salicylates and Acne-Vulgaris

Acne and rosacea are common inflammatory processes historically classified in the same disease category, but evolving understanding of their disparate pathophysiology and exacerbating factors have generated an enormous armamentarium of therapeutic possibilities. Patients seek over-the-counter therapies first when managing cutaneous disease; therefore, this review defines ingredients considered to be effective over-the-counter acne and rosacea products, their mechanisms, and safe formulations, including botanical components, oral supplements, and other anecdotal options in this vast skin care domain.

Topics: Acne Vulgaris; Administration, Cutaneous; Astringents; Benzoyl Peroxide; Dermatologic Agents; Detergents; Evidence-Based Medicine; Global Health; Humans; Hydroxy Acids; Kinetin; Niacinamide; Nonprescription Drugs; Phototherapy; Randomized Controlled Trials as Topic; Resorcinols; Rosacea; Salicylates; Sulfur; Sunscreening Agents; Tea Tree Oil; Treatment Outcome; Tretinoin; Zinc

Precise classification methods are used to define acne according to type (comedonal, papulopustular, or nodular) and severity. The relative effectiveness of several topical and systemic agents has been established in clinical trials, making possible an algorithm of specific treatment decisions based on acne classification.

Topics: Acne Vulgaris; Adapalene; Administration, Oral; Administration, Topical; Algorithms; Anti-Bacterial Agents; Benzoyl Peroxide; Contraceptives, Oral; Controlled Clinical Trials as Topic; Cost-Benefit Analysis; Decision Trees; Dermatologic Agents; Dicarboxylic Acids; Humans; Isotretinoin; Macrolides; Naphthalenes; Nicotinic Acids; Salicylates; Tretinoin; United States

The Jessner's-trichloroacetic acid (TCA) peel is a procedure developed by Monheit to produce a safe, effective medium-depth chemical peel for the treatment of photoaged skin, actinic keratoses, and superficial acne scars. The technique of pretreatment degreasing and combination chemicals allow a deeper penetration for the 35% TCA, increasing its efficacy while preserving its safety. Technique and methods are reviewed.

Topics: Acne Vulgaris; Chemexfoliation; Cicatrix; Drug Combinations; Ethanol; Face; Facial Dermatoses; Humans; Keratosis; Lactates; Lactic Acid; Resorcinols; Salicylates; Skin Aging; Trichloroacetic Acid

Dermatologists frequently are consulted by a pregnant patient or a woman of childbearing age who desires acne therapy. Because there are no published studies in which women took acne medications throughout pregnancy, information about safety must be obtained indirectly from studies in which the agents were taken for another indication during some portion of pregnancy. Oral tetracycline is associated with maternal liver toxicity and deciduous tooth staining in the infant, and tetracycline occasionally has been associated with other congenital anomalies. Maternal isotretinoin ingestion is associated with major craniofacial and cardiac deformities, as well as other congenital anomalies. Erythromycin, however, appears to be safe. Topical acne medications never have been implicated as a cause of fetal deformities in human beings. Dermatologists should be aware of potential toxic and teratogenic effects of acne medicines before prescribing them to women of childbearing age. Prompt reporting of adverse effects is encouraged.

Topics: Abnormalities, Drug-Induced; Acne Vulgaris; Administration, Cutaneous; Administration, Oral; Benzoyl Peroxide; Clindamycin; Erythromycin; Female; Humans; Pregnancy; Pregnancy Complications; Salicylates; Tetracyclines; Tretinoin

Topics: Acne Vulgaris; Administration, Topical; Benzoyl Peroxide; Clindamycin; Dicarboxylic Acids; Erythromycin; Humans; Miconazole; Oxytetracycline; Salicylates; Salicylic Acid; Tretinoin

Today acne vulgaris is a disease which can be well controlled using a combination of topical, systemic, and physical therapeutic modalities. However, successful acne management depends to a large extent on physician interest and the ability of the physician to apply therapy to the evolutionary stage of the disease and to the disturbed pathogenetic mechanisms. It is this author's opinion that grades I and II comedonal and papulopustular acne can be effectively treated solely with topical preparations, particularly the concurrent use of tretinoin with benzoyl peroxide or topical antibiotics. The majority of patients with grades III and IV inflammatory disease require oral antibiotics in addition to aggressive topical treatments. Intralesional steroids can be effective in all grades of acne when lesions develop an inflammatory nodulocystic quality. The physician should consider the use of estrogen (in females) or oral vitamin A in the small group of patients with grades III and IV inflammatory-cystic acne that has been unresponsive to conventional therapy. Combined systemic therapies of high-dose antibiotics, systemic corticosteroids, and sulfones clearly take precedence over topical preparations in conglobate acne and acne fulminans. Finally, oral isotretinoin, alone and perhaps in combination with more conventional modalities, should play an important role in the future management of severe inflammatory-cystic acne.

