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Dermatologic Surgery : Official... Jan 2020Microneedling is a popular, minimally invasive skin rejuvenation modality for acne scarring. Recent reports have evaluated the efficacy and safety of microneedling...
BACKGROUND
Microneedling is a popular, minimally invasive skin rejuvenation modality for acne scarring. Recent reports have evaluated the efficacy and safety of microneedling monotherapy and combination treatment for scarring.
OBJECTIVE
This review aims to systematically analyze the current literature on microneedling techniques used for acne scarring.
METHODS
A PubMed search (2009-current) was used to identify literature on microneedling treatment for acne. All randomized and nonrandomized clinical trials, case cohorts, case reports, and case series were included with the exception of 2 studies, which were excluded due to unavailability.
RESULTS
All 33 articles evaluated showed improvement of acne scar appearance after microneedling treatment. Evidence was inconsistent when comparing microneedling monotherapy to dual therapy or to fractional laser treatment.
CONCLUSION
Microneedling improves acne scarring, and further studies are needed to compare microneedling with other minimally invasive treatments.
Topics: Acne Vulgaris; Cicatrix; Cosmetic Techniques; Humans; Needles; Treatment Outcome
PubMed: 31356435
DOI: 10.1097/DSS.0000000000002020 -
Science Immunology Jul 2022Acne affects 1 in 10 people globally, often resulting in disfigurement. The disease involves excess production of lipids, particularly squalene, increased growth of ,...
Acne affects 1 in 10 people globally, often resulting in disfigurement. The disease involves excess production of lipids, particularly squalene, increased growth of , and a host inflammatory response with foamy macrophages. By combining single-cell and spatial RNA sequencing as well as ultrahigh-resolution Seq-Scope analyses of early acne lesions on back skin, we identified TREM2 macrophages expressing lipid metabolism and proinflammatory gene programs in proximity to hair follicle epithelium expressing squalene epoxidase. We established that the addition of squalene induced differentiation of TREM2 macrophages in vitro, which were unable to kill . The addition of squalene to macrophages inhibited induction of oxidative enzymes and scavenged oxygen free radicals, providing an explanation for the efficacy of topical benzoyl peroxide in the clinical treatment of acne. The present work has elucidated the mechanisms by which TREM2 macrophages and unsaturated lipids, similar to their involvement in atherosclerosis, may contribute to the pathogenesis of acne.
Topics: Acne Vulgaris; Humans; Inflammation; Lipids; Macrophages; Membrane Glycoproteins; Receptors, Immunologic; Squalene
PubMed: 35867799
DOI: 10.1126/sciimmunol.abo2787 -
International Journal of Dermatology Oct 2022Acne affects more than 640 million people worldwide, including about 85% of adolescents. This inflammatory dermatosis affects the entire population, from teenagers to... (Review)
Review
Acne affects more than 640 million people worldwide, including about 85% of adolescents. This inflammatory dermatosis affects the entire population, from teenagers to adults, which reinforces the need to investigate it. Furthermore, in adults, acne has serious consequences, including a psychological impact, low self-esteem, social isolation, and depression. Over the last years, the understanding of acne pathophysiology has improved, mainly thanks to the identification of the pivotal role of the microbiota. The aim of this review was to screen the most recent scientific literature on adult acne and the newly tested treatments. Clinically, therapeutic innovations for the treatment of acne have been recently developed, including pre/probiotics, new molecules, and innovative formulations associated, however, with fewer side effects. Moreover, clinical trials are underway to use off-label molecules that seem to be proving their value in the fight against adult acne.
