Search Results (329)

Acne vulgaris is a highly prevalent inflammatory skin condition involving the interaction between skin microbes and host immunity, which lead with the changes in composition and activities of the skin microbiota disturbing its homeostasis. Several probiotic strains have been tested for their anti-pathogenic activity against the main acne-responsible bacteria, their capacity to contrast pathogenic adhesion to HaCaT cells and the in vitro down-regulation of innate immunity. To investigate whether probiotics have direct effects on the growth of Cutibacterium acnes, Staphyloccoccus aureus, Streptococcus pyogenes and Streptococcus epidermidis, the antimicrobial activity of six probiotics was analyzed by two different methods (modified cross-streak and agar well diffusion). The in vitro blockage of pathogens’ adherence by the probiotic strains to HaCaT cells was also investigated, under three possible mechanisms: exclusion by adhered probiotics, displacement of adhered pathogens and competition for receptor sites. The inflammatory response was evaluated by the Luminex approach, targeting a selection of innate immune markers in the HaCaT cell culture media. All probiotic strains showed anti-pathogenic activity against the pathogens tested. The inhibition result on HaCaT cells highlights a significant (p < 0.05) competition of all probiotics against all pathogens. Each pathogenic strain alone led to an up-regulation of innate immune markers, while restoration of the microbiome diversity by probiotics presence may suppress inflammation via down-regulation of innate immunity. The results suggest that the tested probiotics could prevent colonization of the skin by relevant pathogens through barrier and interference mechanisms (mainly exclusion), suggesting a potential use in the future conventional therapies of skin disorders. Full article

Acne vulgaris is an inflammatory cutaneous condition that disproportionately affects the pediatric population. While there are several risk factors, emerging evidence suggests that ultra-processed foods (UPFs), as part of Western dietary patterns, may contribute to acne pathophysiology through activation of inflammatory pathways, such as mTORC1. This comprehensive review synthesizes current evidence regarding acne pathogenesis in conjunction with diet-associated inflammatory cascades to better illustrate the potential role of diet as an adjunct to clinical management in pediatric patients. The current literature suggests that increased insulin/IGF-1 levels may contribute to alterations in the skin and gut microbiota. Additionally, components commonly found in UPFs have been proposed to activate the mechanistic target of rapamycin complex (mTORC1) through insulin/IGF-1-dependent and -independent mechanisms, perpetuating inflammatory pathways that give rise to acne pathogenesis. However, the majority of available evidence is derived from adult cohorts; pediatric-specific evidence remains limited. While studies have demonstrated clinical significance in acne severity with dietary interventions, future high-quality studies are required. Through understanding the relationship between diet and acne pathogenesis, future therapeutic and preventative strategies may be developed to improve pediatric acne clinical outcomes. Full article

Background/Objectives: The skin microbiome maintains barrier integrity, immune homeostasis, and pathogen defense; dysbiosis contributes to acne vulgaris, dandruff, seborrheic dermatitis, atopic dermatitis, psoriasis, and alopecia. This scoping review critically appraised evidence on prebiotics, probiotics, synbiotics, postbiotics, and paraprobiotics in dermo-cosmetics for acne vulgaris and scalp disorders. Methods: A scoping search (2006–2026) covered SciELO, PubMed/PMC, Google Scholar, CAPES Portal, Scopus, Heliyon, Frontiers, Nature, Wiley, and MDPI, following PRISMA 2020 guidelines. Results: Of 1665 records, 66 were included. For acne, effective prebiotics included blackcurrant, grape seed, ginseng, trehalose, and glucomannan hydrolysate; effective probiotic strains included Streptococcus thermophilus, Bifidobacterium longum, Staphylococcus epidermidis, and Streptococcus salivarius. A synbiotic (B. breve BR03, Lacticaseibacillus casei LC03, Ligilactobacillus salivarius LS03) reduced inflammatory lesions by 56.67% in an 8-week RCT (n = 114). For scalp disorders, oral Lacticaseibacillus paracasei ST11 reduced dandruff by 70% vs. 23% (placebo); Lactiplantibacillus plantarum TCI999 increased hair root diameter (n = 50, 12 weeks); a Lacticaseibacillus rhamnosus plus Bifidobacterium longum mixture improved alopecia areata by 56% vs. 30% (n = 26, 24 weeks). Conclusions: Biotic dermo-cosmetics can modulate the cutaneous microbiome and attenuate inflammation in acne and scalp disorders, with strongest evidence for multi-strain/synbiotic formulations. Formulation stability, strain specificity, regulatory heterogeneity, and lack of standardized microbiological endpoints remain key challenges; larger standardized RCTs with active comparators are needed. Full article

