Mental health consideration necessary for acne patients
Today's report also covers lasering acne scars, ALA-PDT phototherapy, circulating hormones and lipids, and more (1,500 words, 7 minutes, 50 seconds)
The Focus on Acne e-newsletter is supported by an unrestricted grant from Sun Pharma Canada
Good morning and welcome to the fourth 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
Mental health consideration necessary for acne patients
In a recent review, researchers examine current evidence in the field of psychodermatology, highlighting the importance to physicians of considering a patient’s mental health as part of the treatment of acne.
Published in the British Journal of Dermatology, the paper discusses a range of presenting issues. The authors also highlight cases of underserved patients needing additional considerations.
In the paper the authors discuss how psychological sequelae can contribute to acne pathogenesis, as well as how psychotherapeutic approaches can benefit patients with appearance-related distress.
They emphasize the importance of physicians assessing patient mental wellbeing at the same time as their physical symptoms.
They emphasize the importance of physicians assessing patient mental wellbeing at the same time as their physical symptoms.
Greater safety, same efficacy for lower-fluence 1,064 laser in acne scar Tx
Using a low-fluence setting when treating acne scars with a fractional picosecond Nd:YAG 1,064 nm laser appears to have similar efficacy and greater safety than a high-fluence setting.
These findings were published online ahead of print in Photodermatology, Photoimmunology and Photomedicine.
In this 12-week, randomized split-face study, 25 patients with moderate-to-severe acne scars received three sessions of high fluence (1.0 J/cm2) laser treatment on one side of their face, and low-fluence (0.3 J/cm2) on the other side. The treatment sessions were four weeks apart.
At the last follow-up visits, patients achieved a 30% or greater reduction in scar counts in 88.00% of the low-fluence-treated sides, and 92.00% of the high-fluence sides, without a significant difference between the sides.
Researchers found that scar counts, Scar Global Assessment scores, and ECCA scar scores on both sides of patients’ faces were significantly improved four weeks after the last treatment. There was a greater reduction in scar counts (-66.73%) in scar counts on the high-fluence sides compared to the low-fluence sides (-62.13%), the two sides did not have a significant difference in grading scores.
However, significantly more pain and side effect scores were reported on the high-fluence sides both immediately and four weeks after treatment. Histological analysis revealed a significantly increased expression of collagen, elastin, and vimentin on the low-fluence side.
ALA-PDT more effective, safer for severe acne than blue/red light therapy plus triamcinolone and lidocaine
Photodynamic therapy with 5-aminolevulinic acid (ALA-PDT) produces a greater therapeutic effect in the treatment of severe acne than red/blue light combined with triamcinolone and lidocaine injections.
These findings come from a paper published online ahead of print in Journal of Cosmetic Dermatology (Oct. 25, 2023).
Researchers analyzed 104 cases of severe inflammatory acne. They divided the patients into a control group who received red and blue light therapy combined with triamcinolone and lidocaine injections, and an observation group treated with ALA-PDT.
After two, four, and six weeks, investigators observed effectiveness rates in the observational group of 28.85%, 75.00%, and 86.54%, respectively. These rates compared to 9.52%, 51.92%, and 69.23% at the same time points in the control group.
The authors also found that the incidence of adverse reactions in the observational group was 5.77%, compared to 32.69% in the control group.
The number of remaining lesions in the observational group at weeks two, four, and six was also significantly (p<0.01) lower than in the control group.
Circulating hormone, lipid levels elevated in acne patients
Altered lipid and androgen levels should be considered in the pathophysiology of acne and taken into account when planning treatment, researchers report in Health Science Reports (June 1, 2023; 6(6):e1322).
In this case-control study, researchers recruited 100 individuals with acne vulgaris and 100 healthy controls. The investigators analyzed hormonal levels such as estradiol €, total testosterone (TT), and free testosterone (FT). They also analyzed lipid profiles such as triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C).
The investigators found significantly higher hormonal levels in patients with acne compared to the healthy controls (p<=0.05). The same results were also found in TC, TG, LDL-C and HDL-C levels (p<=0.05).
Subscribe to The Chronicle of Skin & Allergy
Established in 1995, The Chronicle of Skin & Allergy is a scientific newspaper providing news and information on practical therapeutics and clinical progress in dermatologic medicine.
To apply for a complimentary* subscription, please email health@chronicle.org with your contact information or click the link below.
If you find the contents of this newsletter interesting, please check out the Yadav on Acne podcast. It’s available at Apple iTunes, Stitcher, Spotify, or wherever you get your podcasts.