Prime Editing Unlocks a Universal Strategy for Restoring Lost Proteins
November 22, 2025
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Background
Acne vulgaris is a chronically recurring and self-limiting inflammatory condition of the pilosebaceous unit. Cutibacterium acnes causes acne vulgaris to appear throughout adolescence when dehydroepiandrosterone is naturally circulating in the blood. Mostly on the face, but sometimes on the forearms and trunk, it is a very common skin ailment that can cause both aggressive and non-inflammatory blisters.
Epidemiology
Adolescence is when acne may first emerge and it can last into the early 30s. Twenty percent of those who have been impacted experience extreme acne that leaves scars.
It appears that certain races are more impacted than others. Extreme acne is much more frequent in Asians and Africans whereas moderate acne is more prevalent in white people. People with a darker complexion also tend to acquire hyperpigmentation. Neonates can also get acne where although it typically goes away on its own.
Anatomy
Pathophysiology
As a result of androgens-the 5-alpha reductase changes testosterone throughout puberty into more effective DHT which attaches to specific targets in the sebaceous glands and increases sebum secretion. Sebum is retained because of the follicular epidermis’ enhanced hyperproliferation.
Inflammation is triggered when distended follicles burst and discharge pro-inflammatory substances into the epidermis.
Acne-causing factors include:
Etiology
Acne is caused by the sebaceous glands being oversensitive to a normal level of androgens in the blood in which P. acnes and inflammation exacerbate.
Acne can result from the following factors:
Genetics
Prognostic Factors
Although it may not be life-threatening the acne has psychosocial repercussions that last a lifetime. Acne sufferers and those with breakouts frequently experience anxiety and sadness. It’s almost impossible to remove acne scars.
Clinical History
The patient of acne vulgaris often presents with the typical facial skin that you notice immediately as the condition is more prevalent in adolescents and young adults.
Mild symptoms– Comedonal acne does not cause inflammation of the skin. These are whiteheads that are covered by skin and blackheads that appear black due to oxidation of sebum. Mild acne is characterized by comedones and a few papulopustules.
Often women with PCOD present with the mild comedonal appearance of the facial skin. In these cases, we can also look for the other symptoms of PCOD.
Hormonal acne erupts more in the lower third of the face along the chin and jaw lines.
Moderate symptoms– There is more area of the skin involved compared to mild symptoms.
Severe symptoms– A single cyst or nodule can form over a larger skin area (> 5mm in diameter). These lesions are often accompanied by pain and pus formation.
Physical Examination
Age group
Associated comorbidity
Associated activity
Acuity of presentation
Differential Diagnoses
Perioral dermatitis
Angiofibroma
Sebaceous hyperplasia
Adnexal tumors
Demodex folliculitis
Laboratory Studies
Imaging Studies
Procedures
Histologic Findings
Staging
Treatment Paradigm
by Stage
by Modality
Chemotherapy
Radiation Therapy
Surgical Interventions
Hormone Therapy
Immunotherapy
Hyperthermia
Photodynamic Therapy
Stem Cell Transplant
Targeted Therapy
Palliative Care
use-of-nonpharmacological-treatment-for-acne-vulgaris
Infectious diseases
Family medicine
Nutrition and Dietetics
The nonpharmacological treatment includes a daily skincare routine that suits the skin type. Oily skin is more prone to develop acne flares since it can easily attract pollutants and dust particles from the surrounding area. The dirt or dust particles can accumulate and clog the skin pores by worsening the condition. It becomes essential to remove the makeup and debris. Covering the face and using sunscreen lotions should be part of the daytime skincare routine. Having a balanced diet helps to control the acne. Patients should be encouraged to avoid fatty foods which include more greens and maintain adequate hydration. Herbs such as curcumin and aloe vera help reduce the flares.
Administration of pharmaceutical agents
Effectiveness of topical treatment in acne vulgaris: – They can be used alone in the initial stages. Topical agents can be combined with oral medications for moderate to severe flares.
