla D-optimal, y se estudió la incidencia de 3 componentes en ambas mascarillas: polyquaternium-7 (salcare SC91® en una de las variantes a ensayar y carboximetil celulosa sódica (CMC en la otra, propilenglicol y agua en ambos casos. Se analizaron en el tiempo el pH y la extensibilidad; resultó óptima la variante 4 del diseño (salcare SC91 2 %, propilenglicol 2 % y agua al 91,6 % en el caso de la formulación con salcare y la variante 5 (CMC 2 %, propilenglicol 4 % y agua 89,6 % en la formulación con CMC.

Dark chocolate exacerbates acne.

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Vongraviopap, Saivaree; Asawanonda, Pravit

2016-05-01

The effects of chocolate on acne exacerbations have recently been reevaluated. For so many years, it was thought that it had no role in worsening acne. To investigate whether 99% dark chocolate, when consumed in regular daily amounts, would cause acne to worsen in acne-prone male subjects, twenty-five acne prone male subjects were asked to consume 25 g of 99% dark chocolate daily for 4 weeks. Assessments which included Leeds revised acne scores as well as lesion counts took place weekly. Food frequency questionnaire was used, and daily activities were recorded. Statistically significant changes of acne scores and numbers of comedones and inflammatory papules were detected as early as 2 weeks into the study. At 4 weeks, the changes remained statistically significant compared to baseline. Dark chocolate when consumed in normal amounts for 4 weeks can exacerbate acne in male subjects with acne-prone skin. © 2015 The International Society of Dermatology.

Usefulness of direct W-plasty application to wound debridement for minimizing scar formation in the ED.

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Min, Jin Hong; Park, Kyung Hye; Choi, Hong Lak; Park, Jung Soo; Lee, Ji Han; Kim, Hoon; Lee, Byung Kook; Lee, Dong Hun; Lee, Taek Gu

2017-12-01

A suture line placed with the same direction as the relaxed skin tension line leads to good healing, but a suture line with over 30 degrees of angle from the relaxed skin tension line leads to longer healing time and more prominent scarring. W-plasty is widely used to change the direction of the scar or to divide it into several split scars. In this study, we applied W-plasty to patients with facial lacerations in the emergency department. From June 2012 to December 2014, 35 patients underwent simple repair or W-plasty for facial lacerations. Patients in the simple repair group underwent resection following a thermal margin, and the W-plasty group was resected within a pre-designed margin of W-shaped laceration. We assessed prognosis using the Stony Brook Scar Evaluation Scale (SBSES) after 10 days (short-term) and six months (long-term), respectively, following suture removal. Among 35 patients, 15 (42.9%) underwent simple debridement and 20 (57.1%) underwent W-plasty. In the W-plasty group, there was no difference between short-term and long-term follow-up showing high SBSES, but in the simple debridement group, long-term follow-up SBSES significantly decreased. W-plasty SBSES was higher than simple debridement at short-term as well as long-term follow-up. We experienced good results of direct W-plasty application at six-month long-term follow-up. Therefore, W-plasty application is more effective in reducing scar appearance than a simple debridement method for facial laceration patients with an angle of 30 degrees or more to the relaxed skin tension line. Copyright © 2017 Elsevier Inc. All rights reserved.

A new LED device used for photodynamic therapy in treatment of moderate to severe acne vulgaris.

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Dong, Yiyun; Zhou, Guoyu; Chen, Jinan; Shen, Lingyue; Jianxin, Zhao; Xu, Qing; Zhu, Yulan

2016-03-01

This study investigated the efficacy and safety of a newly designed LED device used in photodiagnosis and photodynamic therapy of moderate to severe acne vulgaris in Chinese patients. Forty-six patients with moderate to severe facial acne showing high degrees of fluorescence by ultraviolet light examination were illuminated during ALA-PDT with two wavelengths of light (543-548 nm, and 630±6 nm, respectively) after 2 h of incubation with ALA. Each patient received treatment once every 30 days for two or three sessions. Two independent investigators assigned an acne severity score at baseline, one week after each treatment, as well as 4, 8, and 12 weeks after the completion of treatment. Adverse effects were recorded during and after each treatment. All patients rated their satisfaction with the results of treatment at a 12-week follow up visit. The ALA-PDL treatment regimen showed an overall effectiveness rate of 89.13% (41/46 patients). Some degree of clinical efficacy was seen in 71.42%, 86.67%, and 95.83% of patients with grades IV, V, and VI acne, respectively, and the rate of clinical effectiveness increased with increasing acne severity. When compared with baseline scores, significant reductions in acne scores were obtained at 8, and 12 weeks after completion of treatment. Maximum efficacy was shown at the 12 week follow up. No severe adverse events were observed. ALA-PDT administered with the newly designed LED device was an effective treatment for moderate to severe acne vulgaris, and side effects were mild and reversible. Copyright © 2015 Elsevier B.V. All rights reserved.

Topical application of ALA PDT for the treatment of moderate to severe acne vulgaris

Science.gov (United States)

Wang, Xiu-Li; Wang, Hong-Wei; Zhang, Ling-Lin; Su, Lina; Guo, Ming-Xia; Huang, Zheng

2009-06-01

Objectives: To evaluate the effectiveness of topical 5-aminolevulinic acid (ALA)- medicated photodynamic therapy (ALA PDT) for the treatment of moderate to severe acne vulgaris. Methods: Sixteen Chinese patients with moderate to severe facial acne were treated with 1-3 courses of ALA PDT. ALA cream (3%) was freshly prepared and applied to acne lesions for 3-4 h. The lesions were irradiated by a 635 nm diode laser at dose levels of 60 - 80 J/cm2 at 100 mW/cm2. Clinical assessments were conducted before and after treatment up to 3 months. Results: All patents showed response to ALA PDT. Complete clearance was seen in 10 patients (62.5%) and partial clearance in 6 patients (37.5%). One case showed recurrence after complete clearance at 2 months and another two showed recurrence after complete clearance at 3 months. However, the number of new lesions were significantly reduced. Adverse effects were minimal. Conclusions: The results of this preliminary clinical study is encouraging. ALA PDT is a simple, safe and useful therapeutic option for the treatment of moderate to severe acne. Further studies to evaluate the treatment with a larger number of patients and for a longer period of follow-up are needed.

Tretinoin microsphere gel 0.04% pump for treating acne vulgaris in preadolescents: a randomized, controlled study.

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Eichenfield, Lawrence F; Hebert, Adelaide A; Schachner, Lawrence; Paller, Amy S; Rossi, Ana Beatris; Lucky, Anne W

2012-01-01

Although acne vulgaris is common in preadolescents (TMG) 0.04% pump in children aged 9-11 with acne vulgaris. In this multicenter, randomized, double-blind, vehicle-controlled pilot study, patients applied TMG 0.04% pump or vehicle once daily to the face for 12 weeks. Efficacy measures were changes in facial lesion counts, Investigator Global Evaluation of acne severity using two scales, and Investigator Global Assessment of Improvement from baseline to week 12. Of the 110 patients enrolled, 55 received TMG 0.04% pump, and 55 received vehicle. At week 12, there was significantly greater improvement in the least-squares mean change in noninflammatory lesions with TMG 0.04% than with vehicle (-19.9 vs -9.7, p = 0.04) and a significant difference in Investigator Global Assessment of improvement at week 12 between the children treated with TMG 0.04% pump and those treated with vehicle (p = 0.02), but there were no discernible differences in static acne severity scales. Change from baseline in signs and symptoms of cutaneous irritation were similar between the active and vehicle arms at week 12. This study demonstrated statistically significant differences in the reduction of noninflammatory lesions between TMG 0.04% pump and vehicle in patients aged 9-11 with acne vulgaris. Additional studies are warranted to further characterize the safety and efficacy of TMG 0.04% pump for the treatment of acne in the preadolescent population. © 2012 Wiley Periodicals, Inc.

A randomized, controlled, split-face clinical trial of 1320-nm Nd:YAG laser therapy in the treatment of acne vulgaris.

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Orringer, Jeffrey S; Kang, Sewon; Maier, Lisa; Johnson, Timothy M; Sachs, Dana L; Karimipour, Darius J; Helfrich, Yolanda R; Hamilton, Ted; Voorhees, John J

2007-03-01

There is a need for additional effective treatments for acne vulgaris. Laser therapy has been explored as a therapeutic option for acne, but rigorously designed studies in this area have been limited. We sought to examine the efficacy of an infrared laser in the treatment of acne. We conducted a randomized, controlled, single-blind, split-face clinical trial of 46 patients with facial acne. Patients received a series of 3 nonablative laser treatments using a novel neodymium:yttrium-aluminum-garnet (Nd:YAG) laser to half of the face. Serial blinded lesion counts and global acne severity rating of standardized bilateral patient photographs were performed. Sebum production was measured, and patient self-assessment surveys were administered. A transient but statistically significant improvement in lesion counts of open comedones was demonstrated in treated skin as compared with untreated skin. There were no significant differences between treated and control sides of the face in terms of changes in mean papule or pustule counts. Grading of serial photographs revealed no significant differences between treated and untreated skin. Patient surveys indicated that the majority of patients found the treatments to be at least mildly effective for both acne and oiliness. The current study only addresses the efficacy of a single laser system employing a specific treatment regimen. Infrared laser therapy may improve comedonal acne. Additional work is needed to better define the degree and duration of the effect. Patients appear to positively view such therapy for both acne and oily skin.

Facial nerve conduction after sclerotherapy in children with facial lymphatic malformations: report of two cases.

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Lin, Pei-Jung; Guo, Yuh-Cherng; Lin, Jan-You; Chang, Yu-Tang

2007-04-01

Surgical excision is thought to be the standard treatment of choice for lymphatic malformations. However, when the lesions are limited to the face only, surgical scar and facial nerve injury may impair cosmetics and facial expression. Sclerotherapy, an injection of a sclerosing agent directly through the skin into a lesion, is an alternative method. By evaluating facial nerve conduction, we observed the long-term effect of facial lymphatic malformations after intralesional injection of OK-432 and correlated the findings with anatomic outcomes. One 12-year-old boy with a lesion over the right-side preauricular area adjacent to the main trunk of facial nerve and the other 5-year-old boy with a lesion in the left-sided cheek involving the buccinator muscle were enrolled. The follow-up data of more than one year, including clinical appearance, computed tomography (CT) scan and facial nerve evaluation were collected. The facial nerve conduction study was normal in both cases. Blink reflex in both children revealed normal results as well. Complete resolution was noted on outward appearance and CT scan. The neurophysiologic data were compatible with good anatomic and functional outcomes. Our report suggests that the inflammatory reaction of OK-432 did not interfere with adjacent facial nerve conduction.

Acne e dieta: verdade ou mito? Acne and diet: truth or myth?

Directory of Open Access Journals (Sweden)

Adilson Costa

2010-06-01

Full Text Available Nos últimos 50 anos, foram publicados inúmeros estudos com a finalidade de comprovar se a dieta está relacionada à etiologia da acne. Embora existam estudos antigos, que são bem difundidos entre os dermatologistas e negam a associação entre acne e dieta, seu delineamento científico é pobre. Recentemente, novos artigos demonstraram evidências contrárias às publicações anteriores. Sendo assim, os autores realizaram esta revisão bibliográfica com o intuito de averiguar se a dieta influencia direta ou indiretamente um ou mais dos quatro pilares etiopatogênicos fundamentais da acne: (1 hiperproliferação dos queratinócitos basais, (2 aumento da produção sebácea, (3 colonização pelo Propionibacterium acnes e (4 inflamação.Numerous studies were published over the last 50 years to investigate whether diet is associated with the etiology of acne. Although older studies well known by dermatologists that refute the association between acne and diet exist, their scientific foundation is weak. New articles have recently brought to light evidence contrary to previous findings. Therefore, we would like to investigate whether diet, directly or indirectly, influences one or more of the four fundamental etiopathogenic pillars of acne: (1 hyperproliferation of basal keratinocytes, (2 increase of sebaceous production, (3 colonization by Propionibacterium acnes, and (4 inflammation.

Efficacy and Safety of Sarecycline, a Novel, Once-Daily, Narrow Spectrum Antibiotic for the Treatment of Moderate to Severe Facial Acne Vulgaris: Results of a Phase 2, Dose-Ranging Study.

Science.gov (United States)

Leyden, James J; Sniukiene, Vilma; Berk, David R; Kaoukhov, Alexandre

2018-03-01

There is a need for new oral antibiotics for acne with improved safety profiles and targeted antibacterial spectra. Sarecycline is a novel, tetracycline-class antibiotic specifically designed for acne, offering a narrow spectrum of activity compared with currently available tetracyclines, including less activity against enteric Gram-negative bacteria. This phase 2 study evaluated the efficacy and safety of three doses of sarecycline for moderate to severe facial acne vulgaris. In this multicenter, double-blind, placebo-controlled study, patients aged 12 to 45 years were randomized to once-daily sarecycline 0.75 mg/kg, 1.5 mg/kg, 3.0 mg/kg, or placebo. Efficacy analyses included change from baseline in inflammatory and noninflammatory lesion counts at week 12, with between-group comparisons using analysis of covariance. Safety assessments included adverse events (AEs), clinical laboratories, vital signs, electrocardiograms, and physical examinations. Overall, 285 randomized patients received at least one dose of study drug. At week 12, sarecycline 1.5 mg/kg and 3.0 mg/kg groups demonstrated significantly reduced inflammatory lesions from baseline (52.7% and 51.8%, respectively) versus placebo (38.3%; P=0.02 and P=0.03, respectively). Sarecycline was safe and well tolerated, with similar gastrointestinal AE rates in sarecycline and placebo groups. Vertigo and photosensitivity AEs occurred in less than 1% of patients when pooling sarecycline groups; no vulvovaginal candidiasis AEs occurred. Discontinuation rates due to AEs were low. No serious AEs occurred. Once-daily sarecycline 1.5 mg/kg significantly reduced inflammatory lesions versus placebo and was safe and well tolerated with low rates of AEs, including gastrointestinal AEs. Sarecycline 3.0 mg/kg did not result in additional efficacy versus 1.5 mg/kg. Sarecycline may represent a novel, once-daily treatment for patients with moderate to severe acne. It offers a narrow antibacterial spectrum relative to other

Minimally invasive aesthetic procedures in young adults

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Wollina U

2011-03-01

Full Text Available Uwe Wollina1, Alberto Goldman21Department of Dermatology and Allergology, Academic Teaching Hospital Dresden-Friedrichstadt, Dresden, Germany; 2Clinica Goldman, Porto Alegre, Rio Grande du Sul, BrazilAbstract: Age is a significant factor in modifying specific needs when it comes to medical aesthetic procedures. In this review we will focus on young adults in their third decade of life and review minimally invasive aesthetic procedures other than cosmetics and cosmeceuticals. Correction of asymmetries, correction after body modifying procedures, and facial sculpturing are important issues for young adults. The implication of aesthetic medicine as part of preventive medicine is a major ethical challenge that differentiates aesthetic medicine from fashion.Keywords: acne scars, ice pick scars, boxcar scars, fillers 

Acne vulgaris: endocriene aspecten

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Dekkers, O. M.; Thio, B. H.; Romijn, J. A.; Smit, J. W. A.

2006-01-01

Androgens play an important part in the development of acne vulgaris. Androgen levels in patients with acne are higher than those in controls and people with the androgen insensitivity syndrome do not develop acne. Local factors other than androgen plasma levels, also play a part in the development

Acne and anticonvulsants.

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Greenwood, R; Fenwick, P B; Cunliffe, W J

1983-01-01

The severity of acne and rate of excretion of sebum were assessed in 243 patients with epilepsy taking various anticonvulsants who were in hospital long term and in matched controls derived from a normal population of 2176 people. Neither the prevalence of acne nor the sebum excretion rate significantly increased in the patients compared with the controls or in patients taking phenytoin compared with those not. It is concluded that anticonvulsant treatment does not cause acne. PMID:6227369

Facial discrimination in body dysmorphic, obsessive-compulsive and social anxiety disorders.

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Hübner, Claudia; Wiesendahl, Wiebke; Kleinstäuber, Maria; Stangier, Ulrich; Kathmann, Norbert; Buhlmann, Ulrike

2016-02-28

Body dysmorphic disorder (BDD) is characterized by preoccupation with perceived flaws in one's own appearance. Several risk factors such as aesthetic perceptual sensitivity have been proposed to explain BDD's unique symptomatology. Although research on facial discrimination is limited so far, the few existing studies have produced mixed results. Thus, the purpose of this study was to further examine facial discrimination in BDD. We administered a facial discrimination paradigm, which allows to assess the ability to identify slight to strong facial changes (e.g., hair loss, acne) when presented with an original (unmodified) facial image, relative to a changed (modified) facial image. The experiment was administered in individuals with BDD, social anxiety disorder, obsessive-compulsive disorder, and mentally healthy controls (32 per group, respectively). Overall, groups did not differ with respect to their ability to correctly identify facial aberrations when presented with other people's faces. Our findings do not support the hypothesis of enhanced general aesthetic perceptual sensitivity in individuals with (vs. without) BDD. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Correlation between the severity and type of acne lesions with serum zinc levels in patients with acne vulgaris.

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Rostami Mogaddam, Majid; Safavi Ardabili, Nastaran; Maleki, Nasrollah; Soflaee, Maedeh

2014-01-01

Acne vulgaris is the most common cutaneous disorder affecting adolescents and young adults. Some studies have reported an association between serum zinc levels and acne vulgaris. We aimed to evaluate the serum zinc level in patients with acne vulgaris and compare it with healthy controls. One hundred patients with acne vulgaris and 100 healthy controls were referred to our clinic. Acne severity was classified according to Global Acne Grading System (GAGS). Atomic absorption spectrophotometry was used to measure serum zinc levels. Mean serum level of zinc in acne patients and controls was 81.31 ± 17.63 μg/dl and 82.63 ± 17.49 μg/dl, respectively. Although the mean serum zinc level was lower in acne group, it was not statistically significant (P = 0.598). There was a correlation between serum zinc levels with severity and type of acne lesions. The results of our study suggest that zinc levels may be related to the severity and type of acne lesions in patients with acne vulgaris. Relative decrease of serum zinc level in acne patients suggests a role for zinc in the pathogenesis of acne vulgaris.

Heredity of acne in Korean patients.

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Cho, Eun Byul; Ha, Ji Min; Park, Eun Joo; Kim, Kwang Ho; Kim, Kwang Joong

2014-10-01

Acne is a chronic inflammatory disease of the pilocebaceous unit that presents with various spectrum and severity. Genetic backgrounds and environmental factors are also considered to be relevant, but few studies have focused on Korean patients. A cross-sectional epidemiologic study on family history of Korean acne patients was performed to analyze family history of acne, and to compare the severity and characteristics of acne in association with family history. A total of 221 patients were enrolled, 98 male (44.3%) and 123 female (55.7%). Patients were grouped as patients with (A+) or without (A-) family history of acne. In a second analysis, patients with any experience of acne treatment were evaluated. Severity of acne was measured with Burton's grading system and Korean Acne Grading System (KAGS). Female patients had a higher tendency to have family history than males (P = 0.002). Group A+ had statistically significant earlier onset of acne (P = 0.002). In inexperienced patients, patients with family history showed a relatively earlier onset (P = 0.084). This study confirmed the role of heredity in acne. Family history of acne is associated with earlier onset of the disease, and more non-inflammatory lesions. © 2014 Japanese Dermatological Association.

Content Validity of Patient-Reported Outcome Instruments used with Pediatric Patients with Facial Differences: A Systematic Review.

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Wickert, Natasha M; Wong Riff, Karen W Y; Mansour, Mark; Forrest, Christopher R; Goodacre, Timothy E E; Pusic, Andrea L; Klassen, Anne F

2018-01-01

Objective The aim of this systematic review was to identify patient-reported outcome (PRO) instruments used in research with children/youth with conditions associated with facial differences to identify the health concepts measured. Design MEDLINE, EMBASE, CINAHL, and PsycINFO were searched from 2004 to 2016 to identify PRO instruments used in acne vulgaris, birthmarks, burns, ear anomalies, facial asymmetries, and facial paralysis patients. We performed a content analysis whereby the items were coded to identify concepts and categorized as positive or negative content or phrasing. Results A total of 7,835 articles were screened; 6 generic and 11 condition-specific PRO instruments were used in 96 publications. Condition-specific instruments were for acne (four), oral health (two), dermatology (one), facial asymmetries (two), microtia (one), and burns (one). The PRO instruments provided 554 items (295 generic; 259 condition specific) that were sorted into 4 domains, 11 subdomains, and 91 health concepts. The most common domain was psychological (n = 224 items). Of the identified items, 76% had negative content or phrasing (e.g., "Because of the way my face looks I wish I had never been born"). Given the small number of items measuring facial appearance (n = 19) and function (n = 22), the PRO instruments reviewed lacked content validity for patients whose condition impacted facial function and/or appearance. Conclusions Treatments can change facial appearance and function. This review draws attention to a problem with content validity in existing PRO instruments. Our team is now developing a new PRO instrument called FACE-Q Kids to address this problem.

[Diet in pathogenesis of acne vulgaris].

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Ozdarska, Katarzyna; Osucha, Karolina; Savitskyi, Stepan; Malejczyk, Jacek; Galus, Ryszard

2017-10-23

Acne vulgaris is one of the most common dermatologic condition especially among adolescents. Acne is related to excess sebum production by sebaceous glands, inflammation both within and adjacent to the comedones, hyperproliferation of Propionibacterium acnes. Some of investigations show association between acne and diet. Milk increases the level of IGF-1 leading to the synthesis of androgen-mediated increases sebum production. Chocolate predispose to hyperglycemia and insulinemia which aggravate of acne vulgaris. High levels of omega-6 fatty acids have been associated with increase of acne in contrast to omega-3 fatty acids, which decrease inflammation. Food have huge impact on development and severity of acne and may exert beneficial effect in the treatment of this disorder.

Neonatal and infantile acne vulgaris: an update.

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Serna-Tamayo, Cristian; Janniger, Camila K; Micali, Giuseppe; Schwartz, Robert A

2014-07-01

Acne may present in neonates, infants, and small children. Neonatal and infantile acne vulgaris are not considered to be rare. The presentation of acne in this patient population sometimes represents virilization and may portend later development of severe adolescent acne. Neonatal and infantile acne vulgaris must be distinguished from other cutaneous disorders seen in newborns and infants. Infantile acne tends to be more pleomorphic and inflammatory, thus requiring more vigorous therapy than neonatal acne.

Acne Scars

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The long-term effect of 1550 nm erbium:glass fractional laser in acne vulgaris.

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Liu, Yale; Zeng, Weihui; Hu, Die; Jha, Smita; Ge, Qin; Geng, Songmei; Xiao, Shengxiang; Hu, Guanglei; Wang, Xiaoxiao

2016-04-01

We evaluated the short-term and long-term effects of the 1550 nm erbium:glass (Er:glass) fractional laser in the treatment of facial acne vulgaris. Forty-five (9 male and 36 female) acne patients were treated 4 times at 4-week intervals with the following parameters: 169 spot density and 15-30 mJ/cm(2) fluence. There was no control group. The laser spots were adjustable (maximum overlap: 20%) according to the treatment area, and delivered in rows in order to cover all the face. Clinical photographs were taken. The IGA scores and lesion counts were performed for each treatment. Their current state was obtained by phone call follow-up to determine the long-term effect and photographs were offered by themselves or taken in hospital. After four treatments, all patients had an obvious reduction of lesion counts and IGA score and the peak lesion counts decreased to 67.7% after the initial four treatment sessions. For long-term effect, 8 patients lost follow-up, hence 37 patients were followed-up. 8 patients were 2-year follow up, 27 at the 1-year follow-up, and all patients at the half-year follow-up. The mean percent reduction was 72% at the half-year follow-up, 79 at the 1-year follow-up and 75% at the 2-year follow-up. Side effects and complications were limited to transient erythema and edema, and few patients suffered from transient acne flare-ups and sensitivity. All patients responded that their skin was less prone to oiliness. In conclusion, acne can be successfully treated by 1550 nm Er:glass fractional laser, with few side effects and prolonged acne clearing.

The role of combined oral contraceptives in the management of acne and seborrhea.

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del Marmol, V; Teichmann, A; Gertsen, K

2004-06-01

Acne and seborrhea (or facial oiliness) are related androgenic skin disorders which affect a high proportion of women after menarche. They can have a negative effect on psychological well-being and social life. Androgens play an important role in the pathogenesis of acne through the stimulation of sebum secretion, increasing sebaceous gland size and possibly through follicular hyperkeratinization. Conversely, estrogens decrease sebum production by suppressing gonadotropin release and androgen production and increasing sex hormone binding globulin production. One of the treatment options for these conditions is hormonal therapy, especially for women who require contraception. The effect of combined oral contraceptives in androgenic skin disorders depends on their estrogen:progestogen balance and on the antiestrogenic activity of the progestogen component. Improved understanding of what women value about oral contraceptives suggests that the choice of product should be tailored as much as possible to the individual. Several combined oral contraceptives containing new-generation progestogens (e.g. desogestrel, gestodene) or progestational antiandrogens (e.g. cyproterone acetate, chlormadinone acetate) have demonstrated efficacy in the treatment of women with acne, although comparisons between trials are difficult because of differing endpoints. Seborrhea has been less well studied, but the few studies that are available show an improvement in women with this condition using combined oral contraceptives.

Evaluation of acne quality of life, loneliness and life satisfaction levels in adolescents with acne vulgaris

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İjlal Erturan

2014-12-01

Full Text Available Background and Design: Acne vulgaris is a dermatological disorder mainly seen in adolescents. Psychiatric morbidity has been reported in these patients. The aim of the present study was to investigate the quality of life, loneliness and life satisfaction levels in adolescents with acne vulgaris. Materials and Methods: A total of 264 adolescents with acne and 250 controls were included in the study. Acne severity was determined by the Global Acne Grading System (GAGS. Acne Quality of Life Scale (AQOL; developed by Gupta et al., UCLA Loneliness scale (ULS; developed by Russell, Peplau & Ferguson (1978, and the Life Satisfaction Scale (LSS; developed by Diener et al. were used to asses life quality, loneliness and life satisfaction levels, respectively in adolescents with acne and in controls. Results: The mean AQOL and the mean ULS scores were significantly higher in patients (13.67±4.75 vs 11.14±2.94, p<0.001 and 32.15±8.46 vs 30.52±8.70,p=0.031, respectively. The mean LSS score was significantly lower in acne patients (21.82±6.40 than in controls (23.04±6.45, p=0.033. There was a statistically significant difference in the mean LSS scores between the mild, moderate and severe acne patients (22.15±6.32, 21.61±6.20, 16.00±7.26, respectively; Kruskal Wallis Test p=0.036. While there was no significant difference in the mean ULS and LSS scores between the genders. The mean ALQI score was significantly higher in males than in females (p=0.004. Conclusion: Our results indicated that acne quality of life and life satisfaction levels were significantly reduced while loneliness levels were significantly increased in adolescents with acne compared to controls. Our study is important in terms of being the first study investigating the loneliness and life satisfaction levels in acne patients and the relationship between these parameters and severity of acne.

Demographic Features, Beliefs And Socio–Psychological Impact Of Acne Vulgaris Among Its Sufferers In Two Towns In Nigeria

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Ikaraoha CI

2005-05-01

Full Text Available There is paucity of reports in the demographic knowledge, belief and socio-psychological impact of acne vulgaris sufferers towards the disorder in a black population. This is the first study from Nigeria designed to address this issue. A total of 174 facial acne sufferers completed a self-administered questionnaire, which contained several items mentioning different areas in their belief, knowledge, perception, severity, socio-psychological impact and medication attention. The findings were discussed and compared to those of the Caucasians. The occurrence of the disorder was higher in females (65.0% compared to the males (35.0%. About 54.0% of the female subjects indicated increase in severity of the disorder during their pre-menstrual period. Also 64.9% of acne sufferers indicated increase in severity during the rainy season, while 93.1% of the population implicated stress to perpetuate the severity of the disorder. Most (75.7% of the acne sufferers believed that it is caused by oily diet, 40.8% thought that it is hereditary, while barely 5.2% had at sometime sought doctor's attention. Non- prescription products used by acne sufferers were cleansers and cream/lotions. Psychological abnormalities experienced by the sufferers included social inhibition, depression and anxiety. Pain and discomfort are the psychosomatic symptoms. No major differences were found in the beliefs, misconception and socio-psychological impact of acne sufferers in a black population (Nigeria compared to the Caucasians. There is need to improve the understanding of the disorder in Nigeria through health education programmes

Diseño y desarrollo de dos mascarillas faciales para el acné con quitina como sustancia bioactiva Design and development of two face packs for the acne where chitin is the bioactive substance

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Jessy Pavón Pérez

2011-06-01

Full Text Available La industria cosmética brinda importancia al logro de un cosmético más completo, un cosmecéutico, que represente seguridad en el mantenimiento de la salud y la belleza. En este trabajo se diseñaron y desarrollaron 2 mascarillas faciales para el acné con quitina al 2 % como sustancia activa. Este polímero de origen marino posee propiedades hidratantes, filmógenas, ha sido demostrada su acción cicatrizante y antimicrobiana. Se realizaron 2 diseños de experimentos con mezcla D-optimal, y se estudió la incidencia de 3 componentes en ambas mascarillas: polyquaternium-7 (salcare SC91® en una de las variantes a ensayar y carboximetil celulosa sódica (CMC en la otra, propilenglicol y agua en ambos casos. Se analizaron en el tiempo el pH y la extensibilidad; resultó óptima la variante 4 del diseño (salcare SC91 2 %, propilenglicol 2 % y agua al 91,6 % en el caso de la formulación con salcare y la variante 5 (CMC 2 %, propilenglicol 4 % y agua 89,6 % en la formulación con CMC.The cosmetics industry attaches importance to the achievement of a more complete cosmetic, a cosmoceutic representing safety in health and beauty maintenance. In present paper were designed and developed two face packs for acne using 2 % chitin as active substance. This polymer of marine origin has phylmogen and hydration properties and a demonstrated healing and antimicrobial action. Two experimental designs were carried out with a D-optimal mixture and also the study of incidence of three components of both face packs, polyquaaterium-7 (salcare SC91® in one of the variants be assayed and sodium cellulose carboxymethyl (SCC in the other one, 2 % propylene glycol and 91.6 % water in the case of salcare formula and the 5 variant (2 % SCC, 4 % propylene glycol and 89.6 % water in SCC formula.

Reduced expression of dermcidin, a peptide active against propionibacterium acnes, in sweat of patients with acne vulgaris.

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Nakano, Toshiaki; Yoshino, Takashi; Fujimura, Takao; Arai, Satoru; Mukuno, Akira; Sato, Naoya; Katsuoka, Kensei

2015-09-01

Dermcidin (DCD), an antimicrobial peptide with a broad spectrum of activity against bacteria such as Propionibacterum acnes, is expressed constitutively in sweat in the absence of stimulation due to injury or inflammation. The aim of this study was to determine the relationship between DCD expression and acne vulgaris associated with P. acnes. The antimicrobial activity of recombinant full-length DCD (50 μg/ml) was 97% against Escherichia coli and 100% against Staphylococcus aureus. Antimicrobial activity against P. acnes ranged from 68% at 50 μg/ml DCD to 83% at 270 μg/ml DCD. DCD concentration in sweat from patients with acne vulgaris (median 9.8 μg/ml, range 6.9-95.3 μg/ml) was significantly lower than in healthy subjects (median 136.7 μg/ml, range 45.4-201.6 μg/ml) (p = 0.001). DCD demonstrated concentration-dependent, but partial, microbicidal activity against P. acnes. These results suggest that reduced DCD concentration in sweat in patients with inflammatory acne may permit proliferation of P. acnes in pilosebaceous units, resulting in progression of inflammatory acne.

The effect of Propionibacterium acnes on maturation of dendritic cells derived from acne patients' peripherial blood mononuclear cells.

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Maria Juszkiewicz-Borowiec

2009-01-01

Full Text Available Propionibacterium acnes (P. acnes has been implicated in the pathogenesis of acne vulgaris which is the most common cutaneous disorder. It has a proinflammatory activity and takes part in immune reactions modulating the Th1/Th2 cellular response. The exposure of dendritic cells (DCs to whole bacteria, their components, cytokines or other inflammatory stimuli and infectious agents induces differentiation from immature DCs into antigen-presenting mature DCs. The aim of the study was to evaluate the capability of P. acnes to induce the maturation of DCs. We stimulated monocyte derived dendritic cells (Mo-DCs from acne patients with various concetrations of heat-killed P. acnes (10(6-10(8 bacteria/ml cultured from acne lesions. The results showed an increase in CD80+/CD86+/DR+ and CD83+/CD1a+/DR+ cells percentage depending on the concetration of P. acnes. The expression of CD83 and CD80 (shown as the mean fluorescence intensity - MFI increased with higher concetrations of P. acnes. There were also significant correlations between MFI of CD83, CD80, CD86 and concetration of P. acnes. The study showed that P. acnes in the concetration of 10(8 bacteria/ml is most effective in the induction of Mo-DCs maturation. Futher studies concerning the influence on the function of T cells are needed.

