The possibilities of improving the effectiveness of acne therapy
https://doi.org/10.21518/ms2024-374
Abstract
Acne is one of the most urgent problems of dermatology, since this dermatosis is widespread, often occurs during puberty, is accompanied by cosmetic defects, causes increased anxiety, dysmorphic phobia and depressive states. As a result, the quality of life and the possibility of social adaptation decrease in patients. Therefore, it is necessary to optimize the treatment of this disease with the inclusion of modern highly effective drugs. When prescribing treatment, it is necessary to take into account all links in the pathogenesis of acne, and also remember that inflammation plays an important role in the development of dermatosis (especially severe course). With mild acne, it is recommended to prescribe only external therapy, with medium – external therapy and, if necessary, systemic, with severe systemic therapy is used as the main one. The appointment of antibiotics for this dermatosis is dictated by the presence of bacterial flora. Clindamycin is one of the antibiotics that effectively reduce colonization of C. аcnes. To ensure the high efficiency and safety of topical therapy, as well as the prevention of the development of resistance of microorganisms, there is a need to use a combination of at least two drugs. Thus, the combination of clindamycin with benzoyl peroxide makes it possible to increase the effectiveness of therapy due to bactericidal, bacteriostatic, anti-inflammatory and keratolytic actions. The convenient mode of use and the rapid therapeutic effect make it possible to include this combination in the group of priority drugs for the treatment of acne. Comedonolytic, anti-inflammatory and bactericidal effects are also observed in azelaic acid, and therefore drugs containing this component show a high pathogenetic effect in acne.
About the Authors
R. M. Zagrtdinova
Izhevsk State Medical Academy
Russian Federation
Russian Federation
Rizida M. Zagrtdinova, Dr. Sci. (Med.), Professor, Head of the Department of Dermatovenerology
281, Kommunarov St., Izhevsk, 426056
R. N. Zagrtdinova
Izhevsk State Medical Academy
Russian Federation
Russian Federation
Rizilya N. Zagrtdinova, Assistant of the Department of Dermatoneverology
281, Kommunarov St., Izhevsk, 426056
E. Sh. Mustafayeva
Izhevsk State Medical Academy
Russian Federation
Russian Federation
Elnara Sh. Mustafayeva, Clinical Resident of the Department of Dermatovenerology
281, Kommunarov St., Izhevsk, 426056
References
1. Kaminskaya TV, Maruev MB, Rakovetskaya OG, Kornyushina NI, Zotova EB, Shkurina OA et al. Current aspects of the combined topical treatment of acne. Russian Journal of Clinical Dermatology and Venereology. 2016;15(4): 65–72. (In Russ.) https://doi.org/10.17116/klinderma201615465-72.
2. Кубанов АА, Аравийская ЕА, Самцов АВ, Кондрахина ИН, Махакова ЮБ, Ласеев ДИ. Акне вульгарные: клинические рекомендации. М.; 2020. 33 с.
3. Dreno B, Poli F. Epidemiology of acne. Dermatology. 2003;206(1):7–10. https://doi.org/10.1159/00006.
4. Kovaleva YuS, Kokina OA, Makarenko YeS. Topical Combination Therapy for Mild to Moderate Acne. Effective Pharmacotherapy. 2021;17(14):32–37. (In Russ.) https://doi.org/10.33978/2307-3586-2021-17-14-32-36.
5. Kovaleva YuS, Kokina OA, Makarenko YeS. Combined Topical Acne Therapy: Questions of Efficacy and Safety. Effective Pharmacotherapy. 2019;15(11):16–23. (In Russ.) https://doi.org/10.33978/2307-3586-2019-15-11-16-22.
6. Kovaleva YuS, Vedler AA, Karkhova VV. Micronization technology of in dermatology: therapeutic applications of azelaic acid (in Russian only). Russian Journal of Clinical Dermatology and Venereology. 2018;17(6):13–20. (In Russ.) https://doi.org/10.17116/klinderma20181706113.
7. Kovaleva JuS, Reshetova SV, Nikolaeva MG. Focus on azelaic acid in topical rosacea therapy. Russian Journal of Clinical Dermatology and Venereology. 2021;20(5):103–108. (In Russ.) https://doi.org/10.17116/klinderma202120051103.
8. Rocha MA, Costa CS, Bagatin E. Acne vulgaris: an inflammatory disease even before the onset of clinical lesions. Inflamm Allergy Drug Targets. 2014;13(3):162–167. https://doi.org/10.2174/1871528113666140606110024.