Topics: Acne Vulgaris; Anti-Bacterial Agents; Benzoyl Peroxide; Estrogens; Glucocorticoids; Humans; Salicylates; Salicylic Acid; Sulfones; Vitamin A

Although the basic cause of acne vulgaris remains unknown, considerable data that concern its pathogenesis and that have been accumulated in recent years allow a rational and therapeutically successful approach to the management of this disorder. To date, there is no single treatment for acne. Therapy must be individualized, with appropriate variations and modifications as the degree or severity of this disorder fluctuates. Today, this goal can be achieved by proper selection of available medications, coupled with the cooperation of the patient, and the knowledge, continued interest, and enthusiasm of the physician and his staff.

Topics: Acne Vulgaris; Adolescent; Adult; Anti-Bacterial Agents; Benzoyl Peroxide; Diet; Drug Therapy, Combination; Estrogens; Female; Humans; Male; Salicylates; Tretinoin; Zinc

Antibiotics and retinoids have been used for acne vulgaris for decades. Though effective, each has its own drawbacks. Chemical peels have been used for treatment of acne vulgaris with inadequate clinical evidence. We sought to determine the efficacy and safety of Jessner's solution (JS) in comparison with salicylic acid (SA) 30% in the management of acne vulgaris and postacne hyperpigmentation in patients with colored skin.. A total of 36 subjects (94.5% Fitzpatick Type IV-V) were recruited in this randomized double-blinded, split-face, controlled trial. Each side of the face was randomly assigned for treatment with either JS or SA. Subjects were treated once fortnightly for a total of three sessions. Lesion counting, Michaelsson acne score (MAS), photographs, and postacne hyperpigmentation index (PAHPI) were used to objectively assess the improvement. Complications were assessed during each visit. Statistical analysis was conducted using SPSS v22.0. Significance was set at P = 0.05.. At the end of therapy, significant reduction in inflammatory, noninflammatory lesions, MAS, and PAHPI scores (P < 0.001, respectively) were noted in comparison to baseline. Mixed model analysis revealed no significant outcome difference between the two groups. Patients who reported good and very good outcome were 76.4% (JS) and 85.3% (SA). Burning, stinging sensation, and exfoliation were the common complications reported. Postinflammatory hyperpigmentation was reported only once in the JS arm.. Both JS and SA were equally effective in the treatment of acne vulgaris and reducing postacne hyperpigmentation in patients with colored skin.

Topics: Acne Vulgaris; Adult; Chemexfoliation; Double-Blind Method; Drug Combinations; Ethanol; Facial Dermatoses; Female; Humans; Hyperpigmentation; Keratolytic Agents; Lactic Acid; Male; Pain; Resorcinols; Salicylates; Salicylic Acid; Severity of Illness Index; Skin Pigmentation; Treatment Outcome; Young Adult

Topics: Acne Vulgaris; Chemexfoliation; Cicatrix; Combined Modality Therapy; Cosmetic Techniques; Drug Combinations; Ethanol; Humans; Lactic Acid; Needles; Quality of Life; Resorcinols; Salicylates

Superficial chemical peels are frequently used in acne vulgaris treatment. Although glycolic acid (GA) has been widely used in clinical practice, its pH ranges from 0.08-2.75 and thus should be neutralized after application to avoid burns.. To evaluate treatment efficacy and safety of chemical peeling using buffered 50% GA (pH 3.0) + 0.5% salicylic acid (SA) solution that does not need to be neutralized in the treatment of acne vulgaris compared to the conventional peeling using Jessner's solution.. We performed a prospective, randomized, evaluator-blind, split-face clinical trial. Twenty patients were randomized by assigning one side of each patient's face to receive a 50% GA (pH 3.0) + 0.5% SA peel (GA side) and the other side to receive the Jessner's solution (Jessner's solution side). All patients underwent 2 sessions of treatment spaced 2 weeks apart. Lesion count, acne severity, subjective efficacy assessment, and side effects were evaluated.. The total lesion count was significantly reduced for the GA and Jessner's solution sides (P < .001). However, there was no significant difference in the total lesion count, acne severity, or subjective efficacy assessment between the 2 sides (P > .05). The GA side had fewer side effects than the Jessner's solution side.. The results of this study suggest that chemical peeling using the 50% GA (pH 3.0) + 0.5% SA solution can be as effective and convenient as the conventional peeling using Jessner's solution in the treatment of acne vulgaris and may show fewer adverse events than the conventional peeling.