Topical antibiotics: – It consists of clindamycin, erythromycin, and, more recently, dapsone and minocycline topical foam 4%. If the patients develop resistance, they can be combined with benzoyl peroxide and retinoids. Topical dapsone is available in 5% twice-daily and 7.5% once-daily formulations. It may also be helpful to use benzoyl peroxide with an antibiotic course for 5-7 days to reduce resistance in organisms on the skin.
Benzoyl peroxide: – It is an effective bactericidal. It is available in various skin care products, including gels, creams, and face washes.
Retinoids (e.g., tretinoin, adapalene): – They promote skin cell production and prevent clogging of hair follicles. Topical retinoids contain chemicals derived from vitamin A. They are anti-inflammatory and may be used to treat current acne and prevent further breakouts. Some topical retinoids include adapalene, tazarotene, tretinoin, and isotretinoin.
Azelaic acid: – It has antimicrobial and anti-inflammatory properties and helps in unclogging pores.
Androgen receptor antagonists: – Clascoterone 1% topical cream is a first-in-class topical androgen receptor inhibitor approved by the FDA. It is used for acne vulgaris in patients aged 12 years and older.
Other: Salicylic acid can be effective as a topical treatment for acne. It is a beta-hydroxy acid with anti-inflammatory and antimicrobial properties.
common-procedures-and-interventions-in-acne-vulgaris
Family medicine
Chemical Peels: The carefully planned administration of chemical agents of different strengths in the clinical trial shed off damaged dermis and epidermis by which in turn promotes the regeneration processes. Allergens are divided into two categories: the ones that get to the lower skin layers and the ones that just touch the skin surface. Chemical peels which are consisted of either of these two ingredients ‘salicylic or glycolic acid’ are very helpful in unclogging pores and reducing acne. They not only stimulate the natural regeneration of skin and enhance its overall texture appearance but they do speed up the process of skin exfoliation too. Hydroxy-α acids are exfoliation preparations or peels which are light or medium depth. Even if they are proved to be the best treatment option for acne as well as the scars and they may not be available to everyone who needs them. Besides their anti-inflammatory and antioxidant properties such as glycolic acid peels are a great choice for removing acne scars and assisting the skin in shedding dead cells.
Light and Laser Therapies: Lights and lasers are used on the face and acne scars due to their ability to calm inflamented acne lesions by destroying some of the main reasons why inflamation occurs such as P. acnes bacteria. It offers 532nm Potassium Titanyl Phosphate Laser and dual Port Dye-Coupled Dye capable of Photodynamic Therapy.
Extraction: Congenital disease allows you to remove the contaminated parts in sterile clinical settings to prevent infection and further spreading of the lesion.
phases-of-management
Infectious diseases
Family medicine
Endocrinology
Assessment and Diagnosis: An examination by a physician tends to be a dermatologist who will assess the types of acne blemishes and the size of the involvement and whether there are any secondary contributing elements. It is important for us to distinguish acne from vulgaris from other skin disorders whose appearance is quite similar.
Mild to moderate acne management: Mild to moderate acne management:
Topical treatments:
Benzoyl peroxide is effective in killing pus-causing bacteria which reduce the inflammation and clearing the way for pores from clogging.
Topical antimicrobials such as erythromycin or clindamycin lower the c-oncentrations of bacteria that cause acne, while retinoid compounds s-peed up skin regeneration, lessen hair follicle clogging, and help prevent hardening of the skin.
Hormonal therapy: For people who have hormonal acne the hormonal treatments like oral contraceptives or anti-androgens should be considered.
Isotretinoin: One of the most potent and severe acne treatment options is prescription of oral retinoid isotretinoin in cases that do not respond to other treatments. Isotretinoin is highly effective but has many different adverse reactions.
Maintenance phase: Once hair loss has been stopped the patient will only need to stabilize his condition. In the early stages of the treatment or the relapse, the routine of the treatment will be adjusted and preventing future relapse and limiting new acne lesions will be the focus.
