Serum lipid profile in adolescents and adults with acne vulgaris receiving isotretinoin.

Background: Acne vulgaris is a chronic, inflammatory disease and one of the most common skin diseases. Isotretinoin is the best treatment for severe nodulocystic acne compared to other systemic medicine. Although serum lipids elevation is one of the side effects of this medicine; recent studies have shown controversial results. This study aimed to assess the serum lipid profile in adolescents and adults with acne vulgaris receiving isotretinoin. Methods: This is a cross-sectional study on 65 adolescents and adults older than 16 years old (55 females and 10 males) with moderate to severe degrees of acne vulgaris under a fixed low dose of 20 mg/day Isotretinoin treatment for 120 days. We analyzed the data using the SPSS software Version 16 using paired sample t-test, Wilcoxon, and ANCOVA test. Results: In this study, 65 records of patients with a mean age of 22.21±6.25 years were assessed. There was a significant elevation in Cholesterol and LDL levels, but in HDL and triglyceride levels no significant change occurred. A significant change in cholesterol levels was noticed in the adolescent age group, the female sex, and the normal weight group. Triglyceride had a significant change in the female sex and normal weight group and HDL significantly increased in male patients. Conclusion: Although a low dose of isotretinoin can be used with minimal concern for changes in lipid profile in acne vulgaris patients, in the long-term follow-up and treatment, it seems that we have to administer it cautiously.

Effectiveness of Standard Therapy for Acne Vulgaris Based on Clinical Practice Guidelines in Indonesia.

Purpose: To evaluate the effectiveness of standard therapy for acne vulgaris based on Indonesian guidelines. Patients and Methods: New patients with acne vulgaris at Dr. Cipto Mangunkusumo National Central General Hospital, the national referral center in Indonesia, who met the criteria were included in this study. Patients were treated with standard therapy for acne vulgaris based on the 2017 guidelines of Dr. Cipto Mangunkusumo Hospital, depending on severity. Changes in the number of non-inflammatory, inflammatory, and total lesions and the proportion of acne severity after three months of therapy were analyzed retrospectively. Results: Among the 131 subjects, 63.4% had moderate acne; 20.6% had mild acne, and 16% had severe acne at baseline. Most patients (29 (22.2%)) received a combination of retinoic acid, benzoyl peroxide, and topical or oral antibiotics. Standard therapies reduced the median of non-inflammatory (25 (5-135) vs 8 (0-53)), inflammatory (10 (0-93) vs 2 (0-22)), and total lesions (41 (10-160) vs 10 (1-71)) at week 12 (all p < 0.001). The proportion of acne severity differed significantly after three months, with an increasing proportion of mild acne (20.6% vs 93.1%) and a decreasing percentage of moderate and severe acne (moderate = 63.6% vs 6.1%; severe, 16% vs 0.8%; p < 0.001). Conclusion: Standard therapy for acne vulgaris based on the clinical practice guidelines in Indonesia improved acne lesions and severity after 12 weeks. These results support the implementation of national guidelines for acne management in Indonesia, with the practice of improving antimicrobial stewardship.

No genetic causal relationship between acne and prostate cancer through Mendelian randomization combined with meta-analysis.

Background: Previous observational studies regarding the relationship between acne and prostate cancer have reported inconsistent results. As such studies are prone to biases, we conducted this Mendelian randomization (MR) analysis to better explore the causal association between acne and prostate cancer. Methods: The genetic data for assessing acne were acquired from the largest genome-wide association study (GWAS) of acne by far, and the genetic data for assessing prostate cancer were acquired from the FinnGen consortium, UK Biobank, European Bioinformatics Institute, and IEU OpenGWAS project. We performed two-sample MR analyses using data from these GWASs followed by a meta-analysis to provide an overall evaluation. The primary MR methods used included inverse variance weighted, MR-Egger, and weighted median. Leave-one-out sensitivity tests, Cochran's Q tests, and MR-Egger intercept tests were used to bolster the robustness of the MR results. Results: Through MR combined with meta-analysis, our study found no genetic causal relationship between acne and prostate cancer (p=0.378; odds ratio=0.985; 95% confidence interval, 0.954-1.018). Sensitivity tests ensured the robustness of this result. Conclusion: Acne should not be considered as a morbidity hazard factor for prostate cancer.

A complex case of PASH syndrome: pyoderma gangrenosum, acne, suppurative hidradenitis, and Crohn's disease in a 36-year-old smoker.