Topics: Acne Vulgaris; Adult; Chemexfoliation; Drug Combinations; Drug Therapy, Combination; Esthetics; Ethanol; Female; Glycolates; Humans; Lactic Acid; Male; Prognosis; Prospective Studies; Resorcinols; Salicylates; Salicylic Acid; Severity of Illness Index; Single-Blind Method; Treatment Outcome; Young Adult

Successful management of acne involves choosing proper medication. Chemical peeling is a well-known option in treatment of acne vulgaris.. To evaluate and compare the clinical efficacy and safety of combination chemical peels vs single peel in treatment of mild-to-moderate acne.. The study included 45 patients with mild-to-moderate acne divided into three equal groups. Group A underwent combination sequential peels with modified Jessner's solution (MJ) followed by trichloro acetic acid (TCA20%) on the right (Rt) side of the face vs TCA 30% on the left (Lt) side. Group B was treated by combination peels of salicylic (20%) mandelic (10%) (SM) mixture on the Rt half vs salicylic acid 30% on the Lt half. Group C underwent combination sequential peeling of MJ and TCA on the Rt side vs SM combination peels on the Lt side. All patients received six sessions with 2-week intervals and followed up for 3 months after the last session. Side effects were reported.. Both sides of the face showed significant improvement of acne lesions but improvement was significantly higher and earlier in sides treated by combination peels. Side effects were minimal.. In conclusion, combination peels achieved a higher and earlier therapeutic response with a reasonable cost that is maintained for a relatively long periods than single peel. Combination sequential peels gave the best results.

Topics: Acne Vulgaris; Adult; Analysis of Variance; Chemexfoliation; Drug Combinations; Drug Therapy, Combination; Ethanol; Female; Glycolates; Humans; Keratolytic Agents; Lactic Acid; Male; Multivariate Analysis; Prognosis; Resorcinols; Salicylates; Salicylic Acid; Severity of Illness Index; Treatment Outcome; Trichloroacetic Acid; Young Adult

Chemical peeling is a well-identified therapeutic modality for acne vulgaris (AV). Jessner's solution (JS) is a known peeling agent for acne since more than 100 years. Salicylic acid (SA) peel is a well-established peeling agent for acne. There is paucity of literature comparing the current peeling agents of choice, that is, SA with the older peeling agents, that is, JS for acne.. To compare the efficacy and safety of 30% SA vs. JS peels in treatment of mild-to-moderate facial acne in Indian patients.. A total of 40 patients with mild-to-moderate AV were enrolled for 12 weeks and were randomly divided into two groups: group 1, 30% SA peels and group 2, JS peels were performed 2 weeks apart with total of six peels in 12-week duration. Clinical improvement was assessed objectively using Michaelsson acne scores (MAS) and clinical photographs. Side effects were observed at each visit.. At the end of therapy, improvement in MAS and percentage decrease in MAS were significantly higher in group 1 as compared to group 2. Likewise, decrease in mean comedone counts in group 1 was significantly higher as compared to group 2. However, there was no statistically significant difference in the decrease in mean papule and pustule counts between the two groups. Both the groups tolerated the peels well.. Thus, 30% SA peels were more effective than JS peels in treatment of noninflammatory lesions, that is, comedones and in overall improvement of mild-to-moderate facial acne vulgaris.

Topics: Acne Vulgaris; Adolescent; Chemexfoliation; Drug Combinations; Ethanol; Facial Dermatoses; Female; Humans; Keratolytic Agents; Lactic Acid; Male; Photography; Resorcinols; Salicylates; Salicylic Acid; Severity of Illness Index; Young Adult

