Understanding innate immunity and inflammation in acne: implications for management

Area of Science:

• Dermatology
• Immunology
• Microbiology

Background:

• Acne pathogenesis involves sebum production, abnormal keratinization, and Propionibacterium acnes-induced inflammation.
• Inflammation is a key feature across all acne lesion types, from microcomedones to scarring.
• The innate immune system's role in acne is increasingly recognized.

Purpose of the Study:

• To highlight the anti-inflammatory properties of topical retinoids in acne management.
• To advocate for combination therapy with topical retinoids and antimicrobials as a first-line treatment for acne.
• To emphasize reducing reliance on oral antibiotics due to antimicrobial resistance concerns.

Main Methods:

• Review of molecular and cellular studies on acne pathogenesis.
• Analysis of clinical trial data supporting combination therapy.
• Consideration of global recommendations for acne treatment.

Main Results:

• Topical retinoids possess significant anti-inflammatory effects.
• Combination therapy with topical retinoids and antimicrobials is a well-established first-line treatment.
• Reducing antibiotic use is crucial in the context of antimicrobial resistance.

Conclusions:

• Inflammation is central to acne and requires multifaceted therapeutic strategies.
• Topical retinoids combined with antimicrobials offer an effective and responsible first-line acne treatment.
• Understanding P. acnes and innate immunity can refine future acne treatment protocols.