Interaction and efficacy of Keigai-rengyo-to extract and acupuncture in male patients with acne vulgaris: A study protocol for a randomized controlled pilot trial

<p>Abstract</p> <p>Background</p> <p>In consideration of patients seeking to use traditional Chinese medicine, an evidence-based potentiality for safe and effective use of herbal medicine and acupuncture in treatment of acne vulgaris has been suggested. However, despite common use of a combination of herbal medicine and acupuncture in clinical practice, the current level of evidence is insufficient to draw a conclusion for an interaction and efficacy of herbal medicine and acupuncture. Therefore, considering these methodological flaws, this study was designed to assess the interaction and efficacy of an available herbal medicine, Keigai-rengyo-to extract (KRTE), and acupuncture for treatment of acne using the 2 × 2 factorial design and the feasibility of a large clinical trial.</p> <p>Methods/Design</p> <p>A randomized, assessor single blinded, 2 × 2 factorial pilot trial will be conducted. Forty four participants with acne vulgaris will be randomized into one of four groups: waiting list group (WL), KRTE only group (KO), acupuncture only group (AO), and KRTE and acupuncture combined treatment group (KA). After randomization, a total of 8 sessions of acupuncture treatment will be performed twice a week in the AO- and KA groups, respectively. Patients in the KO- and KA groups will be prescribed KRTE 3 times a day at a dose of 7.4 g after meals for 4 weeks. The following outcome measurements will be used in examination of subjects: the mean percentage change and the count change of inflammatory and non-inflammatory acne lesions, the Skindex 29, visual analogue scale (VAS) and investigator global assessment (IGA) from baseline to the end of the trial.</p> <p>Trial Registration</p> <p>The trial is registered with the Clinical Research Information Service (CRiS), Republic of Korea: KCT0000071.</p

RALGA (Diacneal((R))), a retinaldehyde and glycolic acid association and postinflammatory hyperpigmentation in acne - A review

Acne vulgaris affects 3 out of 4 adolescents and usually vanishes at the end of puberty with either no sequelae or mild to moderate sequelae, such as postinflammatory hyperpigmenation (PIH), which may result in psychological and emotional damages. The poor tolerability of the actual treatments (secondary inflammation) is a hindrance to therapy. Retinaldehyde (RAL), a precursor of retinoic acid, has shown depigmenting activity. Glycolic acid (GA) decreases the excess of pigment by a wounding and re-epithelization process. Thus, a synergistic effect was expected from the combination of RAL 0.1% and GA 6% RALGA (Diacneal(R)) in the treatment of acne vulgaris and PIH. Efficacy results of preclinical and clinical trials tend to confirm the expectations for both acne and PIH treatment. A good tolerability was observed. In conclusion, the cosmetic cream Diacneal is a well-tolerated treatment for the prevention and healing of PIH in acne patients. Copyright (C) 2005 S. Karger AG, Base

Why and when the treatment of acne fails - What to do

The majority of acne patients show a good response to the proper acne treatment. However, a small percentage not exceeding 10-15% do not respond as satisfactorily as expected. The main reason for the treatment failure is the poor patient compliance. In order to improve the patient compliance the strategy for the treatment of acne has to be carefully planned and includes the following: discussion before treatment; give clear instructions; explain the rhythm of improvement; explain the role of cosmetics; explain the role of sunbathing; explain the expected side effects. It has to be emphasized that all acne cases can be adequately controlled if the relationship between doctor and patient has been built on trust and confidence, maximizing the patient compliance