To date, facial acne flare-ups in adult women during the luteal phase of the menstrual cycle have been poorly investigated. To clinically characterize premenstrual acne flare-up in adult women and investigate the effect of a dermocosmetic treatment. This single-centre study included 32 young adult women with declared premenstrual acne flares and was composed of two phases: (1) an observational phase (two menstrual cycles) and (2) an interventional phase (one menstrual cycle) in a controlled, randomised, double-blind, intra-individual (half-face) setting in which a dermocosmetic (containing lipohydroxyacid, nicotinamide, and piroctone-olamine) and placebo were compared. Initially, during the first part of the study, we observed that premenstrual acne flare-ups in adult women were characterized by a significant increase in the number of papules (20.2 vs. 13.7; p = 0.0008) and to a lesser extent, closed comedones (25.6 vs. 22.7; p = 0.04). Secondly, during the interventional phase, the half-face treated with the dermocosmetic formulation showed a significantly lower number of inflammatory lesions (7.6 vs 9.4; p = 0.01) during the luteal phase compared to the half-face treated with the placebo. Tolerance of the dermocosmetic formulation was rated as good or excellent. Our data indicate a significant increase in the number of papules during premenstrual acne flare-ups in adult women and the use of a dermocosmetic may be of benefit in partially reducing this premenstrual inflammatory flare-up.

Topics: Acne Vulgaris; Adolescent; Adult; Cosmeceuticals; Double-Blind Method; Drug Combinations; Ethanolamines; Female; Humans; Luteal Phase; Niacinamide; Pyridones; Salicylates; Symptom Flare Up; Young Adult

Acne affects many adolescents. Conventional therapy often results in side effects and poor adherence, and the treatment does not consider the psychological effect of acne on patients, which is comparable with that of disabling diseases.. To evaluate the efficacy and tolerability of a peel (30% salicylic acid, triethyl citrate and ethyl linoleate) combined with a home therapy with three topical agents (triethyl citrate, ethyl linoleate and salicylic acid 0.5% cream, lotion) in moderate acne of the face.. Prospective, observational, multicenter, open-label, postmarketing, phase IV study.. Patients were assessed by comparing Global Acne Grading System (GAGS) score and total lesion count from 15 days before the first peel (T-15 ), after four salicylic peels (every 10 ± 2 days (T0 , T10 , T20 , T30 ), and 20 days after of the end of the study (T50 ). This treatment was associated to a home therapy.. Fifty-three patients completed the study. The average GAGS score fell 49% between T-15 and T50 (p < .001). No patient withdrew for adverse events.. This therapy was effective and well-tolerated in all cases. Chemo-exfoliation sessions ensured the continuous monitoring of clinical results and improved patient quality of life.

Topics: Acne Vulgaris; Adolescent; Adult; Chemexfoliation; Child; Citrates; Female; Humans; Linoleic Acids; Male; Prospective Studies; Quality of Life; Salicylates; Young Adult

Salicylic acid was recently formulated in a hydroethanolic vehicle at a concentration of 20% to 30%. Salicylic acid has strong comedolytic effects because of its lipophilic nature.. To compare the therapeutic efficacy and tolerability of salicylic acid peels with those of Jessner's solution peels in patients with acne vulgaris.. Thirteen patients (13 men; mean age 22.6, range 20-28) with facial acne were enrolled. Jessner's solution was applied to one side of each patient's face and 30% salicylic acid to the other in three sessions at 2-week intervals. A blinded investigator counted noninflammatory and inflammatory lesions before treatment and 2 weeks after each treatment.. Inflammatory and noninflammatory acne lesion counts decreased in proportion to the duration of treatment. Inflammatory acne lesion counts did not differ significantly between salicylic acid and Jessner's solution peels, although in terms of noninflammatory acne lesion counts, sites treated with salicylic acid showed significant improvement (p = .04), whereas those treated with Jessner's solution did not.. We found that 30% salicylic acid peels were effective for inflammatory acne and more effective than Jessner's solution peels for treating noninflammatory acne.

Topics: Acne Vulgaris; Adult; Chemexfoliation; Double-Blind Method; Drug Combinations; Ethanol; Face; Humans; Keratolytic Agents; Lactic Acid; Male; Resorcinols; Salicylates; Salicylic Acid; Treatment Outcome

Acne treatment regimens have changed due to the recent over-the-counter (OTC) switch of all prescription benzoyl peroxide (BPO) topical preparations. The elimination of prescription single-agent BPO products means that dermatologists must select from a variety of OTC formulations to utilize the time-tested efficacy of BPO in the treatment of mild to moderate acne. Our research compared the efficacy and safety of an OTC BPO 5.5% formulation with lipohydroxy acid and tretinoin cream 0.025% with prescription clindamycin 1%-BPO 5% gel and tretinoin cream 0.025%. Parity was demonstrated between the 2 treatment regimens at 12 weeks.

