Background/Objectives: Antibiotics are commonly used for acne treatment. However, increasing bacterial resistance has prompted interest in natural antimicrobial agents, such as thymol (THY), as alternative therapies. This study investigated the effectiveness of Leciplex cationic nanovesicles encapsulating thymol (LPX-THY) as a promising topical acne management strategy. Methods: Leciplex nanovesicles were assembled using soy phosphatidylcholine (SPC) and cationic surfactants and characterized in terms of particle size, zeta potential, entrapment efficiency, morphology, in vitro release, and ex vivo skin permeation. The optimized formulation was subsequently incorporated into Carbopol/HPMC gel base and evaluated in terms of viscosity, in vitro release, ex vivo skin permeation, in vitro antimicrobial study, and in vivo assessment in a rat model. Results: Optimal THY-LPX nanovesicles made of SPC and Dimethyldidodecylammonium bromide DDAB in a 1:1 molar ratio showed circular outline with particle size, zeta potential, and entrapment efficiency of 187.7 ± 1.78 nm, 36.97 ±0.21 mV, and 60.5 ± 2.3%, respectively. THY-LPX gel demonstrated minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) at a concentration of 156.25 µg·mL[-1] against Staphylococcus aureus, a clear absence of biofilm coating under SEM, and substantial red fluorescence, indicating reduction in viable bacteria under a confocal laser microscope. In vivo study showed enhanced anti-inflammatory effect evidenced by substantial ear skin thickness reduction; 72.7% for THY-LPX gel-treated rats compared to 41.7% and 20% for THY gel and blank LPX gel-treated groups, respectively. Histopathological investigation further confirmed reduced inflammatory response in rats treated with optimized THY-LPX gel. Conclusions: The developed THY-LPX gel serves as a potential topical delivery platform of THY for acne therapy.

Pediatric hidradenitis suppurativa is a chronic relapsing skin disease that peaks in adolescence and is often misdiagnosed. Clinical diagnosis is made by identifying recurrent, painful nodules in flexural sites that have risk of tunneling and scarring. Initiate education, gentle skin care, and topical therapy while adding age-appropriate oral antibiotics when indicated. Screen for comorbidities and refer early to dermatology for medical management as well as procedural and biological treatments.

Antimicrobial use among children in Japan has declined substantially; however, tetracycline use has increased among adolescents, particularly after 2017 and during the COVID-19 period, and the underlying clinical indications remain unclear. We aimed to characterize long-term trends in oral tetracycline use, changes in clinical indications, and treatment patterns among individuals aged < 20 years in Japan. We conducted a time-series analysis using a nationwide administrative claims database of Japan Health Insurance Association from 2015 to 2023, including 24 million individuals aged < 20 years. Oral tetracycline use was measured as days of therapy (DOTs) per 1000 inhabitants per day, and clinical indications were identified using ICD-10 codes. We assessed trends in tetracycline use and indications over time and described treatment patterns, including concomitant therapies, among patients with acne vulgaris. Oral tetracycline use increased from 0.95 to 1.76 DOTs per 1000 inhabitants per day between 2015 and 2023, primarily driven by doxycycline, with a marked rise after 2020 and highest use among adolescents. The clinical indications shifted substantially, with the proportion of acne vulgaris increasing from 34.1% to 73.6% while respiratory infections decreased, and the mean treatment duration for acne was 37.9 days. Among patients with acne, concomitant use of adapalene- and benzoyl peroxide-based therapies was limited, whereas topical antibiotics were commonly used. Oral tetracycline use among individuals aged < 20 years in Japan increased substantially, with a marked shift in clinical indications toward acne vulgaris. These findings provide a basis for further evaluation of acne treatment patterns, including the use of oral tetracyclines and non-antibiotic topical therapies, in Japan.

