Search Results (319)

Inflammation plays a pivotal role in the pathogenesis of acne vulgaris, with Cutibacterium acnes recognised as a key etiological agent. The global increase in acne prevalence, coupled with the rising incidence of antibiotic-resistant strains, underscores the necessity for alternative therapeutic strategies. Vaccination has emerged as a promising approach, with various candidates targeting live-attenuated strains and specific virulence factors. Nevertheless, the expanding availability of C. acnes genomic data presents an opportunity to identify previously uncharacterized antigens that hold potential as novel targets for the development of next-generation acne vaccines. Therefore, this study aimed to identify core proteins among C. acnes genomes and evaluate their immunogenicity as potential multi-epitope peptide constructs. In addition, IA1-specific proteins of C. acnes were examined to develop the peptide constructs targeting acne-associated isolates. Pan-core analysis of 609 genomes identified 972 core genes. These genes were subsequently analysed for epitope prediction and antigenicity, and the highly antigenic epitopes were selected and combined for further analysis. Multi-epitope peptides were constructed based on predicted MHC-I, MHC-II, and linear B-cell epitopes, yielding four promising candidates derived from C. acnes core proteins and IA1-specific proteins. Molecular docking analysis indicated that both groups showed binding affinity for TLR2 and TLR4 receptors, suggesting possible molecular compatibility with these receptors. Furthermore, in silico immune simulations indicated that both types of multi-epitope peptides were associated with simulated humoral and cellular immune response profiles, although these responses require experimental validation. This computational workflow may help narrow the selection of potential acne vaccine candidates and prioritise multi-epitope peptide constructs for subsequent vaccine design steps and experimental validation. Full article

Industrial hemp (Cannabis sativa L.) has emerged as a sustainable source of bioactive compounds, with increasing interest in cosmeceutical applications for acne management. This systematic review synthesises evidence on cannabinoid-containing hemp extracts, particularly cannabidiol (CBD), with emphasis on anti-inflammatory and sebostatic mechanisms, alongside formulation considerations and supply-chain sustainability. Reporting followed PRISMA 2020 guidelines and encompassed preclinical and clinical evidence relevant to acne-associated outcomes. The review protocol was registered prospectively with PROSPERO (CRD420251272093). Across cell-based, ex vivo and early clinical studies, CBD modulated key inflammatory mediators, including TNF-α, IL-1β, IL-6 and IL-8; normalised sebocyte activity and attenuated Cutibacterium acnes (Propionibacterium acnes)-induced inflammatory signalling. Preliminary clinical observations indicate reductions in lesion counts and erythema, with generally favourable short-term tolerability; however, interpretation is limited by small sample sizes, predominantly non-randomised designs, heterogeneous formulations and frequent co-formulation with additional active ingredients. Evidence supporting direct antimicrobial efficacy and durable clinical benefit remains limited. Lipid-rich hemp seed-derived products were considered only in a contextual capacity for barrier-supportive and nutritional properties and were excluded from efficacy synthesis unless cannabinoid content was verified. Sustainability analyses highlight hemp’s low water requirements, carbon sequestration potential and relevance to Sustainable Development Goal 3 (SDG 3: Good Health and Well-Being) and Sustainable Development Goal 12 (SDG 12: Responsible Consumption and Production), supporting its role in environmentally responsible cosmeceutical development. Overall, CBD-containing hemp extracts show biologically plausible and clinically promising adjunctive potential for mild-to-moderate inflammatory acne, but current evidence remains preliminary. This review highlights the need for methodologically rigorous and transparent clinical studies, standardised formulations, validated outcome measures and the integration of sustainability metrics to strengthen evidence synthesis, clarify clinical relevance and guide responsible cosmeceutical development. Full article

It is crucial to consider newer antibiotics with activity against anaerobes and Helicobacter pylori, given their healthcare importance, and the constantly growing antibiotic resistance/multidrug resistance, which complicates the therapy. The aim of this review was to emphasize certain recently approved or still-under-investigation antibiotics with potential benefits for treating Clostridioides difficile infections (CDIs), other anaerobic infections, and those caused by H. pylori, covering recent data from articles published primarily in 2020–2026. Given the limited number of antibiotics for treating CDI and fidaxomicin nonavailability in many countries, it is necessary to conduct more extensive laboratory and clinical studies of promising antibiotics such as ibezapolstat, delafloxacin, lascufloxacin, omadacycline, eravacycline, ridinilazole, and CRS3123. Against Bacteroides fragilis group species, delafloxacin and eravacycline showed good activity. Research on rifasutenizol for bacterial vaginosis, sarecycline and nadifloxacin for acne vulgaris and amixicile for periodontal diseases needs to be expanded. For H. pylori infection, delafloxacin, sitafloxacin, nemonoxacin, zoliflodacin, and rifasutenizol may improve the suboptimal success of most eradication regimens. However, more efforts, in coordination between medical, scientific, manufacturing, and government representatives, should ensure wider access to and research on the newer antibacterials. Establishing more research groups, careful examination of market issues, and additional approaches, such as nanomaterials, efflux pump inhibitors, phage therapy, and CRISPR-Cas systems, should be beneficial. Notwithstanding the difficulties, there are many opportunities to promote research on and potential use of newer antibiotics which show advantages over the older antibacterials, and to make them available to numerous countries and patients worldwide. Full article