Topics: Acne Vulgaris; Adolescent; Adult; Benzoyl Peroxide; Clindamycin; Dermatologic Agents; Double-Blind Method; Drug Combinations; Drug Therapy, Combination; Female; Humans; Male; Middle Aged; Nonprescription Drugs; Salicylates; Treatment Outcome; Tretinoin; Young Adult

Lipohydroxyacid is a lipophilic derivative of salicylic acid with comedolytic properties.. To compare lipohydroxyacid and salicylic acid peels in subjects with comedonal acne.. In this split face, randomized study, 20 subjects with comedonal acne received lipohydroxyacid peels on one side of the face, while the other side was treated with salicylic acid peels. A total of six peels at 2-week intervals were performed. Efficacy was evaluated by counting noninflammatory and inflammatory lesions and by performing a global change in acne assessment. Safety was assessed by evaluating adverse events, global tolerance, and the presence of erythema, scaling, and dryness.. There was a statistically significant decrease of 55.6% and 48.5% from baseline to Day 98 in the mean number of noninflammatory lesions for the sides treated with lipohydroxyacid and salicylic acid peels, respectively (P < 0.001). There was no significant difference in the degree of reduction in noninflammatory lesions between the two peels. There was no significant reduction in the number of inflammatory lesions. Both peels were generally very well tolerated.. This study suggests that lipohydroxyacid peels can be beneficial to subjects with comedonal acne.

Topics: Acne Vulgaris; Administration, Topical; Adult; Chemexfoliation; Erythema; Face; Female; Humans; Keratolytic Agents; Male; Pruritus; Salicylates; Salicylic Acid; Treatment Outcome

Many clinicians perform glycolic acid peels for facial acne patients, but there has not been a well-controlled study to compare this new therapy with other conventional modalities.. To compare the effectiveness of treatment and side effects in the treatment of facial acne by two agents, 70% glycolic acid and Jessner's solution.. Twenty-six patients with facial acne were treated simultaneously with 70% glycolic acid and Jessner's solution biweekly on each side of the face. The treatment sides were randomized and the evaluation of treatment was done biweekly by a blinded evaluator who did not know the randomization code. Dr. Cunliffe's acne grading system was used for objective comparison. All patients were also asked about the improvement of facial acne and about the side effects experienced. Finally, the patients answered the preference test between the 2 peeling methods.. Acne grading of both treatments improved after 3 treatment sessions. However, there were no significant differences in treatment effects between the 2 methods. As far as side effects were concerned, sites treated with Jessner's solution showed a significantly increased degree of exfoliation compared to glycolic acid (p < 0.01).. Glycolic acid is less widely used than Jessner's solution due to its inconvenient application technique. But considering the equal treatment effect and lesser degree of exfoliation in glycolic acid, we would recommend the use of glycolic acid over Jessner's solution for acne patients.

Topics: Acne Vulgaris; Adolescent; Adult; Chemexfoliation; Drug Combinations; Ethanol; Facial Dermatoses; Female; Glycolates; Humans; Keratolytic Agents; Lactic Acid; Male; Prospective Studies; Resorcinols; Salicylates; Single-Blind Method; Skin; Treatment Outcome

The objective of the present work was to determine the relative bioavailability of salicylic acid (SA) after repeated (14-day) topical application to subjects who presented normal, acnegenic, or photodamaged facial skin. To emulate exposure characteristics likely to be encountered by subjects in these two subpopulations, individuals presenting facial acne were treated with 2% SA in a hydroalcoholic vehicle, and volunteers with aged or photodamaged skin received a comparable topical dose of SA in a cream (moisturizer-like) vehicle. Plasma concentration-time profiles and cumulative urinary excretion of SA were measured after the last dose in subjects who had received 15 consecutive daily topical applications of 27 mg of SA or oral doses of 81 mg of acetylsalicylic acid (ASA). The rate and extent of percutaneous absorption of SA were not affected by facial skin condition. Faster rates of absorption (Cmax) were obtained with a hydroalcoholic compared with a cream vehicle. Systemic SA exposures were at least five-fold higher with oral ASA than topical SA. Based on systemic salicylate concentrations resulting from ingestion of 81 mg of ASA, these results support that patients without gross skin disorders are at minimal risk of adverse systemic effects from routine use of topical products containing 2% SA.