Introduction and importance: PASH syndrome, is autoinflammatory condition driven by immune system dysfunction, resulting in elevated interleukin 1 levels and subsequent production of proinflammatory cytokines and chemokines. The clinical progression of PASH typically starts with acne conglobate in adolescence, followed by hidradenitis suppurativa, and pyoderma gangrenosum. Diagnosis relies on recognizing these hallmark features, but treatment remains a challenge despite current understanding. Conventional immunosuppressive therapies have shown limited efficacy in managing PASH syndrome. Case presentation: The authors present a 36-year-old man with a complex combination of pyoderma gangrenosum, acne, suppurative hidradenitis, obesity, and Crohn's disease. The patient's symptoms began in adolescence with acne and recurrent furuncles, evolving into painful skin ulcers and fistulas over time. Histological examination confirmed the diagnosis of pyoderma gangrenosum. Despite various treatment modalities, including isotretinoin, cyclosporine, azathioprine, and adalimumab, the patient experienced only partial improvement until receiving Infliximab, which led to remarkable improvement. Discussion: PASH syndrome, a rare neutrophilic dermatosis linked to autoinflammatory conditions like Braun Flaco, is characterized by Pyoderma gangrenosum, acne, and suppurative hidradenitis. This clinical entity presents diagnostic challenges due to its unique features and association with obesity and bowel diseases, such as Crohn's disease. Treatment options, including TNF-α blockers like Infliximab, have shown promising results in controlling cutaneous manifestations. Our case study underscores the complexity of treating PASH syndrome and highlights the importance of personalized therapeutic approaches for optimal outcomes. Conclusion: PASH syndrome presents significant diagnostic and treatment challenges due to its complex symptomatology and associations with conditions like Crohn's disease. The case of a 36-year-old man demonstrates the partial efficacy of conventional therapies and highlights the promising results of infliximab. This underscores the need for personalized treatment strategies and ongoing research to improve outcomes for patients with this rare and intricate syndrome.

Enhancing Bioavailability: Advances in Oral Isotretinoin Formulations.

Oral isotretinoin continues to be unsurpassed in efficacy for acne. However, it is associated with potential adverse events including risk of fetal defects, necessitating appropriate mitigation strategies. Furthermore, the variance in bioavailability of the original formulation when ingested in fed versus fasted conditions can lead to differences in daily dosing and duration of exposure. Advances in formulation, with lidose encapsulation and subsequently with micronization, have led to iterative improvements in reducing bioavailability variation between fed and fasted conditions. Differences in bioavailability during fasting were 60% less for originator oral isotretinoin, 33% less for lidose-encapsulated form, and 20% less for micronized-isotretinoin formulation. The latter also demonstrated overall greater bioavailability such that a 20% dose reduction was required compared to the originator and lidose-encapsulated formulations. By reducing the effect of high-fat/high calorie food co-ingestion, this micronized formulation may facilitate clarity in determining appropriate oral isotretinoin dose requirements in achieving optimal patient outcomes.

Transcriptomic Analyses Predict Enhanced Metabolic Activity and Therapeutic Potential of mTOR Inhibitors in Acne-Prone Skin.

Current acne therapies center on preventing new lesions in patients with acne. These therapies were historically found to be beneficial yet were chosen without knowledge of the specific changes in the skin that favor lesion development. A major challenge in developing new treatments is the incomplete understanding of nonlesional (NL), acne-prone skin's molecular characteristics. To address this, we compared RNA-sequencing data from NL skin of 49 patients with acne (denoted as NL acne [NLA]) with those from 19 healthy controls with no acne history. We found 77 differentially expressed genes in NLA (log fold change > 1; P < .05), including genes associated with innate immunity and epidermal barrier function. Notably, K RT 6C, K RT 16, S100A8, S100A9, and lactotransferrin were upregulated, and LCE4A, LCE6A, and CTSE were downregulated. Gene set enrichment analysis revealed that metabolic pathways were enriched in NLA skin, whereas keratinization was negatively enriched. To identify compounds that could shift the gene expression signature of NLA skin toward healthy control skin, we performed connectivity mapping with the Library of Integrated Network-Based Signatures. We identified 187 compounds, particularly mTOR inhibitors, that could potentially normalize the gene expression profile of acne-prone skin to that of healthy skin. Our findings indicate that NLA skin has distinct differences in epidermal differentiation, cellular metabolism, and innate immunity that may promote lesion formation and suggest that mTOR inhibitors could restore NLA skin toward a healthier state, potentially reversing the predisposition to lesion development.