Acne vulgaris is a prevalent inflammatory disorder of the pilosebaceous unit involving follicular hyperkeratinization, altered sebum production, Cutibacterium acnes proliferation, microbiome imbalance, and immune activation. Although antibiotics, retinoids, benzoyl peroxide, and keratolytic agents remain central to clinical management, their long-term use may be limited by irritation, recurrence, adherence issues, and increasing antimicrobial resistance. This narrative review critically evaluates the dermatological relevance of Melaleuca alternifolia tea tree essential oil (TTEO), Mentha piperita peppermint essential oil (PPEO), and polyhydroxy acids (PHAs), as well as their incorporation into biopolymeric delivery systems for acne-oriented topical applications. Following SANRA principles, evidence from clinical, preclinical, ex vivo, and in vitro studies was synthesized, with emphasis on antimicrobial activity, inflammatory modulation, keratolytic and barrier-supportive effects, formulation stability, and release behavior. TTEO shows the strongest clinical support among the reviewed natural bioactives, including reductions in lesion counts and acne severity when applied as conventional or nanoemulsion-based formulations. PPEO is mainly supported by experimental evidence, particularly antimicrobial activity against acne-associated microorganisms, anti-inflammatory potential, and menthol-related neurocutaneous effects, whereas acne-specific clinical validation remains limited. PHAs, particularly gluconolactone, are better supported for barrier improvement, hydration, tolerability, and seboregulation than for direct acne lesion reduction. Hydrogels, electrospun nanofibers, polymeric films, nanoencapsulation systems, and controlled-release platforms may improve local retention, protect volatile or irritation-prone compounds, and modulate active release at the skin surface. However, most biopolymeric platforms still rely on early-stage or indirect dermatological evidence. Overall, biopolymeric delivery systems offer a rational formulation strategy to improve the stability, tolerability, and localized action of selected acne-relevant bioactives, but their clinical translation requires standardized composition, reproducible fabrication, skin-relevant release assays, safety assessment, and controlled human studies. Full article

Objective: To identify modifiable factors associated with acne vulgaris in college students and further delineate the potential mechanistic pathway underlying the effect of psychological stress on acne development. Methods: We conducted a cross-sectional study with a questionnaire-based survey among 819 college students, collecting data on demographic characteristics, lifestyle behaviors, sleep quality, psychological stress, and acne prevalence. Descriptive statistics and univariate analyses were used to compare baseline characteristics between groups, and stepwise adjusted binary logistic regression models were constructed to identify independent risk factors for acne. The Bootstrap method was applied for mediation effect analysis. Subgroup analyses, interaction tests, sensitivity analyses, and robustness analyses were also performed. Results: The overall prevalence of acne in the study cohort was 33.33%. Multivariable regression analysis revealed that total stress score (OR = 1.187, p < 0.001), poor sleep quality (OR = 1.109, p = 0.010), excessive screen time (OR = 1.107, p = 0.021), intake of sugary drinks (OR = 1.561, p = 0.027), spicy diet (OR = 1.739, p = 0.003), smoking (OR = 1.809, p = 0.031), and use of skincare products (OR = 2.004, p = 0.001) were independent risk factors for acne, while outdoor activities were a protective factor (OR = 0.676, p = 0.048). Mediation effect analysis demonstrated that psychological stress exerted not only a direct effect on acne development, but also an indirect effect to increase disease risk via impairing sleep quality. This indirect effect was statistically significant (95% CI: 0.000–0.013, p < 0.05), accounting for approximately 20.67% of the total effect. The sensitivity analysis revealed that the E-values of all significant variables were greater than 1.4. The robustness test indicated that the results remained unchanged after excluding students majoring in medicine and extreme values. Furthermore, LASSO variable screening and Bootstrap internal validation further verified the stability of the model. Conclusions: Although as a cross-sectional study, this work cannot establish causal relationships, but we found that psychological stress and sleep disturbance are key modifiable risk factors for acne, and the impact of stress on acne is partially mediated by the impairment of sleep quality. Full article

