| treatment guide
Alternative treatments Topical photodynamic therapy (PDT) for acne is an emerging treatment resulting in a reduction in inflammatory lesions and a significant improvement in acne, without causing bacterial resistance. PDT uses
light-activated agents
(5-aminolevulinic acid (ALA) and methyl aminolevulinate (MAL)) that are absorbed into the pilosebaceous unit, causing the release of reactive oxygen species, the photodestruction of P. acnes and the reduction of the sebaceous gland size8
.
However, the lack of sufficient science-based evidence does not permit a high-level strength of recommendation of PDT for acne2
. Zinc salts, mainly zinc gluconate,
have been used for the treatment of mild to moderate acne with favourable results, without inducing bacterial resistance or phototoxicity/photosensitivity. Zinc salts seem to be less effective than tetracyclines, but might be an alternative treatment in inflammatory acne when
tetracyclines . are
contraindicated, especially in pregnant women, in children, and during the summer months9
Emerging treatments Emerging treatments include agents, such as zileuton and a tripeptide derivative of α-MSH, that may selectively target key pathogenetic events in acne, thus providing optimal efficacy with a
RevLite conBio
Description The RevLite Q-switched Nd:YAG features PhotoAcoustic Technology Pulse (PTP), designed to provide safe and effective acne scar treatments at higher energy levels than traditional lasers. High-speed repetition rates of PTP produce maximum energy output over a large spot size at the
same fluence level, enabling physicians to treat scars successfully and rapidly. This versatile workstation features four gold standard wavelengths — 1064 nm, 532 nm, 650 nm, and 585 nm — to treat all skin types and for a variety of indications.
Indications Acne scarring, skin toning
prime-journal.com | November/December 2011 ❚ 77
and rejuvenation, treatment of vascular and pigmented lesions, tattoo removal, and hair removal.
Availability FDA approved, CE marked, available in most countries worldwide.
Contact
www.conbio.com
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favourable safety/tolerability profile. Zileuton, an oral 5-lipoxygenase
inhibitor, prevented the activation of the leukotriene pathway that participates in the pathogenesis of acne. Zileuton resulted in the reduction of inflammatory acne lesions, acne severity, total sebum lipids and free fatty acids10
. Furthermore,
KdPT, a tripeptide derivative of α-MSH, has recently been shown to have an anti-inflammatory action in human sebocytes in vitro via suppression of IL‑1β-mediated cytokine expression11
. Body augmentation
Conclusions Treating acne relies on appropriate patient selection and effectively targeting as many of the implicated pathogenetic factors as possible. The deciphering of acne pathogenesis may pave the way for the development of new exciting treatments for acne with a favourable efficacy and safety/ tolerability profile.
Clio Dessinioti is dermatologist, Department of Dermatology,
Andreas Sygros Hospital, University of Athens, Greece;
and Andreas Katsambas is Professor and Chairman, Department of Dermatology, Andreas Sygros Hospital, University of Athens, Greece
References
1. Katsambas AD, Dessinioti C. New and emerging treatments in dermatology: acne. Dermatol Ther 2008; 21(2): 86–95
2. Thiboutot D, Gollnick H, Bettoli V et al. New insights into the management of acne: an update from the Global Alliance to Improve Outcomes in Acne group. J Am Acad Dermatol 2009; 60(5 Suppl): S1–50
3. Katsambas AD, Dessinioti C. Hormonal therapy for acne: why not as first line therapy? Facts and controversies. Clin Dermatol 2010; 28(1): 17–23
4. Dessinioti C, Katsambas AD. Congenital adrenal hyperplasia. DermatoEndocrinol 2009; 1: 87–91
5. Chen W, Obermayer-Pietsch B, Hong JB et al. Acne-associated syndromes: models for better understanding of acne pathogenesis. J Eur Acad Dermatol Venereol 2011; 25(6): 637–46
6. Gollnick H, Cunliffe W, Berson D et al. Management of acne: a report from a Global Alliance to Improve Outcomes in Acne. J Am Acad Dermatol 2003; 49(1 Suppl): S1–37
7. Dréno B, Bettoli V, Ochsendorf F et al. An expert view on the treatment of acne with systemic antibiotics and/or oral isotretinoin in the light of the new European recommendations. Eur J Dermatol 2006; 16(5): 565–71
8. Katsambas AD, Kontochristopoulos G, Salavastru C, Dessinioti C. Photodynamic therapy for acne vulgaris. Prime 2011; 1(3): 43–50
9. Brocard A, Dréno B. Innate immunity: a crucial target for zinc in the treatment of inflammatory dermatosis. J Eur Acad Dermatol Venereol 2011; 25(10): 1146–52
10.Zouboulis CC, Nestoris S, Adler YD et al. A new
concept for acne therapy: a pilot study with zileuton, an oral 5-lipoxygenase inhibitor. Arch Dermatol 2003; 139(5): 668–70
11. Mastrofrancesco A, Kokot A, Eberle A et al. KdPT, a tripeptide derivative of α-melanocyte stimulating hormone, suppresses IL-1β-mediated cytokine expression and signaling in human sebocytes. J Immunol 2010; 185(3): 1903–11
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