Follow-up and Monitoring: The medical professional must be visited frequently in order to assess the progress and if necessary and to make the specific treatment changes as well as to rule out the side-effects and concerns that often occur.
Medication
Apply a thin layer of the product on the affected area each day in the evening
An initial dose of 1 gm/day orally
After the gradual improvement, reduce the dose to 125-500 mg/day
Indicated as topical administration for acne vulgaris
After washing the face, apply the dosage form as a thin film on the affected area of the skin every evening
A warm sensation may occur on the skin after applying the same
In case of apparent worsening, do not discontinue the treatment
Massage the topical dosage form on the affected area every 12 hours
Massage the topical dosage form on the affected area every 12 hours
Massage the topical dosage form on the affected area every 12 hours
Cleansers- Apply the product through gentle massage onto the wet face & neck until lather formation
Rinse thoroughly
Utilize it twice daily
Scrub- Use it the same way as the cleanser, but once daily
Cream/gel/foam- After clean-up, apply the product to the affected area thrice daily
Wipes/pads- After clean-up, wipe off the face & neck with them, do not rinse
Shower soaps/gels- utilize the product once daily, massage over the affected body, and rinse well
Administer the medication topically twice daily, in the morning and evening, to the affected regions of the skin, following a thorough cleansing and gentle drying
erythromycin topical/benzoyl peroxide
Acne Vulgaris
Apply topically two times in a day (morning & evening) near the affected areas after the skin is neatly washed and dried
drospirenone/ethinyl estradiol
1 active tablet containing 3 mg drospirenone/ 0.02 mg ethinyl estradiol taken by mouth once daily for 24 days, followed by 1 placebo tablet taken by mouth once daily for 4 days
Dosage Modifications
Renal impairment: not recommended
Hepatic impairment: not recommended
Dosing considerations
For females it is recommended to utilize extra non-hormonal contraception throughout the initial 7 days of treatment.
Elevated possibility of venous thromboembolism (VTE) when using combined hormonal contraceptives after childbirth; chance decreases swiftly after 21 days but does not reach the usual level until 42 days after delivery.
For women who have given birth but do not breastfeed or have undergone a second trimester abortion: It is recommended to wait for at least four weeks before beginning therapy.
For women who have had a caesarean section delivery: It is recommended to wait for at least six weeks before beginning therapy.
It is recommended to apply a topical 5% gel daily topical 100% solution should be applied twice a day for six months
Following the process of cleaning, use a small amount of the solution on the impacted regions up to three times a day
Cream: Administer a thin layer of the cream as required, either once daily or up to three times daily
Foam: This should be done once a day or twice a day
If necessary, rinse off the foam after 1-2 minutes
Cleanser: Apply the cleanser to damp skin and gently massage it either once a day or twice a day
Afterward, rinse your skin thoroughly and pat it dry
Cleansing Pads: Take a wet pad and apply it to wet skin
Work the pad into a full lather, excluding the eye area, for 10-20 seconds
To cure potential dryness, it is advisable to commence with a single daily application and progressively recommend it to 2-3 times per day as deemed necessary
Cream/Ointment/lotion: After washing, apply gently to the affected area twice or thrice a day
Bar/Cleanser: Apply cleanser to a damp face and the neck, massaging it until lather forms. Rinse completely
Use once or twice daily
Altreno, Avita,Tretin-X, Retin-A, Atralin, Retin-A Micro
Apply a little quantity topically to the skin every night before bed, wherever acne lesions occur. Use enough to cover the whole affected region softly.
drospirenone/ethinyl estradiol/levomefolate
Beyaz
For the first 24 days, take one active tablet (3 mg drospirenone/0.02 mg ethinyl estradiol) orally daily; for the next 4 days, take one inert tablet orally daily.
benzoyl peroxide and tretinoin topical
Indicated for the treatment of acne vulgaris
Apply a bit of cream on the affected area each day
Spread a thin layer of the medication topically to the impacted regions twice daily
cyproterone and ethinyl estradiol
Administer one tablet daily once for 21 days, then skip the dosing for 7 days.