Topics: Acne Vulgaris; Administration, Topical; Adolescent; Adult; Aging; Area Under Curve; Biological Availability; Female; Humans; Middle Aged; Salicylates; Salicylic Acid; Skin Absorption

Topics: Acne Vulgaris; Adult; Aluminum Silicates; Clay; Erythromycin; Ethanol; Female; Humans; Male; Salicylates; Tretinoin; Tunisia; Zinc Oxide

Comedolytic activity was assessed in acne patients by determining the reduction in facial microcomedones using the cyanoacrylate follicular biopsy technique. Microcomedones were counted in five-em squares after 8 to 12 weeks of treatment. Only salicylic acid and tretinoin among seven conventional anti-acne medications were found to possess comedolytic activity. The latter was the more effective.

Topics: Acne Vulgaris; Biopsy; Cyanoacrylates; Female; Hair; Humans; Male; Salicylates; Tretinoin

Topics: Acne Vulgaris; Adolescent; Adult; Child; Clinical Trials as Topic; Detergents; Double-Blind Method; Ethanol; Female; Humans; Male; Pharmaceutical Vehicles; Placebos; Salicylates; Salicylic Acid

Topics: Acne Vulgaris; Administration, Topical; Benzoyl Peroxide; Humans; Peroxides; Resorcinols; Salicylates; Time Factors

Topics: Acne Vulgaris; Adolescent; Adult; Carotenoids; Clinical Trials as Topic; Female; Humans; Male; Salicylates

Topics: Acne Vulgaris; Chemexfoliation; Drug Combinations; Ethanol; Humans; Keratolytic Agents; Lactic Acid; Male; Resorcinols; Salicylates; Salicylic Acid

Glycolic acid and Jessner's solution are popular superficial chemical peel agents for the treatment of facial acne, and increased sebum secretion is one of the major aetiological factors of acne.. To compare the effects of 30% glycolic acid peels and Jessner's solution peels on sebum secretion in facial acne patients.. Thirty-eight patients with mild to moderate facial acne were included. Twenty-seven patients were treated with 30% glycolic acid peels and 11 patients with Jessner's solution peels. Each peel was performed twice with an interval of 2 weeks. Before and 2 weeks after each peel, sebum levels of forehead, nose, chin and cheeks were measured by using a Sebumeter (SM810 Courage & Khazaka, Cologne, Germany).. The sebum levels were not significantly changed by two peels treatments of 30% glycolic acid peels or Jessner's solution peels on the facial skins of patients with facial acne.. The two types of peels, 30% glycolic acid peels and Jessner's solution peels, did not affect sebum secretion of the facial skins of patients with facial acne after the two peels treatments. The accumulative effects of more than two peels treatments using these modalities need further evaluation.

Topics: Acne Vulgaris; Adolescent; Adult; Chemexfoliation; Drug Combinations; Ethanol; Facial Dermatoses; Female; Glycolates; Humans; Lactic Acid; Male; Resorcinols; Salicylates; Sebum

Multiple modalities are available for treating acne scars, one of which is chemical peeling.. To evaluate the efficacy of medium-depth peels in the treatment of acne scars.. A total of 15 patients (14 women and 1 man) were seen between November 1998 and March 2000. A medium-depth chemical peel was performed. The peel was performed using a combination of Jessner's solution followed by the application of 35% trichloroacetic acid (TCA). The mean age of patients who entered the study was 28 years. A total of 42 peeling sessions were performed: 13 patients had the full three-session regiment, 1 patient had two sessions, and 1 had only one session.. Patients in our study had two forms of acne scars, the atrophic saucer or crater-like form and the pitted (ice-pick) form. Improvement occurred in all except one of our patients. Significant improvement (greater than 75% clearance of lesions) occurred in 1 patient (6.6%), moderate improvement (51-75% clearance) in 8 patients (53.3%), mild improvement (26-50% clearance) in 4 patients (26.6%), minimal improvement (1-25% clearance) in 1 patient (6.6%), and no response in 1 patient (6.6%). All patients had different combinations of the above two forms. Four patients (26.6%) had mainly pitted scars and deep atrophic scars. The clinical response in those patients was moderate, mild, minimal, and no response, respectively. The remainder of our patients had mainly atrophic scars of moderate depth. Nine patients (73.4%) suffered from transient postinflammatory hyperpigmentation. In two of them it was preceded by erythema that lasted for more than 1 month. All patients were free of noticeable pigmentation 3 months after the final peel. Patients in whom hyperpigmentation did not develop were of light brown complexion.. We conclude that medium-depth chemical peel is a safe and effective method of treating acne scars even in patients with dark complexion.