Introduction: Many studies suggest that dietary factors may significantly influence the development and severity of acne lesions. Objective: The aim of this study was to evaluate the effect of an anti-inflammatory diet on acne severity in patients with acne vulgaris. Methods: This study included 92 participants who followed an individualized dietary intervention tailored to their energy requirements. Acne severity was assessed at baseline and after four weeks of dietary intervention using the Investigator’s Static Global Assessment scale. Results: After four weeks, a reduction in acne severity was observed in 68 of 92 participants (73.91%). The mean acne severity score decreased from 3.3 ± 0.6 to 2.4 ± 0.7 points. The dietary intervention also resulted in statistically significant reductions in body weight (p < 0.0001), body mass index (p < 0.0001), fat mass (p < 0.0001), visceral fat (p = 0.0386), and metabolic age (p = 0.0004). Conclusions: The balanced diet characterized by a low glycemic index and anti-inflammatory properties, combined with reduced intake of saturated fatty acids, sugar, and salt, as well as the elimination of dairy products and highly processed and high glycemic index foods, presumably through the synergistic effect of all the components of the diet, was found to be effective in the reduction of acne severity in the study group. This study supports the feasibility of the applied dietary pattern and suggests possible benefit for patients with acne. Considering the promising results obtained in this study, further research conducted in larger patient populations would be valuable. Full article

Background/Objectives: A matrix system for topical application was developed for a hydrophobic drug model, benzoyl peroxide (BPO), by turning it into its amorphous state to increase its bioavailability. BPO is commonly used to treat acne vulgaris; however, the commercially available products possess several drawbacks including poor absorption due to large crystal size and thus reduced efficacy and skin irritation. Methods: Several polymeric films containing amorphous BPO were successfully prepared for the first time from polymer + plasticizer colloidal dispersions and characterized. Results: The loaded BPO maintained its amorphous state even after 24 months of storage at 5 °C, and drug release could be modulated by adjusting the film compositions. The prepared films were obtained by solvent evaporation, and residual acetone remained below the level of quantification of the analytical method. In addition, the films were thin, flexible, transparent, bioadhesive, and able to remain on the skin for a clinically relevant period. Microscopic imaging confirmed a homogeneous and continuous morphology. Conclusions: The developed formulations may represent promising alternatives for the treatment of acne vulgaris. Full article

Acne vulgaris is a chronic inflammatory disease of the pilosabaceous unit with a multifactorial pathogenesis involving sebaceous gland activity, follicular hyperkeratinization, microbial dysbiosis, and immune dysregulation. Increasing attention has been given to the role of the skin and gut microbiome, as well as the gut–skin axis, although their clinical significance has not yet been fully explained. This review critically evaluates the current evidence regarding the use of probiotics, prebiotics, and synbiotics in the treatment of acne. Available studies suggest that microbiome-targeted interventions may influence inflammatory pathways, microbial composition, and metabolic regulators such as IGF-1 and mTORC1. Some clinical trials indicate improvements in acne severity and skin parameters following oral or local interventions. However, the evidence is heterogeneous and limited by small sample sizes, short study durations, and variability in formulations and outcomes. Therefore, although microbiome-based strategies may have potential as adjunctive therapy, their clinical efficacy remains uncertain. Further, well-designed, large-scale studies are needed to determine their role in dermatological practice. Full article

Cutaneous disorders such as atopic dermatitis, psoriasis, acne vulgaris, and rosacea, together with UV-induced skin injury and photoaging, are highly prevalent conditions that involve varying contributions from dysregulated immune responses, cutaneous inflammation, oxidative stress, barrier dysfunction, microbiome alteration, and exogenous injury. However, these conditions are biologically heterogeneous and should not be regarded as a single mechanistic class. Sulforaphane, a naturally occurring isothiocyanate found primarily in broccoli and other cruciferous vegetables, has attracted interest in dermatology because of its antioxidant, cytoprotective, and context-dependent anti-inflammatory properties. Sulforaphane exerts its biological effects by modulating key signaling pathways, particularly the Keap1/Nrf2 pathway and, in some settings, NF-κB-related signaling, thereby reducing oxidative stress and inflammation, regulating immune responses, enhancing skin barrier function, and potentially influencing the cutaneous microbiome. Preclinical studies and limited human data suggest that sulforaphane may reduce erythema, edema, and other markers of cutaneous damage in selected settings. This comprehensive review explores the role of sulforaphane across heterogeneous cutaneous conditions, with emphasis on molecular mechanisms, disease-specific differences, current evidence, and discusses key translational constraints including formulation, delivery, lack of standardized dosing, and the limitations of cell culture and animal models for predicting human efficacy. Overall, sulforaphane should presently be regarded as a promising but still early-stage translational candidate in dermatology. Robust human efficacy data remain lacking for chronic inflammatory dermatoses such as psoriasis, atopic dermatitis, acne, and rosacea, whereas the strongest current human evidence relates to UV-associated skin outcomes and photoprotection. Full article