A new cycle should also begin when a woman's period initially begins.
Regardless of whether bleeding is associated with withdrawal, subsequent dose cycles should start around the same day of the week as the initial cycle did.
After 3–4 cycles, if your symptoms have improved enough, you may stop treatment.
1.5 mg of diazolidinylurea cream applied on the affected area once or twice a day
408 mg per day for at least eight weeks is the dosage represented in terms of lymecycline (i.e., 408 mg of lymecycline equals 300 mg of tetracycline base)
benzoyl peroxide, clindamycin phosphate, adapalene
A newly approved topical gel by the name Cabtreo is compounded by using three drugs, namely benzoyl peroxide (3.1%), which shows antibiotic action; clindamycin phosphate (1.2%), which shows antibacterial property; adapalene (0.15%) which is a retinoid
Cabtreo is a fixed dose FDA-approved topical treatment for Acne Vulgaris
This topical gel is applied to the affected skin areas as a thin layer daily once. It is only used on the skin as a topical agent
In vivo, data suggests taking 17mg/kg orally either as one dose or in two doses at six to eight hours duration
The oral administration of 34 mg/kg split in either two or three doses is taken every six hours
benzoyl peroxide and hydrocortisone
Apply a thin layer of film on the affected region every thrice a day; gently massage into the skin
Apply a thin layer of the product on the affected area each day in the evening
Apply the product onto the affected skin twice or thrice daily
adapalene and benzoyl peroxide
<9 years: Safety and efficacy not established
>9 years: Apply a thin layer to the affected areas of the face and trunk every night after washing
Children >8 years and adolescents: 50 to 100 mg orally once or twice a day (depends on the severity of infection and symptoms)
Apply the dosage form as a film on the affected area of the skin every evening
Not for children below 12 years
For >12 years
Massage the topical dosage form on the affected area every 12 hours
Apply the product gently and thoroughly on washed and dried skin
erythromycin topical/benzoyl peroxide
Acne Vulgaris
Age >12 years
Apply topically two times in a day (morning & evening) near the affected areas after the skin is neatly washed and dried
Age >12 years
Safety and efficacy not established
drospirenone/ethinyl estradiol
Safety and efficacy not determined in less than 14 years old
≥14 years
1 active tablet containing 3 mg drospirenone/ 0.02 mg ethinyl estradiol taken by mouth once daily for 24 days, followed by 1 placebo tablet taken by mouth once daily for 4 days
Adolescents: following the process of cleaning, use a small amount of the solution on the impacted regions up to three times a day
Cream: Administer a thin coat of the cream to the impacted regions once per day or as required, with the option to increase the frequency up to three times daily
Foam: Massage the foam gently into the affected area once a day or twice a day
If you need to remove the foam, rinse it off after 1-2 minutes
Cleanser: Apply the cleanser to wet skin and gently massage it into the skin once a day or twice a day
Rinse your skin thoroughly and pat it dry afterward
Cleansing Pads: Take a wet pad and apply it to wet skin
Work the pad into a full lather for 10-20 seconds, making sure to avoid the eye area
Rinse your skin thoroughly and pat it dry
Dispose of the used pad properly
To minimize the potential dryness
It is advised to initiate with a single utilization per day and progressively escalate it to 2-3 instances on a daily basis, as deemed necessary
Adults
Cream/Ointment/lotion: After washing, apply gently to the affected area twice or thrice a day
Bar/Cleanser: Use once or twice daily; Apply cleanser to a damp face and neck, massaging it until lather forms. Rinse completely
<9 years: Safety and efficacy not established (Altreno)
<10 years: Safety and efficacy not established (Atralin)
<12 years: Safety and efficacy not established (Retin-A Micro, Avita, Retin-A)
Apply a little quantity topically to the skin every night before bed, wherever acne lesions occur. Use enough to cover the whole affected region softly.