What's New After NICE Acne Guidelines.

INTRODUCTION: Acne remains one of the most common inflammatory dermatoses seen worldwide. There are significant challenges when managing acne relating to a variety of factors, including (1) lack of consensus on the use of the numerous available grading systems and outcome measures, (2) appreciation of the numerous areas that relate to severity, (3) the chronic nature of acne which requires a longitudinal approach to management (including both facial and truncal disease), and (4) the need to target acne early to avoid physical and psychosocial scarring. Consideration of these aspects when managing acne should result in improved outcomes. Acne guidelines review the available evidence based on robust clinical trials and are usually supplemented with some expert opinion when evidence is not available. METHODS: In this paper, the UK Acne Working Group reflects on the latest National Institute for Health and Care Excellence (NICE) acne guidelines with a goal of providing additional practical insights. CONCLUSION: The group have identified areas where new evidence has now become available since the formulation of the NICE acne guidelines. This publication considers newly approved acne medications in the UK, guidance on assessing acne severity, approaches to managing truncal acne, acne sequelae, and adult female acne with hormonal therapies.

The National Institute for Health and Care Excellence (NICE) produced acne guidelines in June 2021 for clinicians and patients. New evidence and information on practical aspects of acne management have emerged since this time. A panel of clinicians with expertise in acne discuss herein some areas of interest that may support acne management, some of which could be considered in a second iteration of NICE acne guidelines. These areas include how to assess acne, the medical approach to truncal acne, how clinicians may manage the long-lasting acne sequelae of scarring and darkly pigmented spots, and the use of medical hormonal therapies for women (such as birth control pills) to manage acne that may have a causative contribution of hormone imbalances.

Protease-Activated Receptor 2 in inflammatory skin disease: current evidence and future perspectives.

Protease-activated receptor-2 (PAR2) is a class-A G protein-coupled receptor (GPCR) activated by serine proteases and is expressed by multiple tissues, including the skin. PAR2 is involved in the skin inflammatory response, promoting Th2 inflammation, delaying skin barrier repair, and affecting the differentiation of keratinocytes. It also participates in the transmission of itch and pain sensations in the skin. Increasing evidence indicates that PAR2 plays an important role in the pathogenesis of inflammatory skin diseases such as acne vulgaris, rosacea, psoriasis, and atopic dermatitis. Additional focus will be placed on potential targeted therapies based on PAR2. The Goal of this review is to outline the emerging effects of PAR2 activation in inflammatory skin disease and highlight the promise of PAR2 modulators.

Clinical aspects and risks of the phenol/croton oil.

Phenol/croton oil is a unique chemical formulation promoting deep skin resurfacing and cellular renovation. Even though it has been used for decades in plastic surgery, the clinicopathological features, as well as the risks related to phenol/croton oil clinical application have not been thoroughly studied. The aim of the present study was to assess the effectiveness of the phenol/croton oil peel, the pathological characteristics from 1 patient at least and the emerging potential risks. A total of 64 patients were treated with phenol/croton oil peel between 2014 and 2023; in total, 21 of them underwent resurfacing at their oral area (upper/lower lips), 15 underwent resurfacing at their lower eyelid wrinkles, 22 patients underwent full face resurfacing, 2 patients were treated for their acne scars and additionally 4 patients were treated for multiple body seborrheic keratosis. The wrinkles, as well as the acne scars were markedly improved in all patients, the seborrheic keratosis was eliminated, while adverse events and undesired clinical manifestations related to peel intervention were mild and reversible for all patients. The application of phenol/croton oil constitutes an immensely powerful tool for deep chemical peeling and facial skin rejuvenation; nevertheless, it should be used cautiously due to its potential complications.

Efficacy and adverse reactions of fractional CO2 lasers for treating papular acne scars: a retrospective study of 35 patients.

