Acne vulgaris is a common chronic skin disorder that often begins in adolescence and may persist or appear later in life.. Acne lesions can differ from one another in terms of morphology and severity. Acne can lead to scarring and have an impact on an individual's mental health.
The aim of this thesis was to systematically review active ingredients used in the treatment of acne. Using a defined criteria, we searched the PubMed database for relevant articles. The findings are presented according to the type of therapy (topical or systemic) and further categorized based on their mechanisms of action. We primarily focused on agents already approved for clinical use.
A total of 51 articles were included in the thesis. We found 53 active ingredients available for treating acne. Among these, 30 are used topically, 36 systemically, with 13 agents that can be employed via both routes. Topical treatments include retinoids, antibacterial agents, chemical peels, and other actives (e.g. clascoterone, metformin, benzoyl peroxide). Systemic treatments comprise retinoids, antibacterial agents, oral contraceptives, and other active ingredients (e.g. nicotinamide, spironolactone, flutamide). Generally, topical agents are indicated for the treatment of mild acne, with benzoyl peroxide, topical retinoids, and azelaic acid being the most commonly used. Systemic therapy is intended for more severe cases or when topical therapy is unsuccessful. Among systemic options, tetracyclines (particularly doxycycline and lymecycline) are most commonly prescribed, along with isotretinoin. Some of the studies also discussed biological actives and plant-derived extracts (e.g. lavender extract, soy bean extract) that are not classified as active ingredients. Biological actives include chemical exfoliants (e.g. glycolic acid, retinoic acid) and dietary supplements (omega-3 and omega-6 fatty acids). Emerging therapeutic agents can resembleexistingtreatmentswithenhancedproperties.Othersrepresententirelynew mechanisms of action (eg. acetylcholine inhibitors, leukotriene inhibitors).
A wide range of therapeutic agents is available for acne treatment, offering diverse mechanisms of action and varying adverse effect profiles. With appropriate selection and individualized treatment involving combination therapies, acne can be effectively managed.
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