9. Jeremy AH, Holland DB, Roberts SG, Thomson KF, Cunliffe WJ. Inflammatory events are involved in acne lesion initiation. J Invest Dermatol. 2003;121(1):20–27. https://doi.org/10.1046/j.1523-1747.2003.12321.x.
10. Humphrey S. Antibiotic resistance in acne treatment. Skin Therapy Lett. 2012;17(9):1–3. Available at: https://pubmed.ncbi.nlm.nih.gov/23032935.
11. Leyden J, Kaidbey K, Levy SF. The combination formulation of clindamycin 1% plus benzoyl peroxide 5% versus 3 different formulations of topical clindamycin alone in the reduction of Propionibacterium acnes. An in vivo comparative study. Am J Clin Dermatol. 2001;2(4):263–266. https://doi.org/10.2165/00128071-200102040-00007.
12. Dvoriankova EV, Denieva MI, Khismatullina ZR. Skin microbiome in patients with acne. Meditsinskiy Sovet. 2023;17(14):45–50. (In Russ.) https://doi.org/10.21518/ms2023-264.
13. Thiboutot DM, Dréno B, Abanmi A, Alexis AF, Araviiskaia E, Barona Cabal MI et al. Practical management of acne for clinicians: An international consensus from the Global Alliance to Improve Outcomes in Acne. J Am Acad Dermatol. 2018;78(2 Suppl.):S1–S23.e1. https://doi.org/10.1016/j.jaad.2017.09.078.
14. Zaenglein AL, Pathy AL, Schlosser BJ, Alikhan A, Baldwin HE, Berson DS et al. Guidelines of care for the management of acne vulgaris. J Am Acad Dermatol. 2016;74(5):945–973.e33. https://doi.org/10.1016/j.jaad.2015.12.037.
15. Cunliffe WJ, Holland KT, Bojar R, Levy SF. A randomized, double-blind comparison of a clindamycin phosphate/benzoyl peroxide gel formulation and a matching clindamycin gel with respect to microbiologic activity and clinical efficacy in the topical treatment of acne vulgaris. Clin Ther. 2002;24(7):1117–1133. https://doi.org/10.1016/s0149-2918(02)80023-6.
16. Leyden JJ. Effect of topical benzoyl peroxide/clindamycin versus topical clindamycin and vehicle in the reduction of Propionibacterium acnes. Cutis. 2002;69(6):475–480. Available at: https://pubmed.ncbi.nlm.nih.gov/12078851.
17. Taylor GA, Shalita AR. Benzoyl peroxide-based combination therapies for acne vulgaris: a comparative review. Am J Clin Dermatol. 2004;5(4):261–265. https://doi.org/10.2165/00128071-200405040-00005.
18. Silina LV, Pismennaya EV, Kolbina MS. Topical antibiotics for acne treatment. Vestnik Dermatologii i Venerologii. 2016;92(2):115–120. (In Russ.) https://doi.org/10.25208/0042-4609-2016-92-2-115-120.
19. Kondratyeva YS, Kokina OA. Experience of applying azelaic acid in dermatology. Vestnik Dermatologii i Venerologii. 2016;92(3):139–144. (In Russ.) https://doi.org/10.25208/0042-4609-2016-92-3-139-144.
20. Круглова ЛС (ред.). Акне и розацеа. Клинические проявления, диагностика и лечение. М.: ГЭОТАР-Медиа; 2021. 208 с. Режим доступа: https://static-sl.insales.ru/files/1/5856/15152864/original/akne_i_rozacea_.pdf.
21. Sethi A, Kaur T, Malhotra SK, Gambhir ML. Moisturizers: The Slippery Road. Indian J Dermatol. 2016;61(3):279–287. https://doi.org/10.4103/0019-5154.182427.
22. Statsenco AV, Gorbunov UG, Khairutdinov VR, Shestopalov NE, Antonova OV. Experience use of azelaic acid in patients with acne. Vestnik Dermatologii i Venerologii. 2014;90(5):100–105. (In Russ.) https://doi.org/10.25208/0042-4609-2014-90-5-100-105.
Review
For citations:
Zagrtdinova RM, Zagrtdinova RN, Mustafayeva ES. The possibilities of improving the effectiveness of acne therapy. Meditsinskiy sovet = Medical Council. 2024;(14):102-106. (In Russ.) https://doi.org/10.21518/ms2024-374
Views:
255
Email this article 