Topics: Acne Vulgaris; Adolescent; Adult; Humans; Probiotics
PubMed: 35521784
DOI: 10.1111/ijd.16220 -
Journal of the American Academy of... Aug 2023Acne vulgaris can be associated with hyperpigmentation, particularly in individuals with skin of color. This acne-induced macular hyperpigmentation (AMH), also called... (Review)
Review
Acne vulgaris can be associated with hyperpigmentation, particularly in individuals with skin of color. This acne-induced macular hyperpigmentation (AMH), also called postinflammatory hyperpigmentation, is often long lasting and negatively impacts quality of life. Large-scale, randomized, controlled clinical trials with regard to the treatment of acne and AMH are lacking. For this reason, evidence-based treatment recommendations cannot be made. However, AMH is a common condition, and it is important for clinicians to have guidance on management strategies. The authors, a group of 10 board-certified dermatologists, conducted a modified Delphi consensus process to reach a consensus on first-line therapy for AMH and determine whether therapeutic choices change in different patient subgroups. We reached a consensus that most patients with acne and AMH should receive early and efficacious acne treatment with a topical retinoid and benzoyl peroxide. Therapies aimed at addressing AMH-including hydroquinone, azelaic acid, chemical peel, or antioxidants-may also be considered for enhancing the effect of the treatment regimen on acne and pigmentation. Chemical peels may be used as adjunctive or second-line therapy. This article details the results of the Delphi process, reviews relevant literature for providing recommendations for AMH, and discusses appropriate treatment options.
Topics: Humans; Quality of Life; Consensus; Delphi Technique; Acne Vulgaris; Hyperpigmentation
PubMed: 36924935
DOI: 10.1016/j.jaad.2023.02.053 -
The Journal of Family Practice Sep 2021THE COMPARISONA. A 27-year-old Hispanic woman with comedonal and inflammatory acne. Erythema is prominent around the inflammatory lesions. Note the pustule on the cheek...
THE COMPARISONA. A 27-year-old Hispanic woman with comedonal and inflammatory acne. Erythema is prominent around the inflammatory lesions. Note the pustule on the cheek surrounded by pink color.B. A teenaged Black boy with acne papules and pustules on the face. There are comedones, hyperpigmented macules, and pustules on the cheek.C. A teenaged Black girl with pomade acne. The patient used various hair care products, which obstructed the pilosebaceous units on the forehead.
Topics: Acne Vulgaris; Adolescent; Adult; Black or African American; Erythema; Female; Health Services Accessibility; Hispanic or Latino; Humans; Hyperpigmentation; Male; Skin Pigmentation; Young Adult
PubMed: 34818170
DOI: 10.12788/jfp.0271 -
American Journal of Clinical Dermatology Jan 2022Acne is a common cause for post-inflammatory hyperpigmentation (PIH), particularly in patients with skin of color (SOC), and PIH is often more distressing to patients... (Review)
Review
Acne is a common cause for post-inflammatory hyperpigmentation (PIH), particularly in patients with skin of color (SOC), and PIH is often more distressing to patients than the acne itself. Topical retinoids are approved for the treatment of acne and for pigmentation disorders such as melasma or mottled hyperpigmentation associated with photodamage; moreover, they have been shown to reduce hyperpigmentation in patients with SOC. Therefore, treatment with topical retinoids should be started as early as possible unless contraindicated. Use of novel formulations or application of commonly recommended moisturizers may help reduce irritation. Combining retinoids with other topical agents and procedures such as superficial chemical peels can help to improve hyperpigmentation. Primary acne lesions are likely to improve weeks before PIH resolves and helping patients manage their expectations may reduce frustration. Providing clinicians and researchers with more education about the presentation and management of dermatologic conditions in patients with SOC is also recommended.
