Hormonal acne Tx evidence reviewed
Hormonal acne Tx evidence reviewed
Today's report also covers severe disease in female acne patients, carbon peel laser treatment in skin of colour, inflammatory acne, and more (1,200 words, 6 minutes, 50 seconds)
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Good morning and welcome to the sixth issue of Focus on Acne presented by Skin Spectrum Weekly. This series provides up-to-date information on developing therapies and trends in acne treatment. We appreciate your feedback and suggestions and invite you to be in touch. Please write to us at health@chronicle.org
Hormonal acne Tx evidence reviewed
A new paper, published in the Journal of Dermatological Treatment, summarizes the current evidence supporting the benefits of targeted hormonal treatment to decrease androgen-stimulated sebum production for the management of acne vulgaris (AV).
The authors note that the association between pubertal hormonal changes and the development of AV has been recognized for almost 100 years.
They prepared a review article to provide an overview of clinical and preclinical evidence supporting the influences of androgens on the skin and their therapeutic importance in AV pathophysiology.
“The cutaneous effects of hormones are attributable, to a large extent, to the influence of steroid hormones, particularly androgens, on sebocyte development and sebum production in both sexes,” the authors write. “Androgen-mediated excess sebum production is implicated as a necessary early step in AV pathophysiology and is therefore considered an important therapeutic target in AV treatment.”
The authors note that while the literature shows local production or activity of androgens within the skin is believed to be important in AV pathophysiology, it has received limited therapeutic attention.
Female acne patients experience less severe disease, greater anxiety, and stigmatization
Findings from new research underscore the importance of considering psychosocial aspects and taking routine measurements in the management of acne.
Published in the Journal of Clinical Medicine, this prospective cross-sectional study explored the differences in psychosocial aspects between male and female acne patients in Poland.
Researchers included 104 consecutive acne patients in the study. The authors evaluated clinical severity, patients’ quality of life, stigmatization levels, and psychiatric disturbances using the following instruments: Investigator Global Assessment (IGA), Dermatology Life Quality Index (DLQI), Cardiff Acne Disability Index (CADI), 6-Item Stigmatization Scale (6-ISS), and Hospital Anxiety and Depression Scale (HADS).
Investigators found that female patients exhibited significantly less severe acne and experienced significantly decreased quality of life and increased levels of stigmatization. Furthermore, anxiety levels among female patients exceeded those observed in their male counterparts. Notably, they observed no disparities in the severity of depression between the two gender groups. Correlations were discerned among all psychosocial parameters in the entire study cohort and the female subgroup, while such correlations were not uniformly observed among male participants.
Carbon peel laser for acne in skin of colour
Treatment with a carbon peel laser is an effective method for the management of acne vulgaris in skin of colour with minimal side effects and significant results.
These findings come from a paper published in the Journal of Cutaneous and Aesthetic Surgery.
This prospective observational study included 35 patients who presented with acne vulgaris Grade II-IV, who were poorly compliant to treatment with topical or systemic agents owing to side effects or the treatment not meeting patient expectations.
Each patient received an initial topical application of carbon suspension followed by treatment with Q-switched neodymium yttrium aluminum garnet (Qs:NdYAG) laser in two modes (quasi-long pulsed mode followed by Q-switched mode 1,064 nm). Each patient underwent three treatment sessions two weeks apart and was asked to avoid the use of any topical or systemic acne medication during this period.
The researchers noted a significant reduction of erythematous and nodular acne lesions after three sittings. Among the 35 patients, 28 (80%) showed greater than 80% improvement and seven (20%) showed 50%-80% improvement in skin lesions. No patient was unresponsive to the treatment.
Post-procedure complications were minimal, with six (20%) patients developing erythema, and one (3.3%) patient developing mild tolerable pain with no post inflammatory hyper- or hypopigmentation. The post-procedure mean Investigator Status Global Assessment (ISGA) was 1.342 as compared with the pre-procedure mean ISGA of 3.657 (p<0.0001).
Nonablative monopolar RF Tx for inflammatory acne
Nonablative monopolar radiofrequency (NMRF) appears to be an effective and safe treatment for inflammatory acne vulgaris (AV), with therapeutic outcomes persisting up to six months after two treatment sessions.
These findings were published in Lasers in Surgery and Medicine.
In this study, 24 patients with moderate to severe AV underwent a series of two NMRF treatment sessions, spaced four weeks apart. Researchers quantified lesion counts and measurements of pore size and volume, and sebum production. They also gathered patients' self-assessment data regarding the degree of improvement and facial oiliness, and the impact of AV on quality of life was assessed using the Dermatology Life Quality Index (DLQI).
Researchers conducted evaluations at baseline, one month after the first treatment, and during follow-up visits one, three, and six months after the last treatment sessions. Adverse effects were also recorded during each visit.
Twenty out of the 24 subjects completed the study protocol. The mean inflammatory lesion counts significantly reduced by 42.86% and 45.71% from the baseline at three (p=0.027) and six months (p=0.032) after the second treatment. Sebum excretion likewise significantly decreased from baseline by 11.62% (p=0.012), 13.37% (p<0.001), and 21.51% (p=0.004), one month after the first treatment, one and six months after the second treatment, respectively. The pore volume continued to decrease by 35% (p=0.003) and 41.5% (p<0.001) at one and six months following the final treatment, respectively. The DLQI significantly decreased from 10.00 (interquartile range [IQR]: 6.50-15.00) to 2.00 (IQR: 1.00-4.75), corresponding to an 80% improvement of the index, one month after the last treatment and was sustained up to the last follow-up visit. Patient self-assessments on the degree of improvement and facial oiliness also significantly improved following NMRF treatments. The treatments were well-tolerated without significant adverse effects.
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