This study assessed the impact of a topical phytocomplex on the acne skin microbiota, encompassing bacterial, fungal, and phage communities. Skin samples obtained from participants exhibiting a positive response to the treatment were analyzed using high-throughput sequencing and bioinformatic approaches including taxonomic profiling, metagenome assembly, functional annotation, and phage identification. Results showed that after treatment, microbial diversity increased, reflecting a more balanced microbial composition. Cutibacterium acnes levels were reduced, particularly virulent IA1/IA2 phylotypes, whereas non-pathogenic or unclassified strains increased. Opportunistic pathogens such as Klebsiella pneumoniae were no longer detected, and beneficial genera including Psychrobacter and Dermabacter were enriched. Functional analysis showed reduced virulence- and biofilm-related pathways, alongside enhanced tryptophan metabolism, SCFA production, lipid synthesis, and riboflavin and folate biosynthesis. Fungal populations, dominated by Malassezia, became more evenly distributed, with notable post-treatment reductions in M. arunalokei, Exophiala spinifera, and Wickerhamomyces anomalus. Phage populations mirrored bacterial changes, with enrichment of Cutibacterium-associated phages post-treatment. These findings demonstrate that the phytocomplex promotes functional rebalancing of the skin microbiota by reducing pathogenic features while maintaining ecosystem stability. The inhibition of quorum sensing, potentially mediated by N-acyl-homoserine lactone acetylation, emerged from metabolic pathway annotation as a hypothetic key mechanism impairing bacterial communication and virulence associated with acne vulgaris. Full article

Topical retinoids are the cornerstone of the treatment of multiple dermatological conditions. Long established in acne therapy, they exert effects on keratinization, inflammation, fibroblast activity, and collagen remodeling, suggesting a potential role in both the prevention and treatment of acne scars. This narrative review summarizes current evidence on the use of topical retinoids in acne vulgaris and acne scarring, focusing on different retinoid molecules, formulation technologies, and combination strategies. A review of published clinical and experimental studies evaluating tretinoin, adapalene, tazarotene, and trifarotene was performed, including their use as monotherapy and in combination with other topical agents or procedural interventions. The available data indicate that topical retinoids have a well-established position in acne treatment, can improve the appearance of atrophic acne scars, reduce the progression of scarring, and support skin remodeling. Advances in formulation technologies have improved tolerability, while combination approaches with agents such as benzoyl peroxide, antibiotics or procedural techniques have shown additive or synergistic effects, particularly in more severe cases. Nevertheless, much of the evidence regarding novel formulations is derived from small or heterogeneous study populations. In conclusion, topical retinoids represent a relevant therapeutic option in acne vulgaris and acne scarring, from monotherapy in mild cases to components of multimodal treatment protocols in more severe disease. Further large-scale, comparative studies are needed to better define the optimal clinical use of advanced drug delivery systems for topical retinoids. Full article

The interest in the use of phytochemicals and herbal medicines for the treatment of acne vulgaris has grown steadily over recent decades. The research on the secondary metabolites and biological properties of bearberry (Arctostaphylos uva-ursi (L.) Spreng.) has been intensified in recent years, but the range of bacterial strains tested, many of which are highly relevant to human health, remains very limited. Therefore, the aim of this study was to evaluate the chemical composition and the antioxidant, antimicrobial, and cytotoxic activities of water and ethanolic bearberry leaf extracts. Compared with the ethanolic extract, the water extract was characterized by higher concentrations of arbutin, hydroquinone, corilagin, and hyperoside and the absence of ursolic acid and oleanolic acid. However, it exhibited lower total phenolic content and reduced levels of penta-O-galloyl-β-d-glucose (PGG). The ethanolic extract of bearberry leaves showed higher antioxidant activity and the most favorable overall biological properties. The therapeutic index (TI) values for the water and ethanolic extracts, respectively, were as follows: Cutibacterium acnes ATCC 11827 (10.70; 21.57), Propionibacterium acnes PCM 2334 (10.70; 43.13), P. acnes PCM (5.33; 21.57), Staphylococcus aureus ATCC 25923 (10.70; 21.57), and S. epidermidis ATCC 12228 (5.33; 10.78). The present findings further support the medicinal and cosmetic use of A. uva-ursi and highlight its potential as a source of natural antibacterial agents for acne treatment. Full article