Dietary patterns associated with high glycemic load and recurrent postprandial glucose excursions may influence skin physiology through mechanisms involving oxidative stress, insulin–IGF-1 signaling, chronic low-grade inflammation, and advanced glycation end product (AGE) formation. Disturbances in glucose homeostasis have been associated with alterations in epidermal barrier integrity, sebaceous gland activity, extracellular matrix remodeling, and tissue repair processes. These mechanisms have been investigated primarily in relation to several dermatological conditions, particularly acne vulgaris, impaired wound healing, xerosis, and skin aging. This narrative review summarizes current evidence regarding the relationship between glycemic dysregulation and skin health, with emphasis on metabolic and molecular pathways potentially involved in cutaneous dysfunction. To reflect the current strength of evidence, mechanistic studies, observational studies, and clinical investigations are distinguished throughout this review whenever possible. Particular focus is placed on postprandial glycemic variability, oxidative stress, hormonal signaling, and glycation-related tissue damage. Current evidence supports biologically plausible associations between metabolic dysregulation and several aspects of skin dysfunction, although direct evidence specifically addressing glycemic variability remains limited. Most available studies are observational or mechanistic in nature, and relatively few clinical investigations have evaluated dermatological outcomes directly. Further research is needed to clarify the clinical relevance of glycemic-targeted dietary and metabolic interventions in dermatology. Full article

Background: Acne vulgaris is a chronic inflammatory disorder of the pilosebaceous unit in which Cutibacterium acnes plays an important role in disease pathogenesis. Rising antimicrobial resistance has intensified interest in selective antimicrobial strategies for acne vulgaris. Bacteriophage-derived endolysins may offer targeted antibacterial activity while potentially sparing the skin microbiota. This scoping review aimed to map current evidence regarding endolysins targeting C. acnes and to evaluate their antibacterial activity, selectivity, safety, formulation challenges, and translational potential. Methods: This scoping review was conducted in accordance with PRISMA-ScR guidelines. Searches on PubMed, Scopus, Embase, Web of Science, and Google Scholar were performed in February 2026. Experimental studies, academic theses, and patent documents investigating phage-derived endolysins active against C. acnes were included and narratively synthesised. Results: Five peer-reviewed studies, three academic theses, and seven patent documents were included. Most available evidence originated from in vitro studies, with only one short-term clinical investigation identified. Endolysins and engineered derivatives demonstrated rapid bactericidal activity against C. acnes, including multidrug-resistant isolates, while several constructs exhibited minimal activity against selected commensal skin bacteria. Lysin-derived peptides retained activity under physiologically relevant pH and temperature conditions and in the presence of retinoic acid. Major translational challenges included limited stability of enzyme formulations, insufficient pilosebaceous unit penetration data, lack of anti-biofilm evidence and unstandardised microbiome assessment methods. Conclusions: Phage-derived endolysins represent a promising targeted therapeutic strategy for acne vulgaris. However, current evidence remains predominantly preclinical, and substantial translational barriers related to delivery, stability, safety, anti-biofilm efficacy, microbiome homeostasis, and clinical validation must be addressed before routine dermatological application. Full article

Background: Acne is a common inflammatory dermatosis with well-documented epidemiology in urban populations; however, data from rural sub-Saharan African settings remain limited. Objective: To characterize the demographic profile, clinical subtypes, severity spectrum, complications, and comorbidities of acne among patients attending a rural tertiary dermatology centre in the Eastern Cape, South Africa. Methods: A quantitative, retrospective cross-sectional study was conducted using census sampling of dermatologist-confirmed acne cases diagnosed between 2022 and 2025. Demographic and clinical variables were extracted from medical records and analysed using descriptive and inferential statistics (p < 0.05). Results: A total of 166 patients were included, all of African ethnicity. Females predominated (89.2%), yielding a female-to-male ratio of 8.2:1. Adult-onset acne was most common (85.5%), with a median onset age of 26 years. Acne vulgaris represented the predominant subtype (83.1%). Papules and comedones were the most frequent lesions, and facial involvement was nearly universal (94.8%). Moderate disease (Grade 2) was most prevalent. Post-acne complications were highly frequent (92.8%), with post-inflammatory hyperpigmentation being the most frequent of these (87.0%). Comorbidities were observed in 52.4% of patients, most commonly eczema and pigmentary disorders. Conclusions: Acne in this rural cohort demonstrated a predominance of adult-onset disease, marked female susceptibility, moderate severity, and a high burden of pigmentary sequelae. These findings highlight the need for context-specific diagnostic and management strategies in underserved rural populations. Full article

