Korean J Dermatol.  1976 Dec;14(4):305-313.

A Clinical Study on Topical Vitamin A Acid In Acne Vulgaris

• Kim SU
• Lee SN

Abstract

In 1932, Harris, et al., reported that vitamin A had an anti-keratinizing effect on acne vulgaris, and in 1948, Straumfjord, somewhat over-enthusiastically reported that oral use of vitamin A also had a beneficial effect on acne. In spite of studies by Lynch and Cook (1947), and Andrew and Stokoe (1963), which questioned its effectiveness, the original enthusiasm for this regimen has not been completely dampened. Kligman (1969) reported that vitamin A acid (VAA), a metabolic end-product of vitamin A metabolism, produced a peeling effect and when applied topical was effective in tbe treatment of acne. The mechanism of action of VAA is incompletely understood, however, it is observed to cause, arnong other things, an increase in the speed of proliferation of the cells of the epidermis; dissolution of the intracellular lysosomes; increase in the rate of keratin formation and the conversion of hard keratin to soft keratin; and an increase in the secretion of the sebaceous glands. The effect of VAA in acne treatment is due to the increase in the secretion of the sebaceous glands which prevents the formation of comedones. It is believed that the increased spced of cell division, increased keratinization and softening of the keratin cause a weakening of the intercellular adhesion. These processes cause an acceleration of the flow of cells out of the sebaceoua glands which prevents the formation of comed.ones and forces existing comedones to the surface of the skin. For this study, thirty eight patients with acne vulgaris were selected from among the outpatients of Severance Hospital. They were divided into two groups. The first group was treated with application of vitamin A acid alone. The second group was treated concurrently with topical vitamin A acid and oral tetracycline. The results were a.s folIows: l. The group treated for three weeks with VAA alone showed significant improvement in up to 70 of the cases. 2. The group treated with VAA and oral tetracycline showed results which were sirnilar to the group on VAA alone. 3. In both groups. closed cornedones and papules gradually disappeared, however, the number of open com.dones increased in the first week, but decreased threafter, In combined therapy, pustules disappeared grad.ually just like the papules, but in therapy with VAA alone, the number of pustules increased during tbe first week and decreasd. thereafter. 4. In the group which was treated with VAA alone, undesirable side effects such as scaling, erythema, tightness, itching and burning sensation were seen, and also occasionally fissures, edema, pain and oozing were noted. In the group treated with combined therapy, similar findings were recorded.

MeSH Terms

Acceleration
Acne Vulgaris*
Burns
Cell Division
Edema
Epidermis
Erythema
Humans
Lysosomes
Metabolism
Outpatients
Pruritus
Sebaceous Glands
Sensation
Skin
Tetracycline
Tretinoin*
Vitamin A*
Vitamins*
Tetracycline
Tretinoin
Vitamin A
Vitamins