Acne treatments: future trajectories

Area of Science:

• Dermatology and Microbiology
• Endocrinology

Background:

• Current acne treatments have limitations for long-term management of recalcitrant or relapsing acne.
• Key factors in acne pathogenesis include alterations in Cutibacterium acnes phylotypes and the insulin-like growth factor-1 (IGF-1) signaling pathway.

Purpose of the Study:

• To explore novel therapeutic targets and approaches for acne treatment.
• To discuss the potential of modulating the skin microbiota and insulin signaling for acne management.
• To highlight the importance of a holistic approach considering internal and external factors affecting acne.

Main Methods:

• Review of current literature on acne pathogenesis and treatment limitations.
• Analysis of emerging therapeutic strategies targeting microbial diversity and metabolic pathways.
• Discussion of the role of lifestyle, environmental, and psychological factors in acne.

Main Results:

• Loss of skin microbiota diversity and dysregulation of the IGF-1 pathway are potential therapeutic targets.
• Oral or topical probiotics and bacteriophages targeting specific C. acnes phylotypes show promise.
• Insulin-sensitizing agents like metformin and inositols are potential treatments, though further research is needed.
• A holistic approach integrating internal and external factors is crucial for comprehensive acne management.

Conclusions:

• Novel therapeutic strategies for acne involve targeting microbial dysbiosis and metabolic pathways.
• Probiotics, bacteriophages, and insulin-sensitizing agents represent promising avenues for future acne treatments.
• A comprehensive, patient-centered approach addressing lifestyle and psychological well-being is essential for effective acne management.