Topics: Acne Vulgaris; Administration, Topical; Humans; Hyperpigmentation; Patient Education as Topic; Retinoids; Skin Care; Skin Pigmentation
PubMed: 34751927
DOI: 10.1007/s40257-021-00643-2 -
Acta Dermato-venereologica Dec 2023Metformin is a widely used drug for treatment of diabetes mellitus, due to its safety and efficacy. In addition to its role as an antidiabetic drug, numerous beneficial... (Review)
Review
Metformin is a widely used drug for treatment of diabetes mellitus, due to its safety and efficacy. In addition to its role as an antidiabetic drug, numerous beneficial effects of metformin have enabled its use in various diseases. Considering the anti-androgenic, anti-angiogenic, anti-fibrotic and antioxidant properties of metformin, it may have the potential to improve chronic inflammatory skin diseases. However, further evidence is needed to confirm the efficacy of metformin in dermatological conditions, This review focuses on exploring the therapeutic targets of metformin in acne vulgaris, hidradenitis suppurativa and rosacea, by studying their pathogeneses.
Topics: Humans; Hidradenitis Suppurativa; Metformin; Acne Vulgaris; Rosacea; Skin
PubMed: 38078688
DOI: 10.2340/actadv.v103.18392 -
Journal of the American Academy of... Feb 2020
Topics: Acne Vulgaris; Humans
PubMed: 31859048
DOI: 10.1016/j.jaad.2019.01.092 -
JAMA Dermatology Dec 2023Janus kinase (JAK) inhibitors are increasingly used across a range of dermatologic conditions. Adverse events of acne have been noted in some studies in clinical... (Meta-Analysis)
Meta-Analysis
IMPORTANCE
Janus kinase (JAK) inhibitors are increasingly used across a range of dermatologic conditions. Adverse events of acne have been noted in some studies in clinical practice, but the scope of this outcome across JAK inhibitors has not been established.
OBJECTIVE
To systematically analyze all published phase 2 and 3 placebo-controlled randomized clinical trials (RCTs) of JAK inhibitors for the risk of acne as an adverse effect of these medications.
DATA SOURCES
Comprehensive search of Ovid MEDLINE and PubMed databases through January 31, 2023.
STUDY SELECTION
Inclusion criteria were phase 2 and 3 placebo-controlled RCTs of JAK inhibitors published in English with reported adverse events of acne.
DATA EXTRACTION AND SYNTHESIS
Two reviewers independently reviewed and extracted information from all included studies.
MAIN OUTCOMES AND MEASURES
The primary outcome of interest was the incidence of acne following JAK inhibitor use. A meta-analysis was conducted using random-effects models.
RESULTS
A total of 25 unique studies (10 839 unique participants; 54% male and 46% female) were included in the final analysis. The pooled odds ratio (OR) was calculated to be 3.83 (95% CI, 2.76-5.32) with increased ORs for abrocitinib (13.47 [95% CI, 3.25-55.91]), baricitinib (4.96 [95% CI, 2.52-9.78]), upadacitinib (4.79 [95% CI, 3.61-6.37]), deucravacitinib (2.64 [95% CI, 1.44-4.86]), and deuruxolitinib (3.30 [95% CI, 1.22-8.93]). Estimated ORs were higher across studies investigating the use of JAK inhibitors for the management of dermatologic compared with nondermatologic conditions (4.67 [95% CI, 3.10-7.05]) as well as for JAK1-specific inhibitors (4.69 [95% CI, 3.56-6.18]), combined JAK1 and JAK2 inhibitors (3.43 [95% CI, 2.14-5.49]), and tyrosine kinase 2 inhibitors (2.64 [95% CI, 1.44-4.86]).
CONCLUSIONS AND RELEVANCE
In this systematic review and meta-analysis, JAK inhibitor use was associated with an elevated odds of acne. Patients should be properly counseled on this potential adverse effect of these medications before treatment initiation. Future studies are needed to further elucidate the pathophysiology of this association.
Topics: Male; Female; Humans; Janus Kinase Inhibitors; Acne Vulgaris
PubMed: 37851459
DOI: 10.1001/jamadermatol.2023.3830 -
Journal of the American Academy of... Oct 2023
Topics: Humans; Acne Vulgaris; Rosacea
PubMed: 37524168
DOI: 10.1016/j.jaad.2023.07.1019