Adult female acne: a new paradigm.

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Dréno, B; Layton, A; Zouboulis, C C; López-Estebaranz, J L; Zalewska-Janowska, A; Bagatin, E; Zampeli, V A; Yutskovskaya, Y; Harper, J C

2013-09-01

In the adult female, acne is a chronic condition with a substantial negative psychological, social and emotional impact. Based on time of onset, two subtypes of adult female acne are recognized: 'persistent acne' is a continuation of the disease from adolescence, while 'late-onset acne' first presents in adulthood. The morphological characteristics of adult female acne are often distinct from adolescent acne. In adults, inflammatory lesions (particularly papules, pustules and nodules) are generally more prominent on the lower chin, jawline and neck, and comedones are more often closed comedones (micro cysts). Adult acne is mainly mild-to-moderate in severity and may be refractory to treatment. A holistic approach to acne therapy should be taken in adult females, which combines standard treatments with adjunctive therapy and cosmetic use. A number of factors specific to the adult female influence choice of treatment, including the predisposition of older skin to irritation, a possible slow response to treatment, a high likelihood of good adherence, whether of child-bearing age, and the psychosocial impact of the disease. Adherence to therapy should be encouraged through further patient education and a simplified regimen that is tailored to suit the individual patient's needs and lifestyle. This article reviews the specific characteristics of adult female acne, and provides recommendations for acne therapy in this patient group. © 2013 The Authors. Journal of the European Academy of Dermatology and Venereology © 2013 European Academy of Dermatology and Venereology.

Understanding Acne: How to Banish Breakouts

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... Issues Subscribe January 2010 Print this issue Understanding Acne How to Banish Breakouts Send us your comments ... Protect Your Skin from Sun Damage Wise Choices Acne Flare-ups The exact cause of acne is ...

Acne treatment patterns, expectations, and satisfaction among adult females of different races/ethnicities

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Rendon MI

2015-05-01

Full Text Available Marta I Rendon,1 David A Rodriguez,2 Ariane K Kawata,3 Arnold N Degboe,4 Teresa K Wilcox,3 Caroline T Burk,5 Selena R Daniels,4 Wendy E Roberts6 1Rendon Center for Dermatology and Aesthetic Medicine, Boca Raton, FL, USA; 2Dermatology Associates and Research, Coral Gables, FL, USA; 3Evidera, Bethesda, MD, USA; 4Allergan Inc., Irvine, CA, USA; 5Health Outcomes Consultant, Laguna Beach, CA, USA; 6Generational and Cosmetic Dermatology, Rancho Mirage, CA, USA Background: Limited data are available on acne treatment patterns, expectations, and satisfaction in the adult female subpopulation, particularly among different racial and ethnic groups. Objective: Describe acne treatment patterns and expectations in adult females of different racial/ethnic groups and analyze and explore their potential effects on medication compliance and treatment satisfaction. Methods: A cross-sectional, Web-based survey was administered to US females (25–45 years with facial acne (≥25 visible lesions. Data collected included sociodemographics, self-reported clinical characteristics, acne treatment use, and treatment expectations and satisfaction. Results: Three hundred twelve subjects completed the survey (mean age, 35.3±5.9 years, comprising black (30.8%, Hispanic (17.6%, Asian/other (17.3%, and white (34.3%. More than half of the subjects in each racial group recently used an acne treatment or procedure (black, 63.5%; Hispanic, 54.5%; Asian/other, 66.7%; white, 66.4%. Treatment use was predominantly over-the-counter (OTC (47.4% versus prescription medications (16.6%. OTC use was highest in white subjects (black, 42.7%; Hispanic, 34.5%; Asian/other, 44.4%; white, 59.8%; P<0.05. The most frequently used OTC treatments in all racial/ethnic groups were salicylic acid (SA (34.3% and benzoyl peroxide (BP (32.1%. Overall, compliance with acne medications was highest in white versus black (57.0±32.4 vs 42.7±33.5 days, P>0.05, Hispanic (57.0±32.4 vs 43.2±32.9 days, P>0

The Association between Cigarette Smoking and Acne Intensity

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Taheri Ramin

2009-06-01

Full Text Available Background: Acne vulgaris is a common chronic inflammatory disease of pilosebaceous unit. Different factors have been suggested to influence acne including diet, menstruation and occupation. The role of some of these factors on acne intensity is confirmed. The affect of Cigarette smoking on acne intensity has been suggested. In this research, we evaluated the association between cigarette smoking and the acne intensity.Materials and Methods: This cross-sectional study was performed on 278 smoker and 277non smoker males referred to dermatology clinics of Semnan during 2006-2007. The dermatologists interviewing the patients completed questionnaires based on clinical diagnosis and intensity of acne. Data analysis was performed using t-test, Mann-Whitney, Chi-square and Spearman coefficient tests. P-value less than 0.05 were considered significant. Results: Severe acne was observed in 16.6% of non-smokers and 22.7% of smokers. Distribution of acne intensity in both groups was significant (P=0.023. Association between duration of cigarette smoking and acne intensity was significant too (P<0.001. The association between dosage of cigarette smoking and acne intensity was also significant (P<0.001.Conclusion: Significant association between cigarette smoking and acne intensity showed that smoking withdrawal is helpful for reducing the acne intensity

Underestimated clinical features of postadolescent acne.

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Capitanio, Bruno; Sinagra, Jo Linda; Bordignon, Valentina; Cordiali Fei, Paola; Picardo, Mauro; Zouboulis, Christos C

2010-11-01

Postadolescent acne is usually described as an inflammatory, mild-to-moderate dermatosis, frequently involving the lower third of the face, the jawline, and the neck. However, we have also frequently observed a clinical form predominantly characterized by retention lesions (microcomedones and macrocomedones), with few inflammatory lesions (comedonal postadolescent acne [CPAA]), which appears significantly correlated with cigarette smoking. We sought to investigate the clinical features of postadolescent acne in a group of female patients affected by acne and its relationship with cigarette smoking. A total of 226 women with acne (25-50 years) attending our department were examined by a team of 3 dermatologists, to assess the age of onset of the disease, and the number, type, and distribution of acne lesions. In all, 192 of 226 patients (85.0%) were classified as having CPAA and 34 as having papulopustular postadolescent acne. A smoking habit was confirmed in 150 of 226 (66.3%). Remarkably, 72.9% of patients with CPAA were smokers as compared with only 29.4% of those with papulopustular postadolescent acne (P < .0001). Possible limitations are related to geographic area or to the prevalence of darker skin types (III and IV) (data about skin types have not been collected). Other possible aggravating factors (ie, stress and diet) have not been investigated. According to our results, CPAA appears as the most frequent clinical form of postadolescent acne and seems to be strictly correlated with cigarette smoking. Copyright © 2010 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

Randomized, Observer-blind, Split-face Compatibility Study with Clindamycin Phosphate 1.2%/Benzoyl Peroxide 3.75% gel and Facial Foundation Makeup.

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Bhatia, Neal; Pillai, Radhakrishnan

2015-09-01

Cosmetic compatibility in the treatment of acne is an important issue significantly impacting quality of life, but often overlooked, as dermatologists commonly recommended avoidance of cosmetic foundations when treating adult female patients. Fixed combinations of clindamycin/benzoyl peroxide are widely used in the treatment of acne, but little is known about the impact of their concomitant use with facial foundation. To assess the compatibility of clindamycin phosphate 1. 2%/benzoyl peroxide 3. 75% gel with foundation makeup for up to six hours after application. Twenty-nine female subjects applied makeup to their face after randomly applying clindamycin phosphate 1. 2%/benzoyl peroxide 3. 75% gel to one side of the face. Investigator and subject self- assessment included facial skin attributes, facial tolerability, and cosmetic compatibility post-application and at Hour 6; as well as cutaneous tolerability. No statistical difference was noted between the treated and untreated side of the face in terms of coverage, blotchiness, appearance, skin tone, or visual smoothness. Tolerability was excellent, with no erythema, edema, dryness, and peeling post-makeup application. For both the treated and untreated side, there was a slight lack of improvement in cosmetic appearance six hours post-makeup application. Clindamycin/benzoyl peroxide 3. 75% gel was shown to have excellent cosmetic compatibility with facial foundation.

Generation and characterization of chicken egg yolk antibodies against propionibacterium acnes for the prevention of acne vulgaris

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Karthika Selvan

2012-01-01

Full Text Available Introduction: Antigen-specific antibody has been widely used for immunological analysis in the field of diagnosis as well as in pure scientific research, where the IgY antibodies can be raised against P acnes antigen. Material and Methods: To produce IgY against Propionibacterium acnes, laying hens were immunized with P acnes (MTCC No: 1951 and subsequent booster injections were given. The antibodies produced were purified from the egg yolk of immunized chicken using the polyethylene glycol and ammonium sulfate precipitation method and, further, by Diethylaminoethyl (DEAE cellulose ion-exchange column chromatography. The protein fraction of IgY was isolated from the egg yolk. The separation was rapid, and the success of each step was viewed on Sodium Dodecyl Sulphate-polyacrylamide gel electrophoresis (SDS-PAGE. The reactivity of anti-P acnes was evaluated by the Enzyme-linked immunosorbent assay (ELISA test and the dot-immunoassay. Results: With ELISA, the highest titter of 1:10000 was observed on the 150 th day after vaccination. The results of dot-immunoassay suggested that anti-P acnes IgY developed a brown color as positive reaction, which showed the antigen-antibody binding even after a maximum dilution of 1/500. These results suggest that anti-acne IgY was produced and had strong specific antibody reactivity. Conclusion: The findings indicate that anti-acne IgY is worth utilizing as a preventive agent for acne vulgaris.

Spectrum of mucocutaneous, ocular and facial features and delineation of novel presentations in 62 classical Ehlers-Danlos syndrome patients.

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Colombi, M; Dordoni, C; Venturini, M; Ciaccio, C; Morlino, S; Chiarelli, N; Zanca, A; Calzavara-Pinton, P; Zoppi, N; Castori, M; Ritelli, M

2017-12-01

Classical Ehlers-Danlos syndrome (cEDS) is characterized by marked cutaneous involvement, according to the Villefranche nosology and its 2017 revision. However, the diagnostic flow-chart that prompts molecular testing is still based on experts' opinion rather than systematic published data. Here we report on 62 molecularly characterized cEDS patients with focus on skin, mucosal, facial, and articular manifestations. The major and minor Villefranche criteria, additional 11 mucocutaneous signs and 15 facial dysmorphic traits were ascertained and feature rates compared by sex and age. In our cohort, we did not observe any mandatory clinical sign. Skin hyperextensibility plus atrophic scars was the most frequent combination, whereas generalized joint hypermobility according to the Beighton score decreased with age. Skin was more commonly hyperextensible on elbows, neck, and knees. The sites more frequently affected by abnormal atrophic scarring were knees, face (especially forehead), pretibial area, and elbows. Facial dysmorphism commonly affected midface/orbital areas with epicanthal folds and infraorbital creases more commonly observed in young patients. Our findings suggest that the combination of ≥1 eye dysmorphism and facial/forehead scars may support the diagnosis in children. Minor acquired traits, such as molluscoid pseudotumors, subcutaneous spheroids, and signs of premature skin aging are equally useful in adults. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Post-burn scars and scar contractures

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Goel Arun

2010-10-01

Full Text Available The mortality and morbidity from burns have diminished tremendously over the last six to seven decades. However, these do not truly reflect whether the victim could go back to society as a useful person or not and lead a normal life because of the inevitable post-burn scars, contractures and other deformities which collectively have aesthetic and functional considerations. This article gives an overview of the post-burn scars and scar contractures, especially their prevention, minimisation and principles of management.

Side effects assessment in glicolyc acid peelings in patients with acne type I

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Sanja Perić

2011-02-01

Full Text Available Chemical peeling implies the application of a chemical agent to the skin, which causes controlled destruction of a part or the entire epidermis, with or without the dermis, leading to exfoliation and removal of superficial lesions, followed by regeneration of new epidermal and dermal tissues. The present study was directed toward safety concerns associated with superficial chemical peeling with glycolic acid (GA in different concentrations at patients with acne tip I. A sample of 90 patients of either sex, aged between 17 to 21 years, were included in the study and submitted to superficial chemical peeling for acne vulgaris. The study lasted eight weeks and peeling sessions were carried out in each patient. Tolerance to the procedure and any undesirable effects noted during these sessions were recorded. For data statistical analysis and interpretation of results, software program “SPSS version 13” was used. Results were expressed through the descriptive statistics, as simple frequencies and percentages, while for establishing of statistically significant differences, in use was Friedman’s test of significance. Almost all the patients tolerated the procedure well. Of totally 90 patients, only six, at the end of therapy experienced hard erythema, only ten, at the end of therapy experienced hard desquamation and only eleven, at the end of therapy experienced hard sensation of pulling of facial skin. Chemical peeling with glycolic acid is a well tolerated and safe treatment modality in acne type I.

The efficacy of 5% dapsone gel plus oral isotretinoin versus oral isotretinoin alone in acne vulgaris: A randomized double-blind study

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Faghihi, Gita; Rakhshanpour, Mehrdad; Abtahi-Naeini, Bahareh; Nilforoushzadeh, Mohammad Ali

2014-01-01

Background: Acne vulgaris, a common human skin condition, is an inflammatory disease characterized by comedones, papules, nodules and possibly scarring. This study aimed to evaluate the efficacy of a combination of 5% dapsone gel plus oral isotretinoin in the treatment of acne vulgaris. Materials and Methods: A randomized, placebo-controlled, study was carried out on patients with moderate to severe acne. The patients were randomly divided in two groups: (dapsone gel and vehicle gel). All Patients were administered oral isotretinoin 20 mg daily and topical gel twice a day for 8 weeks. The Global Acne Assessment Score (GAAS), the number lesions and side-effects were documented at base line and weeks 4, 8 and 12. Results: A total of 58 patients (age range: 18-25 years) were included in our study. The number of lesions was significantly lower in the dapsone-treated group at all follow-up visits (P < 0.001). The mean GAAS score in the dapsone-treated group and in the Placebo-treated group decreased, but there was no statistical difference in two groups (P < 0.001). The side-effects on the dapsone-treated group were a mild burning sensation in 7 patients (24.13%), mild erythema of the skin and mild dryness in 4 (13.79%) and 3 (10.34%) cases respectively (P < 0.001). In our study, adverse effects were common but they were minor and tolerable. No clinically significant changes in laboratory parameters were observed (P < 0.001). Conclusions: Dapsone gel was an effective medication for patients who received isotretinoin for acne vulgaris treatment resulting in a significant reduction of the number of lesions. PMID:25250291

Techniques for Optimizing Surgical Scars, Part 2: Hypertrophic Scars and Keloids.

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Potter, Kathryn; Konda, Sailesh; Ren, Vicky Zhen; Wang, Apphia Lihan; Srinivasan, Aditya; Chilukuri, Suneel

2017-01-01

Surgical management of benign or malignant cutaneous tumors may result in noticeable scars that are of great concern to patients, regardless of sex, age, or ethnicity. Techniques to optimize surgical scars are discussed in this three-part review. Part 2 focuses on scar revision for hypertrophic and keloids scars. Scar revision options for hypertrophic and keloid scars include corticosteroids, bleomycin, fluorouracil, verapamil, avotermin, hydrogel scaffold, nonablative fractional lasers, ablative and fractional ablative lasers, pulsed dye laser (PDL), flurandrenolide tape, imiquimod, onion extract, silicone, and scar massage.

Acne

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... squeezing existing pimples. Scrubbing your skin too harshly. Chocolate, dirt, and sexual activity do not cause acne. ... of Sun ExposureIt is important to know the benefits and dangers of sun exposure.How to Protect ...

Acne is not Associated with yet Uncultured Bacteria

DEFF Research Database (Denmark)

Bek-Thomsen, Malene; Lomholt, Hans Bredsted; Kilian, Mogens

2008-01-01

Current clinical and microbiological information on acne fail to demonstrate a clear association between particular species, including Propionibacterium acnes, and disease, and the disease continues to be a considerable problem. To test if acne is associated with hitherto uncultured bacteria...... residing in diseased skin follicles, sequencing and phylogenetic analysis of approximately 5,700 amplified and cloned 16S rRNA genes were used to determine the microbial diversity in follicles from acne patients and healthy individuals and from superficial skin of acne patients. Follicles from healthy skin...... were exclusively colonized by P. acnes, whereas the follicular microbiota of acne patients, in addition, included S. epidermidis and minor proportions of other species. In comparison, samples from superficial skin showed a complex microbiota with 12 to 16 bacterial species represented. The study...

Topical Acne Treatments and Pregnancy

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Topical Acne Treatments In every pregnancy, a woman starts out with a 3-5% chance of having a baby ... This sheet talks about whether exposure to topical acne treatments may increase the risk for birth defects ...

A pilot study on efficacy treatment of acne vulgaris using a new method: results of a randomized double-blind trial with Acne Dressing.

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Chao, Chao-Ming; Lai, Wei-Yu; Wu, Bai-Yao; Chang, Hung-Chia; Huang, Wei-Shuan; Chen, Yu-Fei

2006-01-01

For many years the positive effect of hydrocolloid dressings on skin-related conditions attracted the attention of the medical scientific community. The use of Acne Dressing, a tape of hydrocolloid dressing, for the treatment of acne has not been reported previously. The aim of this study was to evaluate the clinical efficacy and beneficial effect of Acne Dressing on the marker for sebum output evaluations. We also determined the cosmetic outcome of this application during the treatment of acne and whether the material could prevent hand touching and UVB light from reaching the skin surface. The objective of this study was to assess improvement in acne vulgaris and tolerability during one week of short contact treatment with Acne Dressing compared to skin tapes. Efficacy data specific to treatment of acne vulgaris with Acne Dressing (3M Health Care) from a double-blind, randomized, skin types-controlled study is reported. A total of 20 patients with mild-to-moderate acne vulgaris applied the skin tapes or Acne Dressing every two days for up to one week. Twenty patients were enrolled in this study: ten patients received Acne Dressing and ten patients received skin tapes. Both groups showed decreases from baseline to the end of treatment in the mean of the overall severity scale (decrease of 1.37 from 1.8 to 0.43 with Acne Dressing and 0.28 from 1.08 to 0.8 with skin tapes). A statistically significant greater reduction was observed over a period of three to seven days in the overall severity of acne and inflammation in the Acne Dressing group compared with the mono-therapy (skin tapes) group. Similarly, Acne Dressing resulted in a significantly greater improvement in the redness, oiliness, dark pigmentation, and sebum casual level at days 3, 5, and 7. The ratio of transmission of UVB light with Acne Dressing was 7.4%, and 38% with skin tapes, which shows less UVB light reaching the skin surface with the Acne Dressing. No significant adverse events were identified in

Evidence on acne therapy

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Caroline Sousa Costa

Full Text Available Among the current treatments available for acne vulgaris, many widely practiced options lack support from studies at the best level of scientific evidence. The aim of this narrative review was to present the very latest information on topical and systemic treatments for acne vulgaris. Information from systematic reviews and well-designed clinical trials, obtained through a systematic search of the major medical databases, is emphasized. There are important issues regarding the clinical management of acne that still lack consistent grounding in scientific evidence. Among these are the optimum dose and duration of treatment with oral antibiotics that can be given without inducing bacterial resistance, and the safety of oral isotretinoin.

Cardiff acne disability index in Sarawak, Malaysia.

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Yap, Felix Boon-Bin

2012-05-01

Acne is considered a cosmetic nuisance in Malaysia since no insurance coverage is provided for its treatment. Its psychological impact is unknown. The aim of this study is to determine the impact of acne on quality of life and its relationship with severity. A cross-sectional study using the Cardiff acne disability index (CADI) and Global Acne Grading System for acne severity grading was done in three government-run dermatology clinics in Sarawak, Malaysia. The study cohort of 200 patients had a mean CADI score of 5.1. Most of the patients (59.5%) had mild CADI impairment, with the domain of feelings most affected. Patients with a family income 0.05). The correlation between CADI and mild acne severity was low (Pearson correlation coefficient=0.35; pSarawak was moderate and must be addressed. It should be viewed as a psychologically disabling disease requiring optimal management and resource allocation.

Preliminary results in single-step wound closure procedure of full-thickness facial burns in children by using the collagen-elastin matrix and review of pediatric facial burns.

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Demircan, Mehmet; Cicek, Tugrul; Yetis, Muhammed Ikbal

2015-09-01

Management of full-thickness facial burns remains one of the greatest challenges. Controversy exists among surgeons regarding the use of early excision for facial burns. Unfortunately, delayed excision of deeper burns often results in more scarring and subsequent reconstruction becomes more difficult. A collagen-elastin matrix is used to improve the quality of the reconstructed skin, to reduce scarring and to prevent wound contraction. It serves as a foundation for split thickness skin graft and enhances short and long-term results. We report the usage of a collagen-elastin matrix during single-step wound closure technique of severe full-thickness facial burns in 15 children with large burned body surface area, and also we review the literature about pediatric facial burns. There were 15 pediatric patients with severe facial burns, 8 girls and 7 boys ranging in age from 10 months to 12 years, mean age 7 years and 6 months old. The facial burn surface area (FBSA) among the patients includes seven patients with 100%, five with 75%, and three with 50%. The average total body surface area (TBSA) for the patients was 72%, ranging between 50 and 90%. 5 of the patients' admissions were late, more than four days after burns while the rest of the patients were admitted within the first four days (acute admission time). The burns were caused by flame in eight of the patients, bomb blast in four, and scalding in three. All patients were treated by the simultaneous application of the collagen-elastin matrix and an unmeshed split thickness skin graft at Turgut Özal Medical Center, Pediatric Burn Center, Malatya, Turkey. After the treatment only two patients needed a second operation for revision of the grafts. All grafts transplanted to the face survived. The average Vancouver scar scales (VSS) were 2.55±1.42, ranging between one and six, in the first 10 of 15 patients at the end of 6 months postoperatively. VSS measurements of the last 5 patients were not taken since the 6

Current and future treatment options for acne.

NARCIS (Netherlands)

Kerkhof, P.C.M. van de; Kleinpenning, M.M.; Jong, E.M.G.J. de; Gerritsen, M.J.P.; Dooren-Greebe, R.J. van; Alkemade, J.A.C.

2006-01-01

Acne is a frequent skin disease with abnormalities in the process of keratinization, sebaceous gland functioning and inflammation. In this review, our understanding of the pathogenesis of acne has been updated. An overview of efficacy and side effects of available anti-acne treatments is presented.

The Usefulness of Leukosan SkinLink for Simple Facial Laceration Repair in the Emergency Department

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Hyunjoo Kim

2015-07-01

Full Text Available BackgroundRepair of facial laceration in the emergency department can pose a number of difficulties. Children can be uncooperative, but adults can also be if they have sustained head trauma or are intoxicated. Leukosan SkinLink consists of topical adhesive and adhesive tape that can be applied easily to long or tense wounds. In this study, the authors compared conventional suturing with Leukosan SkinLink for facial laceration patients in the emergency department.MethodsThe prospective study was carried out from March 2013 to September 2013 with linear facial laceration patients visiting the emergency department. Exclusion criteria were open fractures, joint injuries, skin defects, hairy skin, and mucosa. The author used Leukosan SkinLink for skin closure in the experimental group and used conventional suturing in the control group. The scar evaluation using the Patient and Observer Scar Assessment Scale (POSAS along with satisfaction scores, procedure times, and complications were compared.ResultsA total of 77 patients (30 in the control group and 47 in the experimental group participated and underwent follow-up for 6 months postoperatively. The scar assessment using the POSAS and the satisfaction score in both groups were similar. The average procedure time in the experimental group was shorter. In the control group, there were four cases of wound dehiscence, two of infection, and one of skin necrosis, whereas four cases of wound dehiscence and one allergic reaction occurred in the experimental group.ConclusionsWith a simple application technique, Leukosan SkinLink is a new effective method for facial laceration repair especially useful for children and uncooperative adults.

[Fat grafting in facial burns sequelae].

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Viard, R; Bouguila, J; Voulliaume, D; Comparin, J-P; Dionyssopoulos, A; Foyatier, J-L

2012-06-01

Fat graft is now part of the armamentarium in face plastic surgery. It is successfully used in burn scars. The aim of our study is the discussion of the value of this technique in optimizing cosmetic result of burns face sequelae. Fifteen adult patients (10 females and five males) with scars resulting from severe burns 2 to 9 years previously were selected. The patients were treated by injection of adipose tissue harvested from abdominal subcutaneous fat and processed according to Coleman's technique. Two to three injections were administered at the dermohypodermal junction. Ages, sexes, aetiology of burn, facial burn sequelae, recipient sites, quantity of fat injected, aesthetic results are discussed. Patient age ranged from 21 to 55 years (average: 38). The mean follow-up of the study was 66 months (23-118). Patients received 7.5 (5-11) facial restorative surgeries before fat graft. Patients underwent two sessions of fat transfer, 33cc average per session. We did not report any complications. The clinical appearance, discussed by three surgeons and subjective patient feelings, after a 6-month follow-up period, suggests considerable improvement in the mimic features, skin texture, and thickness. The result is good in 86% of cases and acceptable in the other cases. Burns sequelae offer local conditions which justify special cannula can cross fibrosis and explaining the value of multiplying the sessions. Indications for lipostructure include four distinct nosological situations, sometimes combined. Lipostructure can restore a missing relief, filling a localized depression, reshape a lack of face volume or smooth a scarring skin. Fat graft seems to complete and improve the results of the standard surgical approach in burned face. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

Energy-Based Devices in Treatment of Acne Vulgaris.

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Handler, Marc Z; Bloom, Bradley S; Goldberg, David J

2016-05-01

Acne vulgaris is a chronic dermatologic complaint with a multifactorial cause. Traditionally, antibiotics and retinoids have been used to manage the condition; patient compliance has been an ongoing issue. A variety of energy-based devices have been reported to be effective in the treatment of acne vulgaris. To review and summarize the current literature specific to treatment of acne vulgaris with energy-based devices. A review of the current literature of energy-based devices used for the treatment of acne vulgaris. Although limited randomized controlled trials for the treatment of acne have been performed, significant clinical improvement of acne vulgaris, especially of inflammatory lesions, has been demonstrated with a variety of energy-based devices. Newer approaches may lead to even better results.

Significance of diet in treated and untreated acne vulgaris

Science.gov (United States)

Szmurło, Agnieszka; Sińska, Beata

2016-01-01

The relationship between diet and acne is highly controversial. Several studies during the last decade have led dermatologists to reflect on a potential link between diet and acne. This article presents the latest findings on a potential impact that diet can have on pathogenesis of acne vulgaris. The association between diet and acne can no longer be dismissed. Compelling evidence shows that high glycemic load diets may exacerbate acne. Dairy ingestion appears to be weakly associated with acne and the roles of omega-3 fatty acids, dietary fiber, antioxidants, vitamin A, zinc and iodine remain to be elucidated. The question of what the impact of diet is on the course of acne vulgaris still remains unclear. PMID:27279815

Do generalists and specialists agree on descriptive acne morphology?

DEFF Research Database (Denmark)

Yazdanyar, S; Bryld, L E; Heidenheim, M

2013-01-01

BACKGROUND: Acne is a common skin disease, which is treated by many different specialities. Clinical guidelines for treatment are based on the recognition of acne morphology. The assessment of acne morphology is therefore an important element of the proper diagnosis and treatment of acne. OBJECTIVE......: To evaluate the level of congruence in the assessment of acne morphology in General Practitioners (GPs) and Dermatologists compared to the assessment of an expert. METHODS: The study was conducted during 2008-2009. Randomly selected GP and Dermatologists Practitioners, (DPs) from Denmark were invited...... in the distribution of answers. CONCLUSION: GPs described acne morphology recognized clinical hallmarks of severity in acne less well than dermatologists and were far less consistent....

Multilocus sequence typing and phylogenetic analysis of Propionibacterium acnes

DEFF Research Database (Denmark)

Kilian, Mogens; Scholz, Christian F. P.; Lomholt, Hans B.

2012-01-01

Propionibacterium acnes is a commensal of human skin but is also implicated in the pathogenesis of acne vulgaris, in biofilm-associated infections of medical devices and endophthalmitis, and in infections of bone and dental root canals. Recent studies associate P. acnes with prostate cancer...... schemes were compared with reference to a phylogenetic tree based on 78 P. acnes genomes and their gene contents. Further support for a basically clonal population structure of P. acnes and a scenario of the global spread of epidemic clones of P. acnes was obtained. Compared to the Belfast scheme...

Development of Acne therapeutic hydrogel patches by radiation technology

Energy Technology Data Exchange (ETDEWEB)

Lim, Younmook; Nho, Youngchang; Gwon, Huijeong; Park, Jongseok; Kim, Jinkyu; Kim, Yongsoo

2012-04-15

In this project, hydrogel patches containing herbal extracts mixture were developed by radiation technology for acne treatment. Propionibacterium acnes (P. acnes), one of the anaerobic bacterium, is the cause of inflammatory acne. To find novel mediation for inflammation of P. acnes, we confirmed the anti-bacterial and anti-inflammatory activities of several herbal extracts against P. acnes. The water extracts from five dried herbs, Phellodendron amurense Rupr., Paeonia lactiflora Pallas., Houttuynia cordata Thumb., Agrimonia pilosa Ledeb. and Glycyrrhiza uralensis Fisch., were mixed into biocompatible polymers and irradiated by using gamma-ray to prepare hydrogels. The hydrogels containing herbal extracts mixture initiated to decrease the growth of P. acnes and reduced the production of pro-inflammatory cytokines, TNF-{alpha}, IL-8, IL-1{beta} and IL-6, in experiment with human monocytic THP-1 cells treated with heat-killed P. acnes at 1 mg/ml of mixture concentration.

Development of Acne therapeutic hydrogel patches by radiation technology

International Nuclear Information System (INIS)

Lim, Younmook; Nho, Youngchang; Gwon, Huijeong; Park, Jongseok; Kim, Jinkyu; Kim, Yongsoo

2012-04-01

In this project, hydrogel patches containing herbal extracts mixture were developed by radiation technology for acne treatment. Propionibacterium acnes (P. acnes), one of the anaerobic bacterium, is the cause of inflammatory acne. To find novel mediation for inflammation of P. acnes, we confirmed the anti-bacterial and anti-inflammatory activities of several herbal extracts against P. acnes. The water extracts from five dried herbs, Phellodendron amurense Rupr., Paeonia lactiflora Pallas., Houttuynia cordata Thumb., Agrimonia pilosa Ledeb. and Glycyrrhiza uralensis Fisch., were mixed into biocompatible polymers and irradiated by using gamma-ray to prepare hydrogels. The hydrogels containing herbal extracts mixture initiated to decrease the growth of P. acnes and reduced the production of pro-inflammatory cytokines, TNF-α, IL-8, IL-1β and IL-6, in experiment with human monocytic THP-1 cells treated with heat-killed P. acnes at 1 mg/ml of mixture concentration

Self-reported acne is not associated with prostate cancer

NARCIS (Netherlands)

Cremers, R.G.; Aben, K.K.; Verrneulen, S.H.; den Heijer, M.; van Oort, I.M.; van de Kerkhof, P.C.; Schalken, JA; Kiemeney, L.A.

2014-01-01

Objective: Some studies have suggested an inverse association between acne vulgaris and the acne-related bacterium Propionibacterium acnes and prostate cancer (PCa). Self-reported acne might be an easily obtainable marker to identify men at relatively low risk of PCa and might be incorporated into

Self-reported acne is not associated with prostate cancer

NARCIS (Netherlands)

Cremers, R.G.H.M.; Aben, K.K.H.; Vermeulen, S.; Heijer, M. den; Oort, I.M. van; Kerkhof, P.C.M. van de; Schalken, J.A.; Kiemeney, L.A.L.M.