Papular acne scars are a special type of acne scar, and the prevalence and treatment of this disease have rarely been reported in the literature; moreover, the prevalence of this disease is often neglected, and treatment is difficult. Our study revealed a high prevalence of this type of acne scar in the clinic and explored an effective and safe method. This retrospective study aimed to analyse the prevalence of papular acne scarring among patients attending our Dermatology Laser Clinic and evaluate the clinical efficacy of fractional CO2 lasers. We retrieved the data of 370 patients with acne scarring who visited our hospital between April 2021 and November 2022 and analysed the prevalence of papillary acne scarring among them. Among these patients, 35 underwent CO2 laser treatment using an artificial grid pattern. A total of three treatments were administered, with a two-month interval between each session. Scar assessment was conducted using the Global Scar Scale (GSS) and the Acne Scar Clinical Assessment (ECCA) scale, along with physician visual evaluation and patient satisfaction surveys, both before the first treatment and one month after the final treatment. Adverse reactions were recorded during follow-up visits after each treatment. Among the 370 patients with acne scarring, 128 exhibited papular acne scarring, resulting in a prevalence rate of 34.6%. Among them, 37.5% were male and 32.6% were female. A total of 90.6% of patients had combined other types of acne scarring, while 9.4% had papular acne scarring exclusively. Following CO2 laser grid treatment, there was a significant reduction in GSS scores and ECCA values, accompanied by a noticeable improvement in physician visual evaluation and patient satisfaction scores. Papular acne scarring has a relatively high incidence rate, and there is no significant sex difference. It often coexists with other types of acne scarring. CO2 laser treatment using an artificial grid pattern effectively improved papular acne scarring with a good safety profile.

Assessing top quality of life measures in Acne Vulgaris studies: a crucial dimension in patient-centric care.

This study examines the origins and utilization trends of top quality-of-life (QoL) measures in acne research. A literature search on PubMed identified the Dermatology Life Quality Index (DLQI), Cardiff Acne Disability Index (CADI), and Acne Quality-of-Life Questionnaire (Acne-QoL) as the most frequently used QoL measures in studies on Acne Vulgaris. The DLQI was implemented in 142 studies it since its inception, compared to 43 utilizing CADI and 21 utilizing Acne-QoL. Despite it not being acne-specific, DLQI's usage surpassed other measures by over 50% annually since 2006. While DLQI displayed the steepest rise in utilization, usage of all measures increased significantly from 2010 to 2020. This trend underscores the growing emphasis on patient-centered outcomes in acne research, highlighting the need to incorporate both patient-reported and objective outcomes to better capture disease severity and its impact on patients' lives. For dermatologists, QoL indices can expand disease severity beyond purely objective clinical measurements.

Factors Affecting Wound Healing after the Wide Surgical Excision of Hidradenitis Suppurativa Lesions.

Background: Hidradenitis suppurativa (HS) is a chronic and inflammatory disease. Its management depends on the stage and extent of the disease. Surgery plays an important role in treatment options. This study explores the factors influencing healing after wide excision. Methods: This study analyzed data from patients who underwent wide excision for HS between 2016 and 2021. Results: A total of 160 patients (64.4% women) were included, with surgeries performed in the axillae (70), inguinal-ano-genital (73), and other locations (17, including gluteal). The mean TTWC was 74 ± 6 days, varying from 11 to 445 days. Factors negatively influencing TTWC included axillary localization (p < 0.001) and the presence of another inflammatory disease (p = 0.017). Factors positively influencing healing were smoking (<0.001) and previous or ongoing medical treatment (antibiotherapy or biologics) (p = 0.011). Obesity or being overweight did not impact the TTWC in multivariate analysis, although overweight was significant in univariate analysis. Conclusions: While smoking cessation remains important in the management of HS, it does not appear to be a prerequisite for successful surgical treatment. Conversely, patients with an inflammatory disease or those undergoing surgery for an axillary lesion exhibit slower healing and should be informed of potential healing delays before surgery.

Clinical and cost-effectiveness of spironolactone in treating persistent facial acne in women: SAFA double-blinded RCT.