Topics: Acne Vulgaris; Adolescent; Adult; Caustics; Chemexfoliation; Cicatrix; Drug Combinations; Drug Therapy, Combination; Ethanol; Female; Humans; Iraq; Lactic Acid; Male; Resorcinols; Salicylates; Skin Pigmentation; Trichloroacetic Acid

Topics: Acne Vulgaris; Administration, Cutaneous; Humans; Nonprescription Drugs; Salicylates; Salicylic Acid

Acne vulgaris is a disorder of sebaceous follicles that usually begins at the time of the sharp increase in androgen production that occurs in adolescence. This disease is most prevalent among teenagers, but it does occur in patients in their twenties and thirties. Three major areas of pathophysiology have been identified in acne: hyperkeratinization and obstruction of sebaceous follicles, resulting from abnormal desquamation of follicular epithelium; an androgen-stimulated increase in the production of sebum; and proliferation of Propionibacterium acnes, which generates inflammation. Disruption of the preclinical precursor lesion known as the microcomedo produces inflammation, which leads to the pustules and papules of clinical disease and may eventually result in scarring. Rational therapy for acne should be directed at the three factors involved in the pathophysiology of the disease. Tretinoin (all-trans-retinoic acid) acts to normalize desquamation of follicular epithelium, promote drainage of comedones, and inhibit formation of new ones. Salicylic acid is also comedolytic, but to a much lesser degree. Benzoyl peroxide and topical or systemic antibiotics work by decreasing the follicular population of P. acnes, thus reducing inflammation. Direct injection of corticosteroids may be used to reduce large inflammatory lesions. Physical removal of comedones is also useful. Severe nodulocystic acne and other cases that fail to respond to these measures may be treated systemically with isotretinoin (13-cis-retinoic acid).

Topics: Acne Vulgaris; Administration, Topical; Anti-Bacterial Agents; Benzoyl Peroxide; Drug Therapy, Combination; Humans; Peroxides; Salicylates; Salicylic Acid; Skin; Tretinoin

Topics: Acne Vulgaris; Adolescent; Adult; Androgen Antagonists; Anti-Bacterial Agents; Benzoyl Peroxide; Estrogens; Female; Humans; Isotretinoin; Male; Salicylates; Salicylic Acid; Tretinoin

Topics: Acne Vulgaris; Administration, Topical; Animals; Humans; Light; Salicylates; Tretinoin

Acne vulgaris is a common skin disorder that is socially disabling to some degree in the majority of adolescents. Effective management of this disease has two major components: a strong physician-patient relationship and a sound medical regimen. The former is necessary to foster patient compliance with the long-term therapeutic regimen required, as well as to reduce the disease's potential for emotional scarring. The rational usage of the various topical and systemic medications available will serve to decrease the frequency and severity of exacerbations as well as to minimize possible scarring. Specific recommendations as to moisturizers and cosmetics are included.

Topics: Acne Vulgaris; Benzoyl Peroxide; Cosmetics; Erythromycin; Humans; Physician-Patient Relations; Salicylates; Tetracycline; Tretinoin

Few studies of topical treatment in acne stand up to modern scientific requirements, and several of those which do suggest that some modalities make acne worse rather than better. There is evidence that sulphur, soap, and light treatment prolong the course of illness. This also applies to some components of the vehicles used for acne medicaments. Fortunately, traditional treatment can be abandoned in favour of the superior benzoyl peroxide and retinoic acid.

Topics: Acne Vulgaris; Administration, Topical; Animals; Emulsions; Humans; Keratolytic Agents; Rabbits; Salicylates; Soaps; Sulfur; Sunlight; Tretinoin

Topics: Acne Vulgaris; Contraceptives, Oral; Humans; Resorcinols; Salicylates; Sulfur; Tetracycline; Tretinoin

Topics: Acne Vulgaris; Administration, Topical; Adolescent; Adult; Dose-Response Relationship, Drug; Drug Evaluation; Drug Evaluation, Preclinical; Humans; In Vitro Techniques; Male; Propionibacterium; Salicylates; Sebaceous Glands; Skin Diseases

Topics: Acne Vulgaris; Administration, Topical; Adolescent; Adult; Dexamethasone; Drug Resistance, Microbial; Female; Hexachlorophene; Humans; Lactates; Magnesium Sulfate; Male; Ointments; Salicylates; Tetracycline; Zinc

Topics: Acne Vulgaris; Chemexfoliation; Humans; Naphthols; Resorcinols; Salicylates; Sulfur

Topics: Acne Vulgaris; Adolescent; Anti-Bacterial Agents; Benzoyl Peroxide; Humans; Salicylates; Tretinoin

