• [Show abstract] [Hide abstract]
    ABSTRACT: Introduction: Current acne treatment guidelines, as well as, treatment efficacy, safety, tolerability and patient preferences must all be considered in determining appropriate treatment regimes. Literature can assist physicians' evidence-based recommendations according to these factors. Areas covered: To determine the current and future direction of pharmacotherapy for treatment of acne, a PubMed search was conducted to identify all clinical trials involving the treatment of acne from 2009 to 2012. A total of 65 publications met inclusion criteria and were reviewed. Literature was heavily focused on the efficacy and tolerability of topical combination therapies and supported their use compared with monotherapy. A few studies on topical antiandrogens and antioxidants showed an alternative approach to targeting acne. Studies on oral monotherapy provided some evidence for the use of pulsed azithromycin for acne in adolescents. Literature also supports the use of low-dose isotretinoin for moderate acne, which was comparable in efficacy to high-dose regimes and better tolerated. Expert opinion: Combination acne therapy, whether it be combination topical therapy or combination oral and topical therapy, is well supported by recent studies. Given the multifactorial pathogenesis of acne and the hurdles of adherence to treatment, we anticipate greater development of and reliance on combination acne products in the future.
    Expert Opinion on Pharmacotherapy 11/2013; · 2.86 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Retinoids are compounds, which show the activity of vitamin A. Both naturally occurred (retinol, ratinaldehyde, retinoic acid) and synthetic (eg. acitretin, adapalene, tazarotene, bexarotene) compounds belong to this group. They show their activity through nuclear receptors which bind to DNA in promoter regions of genes regulated by retinoids. Some of them are ligands of the receptors while other need to be metabolized to active derivatives. Naturally occurred in the organism retinoids take part in such processes as proliferation and differentiation of cells, reproduction, maintenance of epithelial tissue, immune function and vision (retinaldehyde). Considering their mechanism of action they are used in the therapy of various disorders like acne, psoriasis or neoplasms. They can be administered orally (acitretin) or topically (alitretinoin, motretinide, adapalene, tazatorene) and some of them both routes (tretinoin, isotretinoin, bexarotene). They are also active constituents of cosmeceuticals. The usage of retinoids is limited by adverse effects caused by them to which belong teratogenicity, mucocutaneous and skeletal toxicity.
    Farmacja polska 07/2014; 66(3):187-192.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Abstract Background: Topical retinoids are considered first line therapy in the treatment of acne vulgaris, yet can be associated with cutaneous irritations. Combination therapy with natural preparations could be effective in treatment and decreasing adverse events. Objective: The aim of this study was to compare the efficacy and safety of the combination of tretinoin cream (0.05%) and Aloe vera topical gel (50%) with tretinoin and vehicle. Methods: The randomized, double blind, prospective 8-week trial evaluated inflammatory and noninflammatory lesion scores and tolerability in 60 subjects with mild to moderate acne vulgaris (Global Acne Grading System scale). Results: Several formulations of Aloe vera leaf gel were prepared and the most stable one was selected for clinical study based on physicochemical evaluations. The combination therapy showed superior efficacy to tretinoin and placebo. Tretinoin/Aloe gel was significantly more effective in reducing noninflammatory (P=0.001), inflammatory (P=0.011), and total (P=0.003) lesion scores than control group. The highest percentage of adverse cutaneous effect was reported for scaling. At the end of study erythema in the tretinoin/Aloe gel treated group was significantly less severe (P=0.046). Conclusion: The combination tretinoin/Aloe gel was well tolerated and significantly more effective than tretinoin and vehicle for the treatment of mild to moderate acne vulgaris.
    Journal of Dermatological Treatment 01/2013; · 1.50 Impact Factor