2014-01-01

OBJECTIVE: Some studies have suggested an inverse association between acne vulgaris and the acne-related bacterium Propionibacterium acnes and prostate cancer (PCa). Self-reported acne might be an easily obtainable marker to identify men at relatively low risk of PCa and might be incorporated into

Acné: un nuevo aporte terapéutico Acne: a new therapeutical approach

Directory of Open Access Journals (Sweden)

C. M. M. Paiva

2007-06-01

Full Text Available El acné es una patología que afecta casi al 80% de la población en algún momento de la vida. Múltiples terapéuticas locales y generales han sido utilizadas. En el presente estudio evaluamos la eficacia y seguridad del tratamiento de las lesiones activas de acné con luz pulsada como única terapéutica. Fueron tratados 91 pacientes y los resultados indican que la fototerapia es una opción terapéutica local con pocos efectos colaterales que evitaría el uso de drogas por vía general. Estos resultados fueron obtenidos en un período promedio de 4 semanas.Acne is a very common disease which affects a lot of people around the world. Multiple treatments options are available nowadays. In this study we evaluate the efficacy of IPL in active lesions of acne, as unique therapy. We treated 91 patients and results show the reduction of lesions in periods of follow-up between 4 to 6 weeks and provide a non-invasive alternative with drugs with potential secondary effects.

Topical erythromycin vs blank vehicle in a multiclinic acne study.

Science.gov (United States)

Jones, E L; Crumley, A F

1981-09-01

A stable solution of erythromycin was developed using a vehicle of ethanol, propylene glycol, and citric acid buffer. In a controlled, randomized, double-blind comparison, a 2% solution of erythromycin applied to moderately severe facial acne was found to be superior to the blank vehicle in reducing the number of inflamed papules. During a period of 12 weeks, such papules were reduced by 56% in the erythromycin group, compared with 33% in the blank vehicle group. In the erythromycin group, 62% of the subjects had a good or excellent response, compared with 27% of those in the blank vehicle group. Adverse effects were similar in type in both groups and included redness, scaling, dryness, oiliness, burning, itching, and irritation of the eyes. No allergic reactions or skin infections were encountered.

21 CFR 333.310 - Acne active ingredients.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 5 2010-04-01 2010-04-01 false Acne active ingredients. 333.310 Section 333.310... FOR HUMAN USE TOPICAL ANTIMICROBIAL DRUG PRODUCTS FOR OVER-THE-COUNTER HUMAN USE Topical Acne Drug Products § 333.310 Acne active ingredients. The active ingredient of the product consists of any of the...

Complementary therapies for acne vulgaris.

Science.gov (United States)

Cao, Huijuan; Yang, Guoyan; Wang, Yuyi; Liu, Jian Ping; Smith, Caroline A; Luo, Hui; Liu, Yueming

2015-01-19

Acne is a chronic skin disease characterised by inflamed spots and blackheads on the face, neck, back, and chest. Cysts and scarring can also occur, especially in more severe disease. People with acne often turn to complementary and alternative medicine (CAM), such as herbal medicine, acupuncture, and dietary modifications, because of their concerns about the adverse effects of conventional medicines. However, evidence for CAM therapies has not been systematically assessed. To assess the effects and safety of any complementary therapies in people with acne vulgaris. We searched the following databases from inception up to 22 January 2014: the Cochrane Skin Group Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL; 2014,Issue 1), MEDLINE (from 1946), Embase (from 1974), PsycINFO (from 1806), AMED (from 1985), CINAHL (from 1981), Scopus (from 1966), and a number of other databases listed in the Methods section of the review. The Cochrane CAM Field Specialised Register was searched up to May 2014. We also searched five trials registers and checked the reference lists of articles for further references to relevant trials. We included parallel-group randomised controlled trials (or the first phase data of randomised cross-over trials) of any kind of CAM, compared with no treatment, placebo, or other active therapies, in people with a diagnosis of acne vulgaris. Three authors collected data from each included trial and evaluated the methodological quality independently. They resolved disagreements by discussion and, as needed, arbitration by another author. We included 35 studies, with a total of 3227 participants. We evaluated the majority as having unclear risk of selection, attrition, reporting, detection, and other biases. Because of the clinical heterogeneity between trials and the incomplete data reporting, we could only include four trials in two meta-analyses, with two trials in each meta-analysis. The categories of CAM included

Yashada bhasma (Zinc calx) and Tankana (Borax) inhibit Propionibacterium acne and suppresses acne induced inflammation in vitro.

Science.gov (United States)

Sandeep Varma, R; Shamsia, S; Thiyagarajan, O S; Vidyashankar, S; Patki, P S

2014-08-01

Yashada bhasma (YB) and Tankana (TA) are well characterized minerals used in traditional medicine for the treatment of various skin ailments. Yashada bhasma and TA are a unique preparation of zinc and borax, respectively. The study was conducted to evaluate the in vitro inhibitory effect of YB, TA and its combination (YBTA) on Propionibacterium acne growth and P. acne-induced inflammation. The minerals were tested for anti-P. acne activity by disc diffusion and broth microdilution methods. The effect of these minerals on P. acne induced TNF-α and IL-8 production and gene expression were studied in THP-1 cells. In vitro toxicity was tested on human keratinocytes (HaCaT) and mouse embryonic fibroblasts (NIH3T3) using MTT assay. The minimum inhibitory concentrations (MIC values) for YB, TA and YBTA against P. acne were 0.1 ± 0.2, 1.9 ± 0.5 and 0.3 ± 0.5 mg mL(-1) , respectively. YB, TA and YBTA inhibited TNFα by 57.57%, 59.09% and 68.93% and IL-8 production by 48.76%, 47.92% and 51.13% in P. acne-stimulated THP-1 cells, respectively. The CTC50 values on HaCaT and NIH3T3 was 17.44 ± 0.5 and 16.37 ± 0.2 μg mL(-1) for YB, 1023.03 ± 4.0 and 1286.17 ± 4.4 μg mL(-1) for TA and 89.12 ± 2.3 and 111.58 ± 3.5 μg mL(-1) for YBTA, respectively. The present study revealed the inhibitory effect of YB, TA and YBTA on P. acne growth and inflammation. Clinical studies have suggested the anti-acne benefits of formulations containing YB and TA. The findings obtained from the present in vitro studies provide evidence to support the mechanism of anti-acne properties of YB and TA. © 2014 Society of Cosmetic Scientists and the Société Française de Cosmétologie.

Is acne a sign of androgen excess disorder or not?

Science.gov (United States)

Uysal, Gulsum; Sahin, Yılmaz; Unluhizarci, Kursad; Ferahbas, Ayten; Uludag, Semih Zeki; Aygen, Ercan; Kelestimur, Fahrettin

2017-04-01

Acne is not solely a cosmetic problem. The clinical importance of acne in the estimation of androgen excess disorders is controversial. Recently, the Amsterdam ESHRE/ASRM-sponsored third PCOS Consensus Workshop Group suggested that acne is not commonly associated with hyperandrogenemia and therefore should not be regarded as evidence of hyperandrogenemia. Our aim was to investigate whether acne is a sign of androgen excess disorder or not. This is a cross sectional study that was performed in a university hospital involving 207 women, aged between 18 and 45 years, suffering mainly from acne. The women were assigned as polycystic ovary syndrome (PCOS), idiopathic hirsutism (IH), idiopathic hyperandrogenemia (IHA). Women with acne associated with any of the androgen excess disorders mentioned above were named as hyperandrogenemia associated acne (HAA). Women with acne but without hirsutism and hyperandrogenemia and having ovulatory cycles were named as "isolated acne". Serum luteinizing hormone, follicle stimulating hormone, estradiol, progesterone, 17-hydroxyprogesterone, dehydroepiandrosterone-sulfate (DHEAS), androstenedione, total testosterone and lipid levels were measured. Acne score was similar between the women with isolated acne and HAA. The most common cause for acne was PCOS and only 28% of the women had isolated acne. 114 (55%) women had at least one raised serum androgen level. In this study, 72% of acneic women had clinical and/or biochemical hyperandrogenemia. In contrast to the suggestion of ESHRE/ASRM-sponsored third PCOS Consensus Workshop Group, our data indicate that the presence of androgen excess disorders should be evaluated in women presenting with acne. Copyright © 2017 Elsevier B.V. All rights reserved.

Nanoparticle Stabilized Liposomes for Acne Therapy

Science.gov (United States)

Fu, Victoria

Acne vulgaris is a common skin disease that affects over 40 million people in the United States alone. The main cause of acne vulgaris is Propionibacterium acnes (P. acnes), resides deep in the pores and follicles of the skin in order to feed on oil produced by the sebaceous glands. The liposome is a lipid based nanoparticle with numerous advantages over free drug molecules as an acne treatment alternative. Bare liposomes loaded with lauric acid (LipoLA) were found to show strong antimicrobial activity against P. acnes while generating minimal toxicity. However, the platform is limited by the spontaneous tendency of liposomes to fuse with each other. Attaching nanoparticles to the surface of liposomes can overcome this challenge by providing steric repulsion and reduce surface tension. Thus, carboxyl-functionalized gold nanoparticles (AuC) were attached to the surface of liposomes (AuC-liposomes) loaded with doxycycline, a general tetracycline antibiotic. These particles were found to have a diameter of 120 nm and a zeta potential of 20.0 mV. Both fluorescent and antimicrobial studies demonstrated that based on electrostatic interaction, negatively charged AuC attached to the liposome's positively charged surface and stabilized liposomes in a neutral pH environment (pH = 7.4). Upon entering the skin's acidic environment (pH = 4), AuC detached from the liposome's surface and liposomes could fuse with P. acnes residing in the pores. Furthermore, toxicity studies showed that AuC-liposomes did not induce any significant toxicity, while two of the leading over-the-counter therapies, benzoyl peroxide and salicylic acid, generated substantial skin irritation.

Multiple Activities of Punica granatum Linne against Acne Vulgaris.

Science.gov (United States)

Lee, Chia-Jung; Chen, Lih-Geeng; Liang, Wen-Li; Wang, Ching-Chiung

2017-01-12

Acne is a common skin condition with sebum overproduction, hyperkeratosis, Propionibacterium acnes ( P . acnes ) and Staphylococcus aureus , and inflammation. Punica granatum (pomegranate) is well-known for its anti-inflammatory effects; however, few studies have discussed the anti-acne effects of pomegranate. In this study, we found that pomegranate extract (PG-E) significantly reduced P . acnes -induced edema in Wistar rat ears. Therefore, an evaluation platform using multiple pathogenic mechanisms of acne was established to explore the anti-acne effects of pomegranate. Results showed that PG-E inhibited bacterial growth and lipase activity. Through a bioguided-fractionation-isolation system, four hydrolysable tannins, punicalagin ( 1 ), punicalin ( 2 ), strictinin A ( 3 ), and granatin B ( 4 ), were isolated. Compounds 1 and 2 had greater anti-bacterial activities and anti-testosterone-induced HaCaT proliferative effects than the others. Compounds 1 , 3 , and 4 displayed lipase inhibitory effects. Compound 4 decreased cyclooxygenase-2 expression and downregulated prostaglandin E₂ production in heat-killed P . acnes -treated RAW 246.7 cells. In conclusion, PG-E is abundant in hydrolysable tannins that display multiple anti-acne capacities, including anti-bacterial, anti-lipase, anti-keratinocyte proliferation, and anti-inflammatory actions. Hence, PG-E has great potential in the application of anti-acne and skin-care products, and punicalagin ( 1 ), the most effective component in PG-E, can be employed as a quality control marker.

Fraxel laser indications and long-term follow-up.

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Tanzi, Elizabeth L; Wanitphakdeedecha, Rungsima; Alster, Tina S

2008-01-01

Fractional photothermolysis, based on creating spatially precise microscopic thermal wounds, is performed using a 1550-nm erbium fiber laser that targets water-containing tissue to effect the photocoagulation of narrow, sharply defined columns of skin known as microscopic thermal zones. According to the authors, Fraxel resurfacing has been shown to be both safe and effective for facial and nonfacial photodamage, atrophic acne scars, hypopigmented scars, and dyspigmentation. Because only a fraction of the skin is treated during a single session, a series (typically 3 to 6 treatments) of fractional resurfacing at 2- to 4-week intervals is required for the best clinical improvement. It is the authors' experience that a series of Fraxel treatments can achieve a similar clinical result for atrophic scars compared with traditional ablative laser skin resurfacing. However, the improvement seen after a series of Fraxel treatments for perioral laxity and rhytides often falls short of the impressive results that can be achieved with ablative laser skin resurfacing.

Antimicrobial effects of Indian medicinal plants against acne ...

African Journals Online (AJOL)

Propionibacterium acnes and Staphylococcus epidermidis have been recognized as pus-forming bacteria triggering an inflammation in acne. The present study was conducted to evaluate antimicrobial activities of Indian medicinal plants against these etiologic agents of acne vulgaris. Ethanolic extracts of Hemidesmus ...

Proteomic identification of secreted proteins of Propionibacterium acnes

Directory of Open Access Journals (Sweden)

Holland Carsten

2010-08-01

Full Text Available Abstract Background The anaerobic Gram-positive bacterium Propionibacterium acnes is a human skin commensal that resides preferentially within sebaceous follicles; however, it also exhibits many traits of an opportunistic pathogen, playing roles in a variety of inflammatory diseases such as acne vulgaris. To date, the underlying disease-causing mechanisms remain ill-defined and knowledge of P. acnes virulence factors remains scarce. Here, we identified proteins secreted during anaerobic cultivation of a range of skin and clinical P. acnes isolates, spanning the four known phylogenetic groups. Results Culture supernatant proteins of P. acnes were separated by two-dimensional electrophoresis (2-DE and all Coomassie-stained spots were subsequently identified by MALDI mass spectrometry (MALDI-MS. A set of 20 proteins was secreted in the mid-exponential growth phase by the majority of strains tested. Functional annotation revealed that many of these common proteins possess degrading activities, including glycoside hydrolases with similarities to endoglycoceramidase, β-N-acetylglucosaminidase and muramidase; esterases such as lysophospholipase and triacylglycerol lipase; and several proteases. Other secreted factors included Christie-Atkins-Munch-Petersen (CAMP factors, glyceraldehyde 3-phosphate dehydrogenase (GAPDH, and several hypothetical proteins, a few of which are unique to P. acnes. Strain-specific differences were apparent, mostly in the secretion of putative adhesins, whose genes exhibit variable phase variation-like sequence signatures. Conclusions Our proteomic investigations have revealed that the P. acnes secretome harbors several proteins likely to play a role in host-tissue degradation and inflammation. Despite a large overlap between the secretomes of all four P. acnes phylotypes, distinct differences between predicted host-tissue interacting proteins were identified, providing potential insight into the differential virulence

Autoinflammatory syndromes associated with hidradenitis suppurativa and/or acne

DEFF Research Database (Denmark)

Vinkel, Caroline; Thomsen, Simon F.

2017-01-01

Autoinflammatory syndromes associated with hidradenitis suppurativa (HS) and/or acne are rare but potentially debilitating disorders if not diagnosed and treated correctly. They share a common pathogenesis involving a dysregulated innate immune system with abnormal interleukin (IL)-1 signaling...... leading to sterile neutrophilic inflammation. The clinical features are recurrent episodes of fever, painful arthritis, and skin lesions consistent with HS, acne, and pyoderma gangrenosum (PG) accompanied by elevated systemic inflammatory markers in blood. So far, several clinically different syndromes...... have been reported in the literature including pyoderma gangrenosum, acne, and pyogenic arthritis (PAPA), pyoderma gangrenosum, acne, and hidradenitis suppurativa (PASH), pyoderma gangrenosum, acne, and spondyloarthritis (PASS), pyoderma gangrenosum, acne, pyogenic arthritis, and hidradenitis...

21 CFR 333.350 - Labeling of acne drug products.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 5 2010-04-01 2010-04-01 false Labeling of acne drug products. 333.350 Section... Acne Drug Products § 333.350 Labeling of acne drug products. (a) Statement of identity. The labeling of the product contains the established name of the drug, if any, and identifies the product as an “acne...

[Contribution of botulinum toxin to maxillo-facial surgery].

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Batifol, D; de Boutray, M; Goudot, P; Lorenzo, S

2013-04-01

Botulinum toxin has a wide range of use in maxillo-facial surgery due to its action on muscles, on the glandular system, and against pain. It already has been given several market authorizations as indicated for: blepharospasm, spasmodic stiff neck, and glabellar lines. Furthermore, several studies are ongoing to prove its effectiveness and usefulness for many other pathologies: treatment of pain following cervical spine surgery; action on salivary glands after trauma, hypertrophy, or hyper-salivation; analgesic action (acknowledged but still being experimented) on neuralgia, articular pain, and keloids scars due to its anti-inflammatory properties. Botulinum toxin injections in the cervico-facial area are more and more used and should be to be correctly assessed. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

A Honey Trap for the Treatment of Acne: Manipulating the Follicular Microenvironment to Control Propionibacterium acnes

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E. Anne Eady

2013-01-01

Full Text Available Today, as 40 years ago, we still rely on a limited number of antibiotics and benzoyl peroxide to treat inflammatory acne. An alternative way of suppressing the growth of Propionibacterium acnes is to target the environment in which it thrives. We conjecture that P. acnes colonises a relatively “extreme” habitat especially in relation to the availability of water and possibly related factors such as ionic strength and osmolarity. We hypothesise that the limiting “nutrient” within pilosebaceous follicles is water since native sebum as secreted by the sebaceous gland contains none. An aqueous component must be available within colonised follicles, and water may be a major factor determining which follicles can sustain microbial populations. One way of preventing microbial growth is to reduce the water activity ( of this component with a biocompatible solute of very high water solubility. For the method to work effectively, the solute must be small, easily diffusible, and minimally soluble in sebaceous lipids. Xylose and sucrose, which fulfil these criteria, are nonfermentable by P. acnes and have been used to reduce water activity and hence bacterial colonisation of wounds. A new follicularly targeted topical treatment for acne based on this approach should be well tolerated and highly effective.

Acne and the Internet.

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Zeichner, Joshua A; Del Rosso, James Q

2016-04-01

The Internet provides both education and miseducation for acne patients. Although some sites provide disease background information and objective treatment guidance, support networks, and research findings, others may seem to be objective on the surface, but are in reality run by untrained, self-proclaimed experts or are promotional in nature. Providers must be aware of the potential benefits and pitfalls the Internet provides for those suffering with acne. Copyright © 2016 Elsevier Inc. All rights reserved.

A facial reconstruction and identification technique for seriously devastating head wounds.

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Joukal, Marek; Frišhons, Jan

2015-07-01

Many authors have focused on facial identification techniques, and facial reconstructions for cases when skulls have been found are especially well known. However, a standardized facial identification technique for an unknown body with seriously devastating head injuries has not yet been developed. A reconstruction and identification technique was used in 7 cases of accidents involving trains striking pedestrians. This identification technique is based on the removal of skull bone fragments, subsequent fixation of soft tissue onto a universal commercial polystyrene head model, precise suture of dermatomuscular flaps, and definitive adjustment using cosmetic treatments. After reconstruction, identifying marks such as scars, eyebrows, facial lines, facial hair and partly hairstyle become evident. It is then possible to present a modified picture of the reconstructed face to relatives. After comparing the results with photos of the person before death, this technique has proven to be very useful for identifying unknown bodies when other identification techniques are not available. This technique is useful for its being rather quick and especially for its results. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

High Frequency of Fibromyalgia in Patients With Acne Vulgaris.

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Yazmalar, Levent; Çelepkolu, Tahsin; Batmaz, İbrahim; Sariyildiz, Mustafa Akif; Sula, Bilal; Alpayci, Mahmut; An, İsa; Burkan, Yahya Kemal; Uçak, Haydar; Çevik, Remzi

2016-06-01

This study aims to investigate the frequency of fibromyalgia syndrome and to specify fibromyalgia syndrome-associated clinical symptoms in patients with acne vulgaris. Eighty-eight patients (28 males, 60 females; mean age 23.2±5.1 years; range 18 to 40 years) with acne vulgaris and age, sex- and body mass index-similar 76 healthy controls (14 males, 62 females; mean age 24.5±2.9 years; range 18 to 35 years) were included. Acne vulgaris was evaluated by using the Global Acne Scale, while Hospital Anxiety and Depression Scale was used to evaluate anxiety. Fibromyalgia-associated pain, sleep disturbance, anxiety, and menstrual cycle disturbance were significantly more frequent in patients with acne vulgaris than controls. Also, the severity of anxiety and the number of tender points were significantly higher in the acne vulgaris patients than controls. This study indicates that patients with acne vulgaris have increased frequency of fibromyalgia syndrome than healthy controls (21.6% versus 5.3%, respectively).

[Using combined magnetotherapy in patients with acne].

Science.gov (United States)

Kul'chitskaia, D B; Orekhova, E M; Vasil'eva, E S

2004-01-01

Laser Doppler flowmetry discovered microcirculatory disorders in acne patients. Affected are arterioles as well as capillaries and venules. Combination of magnetotherapy with medication improves microcirculation in acne patients. More marked positive changes occurred in the microcirculatory system due to combined treatment compared to medication therapy only. Thus, laser Doppler flowmetry is a new, noninvasive method of assessing microcirculation in acne patients and can serve an objective criterion of treatment efficacy.

The epidemiology of acne vulgaris in late adolescence.

Science.gov (United States)

Lynn, Darren D; Umari, Tamara; Dunnick, Cory A; Dellavalle, Robert P

2016-01-01

Acne vulgaris is the most common skin condition affecting late adolescents across the globe. Although prior studies have evaluated epidemiologic patterns of acne vulgaris in various ethnicities and regions, adequate understanding of the worldwide burden of the disease associated with patients in their late adolescence (15-19-year olds) remains lacking. To assess the global burden of the disease associated with acne vulgaris for late adolescents (15-19-year olds) and provide an overview of the epidemiology, pathophysiology, and treatment options for acne in this population. Database summary study. Global Burden of Disease Study 2010 database. Global Burden of Disease regions comprised countries with prevalence of acne vulgaris between the ages of 15 and 19 years. Geographic region-level disability-adjusted life year rates (per 100,000 persons) associated with acne vulgaris in years 1990 through 2010. Median percentage change in disability-adjusted life year rates was estimated for each region across the specified study period. Acne vulgaris-associated disease burden exhibits global distribution and has continued to grow in prevalence over time within this population. This continued growth suggests an unmet dermatologic need worldwide for this disorder and potential opportunities for improved access and delivery of dermatologic care. Our analysis of the literature reveals numerous opportunities for enhanced patient care. To that end, we highlight some of the effective and promising treatments currently available and address important factors, such as sex, nationality, genetics, pathophysiology, and diet, as they relate to acne vulgaris in late adolescence.

Efficiency of Carbon Dioxide Fractional Laser in Skin Resurfacing.

Science.gov (United States)

Petrov, Andrej

2016-06-15

The aim of the study was to confirm the efficiency and safety of the fractional CO2 laser in skin renewal and to check the possibility of having a synergistic effect in patients who besides carbon dioxide laser are treated with PRP (platelet-rich plasma) too. The first group (Examined Group 1 or EG1) included 107 patients treated with fractional CO2 laser (Lutronic eCO2) as mono-therapy. The second group (Control Group or CG) covered 100 patients treated with neither laser nor plasma in the same period but subjected to local therapy with drugs or other physio-procedures under the existing protocols for treatment of certain diseases. The third group (Examined Group 2 or EG2) treated 25 patients with combined therapy of CO2 laser and PRP in the treatment of facial rejuvenation or treatment of acne scars. Patient's satisfaction, in general, is significantly greater in both examined groups (EG1 and EG2) (p skin is significant (χ2 = 39.41; df = 4; p skin was significantly lower in examined group (treated with laser), p = 0.0002. Multifunctional fractional carbon dioxide laser used in treatment of patients with acne and pigmentation from acne, as well as in the treatment of scars from different backgrounds, is an effective and safe method that causes statistically significant better effect of the treatment, greater patients' satisfaction, minimal side effects and statistically better response to the therapy, according to assessments by the patient and the therapist.

Multilocus Sequence Typing (MLST) and Phylogenetic Analysis of Propionibacterium acnes

DEFF Research Database (Denmark)

Kilian, Mogens; Scholz, Christian; Lomholt, Hans B

2011-01-01

Propionibacterium acnes is a commensal of human skin but is also implicated in the pathogenesis of acne vulgaris and in biofilm-associated infections of medical devices and endophthalmitis, and in infections of bone and dental root canals. Recent studies associate P. acnes with prostate cancer...... with reference to a phylogenetic tree based on 78 P. acnes genomes and their gene contents. Further support for a basically clonal population structure of P. acnes and a scenario of global spread of epidemic clones of P. acnes was obtained. Compared with the Belfast scheme, the Aarhus MLST scheme (http...

Facial Pores: Definition, Causes, and Treatment Options.

Science.gov (United States)

Lee, Sang Ju; Seok, Joon; Jeong, Se Yeong; Park, Kui Young; Li, Kapsok; Seo, Seong Jun

2016-03-01

Enlarged skin pores refer to conditions that present with visible topographic changes of skin surfaces. Although not a medical concern, enlarged pores are a cosmetic concern for a large number of individuals. Moreover, clear definition and possible causes of enlarged pores have not been elucidated. To review the possible causes and treatment options for skin pores. This article is based on a review of the medical literature and the authors' clinical experience in investigating and treating skin pores. There are 3 major clinical causes of enlarged facial pores, namely high sebum excretion, decreased elasticity around pores, and increased hair follicle volume. In addition, chronic recurrent acne, sex hormones, and skin care regimen can affect pore size. Given the different possible causes for enlarged pores, therapeutic modalities must be individualized for each patient. Potential factors that contribute to enlarged skin pores include excessive sebum, decreased elasticity around pores, and increased hair follicle volume. Because various factors cause enlarged facial pores, it might be useful to identify the underlying causes to be able to select the appropriate treatment.

Role of insulin resistance and diet in acne

Directory of Open Access Journals (Sweden)

Rashmi Kumari

2013-01-01

Full Text Available There is increasing evidence in support of the interplay of growth hormone (GH, insulin, and insulin-like growth factor-1 (IGF-1 signaling during puberty, which have a causal role in pathogenesis of acne by influencing adrenal and gonadal androgen metabolism. Milk consumption and hyperglycemic diets can induce insulin and IGF-1-mediated PI3K ⁄ Akt-activation inducing sebaceous lipogenesis, sebocyte, and keratinocyte proliferation, which can aggravate acne. Occurence of acne as part of various syndromes also provides evidence in favor of correlation between IGF-1 and acne.

Propionibacterium acnes: A Treatable Cause of Constrictive Pericarditis

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Daniel Cruz

2015-01-01

Full Text Available In this case report we share a case of infective Pericarditis caused by Propionibacterium acnes (P. acnes in an immune-competent, nonsurgical patient. This case and review will illustrate the importance of considering P. acnes as a cause of idiopathic pericardial effusion and effusive constrictive disease. The patient was a 61-year-old male with history of osteoarthritis of the knee. He received an intra-articular steroid injection in July 2013. Two months later, he presented with atrial fibrillation and heart failure. He was found to have pericardial and bilateral pleural effusions which grew P. acnes. This organism was initially considered to be contaminant; however, as P. acnes was isolated from both pleural and pericardial fluids, he was started on oral amoxicillin. He was noted to have recurrence of effusions within 2 weeks with evidence of constrictive physiology by echocardiography. Treatment was subsequently changed to intravenous Penicillin G with marked symptomatic improvement, resolution of pericardial/pleural effusions, and no echocardiographic evidence of constrictive pericarditis at 10 weeks follow-up. Pursuit and treatment of P. acnes could lead to prevention of constrictive pericarditis. We believe that further studies are needed to assess prevalence of P. acnes and response to intravenous Penicillin G in patients presenting with effusive constrictive disease.

Acne: a new model of immune-mediated chronic inflammatory skin disease.

Science.gov (United States)

Antiga, E; Verdelli, A; Bonciani, D; Bonciolini, V; Caproni, M; Fabbri, P

2015-04-01

Acne is a chronic inflammatory disease of the sebaceous-pilosebaceous unit. Interestingly, inflammation can be detected by histopathological examination and immuohistochemical analysis even in the apparently non-inflammatory acneic lesions, such as comedones. In the last years, it has been clearly demonstrated that acne development is linked to the combination of predisposing genetic factors and environmental triggers, among which a prominent role is played by the follicular colonization by Propionibacterium acnes (P. acnes). P. acnes displays several activities able to promote the development of acne skin lesions, including the promotion of follicular hyperkeratinisation, the induction of sebogenesis, and the stimulation of an inflammatory response by the secretion of proinflammatory molecules and by the activation of innate immunity, that is followed by a P. acnes-specific adaptive immune response. In addition, P. acnes-independent inflammation mediated by androgens or by a neurogenic activation, followed by the secretion in the skin of pro-inflammatory neuropeptides, can occur in acne lesions. In conclusion, acne can be considered as a model of immune-mediated chronic inflammatory skin disease, characterized by an innate immune response that is not able to control P. acnes followed by a Th1-mediated adaptive immune response, that becomes self-maintaining independently from P. acnes itself.

An update on the management of acne vulgaris

Directory of Open Access Journals (Sweden)

Jonette Keri

2009-06-01

Full Text Available Jonette Keri1,2, Michael Shiman11Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA; 2Dermatology Service, Miami VA Hospital, FL, USAAbstract: Acne vulgaris is a common skin disorder that can affect individuals from childhood to adulthood, most often occurring in the teenage years. Acne can have a significant physical, emotional, and social impact on an individual. Many different treatment options are available for the treatment of acne vulgaris. Commonly used topical treatments include benzoyl peroxide, antibiotics, sulfur and sodium sulfacetamide, azelaic acid, and retinoids. Systemic treatment is frequently used and includes the use of systemic antibiotics, oral contraceptives, antiandrogens, and retinoids. Other treatment modalities exist such as the use of superficial chemical peels as well as using laser and light devices for the treatment of acne. With the multitude of treatment options and the rapidly expanding newer technologies available to clinicians, it is important to review and be aware of the current literature and studies regarding the treatment of acne vulgaris.Keywords: acne vulgaris, treatment, benzoyl peroxide, antibiotics, retinoids, lasers

In vivo animal histology and clinical evaluation of multisource fractional radiofrequency skin resurfacing (FSR) applicator.

Science.gov (United States)

Sadick, Neil S; Sato, Masaki; Palmisano, Diana; Frank, Ido; Cohen, Hila; Harth, Yoram

2011-10-01

Acne scars are one of the most difficult disorders to treat in dermatology. The optimal treatment system will provide minimal downtime resurfacing for the epidermis and non-ablative deep volumetric heating for collagen remodeling in the dermis. A novel therapy system (EndyMed Ltd., Cesarea, Israel) uses phase-controlled multi-source radiofrequency (RF) to provide simultaneous one pulse microfractional resurfacing with simultaneous volumetric skin tightening. The study included 26 subjects (Fitzpatrick's skin type 2-5) with moderate to severe wrinkles and 4 subjects with depressed acne scars. Treatment was repeated each month up to a total of three treatment sessions. Patients' photographs were graded according to accepted scales by two uninvolved blinded evaluators. Significant reduction in the depth of wrinkles and acne scars was noted 4 weeks after therapy with further improvement at the 3-month follow-up. Our data show the histological impact and clinical beneficial effects of simultaneous RF fractional microablation and volumetric deep dermal heating for the treatment of wrinkles and acne scars.

Acne vulgaris: Perceptions and beliefs of Saudi adolescent males

Science.gov (United States)

Al-Natour, Sahar H.

2017-01-01

INTRODUCTION: Although acne vulgaris is common in adolescents, information on their understanding of acne is minimal. OBJECTIVES: To evaluate the perceptions and beliefs of Saudi youth on acne. MATERIALS AND METHODS: Three hundred twenty-nine male students (aged 13–22 years) from 6 secondary schools in the Eastern Saudi Arabia completed a self-reported questionnaire on knowledge, causation, exacerbating and relieving factors of acne. Data were analyzed by SPSS version 15.0. Results of subjects with acne, a family history of acne, and parents' educational levels were compared. Differences between the analyzed groups were assessed by a Chi-square test; p ≤ 0.05 was considered statistically significant. RESULTS: Over half (58.9%) of the participants considered acne a transient condition not requiring therapy. Only 13.1% knew that the proper treatment of acne could take a long time, even several years. Over half (52%) thought acne can be treated from the first or after few visits to the doctor. Popular sources of information were television/radio (47.7%), friends (45.6%), and the internet (38%). Only 23.4% indicated school as a source of knowledge. Reported causal factors included scratching (88.5%) and squeezing (82.1%) of pimples, poor hygiene (83.9%), poor dietary habits (71.5%), and stress (54.1%). Ameliorating factors included frequent washing of the face (52.9%), exercise (41.1%), sunbathing (24.1%), and drinking of mineral water (21%). The correlations of these facts are discussed. CONCLUSION: Results of this study point out that misconceptions of acne are widespread among Saudi youth. A health education program is needed to improve the understanding of the condition. PMID:28163574

Botanical and phytochemical therapy of acne: a systematic review.

