madman
Super Moderator
ABSTRACT
Aim: The aim of this study was to determine the change in facial skin sebum, hydration, and elasticity of acne vulgaris patients after being treated with systemic isotretinoin.
Method: Patients who were diagnosed with acne vulgaris and who received systemic isotretinoin treatment for 6 months in Cerrahpas¸a Medical Faculty Department of Dermatology between June 2012 and May 2017 was included in this study. The sebum, hydration, and elasticity of the skin were measured non-invasively with a device called “Soft Plus Skin Analyses System” before treatment and 6 months after treatment. The relationship between the pre-treatment and post-treatment values was evaluated statistically. 35 adult patients (20 female, 15 male) who were diagnosed with acne vulgaris and who received systemic isotretinoin treatment for 6 months.
Results: The pre-treatment sebum value for both sexes ranged between 5 and 100 and the mean value was calculated as 75.8 ± 28.0. The post-treatment sebum values ranged between 1 and 98 and the mean value was calculated as 48.4 ± 31.8. The difference between the pre-treatment and post-treatment values was statistically significant, p< 0.001. The decline in sebum value after treatment was 36%. The pre-treatment hydration values ranged between 9 and 77.5 and the mean was 34.6 ± 14.6. The post-treatment hydration values ranged between 4.8 and 100 and the mean was calculated as 62.4 ± 28.6. The difference between the pre-treatment and post-treatment hydration values was statistically significant, p< 0.001. The post-treatment increase in hydration was 79%. The pre-treatment skin elasticity ranged between 28 and 50; the mean was 40.4 ± 5.5. The post-treatment elasticity values ranged between 20 and 50, and the mean was 37.5 ± 8.2. However, the difference was not statistically significant (p¼ 0.1).
Conclusion: With this study, it was concluded that systemic isotretinoin leads to a 36% decline in skin sebum values and a 79% increase in skin hydration. However, the change in skin elasticity was not statistically significant. Furthermore, the changes in sebum and skin hydration did not lead to a change in skin elasticity.
1. Introduction
Acne vulgaris is a chronic inflammatory disease of the pilosebaceous unit. It is characterized by inflammatory lesions (e.g. comedones, papules, pustules, and nodules) in the seborrheic areas of the body such as the face, the chest, and the back. It is a disease that can affect all age groups; however, it has an increased prevalence in adolescents1. There are four important components in the pathogenesis of acne vulgaris. These are the increased production of sebum, follicular hyperkeratinization, colonization of propionibacterium acnes, and inflammation2,3.
As sebum production is one of the components of acne pathogenesis, the changes in the sebum levels can affect the disease course. Sebum is composed of sebaceous and extracellular lipids. The sebaceous lipids moisturize the skin, decrease transepidermal water loss and add to the antimicrobial barrier of the skin4,5 . The moisturization level of the skin is determined by the hydration level of the upper epidermis which in turn is determined by the transepidermal water loss of the skin6–8 . The mechanical properties of the skin are determined by its composition of collagen and elastin fibers. The elasticity of the skin is decreased with aging and ultraviolet exposure9–11.
Acne vulgaris is a frequent challenge in outpatient clinics because not only patients are using off-the-counter products but also have a propensity of being unsatisfied due to their increased anxiety caused by the disease. Providing effective treatment for acne requires a good history and detailed dermatologic examination12. The treatment modalities can be divided into two groups: topical and systemic. Systemic treatment modalities include systemic antibiotics (e.g. macrolides and tetracyclines), hormonal therapies, and oral isotretinoin12,13. Oral isotretinoin is an FDA-approved treatment modality that has been used for nodulocystic acne lesions since 1982 14. Isotretinoin is a pre-drug that is transformed into its metabolites which have high affinities towards the retinoic acid nuclear receptors (RAR and RXR) and retinol-binding protein. This way isotretinoin decreases follicular hyperkeratinization and thus decreases comedone formation. Isotretinoin also decreases the colonization of propionibacterium acnes indirectly and has anti-inflammatory properties. Six weeks of isotretinoin therapy is known to reduce sebum production up to 90% 15. The therapy should be initiated at 0.5–1 mg/kg/day and if the patient tolerates the drug, the dose may be increased up to 1 mg/kg/day. The frequently encountered side effects of the drug are mucocutaneous, ophthalmic, and skeletal symptoms resembling hypervitaminosis A, which subside when the therapy is stopped16.
*The aim of this study was to determine the changes in facial skin sebum, hydration, and elasticity of acne vulgaris patients after being treated with systemic isotretinoin.
In conclusion, systemic isotretinoin treatment has led to a 36% decline in the skin sebum levels and this decline was statistically significant. The therapy has led to a 79% increase in skin hydration, which again was statistically significant. However, the difference between the pre-treatment and post-treatment skin elasticity levels was statistically insignificant. Regarding these results, one can conclude that oral isotretinoin therapy leads to a significant decline in skin sebum levels and a significant increase in skin hydration. However, its effect on skin elasticity is insignificant.