drospirenone/ethinyl estradiol/levomefolate
<14 years: Safety and efficacy not established
≥14 years:
Beyaz
For the first 24 days, take one active tablet (3 mg drospirenone/0.02 mg ethinyl estradiol) orally daily; for the next 4 days, take one inert tablet orally daily.
benzoyl peroxide and tretinoin topical
Indicated for the treatment of acne vulgaris
For <9 years: Safety and efficacy are not seen in pediatrics
For >9 years: Apply a small amount of cream on the affected area each day
Safety and efficacy not determined in less than twelve years
≥12 years: Spread a thin layer of the medication topically to the impacted regions twice daily
benzoyl peroxide and hydrocortisone
Above 12 years: Apply a thin layer of film on the affected region every thrice a day; gently massage into the skin
Future Trends
References
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2884837/
Acne vulgaris is a chronically recurring and self-limiting inflammatory condition of the pilosebaceous unit. Cutibacterium acnes causes acne vulgaris to appear throughout adolescence when dehydroepiandrosterone is naturally circulating in the blood. Mostly on the face, but sometimes on the forearms and trunk, it is a very common skin ailment that can cause both aggressive and non-inflammatory blisters.
Adolescence is when acne may first emerge and it can last into the early 30s. Twenty percent of those who have been impacted experience extreme acne that leaves scars.
It appears that certain races are more impacted than others. Extreme acne is much more frequent in Asians and Africans whereas moderate acne is more prevalent in white people. People with a darker complexion also tend to acquire hyperpigmentation. Neonates can also get acne where although it typically goes away on its own.
As a result of androgens-the 5-alpha reductase changes testosterone throughout puberty into more effective DHT which attaches to specific targets in the sebaceous glands and increases sebum secretion. Sebum is retained because of the follicular epidermis’ enhanced hyperproliferation.
Inflammation is triggered when distended follicles burst and discharge pro-inflammatory substances into the epidermis.
Acne-causing factors include:
Acne is caused by the sebaceous glands being oversensitive to a normal level of androgens in the blood in which P. acnes and inflammation exacerbate.
Acne can result from the following factors:
Although it may not be life-threatening the acne has psychosocial repercussions that last a lifetime. Acne sufferers and those with breakouts frequently experience anxiety and sadness. It’s almost impossible to remove acne scars.
The patient of acne vulgaris often presents with the typical facial skin that you notice immediately as the condition is more prevalent in adolescents and young adults.
Mild symptoms– Comedonal acne does not cause inflammation of the skin. These are whiteheads that are covered by skin and blackheads that appear black due to oxidation of sebum. Mild acne is characterized by comedones and a few papulopustules.
Often women with PCOD present with the mild comedonal appearance of the facial skin. In these cases, we can also look for the other symptoms of PCOD.
Hormonal acne erupts more in the lower third of the face along the chin and jaw lines.
Moderate symptoms– There is more area of the skin involved compared to mild symptoms.
Severe symptoms– A single cyst or nodule can form over a larger skin area (> 5mm in diameter). These lesions are often accompanied by pain and pus formation.
Perioral dermatitis
Angiofibroma
Sebaceous hyperplasia
Adnexal tumors
Demodex folliculitis
Dermatology, General
Infectious diseases
Family medicine
Nutrition and Dietetics
The nonpharmacological treatment includes a daily skincare routine that suits the skin type. Oily skin is more prone to develop acne flares since it can easily attract pollutants and dust particles from the surrounding area. The dirt or dust particles can accumulate and clog the skin pores by worsening the condition. It becomes essential to remove the makeup and debris. Covering the face and using sunscreen lotions should be part of the daytime skincare routine. Having a balanced diet helps to control the acne. Patients should be encouraged to avoid fatty foods which include more greens and maintain adequate hydration. Herbs such as curcumin and aloe vera help reduce the flares.