Introduction: Chronic dermatological diseases that appear in adolescence, such as acne vulgaris, atopic dermatitis, alopecia areata and psoriasis vulgaris, not only cause physical symptoms but also significantly affect young people’s quality of life, mental state, self-esteem and social relationships. Social media, especially information spread by influencers, significantly influences adolescents’ body image, health-related attitudes and even the quality of the physician-patient relationship. The aim of our study was to explore the relationships between dermatology-related quality of life, media use, health values, body image and self-esteem among adolescents with chronic dermatological diseases. Methods: In our cross-sectional, quantitative study, we used validated questionnaires (DLQI, EQ-5D-5L, IRVS, Attitude Scale, STAI-Y2, SWLS-H, Rosenberg Scale, BAT), which we supplemented with a media consumption questionnaire of our own design. Structured data collection took place between October 2024 and March 2025, with the participation of 208 adolescents aged 11–18. Data analysis was performed using SPSS 26.0 (Spearman’s correlation, Mann–Whitney test). Differences were considered significant at p < 0.05. Ethical approval: BM/22429-1/2024. Results: Acne vulgaris was the most common diagnosis (65%), followed by atopic dermatitis (22%) and psoriasis (11%). Over a quarter of the adolescents (27%) followed influencers who provided skincare advice. The mean daily screen time was 4.5 h, with 3.7 h on smartphones. A longer screen time was significantly correlated with poorer dermatological quality of life. Greater dermatology-related quality of life impairment (higher DLQI scores) was associated with poorer general quality of life (EQ-5D-5L). Following skincare-related influencers was significantly associated with dermatology-related quality of life and anxiety. Conversely, stronger health values were significantly linked to more favourable health behaviors. Conclusions: In this sample, greater dermatology-related quality-of-life impairment was associated with poorer psychosocial outcomes. Longer screen time was associated with poorer dermatology-related quality of life and less favourable psychosocial outcomes. The novelty of our study lies in the use of a self-developed media consumption questionnaire, which is suitable for the complex mapping of psychological and quality-of-life factors in adolescents. Full article

Acne vulgaris is a common chronic inflammatory disorder of the pilosebaceous unit that is increasingly recognized as a condition linked to systemic metabolic disturbances. Growing evidence suggests that alterations in lipid metabolism, both in sebum composition and circulating lipid profiles, may play a key role in acne pathogenesis. This narrative review aims to summarize current knowledge on the relationships between lipid metabolism, body composition, diet, and acne. Acne vulgaris should be considered not only a dermatological condition but also a disorder with metabolic components. A deeper understanding of lipid-related mechanisms may support the development of more personalized and metabolically targeted therapeutic strategies. Full article

Acne vulgaris is a prevalent inflammatory skin condition that requires accurate severity assessment for effective management. As a step toward more objective and reproducible severity assessment, this study developed an optimized transfer learning-based convolutional neural network (CNN) framework for facial acne severity classification using a restricted, imbalanced, non-public facial image dataset. A total of 442 frontal facial images were collected under natural lighting conditions. Acne severity was graded by a board-certified dermatologist using the Investigator’s Global Assessment (IGA) scale and categorized into three levels. The study systematically investigated model architecture selection, hyperparameter tuning, optimizer comparison, cross-validation, and class-imbalance handling through random oversampling, Synthetic Minority Over-sampling Technique (SMOTE), and Generative Adversarial Networks (GANs). The 5-fold cross-validation experiment supported the reliability of model performance across different data partitions, achieving an accuracy of 0.51. Resampling methods showed limited overall benefit, although some methods altered class-wise prediction patterns. To further examine model behavior, Gradient-weighted Class Activation Mapping (Grad-CAM) visualization was used to provide qualitative insight into the facial regions contributing to model predictions. Although the findings are limited by dataset size and diversity, the proposed framework suggests exploratory feasibility for automated acne severity assessment. Rather than serving as an immediately deployable clinical tool, this pipeline provides a preliminary baseline framework that requires further validation using larger, more diverse datasets, particularly to address subtle visual differences between acne severity classes. Full article

Background: Acne vulgaris affects up to 80% of individuals aged 11–30 years and frequently results in permanent scarring with significant psychosocial impact. This prospective single-arm case series evaluated the safety and high-frequency ultrasound-assessed morphological changes in a combined protocol integrating subcision, PEGDE-crosslinked hyaluronic acid supplemented with calcium hydroxyapatite (CaHA), and fractional 1470 nm diode laser therapy in patients with facial atrophic acne scars. Methods: Twenty patients (aged 18–42 years, Fitzpatrick phototypes I–II) with moderate-to-severe atrophic acne scars underwent subcision of fibrotic adhesions using a 22G cannula combined with a single subcutaneous injection of 2 mL PEGDE-crosslinked hyaluronic acid with CaHA microparticles on day 0, followed by two sessions of fractional 1470 nm diode laser therapy on days 7 and 28. Scar depth and diameter were assessed using high-frequency ultrasound (48 MHz) at baseline and on days 28, 49, 77, and 139. Results: All participants completed the protocol without serious adverse events. High-frequency ultrasound demonstrated progressive reductions in mean scar depth (from 0.35 to 0.05 mm; −86%) and scar diameter (from 4.27 to 1.06 mm; −75%) by day 139, with reductions continuing beyond the active treatment phase. In linear mixed-effects models accounting for within-patient clustering of the two lesions assessed per participant, the reductions in both depth and diameter were statistically significant at every follow-up timepoint relative to baseline (all p < 0.001). These ultrasound findings were not corroborated by a control group, blinded assessment, validated clinical grading, or patient-reported outcomes. Conclusions: In this single-arm case series, the combined subcision, PEGDE-crosslinked HA–CaHA filler, and fractional 1470 nm diode laser protocol was well tolerated and associated with progressive, sustained reductions in high-frequency ultrasound-measured scar depth and diameter. As an uncontrolled, unblinded study without validated clinical grading or patient-reported outcomes, these findings are preliminary and require confirmation in larger, controlled trials. Full article

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