Science.gov (United States)

Fisk, Whitney A; Lev-Tov, Hadar A; Sivamani, Raja K

2014-08-01

Acne is prevalent among adolescents and adults with significant psychological effects. Standard oral and topical therapies can have significant side effects including skin irritation, gastrointestinal upset, and the development of drug-resistant bacteria. The use of botanicals and phytochemicals in dermatological products is increasingly popular, and many patients are turning to these alternative therapies for treatment of acne. This study aimed to systematically review clinical studies that have investigated the use of botanical agents in the treatment of acne. PubMed and Embase databases were searched in March 2013 for trials assessing botanical therapies in the treatment of acne vulgaris. Data from these trials are presented, and methodology of each study is assessed. Twenty-three trials met inclusion criteria. Interventions included plant extracts, herbal formulations, and phytochemicals. All studies reported favorable results, and several showed equal or superior treatment to standard therapies. No serious adverse events were reported. Few studies were methodologically rigorous. Each botanical was studied in only one or two trials. Botanicals are promising therapies for acne vulgaris although further research is warranted, especially with regard to severe acne and acne resistant to conventional therapy. There is a need for standardized methods for grading acne and assessing therapeutic effects. Copyright © 2014 John Wiley & Sons, Ltd.

Severe acne vulgaris and tobacco smoking in young men.

Science.gov (United States)

Klaz, Itay; Kochba, Ilan; Shohat, Tzipora; Zarka, Salman; Brenner, Sarah

2006-08-01

As the relationship between tobacco smoking and acne remains unclear, we examined the relationship between cigarette smoking and severe acne in a large cohort of young men. Trained nurses interviewed subjects upon discharge from compulsory military service, regarding family history, habits, and tobacco smoking habits. Data was correlated with severe acne status, as diagnosed and coded by board-certified dermatologists. In total, 27,083 male subjects participated in the study from 1983 to 2003, of which 237 (0.88%) had severe acne, 11,718 (43.27%) were active smokers, and 15,365 (56.73%) were nonsmokers at the time of interviews. Active smokers showed a significantly lower prevalence of severe acne (0.71%) than nonsmokers (1.01%) (P = 0.0078). An inverse dose-dependent relationship between severe acne prevalence and daily cigarette consumption became significant from 21 cigarettes a day (chi2 and trend test: P < 0.0001), odds ratio: 0.2 (95% CI: 0.06-0.63). The study did not aim to establish a temporal correlation, and passive smoking and acne treatments were not measured. Previous in vitro and clinical studies strongly support an association with nicotine. We suggest a trial with topical nicotine treatment for acne to further investigate this association.

The epidemiology of acne vulgaris in late adolescence

Science.gov (United States)

Lynn, Darren D; Umari, Tamara; Dunnick, Cory A; Dellavalle, Robert P

2016-01-01

Importance Acne vulgaris is the most common skin condition affecting late adolescents across the globe. Although prior studies have evaluated epidemiologic patterns of acne vulgaris in various ethnicities and regions, adequate understanding of the worldwide burden of the disease associated with patients in their late adolescence (15–19-year olds) remains lacking. Objective To assess the global burden of the disease associated with acne vulgaris for late adolescents (15–19-year olds) and provide an overview of the epidemiology, pathophysiology, and treatment options for acne in this population. Design Database summary study. Setting Global Burden of Disease Study 2010 database. Participants Global Burden of Disease regions comprised countries with prevalence of acne vulgaris between the ages of 15 and 19 years. Main outcomes and measures Geographic region-level disability-adjusted life year rates (per 100,000 persons) associated with acne vulgaris in years 1990 through 2010. Median percentage change in disability-adjusted life year rates was estimated for each region across the specified study period. Conclusion and relevance Acne vulgaris-associated disease burden exhibits global distribution and has continued to grow in prevalence over time within this population. This continued growth suggests an unmet dermatologic need worldwide for this disorder and potential opportunities for improved access and delivery of dermatologic care. Our analysis of the literature reveals numerous opportunities for enhanced patient care. To that end, we highlight some of the effective and promising treatments currently available and address important factors, such as sex, nationality, genetics, pathophysiology, and diet, as they relate to acne vulgaris in late adolescence. PMID:26955297

Dietary intervention in acne

Science.gov (United States)

Melnik, Bodo

2012-01-01

The purpose of this paper is to highlight the endocrine signaling of Western diet, a fundamental environmental factor involved in the pathogenesis of epidemic acne. Western nutrition is characterized by high calorie uptake, high glycemic load, high fat and meat intake, as well as increased consumption of insulin- and IGF-1-level elevating dairy proteins. Metabolic signals of Western diet are sensed by the nutrient-sensitive kinase, mammalian target of rapamycin complex 1 (mTORC1), which integrates signals of cellular energy, growth factors (insulin, IGF-1) and protein-derived signals, predominantly leucine, provided in high amounts by milk proteins and meat. mTORC1 activates SREBP, the master transcription factor of lipogenesis. Leucine stimulates mTORC1-SREBP signaling and leucine is directly converted by sebocytes into fatty acids and sterols for sebaceous lipid synthesis. Over-activated mTORC1 increases androgen hormone secretion and most likely amplifies androgen-driven mTORC1 signaling of sebaceous follicles. Testosterone directly activates mTORC1. Future research should investigate the effects of isotretinoin on sebocyte mTORC1 activity. It is conceivable that isotretinoin may downregulate mTORC1 in sebocytes by upregulation of nuclear levels of FoxO1. The role of Western diet in acne can only be fully appreciated when all stimulatory inputs for maximal mTORC1 activation, i.e., glucose, insulin, IGF-1 and leucine, are adequately considered. Epidemic acne has to be recognized as an mTORC1-driven disease of civilization like obesity, type 2 diabetes, cancer and neurodegenerative diseases. These new insights into Western diet-mediated mTORC1-hyperactivity provide a rational basis for dietary intervention in acne by attenuating mTORC1 signaling by reducing (1) total energy intake, (2) hyperglycemic carbohydrates, (3) insulinotropic dairy proteins and (4) leucine-rich meat and dairy proteins. The necessary dietary changes are opposed to the evolution of

Biophysical evaluation of fractional laser skin resurfacing with an Er:YSGG laser device in Japanese skin.

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Kimura, Utako; Kinoshita, Ayako; Osawa, Aki; Negi, Osamu; Haruna, Kunitaka; Mizuno, Yuki; Suga, Yasushi

2012-05-01

Ablative fractional laser skin resurfacing (FLSR) has recently been used for the amelioration of acne scars, and previous studies have shown clinical effectiveness. Despite its extensive use, few studies have focused on the associated changes in biophysical properties of the epidermis. Herein, we evaluate transepidermal water loss, sebum levels, skin hydration, and skin elasticity, following FLSR treatments with an Er:YSGG laser device (Pearl FractionalTM, Cutera Inc., Brisbane, CA), employing non-invasive measurements. Five Japanese patients with facial acne scars underwent one FLSR session. Some acne scars appeared to become less obvious as a consequence of the treatment. All patients were aware of a feeling of skin tightness in treated areas. Objective measurements on the lower lateral angle of the eye and on the inner cheeks were evaluated at baseline and at 3 days, 1 week, and 4 weeks after FLSR. Transepidermal water loss showed a significant two-fold (100%) increase at day 3, but had returned to almost the baseline level at week 4 in both areas. Sebum secretion showed a 50% increase at day 3, but had returned to the baseline level after day 7. Skin hydration showed a significant decrease at day 3, but had returned to the baseline level by day 7, and showed significant improvement at the end of the study. Skin elasticity (R2) was still at baseline on day 3, but showed some improvement--an increase of at least 30%--at the end of the study. Based on our findings, we believe that FLSR should be performed no more than once a month to allow sufficient time for the damaged skin to recover its barrier function in most areas of the face.

The epidemiology of adolescent acne in North East China.

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Wei, B; Pang, Y; Zhu, H; Qu, L; Xiao, T; Wei, H-C; Chen, H-D; He, C-D

2010-08-01

Adolescent acne impacts self-esteem and quality of life in adolescents and its aetiology is not fully clarified. The aim of this study was to describe the epidemiological features of adolescent acne in North East China and determine the impact of genetic and environmental factors on the pathogenesis of acne. Data were collected from 5696 undergraduates (2920 patients and 2776 controls) using questionnaire. The survey data were analysed using spss version 13.0 and heritability of adolescent acne was calculated using Falconer's method. Total prevalence of adolescent acne was 51.30% (52.74% in males, 49.65% in females). The difference between genders was statistically significant (P skin and mixed type skin. Protective factors include (presented in descending order of occurrence) dry skin, neutral skin, frequent fruit consumption and computer access time skin oiliness and high caloric diets may also contribute to the onset of acne in Chinese adolescents.

The Difference in Interleukin-19 Serum on Degrees of Acne Vulgaris Severity.

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Mochtar, Moerbono; Murasmita, Alamanda; Irawanto, M Eko; Julianto, Indah; Kariosentono, Harijono; Waskito, Fajar

2018-01-01

Acne vulgaris is a multifactorial disease. Recent study showed that inflammation does have a central role in the formation of both inflammatory and noninflammatory lesions in acne vulgaris. There are various findings of proinflammatory cytokines related to acne vulgaris, but no previous study correlate interleukin- (IL-) 19 to acne vulgaris. This pilot study aims to look at difference in IL-19 serum concentration on degrees of severity of acne vulgaris. This is an analytical observational cross-sectional study. Sample subjects were patients with acne vulgaris who met the inclusion criteria. Enzyme-linked immunosorbent assay (ELISA) study was applied to measure IL-19 serum. Analysis test found statistically significant difference between IL-19 serum concentration of group of patients with mild acne vulgaris and that of group of patients with severe acne vulgaris. Moreover, analysis revealed significant difference between IL-19 serum concentration of group of patients with moderate acne vulgaris and that of group of patients with severe acne vulgaris. There are differences in serum levels of IL-19 on the severity of acne vulgaris. The significant difference might show that inflammation has a core role in severity of acne vulgaris, and IL-19 might potentially be related to acne vulgaris.

The Difference in Interleukin-19 Serum on Degrees of Acne Vulgaris Severity

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Moerbono Mochtar

2018-01-01

Full Text Available Introduction. Acne vulgaris is a multifactorial disease. Recent study showed that inflammation does have a central role in the formation of both inflammatory and noninflammatory lesions in acne vulgaris. There are various findings of proinflammatory cytokines related to acne vulgaris, but no previous study correlate interleukin- (IL- 19 to acne vulgaris. This pilot study aims to look at difference in IL-19 serum concentration on degrees of severity of acne vulgaris. Methods. This is an analytical observational cross-sectional study. Sample subjects were patients with acne vulgaris who met the inclusion criteria. Enzyme-linked immunosorbent assay (ELISA study was applied to measure IL-19 serum. Result. Analysis test found statistically significant difference between IL-19 serum concentration of group of patients with mild acne vulgaris and that of group of patients with severe acne vulgaris. Moreover, analysis revealed significant difference between IL-19 serum concentration of group of patients with moderate acne vulgaris and that of group of patients with severe acne vulgaris. Conclusions. There are differences in serum levels of IL-19 on the severity of acne vulgaris. The significant difference might show that inflammation has a core role in severity of acne vulgaris, and IL-19 might potentially be related to acne vulgaris.

Randomized, controlled trial split-faced study of 595-nm pulsed dye laser in the treatment of acne vulgaris and acne erythema in adolescents and early adulthood.

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Lekwuttikarn, Ramrada; Tempark, Therdpong; Chatproedprai, Susheera; Wananukul, Siriwan

2017-08-01

The high prevalence of acne vulgaris in teenagers has increased comorbidities. Lasers offer alternative options for acne treatment because they have rapid action, low systemic adverse effects, and do not require everyday treatment. To study the efficacy and patients' satisfaction of 595-nm pulse dye laser (PDL) treatment of acne vulgaris and acne erythema in adolescents and early adulthood, we designed a blocked-randomized, split-faced 595-nm PDL (fluence 8 J/cm 3 pulse duration 10 ms, spot size 7 mm, 2 session every 2 weeks) study in patients with mild to moderate acne by comparing the laser-treated and non-treated side. The acne lesion counts, acne erythema grading, and acne severity grading were evaluated at baseline and 2, 4, and 8 weeks. Thirty patients were recruited. The results showed no statistically significant difference except the papule count at week 4 which was -1.828 on the treated side and 0.103 on the non-treated side of the face, P-value 0.0018. There was no statistically significant difference of acne severity grading and acne erythema grading between both sides of the face. The mean scores of patients' satisfaction on the laser-treated side were 75, 81, and 81%, respectively. The PDL treatment in this study reveals no significant improvement in acne therapy; however, the patients were satisfied with this laser treatment. © 2017 The International Society of Dermatology.

A study on scar revision

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Ashutosh Talwar

2016-04-01

Full Text Available Introduction: Scars are psychologically distressing for the patients and have an impact on the quality of life and self esteem of the patients. Scar revision is an aesthetic skill which is mastered by plastic surgeons and encroached now by dermatosurgeons. Scars on the face are aesthetically unacceptable and various techniques have been improvised for making a scar aesthetically acceptable. Various types of techniques are used for scar revision like W plasty, Z plasty and VY plasty. Aims: To see the efficacy of various scar revision techniques including Z plasty, VY plasty and W plasty in 30 patients with disfiguring scars. Methods: We selected twenty patients of disfiguring scars for the study. The scars from various causes including trauma and burns were included in our study. Various techniques of scar revision include Z plasty, W plasty and VY plasty were performed according to the type and site of scar. Results: Male: female was 1.5: 1. The scar revision surgery yielded excellent results with minimal complications including haematoma formation, secondary infection and delayed healing seen in 5% patients each. Regarding the efficacy of scar revision, excellent improvement was seen in 60% patients, moderate improvement was seen in 30% patients and mild improvement was seen in 10% patients. Conclusions: Dermatologists can employ a number of surgical scar revision techniques. While some are better suited to treat specific types of scars, they can be used in combination with each other or with adjunctive therapies to achieve optimal results.

Complementary therapies for acne vulgaris

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Cao, Huijuan; Yang, Guoyan; Wang, Yuyi; Liu, Jian Ping; Smith, Caroline A; Luo, Hui; Liu, Yueming

2015-01-01

Background Acne is a chronic skin disease characterised by inflamed spots and blackheads on the face, neck, back, and chest. Cysts and scarring can also occur, especially in more severe disease. People with acne often turn to complementary and alternative medicine (CAM), such as herbal medicine, acupuncture, and dietary modifications, because of their concerns about the adverse effects of conventional medicines. However, evidence for CAM therapies has not been systematically assessed. Objectives To assess the effects and safety of any complementary therapies in people with acne vulgaris. Search methods We searched the following databases from inception up to 22 January 2014: the Cochrane Skin Group Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL; 2014, Issue 1), MEDLINE (from 1946), Embase (from 1974), PsycINFO (from 1806), AMED (from 1985), CINAHL (from 1981), Scopus (from 1966), and a number of other databases listed in the Methods section of the review. The Cochrane CAM Field Specialised Register was searched up to May 2014. We also searched five trials registers and checked the reference lists of articles for further references to relevant trials. Selection criteria We included parallel-group randomised controlled trials (or the first phase data of randomised cross-over trials) of any kind of CAM, compared with no treatment, placebo, or other active therapies, in people with a diagnosis of acne vulgaris. Data collection and analysis Three authors collected data from each included trial and evaluated the methodological quality independently. They resolved disagreements by discussion and, as needed, arbitration by another author. Main results We included 35 studies, with a total of 3227 participants. We evaluated the majority as having unclear risk of selection, attrition, reporting, detection, and other biases. Because of the clinical heterogeneity between trials and the incomplete data reporting, we could only include four

Hormonal and dietary factors in acne vulgaris versus controls.

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Stewart, Thomas Jonathan; Bazergy, Carl

2018-01-01

Background : Acne vulgaris is an inflammatory skin disorder with not as yet fully understood pathogenesis. In this controlled study, we assessed acne vulgaris patients for several possible pathogenic factors such as vitamin D deficiency, vegan diet, increased body mass index (BMI) and positive anti-transglutaminase antibody. Methods : We screened 10 years of records at a family medicine clinic for patients diagnosed with acne vulgaris. In eligible subjects, we collected data regarding 25-hydroxylvitamin D levels, BMI, dietary preference and serum IgA tissue transglutaminase levels. Controls were age- (+/- 12 months) and sex-matched patients seen during the study period without a diagnosis of acne vulgaris. Results : 453 patients were given a diagnosis of acne vulgaris during the study period. Compared with controls, we found significant associations between vitamin D deficiency (4.0U/mL) and a diagnosis of acne vulgaris. Conclusions : Our study adds important information to the current body of literature in pursuit of elucidating the pathogenesis of this complex multifactorial disease.

Management of periocular post burn scarring in the epileptics

International Nuclear Information System (INIS)

Cheema, A.M.; Saeed, M.; Ghani, A.; Akhter, S.W.

2003-01-01

Objective: To assess the clinical presentation and management of patients with epilepsy presenting with periocular post burn scarring. Results: There were 18 (78.26%) female and 5(21.73%) male patients. The age range was from 18 to 45 years with a mean of 28 years. In 17 (73.91%) patients, lid contracture was released to cover their eyeballs. In 6 (26.08%) patients the eyeball was lost due to late presentation. Conclusion: There should be a high index of suspicion in facial burns for ophthalmic damage and early referral to an ophthalmologist should be made to prevent complications. Early release of contracture with application of full or partial thickness skin grafts is advisable. (author)

Acne | Lambert | South African Family Practice

African Journals Online (AJOL)

Acne vulgaris is a common skin condition with a high prevalence in teenagers and young adults. It is a condition of the pilosebaceous follicles, resulting in comedones, papules, pustules or nodules which occur primarily on the face, but which may also present on other areas of the body. Although acne is not physically ...

Tissue Liver X-Receptor Alpha (LXRα) Level In Acne Vulgaris

International Nuclear Information System (INIS)

Nada, E.A.A.

2012-01-01

Acne vulgaris is a disease of the pilosebaceous unit. Increased sebum lipogenesis by sebaceous gland is the major factor in the pathophysiology of acne. LXRα have been recognized in the regulation of genes involved in lipid biosynthesis. Activation of LXRα inhibits proliferation, increase lipogenesis and improve differentiation of sebocytes. Aim: To investigate the level of tissue expression of LXRα in inflammatory and non inflammatory acne lesions and in comparison with normal skin. Patients and methods: Seventeen patients with inflammatory and non inflammatory acne lesions and sixteen age and sex comparable healthy volunteers as control were included in the study. Punch skin biopsies were taken from the acne lesions and normal skin of the volunteers for detection of gene expression of LXRα by RT- PCR. Results: the level of LXRα was significantly higher in the lesional skin either inflammatory (with a mean of 1188.52 ± 129.5) or comedonal acne (with a mean of 892.52 ± 66.08) in a statistically significant manner than the controls (with a mean of 600.50 ± 95.30) where the P value was <0.001. In addition, the level of LXRα was significantly higher in inflammatory acne (with a mean of 1188.52 ± 129.5) in a statistically significant manner) than comedonal acne (with a mean of 892.52 ± 66.08) where the P value was <0.001. Conclusion: the significant increase in the level of LXRα in acne lesions compared to controls suggesting that LXRα may have a role in the pathogenesis of acne vulgaris itself and is not a consequence of inflammation. In addition, it may play a role in the progression of the disease from comedonal to inflammatory. Further studies are recommended to evaluate the therapeutic benefits of the use of LXRα antagonists as a new therapeutic modality for acne vulgaris.

The flexible gene pool of Propionibacterium acnes

DEFF Research Database (Denmark)

Brüggemann, Holger; Lomholt, Hans B; Kilian, Mogens

2012-01-01

Propionibacterium acnes is a Gram-positive bacterium that is intimately associated with humans. The nature and consequences of this symbiosis are poorly understood; it might comprise both mutualistic and parasitic properties. Recent advances in distinguishing phylotypes of P. acnes have revealed ...

Topical antibiotic monotherapy prescribing practices in acne vulgaris.

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Hoover, William D; Davis, Scott A; Fleischer, Alan B; Feldman, Steven R

2014-04-01

The aim of this study is to evaluate the frequency of dosing topical antibiotics as monotherapy in the treatment of acne vulgaris, and physician specialty prescribing these medications. This study is a retrospective review of all visits with a sole diagnosis of acne vulgaris (ICD-9-CM code 706.1) found on the National Ambulatory Medical Care Survey (NAMCS) in 1993-2010. We recorded the number of visits surveyed where acne vulgaris was the sole diagnosis, number of visits where topical antibiotics were the only treatment prescribed, and the specialty of physician in each encounter. Topical erythromycin or clindamycin were the sole medication prescribed in 0.81% of the visits recorded, with 60% of these prescriptions arising from dermatologists and 40% from non-dermatologists. The trend of prescribing topical antibiotic monotherapy is declining (p acnes to topical antibiotic regimens has led to the need to re-evaluate the use of topical antibiotics in the treatment of acne vulgaris. While the rate of topical antibiotic monotherapy is declining, their use should be reserved for situations where the direct need for antibiotics arises. If a clinician feels that antibiotics are a necessary component to acne therapy, they should be used as part of a combination regimen.

Observational study of Arctium lappa in the treatment of acne vulgaris.

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Miglani, Anjali; Manchanda, Raj K

2014-07-01

Arctium lappa (Lappa) is used in traditional Western and Chinese medicine for acne. It is mentioned in homeopathic literature for acne, but its effect has not previously been evaluated. To determine the effectiveness of homeopathic medicine Lappa in treatment of acne vulgaris. An uncontrolled observational interventional study was conducted on human subjects who fulfilled the inclusion criteria and gave written informed consent. Lappa was prescribed in potencies starting from 6c rising to 1M as required, over a period of 6 months. Objective assessment was change in acne lesion counts supplemented with Global Acne Grading System (GAGS) and subjective assessment by using Acne-Specific Quality of Life questionnaire (Acne-QoL). Out of 34 human subjects, 32 completed the follow-up. Statistical significant results were seen in lesion counts, GAGS and Acne-QoL score (p value Lappa has shown positive effects in the treatment of acne especially of inflammatory type. Further controlled, randomized studies with larger sample size are desirable. Trial is registered at ClinicalTrials.gov Identifier: NCT01040390. Copyright © 2013 The Faculty of Homeopathy. Published by Elsevier Ltd. All rights reserved.

The Efficacy and Safety of Ablative Fractional Resurfacing Using a 2,940-Nm Er:YAG Laser for Traumatic Scars in the Early Posttraumatic Period

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Sun Goo Kim

2012-05-01

Full Text Available BackgroundSkin injuries, such as lacerations due to trauma, are relatively common, and patients are very concerned about the resulting scars. Recently, the use of ablative and non-ablative lasers based on the fractional approach has been used to treat scars. In this study, the authors demonstrated the efficacy and safety of ablative fractional resurfacing (AFR for traumatic scars using a 2,940-nm erbium: yttrium-aluminum-garnet (Er:YAG laser for traumatic scars after primary repair during the early posttraumatic period.MethodsTwelve patients with fifteen scars were enrolled. All had a history of facial laceration and primary repair by suturing on the day of trauma. Laser therapy was initiated at least 4 weeks after the primary repair. Each patient was treated four times at 1-month intervals with a fractional ablative 2,940-nm Er:YAG laser using the same parameters. Post-treatment evaluations were performed 1 month after the fourth treatment session.ResultsAll 12 patients completed the study. After ablative fractional laser treatment, all treated portions of the scars showed improvements, as demonstrated by the Vancouver Scar Scale and the overall cosmetic scale as evaluated by 10 independent physicians, 10 independent non-physicians, and the patients themselves.ConclusionsThis study shows that ablative fractional Er:YAG laser treatment of scars reduces scars fairly according to both objective results and patient satisfaction rates. The authors suggest that early scar treatment using AFR can be one adjuvant scar management method for improving the quality of life of patients with traumatic scars.

Vitamin D levels in acne vulgaris patients treated with oral isotretinoin.

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El-Hamd, Mohammed Abu; El Taieb, Moustafa A; Ibrahim, Hassan M; Aly, Sanaa S

2018-02-20

Acne vulgaris is a common inflammatory skin disease. Vitamin D deficiency plays a role in many inflammatory skin diseases. It may play a role in pathogenesis of acne vulgaris. This study aimed to assess serum levels of 25 hydroxy vitamin D in patients with acne vulgaris before and after treatment with isotretinoin and its relation with acne vulgaris severity. Ninety patients with acne vulgaris and 60 age-sex matched healthy subject as controls have been recruited in this study. Patients were treated with 0.75 mg/kg/d isotretinoin for 3 months. Serum level of 25 hydroxy vitamin D has been measured at baseline and after treatment. Serum levels of 25 hydroxy vitamin D were significantly higher in patients with acne vulgaris than healthy controls (P = .001). There was a significant inverse relation between level of 25 hydroxy vitamin D and severity of acne vulgaris before treatment (P = .001). Serum levels of 25 hydroxy vitamin D were significantly increased after isotretinoin treatment in patients with acne vulgaris (P = .001). This study concluded that vitamin D may play a potential role in pathogenesis of acne vulgaris or acne vulgaris may have a negative effect on vitamin D synthesis. Further studies are needed to confirm these potential relations. © 2018 Wiley Periodicals, Inc.

Antimicrobial effects of Thai medicinal plants against acne-inducing bacteria.

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Chomnawang, Mullika Traidej; Surassmo, Suvimol; Nukoolkarn, Veena S; Gritsanapan, Wandee

2005-10-03

Propionibacterium acnes and Staphylococcus epidermidis have been recognized as pus-forming bacteria triggering an inflammation in acne. The present study was conducted to evaluate antimicrobial activities of Thai medicinal plants against these etiologic agents of acne vulgaris. Crude extracts were tested for antimicrobial activities by disc diffusion and broth dilution methods. The results from the disc diffusion method showed that 13 medicinal plants could inhibit the growth of Propionibacterium acnes. Among those, Senna alata, Eupatorium odoratum, Garcinia mangostana, and Barleria lupulina had strong inhibitory effects. Based on a broth dilution method, the Garcinia mangostana extract had the greatest antimicrobial effect. The MIC values were the same (0.039 mg/ml) for both bacterial species and the MBC values were 0.039 and 0.156 mg/ml against Propionibacterium acnes and Staphylococcus epidermidis, respectively. In bioautography assay, the Garcinia mangostana extract produced strong inhibition zones against Propionibacterium acnes. Antimicrobial activity from fractions of column chromatography revealed one of the active compounds in Garcinia mangostana could be mangostin, a xanthone derivative. Taken together, our data indicated that Garcinia mangostana had a strong inhibitory effect on Propionibacterium acnes and Staphylococcus epidermidis. Therefore, this plant would be an interesting topic for further study and possibly for an alternative treatment for acne.

Combination therapy of acne in women: searching for optimum solutions

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M. V. Goryachkina

2014-01-01

Full Text Available Current data on the acne pathogenesis are given. According to the authors, dermatosis is becoming more prevalent among women of mature age. Issues related to the clinical picture, effect of exogenous and endogenous factors on the course of acne, and psychosocial characteristics of delayed acne manifestations in women are described in detail. The essential role of medical and cosmetic products for the complex therapy of acne is discussed. The authors describe their own experience of treating delayed acne using the Hyseac line of medical and cosmetic products in a combination with microdermabrasion and no-needle mesotherapy using the vitaPeel/vital О2 device.

Association between smoking habits and acne vulgaris. A case-control study

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Alice Mannocci

2012-09-01

Full Text Available

Background: acne vulgaris, is one of the most common skin disorder. Previous studies about the role of smoke in the pathogenesis of acne reported contradictory results. The aim of this study was to conduct a case-control study investigating the relationship between tobacco smoking and acne.

Methods: a case-control study was performed during the period September 2009 - February 2010. A questionnaire was administrated to each participant, to assess the association acne - smoke. Cases were outpatients of the Dermatologic Ambulatory of the “Fiorini” Hospital, Sapienza University of Rome (Italy. Controls were age and gender-matched to the cases. The ratio cases-controls was 1:2. A univariate and a multiple logistic regression analysis were conducted; Odds Ratio (OR and the relative 95% confidence interval (95%CI were assessed. The statistical significance was set at p < 0.05.

Results: crude OR for the association acne - smoke was 7.26 (IC=2.27-23.18; adjusted OR for sex and age was 5.47 (IC=1.67-17.97. Of 93 cases, 6 had a severe grade of acne (6.5%, 19 had an intermediate grade of acne (20.4%, and 68 had a mild grade of acne (73.1%. No one of the smokers had a severe grade of acne, one had an intermediate grade of acne and 11 had mild acne; these differences are not statistically significant.

Conclusions: the association between acne and smoke shows an increased risk (OR=7.26 with a statistically significant CI. Moreover, people ≥ 18 years of age have twice the risk compared to persons < 18 years of age (OR=2.31.

Management of acne vulgaris with hormonal therapies in adult female patients.

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Husein-ElAhmed, Husein

2015-01-01

Acne vulgaris is a very common condition affecting up of 93% of adolescents. Although rare, this disease may persist in adulthood. In adult women with acne (those older than 25 years old), this condition is particularly relevant because of the refractory to conventional therapies, which makes acne a challenge for dermatologists in this group of patients. In order to its potential risk for chronicity and the involvement of visible anatomical sites such as face and upper torso, acne has been associated with a wide spectrum of psychological and social dysfunction such as depression, anxiety, suicidal ideation, somatization, and social inhibition. In particular, adult women with acne have been shown to be adversely impacted by the effect of acne on their quality of life. For the last four decades, dermatologists have used hormonal therapies for the management of acne vulgaris in adult women, which are considered a rational choice given the severity and chronicity of this condition in this group of patients. The aim of this work is to review the hormonal drugs for management of acne. © 2015 Wiley Periodicals, Inc.

Acne -- self-care

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... is no evidence that you need to avoid chocolate, milk, or high-fat foods. High sugar intake ... for severe acne A laser procedure called photodynamic therapy Chemical skin peeling When to Call the Doctor ...

Novel techniques for enhancement and segmentation of acne vulgaris lesions.

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Malik, A S; Humayun, J; Kamel, N; Yap, F B-B

2014-08-01

More than 99% acne patients suffer from acne vulgaris. While diagnosing the severity of acne vulgaris lesions, dermatologists have observed inter-rater and intra-rater variability in diagnosis results. This is because during assessment, identifying lesion types and their counting is a tedious job for dermatologists. To make the assessment job objective and easier for dermatologists, an automated system based on image processing methods is proposed in this study. There are two main objectives: (i) to develop an algorithm for the enhancement of various acne vulgaris lesions; and (ii) to develop a method for the segmentation of enhanced acne vulgaris lesions. For the first objective, an algorithm is developed based on the theory of high dynamic range (HDR) images. The proposed algorithm uses local rank transform to generate the HDR images from a single acne image followed by the log transformation. Then, segmentation is performed by clustering the pixels based on Mahalanobis distance of each pixel from spectral models of acne vulgaris lesions. Two metrics are used to evaluate the enhancement of acne vulgaris lesions, i.e., contrast improvement factor (CIF) and image contrast normalization (ICN). The proposed algorithm is compared with two other methods. The proposed enhancement algorithm shows better result than both the other methods based on CIF and ICN. In addition, sensitivity and specificity are calculated for the segmentation results. The proposed segmentation method shows higher sensitivity and specificity than other methods. This article specifically discusses the contrast enhancement and segmentation for automated diagnosis system of acne vulgaris lesions. The results are promising that can be used for further classification of acne vulgaris lesions for final grading of the lesions. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

The antimicrobial effect of CEN1HC-Br against Propionibacterium acnes and its therapeutic and anti-inflammatory effects on acne vulgaris.