Dermatology, General
Effectiveness of topical treatment in acne vulgaris: – They can be used alone in the initial stages. Topical agents can be combined with oral medications for moderate to severe flares.
Topical antibiotics: – It consists of clindamycin, erythromycin, and, more recently, dapsone and minocycline topical foam 4%. If the patients develop resistance, they can be combined with benzoyl peroxide and retinoids. Topical dapsone is available in 5% twice-daily and 7.5% once-daily formulations. It may also be helpful to use benzoyl peroxide with an antibiotic course for 5-7 days to reduce resistance in organisms on the skin.
Benzoyl peroxide: – It is an effective bactericidal. It is available in various skin care products, including gels, creams, and face washes.
Retinoids (e.g., tretinoin, adapalene): – They promote skin cell production and prevent clogging of hair follicles. Topical retinoids contain chemicals derived from vitamin A. They are anti-inflammatory and may be used to treat current acne and prevent further breakouts. Some topical retinoids include adapalene, tazarotene, tretinoin, and isotretinoin.
Azelaic acid: – It has antimicrobial and anti-inflammatory properties and helps in unclogging pores.
Androgen receptor antagonists: – Clascoterone 1% topical cream is a first-in-class topical androgen receptor inhibitor approved by the FDA. It is used for acne vulgaris in patients aged 12 years and older.
Other: Salicylic acid can be effective as a topical treatment for acne. It is a beta-hydroxy acid with anti-inflammatory and antimicrobial properties.
Dermatology, General
Family medicine
Chemical Peels: The carefully planned administration of chemical agents of different strengths in the clinical trial shed off damaged dermis and epidermis by which in turn promotes the regeneration processes. Allergens are divided into two categories: the ones that get to the lower skin layers and the ones that just touch the skin surface. Chemical peels which are consisted of either of these two ingredients ‘salicylic or glycolic acid’ are very helpful in unclogging pores and reducing acne. They not only stimulate the natural regeneration of skin and enhance its overall texture appearance but they do speed up the process of skin exfoliation too. Hydroxy-α acids are exfoliation preparations or peels which are light or medium depth. Even if they are proved to be the best treatment option for acne as well as the scars and they may not be available to everyone who needs them. Besides their anti-inflammatory and antioxidant properties such as glycolic acid peels are a great choice for removing acne scars and assisting the skin in shedding dead cells.
Light and Laser Therapies: Lights and lasers are used on the face and acne scars due to their ability to calm inflamented acne lesions by destroying some of the main reasons why inflamation occurs such as P. acnes bacteria. It offers 532nm Potassium Titanyl Phosphate Laser and dual Port Dye-Coupled Dye capable of Photodynamic Therapy.
Extraction: Congenital disease allows you to remove the contaminated parts in sterile clinical settings to prevent infection and further spreading of the lesion.
Dermatology, General
Infectious diseases
Family medicine
Endocrinology
Assessment and Diagnosis: An examination by a physician tends to be a dermatologist who will assess the types of acne blemishes and the size of the involvement and whether there are any secondary contributing elements. It is important for us to distinguish acne from vulgaris from other skin disorders whose appearance is quite similar.
Mild to moderate acne management: Mild to moderate acne management:
Topical treatments:
Benzoyl peroxide is effective in killing pus-causing bacteria which reduce the inflammation and clearing the way for pores from clogging.
Topical antimicrobials such as erythromycin or clindamycin lower the c-oncentrations of bacteria that cause acne, while retinoid compounds s-peed up skin regeneration, lessen hair follicle clogging, and help prevent hardening of the skin.
Hormonal therapy: For people who have hormonal acne the hormonal treatments like oral contraceptives or anti-androgens should be considered.
Isotretinoin: One of the most potent and severe acne treatment options is prescription of oral retinoid isotretinoin in cases that do not respond to other treatments. Isotretinoin is highly effective but has many different adverse reactions.