Acne vulgaris is a chronic inflammatory skin disorder in which Cutibacterium acnes contributes to disease persistence through biofilm formation, lipid metabolism, and production of inflammatory metabolites within the pilosebaceous unit. Targeting bacterial physiological pathways that sustain these processes represents a potential therapeutic strategy beyond conventional antibiotic approaches. In this study, we evaluated a panel of halogenated indole derivatives and identified 6-bromo-4-iodoindole as a potent inhibitor of C. acnes growth and biofilm formation. The compound exhibited a minimum inhibitory concentration of 20 μg/mL and disrupted biofilm architecture. Further analyses revealed that treatment markedly altered several virulence-associated phenotypes, including reductions in extracellular lipase activity, cell-surface hydrophobicity, extracellular polymeric substance production, and porphyrin levels, accompanied by increased intracellular reactive oxygen species. Because lipase activity plays a central role in sebum metabolism and follicular colonization by C. acnes, molecular docking was performed to evaluate potential target engagement. Docking simulations suggested that 6-bromo-4-iodoindole occupies the catalytic pocket of C. acnes triacylglycerol lipase, providing a structural basis for the observed suppression of lipase-dependent phenotypes. Importantly, the compound retained biofilm inhibitory activity in polymicrobial C. acnes + Staphylococcus aureus biofilms, exhibited broad-spectrum growth inhibition extending to S. epidermidis, and significantly reduced bacterial recovery in an ex vivo porcine skin model. In silico pharmacokinetic analyses further indicated physicochemical properties compatible with localized topical delivery. Together, these findings demonstrate that a dihalogenated indole reduces lipase-associated virulence related phenotypes in C. acnes and suppresses biofilm formation in skin-relevant environments, supporting further investigation of this scaffold as a therapeutic strategy targeting acne-associated microbial physiology.

Acne vulgaris is a chronic inflammatory disease of the pilosebaceous unit, affecting 9.4% of the population globally, and is one of the most prevalent dermatoses globally. It is most common in adolescents but can continue through adulthood, causing physical and emotional health deterioration. Acne is a multifactorial process involving genetic factors, hormonal factors, sebum production, hyperkeratinization of the follicular lumen, colonization by Cutibacterium acnes bacteria and inflammation [Ma2.1]. Inflammation is now recognised as a critical process from microcomedone formation to the development of inflammatory lesions and scarring, with emerging evidence of the role of epigenetic changes. Conventional therapeutic approaches include topical retinoids, benzoyl peroxide, topical and systemic antibiotics, and hormonal therapies. Nonetheless, they have a low efficacy due to antimicrobial resistance and side effects. New therapies are also focusing on new pathways such as nitric oxide donors, cytokine suppressors, leukotriene suppressors, biologics, as well as optimized retinoid regimens. Plant-based medicines are becoming a popular complementary form of medicine because of their antimicrobial and anti-inflammatory effects. Extracts from Aloe vera, Azadirachta indica, Camellia sinensis, Rosmarinus officinalis, cannabidiol, and Withania somnifera have shown promise against C. acnes and inflammation. Nanotechnology-based vehicles include liposomes, niosomes, ethosomes, and nanofibers, which improve drug stability, penetration, and controlled delivery to increase efficacy and improve tolerance. The paper combines the pathophysiology of acne vulgaris and traditional approaches to treatment with new herbal-based therapeutics and drug delivery systems based on nanocarriers as complementary approaches to enhance the effectiveness, safety, and targeting of follicles. The article provides a targeted system of interconnection between disease processes and developed delivery systems and phyto-medicine interventions to manage acne optimally.

The topical treatment of acne vulgaris by a single therapeutic is difficult given the multifaceted causes of the disease. Treatment with photo-responsive nitric oxide (NO) donors and light represents an attractive alternative to conventional therapeutics due to the potential for multimodal therapeutic action against downstream acne processes. Herein, a topical hyaluronic acid (HA) formulation was developed to facilitate localized NO delivery from mesoporous silica nanoparticle (MSN) NO donors upon blue light exposure, while simultaneously providing anti-inflammatory activity. The NO release was tunable (0.09-0.51 µmol NO mg[-1]) depending on wavelength, with shorter wavelengths and greater irradiances providing more efficient photolytic liberation. Antibacterial activity and cytocompatibility were directly modulated by photolytic NO release and payload, where NO was determined to be the primary antibacterial agent and large, initial NO bursts led to preservation of cell viability. Incorporation of the MSN-based NO donors into an HA formulation afforded additional metabolic and immunomodulatory behavior in vitro, demonstrating potential to decrease sebum production and inflammation in acne vulgaris. Blue light-mediated NO release from the HA formulation presents a multifunctional therapeutic platform that addresses key contributing downstream factors of acne.