Science.gov (United States)

Han, Rui; Blencke, Hans-Matti; Cheng, Hao; Li, Chun

2018-01-01

Propionibacterium acnes is a commensal bacterium, which is involved in acne inflammation. An antimicrobial peptide named CEN1HC-Br, which was isolated and characterized form the green sea urchin, has been shown to possess broad-spectrum antibacterial activity. Little is known concerning the potential effects of its antibacterial and anti-inflammatory properties against P. acnes. To examine the potency of CEN1HC-Br in acne treatment, we conducted experiments to analyze the antibacterial and anti-inflammatory activities of CEN1HC-Br both in vitro and in vivo. The antimicrobial activity of CEN1HC-Br was evaluated by minimal inhibitory concentration (MIC) assays using the broth dilution method. To elucidate the in vitro anti-inflammatory effect, HaCaT cells and human monocytes were treated with different concentration of CEN1HC-Br after stimulation by P. acnes. The expression of TLR2 and the secretion of the pro-inflammatory cytokines IL-6, IL-8, IL-1β, TNF-α, IL-12, respectively, were measured by enzyme immunoassays. An evaluation of P. acnes-induced ear edema in rat ear was conducted to compare the in vivo antibacterial and anti-inflammatory effect of CEN1HC-Br, the expression of IL-8, TNF-α, MMP-2 and TLR2 was evaluated by immunohistochemistry and real time-PCR. CEN1HC-Br showed stronger antimicrobial activity against P. acnes than clindamycin. CEN1HC-Br significantly reduced the expression of interleukin IL-12p40, IL-6, IL-1β, TNF-α and TLR2 in monocytes, but they were not influenced by clindamycin. Both CEN1HC-Br and Clindamycin attenuated P. acnes-induced ear swelling in rat along with pro-inflammatory cytokines IL-8, TNF-α, MMP-2 and TLR2. Our data demonstrates that CEN1HC-Br is bactericidal against P. acnes and that it has an anti-inflammatory effect on monocytes. The anti-inflammatory effect may partially occur through TLR2 down-regulation, triggering an innate immune response and the inhibition of pro-inflammatory cytokines. Copyright © 2017 The

The epidemiology of acne vulgaris in late adolescence

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Lynn DD

2016-01-01

Full Text Available Darren D Lynn,1 Tamara Umari,1 Cory A Dunnick,2,3 Robert P Dellavalle2–4 1Department of Dermatology, University of Colorado School of Medicine, 2Department of Dermatology, University of Colorado Anschutz Medical Campus, Aurora, 3Dermatology Service, US Department of Veterans Affairs, Eastern Colorado Health Care System, Denver, 4Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA Importance: Acne vulgaris is the most common skin condition affecting late adolescents across the globe. Although prior studies have evaluated epidemiologic patterns of acne vulgaris in various ethnicities and regions, adequate understanding of the worldwide burden of the disease associated with patients in their late adolescence (15–19-year olds remains lacking. Objective: To assess the global burden of the disease associated with acne vulgaris for late adolescents (15–19-year olds and provide an overview of the epidemiology, pathophysiology, and treatment options for acne in this population. Design: Database summary study. Setting: Global Burden of Disease Study 2010 database. Participants: Global Burden of Disease regions comprised countries with prevalence of acne vulgaris between the ages of 15 and 19 years. Main outcomes and measures: Geographic region-level disability-adjusted life year rates (per 100,000 persons associated with acne vulgaris in years 1990 through 2010. Median percentage change in disability-adjusted life year rates was estimated for each region across the specified study period. Conclusion and relevance: Acne vulgaris-associated disease burden exhibits global distribution and has continued to grow in prevalence over time within this population. This continued growth suggests an unmet dermatologic need worldwide for this disorder and potential opportunities for improved access and delivery of dermatologic care. Our analysis of the literature reveals numerous

Acne in adolescents: quality of life, self-esteem, mood, and psychological disorders.

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Dunn, Lauren K; O'Neill, Jenna L; Feldman, Steven R

2011-01-15

Acne is a significant adolescent problem and may precipitate emotional and psychological effects. The impact of acne on psychological parameters and implications for acne treatment are not fully understood. We performed a MEDLINE search using the terms "acne" and "adolescent" along with "psychological," "depression," or "psychiatric," which yielded 16 reviewed studies. Qualitative review of the selected articles revealed that the presence of acne has a significant impact on self-esteem and quality of life. Depression and other psychological disorders are more prevalent in acne patients and acne treatment may improve symptoms of these disorders. The reviewed studies were semi-quantitative analyses utilizing various standardized surveys or questionnaires. Therefore, quantitative analysis of selected studies was not possible. The presence of co-morbid psychological disorders should be considered in the treatment of acne patients and future prospective trials are needed to assess the impact of treatment on psychological outcomes.

Novel pharmacological approaches for the treatment of acne vulgaris.

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Valente Duarte de Sousa, Isabel Cristina

2014-10-01

Acne vulgaris is the most common skin disease worldwide; yet, current treatment options, although effective, are associated with unwanted side effects, chronicity, relapses and recurrences. The adequate control of the four pathogenic mechanisms, involved in the appearance of acne lesions, is paramount to treatment success. The authors discuss and evaluate the pathogenic pathways related to the mechanisms of action of novel molecules, which are currently under investigation for the treatment of acne vulgaris. The manuscript is based on comprehensive searches made through PubMed, GoogleScholar and ClinicalTrial.gov, using different combination of key words, which include acne vulgaris, pathogenesis, treatment, sebogenesis and Propionibacterium acnes. In the near future, more effective treatments with fewer side effects are expected. The use of topical antiandrogens, acetylcholine inhibitors and PPAR modulators seem to be promising options for controlling sebum production. Retinoic acid metabolism-blocking agents and IL-1α inhibitors have the potential to become legitimate alternative options to retinoid therapy in the management of infundibular dyskeratosis. Indeed, the authors believe that there will likely be a decline in the use of antibiotics for controlling P. acnes colonization and targeting the inflammation cascade.

Diversity of bacterial communities on the facial skin of different age-group Thai males

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Alisa Wilantho

2017-11-01

Full Text Available Background Skin microbiome varies from person to person due to a combination of various factors, including age, biogeography, sex, cosmetics and genetics. Many skin disorders appear to be related to the resident microflora, yet databases of facial skin microbiome of many biogeographies, including Thai, are limited. Methods Metagenomics derived B-RISA and 16S rRNA gene sequencing was utilized to identify the culture-independent bacterial diversity on Thai male faces (cheek and forehead areas. Skin samples were categorized (grouped into (i normal (teenage.hea and (ii acne-prone (teenage.acn young adults, and normal (iii middle-aged (middle.hea and (iv elderly (elderly.hea adults. Results The 16S rRNA gene sequencing was successful as the sequencing depth had an estimated >98% genus coverage of the true community. The major diversity was found between the young and elderly adults in both cheek and forehead areas, followed by that between normal and acne young adults. Detection of representative characteristics indicated that bacteria from the order Rhizobiales, genera Sphingomonas and Pseudoalteromonas, distinguished the elderly.hea microbiota, along the clinical features of wrinkles and pores. Prediction of the metabolic potential revealed reduced metabolic pathways involved in replication and repair, nucleotide metabolism and genetic translation in the elderly.hea compared with that in the teenage.hea. For young adults, some unique compositions such as abundance of Propionibacterium acnes and Staphylococcus epidermidis, with a minor diversity between normal and acne skins, were detected. The metabolic potentials of the acne vs. normal young adults showed that teenage.acn was low in many cellular processes (e.g., cell motility and environmental adaptation, but high in carbohydrate metabolism, which could support acne growth. Moreover, comparison with the age-matched males from the US (Boulder, Colorado to gain insight into the diversity across

Diversity of bacterial communities on the facial skin of different age-group Thai males.

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Wilantho, Alisa; Deekaew, Pamornya; Srisuttiyakorn, Chutika; Tongsima, Sissades; Somboonna, Naraporn

2017-01-01

Skin microbiome varies from person to person due to a combination of various factors, including age, biogeography, sex, cosmetics and genetics. Many skin disorders appear to be related to the resident microflora, yet databases of facial skin microbiome of many biogeographies, including Thai, are limited. Metagenomics derived B-RISA and 16S rRNA gene sequencing was utilized to identify the culture-independent bacterial diversity on Thai male faces (cheek and forehead areas). Skin samples were categorized (grouped) into (i) normal ( teenage.hea ) and (ii) acne-prone ( teenage.acn ) young adults, and normal (iii) middle-aged ( middle.hea ) and (iv) elderly ( elderly.hea ) adults. The 16S rRNA gene sequencing was successful as the sequencing depth had an estimated >98% genus coverage of the true community. The major diversity was found between the young and elderly adults in both cheek and forehead areas, followed by that between normal and acne young adults. Detection of representative characteristics indicated that bacteria from the order Rhizobiales, genera Sphingomonas and Pseudoalteromonas , distinguished the elderly.hea microbiota, along the clinical features of wrinkles and pores. Prediction of the metabolic potential revealed reduced metabolic pathways involved in replication and repair, nucleotide metabolism and genetic translation in the elderly.hea compared with that in the teenage.hea . For young adults, some unique compositions such as abundance of Propionibacterium acnes and Staphylococcus epidermidis , with a minor diversity between normal and acne skins, were detected. The metabolic potentials of the acne vs. normal young adults showed that teenage.acn was low in many cellular processes (e.g., cell motility and environmental adaptation), but high in carbohydrate metabolism, which could support acne growth. Moreover, comparison with the age-matched males from the US (Boulder, Colorado) to gain insight into the diversity across national biogeography

A Review of Acne Etiology and Treatment in Iranian Traditional Medicine

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Laila Shirbeigi

2016-02-01

Full Text Available Context Iranian traditional medicine (ITM is based on humoral theory. Temperament or Mizaj is the result of a combination of four cardinal humors. They are blood, phlegm, yellow bile (Safra and black bile (melancholy. Like any other disease, acne is the result of humoral imbalance. Acne is a highly prevalent dermatologic problem, which has both physical and psychological effects. The aim of this study was to introduce the etiology of acne and its remedies from the perspective of ITM. Evidence Acquisition Etiology and treatment of acne were studied and analyzed from selected medical textbooks of ITM. Some of the effective plants in these books were assessed in a table, and their anti-acne activities were compared with conventional medicine’s database. Results From the perspective of ITM, considering six essential schemes for health, diet and herbal remedies as well as manipulation are recommended for acne treatment. Although the introduced plants have antibacterial, anti-inflammatory and antioxidant effects but some of them have special proven effects on acne formation process. There is also a strong relationship between digestive system and skin. Conclusions This paper was rendered to show ancient Persian scholar’s point of view about acne and its treatment, and it was shown that Iranian traditional medicine has practical recommendations for acne treatment.

2010 American Conference on Neutron Scattering (ACNS 2010)

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Billinge, Simon

2011-06-17

The ACNS provides a focal point for the national neutron user community to strengthen ties within this diverse group, while at the same time promoting neutron research among colleagues in related disciplines identified as “would-be” neutron users. The American Conference on Neutron Scattering thus serves a dual role as a national user meeting and a scientific meeting. As a venue for scientific exchange, the ACNS showcases recent results and provides forums for scientific discussion of neutron research in diverse fields such as hard and soft condensed matter, liquids, biology, magnetism, engineering materials, chemical spectroscopy, crystal structure, and elementary excitations, fundamental physics and development of neutron instrumentation through a combination of invited talks, contributed talks and poster sessions. As a “super-user” meeting, the ACNS fulfills the main objectives of users' meetings previously held periodically at individual national neutron facilities, with the advantage of a larger and more diverse audience. To this end, each of the major national neutron facilities (NIST, LANSCE, HFIR and SNS) have an opportunity to exchange information and update users, and potential users, of their facility. This is also an appropriate forum for users to raise issues that relate to the facilities. For many of the national facilities, this super-user meeting should obviate the need for separate user meetings that tax the time, energy and budgets of facility staff and the users alike, at least in years when the ACNS is held. We rely upon strong participation from the national facilities. The NSSA intends that the American Conference on Neutron Scattering (ACNS) will occur approximately every two years, but not in years that coincide with the International or European Conferences on Neutron Scattering. The ACNS is to be held in association with one of the national neutron centers in a rotating sequence, with the host facility providing local

Minimal Nasolabial Incision Technique for Nasolabial Fold Modification in Patients With Facial Paralysis.

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Faris, Callum; Heiser, Alyssa; Jowett, Nate; Hadlock, Tessa

2018-03-01

Creation of symmetrical nasolabial folds (NLFs) is important in the management of the paralyzed face. Established techniques use a linear incision in the NLF, and technical refinements now allow the linear incision to be omitted. This retrospective case series was conducted in a tertiary care setting from February 2, 2017, to June 7, 2017. Participants were all patients (N = 21) with peripheral facial paralysis who underwent NLF modification that used the minimal nasolabial incision technique at the Massachusetts Eye and Ear Infirmary Facial Nerve Center from February 1, 2015, through August 31, 2016. Patient-reported outcome measures using the validated, quality-of-life Facial Clinimetric Evaluation (FaCE) Scale; clinician-reported facial function outcomes using a validated electronic clinician-graded facial paralysis assessment (eFACE); layperson assessment of the overall aesthetic outcome of the NLF; and expert-clinician scar assessment of the NLF. Of the 21 patients who underwent NLF modification that used the minimal nasolabial incision technique, 9 patients (43%) were female and 12 (57%) were male. The mean age was 41 (range, 9-90) years; 17 patients (81%) were adults (≥18 years) and 4 (19%) were children (<18 years). Overall, significant improvements were observed after NLF modification in all outcome measures as graded by both clinicians and patients. The mean (SD) scores for total eFACE were 60.7 (14.9) before the operation and 77.2 (8.9) after the operation (mean difference, 16.5 [95% CI, 8.5-24.2]; P < .001). The mean (SD) static eFACE scores were 61.4 (20.6) before the operation and 82.7 (12.4) after the operation (mean difference, 21.3 [95% CI, 10.7-31.9]; P < .001). The mean (SD) FaCE quality-of-life scores were 51.3 (20.1) before the operation and 70.3 (12.6) after the operation (mean difference, 19.0 [95% CI, 6.5-31.6]; P  =  .001). The layperson self-assessment of the overall aesthetic outcome of the NLF modification was

ACNE VULGARIS. EVALUATION OF A MEDICATED CLEANSING PAD.

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ROTH, H L

1964-03-01

Using the technique of simultaneous, symmetrical paired comparisons, a medicated cleansing pad that can be easily used at work or at school as an adjunctive in the treatment of acne vulgaris was evaluated.The experimental pads were significantly beneficial in reducing skin oiliness and in clinical improvement of the acne. Response to standard acne therapy was faster when the pads were used adjunctively, although the significant results seen initially tended to even out as therapy continued. Use of the medicated pads produced no untoward side effects and were well accepted by patients.

ACNE VULGARIS—Evaluation of a Medicated Cleansing Pad

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Roth, Harry L.

1964-01-01

Using the technique of simultaneous, symmetrical paired comparisons, a medicated cleansing pad that can be easily used at work or at school as an adjunctive in the treatment of acne vulgaris was evaluated. The experimental pads were significantly beneficial in reducing skin oiliness and in clinical improvement of the acne. Response to standard acne therapy was faster when the pads were used adjunctively, although the significant results seen initially tended to even out as therapy continued. Use of the medicated pads produced no untoward side effects and were well accepted by patients. PMID:14131397

Carrier-Based Drug Delivery System for Treatment of Acne

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Vyas, Amber; Kumar Sonker, Avinesh

2014-01-01

Approximately 95% of the population suffers at some point in their lifetime from acne vulgaris. Acne is a multifactorial disease of the pilosebaceous unit. This inflammatory skin disorder is most common in adolescents but also affects neonates, prepubescent children, and adults. Topical conventional systems are associated with various side effects. Novel drug delivery systems have been used to reduce the side effect of drugs commonly used in the topical treatment of acne. Topical treatment of acne with active pharmaceutical ingredients (API) makes direct contact with the target site before entering the systemic circulation which reduces the systemic side effect of the parenteral or oral administration of drug. The objective of the present review is to discuss the conventional delivery systems available for acne, their drawbacks, and limitations. The advantages, disadvantages, and outcome of using various carrier-based delivery systems like liposomes, niosomes, solid lipid nanoparticles, and so forth, are explained. This paper emphasizes approaches to overcome the drawbacks and limitations associated with the conventional system and the advances and application that are poised to further enhance the efficacy of topical acne formulations, offering the possibility of simplified dosing regimen that may improve treatment outcomes using novel delivery system. PMID:24688376

Outcome after burns: an observational study on burn scar maturation and predictors for severe scarring.

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van der Wal, Martijn B A; Vloemans, Jos F P M; Tuinebreijer, Wim E; van de Ven, Peter; van Unen, Ella; van Zuijlen, Paul P M; Middelkoop, Esther

2012-01-01

Long-term outcome of burn scars as well as the relation with clinically relevant parameters has not been studied quantitatively. Therefore, we conducted a detailed analysis on the clinical changes of burn scars in a longitudinal setup. In addition, we focused on the differences in scar quality in relation to the depth, etiology of the burn wound and age of the patient. Burn scars of 474 patients were subjected to a scar assessment protocol 3, 6, and 12 months postburn. Three different age groups were defined (≤5, 5-18, and ≥18 years). The observer part of the patient and observer scar assessment scale revealed a significant (p burned (p  0.230) have no significant influence on scar quality when corrected for sex, total body surface area burned, time, and age or etiology, respectively. © 2012 by the Wound Healing Society.

The In vitro anti-acne activity of two unani drugs

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Shahid Shah Chaudhary

2013-01-01

Full Text Available Background: Acne is the most common disorder treated by dermatologists. As many as 80-90% of all adolescents have some type of acne and 30% of them require medical treatment. It is an inflammatory disease of the pilosebaceous unit characterized by the formation of open and closed comedones, papules, pustules, nodules, and cysts. Aims: The present study was conducted to investigate the in vitro anti-acne activity of two Unani single drugs Darchini (Cinnamomum zeylanicum Bl. and Tukhm Khashkhash (Papaver somniferum L. seeds. Materials and Methods: The antibacterial activity of aqueous, ethanolic and hydroalcoholic extracts of both drugs were investigated against two acne causing bacteria, i.e., Propionibacterium acne and Staphylococcus epidermidis using well diffusion method. Results: The result showed that both drugs were active against the two bacteria. Against P. acne aqueous and ethanolic extract of Darchini and Tukhm Khashkhash showed the zone of inhibition of 18 ± 1.02 mm and 18 ± 1.6 mm and 13 ± 1.04 mm and 14 ± 1.8 mm, respectively. Against S. epidermidis aqueous, hydroalcoholic and ethanolic extracts of Darchini showed 22 ± 1.7 mm, 22 ± 1.2 mm and 15 ± 1.8 mm zone of inhibition respectively. Hydroalcoholic and ethanolic extracts of Tukhm Khashkhash showed 15 ± 1.09 mm and 13 ± 1.6 mm zone of inhibition respectively. Conclusion: This suggests that C. zeylanicum and P. somniferum have potential against acne causing bacteria and hence they can be used in topical anti-acne preparations and may address the antibiotic resistance of the bacteria.

Isotretinoin therapy changes the expression of antimicrobial peptides in acne vulgaris.

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Borovaya, Alena; Dombrowski, Yvonne; Zwicker, Stephanie; Olisova, Olga; Ruzicka, Thomas; Wolf, Ronald; Schauber, Jürgen; Sárdy, Miklós

2014-10-01

In acne vulgaris, antimicrobial peptides (AMPs) could play a dual role; i.e., protective by acting against Propionibacterium acnes, pro-inflammatory by acting as signalling molecules. The cutaneous expression of 15 different AMPs was investigated in acne patients; furthermore, the impact of isotretinoin therapy on AMP expression was analysed in skin biopsies from 13 patients with acne vulgaris taken before, during and after a 6-month treatment cycle with isotretinoin using quantitative real-time polymerase chain reaction. Cutaneous expression of the AMPs cathelicidin, human β-defensin-2 (HBD-2), lactoferrin, lysozyme, psoriasin (S100A7), koebnerisin (S100A15), and RNase 7 was upregulated in untreated acne vulgaris, whereas α-defensin-1 (HNP-1) was downregulated compared to controls. While relative expression levels of cathelicidin, HBD-2, lactoferrin, psoriasin (S100A7), and koebnerisin (S100A15) decreased during isotretinoin treatment, only those of cathelicidin and koebnerisin returned to normal after 6 months of isotretinoin therapy. The increased expression of lysozyme and RNase 7 remained unaffected by isotretinoin treatment. The levels of granulysin, RANTES (CCL5), perforin, CXCL9, substance P, chromogranin B, and dermcidin were not regulated in untreated acne patients and isotretinoin had no effect on these AMPs. In conclusion, the expression of various AMPs is altered in acne vulgaris. Isotretinoin therapy normalizes the cutaneous production of distinct AMPs while the expression of others is still increased in healing acne. Considering the antimicrobial and pro-inflammatory role of AMPs, these molecules could serve as specific targets for acne therapy and maintenance of clinical remission.

Chemical Peeling with a Modified Phenol Formula for the Treatment of Facial Freckles on Asian Skin.

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Sun, Hua-Feng; Lu, Hai-Shan; Sun, Le-Qi; Ping, Wei-Dong; Mao, Dong-Sheng; Li, Dan

2018-04-01

Chemical peeling is an efficient method for the treatment of pigment disorders. For freckles, medium-depth to deep peeling using a phenol solution is one of the most effective chemical peels, and modifications of facial skin can be observed up to 20 years after peeling. However, applying phenol to the skin may cause serious side effects. Phenol peeling has been rarely used in Asia due to its tendency to cause permanent pigmentary changes and hypertrophic scars. In total, 896 Chinese inpatients with facial freckles were enrolled in this study. The phenol formula was modified with crystalline phenol, dyclonine, camphor, anhydrous alcohol and glycerin and adjusted to a concentration of 73.6-90.0%. The entire peeling treatment was divided into two procedures performed separately on 2 days. All patients exhibited 26% or greater improvement, and 99.66% of patients exhibited 51% or greater improvement (good and excellent). Scarring and systemic complications were not observed in any patient. The modified phenol formula is very effective and safe for the treatment of facial freckles in Asian patients. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Psychological impact of isotretinoin treatment in patients with moderate and severe acne.

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Simić, Dubravka; Situm, Mirna; Letica, Edita; Penavić, Jasna Zeljko; Zivković, Maja Vurnek; Tomić, Teo

2009-12-01

Acne patients are subject to different degree of psychosocial distress. The emotional impact of acne vulgaris due to disfigurement caused by the disease is undisputed. Most common reactions to the acne are depression and anxiety. The use of isotretinoin, one of the most effective options in acne treatment, increases depression symptoms. The aim of this study was to investigate the psychological status of the patients with moderate to severe acne and to compare patients treated with isotretinoin with patients treated with vitamin C. A total of 85 patients suffering from acne vulgaris were included in the study. The results of this study do not find a significant correlation between the use of isotretinoin and the psychological effects of the drug.

Etiologic Aspect of Sarcoidosis as an Allergic Endogenous Infection Caused by Propionibacterium acnes

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Yoshinobu Eishi

2013-01-01

Full Text Available Sarcoidosis is a systemic granulomatous disease of unknown etiology. Propionibacterium acnes is the only microorganism that has been isolated from sarcoid lesions. Many P. acnes have been detected in sarcoid lymph nodes using quantitative PCR and in sarcoid granulomas by in situ hybridization. P. acnes trigger factor protein causes a cellular immune response only in sarcoid patients and induces pulmonary granulomas in mice sensitized with the protein and adjuvant, but only those with latent P. acnes infection in their lungs. Eradication of P. acnes by antibiotics prevents the development of granulomas in this experimental model. Although P. acnes is the most common commensal bacterium in the lungs and lymph nodes, P. acnes-specific antibody detected the bacterium within sarcoid granulomas of these organs. P. acnes can cause latent infection in the lung and lymph node and persist in a cell-wall-deficient form. The dormant form is activated endogenously under certain conditions and proliferates at the site of latent infection. In patients with P. acnes hypersensitivity, granulomatous inflammation is triggered by intracellular proliferation of the bacterium. Proliferating bacteria may escape granulomatous isolation, spreading to other organs. Latent P. acnes infection in systemic organs can be reactivated by another triggering event, leading to systemic sarcoidosis.

The Functionality of Facial Appearance and Its Importance to a Korean Population

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Young Jun Kim

2013-11-01

Full Text Available BackgroundMany people have an interest in the correction of facial scars or deformities caused by trauma. The increasing ability to correct such flaws has been one of the reasons for the increase in the popularity of facial plastic surgery. In addition to its roles in communication, breathing, eating, olfaction and vision, the appearance of the face also plays an important role in human interactions, including during social activities. However, studies on the importance of the functional role of facial appearance. As a function of the face are scare. Therefore, in the present study, we evaluated the importance of the functions of the face in Korea.MethodsWe conducted an online panel survey of 300 participants (age range, 20-70 years. Each respondent was administered the demographic data form, Facial Function Assessment Scale, Rosenberg Self-Esteem Scale, and standard gamble questionnaires.ResultsIn the evaluation on the importance of facial functions, a normal appearance was considered as important as communication, breathing, speech, and vision. Of the 300 participants, 85% stated that a normal appearance is important in social activities.ConclusionsThe results of this survey involving a cross-section of the Korean population indicated that a normal appearance was considered one of the principal facial functions. A normal appearance was considered more important than the functions of olfaction and expression. Moreover, a normal appearance was determined to be an important facial function for leading a normal life in Korea.

The influence of united psychosomatic factors on clinical features of acne vulgaris

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Dejanović Lidija

2014-01-01

Full Text Available Acne is a chronic inflammatory disorder of the pilosebaceal unit. Dermatological disorders are often associated with a variety of psychological problems which the patient have. Psichodermatologic disorders (acne are associated with skin problems that are not directly connected to the mind, but that react to emotional states, such as stress. The aim of this article is to show if there is any psychological characteristic which are common for the whole group of ill-patients from acne, as well as whether there is correlation between any type of acne and psychological parameters. Own exploration consist at thirty patients with three clinical type of acne. Personality test-Kornel index were used for identification and diagnostic psychosomatic disorders. The results are: neurastenic parameters, parameters of conversion and parameters of psychopathy in different percent at both sex, and different clinical features. We show correlation united 2-6 psichosomatic disorders in male sex with softly type of acne. In female sex with any type of acne are responsible 7-12 united findings. The association of several psychosomatic factors could possibly be responsible for the onset of acne at any type.

Oral Antibacterial Therapy for Acne Vulgaris: An Evidence-Based Review.

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Bienenfeld, Amanda; Nagler, Arielle R; Orlow, Seth J

2017-08-01

To some degree, acne vulgaris affects nearly every individual worldwide. Oral antibiotic therapy is routinely prescribed for the treatment of moderate to severe inflammatory acne; however, long-term use of oral antibiotics for acne may have unintended consequences. The aim of this study was to provide a systematic evaluation of the scientific evidence on the efficacy and appropriate use of oral antibiotics in the treatment of acne. A systematic search of MEDLINE was conducted to identify randomized controlled clinical trials, systematic reviews, and meta-analyses evaluating the efficacy of oral antibiotics for acne. Overall, 41 articles that examined oral antibiotics compared with placebo, another oral therapy, topical therapy, alternate dose, or duration were included in this study. Tetracyclines, macrolides, and trimethoprim/sulfamethoxazole are effective and safe in the treatment of moderate to severe inflammatory acne. Superior efficacy of one type or class of antibiotic could not be determined, therefore the choice of antibiotic is generally based on the side-effect profile. Although different dosing regimens have been studied, there is a lack of standardized comparator trials to determine optimal dosing and duration of each oral antibiotic used in acne. The combination of oral antibiotics with a topical therapy is superior to oral antibiotics alone. This article provides a systematic evaluation of the scientific evidence of the efficacy of oral antibiotics for acne. Due to heterogeneity in the design of the trials, there is insufficient evidence to support one type, dose, or duration of oral antibiotic over another in terms of efficacy; however, due to increasing resistance to antibiotics, dermatologists should heed consensus guidelines for their appropriate use.

Acne Vulgaris and Quality of Life Among Young Adults in South India

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Durai, Priya Cinna T; Nair, Dhanya G

2015-01-01

Acne vulgaris is a chronic condition affecting more than 85% of adolescents and young adults. It is one of the most common diseases affecting humanity and its impact on quality of life (QoL) is important. The impact of acne on QoL in Indian patients remains undocumented. The study was undertaken to detect the impact of acne vulgaris and related factors that may influence the QoL. Materials and Methods: This was a hospital-based, prospective, cross-sectional, prestructured, questionnaire-based study done on 140 consenting individuals, who attended the Dermatology outpatient department. Acne vulgaris was graded using simple grading system. QoL was measured using a combination of skin disease-specific (Dermatological Life Quality Index (DLQI)) and acne-specific (Cardiff Acne Disability Index (CADI)) questionnaires. Results: Majority of our study population were students (103, 73.6%). Face (139, 99.3%) was the commonest site of acne and comedones 133, 95% were the commonest type of lesion. Most of the individuals 66, 47.1% were observed to have grade 1 acne. The mean DLQI score was 6.91 and the mean CADI score was 5.2. Association between the scores was statistically significant. Age, occupation, marital status, family, and treatment history played a role in affecting the QoL. Diet, smoking, and alcohol did not influence the QoL. Conclusion: Though acne had impact on patient's QoL, it was less severe in our study. It is important for health professionals to incorporate QoL measurements when managing acne patients to provide better and appropriate care. PMID:25657394

Acne vulgaris: prevalence and clinical forms in adolescents from São Paulo, Brazil*

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Bagatin, Ediléia; Timpano, Denise Lourenço; Guadanhim, Lilia Ramos dos Santos; Nogueira, Vanessa Mussupapo Andraus; Terzian, Luiz Roberto; Steiner, Denise; Florez, Mercedes

2014-01-01

BACKGROUND Acne is a common disease in adolescents, but there are no epidemiological data for acne in Brazil. OBJECTIVES To estimate the prevalence and degree of acne in adolescents from Sao Paulo and study socio-demographic factors, family history and lifestyle, associated with the disease. METHODS Cross-sectional study with 452 adolescents aged between 10 and 17 (mean=13.3 years), students from elementary and high school, examined by 3 independent evaluators. RESULTS 62.4% were female, 85.8% white and 6.4% were aged 14. The prevalence was 96.0% and increased with age - all students over 14 had acne. The most prevalent form of acne was comedonal (61.1%), followed by mild (30.6%) and moderate (7.6%) papular-pustular, which affected mostly the face (97.5%). About half of the adolescents reported family history for acne in mother or father, and 20.6% reported previous treatment for acne. There was a higher chance of presenting non-comedonal acne with increased age (pacne in adolescents varies widely due to the clinical features and diagnostic methods used. Adolescents whose brothers/sisters had acne (OR=1.7-p=0.027) and those over 13 (OR=8.3-pacne. CONCLUSION This study showed high prevalence of acne in adolescents from Sao Paulo, predominantly the comedonal form on the face, with a higher chance of presenting non-comedonal acne with increased age. PMID:24937816

The clinical outcome of cesarean scar pregnancies implanted "on the scar" versus "in the niche".

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Kaelin Agten, Andrea; Cali, Giuseppe; Monteagudo, Ana; Oviedo, Johana; Ramos, Joanne; Timor-Tritsch, Ilan

2017-05-01

The term cesarean scar pregnancy refers to placental implantation within the scar of a previous cesarean delivery. The rising numbers of cesarean deliveries in the last decades have led to an increased incidence of cesarean scar pregnancy. Complications of cesarean scar pregnancy include morbidly adherent placenta, uterine rupture, severe hemorrhage, and preterm labor. It is suspected that cesarean scar pregnancies that are implanted within a dehiscent scar ("niche") behave differently compared with those implanted on top of a well-healed scar. To date there are no studies that have compared pregnancy outcomes between cesarean scar pregnancies implanted either "on the scar" or "in the niche." The purpose of this study was to determine the pregnancy outcome of cesarean scar pregnancy implanted either "on the scar" or "in the niche." This was a retrospective 2-center study of 17 patients with cesarean scar pregnancy that was diagnosed from 5-9 weeks gestation (median, 8 weeks). All cesarean scar pregnancies were categorized as either implanted or "on the scar" (group A) or "in the niche" (group B), based on their first-trimester transvaginal ultrasound examination. Clinical outcomes based on gestational age at delivery, mode of delivery, blood loss at delivery, neonate weight and placental histopathologic condition were compared between the groups with the use of the Mann-Whitney U test. Myometrial thickness overlying the placenta was compared among all the patients who required hysterectomy and those who did not with the use of the Mann-Whitney U test. Myometrial thickness was also correlated with gestational age at delivery with the use of Spearman's correlation. Group A consisted of 6 patients; group B consisted of 11 patients. Gestational age at delivery was lower in group B (median, 34 weeks; range, 20-36 weeks) than in group A (median, 38 weeks; range, 37-39 weeks; P=.001). In group A, 5 patients were delivered via cesarean delivery (with normal placenta), and

Light-based therapies in acne treatment

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Pei, Susan; Inamadar, Arun C.; Adya, Keshavmurthy A.; Tsoukas, Maria M.