Maintenance phase: Once hair loss has been stopped the patient will only need to stabilize his condition. In the early stages of the treatment or the relapse, the routine of the treatment will be adjusted and preventing future relapse and limiting new acne lesions will be the focus.
Follow-up and Monitoring: The medical professional must be visited frequently in order to assess the progress and if necessary and to make the specific treatment changes as well as to rule out the side-effects and concerns that often occur.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2884837/
Acne vulgaris is a chronically recurring and self-limiting inflammatory condition of the pilosebaceous unit. Cutibacterium acnes causes acne vulgaris to appear throughout adolescence when dehydroepiandrosterone is naturally circulating in the blood. Mostly on the face, but sometimes on the forearms and trunk, it is a very common skin ailment that can cause both aggressive and non-inflammatory blisters.
Adolescence is when acne may first emerge and it can last into the early 30s. Twenty percent of those who have been impacted experience extreme acne that leaves scars.
It appears that certain races are more impacted than others. Extreme acne is much more frequent in Asians and Africans whereas moderate acne is more prevalent in white people. People with a darker complexion also tend to acquire hyperpigmentation. Neonates can also get acne where although it typically goes away on its own.
As a result of androgens-the 5-alpha reductase changes testosterone throughout puberty into more effective DHT which attaches to specific targets in the sebaceous glands and increases sebum secretion. Sebum is retained because of the follicular epidermis’ enhanced hyperproliferation.
Inflammation is triggered when distended follicles burst and discharge pro-inflammatory substances into the epidermis.
Acne-causing factors include:
Acne is caused by the sebaceous glands being oversensitive to a normal level of androgens in the blood in which P. acnes and inflammation exacerbate.
Acne can result from the following factors:
Although it may not be life-threatening the acne has psychosocial repercussions that last a lifetime. Acne sufferers and those with breakouts frequently experience anxiety and sadness. It’s almost impossible to remove acne scars.
The patient of acne vulgaris often presents with the typical facial skin that you notice immediately as the condition is more prevalent in adolescents and young adults.
Mild symptoms– Comedonal acne does not cause inflammation of the skin. These are whiteheads that are covered by skin and blackheads that appear black due to oxidation of sebum. Mild acne is characterized by comedones and a few papulopustules.
Often women with PCOD present with the mild comedonal appearance of the facial skin. In these cases, we can also look for the other symptoms of PCOD.
Hormonal acne erupts more in the lower third of the face along the chin and jaw lines.
Moderate symptoms– There is more area of the skin involved compared to mild symptoms.
Severe symptoms– A single cyst or nodule can form over a larger skin area (> 5mm in diameter). These lesions are often accompanied by pain and pus formation.
Perioral dermatitis
Angiofibroma
Sebaceous hyperplasia
Adnexal tumors
Demodex folliculitis
Dermatology, General
Infectious diseases
Family medicine
Nutrition and Dietetics
The nonpharmacological treatment includes a daily skincare routine that suits the skin type. Oily skin is more prone to develop acne flares since it can easily attract pollutants and dust particles from the surrounding area. The dirt or dust particles can accumulate and clog the skin pores by worsening the condition. It becomes essential to remove the makeup and debris. Covering the face and using sunscreen lotions should be part of the daytime skincare routine. Having a balanced diet helps to control the acne. Patients should be encouraged to avoid fatty foods which include more greens and maintain adequate hydration. Herbs such as curcumin and aloe vera help reduce the flares.
Dermatology, General
Effectiveness of topical treatment in acne vulgaris: – They can be used alone in the initial stages. Topical agents can be combined with oral medications for moderate to severe flares.
Topical antibiotics: – It consists of clindamycin, erythromycin, and, more recently, dapsone and minocycline topical foam 4%. If the patients develop resistance, they can be combined with benzoyl peroxide and retinoids. Topical dapsone is available in 5% twice-daily and 7.5% once-daily formulations. It may also be helpful to use benzoyl peroxide with an antibiotic course for 5-7 days to reduce resistance in organisms on the skin.