Background: Acne is common, can cause significant impact on quality of life and is a frequent reason for long-term antibiotic use. Spironolactone has been prescribed for acne in women for many years, but robust evidence is lacking. Objective: To evaluate whether spironolactone is clinically effective and cost-effective in treating acne in women. Design: Pragmatic, parallel, double-blind, randomised superiority trial. Setting: Primary and secondary healthcare and community settings (community and social media advertising). Participants: Women aged 18 years and older with facial acne persisting for at least 6 months, judged to potentially warrant oral antibiotic treatment. Interventions: Participants were randomised 1 : 1, using an independent web-based procedure, to either 50 mg/day spironolactone or matched placebo until week 6, increasing to 100 mg/day spironolactone or matched placebo until week 24. Participants continued usual topical treatment. Main outcome measures: Primary outcome was the adjusted mean difference in Acne-Specific Quality of Life symptom subscale score at 12 weeks. Secondary outcomes included Acne-Specific Quality of Life total and subscales; participant self-assessed improvement; Investigator's Global Assessment; Participant's Global Assessment; satisfaction; adverse effects and cost-effectiveness. Results: Of 1267 women assessed for eligibility, 410 were randomised (201 intervention, 209 control), 342 in the primary analysis (176 intervention, 166 control). Mean age was 29.2 years (standard deviation 7.2) and 7.9% (28/356) were from non-white backgrounds. At baseline, Investigator's Global Assessment classified acne as mild in 46%, moderate in 40% and severe in 13%. At baseline, 82.9% were using topical treatments. Over 95% of participants in both groups tolerated the treatment and increased their dose. Mean baseline Acne-Specific Quality of Life symptom subscale was 13.0 (standard deviation 4.7) across both groups. Mean scores at week 12 were 19.2 (standard deviation 6.1) for spironolactone and 17.8 (standard deviation 5.6) for placebo [difference favouring spironolactone 1.27 (95% confidence interval 0.07 to 2.46) adjusting for baseline variables]. Mean scores at week 24 were 21.2 (standard deviation 5.9) in spironolactone group and 17.4 (standard deviation 5.8) in placebo group [adjusted difference 3.77 (95% confidence interval 2.50 to 5.03) adjusted]. Secondary outcomes also favoured spironolactone at 12 weeks with greater differences at 24 weeks. Participants taking spironolactone were more likely than those taking placebo to report overall acne improvement at 12 weeks {72.2% vs. 67.9% [adjusted odds ratio 1.16 (95% confidence interval 0.70 to 1.91)]} and at 24 weeks {81.9% vs. 63.3% [adjusted odds ratio 2.72 (95% confidence interval 1.50 to 4.93)]}. Investigator's Global Assessment was judged successful at week 12 for 31/201 (18.5%) taking spironolactone and 9/209 (5.6%) taking placebo [adjusted odds ratio 5.18 (95% confidence interval 2.18 to 12.28)]. Satisfaction with treatment improved in 70.6% of participants taking spironolactone compared with 43.1% taking placebo [adjusted odds ratio 3.12 (95% confidence interval 1.80 to 5.41)]. Adverse reactions were similar between groups, but headaches were reported more commonly on spironolactone (20.4% vs. 12.0%). No serious adverse reactions were reported. Taking account for missing data through multiple imputation gave an incremental cost per quality-adjusted life-year of £27,879 (adjusted) compared to placebo or £2683 per quality-adjusted life-year compared to oral antibiotics. Conclusions: Spironolactone resulted in better participant-reported and investigator-reported outcomes than placebo, with greater differences at week 24 than week 12. Trial registration: This trial is registered as ISRCTN12892056 and EudraCT (2018-003630-33). Funding: This award was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme (NIHR award ref: 16/13/02) and is published in full in Health Technology Assessment; Vol. 28, No. 56. See the NIHR Funding and Awards website for further award information.

Acne (or spots) is common and often persists into adulthood. Many people take long courses of antibiotic tablets, but concerns about antibiotic resistance mean alternatives are needed. Spironolactone is a medicine that is sometimes used for acne in women. However, we do not know whether it works. This trial aimed to answer this question. We invited women aged over 18 who had acne on their face for at least 6 months to take part via their general practitioner surgery, hospital or advertising. Women were randomly assigned to two groups: one group was given spironolactone and the other group was given identical-looking placebo ('dummy pill') daily for 24 weeks. Women in both groups could continue using acne treatments applied to the skin (gels/creams/lotions). We asked participants to rate their acne using a questionnaire called Acne-Specific Quality of Life, asked whether they felt their skin had improved and asked skin specialists to assess their skin. Four hundred and ten women took part, many of whom had had acne for a long time. Acne-Specific Quality of Life scores improved in both groups by 12 weeks but improved more in the spironolactone group at 12 and 24 weeks. When asked directly whether their skin had improved, 71% of participants in the spironolactone group said it had, compared with 43% on placebo. Skin specialists were also more likely to report that the acne had improved in the spironolactone group. Side effects were mild and similar in both groups but there were slightly more headaches on spironolactone (20% compared with 12%). Spironolactone is likely to represent value for money for the National Health Service, though this depends on a number of factors including what it is compared to. This trial suggests that spironolactone is a useful additional treatment for women with persistent acne.

A Current Perspective on the Effects of Flavonoids in the Treatment of Acne.

