ACNE TREATMENTS

Coordonator: Şef. lucr. dr. Nicoleta Todoran

Autor: Stud. Adriana-Elena Simion

a review of the present for identifying the future research perspectives

Universitatea de Medicină şi Farmacie din Tîrgu MureşFacultatea de FarmacieDisciplina de Tehnologie farmaceutică

Acne, medically known as Acne vulgaris, is a chronic disease of the pilosebaceous follicle that most frequently occurs during puberty.

It causes polymorph cutaneous lesions and among them: comedones, papules, cysts, pustules, and abscesses.

Although it is not a life threatening disease, it has a major impact on the quality of life of teenagers and adults alike.

Introduction

http://www.kelownadermatology.ca/acne/

The means of research used were online medical articles and studies regarding the treatment of acne in controlled groups, as well as post trial maintenance studies.

MATERIALS AND METHODS

RESULTS

OBJECTIVESThe aime of this paper is to gather data on the currently available treatment forms for acne and also to explore new treatment options in order to establish the future research directions.

HORMONAL CONTROL OF SEBACEOUS GLANDS:

http://epomedicine.com/medical-students/anatomy-and-physiology-of-sebaceous-glands/

http://www.skin-care-forum.basf.com/en/artikel/home/new-concepts-in-acne-pathogenesis/2013/12/10?id=2618a2cd-f87f-6a2e-9f6c-ff00000b5c72&mode=Detail

acne has a genetic predisposition

androgen plays a major role

acne is an inflammatory disease to whose pathogenesis androgens, natural PPAR (peroxisome proliferator-activated receptors) ligands, regulating neuropeptides and environmental factors, such as smoking and diet, are involved

these factors interrupt the natural cyclic process in the sebaceous follicles and support the transition from microcomedones to comedones and inflammatory lesions

Zouboulis CC- Pathophysiologie der Akne: was ist gesichert?, Hautarzt, 2013, 64:2 35-240.

ACNE PATHOGENESIS:

RUSSELL JJ- Topical Therapy for Acne, Am Fam Physician, 2000, 61(2): 357-365.http://www.diseasesofman.com/2014/03/acne-vulgaris.html

I II III

CLINICAL ACNE TYPESI-MILD comedonal (noninflamatory)

II-MODERATE papulopustular (inflamatory)

III-SEVERE nodular(inflamed sinus tracts under the skin)

TREATMENT OPTIONS:

Dragomirescu A- Actualități în dermofarmacie și cosmetologie, Ed. Victor Babeș. Timișoara, 2012.http://www.accarecosmetics.com/pages/best-acne-serum

CURRENT THERAPEUTIC TREATMENT OF ACNE (1):

Mild acne (before one sees the physician):

regular cleansing of the affected area;improved nutritional habits;treatment with:

-nonprescription topical antiseptics (e.g. benzoyl peroxide)

-and/or keratolitics (e.g. resorcinol, salicylic acid, sulfur)

Benzoyl peroxide (BPO)

Walters HA, Roberts MS and al- Dermatologic, Cosmeceutic, and Cosmetic Development- Therapeutic and Novel Approaches, Informa Healthcare USA INC, New York, 2008: 243-255.

High-fat dairy products

Intakes of red meat

Sugary desserts

High-fat foods

Refined grains

The western diet

Is a pattern of diet in medical literature, regardless of where the diet is found, and is often contrasted with the "prudent" diet

High glycemic load diet is associated with worsening acne

Consumption of milk adds a greater rate and severity of acne

Cordain L et al- Origins and evolution of the Western diet: health implications for the 21st century, Am J Clin Nutr, 2005, 81 (2 ): 341-354.

CURRENT THERAPEUTIC TREATMENT OF ACNE (2):

Moderate to severe acne (medical prescription):

Walters HA, Roberts MS and al- Dermatologic, Cosmeceutic, and Cosmetic Development- Therapeutic and Novel Approaches, Informa Healthcare USA INC, New York, 2008: 243-255.http://www.kelownadermatology.ca/acne/

retinoids (topical/ sistemic);antibiotics (topical/ oral);antiandrogens.

Combinations:Zinc Erytromycin (Zineryt)BPO Erytromycin (Benzamycin)

TOPICAL TREATMENT VEHICLEIn the treatment of acne, the vehicle (cream, gel, lotion or solution) may be as important as the active agent. Consequently, it is important to assess the patient's skin type.

Creams are appropriate for patients with sensitive or dry skin who require a nonirritating, nondrying formulation. Patients with oily skin may complain of an “oily” feel with creams.

Patients who have oily skin may be more comfortable with gels, which have a drying effect. However, gels may cause a burning-type irritation in some patients and may prevent certain kinds of cosmetics from adhering to the skin.

Lotions can be used with any skin type, and they spread well over hair-bearing skin. Yet lotions contain propylene glycol and thus may have burning or drying effects.

Solutions are mainly used with topical antibiotics, which are often dissolved in alcohol. Like gels, solutions work best in patients with oily skin.

RUSSELL JJ- Topical Therapy for Acne, Am Fam Physician, 2000, 61(2): 357-365.

Changing the microbiome (targeting the environment in which Propionibacterium acnes thrives):

NEW APROACHES IN THE TREATMENT OF ACNE:

by limiting within pilosebaceous follicles its "nutrients„by having bacterial members in the skin microbiome whose development is competitive and so they can rein in the overgrowth of P. acnes.

oThe solute must be easily diffusible and minimally soluble in sebaceous lipids

oWater is the limiting "nutrient“

oXylose and Sucrose

oThe use of S. epidermidis

Succinic acid

Targeting the inflamation skin site: (Combining bactericidal potencial and anti-inflammatory properties):

LZ1 (a Tryptophan–Lysine-rich peptide) Sintetic peptide containing 15 amino acid residues The hydrophobic Trp has preference for the interfacial region of lipid bilayers Lys and Arg residues endow the peptides with cationic charges and H+ bonding propertiesStrong anti-inflammatory effects and demonstrated antimicrobial effect against skin bacteria

Zhang Z et al- A Small Peptide with Therapeutic Potential for Inflammatory Acne Vulgaris, 2013, PLoS ONE 8(8): e72923. doi:10.1371/journal.pone.0072923 (http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0072923 )

Thank you for your attention! 

Conclusion The present documentation is the starting point for identifying the future perspectives in developing more targeted acne treatments.