Benzoyl peroxide: – It is an effective bactericidal. It is available in various skin care products, including gels, creams, and face washes.
Retinoids (e.g., tretinoin, adapalene): – They promote skin cell production and prevent clogging of hair follicles. Topical retinoids contain chemicals derived from vitamin A. They are anti-inflammatory and may be used to treat current acne and prevent further breakouts. Some topical retinoids include adapalene, tazarotene, tretinoin, and isotretinoin.
Azelaic acid: – It has antimicrobial and anti-inflammatory properties and helps in unclogging pores.
Androgen receptor antagonists: – Clascoterone 1% topical cream is a first-in-class topical androgen receptor inhibitor approved by the FDA. It is used for acne vulgaris in patients aged 12 years and older.
Other: Salicylic acid can be effective as a topical treatment for acne. It is a beta-hydroxy acid with anti-inflammatory and antimicrobial properties.
Dermatology, General
Family medicine
Chemical Peels: The carefully planned administration of chemical agents of different strengths in the clinical trial shed off damaged dermis and epidermis by which in turn promotes the regeneration processes. Allergens are divided into two categories: the ones that get to the lower skin layers and the ones that just touch the skin surface. Chemical peels which are consisted of either of these two ingredients ‘salicylic or glycolic acid’ are very helpful in unclogging pores and reducing acne. They not only stimulate the natural regeneration of skin and enhance its overall texture appearance but they do speed up the process of skin exfoliation too. Hydroxy-α acids are exfoliation preparations or peels which are light or medium depth. Even if they are proved to be the best treatment option for acne as well as the scars and they may not be available to everyone who needs them. Besides their anti-inflammatory and antioxidant properties such as glycolic acid peels are a great choice for removing acne scars and assisting the skin in shedding dead cells.
Light and Laser Therapies: Lights and lasers are used on the face and acne scars due to their ability to calm inflamented acne lesions by destroying some of the main reasons why inflamation occurs such as P. acnes bacteria. It offers 532nm Potassium Titanyl Phosphate Laser and dual Port Dye-Coupled Dye capable of Photodynamic Therapy.
Extraction: Congenital disease allows you to remove the contaminated parts in sterile clinical settings to prevent infection and further spreading of the lesion.
Dermatology, General
Infectious diseases
Family medicine
Endocrinology
Assessment and Diagnosis: An examination by a physician tends to be a dermatologist who will assess the types of acne blemishes and the size of the involvement and whether there are any secondary contributing elements. It is important for us to distinguish acne from vulgaris from other skin disorders whose appearance is quite similar.
Mild to moderate acne management: Mild to moderate acne management:
Topical treatments:
Benzoyl peroxide is effective in killing pus-causing bacteria which reduce the inflammation and clearing the way for pores from clogging.
Topical antimicrobials such as erythromycin or clindamycin lower the c-oncentrations of bacteria that cause acne, while retinoid compounds s-peed up skin regeneration, lessen hair follicle clogging, and help prevent hardening of the skin.
Hormonal therapy: For people who have hormonal acne the hormonal treatments like oral contraceptives or anti-androgens should be considered.
Isotretinoin: One of the most potent and severe acne treatment options is prescription of oral retinoid isotretinoin in cases that do not respond to other treatments. Isotretinoin is highly effective but has many different adverse reactions.
Maintenance phase: Once hair loss has been stopped the patient will only need to stabilize his condition. In the early stages of the treatment or the relapse, the routine of the treatment will be adjusted and preventing future relapse and limiting new acne lesions will be the focus.
Follow-up and Monitoring: The medical professional must be visited frequently in order to assess the progress and if necessary and to make the specific treatment changes as well as to rule out the side-effects and concerns that often occur.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2884837/
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