Background: Conventional therapies for moderate-to-severe inflammatory acne include topical agents, systemic antibiotics, hormonal treatments, and oral isotretinoin. However, increasing resistance of Cutibacterium acnes to antibiotics and the potential adverse effects of systemic agents have prompted growing interest in non-pharmacological alternatives such as fractional microneedling radiofrequency (RF-MN), recently introduced in the clinical practice. Objective: This report of five cases aims to document the clinical benefits and safety of RF-MN using the Focus Dual^® device in the treatment of moderate-to-severe inflammatory acne vulgaris. Methods: Five patients (2 male, 3 female; aged 19–28 years; Fitzpatrick skin types II–III) with moderate-to-severe acne were treated with two RF-MN sessions at 4-week intervals using the Focus Dual^® device (Med & Tech, Occhiobello (RO), Italy). Acne severity was assessed using the Face Global Acne Grading System (F-GAGS) and the 5-point Global Improvement Score (GIS), with evaluations performed by two independent blinded raters (G.P and O.R). Standardized photographic documentation and lesion counting were conducted at baseline (T0) and 4 weeks after the second session (T2). All individual F-GAGS scores for each of the five patients showed a reduction from baseline to T2, as consistently assessed by both evaluators. Two patients improved from moderate to mild acne, one improved from severe to moderate, and one remained mild. GISs indicated clinical improvement ranging from Grade 1 to Grade 2 in all cases, with individual improvements between 8.33% and 37.93%. No adverse events were reported during treatment or follow-up. Conclusions: RF-MN appears to be a promising therapeutic option for moderate-to-severe inflammatory acne, providing clinical improvement and reduction in acne severity without adverse effects. Prospective studies with a larger sample are needed to confirm these preliminary results and support the potential role of RF-MN as an adjunctive or standalone treatment in patients with limited tolerance or response to conventional therapies. Full article

Succinic acid (SA) is a naturally occurring dicarboxylic acid with diverse biological roles, including participation in cellular energy metabolism and signaling. Despite its wide industrial use, clinical and in vivo evidence supporting the application of SA in cosmetics, cosmetology, dermatology, and aesthetic medicine remains limited, although mechanistic and experimental studies describing its biological activity are increasingly available. This review summarizes the chemical properties, natural occurrence, and physiological functions of SA, with a focus on its potential in topical and intradermal applications. The use of SA in cosmetic formulations, including personal care products, moisturizers, and masks, is discussed, alongside its emerging roles in the management of acne vulgaris and rosacea, hyperpigmentation, and as a chemical exfoliant and biostimulatory agent. Available studies suggest that SA can modulate inflammation, enhance microcirculation, support fibroblast proliferation, and stimulate collagen and elastin production, although most clinical evidence derives from small-scale or preliminary studies. Looking forward, the growing market and increasing scientific interest indicate a potential expansion of SA-based products in aesthetic dermatology. Further clinical and mechanistic studies are required to validate its applications and establish standardized protocols for its use in cosmetic and medical settings. The aim of this article is to summarize the existing knowledge on the use of succinic acid in cosmetics and aesthetic dermatology. Despite the growing interest in this compound, no comprehensive review addressing its applications in these fields is currently available. Therefore, this work responds to this gap by integrating and discussing the limited but emerging scientific reports concerning the cosmetic and dermatological potential of succinic acid. Full article

This review discusses the microbiology of acne vulgaris, a chronic inflammatory condition of the pilosebaceous unit that affects most adolescents and can persist into adulthood. The current standard of care consists largely of antibacterial interventions, based on the traditional view of Cutibacterium acnes as a pathogen. Alternative treatments are suggested by the “comedo switch” hypothesis, which attributes acne to aberrant differentiation of LRIG1+ sebaceous progenitor cells. While there is strong evidence to support this idea, it does not explain the efficacy of antibacterial interventions. We propose a unified mechanism wherein C. acnes phylotype IA1 can act as a trigger for the comedo switch. Unlike commensal strains, phylotype IA1 has high lipase activity, hydrolyzing sebum triglycerides into free fatty acids, specifically palmitic acid. This metabolite stimulates LRIG1+ progenitors, inducing inflammation and initial comedo formation. The review discusses C. acnes phylotypes, emphasizing known virulence factors of IA1, such as enhanced biofilm formation. We evaluate the efficacy and limitations of both old and new antibacterials, noting how newer materials that selectively remove C. acnes IA1 can reduce non-inflammatory acne lesions, supporting a key role for this phylotype in the pathogenesis of acne. Full article