2015-01-01

The use of light and laser in the treatment of acne is increasing as these modalities are safe, effective, and associated with no or minimal complications when used appropriately. These light and laser sources are also being used in combination with pharmacological and/or physical measures to synergize their effects and optimize the therapeutic outcome. This review focuses on optical devices used in treating acne and serves to delineate the current application of various methods, including their utility and efficacy. PMID:26009707

Improving adherence to acne treatment: the emerging role of application software

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Park C

2014-02-01

Full Text Available Chanhyun Park,1 Gilwan Kim,1 Isha Patel,2 Jongwha Chang,3 Xi Tan2 1College of Pharmacy, University of Texas at Austin, Austin, TX, USA; 2College of Pharmacy, University of Michigan, Ann Arbor, MI, USA; 3McWhorter School of Pharmacy, Samford University, Birmingham, AL, USA Objective: To examine recent studies on the effect of mobile and electronic (ME-health technology on adherence to acne treatment. Background: With emerging use of ME-health technology, there is a growing interest in evaluating the effectiveness of the tools on medication adherence. Examples of ME-health technology-based tools include text message-based pill reminders and Web-based patient education. Methods: MEDLINE, Cochrane Library, and Web of Science were searched for articles on adherence to acne treatment published through November 2013. A combination of search terms such as "acne" and "adherence" or "compliance" were used. Results: Adherence to oral acne medication was higher than for topical acne medication. The frequency of office visits was also an influencing factor for acne treatment adherence. The telephone-based reminders on a daily basis did not improve acne patients' medication adherence, whereas the Web-based educational tools on a weekly basis had a positive effect on medication adherence in acne treatment. Conclusion: In using ME-health interventions, factors such as medication dosage forms, frequency of intervention, and patients' preferences should be taken into consideration. Developing disease-specific text message reminders may be helpful to increase adherence rates. In addition, a combination of text message reminders with another type of intervention may improve medication adherence. Keywords: acne vulgaris, medication adherence, compliance, mobile and electronic health technology, application software, telemedicine

Cesarean Scar Ectopic Pregnancy: Laparoscopic Resection and Total Scar Dehiscence Repair.

Science.gov (United States)

Mahgoub, Sara; Gabriele, Victor; Faller, Emilie; Langer, Bruno; Wattiez, Arnaud; Lecointre, Lise; Akladios, Cherif

2018-02-01

To illustrate a laparoscopic technique for the resection of cesarean scar ectopic pregnancy, associated with isthmocele repair. Case report (Canadian Task Force classification III). A tertiary referral center in Strasbourg, France. Cesarean scar pregnancy is a rare form of ectopic pregnancy. The major risk of this type of pregnancy is the early uterine rupture with massive, sometimes life-threatening, bleeding. Thus, active management of these pregnancies starting immediately after diagnosis is crucial. Therapeutic options can be medical, surgical, or a combination. Numerous case reports or case series can be found in the literature, but there are few clinical studies, which are difficult to conduct because of case rarity and inconclusiveness. A 2016 meta-analysis that included 194 articles published between 1978 and 2014 (126 case reports, 45 cases series, and 23 clinical studies) concluded that hysteroscopy or laparoscopic hysterotomy seems to be the best first-line approach to treating cesarean scar ectopic pregnancy, with uterine artery embolization reserved for significant bleeding and/or a high suspicion index for arteriovenous malformation [1]. There is no consensus on the treatment of reference, however. The case involves a 38-year-old primiparous women who underwent a cesarean section delivery in 2010 and who was diagnosed by ultrasound scan at 7 weeks gestation with cesarean scar ectopic pregnancy, which was confirmed by pelvic magnetic resonance imaging. The patient initially received medical treatment with 2 intramuscular injections of methotrexate and one local intragestational injection of KCl. Her initial human chorionic gonadotropin (hCG) level was 82 000 IU/L. Rigorous weekly biological and ultrasound monitoring revealed an involution of the ectopic pregnancy associated with decreasing hCG. No bleeding or infectious complications occurred during this period. After 10 weeks of monitoring, her hCG had stabilized at 300 IU/L, and a residual image

[Bacterial resistance in acne? A meta-analysis of the controversy].

Science.gov (United States)

Alvarez-Sánchez, Mariana; Rodríguez-Ayala, Ernesto; Ponce-Olivera, Rosa María; Tirado-Sánchez, Andrés; Arellano-Mendoza, María Ivonne

2016-01-01

Acne is one of the dermatological pathologies with the highest incidence around the world. It is a multifactorial disease and its treatment can be complex. Propionibacterium acnes play a key role in the inflammation of this dermatosis. Topical antibiotics, including mainly erythromycin and clindamycin, have been used, but there is controversy over their use due to the widely documented bacterial resistance. For this reason a meta-analysis of the publications over the past 10 years is presented in order to confirm this hypothesis. A search was made of the publications over the past 10 years that included the results of antibiogams of patients with acne. MeSH type searches were performed with the terms "acne vulgaris", "Propionibacterium acnes", "topical administration", "treatment", "erythromycin", "clindamycin", "nadifloxacin", "antibacterial agent", "bacterial drug resistance" in PubMed, Ovid, EBSCO, Cochrane, ScienceDirect and ClinicalKey meta-searches. A total of 13 articles were found that met the inclusion criteria. The mean odds ratio (OR 1.24, 95% CI) of the articles showed a slight tendency toward resistance of Propionibacterium acnes. An increase in bacterial resistance to topical erythromycin and clindamycin can be confirmed, thus the use of these antibiotics is recommended in selective cases for short periods, and in combination with benzoyl peroxide for the best clinical outcome in patients with acne vulgaris. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.

Radiation scars on mammograms

International Nuclear Information System (INIS)

Otto, H.; Breining, H.; Knappschafts-Krankenhaus Essen

1985-01-01

Six patients with radiation scars are described. In each case the diagnosis was confirmed histologically in five cases corresponding mammograms were available. The histological appearances of radiation scars are described and the radiological features are presented. These lesions can be diagnosed mammographically in vivo. Macroscopically differentiation from a scirrhous carcinoma is not possible and therefore a radiation scar must always be excised; this also leads to definitive cure. On mammographic screening the incidence is 0.5 to 0.9 per thousand. The significance of radiation scars depends on the fact that they are pre-cancerous and therefore are equivalent to the early diagnosis of a carcinoma with the possibility of a complete cure. (orig.) [de

Incidence of Propionibacterium acnes in initially culture-negative thioglycollate broths

DEFF Research Database (Denmark)

Kvich, L.; Jensen, Peter Østrup; Justesen, U. S.

2016-01-01

The aim of this study was to prospectively investigate the incidence of Propionibacterium acnes in thioglycollate broths reported as culture-negative at the Department of Clinical Microbiology, Rigshospitalet, to evaluate whether 5 days of incubation was enough to find all relevant cases. Five....... After exclusion criteria were met, P. acnes was cultured from ten out of 151 patients (6.6%) in the infected group and from one out of 138 participants (0.7%) in the control group. This resulted in more findings of P. acnes in the infected group on day 14 than on day 5 (p 0.002). Furthermore, P. acnes...... was cultured more often from bone tissue and tissue surrounding foreign materials on day 14 than on day 5 (p 0.04). Clinical microbiology laboratories should consider incubating thioglycollate broths for at least 14 days to find all relevant cases of P. acnes, especially when it comes to bone tissue and tissue...

Differentiated treatment of patients with acne and concomitant candida infection

Directory of Open Access Journals (Sweden)

Yaakubi Randa

2016-12-01

Full Text Available There are a lot of works, which are devoted to the study of acne, but these data are often contradictory on the issue of interrelationship and interdependence of clinical manifestations, course and some factors in the pathogenesis of acne and candida infection. Aim of the research was to study the effect of the recommended differentiated therapy on the pathogenetic disorders in patients with acne and concomitant Candida infection. Methods and results. 120 patients with acne were examined. In 100 of them concomitant skin malasseziosis was set in the form of pityriasis rosea, kerosis, comedones, folliculitis, seborrhea, multicolored zoster, with some features, as well as candidiasis. Methods of the research – bacterioscopic, bacteriological, study of skin oiliness and moisture, skin pH, the level of Ca ++, parathyroid hormone and calcitonin. In patients with acne significant shifts in the composition of water-lipid mantle, increased oiliness and decreased moisture of skin, pH changes with a shift to the alkaline side were revealed, the most pronounced – in acne patients with Candida infection. The content of Ca ++ in the organism, as well as parathyroid hormone and calcitonin was increased and also the most indicative it was in patients with acne and concomitant Candida infection. After the comparative analysis on the basis of different levels of clinical and laboratory violations two clinical-therapeutic groups were distinguished, in accordance with that the differentiated therapy offered by us was conducted. Increased oiliness and Рh of skin, decline of moisture before the treatment, especially in patients with III and IV stages of acne, complicated by Candida infection, were normalized after treatment, unlike in patients treated traditionally. Conclusion. After treatment intensity of microbal colonization and also microbal associations of skin was diminished, the level of Ca++, parathyroid hormone and calcitonin went down.

An aqueous gel fixed combination of clindamycin phosphate 1.2% and benzoyl peroxide 3.75% for the once-daily treatment of moderate to severe acne vulgaris.

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Pariser, David M; Rich, Phoebe; Cook-Bolden, Fran E; Korotzer, Andrew

2014-09-01

To evaluate efficacy, safety, and tolerability of a fixed combination clindamycin phosphate 1.2% and benzoyl peroxide 3.75% (clindamycin-BP 3.75%) aqueous gel in moderate to severe acne vulgaris. A total of 498 patients, 12-40 years of age, were randomized to receive clindamycin-BP 3.75% or vehicle in a double-blind, controlled 12-week, 2-arm study evaluating safety and efficacy using inflammatory and noninflammatory lesion counts, Evaluator Global Severity Scores (EGSS) and subject self-assessment (SSA). In addition, patients completed a patient satisfaction survey (PSS), acne-specific QoL questionnaire, and assessed their facial skin for shininess/oiliness. Clindamycin-BP 3.75% demonstrated statistical superiority to vehicle in reducing both inflammatory and noninflammatory lesions and acne severity. Clindamycin-BP 3.75% showed greater efficacy relative to vehicle in assessments of skin oiliness, SSA and PSS. No substantive differences were seen in cutaneous tolerability among treatment groups and no patients discontinued treatment with Clindamycin-BP 3.75% because of adverse events. Data from controlled studies may differ from clinical practice. It is not possible to determine the contributions from the individual active ingredients. Clindamycin-BP 3.75% provides statistically significant greater efficacy than vehicle with a favorable safety and tolerability profile.

[Physical treatment methods for acne. Light, laser, photodynamic therapy and peeling].

Science.gov (United States)

Borelli, C; Korting, H C

2010-02-01

The medical treatment of acne is generally sufficient to meet the expectations of acne patients. However, in a number of situations additional therapeutic approaches may be advisable. There are a wide variety of useful physical methods. They range from electromagnetic waves, usually light, to peeling and manual therapy. Phototherapy of acne includes not just visible light but also laser and flash lamp therapy. The present review provides an overview on the evidence. Visible light, in particular blue light, provides an effective option for treatment of inflammatory acne. Photodynamic therapy also is efficacious; however, it should not be used because of an unfavorable risk-benefit ratio. UV treatment of acne is obsolete. Newer studies on the use of a variety of laser systems and flash lamps have demonstrated in part rewarding results.

Beliefs, perceptions and psychological impact of Acne vulgaris ...

African Journals Online (AJOL)

Background: There is a paucity of reports in the literature detailing the assessment of the beliefs,perception and psychological impact of acne patients . This is the first study from Saudi Arabia designed to address this issue. Materials and methods: A voluntary self-completed questionnaire was used to collect data from acne ...

Effects of bee venom against Propionibacterium acnes-induced inflammation in human keratinocytes and monocytes.

Science.gov (United States)

Kim, Jung-Yeon; Lee, Woo-Ram; Kim, Kyung-Hyun; An, Hyun-Jin; Chang, Young-Chae; Han, Sang-Mi; Park, Yoon-Yub; Pak, Sok Cheon; Park, Kwan-Kyu

2015-06-01

Propionibacterium acnes (P. acnes) cause inflammatory acne and play an important role in the pathogenesis of acne by inducing inflammatory mediators. P. acnes contributes to the inflammatory responses of acne by activating inflammatory cells, keratinocytes and sebocytes to secrete pro-inflammatory cytokines such as tumor necrosis factor-α (TNF-α), interleukin (IL)-1β and IL-8. Bee venom has traditionally been used in the treatment of certain immune-related diseases. However, there has not yet been a robust trial to prove the therapeutic effect of bee venom in skin inflammation. The aim of the present study was to investigate anti-inflammatory properties of bee venom in skin inflammation induced by P. acnes using keratinocytes (HaCaT) and monocytes (THP-1). P. acnes is known to stimulate the production of pro-inflammatory cytokines such as IL-1, IL-8, IL-12 and TNF-α. In the present study, the production of interferon-γ (IFN-γ), IL-1β, IL-8 and TNF-α was increased by P. acnes treatment in HaCaT and THP-1 cells. By contrast, bee venom effectively inhibited the secretion of IFN-γ, IL-1β, IL-8 and TNF-α. Furthermore, P. acnes treatment activated the expression of IL-8 and toll-like receptor 2 (TLR2) in HaCaT cells. However, bee venom inhibited the expression of IL-8 and TLR2 in heat-killed P. acnes. Based on these results, it is concluded that bee venom has an effective anti-inflammatory activity against P. acnes in HaCaT and THP-1 cells. Therefore, we suggest that bee venom is an alternative treatment to antibiotic therapy of acne.

Keloid Skin Flap Retention and Resurfacing in Facial Keloid Treatment.

Science.gov (United States)

Liu, Shu; Liang, Weizhong; Song, Kexin; Wang, Youbin

2018-02-01

Facial keloids commonly occur in young patients. Multiple keloid masses often converge into a large lesion on the face, representing a significant obstacle to keloid mass excision and reconstruction. We describe a new surgical method that excises the keloid mass and resurfaces the wound by saving the keloid skin as a skin flap during facial keloid treatment. Forty-five patients with facial keloids were treated in our department between January 2013 and January 2016. Multiple incisions were made along the facial esthetic line on the keloid mass. The keloid skin was dissected and elevated as a skin flap with one or two pedicles. The scar tissue in the keloid was then removed through the incision. The wound was covered with the preserved keloid skin flap and closed without tension. Radiotherapy and hyperbaric oxygen were applied after surgery. Patients underwent follow-up examinations 6 and 12 months after surgery. Of the 45 total patients, 32 patients were cured and seven patients were partially cured. The efficacy rate was 88.9%, and 38 patients (84.4%) were satisfied with the esthetic result. We describe an efficacious and esthetically satisfactory surgical method for managing facial keloids by preserving the keloid skin as a skin flap. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Effect of Lactobacillus reuteri on the proliferation of Propionibacterium acnes and Staphylococcus epidermidis.

Science.gov (United States)

Kang, Mi-Sun; Oh, Jong-Suk; Lee, Seok-Woo; Lim, Hoi-Soon; Choi, Nam-Ki; Kim, Seon-Mi

2012-02-01

While it is generally accepted that Propionibacterium acnes is involved in the development of acne, other bacteria including Staphylococcus epidermidis have also been isolated from the acne lesion. The interaction between Lactobacillus reuteri, a probiotic bacterium, and acnegenic bacteria is unclear. This study examined the effects of L. reuteri on the proliferation of P. acnes and S. epidermidis. Human-derived L. reuteri strains (KCTC 3594 and KCTC 3678) and rat-derived L. reuteri KCTC 3679 were used. All strains exhibited significant inhibitory effects on the growth of P. acnes and S. epidermidis. The proliferation of P. acnes was decreased by 2-log scales after incubation with L. reuteri for 24 h. In addition, the proliferation of S. epidermidis was decreased by 3-log scales after incubation with L. reuteri for 24 h, whereas the growth of L. reuteri was unaffected by P. acnes or S. epidermidis. Among the L. reuteri strains examined, L. reuteri KCTC 3679 had the strongest inhibitory effect on the growth of P. acnes and S. epidermidis, followed by L. reuteri KCTC 3594 and L. reuteri KCTC 3678. Interestingly, reuterin, an antimicrobial factor, was produced only by L. reuteri KCTC 3594. The most pronounced the antibacterial activities of L. reuteri were attributed to the production of organic acids. Overall, these results suggest that L. reuteri may be a useful probiotic agent to control the growth of bacteria involved in acne inflammation and prevent acne.

Evaluation of social anxiety, self-esteem, life quality in adolescents with acne vulgaris.

Science.gov (United States)

Unal, Dilek; Emiroğlu, Nazan; Cengiz, Fatma Pelin

2016-08-05

Acne vulgaris is a visible skin disease commonly seen in adolescence. As it affects the appearance, it is likely to bring stress to the adolescent's life regarding sensitivity about their appearance. The aim of the study was to investigate the social anxiety level, acne-specific life quality, and self-esteem among adolescents with acne vulgaris. In addition, we evaluated the relationship between these parameters, clinical severity, and sociodemographic data. One hundred and two adolescents with acne vulgaris, aged 12-17 years without any psychiatric or medical comorbidity were recruited. The control group consisted of 83 adolescents in the same age range, who had neither psychiatric disease nor acne. Sociodemographic form (SDF), Capa Social Phobia Scale for Children and Adolescents (CSPSCA), and Rosenberg Self-esteem Scale (RSES) were applied to both groups. Additionally, the severity of acne was determined with Global Acne Grading System (GAGS), and life quality of the patients was evaluated with Acne Quality of Life Scale (AQOL). There was no significant difference in social anxiety levels and self-esteem between the study and control groups. Life quality impairment and high social anxiety levels, as well as low self-esteem, were found to be associated regardless of the clinical severity. Clinicians should be aware of the psychiatric comorbidities when treating adolescents with acne vulgaris. Especially, low self-esteem and life quality impairment should warn clinicians to predict high social anxiety levels in adolescent acne patients.

THE ROLE OF INFLAMMATORY CYTOKINES IN THE INITIATION AND COURSE OF ACNE: A MODERN VIEW

Directory of Open Access Journals (Sweden)

A. V. Kormilitcyna

2017-01-01

Full Text Available The publication provides an overview of current scientific and medical literature devoted to the study of mechanisms of immunopathogenesis of acne. The concept of the pathophysiology and immunopathogenesis of acne expanded significantly in recent years, many scientists have pointed out the link between the presence of acne and disorders of the endocrine, nervous, digestive and immune systems. Despite the fact that the individual links in the pathogenesis of acne are well studied, there are still questions about the role of commensal Propionibacterium acnes in the initiation and development of acne. So far there is no information on the number of P. acnes in healthy and diseased skin, the relationship between the numder of P. acnes and severity of the disease, also an important question remains unanswered — why do P. acnes cause inflammation for some people, while it don`t for the others? Despite the presence of bacterial factor in the pathogenesis of acne, there are a large number of studies showing that the nature of the patient’s immune response to P. acnes is more important than the infectious agent. For quite a long time data was received that proinflammatory cytokines play an important role in the initiation of acne. Interleukins IL-6 and IL-8 are involved in the stimulation of sebum hypersecretion, and subpopulation Th1 derived from a patient with acne, recognize P. acnes antigens. A number of recently obtained results suggest that P. acnes is a potent inducer of Th17 and Th1, and the study of the role of proinflammatory cytokines in the development of acne suggests new possibilities of acne therapy. Presented in this article is a clinical case clearly illustrates the part of the immune inflammation in acne. Prospective areas of research on the role of signaling molecules in the pathogenesis of acne are covered: such as the mechanism of action of nitric oxide on the secretion of interleukin IL-1 beta, which was shown as

Hidradenitis Suppurativa/Acne Inversa

DEFF Research Database (Denmark)

Zouboulis, Christos C.; Del Marmol, Véronique; Mrowietz, Ulrich

2015-01-01

BACKGROUND: Hidradenitis suppurativa/acne inversa (HS) is a chronic, inflammatory, recurrent, debilitating disease, which inflicts a significant burden on patients and is associated with comorbid disorders, such as significantly reduced quality of life, depression, stigmatization, inactivity...

Roentgenodiagnosis of stomach postulcer scar

International Nuclear Information System (INIS)

Strunin, A.E.

1985-01-01

A study was made of the X-ray picture of the stomach postulcer scar in correlation with fibrogastroscopy in 39 patients. The X-ray picture was characterized by considerable polymorphism and at the same time it was difficult to single out pathognomonic features. For specified diagnosis and differentiation the detection of the postulcer scar must become a multifaceted roentgenoendoscopic problem. Stomach ulcers may scar, sometimes with the complete regeneration of the mucosa relief, however their recurrences can develop in the zone of the postulcer scar

Prefabricated neck expanded skin flap with the superficial temporal vessels for facial resurfacing.

Science.gov (United States)

Lazzeri, Davide; Su, Weijie; Qian, Yunliang; Messmer, Caroline; Agostini, Tommaso; Spinelli, Giuseppe; Marcus, Jeffrey R; Levin, L Scott; Zenn, Micheal R; Zhang, Yi Xin

2013-05-01

The achievement of a normal-appearing face after surgical resurfacing remains an elusive goal. This is due in part to insufficient color matching, restoration of contours, and the persistence of visible scars. Flap prefabrication is a staged procedure that provides an independent axial blood supply to local expanded tissues. We describe a new reconstructive alternative with superior reconstructive surgical options for facial resurfacing that better matches damaged or discarded facial tissues. A superficial temporal fascial flap was harvested as the vascular supply of the prefabricated neck flap and located in a subcutaneous neck pocket over a tissue expander. After a 5-month period for expansion and maturation, the prefabricated skin flap was raised, islanded, and rotated to resurface the facial defect. Four patients with hemifacial postburn contracture and two patients affected by hemifacial vascular malformations aged 17 to 42 years (mean 29 years) were successfully treated with no major complication after a mean period of 15 months. Prefabricated neck-expanded skin flap demonstrated an excellent color and texture match with facial skin that surrounded the repair sites, and optimal aesthetic results were obtained. Importantly, facial expression was completely maintained due to thinness and pliability of the rotated skin. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Evaluation of leptin, adiponectin, and ghrelin levels in patients with acne vulgaris.

Science.gov (United States)

Ozuguz, P; Kacar, S D; Asik, G; Ozuguz, U; Karatas, S

2016-02-09

The research evaluating adipokines are very few in patients with acne vulgaris. The hypothesis that hyperinsulinemic and high glycemic index diet plays a role in the pathogenesis of acne is still controversial. In this study, we aimed to evaluate adipokines such as leptin (L), adiponectin (A), ghrelin and A levels, and A/L rates that indicate insulin resistance in nonobese patients with severe acne vulgaris. Thirty patients who are nonobese with moderate acne vulgaris, aged 18 to 25 years, and 15 age-sex compatible controls were included in our study. The acne lesions were assessed using the Global Acne Grading Scale (GAGS). All participants were evaluated for the parameters that may affect the metabolism of serum L, A, and ghrelin levels in blood, and their body mass index were calculated. The significance level was determined as p ≤ 0.05. Of the 30 patients, 17 were women and 13 were men. The mean age was 20.60 years and the mean duration of the disease were 2.8 years. All of patients had moderate acne vulgaris (GAGS 19-30). Of the 15 controls, 11 were women and 4 were men. The mean age was 21.20 years. There were not a statistically significant difference in L, ghrelin, A levels, and A/L ratio between the two groups. Adipokines may have a role in the pathogenesis of acne vulgaris. L, A, ghrelin, and insulin resistance may not participate in the responsible mechanisms in nonobese patients with moderate acne vulgaris. © The Author(s) 2016.

Propionibacterium acnes in shoulder surgery: is loss of hair protective for infection?

Science.gov (United States)

Hudek, Robert; Sommer, Frank; Abdelkawi, Ayman F; Kerwat, Martina; Müller, Hans-Helge; Gohlke, Frank

2016-06-01

Propionibacterium acnes (P acnes) has been linked to chronic infections in shoulder surgery. It was recently observed during first-time shoulder surgery in healthy patients at a rate between 36% and 56%. Male gender and the anterolateral approach were reported risk factors. Because the skin biology greatly differs, we aimed to correlate skin complaints with P acnes-positive intraoperative cultures from different tissue layer samples in patients undergoing shoulder surgery for the first time. Intraoperative samples (1 skin, 1 superficial, 1 deep tissue, and 1 control sample) from 112 patients (70 men, 42 women; aged 59.2 years) were cultured. The association between the presence of P acnes in the deep or superficial tissue, or both, and 10 items of a validated preoperative questionnaire for skin pathology was explored. The cultures were positive for P acnes in 38.4% (n = 43) of the cases. Skin samples were positive for P acnes in 8% (n = 9), superficial samples were positive in 23% (n = 26), and deep samples were positive in 30% (n = 34). Self-reported "loss of hair" was significantly negatively associated with the presence of P acnes in the superficial or deep tissue sample (P = .00028). Patients who report having "loss of hair" show fewer P acnes-positive cultures in intraoperative tissue samples taken during open shoulder surgery. Whether this subgroup is at a lesser risk for P acnes infections remains to be substantiated. Basic Science Study; Microbiology. Copyright © 2016 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

QUALITY OF LIFE AMONG ADOLESCENTS WITH ACNE IN A TERTIARY REFERRAL CENTRE IN BANGALORE

Directory of Open Access Journals (Sweden)

Belliappa Pemmanda Raju

2016-08-01

Full Text Available BACKGROUND Acne is a common problem in adolescent children and has a considerable impact on their quality of life. AIMS The impact of acne on quality of life (QoL in Indian adolescent patients remains undocumented. The study was undertaken to detect the impact of acne vulgaris in adolescents on the QoL using 2 questionnaires: The Children’s Dermatology Life Quality Index (CDLQI and the Cardiff Acne Disability Index (CADI. MATERIALS AND METHODS This was a hospital-based, prospective, cross-sectional, pre-structured, questionnaire-based study done on 140 consenting individuals, who attended the Acne Clinic of our Dermatology Outpatient Department. Acne vulgaris was graded using simple grading system. QoL was measured using a combination of skin disease-specific (Children’s Dermatological Life Quality Index (CDLQI and acne-specific (Cardiff Acne Disability Index (CADI questionnaires. RESULTS The study population included 140 cases with a female to male ratio of 1.5:1. Comedones (123, 87.9% were the most common type of lesion. Grade I acne was the most common clinical type (76.4%. There was a statistically significant difference between acne severity and gender. The overall mean CDLQI score (7.21 of max. 30 and the overall mean CADI score (4.8 of max. 15 were low, indicating a mild impairment of QoL among adolescents. Statistically significant association was noted between CDLQI and CADI scores and grade of acne. There was no statistically significant association noted between CDLQI and CADI scores and gender. CONCLUSION Though acne had impact on patient’s QoL, it was less severe in our study. The CDLQI and CADI questionnaires represent simple and reliable instruments for the assessment of QoL among adolescents and should be incorporated when managing acne patients to provide better and appropriate care.

Outcome after burns: An observational study on burn scar maturation and predictors for severe scarring

NARCIS (Netherlands)

van der Wal, M.B.A.; Vloemans, J.F.P.M.; Tuinebreijer, W.E.; van de Ven, P.M.; van Unen, E.; van Zuijlen, P.P.M.; Middelkoop, E.

2012-01-01

Long-term outcome of burn scars as well as the relation with clinically relevant parameters has not been studied quantitatively. Therefore, we conducted a detailed analysis on the clinical changes of burn scars in a longitudinal setup. In addition, we focused on the differences in scar quality in

Subjective facial skin type, based on the sebum related symptoms, can reflect the objective casual sebum level in acne patients.

Science.gov (United States)

Choi, C W; Choi, J W; Youn, S W

2013-05-01

The relationship between the subjective skin type and the casual sebum level was not fully clarified. To investigate the characteristics of subjective skin type and to find the relationship between the subjective skin types and the skin type-related symptoms, casual sebum level, along with the objective skin type. Seven hundred and nine patients, clinically diagnosed with acne, were included. The questionnaire and the casual sebum level measurement were performed. The determining symptoms of each subjective skin type were investigated. The 95% confidence interval of casual sebum level of each subjective skin type was calculated. The most frequent subjective skin type was the combination type. The dryness, tightness, and oiliness can be conclusive symptoms in determining the subjective skin type. The mean and the 95% confidence interval of the casual sebum level was highest in the oily skin type, followed by the combination, normal, and dry skin type. We found that the subjective skin type was determined by the skin type-related symptoms. The 95% confidence intervals of the casual sebum level of each subjective skin type were established. Based on the skin type-related symptoms, the casual sebum level of acne patients can be estimated. © 2012 John Wiley & Sons A/S. Published by Blackwell Publishing Ltd.

[Light, laser and PDT therapy for acne].

Science.gov (United States)

Borelli, C; Merk, K; Plewig, G; Degitz, K

2005-11-01

In recent years, a number of studies have evaluated the treatment of acne using electromagnetic waves, such as lasers, photodynamic therapy, visible light or radio waves. While the efficacy of laser treatment is still uncertain, photodynamic therapy shows promising results, but with marked side-effects, as destruction of sebaceous glands. Treatment with blue light (405-420 nm wavelength) also appears effective and can be regarded as an treatment option for inflammatory acne.

The constellation of dietary factors in adolescent acne: a semantic connectivity map approach.

Science.gov (United States)

Grossi, E; Cazzaniga, S; Crotti, S; Naldi, L; Di Landro, A; Ingordo, V; Cusano, F; Atzori, L; Tripodi Cutrì, F; Musumeci, M L; Pezzarossa, E; Bettoli, V; Caproni, M; Bonci, A

2016-01-01

Different lifestyle and dietetic factors have been linked with the onset and severity of acne. To assess the complex interconnection between dietetic variables and acne. This was a reanalysis of data from a case-control study by using a semantic connectivity map approach. 563 subjects, aged 10-24 years, involved in a case-control study of acne between March 2009 and February 2010, were considered in this study. The analysis evaluated the link between a moderate to severe acne and anthropometric variables, family history and dietetic factors. Analyses were conducted by relying on an artificial adaptive system, the Auto Semantic Connectivity Map (AutoCM). The AutoCM map showed that moderate-severe acne was closely associated with family history of acne in first degree relatives, obesity (BMI ≥ 30), and high consumption of milk, in particular skim milk, cheese/yogurt, sweets/cakes, chocolate, and a low consumption of fish, and limited intake of fruits/vegetables. Our analyses confirm the link between several dietetic items and acne. When providing care, dermatologists should also be aware of the complex interconnection between dietetic factors and acne. © 2014 European Academy of Dermatology and Venereology.

The use of oral antibiotics in treating acne vulgaris: a new approach.

Science.gov (United States)

Farrah, Georgia; Tan, Ernest

2016-09-01

Although acne is not an infectious disease, oral antibiotics have remained a mainstay of treatment over the last 40 years. The anti-inflammatory properties of oral antibiotics, particularly the tetracyclines, are efficacious in treating inflammatory acne lesions. Common prescribing practices in Dermatology exert significant selection pressure on bacteria, contributing to the development of antibiotic resistance. Antibiotic use for acne not only promotes resistance in Propionibacterium acnes, but also affects other host bacteria with pathogenic potential. This review will summarize the commonly used treatments for acne vulgaris, and how they should be combined as rational treatment. The indications for using oral antibiotics in acne will be highlighted. Strategies described in the literature to conserve the utility of oral antibiotics will be summarized. These include limiting the duration of antibiotic therapy, concomitant use of a topical non-antibiotic agent, use of subantimicrobial dose doxycycline, and the introduction of topical dapsone. © 2016 Wiley Periodicals, Inc.

Translation, cultural adaptation and validation for Brazilian Portuguese of the Cardiff Acne Disability Index instrument.

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Grando, Luciana Rosa; Horn, Roberta; Cunha, Vivian Trein; Cestari, Tania Ferreira

2016-04-01

The Cardiff Acne Disability Index was originally developed in English for measuring quality of life of acne patients. Considering the psychosocial impact of this disease, it is important to have instruments culturally and linguistically validated for use in Brazilian adolescents. To translate the Cardiff Acne Disability Index into Brazilian Portuguese, culturally adapt it, and verify its reliability and validity in adolescent patients with acne. In the first step, the Cardiff Acne Disability Index was translated and validated linguistically to Brazilian Portuguese in accordance with international guidelines published. In the second step, the validation of the Cardiff Acne Disability Index into Brazilian Portuguese instrument was performed, when patients aged from 12 to 20 years with acne were selected. The participants were interviewed to collect demographic data, submitted to the classification of acne by the Global Acne Grading System and invited to respond the Cardiff Acne Disability Index into Brazilian Portuguese version and DLQI (>16 years) or CDLQI (≤16 years). The internal consistency of Cardiff Acne Disability Index into Brazilian Portuguese was assessed by Cronbach's alpha coefficient and concurrent validity was measured by the Spearman correlation coefficient and Student 's t-test for paired samples. The study included 100 adolescents. The Cardiff Acne Disability Index into Brazilian Portuguese version showed good reliability and internal consistency (Cronbach's alpha = 0.73). The concurrent validity of the scale was supported by a strong and significant correlation with CDLQI / DLQI instruments (rs=0.802;pPortuguese version is a reliable, valid and valuable tool to measure the impact of acne on quality of life in adolescent patients.

The influence of dietary patterns on acne vulgaris in Koreans.

