ABSTRACT
OBJECTIVE: Comparatively little attention has been paid to the role of free radical oxidation in acne vulgaris. Here, using the traditional abnormalities cited for acne, the authors address the role of free radical oxidation throughout the pathogenesis by detailing the chemistry that may contribute to clinical changes. To probe the effects of free radical oxidation and test an antioxidant, they conducted a preliminary study of topically applied vitamin E. METHODS: Seventeen patients with mild-to-moderate acne vulgaris were evaluated over an eight-week period in two private dermatology practices in this open-label study. All patients enrolled were on the same baseline regimen of salicylic acid and benzoyl peroxide. This regimen was then supplemented with topical vitamin E in sunflower seed oil. RESULTS: At the end of the eight-week period, all patients demonstrated clinical improvement, as indicated by a reduction in the number of lesions and global mean difference. A statistically significant reduction was noted as early as Week 2. Enrolled patients also expressed a positive experience due to good tolerability and easy application. CONCLUSION: Although the exact pathogenesis of acne vulgaris remains unknown, the presence of excessive reactive oxygen species can be implicated in each of the major abnormalities involved. This presence, along with the positive results of the authors' preliminary study, demonstrates the need for more exploration on the use of topical antioxidants in limiting free radical oxidation in the acne model. This paper is designed to stimulate academic discussion regarding a new way of thinking about the disease state of acne.
ABSTRACT
The 21-day cumulative irritation test for assessing the irritancy of topical products and chemicals is a venerable procedure that appears to have become the gold standard for manufacturers. Berger and Bowman in 1982 (1) showed that reducing the exposure to 14 days was less traumatic to the volunteers, less costly, less arduous, and did not affect reliability or the capacity to place the test agents in the proper rank order of irritancy. In the current study we compared (a) the 21-day cumulative irritation test, (b) the 14-day cumulative irritation test, and (c) the 14-day test with every-other-day patching. Additionally, ten-day, seven-day and four-day data from the 21-day test were compared. Forty-one subjects completed this study of six test materials. Two sets of patches were applied to each subject' lower back. One set had 21 consecutive applications of the test articles. The second set was applied, and removal of the test articles occurred Monday, Wednesday, and Friday for 14 days. The 21-day test fully differentiated the test materials from each other. Using only the first 14 days of the 21-day test also fully differentiated the test materials. Every-other-day patching rank ordered the test materials the same as the everyday patching, but full differentiation of the test materials was not obtained. We conclude that the 14-day cumulative irritancy test is as reliable and sensitive as the 21-day test, along with the obvious advantages in time, cost, and minimization of trauma to the test subjects.