Topics: Acne Vulgaris; Humans; Ointments; Oxytetracycline; Resorcinols; Salicylates; Sulfur

Topics: Acne Vulgaris; Adolescent; Adult; Benzoyl Peroxide; Drug Therapy, Combination; Estrogens; Humans; Infant, Newborn; Resorcinols; Salicylates; Sulfur; Tretinoin

Topics: Acne Vulgaris; Adolescent; Adult; Clindamycin; Erythromycin; Female; Humans; Male; Ointments; Resorcinols; Salicylates; Tetracycline

Topics: Acne Vulgaris; Administration, Topical; Aluminum Hydroxide; Anti-Inflammatory Agents; Colloids; Female; Humans; Hydrocortisone; Resorcinols; Salicylates; Thiosulfates

Topics: Acetates; Acne Vulgaris; Administration, Topical; Anti-Inflammatory Agents; Dermatologic Agents; Humans; Hydrocortisone; Resorcinols; Salicylates; Sodium; Thiosulfates

Topics: Acne Vulgaris; Administration, Topical; Adolescent; Adrenal Cortex Hormones; Adult; Anti-Bacterial Agents; Child; Drug Combinations; Drug Evaluation; Female; Hexachlorophene; Humans; Male; Middle Aged; Remission, Spontaneous; Salicylates; Sulfur

Topics: Acne Vulgaris; Adult; Diet Therapy; Female; Humans; Male; Resorcinols; Salicylates; Sulfur; Ultraviolet Therapy

Topics: Acne Vulgaris; Alcohols; Dermatologic Agents; Female; Humans; Male; Resorcinols; Salicylates; Thiosulfates

Topics: Acne Vulgaris; Administration, Oral; Benzoates; Cosmetics; Dermatologic Agents; Diet Therapy; Erythromycin; Estrogens; Female; Humans; Male; Peroxides; Resorcinols; Salicylates; Sulfur; Tetracycline; Thiosulfates

Topics: Acne Vulgaris; Benzoates; Drug Hypersensitivity; Humans; Peroxides; Salicylates; Sulfur

Topics: Acne Vulgaris; Adult; Female; Humans; Lentigo; Mercury Poisoning; Ointments; Resorcinols; Salicylates; Skin Absorption

Topics: Acne Vulgaris; Colloids; Dermatologic Agents; Dexamethasone; Hexachlorophene; Humans; Rosacea; Salicylates; Sulfur

Topics: Acne Vulgaris; Antifungal Agents; Dermatomycoses; Dexamethasone; Erythema; Humans; Pharmaceutic Aids; Salicylates; Thiazoles; Tinea; Tinea Versicolor

Topics: Acne Vulgaris; Adolescent; Adult; Female; Glycine max; Hexachlorophene; Humans; Male; Middle Aged; Plant Proteins; Salicylates; Sulfur

Topics: 1-Propanol; Acne Vulgaris; Adolescent; Adult; Dermatologic Agents; Dexamethasone; Diet Therapy; Drug Synergism; Female; Hexachlorophene; Humans; Male; Salicylates; Sulfur; Tetracycline

Topics: Acne Vulgaris; Adult; Camphor; Female; Humans; Male; Resorcinols; Salicylates

Topics: Acne Vulgaris; Anti-Infective Agents, Local; Humans; Resorcinols; Salicylates

Topics: Acne Vulgaris; Adolescent; Bromides; Chlorpromazine; Gynecomastia; Humans; Iatrogenic Disease; Male; Methantheline; Neurotic Disorders; Obsessive-Compulsive Disorder; Pityriasis; Quaternary Ammonium Compounds; Salicylates; Sweating; Testosterone; Toxicology

Topics: Acne Vulgaris; Adolescent; Adrenal Cortex Hormones; Adrenocorticotropic Hormone; Androgens; Anti-Bacterial Agents; Drug Therapy; Estradiol; Estrogens; Folliculitis; Halogens; Hexachlorophene; Humans; Infant; Infant, Newborn; Minor Surgical Procedures; Neomycin; Penicillins; Resorcinols; Salicylates; Sebaceous Glands; Sulfur; Tetracycline; Toxicology; Triamcinolone

Topics: Acne Vulgaris; Amber; Anti-Infective Agents, Local; Humans; Niacin; Nicotinic Acids; Salicylates

Topics: Acne Vulgaris; Drug Combinations; Heparin; Humans; Salicylates; Salicylic Acid; Thymol; Vanillic Acid