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Jung, Jae Yoon; Yoon, Mi Young; Min, Seong Uk; Hong, Jong Soo; Choi, Yu Sung; Suh, Dae Hun

2010-01-01

The association between acne and food has been evaluated with inconsistent results. We enrolled 783 patients with acne and 502 control subjects. For the patients with acne, blood tests for insulin, insulin-like growth factor-1 (IGF-1), insulin-like growth factor binding protein-3 (IGFBP-3), post prandial 2 hours blood glucose (PP2), and dehydroepiandrosterone sulphate (DHEAS) were performed. The acne patients were divided into an "aggravated by food" group (AF) and a "not aggravated by food" group (NAF). All participants were asked to fill out a questionnaire. The frequency of vegetables (yellow, green leafy, cruciferous) (P = .001) and fish (white flesh and green fish, blue tuna) ((P = .03) intake was significantly higher in the control group than in the acne group. Intake of instant noodles (P = .01), junk food (P = .002), carbonated drinks (P = .005), snacks (P = .001), processed cheeses (P = .04), pork (braised) (P = .02), pork (roast) (P < .001), chicken (fried) (P = .001), chicken (stewed) (P = .001), nuts (P = .002) and seaweed (P = .003) were significantly higher in the acne patients than in the controls. Intake of roast pork (P = .02), fried chicken (P < .02), and nuts (P = .03) was significantly higher in the AF than NAF. In addition, the regularity of inter-meal intervals (P < .001) and breakfast intake (P < .001) were significantly lower in the acne patients. IGF-1 and IGFBP-3 showed sexual differences. This study also showed that a high glycemic load diet, dairy food intake, high fat diet, and iodine in Korean foods appear to play a role in acne exacerbation. In addition, irregular dietary patterns were found to aggravate acne.

Heritability and GWAS Analyses of Acne in Australian Adolescent Twins.

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Mina-Vargas, Angela; Colodro-Conde, Lucía; Grasby, Katrina; Zhu, Gu; Gordon, Scott; Medland, Sarah E; Martin, Nicholas G

2017-12-01

Acne vulgaris is a skin disease with a multifactorial and complex pathology. While several twin studies have estimated that acne has a heritability of up to 80%, the genomic elements responsible for the origin and pathology of acne are still undiscovered. Here we performed a twin-based structural equation model, using available data on acne severity for an Australian sample of 4,491 twins and their siblings aged from 10 to 24. This study extends by a factor of 3 an earlier analysis of the genetic factors of acne. Acne severity was rated by nurses on a 4-point scale (1 = absent to 4 = severe) on up to three body sites (face, back, chest) and on up to three occasions (age 12, 14, and 16). The phenotype that we analyzed was the most severe rating at any site or age. The polychoric correlation for monozygotic twins was higher (r MZ = 0.86, 95% CI [0.81, 0.90]) than for dizygotic twins (r DZ = 0.42, 95% CI [0.35, 0.47]). A model that includes additive genetic effects and unique environmental effects was the most parsimonious model to explain the genetic variance of acne severity, and the estimated heritability was 0.85 (95% CI [0.82, 0.87]). We then conducted a genome-wide analysis including an additional 271 siblings - for a total of 4,762 individuals. A genome-wide association study (GWAS) scan did not detect loci associated with the severity of acne at the threshold of 5E-08 but suggestive association was found for three SNPs: rs10515088 locus 5q13.1 (p = 3.9E-07), rs12738078 locus 1p35.5 (p = 6.7E-07), and rs117943429 locus 18q21.2 (p = 9.1E-07). The 5q13.1 locus is close to PIK3R1, a gene that has a potential regulatory effect on sebocyte differentiation.

Management of mild to moderate acne vulgaris | Malahlela | South ...

African Journals Online (AJOL)

Acne is a chronic inflammatory disease of the pilosebaceous units. It is the most common diagnosis in dermatology and regularly affects adolescents and young adults. Acne can be mild, moderate or severe. Treatment includes topical keratolytics, topical retinoids, antibiotics, hormonal therapy and systemic retinoids in ...

SCAR/WAVE: A complex issue.

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Davidson, Andrew J; Insall, Robert H

2013-11-01

The SCAR/WAVE complex drives the actin polymerisation that underlies protrusion of the front of the cell and thus drives migration. However, it is not understood how the activity of SCAR/WAVE is regulated to generate the infinite range of cellular shape changes observed during cell motility. What are the relative roles of the subunits of the SCAR/WAVE complex? What signaling molecules do they interact with? And how does the complex integrate all this information in order to control the temporal and spatial polymerisation of actin during protrusion formation? Unfortunately, the interdependence of SCAR complex members has made genetic dissection hard. In our recent paper,(1) we describe stabilization of the Dictyostelium SCAR complex by a small fragment of Abi. Here we summarize the main findings and discuss how this approach can help reveal the inner workings of this impenetrable complex.

Fibromodulin reduces scar size and increases scar tensile strength in normal and excessive-mechanical-loading porcine cutaneous wounds.

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Jiang, Wenlu; Ting, Kang; Lee, Soonchul; Zara, Janette N; Song, Richard; Li, Chenshuang; Chen, Eric; Zhang, Xinli; Zhao, Zhihe; Soo, Chia; Zheng, Zhong

2018-04-01

Hypertrophic scarring is a major postoperative complication which leads to severe disfigurement and dysfunction in patients and usually requires multiple surgical revisions due to its high recurrence rates. Excessive-mechanical-loading across wounds is an important initiator of hypertrophic scarring formation. In this study, we demonstrate that intradermal administration of a single extracellular matrix (ECM) molecule-fibromodulin (FMOD) protein-can significantly reduce scar size, increase tensile strength, and improve dermal collagen architecture organization in the normal and even excessive-mechanical-loading red Duroc pig wound models. Since pig skin is recognized by the Food and Drug Administration as the closest animal equivalent to human skin, and because red Duroc pigs show scarring that closely resembles human proliferative scarring and hypertrophic scarring, FMOD-based technologies hold high translational potential and applicability to human patients suffering from scarring-especially hypertrophic scarring. © 2018 The Authors. Journal of Cellular and Molecular Medicine published by John Wiley & Sons Ltd and Foundation for Cellular and Molecular Medicine.

Quality of life in acne vulgaris: Relationship to clinical severity and demographic data.

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Gupta, Aayush; Sharma, Yugal Kishor; Dash, Kedar Nath; Chaudhari, Nitin Dinkar; Jethani, Sumit

2016-01-01

Acne vulgaris is known to impair many aspects of quality of life. However, the correlation of this impairment with clinical severity remains equivocal despite various school, community and hospital-based studies. A hospital-based study was undertaken to measure the impairment of quality of life of patients of acne vulgaris and correlate it with the severity of lesions. This was a cross-sectional, questionnaire-based study in a cohort of 100 patients of acne vulgaris attending the outpatient department of our referral hospital. A physician measured the severity of lesions using the global acne grading system, and patients assessed quality of life by completing a questionnaire (Cardiff acne disability index). A correlation of these two was done; some additional correlations were brought out through demographic data collected from the patients. There was no correlation between the severity of acne vulgaris and an impaired quality of life. Patients who consumed alcohol and/or smoked cigarettes were found to have an impaired quality of life. While the severity of acne progressively lessened in older patients, the impact on quality of life increased. The sample size was small and there was a lack of guaranteed reliability on the self-reported quality of life. The severity of acne vulgaris does not correlate with impairment in quality of life.

[Acne vulgaris: morphologic, endocrinologic and psychosomatic aspects].

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Welp, K; Gieler, U

1990-12-01

25 male patients suffering from acne vulgaris were examined by means of endocrinological, morphological, and 5 psychometric procedures in order to check the correlations and interactions between the psychological and dermatological aspects of the disease. In comparison with a control group, the acne patients did not show any striking endocrinological abnormalities; we found no correlation between the extensiveness of the lesions and the level of DHEA sulphate. All the psychological tests yielded results deviating from those achieved by the representative controls, but they were comparable with those of other patients suffering from psychosomatic diseases. The individual feeling of being "disfigured" found its expression in self-consciousness, lack of trust in his/her own body, as well as the clinically relevant difference between his/her conception of self and the ideal of self. During times of enhanced psychosocial strains subjectively assumed by the patients, the lesions increased and the patients were disturbed in social interaction and communication. Surprisingly, we did not find any correlation between the clinical status and significant psychometric findings. Our results show that in acne vulgaris, the individual experience of wanting physical attractiveness, associated with a predominantly neurotic depressive personal structure, may play a central part in a disturbed process of interaction with the environment and suggest the influence of psychic factors in the pathogenesis of acne vulgaris.

Lesões múltiplas de osteoma cutis na face: terapêutica minimamente invasiva em pacientes com sequela de acne - relato de casos Multiple injuries of osteoma skin in the face: therapeutical least invasive in patients with acne sequela - case report

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Ian Göedert Leite Duarte

2010-10-01

Full Text Available Osteoma cutis é a formação óssea no interior da pele, podendo ser primária ou secundária. Única ou múltipla, de tamanhos variados e acometendo ambos os sexos, é uma lesão cutânea rara, de etiopatogenia e classificação ainda discutidas. Nosso objetivo foi relatar o diagnóstico e a terapêutica minimamente invasiva de lesões múltiplas de osteoma cutis na face em pacientes com sequelas de acne. Fizemos a retirada dos osteomas com agulhas BD 0,70 x 25 22G1, sem anestésicos tópicos ou injetáveis no local. As pequenas incisões foram deixadas expostas, com pomada cicatrizante. Obteve-se um excelente resultado estético em 15 dias.Osteoma cutis is a bone formation in the dermis can to be primary or secondary forms. Only, multiples, many forms, occurring on either sex, they are a rare cutaneous disease. The pathogenesis and classification remains unclear. Our objective was the diagnostic and small invasive surgery treatment of the osteoma cutis multiple of the face, in patients as a sequel of acne. To remove the osteoma we used needle BD 0,70x25 22G1, without anesthetic topic or inject able site. The small wounds were exposed with scarring balsam. We got an excellent esthetic result after 15 days.

The Incidence of Propionibacterium acnes in Shoulder Arthroscopy.

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Chuang, Michael J; Jancosko, Jason J; Mendoza, Vivian; Nottage, Wesley M

2015-09-01

To document the skin colonization and deep tissue inoculation rates associated with arthroscopic shoulder surgery and how these rates differ with procedural and demographic factors. We prospectively recruited outpatient shoulder arthroscopy patients who agreed to participate and met the inclusion criteria from February 2013 to May 2014. All patients received routine antibiotic prophylaxis intravenously. Initial cultures were obtained before the skin preparation by swabbing the skin at the 3 standard portal sites: posterior, anterosuperior, and anterolateral. The skin preparation used 4% chlorhexidine scrub and 2% chlorhexidine gluconate/70% isopropyl alcohol paint applied to the entire shoulder. After completion of the arthroscopic procedure, a second culture was obtained through a cannula at the surgical site. All cultures were plated for 21 days using Brucella medium. We enrolled 51 patients over a 15-month period. Cultures showed a 72.5% Propionibacterium acnes superficial colonization rate: 46.1% of female and 81.6% of male patients (P = .027). We identified a deep culture-positive inoculation rate of 19.6%, all with positive P acnes skin colonization. No correlation could be made concerning diagnosis, procedure, suture anchor use, age, or sex. The rate of skin colonization with P acnes is high at arthroscopic portals, especially in men. Despite standard skin preparation and prophylactic antibiotics, the rate of deep tissue inoculation with P acnes in shoulder arthroscopy is much higher than the rate of infection reported in the literature. Shoulder arthroscopy introduces a significant amount of P acnes into the deep tissues. Copyright © 2015 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Adult-onset acne: prevalence, impact, and management challenges

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Rocha MA

2018-02-01

Full Text Available Marco A Rocha, Ediléia Bagatin Paulista Medical School, Universidade Federal de São Paulo (Federal University of São Paulo, São Paulo, SP, Brazil Abstract: Acne is a multifactorial and inflammatory disease of pilosebaceous follicles, which affects most adolescents. Recent epidemiological data revealed a difference in adults affected by this disease. Women have a high prevalence and incidence when compared with men, especially after 25 years of age. In contrast to what was initially thought, most of these patients do not present endocrinopathy capable of leading to the development of the lesions. When present, polycystic ovarian syndrome is the main cause. However, in these cases, acne is rarely the only dermatological manifestation; hirsutism and acanthosis nigricans are often present. The majority of the normoandrogenic acne patients present a history since adolescence, but in many cases the lesion distribution and intensity change with time. There is often a typical localization of the lesions in the lower third of the face and lateral region of the neck. Another interesting feature is related to the impact on quality of life (QoL, which is always intense. Often there are signs of depression, even when the lesions are mild. As most adult patients are women, in addition to the conventional options, there is also hormone treatment. Combined oral contraceptives and spironolactone are good options. Knowing more about the particularities in etiopathogenesis, impact on QoL, and specific treatment options is important to all dermatologists who face the challenge of treating acne in adults. Keywords: adult, acne, hormonal, female

Pulse Clarithromycin Therapy In Severe ACNE Vulgaris

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Rathi Sanjay K

2002-01-01

Full Text Available Three patients with severe acne vulgaris, not responding with long courses of doxycycline, minocycline and erythromycin were given oral clarithromycin in pulsed regimen. The patients were given 7 days course of clarithromycin 250mg twice daily, which was repeated after a gap of 10 days. Such 3 courses were given. The lesions responded significantly. No significant side effect was noted. Pulse clarithromycin therapy seems to be a good alternative and effective tool in the management of severe acne vulgaris.

Zolav®: a new antibiotic for the treatment of acne

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Dinant, Alexa; Boulos, Ramiz A

2016-01-01

Background Acne is a prominent skin condition affecting >80% of teenagers and young adults and ~650 million people globally. Isotretinoin, a vitamin A derivative, is currently the standard of care for treatment. However, it has a well-established teratogenic activity, a reason for the development of novel and low-risk treatment options for acne. Objective To investigate the effectiveness of Zolav®, a novel antibiotic as a treatment for acne vulgaris. Materials and methods Minimum inhibitory concentration of Zolav® against Propionibacterium acnes was determined by following a standard protocol using Mueller-Hinton broth and serial dilutions in a 96-well plate. Cytotoxicity effects on human umbilical vein endothelial cells and lung cells in the presence of Zolav® were investigated by determining the growth inhibition (GI50) concentration, total growth inhibition concentration, and the lethal concentration of 50% (LC50). The tryptophan auxotrophic mutant of Escherichia coli strain, WP2 uvrA (ATCC 49979), was used for the AMES assay with the addition of Zolav® tested for its ability to reverse the mutation and induce bacterial growth. The in vivo effectiveness of Zolav® was tested in a P. acnes mouse intradermal model where the skin at the infection site was removed, homogenized, and subjected to colony-forming unit (CFU) counts. Results Susceptibility testing of Zolav® against P. acnes showed a minimum inhibitory concentration of 2 µg/mL against three strains with no cytotoxicity and no mutagenicity observed at the highest concentrations tested, 30 µM and 1,500 µg/plate, respectively. The use of Zolav® at a concentration of 50 µg/mL (q8h) elicited a two-log difference in CFU/g between the treatment group and the control. Conclusion This study demonstrates the potential of Zolav® as a novel treatment for acne vulgaris. PMID:27042015

Assessment of Temperament and Character Profile with Anxiety and Depression in Patients with Acne

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Perihan Öztürk

2013-06-01

Full Text Available Background: Acne is the most common skin disease, affecting nearly 85% of the population as well as their lives. Acne can severely affect social and psychological functioning. Patients with acne may have anxiety, depression, decreased self-esteem, interpersonal difficulties, unemployment, social withdrawal, and even suicidal intent. Aims: The aim of this study was to evaluate the temperament and character inventory (TCI of patients with acne and to compare the results with those of healthy controls. Study Design: Case-control study Methods: The study population consisted of 47 patients with acne, and 40 healthy control subjects. All participants were instructed to complete a self-administered 240-item TCI and the Hospital Anxiety and Depression Scale. Results: In this study, the scores for the temperament properties Worry and pessimism (HA1 and Dependence (RD4 and the character properties Social acceptance (C1 and Integrated conscience (C5 were found to be higher in acne patients than in healthy controls (p<0.05. Compared to the controls, depression and anxiety scores were found to be markedly higher in the patients with acne. Acne type correlated positively with the Disorderliness (NS4 subscale of Novelty seeking (NS and anxiety. Additionally, acne type correlated negatively with the Attachment (RD3 subscale of Reward Dependence (RD, with the Transpersonal identification (ST2 and Spiritual acceptance (ST3 subscales of Self-Trancendence (ST, and with the Compassion (C4 subscale of Cooperativeness (C. Conclusion: Studies in this area may lead to the development of specific and focused interventions for TCI in patients with acne vulgaris. We suggest that the evaluation and treatment of acne should also include psychosomatic approaches in clinical practice.

Antibacterial activity of Thai herbal extracts on acne involved microorganism.

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Niyomkam, P; Kaewbumrung, S; Kaewnpparat, S; Panichayupakaranant, P

2010-04-01

Ethyl acetate and methanol extracts of 18 Thai medicinal plants were investigated for their antibacterial activity against Propionibacterium acnes, Stapylococcus aureus, and S. epidermidis. Thirteen plant extracts were capable of inhibiting the growth of P. acnes and S. epidermidis, while 14 plant extracts exhibited an inhibitory effect on S. aureus. Based on the broth dilution method, the ethyl acetate extract of Alpinia galanga (L.) Wild. (Zingiberaceae) rhizome showed the strongest antibacterial effect against P. acnes, with minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) values of 156.0 and 312.0 microg/mL, respectively. On the basis of bioassay-guided purification, the ethyl acetate extract was isolated to afford the antibacterial active compound, which was identified as 1'-acetoxychavicol acetate (1'-ACA). 1'-ACA had a strong inhibitory effect on P. acnes with MIC and MBC values of 62.0 and 250.0 microg/mL, respectively. Thus, 1'-ACA was used as an indicative marker for standardization of A. galanga extract using high performance liquid chromatography. These results suggest that A. galanga extract could be an interesting agent for further studies on an alternative treatment of acne.

Hormonal Disorders as Significant Pathogenetic Factor of Acne in Women

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L.O. Naumova

2014-08-01

Conclusions. Hormonal study of women with acne should include an assessment of the function of ovaries, adrenal glands, thyroid gland, determination of the level of prolactin in the blood plasma and glycated hemoglobin. Treatment should be aimed at management of hormonal and metabolic disorders, and topical treatment of acne. Before 30 years of age it is important to diagnose polycystic ovary syndrome and late forms of congenital dysfunction of the adrenal glands, after 30 — hyperprolactinemia syndrome, hypothyroidism, diabetes mellitus type 2, and after 40 years acne often manifests on the background of ovarian failure.

Fixed-Dose Combination Gel of Adapalene and Benzoyl Peroxide plus Doxycycline 100 mg versus Oral Isotretinoin for the Treatment of Severe Acne: Efficacy and Cost Analysis.

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Penna, Pete; Meckfessel, Matthew H; Preston, Norman

2014-01-01

Acne vulgaris is a chronic skin disease with a high prevalence. Left untreated or inadequately treated, acne vulgaris can lead to psychological and physical scarring, as well as to unnecessary medical expenses. Oral isotretinoin is an effective treatment for severe resistant nodular and conglobate acne vulgaris. A regimen consisting of a fixed-dose combination of adapalene and benzoyl peroxide gel, 0.1%/2.5% (A-BPO) with oral doxycycline 100 mg (A-BPO/D) has been demonstrated to be efficacious and well tolerated in patients with severe acne and may be an alternative to oral isotretinoin for some patients with severe acne. The objective of this analysis was to compare the relative efficacy and associated costs of A-BPO/D versus oral isotretinoin. In this analysis, comparisons of relative efficacy were made using previously published studies involving similar patient populations with severe acne that warrant the use of oral isotretinoin. The pricing for oral doxycycline and oral isotretinoin was estimated based on the maximum allowable cost from 9 states, and the pricing for A-BPO was calculated as the range between the average wholesale price and the wholesale acquisition cost. For this analysis, 2 treatment models were generated to compare costs: (1) a basic treatment model that examined the costs of an initial regimen of either A-BPO/D or oral isotretinoin without considering probable outcomes, and (2) a long-term model that factored in likely treatment outcomes and subsequent treatments into associated costs. The basic treatment model assumed that patients would be prescribed a single regimen of A-BPO/D for 12 weeks or oral isotretinoin for 20 weeks. The long-term model considered the probability of each treatment successfully managing patients' acne, as well as likely additional regimens of A-BPO monotherapy or an additional regimen of oral isotretinoin. As a result of different treatment durations, the costs for each treatment were normalized to weekly cost of

Cosmeceuticals based on Rhealba(®) Oat plantlet extract for the treatment of acne vulgaris.

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Fabbrocini, G; Saint Aroman, M

2014-12-01

Recent evidence suggests that acne vulgaris begins as an inflammation in and around the sebaceous gland and alterations in the lipid content of sebum, which drive hyperproliferation and increased desquamation of keratinocytes within sebaceous follicles. This prevents sebum drainage, causing the formation of microcomedones, which spontaneously regress or become acne lesions when the pilosebaceous unit is further blocked by the accumulation of corneocytes. These conditions are favourable for the proliferation of Propionibacterium acnes, which further aggravates acne by enhancing abnormal desquamation, sebum production and inflammation. Also, skin fragility due to inflammation or irritation by anti-comedogenic agents can worsen the situation. Rhealba(®) Oat plantlet extract (Pierre Fabre Dermo Cosmetique) soothes and restores fragile skin in acne by reducing inflammation and inhibits bacterial adhesion of Propionibacterium acnes. Cosmeceuticals combining Rhealba(®) Oat plantlet extract and hydro-compensating actives, which are available with or without anti-comedogenic hydroxy acids, provide a balanced, multifaceted approach for acne patients. © 2014 European Academy of Dermatology and Venereology.

Proteome Analysis of Human Sebaceous Follicle Infundibula Extracted from Healthy and Acne-Affected Skin

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Bek-Thomsen, Malene; Lomholt, Hans B.; Scavenius, Carsten; Enghild, Jan J.; Brüggemann, Holger

2014-01-01

Acne vulgaris is a very common disease of the pilosebaceous unit of the human skin. The pathological processes of acne are not fully understood. To gain further insight sebaceous follicular casts were extracted from 18 healthy and 20 acne-affected individuals by cyanoacrylate-gel biopsies and further processed for mass spectrometry analysis, aiming at a proteomic analysis of the sebaceous follicular casts. Human as well as bacterial proteins were identified. Human proteins enriched in acne and normal samples were detected, respectively. Normal follicular casts are enriched in proteins such as prohibitins and peroxiredoxins which are involved in the protection from various stresses, including reactive oxygen species. By contrast, follicular casts extracted from acne-affected skin contained proteins involved in inflammation, wound healing and tissue remodeling. Among the most distinguishing proteins were myeloperoxidase, lactotransferrin, neutrophil elastase inhibitor and surprisingly, vimentin. The most significant biological process among all acne-enriched proteins was ‘response to a bacterium’. Identified bacterial proteins were exclusively from Propionibacterium acnes. The most abundant P. acnes proteins were surface-exposed dermatan sulphate adhesins, CAMP factors, and a so far uncharacterized lipase in follicular casts extracted from normal as well as acne-affected skin. This is a first proteomic study that identified human proteins together with proteins of the skin microbiota in sebaceous follicular casts. PMID:25238151

Evaluation of Adolescents Diagnosed with Acne Vulgaris for Quality of Life and Psychosocial Challenges

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Eyüboglu, Murat; Kalay, Incilay; Eyüboglu, Damla

2018-01-01

Background: Acne vulgaris is a common skin condition which affects most adolescents. It has a major impact on quality of life and psychosocial well-being. Aims: The aims of the study were to examine the psychosocial effects of acne on adolescents and changes in quality of life, and to reveal any difference in the possible effect between genders. In addition, an investigation of the association between acne severity and quality of life as well as psychosocial stress was conducted. Materials and Methods: The present study included 164 adolescents with a mean age of 12–18 years and was diagnosed with acne vulgaris without any previous treatment. The control group consisted of 188 healthy volunteers. Acne severity was evaluated by the global acne grading system. All patients filled in a Children's Dermatology Life Quality Index, Pediatric Quality of Life Questionnaire (PedsQL), and a Strength and Difficulties Questionnaire (SDQ). Results: The scores of SDQ and PedsQL were significantly lower in the case group. There was no significant correlation found between the genders in the control group for acne severity and scale scores. No significant correlation was found between acne severity and psychosocial challenges. Conclusions: The results of the present study show that acne has a significant effect on quality of life for adolescents, and this has an impact on their psychosocial life. Another important finding of the present study is that worsening in quality of life is not affected by some factors such as duration, severity of acne and age. PMID:29692454

A Precision Microbiome Approach Using Sucrose for Selective Augmentation of Staphylococcus epidermidis Fermentation against Propionibacterium acnes

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Yanhan Wang

2016-11-01

Full Text Available Acne dysbiosis happens when there is a microbial imbalance of the over-growth of Propionibacterium acnes (P. acnes in the acne microbiome. In our previous study, we demonstrated that Staphylococcus epidermidis (S. epidermidis, a probiotic skin bacterium can exploit glycerol fermentation to produce short-chain fatty acids (SCFAs which have antimicrobial activities to suppress the growth of P. acnes. Unlike glycerol, sucrose is chosen here as a selective fermentation initiator (SFI that can specifically intensify the fermentation activity of S. epidermidis, but not P. acnes. A co-culture of P. acnes and fermenting S. epidermidis in the presence of sucrose significantly led to a reduction in the growth of P. acnes. The reduction was abolished when P. acnes was co-cultured with non-fermenting S. epidermidis. Results from nuclear magnetic resonance (NMR analysis revealed four SCFAs (acetic acid, butyric acid, lactic acid, and succinic acid were detectable in the media of S. epidermidis sucrose fermentation. To validate the interference of S. epidermidis sucrose fermentation with P. acnes, mouse ears were injected with both P. acnes and S. epidermidis plus sucrose or phosphate buffered saline (PBS. The level of macrophage-inflammatory protein-2 (MIP-2 and the number of P. acnes in ears injected with two bacteria plus sucrose were considerably lower than those in ears injected with two bacteria plus PBS. Our results demonstrate a precision microbiome approach by using sucrose as a SFI for S. epidermidis, holding future potential as a novel modality to equilibrate dysbiotic acne.

Zolav®: a new antibiotic for the treatment of acne

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Dinant A

2016-03-01

Full Text Available Alexa Dinant,1 Ramiz A Boulos2,3 1AXD Pty Ltd, Semaphore Park, 2School of Chemical and Physical Sciences, Flinders University, Bedford Park, 3Boulos & Cooper Pharmaceuticals Pty Ltd, Port Adelaide, SA, Australia Background: Acne is a prominent skin condition affecting >80% of teenagers and young adults and ~650 million people globally. Isotretinoin, a vitamin A derivative, is currently the standard of care for treatment. However, it has a well-established teratogenic activity, a reason for the development of novel and low-risk treatment options for acne. Objective: To investigate the effectiveness of Zolav®, a novel antibiotic as a treatment for acne vulgaris. Materials and methods: Minimum inhibitory concentration of Zolav® against Propionibacterium acnes was determined by following a standard protocol using Mueller-Hinton broth and serial dilutions in a 96-well plate. Cytotoxicity effects on human umbilical vein endothelial cells and lung cells in the presence of Zolav® were investigated by determining the growth inhibition (GI50 concentration, total growth inhibition concentration, and the lethal concentration of 50% (LC50. The tryptophan auxotrophic mutant of Escherichia coli strain, WP2 uvrA (ATCC 49979, was used for the AMES assay with the addition of Zolav® tested for its ability to reverse the mutation and induce bacterial growth. The in vivo effectiveness of Zolav® was tested in a P. acnes mouse intradermal model where the skin at the infection site was removed, homogenized, and subjected to colony-forming unit (CFU counts. Results: Susceptibility testing of Zolav® against P. acnes showed a minimum inhibitory concentration of 2 µg/mL against three strains with no cytotoxicity and no mutagenicity observed at the highest concentrations tested, 30 µM and 1,500 µg/plate, respectively. The use of Zolav® at a concentration of 50 µg/mL (q8h elicited a two-log difference in CFU/g between the treatment group and the control

Adapalene gel 0.1% for topical treatment of acne vulgaris in African patients.

Science.gov (United States)

Jacyk, W K; Mpofu, P

2001-10-01

Acne vulgaris is a common dermatologic disease in African patients, as well as in Caucasians. Our report evaluates the safety and efficacy of adapalene gel 0.1% in African patients with acne vulgaris. We used a 12-week, 2-center, open-label, noncomparative study of adapalene gel 0.1% in 65 African patients with acne vulgaris to assess the drug's effect on hyperpigmented lesions in people with dark skin. The study demonstrated that the progressive and significant improvements in lesion counts and global acne grades produced by adapalene in African patients were paralleled by significant improvements in the degree of hyperpigmentation of acne lesions. During treatment with adapalene, less than 5% of patients reported moderate or severe skin irritation at any time during the study, and the incidence of skin oiliness decreased markedly. We conclude that adapalene gel 0.1% was well tolerated and highly effective in African patients with acne vulgaris and was found to reduce hyperpigmentation.

Perbedaan Self-Image Remaja Laki-Laki dan Perempuan Penderita Acne Vulgaris

OpenAIRE

Nasution, Fauziah Nami

2016-01-01

The research aims to find out the differences self-images on adolescent boy’s Acne Vulgaris patient and on adolescent girl’s. Self-image is the mental picture of an individual about his physical appearance Jersild (1963). Acne vulgaris is a chronic inflammation of the follicle polisebasea characterized by comedones, papules, pustules, and cysts in predilection areas, such as the face, shoulders, chest, and back. The population of the research is senior students in Medan who have Acne Vulgaris...

Dermatologisk laser- og lysbehandling af ar

DEFF Research Database (Denmark)

Karmisholt, Katrine; Borch, Jakob E; Omland, Silje Haukali

2016-01-01

the highest available level of evidence from randomized controlled trials (RCTs) and introduces a guideline for laser treatment of scars. Twelve RCTs documented effect on acne, burn and surgical scars. It is recommended that laser- and light-based treatments are considered according to the scar type....

IL-17/Th17 Pathway Is Activated in Acne Lesions

Science.gov (United States)

Kelhälä, Hanna-Leena; Palatsi, Riitta; Fyhrquist, Nanna; Lehtimäki, Sari; Väyrynen, Juha P.; Kallioinen, Matti; Kubin, Minna E.; Greco, Dario; Tasanen, Kaisa; Alenius, Harri; Bertino, Beatrice; Carlavan, Isabelle; Mehul, Bruno; Déret, Sophie; Reiniche, Pascale; Martel, Philippe; Marty, Carine; Blume-Peytavi, Ulrike; Voegel, Johannes J.; Lauerma, Antti

2014-01-01

The mechanisms of inflammation in acne are currently subject of intense investigation. This study focused on the activation of adaptive and innate immunity in clinically early visible inflamed acne lesions and was performed in two independent patient populations. Biopsies were collected from lesional and non-lesional skin of acne patients. Using Affymetrix Genechips, we observed significant elevation of the signature cytokines of the Th17 lineage in acne lesions compared to non-lesional skin. The increased expression of IL-17 was confirmed at the RNA and also protein level with real-time PCR (RT-PCR) and Luminex technology. Cytokines involved in Th17 lineage differentiation (IL-1β, IL-6, TGF-β, IL23p19) were remarkably induced at the RNA level. In addition, proinflammatory cytokines and chemokines (TNF-α, IL-8, CSF2 and CCL20), Th1 markers (IL12p40, CXCR3, T-bet, IFN-γ), T regulatory cell markers (Foxp3, IL-10, TGF-β) and IL-17 related antimicrobial peptides (S100A7, S100A9, lipocalin, hBD2, hBD3, hCAP18) were induced. Importantly, immunohistochemistry revealed significantly increased numbers of IL-17A positive T cells and CD83 dendritic cells in the acne lesions. In summary our results demonstrate the presence of IL-17A positive T cells and the activation of Th17-related cytokines in acne lesions, indicating that the Th17 pathway is activated and may play a pivotal role in the disease process, possibly offering new targets of therapy. PMID:25153527

Quality of life, self-esteem and psychosocial factors in adolescents with acne vulgaris.

