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Acne New in science

A problem that does not cease to excite both doctors and patients. Acne Publications published abroad deserve to devote a whole issue to them.

Biochemistry
Scientists from Bengha University, in Egypt, have studied the role of the peptide hormone ghrelin in the occurrence of acne in patients older than 25 years.

Why did you choose this hormone?

Ghrelin, or as it is also called the “hormone of hunger”, has been under the scrutiny of scientists for a long time. At different times, he was attributed responsibility for the occurrence of alcoholism, prolonging longevity, and a feeling of hunger. Now acne. We will understand the relationship.

Ghrelin was discovered 20 years ago in Japan and is described as an endogenous ligand for growth hormone receptor. It is a peptide hormone consisting of 28 amino acids, mainly produced in the stomach and duodenum, but is also expressed at lower levels in other tissues (liver, pancreas, heart, central nervous system, testicles).

It regulates appetite, but recently there has been compelling evidence of the effect of ghrelin on the regulation of metabolic functions and the secretion of growth hormone, insulin, glucose.

Hyperandrogenism is known to be associated with polycystic ovary syndrome (PCOS). This disorder is believed to lead to age-related acne. In addition, PCOS is associated with manifestations of the metabolic syndrome (hyperinsulinemia, glucose intolerance, dyslipidemia, and visceral obesity). It has been suggested that continuous release of inflammatory mediators in PCOS may be the cause of peripheral insulin resistance, dyslipidemia, and endothelial dysfunction.

Egyptian doctors focused on the latter.

In a case-control study, they included 50 patients with acne and 50 patients compatible by age and gender as controls. Acne severity was assessed on a Hayashi acne grading criteria scale.

Serum ghrelin, fasting blood glucose, total cholesterol, low density lipoprotein, high density lipoprotein, triglycerides and insulin were measured.

It was found that in patients with severe acne, ghrelin was the lowest. Serum levels of insulin, fasting glucose were also increased. Ghrelin positively correlated with lipoproteins and negatively correlated with body mass index, low density lipoproteins, insulin resistance index and insulin.

Thus, the study shows that low ghrelin can cause acne in older patients and predispose them to hyperinsulinemia, type II diabetes, or dyslipidemia. This parameter can also be used by doctors as a diagnostic criterion.

Another study based on the same University evaluated the correlation between levels of brain neurotrophic factor (BDNF) in blood serum and severity of acne, as well as the relationship of this biomarker with stress and quality of life.

BDNF is a good predictor in assessing chronic stress. In patients with acne, it was lowered, with high scores on the HADS and PSS-10 stress scales, indicating a high risk of developing chronic stress, anxiety, and depression.

External acne therapy
Benzoyl peroxide
Doctors from Brazil and the UK have tested the effectiveness of the updated benzoyl peroxide formulation in a facial cleanser.

The new composition, which was tested by scientists, contained active benzoyl peroxide concentrations of 4 and 10% against the standard 10%. In a randomized, blind, single-center study, patients (133 volunteers) applied the drug twice a day for 21 ± 2 days.

Scientists did not note a clinically significant difference between the old composition and the content of 4 or 10%.

Clindamycin phosphate and tretinoin
But this combination has shown its effectiveness.

Clindamycin phosphate 1.2% and tretinoin 0.025% were well tolerated.

The study was conducted in 18 centers in Sweden and included patients ≥15 years of age with acne who were first prescribed this protocol. The observation period was ~ 12 weeks.

Patient ratings on the VAS scale decreased during the study, indicating an improvement: the median percentage reduction compared to the baseline VAS score was 17.6% at week 4 and 63.8% at week 12, with changes compared with baseline were statistically significant.

Seventy percent of patients were satisfied / very satisfied with the result.
Hardware and combined techniques in acne therapy
Kang and colleagues conducted a small, randomized, blind, prospective split study of the treatment of moderate to severe acne on the face using a solid state fractional laser with a combination of wavelengths (589 nm and 1319 nm).

Number of patients: 9.

Number of sessions: 4.

Interval: 2-3 weeks.

On one side of the face, the patients underwent a 1319 nm laser pass, and on the other side a 1319 nm laser pass in combination with 589 nm.

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