Acne is the most common skin disorder in adolescents with a prevalence of 80-85 percent. The problem starts when the hair follicles become clogged by androgen-induced increased sebum production, dirt and dead skin cells.
Sometimes, Propionibacterium acnes can also be present, leading to redness, swelling and pus. The combination of all these factors is acne, which includes whiteheads, blackheads, pimples and cysts.
Sebaceous glands are important regulators of inflammatory events in acne since they have the hormone-production enzyme machinery and express a wide range of receptors for sex steroids, retinoic acid, histamine, prostaglandins, corticotropin-releasing hormone, IGF-1, melanocortin-1 and growth hormones. Therefore, they have the ability to function similar to an endocrine gland.
Acne can be associated with a range of psychological problems, including: social withdrawal, decrease self-esteem, reduced self-confidence, poor body image, embracement, depression, anger, preoccupation, frustration and anxiety.
In terms of stages, acne can be mild, moderate or severe. Treatment strategies for acne can vary with the stage and intensity of the disease.
The treatment of choice for the mild and moderate acne is topical treatments, including antibiotics, retinoids and combination medications. However, in order to treat severe cases, systemic therapy is used, including oral antibiotics, oral retinoids and hormonal treatments.
Furthermore, there are some other treatment methodologies that may not fall under any of the above-mentioned categories, including laser resurfacing, dermabrasion, chemical peels, xenografts, heterografts, autograft and fat transplants.
There are a number of side effects that are demonstrated due to conventional treatments that leads to noncompliance. Some of these side effects include skin dryness, redness, peeling, irritation, bacterial resistance, itching and rash.
An effective acne treatment formulation should possess certain characteristics like controlled drug delivery, proper bidegradation, less expensive price, fewer side effects and enhanced penetration. There have been multiple efforts by different groups of researchers to create more effective novel acne treatment strategies, including novel particulate and vesicular carrier systems to deliver the active pharmaceutical ingredients (API) into the affected areas.
These delivery systems for topical acne treatment fall under three major categories: liposomes, polymeric microspheres and solid nanoparticles. Some of the novel carrier systems under investigation for application and treatment of acne include liposomes, niosomes, microsponges, microemulsions, microspheres, solid lipid nanoparticles (SLN), hydrogels, aerosols, fullerenes, lipospheres and nanostructured lipid carriers.
Same as any other treatments, there are advantages and disadvantages for these acne-treatment delivery systems. Some of their advantages include reduction of anti-acne drug irritancy, better efficacy, a more efficient penetration into the hair follicles and a higher local concentration over a prolonged period. On the other side, some of the disadvantages of these systems, include low drug-loading efficiency, drug leakage and variable stability.
Despite all the new advances in pathophysiology and molecular pathways triggering acne, there are still a lot of questions and the need for more effective treatments with fewer side effects is still present. Therefore, there is still a need for ongoing research at all levels to understand the acne molecular pathway better and come up with novel treatments based on the new findings.