Acne is an inflammatory dermatological disorder largely caused by Cutibacterium acnes (C. acnes), which primarily affects the face, neck, chest, and back, leading to skin impairment. This condition is often associated with post-inflammatory erythema, hyperpigmentation, and scarring, as well as psychosocial and emotional distress. Based on the major pathological characteristics of acne with microbiome colonization, and multiple immune responses, we selected doxycycline, a common clinically used antibiotic and anti-inflammatory drug, and epigallocatechin gallate (EGCG), a polyphenol, to construct topically applicable nanoparticles (NPs). The resulting doxycycline-EGCG (DE) NPs significantly reduced the proportion of dead cells in C. acnes-induced HaCaT cells and demonstrated excellent anti-inflammatory effects through inhibition of NF-κB and STAT3 pathways compared to doxycycline alone. Moreover, the DE NPs exhibited better antibacterial efficacy against C. acnes along with improved antioxidant capacity than doxycycline. In an acne-like mouse model, the DE NPs also effectively suppressed skin inflammation and reduced inflammatory cytokine expression. Overall, this work presents a co-assembly strategy driven by covalent and non-covalent interactions, affording polyphenol-based doxycycline NPs with potent anti-inflammatory, antioxidant and antibacterial properties, and offering new opportunities for safe and effective acne local therapy.

Acne is an inflammatory condition that can affect quality of life. New topical treatments include tazarotene lotion, trifarotene, combined microencapsulated benzoyl peroxide and tretinoin, minocycline foam, topical dapsone, and clascoterone cream. More recent systemic options include subantimicrobial doxycycline, sarecycline, combined oral contraceptives, spironolactone, and isotretinoin-lidose.

Acne vulgaris is a chronic inflammatory skin disease aggravated by Cutibacterium acnes (P. acnes). Conventional drug delivery treatments researchers reported irritation, resistance and poor efficacy. Poor skin permeability, along with oxidative degradation hindering its efficacy on Dermal drug delivery application.

Acne vulgaris is a chronic inflammatory condition primarily caused by Cutibacterium acnes, which disrupts skin homeostasis, thereby triggering immune responses and sebum metabolism. Dysbiosis is an imbalance in the skin and gut microbiota identified as a significant factor contributing to acne progression. Standard therapy often relies on antibiotics, but the long-term use has increased antibiotic resistance, including in Indonesia. Consequently, alternative methods, such as probiotics and mesenchymal stromal cell secretomes, are gaining attention for immunomodulatory and regenerative properties. These novel therapies have shown promising results in modulating the skin and gut microbiota while reducing inflammation.

Dissecting cellulitis of the scalp (DCS) is a cicatricial alopecia characterized by follicular occlusion that progresses to abscess formation and rupture, driven by an intense inflammatory cascade. Part of the follicular occlusion tetrad, DCS typically presents with painful nodules and interconnecting sinus tracts localized to the scalp. Treatment of this recalcitrant disease is difficult, and there is a need for efficacious and durable therapies that control inflammation and address the underlying pathophysiology of disease. Here is the first reported use of bimekizumab, a dual inhibitor of interleukin (IL)-17A and IL-17F, as monotherapy for the management of DCS. The patient was a male aged 27 years who presented with difficult-to-treat DCS and hair loss. After failing to achieve symptomatic control with standard treatments such as oral antibiotics, aggressive topical therapy, and intralesional steroids, the patient received bimekizumab (320 mg subcutaneously every 2 weeks through week 16, and 320 mg every 4 weeks thereafter). At the 16-week follow-up, the patient reported no symptoms of DCS or adverse events from treatment. The outcomes from our case report provide evidence supporting the inhibition of IL-17A and IL-17F for the treatment of DCS to address the underlying inflammatory mechanism, reduce symptoms, and help patients achieve control over their disease and improve their overall quality of life.