See also Skin Disorders See also Skin Care.
Introduction:
The disease of acne is characterized by a great variety of clinical leions. Aljthough one type of lesion may be predominant (typically the comedo), close oservation usually reveals the presence of several types of lesions (comedones, pustules, papules, and/or nodules). The lesions can be either noninflammatory or, more typically, iflammatory. (US 2004/0156873A1 to Gupta and assigned to Bioderm Research).
Definitions:
A comedone is a plugged hair follicle (skin pore) caused by a buildup of sebum (skin oil), dead cells (keratin) and sometimes bacteria.
Treatment: Most acne treatments are directed at preventing inflammatory lesionsk particulalry the larger nodul-cystic lesions that end to be destructive and lead to permanent scarring. In general, visible comdeones are the only minor cosmetic nuisances and do not lead to inflammatory lesions. Most acne treatment is directed to four areas: (1) Keratinous plugs in sebasceous ducts; (2) large sebaceous glands producing exess sebum; (3) increased numbers of resident follicular bacteria; and (4) inflammatory response to chemical mediators passing through the follicular wall. (US 2004/0156873A1 to Gupta and assigned to Bioderm Research).
–Antiobiotics: A number of topical and systemic agents are used to lower the number of bacterial that colonize the follicular duct. These include benzoyl peroxide (BP, BP 5% erythromycin 3% (Benzamycin). Systemic antiotics inclduetetracycline and its analogs, which are used in low doses for years or until the end of the acne prone years. A comedone is a plugged hair follicle (skin pore) caused by a buildup o
–Retinoids: The treatment of acne centers on operning the pore, kiilling P. acnes, reducing sebum produciton and regualting inflammatory resposnes. Retinoids are the agents to reduce sebum production and open the por. As a topical agent, Differin (adapalene) or Retin-A (tretinoin) is used for mild and moderate acne. A comedone is a plugged hair follicle (skin pore) caused by a buildup o
—-Tretinoin: Topical products used to remove comedones are known as comedolytics, the most effective being tretinoin, marketed as a prescription porduct (RetinA). Tretinoin or all-trans retinoic acid is the naturally corruing metabolite of Vitamin A. Tretinoin increases epidermal cell turnover, thus causing comedolysis and most importantly prevetns the promation of new keratenous plugs. Applications of retinoin are normally once a day at bedtime. Improvement is usually not seen for 6-8 weeks. Adapalene 0.1% (Differin) is a topical retinoid like tretinoin. Avaialbe by presecription only, the gel is usually applied once nightlhy. (US 2004/0156873A1 to Gupta and assigned to Bioderm Research).
Acne vulgaris:
Introduction:
Acne affects more than 50 million people in the US. P. acnes, a gram-positive bacterium, is strongly associated with acne vulgaris. The inflammatory stage of acne vulgaris is the greatest concern to patients, as the lesions produced may lead to scarring.
Causes/Etiology Agents:
—Propionibacterium acnes (P. acnes) is an important skin commensal, but it is also considered a pathogenic factor in several diseases including acne vulgaris. Type IA-2 (primarily ribotype 4 [RT4] and RT5) strains have been associated with acne, while type II strains, in particular RT6 and some RT2 strains, have rarely been found in acneic skin or are found to produce low pro-inflammatory metabolites and thus are defined as health-associated strains in the context of acne.
Treatment:
Systemic therapies for acne target P. acnes using antibiotics or target the follicle with retinoids such as isotretinoin. A majority of current therapies to treat acne are formulations of generic compounds such as topical antibiotics, retinoids, benzoyl peroxide, and salicylic acid.
—Systemic antibotic treatments have limitations in that they may kill skin bacterial non-specifically impacting the homeostasis of resident dermal microflora. Oral antibiotics also contain the risk of harming intestinal microflora.
—Istretinoin, 13-cis-retinoic acid, is a vitamin A-derived retinoid that has been widely prescribed for systemic treatment of severe acne. Although it was first approved in the US in 1982 for treating severe acne, it suse has become tighly regulated.
—Sialidase inhibitors: Adherence of P. acnes to human sebocytes has been shown to be augmented after removal of sialic acids form the cell surface and that acne progression and recurrence can be effectively prevented by antibodies against sialidase of P. acnes.
–Synthetic Bacteria:
Taylor US 20190336542 discloses synthetic bacteria that have been modified to affect metabolic pathways rendering the bacteria non-pathogenic. In certain instances these are modifications at the genetic level and involve deleting, in whole or in part, disrupting, inactivating or modifying a gene that affects a step in metabolic pathway, such as, for example the porphyrin pathway. In some embodiments, the gram positive bacteria comprises Propionibacterium acnes, Staphylococcus epedermidis, Staphylococcus auereus, or a combination thereof. In some embodiments, the synthetic bacteria inhibits production of pro-inflammatory neuropeptides in the patient. In some embodiments, the one or more biomolecules produced by the synthetic bacteria is an antioxidant selected from vitamin A, vitamin C, and vitamin D. In another aspect of the disclosure, provided herein is a synthetic bacteria derived from a non-pathogenic bacteria, the synthetic bacteria adapted to secrete a TNF-alpha inhibitor and an interleukin-8 inhibitor. The synthetic bacteria are useful for the treatment of a variety of disorders and diseases, including skin-related disorders such as acne, psoriasis, eczema, rosacea, and seborrheic dermatitis.
Acne Scares:
CO2-Skin Resurfacing:
Sublative™ fractionated bi-polar radio frequency technology places the heat energy effectively into the upper dermis where it can produce a significant increase in both collagen and elastin with minimal epidermal disruption.syneron-and Candela