Science.gov (United States)

Vilar, Gustavo Nunes; Santos, Laís Araújo dos; Sobral Filho, Jader Freire

2015-01-01

Dermatological diseases, among which acne vulgaris, have psychological impact on the affected generating feelings of guilt, shame and social isolation. To compare quality of life, self-esteem and other psychosocial variables amongst adolescents with and without acne vulgaris, and between levels of severity. Cross-sectional observational study in a sample of 355 high school students from the city of João Pessoa. Data collection was performed with questionnaires and clinical-dermatological evaluation. The primary variables were the incidence of AV; quality of life, set by the Children's Dermatology Quality of Life Index and Dermatology Quality of Life Index; and self-esteem, measured by the Rosenberg Self-Esteem Scale. For calculation of statistical tests, we used the SPSS 20.0 software, considering p=0.05. The sample, with an average age of 16, showed 89.3% prevalence of acne vulgaris. The most prevalent psychosocial issue was "afraid that acne will never cease", present in 58% of affected youth. The median score of Quality of Life in Children's Dermatology Index was different amongst students with and without acne vulgaris (p=0.003), as well as the Quality of Life in Dermatology (p=0.038) scores, so that students with acne vulgaris have worse QoL. There was a correlation between the severity of acne vulgaris and worse quality of life. Self-esteem was not significantly associated with the occurrence or severity of acne vulgaris. acne vulgaris assumes significance in view of its high prevalence and the effect on quality of life of adolescents, more severe at the more pronounced stages of disease (pacne vulgaris should be valued in the management of patients with this condition.

Exploring the relationship between stress and acne: a medical student’s perspective

Directory of Open Access Journals (Sweden)

Maleki A

2018-04-01

Full Text Available Aryan Maleki, Noorulain Khalid Faculty of Medicine, Barts and The London School of Medicine and Dentistry, London, UKWe read with great interest the paper by Zari and Alrahmani1 investigating the relationship between stress and acne among female medical students. These findings are relevant as around 20% of young people are affected by moderate-to-severe acne, and indeed acne severity is associated with increased risks of anxiety, depression and suicidal ideation.2 The authors identified that “stress severity strongly correlated with an increase in acne severity,” and suggested that stress likely has an important role in the pathogenesis of acne.1 However, the paper could have been taken further to better establish the true extent of this relationship, and ultimately whether certain patients will benefit from clinical interventions based on their perceived stress scale. View the original paper by Zari and Alrahmani.

Skin cancer full-grown from scar

International Nuclear Information System (INIS)

Zikiryakhodjaev, D.Z.; Sanginov, D.R.

2001-01-01

In this chapter authors investigate the peculiarities of skin cancer full-grown from scar, the theory of it's descent, quote some statistical data on skin cancer full-grown from scar and variety clinical forms of skin cancer full-grown from scar was shown, quote some methods of treatment

Effects of a 1,450 nm diode laser on facial sebum excretion.

Science.gov (United States)

Laubach, Hans-Joachim; Astner, Susanne; Watanabe, Kanna; Clifford, Joan; Rius-Diaz, Francisca; Zurakowski, David; Manstein, Dieter

2009-02-01

Laser therapy with a 1,450 nm diode laser is a clinically effective treatment for acne vulgaris, although the mechanism of action is unknown. To investigate this, we conducted a small, prospective, controlled clinical trial to assess this laser's effects on the facial sebum excretion rate (SER). Fourteen healthy volunteers without active acne were enrolled in this study and received three laser treatments on test areas of the nose and forehead. Nine subjects completed the treatment regimen and were available for follow-up. SER was measured with Sebumeter prior to the first treatment, and at 1 week and 1 month after the third treatment. Photographs were taken and subjective assessment of skin oiliness and pore size determined by questionnaires at 1 month follow-up. No significant reduction in SER was observed comparing treated with control on all treatment sites (P>0.05) on the nose. Reduction in the absolute SER was observed for both test and control sites on the forehead, reaching significance on the treatment site (P = 0.04) and marginal significance on the control site (P = 0.08). While our study was designed to detect only large changes in SER, we conclude that three 1,450 nm laser treatment sessions did not cause marked changes in SER compared to the control (i.e., >44%). Thus, major destruction of sebaceous glands as a result of this treatment is unlikely. However, reduced sebum production was observed on both treatment and control sides at 1 month. Therefore alternative mechanisms should also be considered to explain the clinical efficacy of this treatment for acne vulgaris. (c) 2009 Wiley-Liss, Inc.

Synergistic Antibacterial Effects of Chitosan-Caffeic Acid Conjugate against Antibiotic-Resistant Acne-Related Bacteria.

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Kim, Ji-Hoon; Yu, Daeung; Eom, Sung-Hwan; Kim, Song-Hee; Oh, Junghwan; Jung, Won-Kyo; Kim, Young-Mog

2017-06-08

The object of this study was to discover an alternative therapeutic agent with fewer side effects against acne vulgaris, one of the most common skin diseases. Acne vulgaris is often associated with acne-related bacteria such as Propionibacterium acnes , Staphylococcus epidermidis , Staphylococcus aureus , and Pseudomonas aeruginosa . Some of these bacteria exhibit a resistance against commercial antibiotics that have been used in the treatment of acne vulgaris (tetracycline, erythromycin, and lincomycin). In the current study, we tested in vitro antibacterial effect of chitosan-phytochemical conjugates on acne-related bacteria. Three chitosan-phytochemical conjugates used in this study exhibited stronger antibacterial activity than that of chitosan (unmodified control). Chitosan-caffeic acid conjugate (CCA) showed the highest antibacterial effect on acne-related bacteria along with minimum inhibitory concentration (MIC; 8 to 256 μg/mL). Additionally, the MIC values of antibiotics against antibiotic-resistant P. acnes and P. aeruginosa strains were dramatically reduced in combination with CCA, suggesting that CCA would restore the antibacterial activity of the antibiotics. The analysis of fractional inhibitory concentration (FIC) indices clearly revealed a synergistic antibacterial effect of CCA with antibiotics. Thus, the median sum of FIC (∑FIC) values against the antibiotic-resistant bacterial strains ranged from 0.375 to 0.533 in the combination mode of CCA and antibiotics. The results of the present study suggested a potential possibility of chitosan-phytochemical conjugates in the control of infections related to acne vulgaris.

[Clinical trials in dermatology. Evaluation of the tolerability and efficacy of a topical anti-acne].

Science.gov (United States)

Verschoore, M; Poncet, M; Schaefer, H; Revuz, J; De Prost, Y; Guillaume, J C; Ortonne, J P; Czernielewski, J

1991-01-01

Acne is a frequent dermatologic disease of the teenagers. Methodology of antiacne preparations clinical trials has evolved recently, leading to better comprehension of acne treatment on acne lesions. The main rules for good clinical evaluation of acne treatments are: an objective counting of each individual lesions on a defined area (face, back), a global acne assessment, a therapy duration from 1 to 3 months or more, a skin safety evaluation for erythema, desquamation, dryness, itching, burning and oiliness with a 0 to 3 scoring system.

Metastatic basal cell carcinoma caused by carcinoma misdiagnosed as acne - case report and literature review

DEFF Research Database (Denmark)

Aydin, Dogu; Hölmich, Lisbet Rosenkrantz; Jakobsen, Linda Plovmand

2016-01-01

Basal cell carcinoma can be misdiagnosed as acne; thus, carcinoma should be considered in treatment-resistant acne. Although rare, neglected basal cell carcinoma increases the risk of metastasis.......Basal cell carcinoma can be misdiagnosed as acne; thus, carcinoma should be considered in treatment-resistant acne. Although rare, neglected basal cell carcinoma increases the risk of metastasis....

Systemic isotretinoin in the management of acne – a patient ...

African Journals Online (AJOL)

Background: The primary aim was to investigate the appropriateness (as outlined in the South African Acne Treatment Guideline1) for the prescription of systemic isotretinoin in the management and counselling of acne in the Nelson Mandela Bay Metropole. Methods: A questionnaire was distributed to patients receiving ...

0.5% Liposome-encapsulated 5-aminolevulinic acid (ALA) photodynamic therapy for acne treatment.

Science.gov (United States)

An, Jee-Soo; Kim, Jeong-Eun; Lee, Dong-Hun; Kim, Byung-Yoon; Cho, Soyun; Kwon, In-Ho; Choi, Won-Woo; Kang, Seong-Min; Won, Chong-Hyun; Chang, Sung-Eun; Lee, Mi-Woo; Choi, Jee-Ho; Moon, Kee-Chan

2011-02-01

Photodynamic therapy using topical 5-aminolevulinic acid (ALA) has been successful in treating acne vulgaris, but sun avoidance for at least 48 hours after treatment is necessary due to the risk of post-treatment photosensitivity. Recently, a lower concentration of liposome-encapsulated 5-ALA was introduced to minimize this risk. To evaluate the efficacy and safety of liposome-encapsulated 0.5% 5-ALA in the photodynamic therapy of inflammatory acne and its effects on sebum secretion in Asian skin. Thirteen Korean subjects with inflammatory acne were administered 0.5% ALA spray before photoradiation treatment. Photoradiation was performed at 3.5-6.0 J/cm(2) three times during each of two visits, performed 2 weeks apart. Improvement of acne was evaluated subjectively and objectively based on the Korean Acne Grading System. Sebum secretion was measured quantitatively at each visit. The mean reduction in acne grade at the end of the treatment was 43.2%. Of the patients, 69.2% reported improvements in subjective skin oiliness, but fewer showed objective reductions in sebum secretion as determined by the Sebumeter® SM10. No serious adverse events were observed. Photodynamic therapy using liposome-encapsulated 0.5% 5-ALA improved inflammatory acne with minimal side effects in Asians.

Medicinal Plants for the Treatment of Acne Vulgaris: A Review of Recent Evidences.

Science.gov (United States)

Nasri, Hamid; Bahmani, Mahmoud; Shahinfard, Najmeh; Moradi Nafchi, Atefeh; Saberianpour, Shirin; Rafieian Kopaei, Mahmoud

2015-11-01

Acne vulgaris affects about 85% of teenagers and may continue to adulthood. There are about two million visits to physicians per year for teenagers and the direct cost of acne treatment in the US exceeds $1 billion per year. A wide variety of treatment regimens exist for acne vulgaris including benzoil peroxide, retinoids, isotretinoids, keratolytic soaps, alpha hydroxy acids, azelaic acid, salicilic acid as well as hormonal, anti-androgen or antiseborrheic treatments. However, none of these methods is free of side effects and their exact role in therapy is not clear. In this paper apart from presenting the possible causes of acne vulgaris and its available drugs, recently published papers about medicinal plants used in the treatment of acne vulgaris were reviewed. Consumption of alternative and complementary medicine, including medicinal plants, is increasing and is common amongst patients affected by acne and infectious skin diseases. Medicinal plants have a long history of use and have been shown to possess low side effects. These plants are a reliable source for preparation of new drugs. Many plants seem to have inhibitory effects on the growth of bacteria, fungi and viruses in vitro. However, there are a few clinical evidences about the effectiveness and safety of these plants in the treatment of acne and other skin infections.

Antimicrobial and anti-inflammatory activities of endophytic fungi Talaromyces wortmannii extracts against acne-inducing bacteria.

Directory of Open Access Journals (Sweden)

Alexander Pretsch

Full Text Available Acne vulgaris is the most common skin disease, causing significant psychosocial problems such as anxiety and depression similar to a chronic illness for those afflicted. Currently, obtainable agents for acne treatment have limited use. Thus, development of novel agents to treat this disease is a high medical need. The anaerobic bacterium Propionibacterium acnes has been implicated in the inflammatory phase of acne vulgaris by activating pro-inflammatory mediators such as the interleukin-8 (IL-8 via the NF-κB and MAPK pathways. Talaromyces wortmannii is an endophytic fungus, which is known to produce high bioactive natural compounds. We hypothesize that compound C but also the crude extract from T. wortmannii may possess both antibacterial activity especially against P. acnes and also anti-inflammatory properties by inhibiting TNF-α-induced ICAM-1 expression and P. acnes-induced IL-8 release. Treatment of keratinocytes (HaCaT with P. acnes significantly increased NF-κB and activator protein-1 (AP-1 activation, as well as IL-8 release. Compound C inhibited P. acnes-mediated activation of NF-κB and AP-1 by inhibiting IκB degradation and the phosphorylation of ERK and JNK MAP kinases, and IL-8 release in a dose-dependent manner. Based on these results, compound C has effective antimicrobial activity against P. acnes and anti-inflammatory activity, and we suggest that this substance or the crude extract are alternative treatments for antibiotic/anti-inflammatory therapy for acne vulgaris.

Antimicrobial and Anti-Inflammatory Activities of Endophytic Fungi Talaromyces wortmannii Extracts against Acne-Inducing Bacteria

Science.gov (United States)

Schwendinger, Katja; Kreiseder, Birgit; Wiederstein, Martina; Pretsch, Dagmar; Genov, Miroslav; Hollaus, Ralph; Zinssmeister, Daniela; Debbab, Abdesamad; Hundsberger, Harald; Eger, Andreas; Proksch, Peter; Wiesner, Christoph

2014-01-01

Acne vulgaris is the most common skin disease, causing significant psychosocial problems such as anxiety and depression similar to a chronic illness for those afflicted. Currently, obtainable agents for acne treatment have limited use. Thus, development of novel agents to treat this disease is a high medical need. The anaerobic bacterium Propionibacterium acnes has been implicated in the inflammatory phase of acne vulgaris by activating pro-inflammatory mediators such as the interleukin-8 (IL-8) via the NF-κB and MAPK pathways. Talaromyces wortmannii is an endophytic fungus, which is known to produce high bioactive natural compounds. We hypothesize that compound C but also the crude extract from T. wortmannii may possess both antibacterial activity especially against P. acnes and also anti-inflammatory properties by inhibiting TNF-α-induced ICAM-1 expression and P. acnes-induced IL-8 release. Treatment of keratinocytes (HaCaT) with P. acnes significantly increased NF-κB and activator protein-1 (AP-1) activation, as well as IL-8 release. Compound C inhibited P. acnes-mediated activation of NF-κB and AP-1 by inhibiting IκB degradation and the phosphorylation of ERK and JNK MAP kinases, and IL-8 release in a dose-dependent manner. Based on these results, compound C has effective antimicrobial activity against P. acnes and anti-inflammatory activity, and we suggest that this substance or the crude extract are alternative treatments for antibiotic/anti-inflammatory therapy for acne vulgaris. PMID:24887557

[Physical therapy for scars].

Science.gov (United States)

Masanovic, Marguerite Guillot

2013-01-01

Physical therapy consists notably of hand or mechanical massages, pressure therapy using various fabrics or splints, cryotherapy, laser therapy, etc. It forms part of the range of therapies used to treat pathological scars, including medical and surgical treatment. While the results are often satisfactory for hypertrophic scars, they remain uncertain for major keloids.

Ghrelin in the pilosebaceous unit: alteration of ghrelin in patients with acne vulgaris.

Science.gov (United States)

Cicek, Demet; Demir, Betul; Erder, Ilker; Kuloglu, Tuncay; Ucer, Ozlem; Aydin, Suleyman; Ucak, Haydar; Dertlioglu, Selma; Kalayci, Mehmet

2015-01-01

Ghrelin in the pilosebaceous tissues of human skin and ghrelin levels in patients with acne vulgaris have not yet been investigated. The purpose of this study was to screen ghrelin immunoreactivity by immunohistochemistry in human pilosebaceous tissues of human skin and also to determine the quantities of ghrelin in the serum of the patients with acne vulgaris. 30 patients presenting with acne vulgaris and 30 control subjects participated in this study. Ghrelin levels were determined by enzyme linked immunosorbent assay (ELISA). Human hair follicles and sebaceous glands were immunohistochemically examined. Immunohistochemistry results showed that there is a strong ghrelin immunoreactivity in the hair follicles and sebaceous glands in sections of human skin. The mean serum ghrelin levels (27.58 ・} 15.44 pg/mL) in patients with acne vulgaris was significantly lower than those of controls (35.62・}20.46 pg/mL). Ghrelin produced in hair follicles and sebaceous glands of the skin might participate in the pathogenesis of acne vulgaris and also acne vulgaris in humans might be associated with decreased serum ghrelin.

Abuse of anabolic-androgenic steroids and bodybuilding acne: an underestimated health problem.

Science.gov (United States)

Melnik, Bodo; Jansen, Thomas; Grabbe, Stephan

2007-02-01

Abuse of anabolic-androgenic steroids (AAS) by members of fitness centers and others in Germany has reached alarming dimensions. The health care system provides the illegal AAS to 48.1 % of abusers. Physicians are involved in illegal prescription of AAS and monitoring of 32.1 % of AAS abusers. Besides health-threatening cardiovascular, hepatotoxic and psychiatric long-term side effects of AAS, acne occurs in about 50 % of AAS abusers and is an important clinical indicator of AAS abuse, especially in young men 18-26 years of age. Both acne conglobata and acne fulminans can be induced by AAS abuse. The dermatologist should recognize bodybuilding acne, address the AAS abuse, and warn the patient about other potential hazards.

Assessment of a new biological complex efficacy on dysseborrhea, inflammation, and Propionibacterium acnes proliferation

Directory of Open Access Journals (Sweden)

Trompezinski S

2016-08-01

Full Text Available Sandra Trompezinski,1 Sophie Weber,1 Benoît Cadars,2 Florence Larue,1 Nathalie Ardiet,1 Marlène Chavagnac-Bonneville,2 Michèle Sayag,2 Eric Jourdan2 1NAOS, Aix-en Provence, 2Direction Scientifique Bioderma (NAOS, Lyon, France Introduction: Acne vulgaris is a common chronic inflammatory disease of the pilosebaceous unit triggered by Propionibacterium acnes. A bakuchiol, Ginkgo biloba extract, and mannitol (BGM complex has been developed to provide patients with acne with a specific dermocosmetic to be used adjunctively with conventional treatments. Objective: The aim of these studies was to assess the antibacterial, anti-inflammatory, and antioxidative potential of BGM complex and its individual compounds as well as its impact on sebum composition. Methods: The antibacterial, anti-inflammatory, and antioxidative potential of BGM complex and its compounds was assessed through in vitro, ex vivo, and clinical studies. The clinical benefit of BGM complex formulated in a cream was assessed in subjects prone to acne through sebum composition analysis and photometric assessments. Results: Results from the studies showed that the BGM complex has significant antibacterial, anti-inflammatory, and antioxidative properties. At similar concentrations, bakuchiol has up to twice the antioxidative potential than vitamin E. In subjects, BGM complex regulated the sebum composition in acne patients by increasing the level of sapienic and linolenic acid and reducing the level of oleic acid. The reduced number of porphyrins on the skin surface showed that it is also effective against P. acnes. Conclusion: BGM complex provides a complete adjunctive care in patients with acne by targeting etiopathogenic factors of acne: dysseborrhea, inflammation, and P. acnes proliferation. Keywords: acne, antibacterial, anti-inflammatory, antioxidation, cosmetics, sebum

Effect of a single overnight topical application of miconazole nitrate paste on acne papules.

Science.gov (United States)

Flagothier, Caroline; Vroome, Valérie; Borgers, Marcel; Wang, Xuemin; Cauwenbergh, Geert; Piérard, Gérald E

2006-03-01

The classical management of acne calls for prolonged oral and/or topical treatments; however, some patients request a rapid effect to make the papules disappear within a few hours or days. To test the effect of a single overnight application of a paste containing 0.25% miconazole nitrate on acne papules, and comparison with the effect of the same but unmedicated paste. Narrow-band reflectance spectroscopy was used to assess the changes in E index (erythema) after overnight application of the pastes. In the first study, a total of 117 acne papules were assessed in 15 adolescents. Measurements of the E index were performed at 24-h intervals for 4 days on acne papules and the surrounding normal-looking skin. The last two assessments were performed the mornings preceding and following, respectively, a single application of the medicated paste. The second part of the study consisted of a double-blind, split-face study on 25 adolescents with acne. They applied each of the two formulations on a randomized part of the forehead. A total of 161 acne papules received the medicated paste and 160 received the same but unmedicated paste. Measurements were performed the mornings before and after the overnight treatment. In the first part of the study, no significant daily difference was observed between the three series of pretreatment E indices, on both acne papules and normal skin. The treatment did not affect the E index of normal skin. By contrast, it decreased significantly the E index of the acne papules. The second part of the study also showed that the medicated paste significantly decreased the E index of acne papules. This effect was significantly (P < 0.05) superior to that of the unmedicated paste. A single overnight application of miconazole nitrate paste appears to reduce the erythematous aspect of acne papules.

Multidirectional Vector Excision Leads to Better Outcomes than Traditional Elliptical Excision of Facial Congenital Melanocytic Nevus

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Seung Il Oh

2013-09-01

Full Text Available Background The elliptical excision is the standard method of removing benign skin lesions,such as congenital melanocytic nevi. This technique allows for primary closure, with little to nodog-ear deformity, but may sacrifice normal tissue adjacent to the lesion, resulting in scarswhich are unnecessarily long. This study was designed to compare the predicted results ofelliptical excision with those resulting from our excision technique.Methods Eighty-two patients with congenital melanocytic nevus on the face were prospectivelystudied. Each lesion was examined and an optimal ellipse was designed and marked onthe skin. After an incision on one side of the nevus margin, subcutaneous undermining wasperformed in the appropriate direction. The skin flap was pulled up and approximated alongseveral vectors to minimize the occurrence of dog-ear deformity.Results Overall, the final wound length was 21.1% shorter than that achieved by ellipticalexcision. Only 8.5% of the patients required dog-ear repair. There was no significant distortionof critical facial structures. All of the scars were deemed aesthetically acceptable based ontheir Patient and Observer Scar Assessment Scale scores.Conclusions When compared to elliptical excision, our technique appears to minimize dogeardeformity and decrease the final wound length. This technique should be considered analternative method for excision of facial nevi.

Vertical scar versus the inverted-T scar reduction mammaplasty : A 10-year follow-up

NARCIS (Netherlands)

Bouwer, Lesley R.; van der Biezen, Jan Jaap; Spronk, Cees A.; van der Lei, Berend

2012-01-01

A retrospective study was undertaken to evaluate whether the initial outcome of two types of reduction mammaplasty techniques (vertical scar reduction mammaplasty vs. the inverted-T scar reduction mammaplasty) remains stable in the long term: Sixty-nine patients who had undergone breast reduction

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

NARCIS (Netherlands)

Chernyshov, P. V.; Zouboulis, C. C.; Tomas-Aragones, L.; Jemec, G. B.; Manolache, L.; Tzellos, T.; Sampogna, F.; Evers, A. W. M.; Dessinioti, C.; Marron, S. E.; Bettoli, V.; van Cranenburgh, O. D.; Svensson, A.; Liakou, A. I.; Poot, F.; Szepietowski, J. C.; Salek, M. S.; Finlay, A. Y.

2018-01-01

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

Efficacy of peeling during different periods of the menstrual cycle on acne.

Science.gov (United States)

Bulbul Baskan, Emel; Tilki Günay, Işıl; Saricaoglu, Hayriye

2017-10-01

The aim of this study was to investigate the efficacy of 50% glycolic acid peeling performed at different phases of menstruation on acne. This study included 30 patients with mild-to-moderate acne. Those with regular menstrual cycles and no history or laboratory evidence of hormonal pathology, hirsutism were selected. Thirty patients were divided in three groups. The first group received peeling applications in the first 7 days of menstruation; the second group received the peel between 10 and 14 days; and the third group received the peel during the last 10 days of menstruation. The 30 female patients included in study. All patients' menstrual cycles were regular. All groups were homogenous in terms of initial acne severity scores. Acne severity scores decreased in all groups after 3 months of therapy; statistically significant differences were achieved only in the second group. The results of our study suggest that chemical peeling administered during ovulation provides the most significant benefit for acne lesions. Ovulation is the period when estrogen reaches its highest level. Estrogen decreases sebum production through different mechanisms. The beneficial effects of estrogen on acne and healing in combination with those of chemical peeling may cause synergistic therapeutic effects with pronounced results.

Anti-acne activity of Italian medicinal plants used for skin infection

Directory of Open Access Journals (Sweden)

Kate Nelson

2016-11-01

Full Text Available Propionibacterium acnes is implicated in the pathogenesis of acne vulgaris, which impacts >85% of teenagers. Novel therapies are in high demand and an ethnopharmacological approach to discovering new plant sources of anti-acne therapeutics could contribute to filling this void in effective therapies. The aims of our study were two-fold: 1 To determine if species identified in ethnopharmacological field studies as having traditional uses for skin and soft tissue infection (SSTI exhibit significantly more activity against P. acnes than species with no such reported use; and 2 Chemically characterize active extracts and assess their suitability for future investigation. Extracts of Italian medicinal (for acne and other skin infection and randomly collected plants and fungi were screened for growth-inhibitory and anti-biofilm activity in P. acnes using broth microdilution methods. Bioactive extracts were chemically characterized by HPLC and examined for cytotoxicity against human keratinocytes (HaCaTs. Following evaluation of 157 extracts from 10 fungi and 58 plants, we identified crude extracts from seven species exhibiting growth inhibitory activity (MICs 64-256 µg mL-1. All active extracts were examined for cytotoxicity against HaCaTs; extracts from one fungal and one plant species were toxic (IC50 256 µg mL-1. HPLC analysis with chemical standards revealed many of these extracts contained chlorogenic acid, p-coumaric acid, ellagic acid, gallic acid and tannic acid. In conclusion, species used in traditional medicine for the skin exhibited significantly greater (p<0.05 growth inhibitory and biofilm eradication activity than random species, supporting the validity of an ethnobotanical approach to identifying new therapeutics. The anti-acne activity of three extracts is reported for the first time: Vitis vinifera leaves, Asphodelus microcarpus leaves and Vicia sativa aerial parts.

Linking diet to acne metabolomics, inflammation, and comedogenesis: an update

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Melnik BC

2015-07-01

Full Text Available Bodo C Melnik Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Germany Abstract: Acne vulgaris, an epidemic inflammatory skin disease of adolescence, is closely related to Western diet. Three major food classes that promote acne are: 1 hyperglycemic carbohydrates, 2 milk and dairy products, 3 saturated fats including trans-fats and deficient ω-3 polyunsaturated fatty acids (PUFAs. Diet-induced insulin/insulin-like growth factor (IGF-1-signaling is superimposed on elevated IGF-1 levels during puberty, thereby unmasking the impact of aberrant nutrigenomics on sebaceous gland homeostasis. Western diet provides abundant branched-chain amino acids (BCAAs, glutamine, and palmitic acid. Insulin and IGF-1 suppress the activity of the metabolic transcription factor forkhead box O1 (FoxO1. Insulin, IGF-1, BCAAs, glutamine, and palmitate activate the nutrient-sensitive kinase mechanistic target of rapamycin complex 1 (mTORC1, the key regulator of anabolism and lipogenesis. FoxO1 is a negative coregulator of androgen receptor, peroxisome proliferator-activated receptor-γ (PPARγ, liver X receptor-α, and sterol response element binding protein-1c (SREBP-1c, crucial transcription factors of sebaceous lipogenesis. mTORC1 stimulates the expression of PPARγ and SREBP-1c, promoting sebum production. SREBP-1c upregulates stearoyl-CoA- and Δ6-desaturase, enhancing the proportion of monounsaturated fatty acids in sebum triglycerides. Diet-mediated aberrations in sebum quantity (hyperseborrhea and composition (dysseborrhea promote Propionibacterium acnes overgrowth and biofilm formation with overexpression of the virulence factor triglyceride lipase increasing follicular levels of free palmitate and oleate. Free palmitate functions as a “danger signal,” stimulating toll-like receptor-2-mediated inflammasome activation with interleukin-1β release, Th17 differentiation, and interleukin-17-mediated keratinocyte

Propionibacterium Acnes Phylogenetic Type III is Associated with Progressive Macular Hypomelanosis

DEFF Research Database (Denmark)

Petersen, Rolf L W; Scholz, Christian F P; Jensen, Anders

2017-01-01

Progressive macular hypomelanosis (PMH) is a skin disorder that is characterized by hypopigmented macules and usually seen in young adults. The skin microbiota, in particular the bacterium Propionibacterium acnes, is suggested to play a role. Here, we compared the P. acnes population of 24 PMH...... lesions from eight patients with corresponding nonlesional skin of the patients and matching control samples from eight healthy individuals using an unbiased, culture-independent next-generation sequencing approach. We also compared the P. acnes population before and after treatment with a combination...... of lymecycline and benzoylperoxide. We found an association of one subtype of P. acnes, type III, with PMH. This type was predominant in all PMH lesions (73.9% of reads in average) but only detected as a minor proportion in matching control samples of healthy individuals (14.2% of reads in average). Strikingly...

Cutibacterium acnes Septic Arthritis of the Nonoperated Knee: A Case Report

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Okoroha, Kelechi R.; Gabbard, Michael D.; Fitts, Jamal; Banka, Trevor R.

2017-01-01

Cutibacterium (Propionibacterium) acnes , a gram-positive bacillus with low pathogenicity, is an uncommon but known cause of prosthetic joint infections, particularly related to shoulder surgery. C. acnes , however, is an extremely rare pathogen in the nonoperated knee joint. This report details an uncommon case of C. acnes septic knee arthritis after multiple intra-articular steroid injections in a 56-year-old male patient. After an indolent presentation and late diagnosis, the patient underwent surgical debridement with IV antibiotic management. This case illustrates that intra-articular corticosteroid injections for the management of osteoarthritis are not without risk. Literature supporting their use remains limited and clinicians should use proficient clinical judgment for appropriate patient selection for these injections. Vigilance following injections or aspirations of the knee should be maintained to identify the indolent clinical presentation of C. acnes septic arthritis. PMID:28825032

The fate of facial asymmetry after surgery for "muscular torticollis" in early childhood

Directory of Open Access Journals (Sweden)

Dinesh Kittur

2016-01-01

Full Text Available Aims and Objectives: To study wheather the facial features return to normal after surgery for muscular torticollis done in early childhood. Materials and Methods: This is a long-term study of the fate of facial asymmetry in four children who have undergone operation for muscular torticollis in early childhood. All the patients presented late, i.e., after the age of 4 years with a scarred sternomastoid and plagiocephaly, so conservative management with physiotherapy was not considered. All the patients had an x-ray of cervical spine and eye and dental checkup before making a diagnosis of muscular torticollis. Preoperative photograph of the patient′s face was taken to counsel the parents about the secondary effect of short sternomastoid on facial features and the need for surgery. After division of sternomastoid muscle and release of cervical fascia when indicated, the head was maintained in a hyperextended position supported by sand bags for three days. Gradual physiotherapy was then started followed by wearing of a Minerva collar that the child wore for a maximum period of time in 24 h. Physiotherapy was continued three times a day till the range of movements of the head returned to normal. During the follow-up, serial photographs were taken to note the changes in the facial features. Results: In all four patients, the asymmetry of the face got corrected and the facial features returned to normal. Conclusion: Most of the deformity of facial asymmetry gets corrected in the first two years after surgery. By adolescence, the face returns to normal.

Cheilitis in acne vulgaris patients with no previous use of systemic retinoid products.

Science.gov (United States)

Balighi, Kamran; Daneshpazhooh, Maryam; Lajevardi, Vahideh; Talebi, Shahin; Azizpour, Arghavan

2017-08-01

Isotretinoin is commonly used in the treatment of acne vulgaris. While one of the more common side-effects is cheilitis, we have observed an increased incidence of cheilitis prior to the commencement of systemic isotretinoin. The aim of this study was to assess the prevalence of cheilitis among acne vulgaris patients. A non-interventional cross-sectional study of patients with acne vulgaris. Patients with previous use of systemic retinoids were excluded. The patients were examined for signs and symptoms of cheilitis. Of a total of 400 patients, 134 (34%) had evidence of cheilitis at initial presentation. Two-thirds (63%) were female (P acne excorie, compared with only 8% of patients with no signs of cheilitis. Our findings suggest that cheilitis is quite common among acne vulgaris patients even before treatment with isotretinoin. © 2016 The Australasian College of Dermatologists.

Strong quantum scarring by local impurities

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Luukko, Perttu J. J.; Drury, Byron; Klales, Anna; Kaplan, Lev; Heller, Eric J.; Räsänen, Esa

2016-11-01

We discover and characterise strong quantum scars, or quantum eigenstates resembling classical periodic orbits, in two-dimensional quantum wells perturbed by local impurities. These scars are not explained by ordinary scar theory, which would require the existence of short, moderately unstable periodic orbits in the perturbed system. Instead, they are supported by classical resonances in the unperturbed system and the resulting quantum near-degeneracy. Even in the case of a large number of randomly scattered impurities, the scars prefer distinct orientations that extremise the overlap with the impurities. We demonstrate that these preferred orientations can be used for highly efficient transport of quantum wave packets across the perturbed potential landscape. Assisted by the scars, wave-packet recurrences are significantly stronger than in the unperturbed system. Together with the controllability of the preferred orientations, this property may be very useful for quantum transport applications.

Evaluation of anti-acne property of purified bee venom serum in humans.