Acne is very common skin problem among adolescents and young adults in 11-30 age group. More correctly acne is known as Acne vulgaris. Vulgaris is the scientific word for common acne. So represent pimples which are commonly seen.
Acne vulgaris is a chronic inflammatory disease of pilosebaceous gland. It is characterised by the appearance of lesions of the hair follicle and sebaceous gland(a small gland in the skin secretes oil or sebum to lubricate hair and skin). Acne mostly affects the face but in some cases may also affect the back area below the shoulder and even hands and neck.
Acne is a result of androgen (male sex hormone) induced:
- increase sebum production
- altered keratinization
- bacterial colonisation of hair follicles
Acne is characterized by oily skin, non-inflammatory lesions called as comedones (open and closed), inflammatory lesions called as papules and pustules, and various degrees of scarring. Acne can be of varying type some of them are:
- Superficial lesions – blackheads, whiteheads, small tender red bumps, white or yellow squeezable spots.
- Deeper lesions – large painful red bumps.
- Secondary lesions – scars, dark marks from old spots.
Acne and facial scarring due to acne can persist from adolescence to adulthood and can cause detrimental effects on the self-esteem of any individual suffering from the disease.
Acne can also be graded on the basis of their severity, they can be:
- Mild acne – non-inflammatory superficial lesions with very less population.
- Moderate acne – mostly non inflammatory lesions with few inflammatory deeper lesions.
- Severe acne – a very large population of inflammatory deeper lesions.
Many treatments for acne are now available in the market based on topical therapies such as benzoyl peroxide, retinoids, antibiotics with alcohol based preparation, and salicylic acid, but these can cause skin irritation and dryness. Both skin irritation and dryness can lead to inflammation and increased water loss. So these treatments are not preferred by every person.
What happened in the study?
This study was conducted to compare the effect of tretinoincream (0.05%) and Aloe vera topical gel (50%) with tretinoin and vehicle (moisturizer). The main focus of the study was on the count of lesions and tolerance of treatment in the person.
It was a randomized and double blind study i.e. neither the patient was aware of the kind of treatment he was given nor the experimenters.
The study was conducted on 60 persons with a mild and moderate level of acne vulgaris for 8 weeks. Then person was analysed for inflammatory and non-inflammatory lesions and the tolerability of treatment.
Aloe vera gel was prepared from aloe vera leaf using different formulations and the most stable gel was selected using physiochemical evaluations to conduct the study.
The goal was to score reduce in inflammatory and non-inflammatory lesions after treatment.
What were the results of the study?
The result of the study shows that aloe vera with tretinoin was more effective in reducing lesions and this treatment also reduce chances of major side effects like persistent irritation or redness of the skin (erythema).
The combination therapy of aloe vera gel with tretinoin shows better efficacies than tretinoin cream alone or with some placebo. It was also observed that scaling cause the most adverse cutaneous effect on the patient with acne vulgaris.
After the treatment with combined therapy of aloe vera with tretinoin, the participants showed more than 80% decrease in the total score of lesions and possibility of erythema than the participants who were given the only tretinoin with placebo.
After four weeks an overall reduction in inflammatory and non-inflammatory lesions was found. Redness and inflammation were also reduced more significantly in aloe vera patient than with only tretinoin patients.
Hence from the result, it can be concluded that combination therapy of aloe vera with tretinoin was more tolerated and significantly more effective than tretinoin treatment with some vehicle for the treatment of mild and moderate level of acne vulgaris.
How did this occur?
Tretinoin is a retinol which is used to treat acne. It keeps the skin pores clear so that chances of inflammation are reduced due to a collection of dust particles and bacteria in skin pores.
It can also be used for other skin related conditions like sun burn, fine wrinkles, dark spots, rough skin etc. It functions by replacing the old skin with the new one and lightening the skin. It slows down the way skin cells are removed from the body which is harmed by the sun.
However, its action is not permanent and sometimes even increase the damage to the skin. It also has major side effects which are very common. Various side effects include skin redness, peeling, itching, blistering, crusting, or swelling which may persist longer.
So to lighten the severe effect of tretinoin it should be the best use with some skin protecting and caring agent. Moisturizers were used earlier but show very fewer efficacies than aloe vera.
Aloe vera was listed as a skin protectant by the U.S. pharmacopoeia in 1820 . It is the only herbal plant which is still used in western society as medicine.
The Aloe vera gel contains a polysaccharide named acetylated mannan (acemannan) possesses biological activity. It appears to be a superb emollient with moisturizing capabilities and hence very effective for the treatment of skin disease.
It has been observed in a study that aloe vera show humectant mechanism when improving the skin moisture. It increases the water content of the skin layers and did not cause any transepidermal water loss. In another study, aloe vera shows anti-inflammatory effects on long term use.
The retention of water and hydration balance in skin ensures skin elasticity and flexibility and help skin to heal easily from minor damage like mild acne.
In another study (based on sodium lauryl sulphate exposure test) conducted to check the effect of aloe vera gel on erythema (redness), it was found that aloe vera gel has very high anti-erythema effect as compared to other placebo gels.
It has been also seen in a study that aloe vera inhibit cyclooxygenase (a common enzyme in inflammation pathway) and hence possess potent anti-inflammatory, antioxidant properties.
What does this mean?
The anti-erythematic, anti-inflammatory and hydrating property of skin improve the skin quality and also treat acne vulgaris. Use of aloe vera with tretinoin prevents any side effect like erythema caused due to sensitivity or overdose of tretinoin.
Daily use of aloe vera gel with tretinoin for 8 weeks can help in getting rid of acne completely and keep skin hydrated and healthy.
So a moisturizer with aloe vera extract is worth buying.
Read full article on: https://www.ncbi.nlm.nih.gov/pubmed/23336746