Pimples, blackheads, whiteheads, etc., are common types of acne that pop up on the skin each time, whenever dead cells and oils obstruct the outgrowth of hair from the hair follicle. It is very common to observe this condition in teenagers, but regardless of age, if the causing condition is met, acne can occur at any point in life. The characteristic feature of all types of acne is it starts with inflammation of the skin. These inflammatory marks (like black spots, pores, small scars, etc.) leave behind even when acne disappears. Plants like vegetables and flowers are naturally rich in different types of polyphenolic compounds called flavonoids. These flavonoids have various key functions, from guiding cell movement to maintaining oxidative pressure in the body. In this study, we discuss six types of flavonoids that have the potential to be used as med-icine for the treatment of different kinds of skin breakouts. Moreover, the result of molecular docking of different proteins that have an association with acne is also discussed.

The 2910-nm Fiber Laser Is Safe and Effective for Improving Acne Scarring.

BACKGROUND: Acne scarring results from the inflammation associated with acne papules, which alters dermal collagen, typically producing depressed scars. Lasers have been used to remodel skin improving the texture and appearance of acne scars. Herein, we investigate a new 2910 nm, erbium-doped, fluoride glass, fiber laser for improving acne scars. This novel laser delivers up to 5000 Hz low-energy pulses, providing a unique treatment modality. METHODS: Fourteen subjects with rolling and/or boxcar acne scars were enrolled in this study. Thirteen subjects completed the final visit and received three treatments with the 2910 nm fiber laser at 6-8-week intervals. Eight subjects were Fitzpatrick type II and five were Fitzpatrick type III. Digital images were taken pre- and 1- and 3-months posttreatment and evaluated by two blinded reviewers in a randomized fashion for improvement. Subjects and the treating physician completed a Global Aesthetic Improvement Scale (GAIS) before treatment and at each visit to subjectively evaluate treatment effect. Histological analysis was performed on ex vivo lower eyelid skin samples. Side effects were evaluated by the treating physician and included erythema, edema, and pinpoint bleeding. RESULTS: Evaluation of blinded digital images revealed a mean improvement of 47.3% ± 14.2% (mean ± SEM) 3 months following the final treatment. GAIS scores demonstrated improvement as evaluated by both the subjects and the treating physician. Side effects averaged trace-to-mild erythema, edema, and pinpoint bleeding. CONCLUSION: This study shows that the 2910 nm, erbium-doped, fluoride glass, fiber laser is safe and effective for improving the appearance of acne scars.

Evaluating the Readability of the iPledge Comprehension Assessment and its Impact on Isotretinoin Accessibility.

Isotretinoin, the standard treatment for severe nodular acne, is subject to stringent iPLEDGE regulations due to its teratogenic risks, requiring monthly assessments for patients of childbearing potential. Analysis of the iPLEDGE Comprehension Assessment (iPCA) revealed an average readability score of grade 8.5, exceeding the recommended grade 6 level for optimal patient comprehension. The complex language of iPCA may hinder patients from accessing treatment, contributing to delays and potential discontinuation, especially among female patients. While the overall number of isotretinoin-exposed pregnancies has decreased since the inception of iPledge, several hundred pregnancies continue to be reported, and simplification of iPCA presents one avenue to improve patient comprehension, safety, and ensuring equitable access to isotretinoin.

Targeted precision cryotherapy for acne vulgaris.

BACKGROUND: Acne vulgaris poses a significant dermatological challenge, necessitating alternative treatments due to limitations and side effects associated with current therapies. This pilot clinical trial investigated the feasibility and efficacy of precision cryotherapy for acne vulgaris. METHODS: A total of 20 volunteers underwent targeted precision cryotherapy using a carbon dioxide-based device. Treatment outcomes were assessed using various parameters, including Investigator Global Assessment (IGA) score, acne lesion count, erythema index (EI), global evaluation score, and participant satisfaction. Safety monitoring included adverse event reporting and physical examination. RESULTS: Precision cryotherapy demonstrated a significant reduction (90.25%) in the acne lesion count by week 4, with clinical improvement indicated by IGA score reduction (p < 0.001). The EI showed notable improvements at weeks 1, 2, and 4. The global evaluation score demonstrated a 75%-100% clinical improvement at Visit 4. Participants reported high satisfaction (6.75 ± 0.79) with the procedure. No adverse event or discomfort was reported. CONCLUSION: Precision cryotherapy effectively improved acne lesions, which was safe and satisfactory for participants. These findings suggest its potential as an alternative therapeutic modality, especially for populations with limited treatment options. Further research is needed to validate the results and explore underlying mechanisms.