title: Novel pharmacological approaches for the treatment of acne vulgaris.
abstract: BACKGROUND
  Acne vulgaris is the most common skin disease worldwide; yet, current treatment options, although effective, are associated with unwanted side effects, chronicity, relapses and recurrences. The adequate control of the four pathogenic mechanisms, involved in the appearance of acne lesions, is paramount to treatment success.
  
  
  METHODS
  The authors discuss and evaluate the pathogenic pathways related to the mechanisms of action of novel molecules, which are currently under investigation for the treatment of acne vulgaris. The manuscript is based on comprehensive searches made through PubMed, GoogleScholar and ClinicalTrial.gov, using different combination of key words, which include acne vulgaris, pathogenesis, treatment, sebogenesis and Propionibacterium acnes.
  
  
  CONCLUSIONS
  In the near future, more effective treatments with fewer side effects are expected. The use of topical antiandrogens, acetylcholine inhibitors and PPAR modulators seem to be promising options for controlling sebum production. Retinoic acid metabolism-blocking agents and IL-1α inhibitors have the potential to become legitimate alternative options to retinoid therapy in the management of infundibular dyskeratosis. Indeed, the authors believe that there will likely be a decline in the use of antibiotics for controlling P. acnes colonization and targeting the inflammation cascade.
authors.affiliation: Private Dermatology Practice , Manzanas 44, Piso 5, Col. Tlacoquemecatl, Del. Benito Juarez, 03200 DF México, Mexico City , Mexico +5215510056226 ; cristinavalente@me.com.
authors.forename: Isabel Cristina
authors.initials: IC
authors.lastname: Valente Duarte de Sousa
mesh_terms: D000152:Acne Vulgaris / Q000188:drug therapy* / Q000382:microbiology / Q000473:pathology; D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003879:Dermatologic Agents / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D015195:Drug Design; D006801:Humans; D007249:Inflammation / Q000188:drug therapy / Q000473:pathology; D011425:Propionibacterium acnes / Q000302:isolation & purification; D012008:Recurrence; D012629:Sebum / Q000187:drug effects / Q000378:metabolism
chemical_list: D000900:Anti-Bacterial Agents; D003879:Dermatologic Agents
keywords: PPARs; Propionibacterium acnes; acne vulgaris; antiandrogens; antimicrobial peptides; comedo; melanocortin receptor antagonist; monoclonal antibodies anti-IL-1α; retinoic acid metabolism-blocking agents; sebogenesis