Aim: The aim of this study was to determine the change in facial skin sebum, hydration, and elasticity of acne vulgaris patients after being treated with systemic isotretinoin.
Method: Patients who were diagnosed with acne vulgaris and who received systemic isotretinoin treatment for 6 months in Cerrahpas¸a Medical Faculty Department of Dermatology between June 2012 and May 2017 was included in this study. The sebum, hydration, and elasticity of the skin were measured non-invasively with a device called “Soft Plus Skin Analyses System” before treatment and 6 months after treatment. The relationship between the pre-treatment and post-treatment values was evaluated statistically. 35 adult patients (20 female, 15 male) who were diagnosed with acne vulgaris and who received systemic isotretinoin treatment for 6 months.
Results: The pre-treatment sebum value for both sexes ranged between 5 and 100 and the mean value was calculated as 75.8 ± 28.0. The post-treatment sebum values ranged between 1 and 98 and the mean value was calculated as 48.4 ± 31.8. The difference between the pre-treatment and post-treatment values was statistically significant, p< 0.001. The decline in sebum value after treatment was 36%. The pre-treatment hydration values ranged between 9 and 77.5 and the mean was 34.6 ± 14.6. The post-treatment hydration values ranged between 4.8 and 100 and the mean was calculated as 62.4 ± 28.6. The difference between the pre-treatment and post-treatment hydration values was statistically significant, p< 0.001. The post-treatment increase in hydration was 79%. The pre-treatment skin elasticity ranged between 28 and 50; the mean was 40.4 ± 5.5. The post-treatment elasticity values ranged between 20 and 50, and the mean was 37.5 ± 8.2. However, the difference was not statistically significant (p¼ 0.1).
Conclusion: With this study, it was concluded that systemic isotretinoin leads to a 36% decline in skin sebum values and a 79% increase in skin hydration. However, the change in skin elasticity was not statistically significant. Furthermore, the changes in sebum and skin hydration did not lead to a change in skin elasticity.
1. Introduction
Acne vulgaris is a chronic inflammatory disease of the pilosebaceous unit. It is characterized by inflammatory lesions (e.g. comedones, papules, pustules, and nodules) in the seborrheic areas of the body such as the face, the chest, and the back. It is a disease that can affect all age groups; however, it has an increased prevalence in adolescents1. There are four important components in the pathogenesis of acne vulgaris. These are the increased production of sebum, follicular hyperkeratinization, colonization of propionibacterium acnes, and inflammation2,3.
As sebum production is one of the components of acne pathogenesis, the changes in the sebum levels can affect the disease course. Sebum is composed of sebaceous and extracellular lipids. The sebaceous lipids moisturize the skin, decrease transepidermal water loss and add to the antimicrobial barrier of the skin4,5 . The moisturization level of the skin is determined by the hydration level of the upper epidermis which in turn is determined by the transepidermal water loss of the skin6–8 . The mechanical properties of the skin are determined by its composition of collagen and elastin fibers. The elasticity of the skin is decreased with aging and ultraviolet exposure9–11.
Acne vulgaris is a frequent challenge in outpatient clinics because not only patients are using off-the-counter products but also have a propensity of being unsatisfied due to their increased anxiety caused by the disease. Providing effective treatment for acne requires a good history and detailed dermatologic examination12. The treatment modalities can be divided into two groups: topical and systemic. Systemic treatment modalities include systemic antibiotics (e.g. macrolides and tetracyclines), hormonal therapies, and oral isotretinoin12,13. Oral isotretinoin is an FDA-approved treatment modality that has been used for nodulocystic acne lesions since 1982 14. Isotretinoin is a pre-drug that is transformed into its metabolites which have high affinities towards the retinoic acid nuclear receptors (RAR and RXR) and retinol-binding protein. This way isotretinoin decreases follicular hyperkeratinization and thus decreases comedone formation. Isotretinoin also decreases the colonization of propionibacterium acnes indirectly and has anti-inflammatory properties. Six weeks of isotretinoin therapy is known to reduce sebum production up to 90% 15. The therapy should be initiated at 0.5–1 mg/kg/day and if the patient tolerates the drug, the dose may be increased up to 1 mg/kg/day. The frequently encountered side effects of the drug are mucocutaneous, ophthalmic, and skeletal symptoms resembling hypervitaminosis A, which subside when the therapy is stopped16.
*The aim of this study was to determine the changes in facial skin sebum, hydration, and elasticity of acne vulgaris patients after being treated with systemic isotretinoin.
In conclusion, systemic isotretinoin treatment has led to a 36% decline in the skin sebum levels and this decline was statistically significant. The therapy has led to a 79% increase in skin hydration, which again was statistically significant. However, the difference between the pre-treatment and post-treatment skin elasticity levels was statistically insignificant. Regarding these results, one can conclude that oral isotretinoin therapy leads to a significant decline in skin sebum levels and a significant increase in skin hydration. However, its effect on skin elasticity is insignificant.
