Integrated treatment of acne with phytocomplexes    


Department of Dermatology at Cremona Hospital - General Director Prof. P. Spaggiari

C.U.O. Dermatological -   Cremona Hospital Institute

Caresana G, Pezzarossa E, Domaneschi E, Vecchini F, Felisi 

Acne is a multifactorial disease that develops in genetically predisposed individuals. The prevalence is about 30% in population between 15 and 20 years, it decreases remaining at significant levels until 35 years; 1/10 of the cases are severe nodular cystic acne.
The etiology is related to hyperseborrhoea, hyperkeratinization of the follicular epithelium, proliferation of Propionibactrium acnes, which maintains and amplifies inflammation intra and perifollicular.
Acne therapy makes use of topical and systemic treatments combined and graded according to the clinical extent (mild, medium, severe). Many of these drugs are indicated for the treatment of rosacea acne: antibiotics (topical and systemic), retinoids (topical and systemic), antiandrogens (for females), topical benzoyl peroxide, topical azelaic acid, topical chemo-exfoliates, metronidazole ( rosacea). In some cases, there are limitations to conventional therapy (antibiotics, retinoids, antiandrogens): antibiotic resistance, side effects, intolerance, allergies, contraindications, adverse interactions. In some other cases, however, alternative therapeutic approaches can integrate the conventional topical and systemic therapies. Among these phyto-derivatives may be indicated, such ​​as Bioenergen ®, a dietary supplement, which has among its indications acne treatment containing several active ingredients extracted from plants: Hydrocotyle asiatica, Schiasandra chinensis, Spirea ulmaria, Harpagophytum procumbens , Fucus vesicolosus, Smilax utilis, Erythroxylon catauba, Turnera diffusa, Pfaffia panicolata, Theobroma cacao, Citrus grandis.
Twenty patients with polymorphic acne (17 cases) and acne rosacea (3 cases) were treated with this preparation during an observational study. The preparation has been used in accordance with the dosage of 30 drops 2 times a day for three months, administered without food, and associated with conventional topical and / or systemic therapies for polymorphous acne and acne rosacea. The study considered and evaluated the tolerability of the preparation, and investigated also its supplementary action on the treatment of acne, the action on the general conditions of the patients and the possible interactions with other systemic therapies. The severity of acne shape of each patient was quantified with a baseline score and re-evaluated after 3 months of therapy. The forms appeared, before treatment with the following score: 4 severe, 13 intermediate grade, 3 minor. The related therapies included only topical treatments for 13 patients: retinoids, antibiotics, benzoyl peroxide, azelaic acid, metronidazole; 7 patients had bioenergen associated with, in addition to topical treatment, also drugs for systemic use: isotretinoin in 2 cases, limeciclina in 4 cases, azithromycin in a case. The total score after three months of treatment showed: 15 cases of mild acne, three intermediate forms, and 2 cases of severe acne. The comparison of the baseline score of each individual case with the score after 3 months of treatment showed: only one case of deterioration (score from intermediate to severe), 12 cases of improvement (from severe to mild and from intermediate to mild), 2 cases of marked improvement (from severe to mild). In all cases treated, full tolerability was found to occur. There were no adverse interactions with systemic therapies (for both acne and other concurrent conditions). Compared with the results expected from associated anti-acne therapies topical and / or systemic, an additional action on inflammation has been appreciated, with a net reduction of erythema in 4 cases, including 2 cases of acne rosacea. Unexpected favorable effects were also encountered on other associated conditions: constipation improved in 3 cases, reduction of dysmenorrhea in one case, improved coenaesthesia in a case. These preliminary data are indicative of a rational study of the pharmacological action of this preparation through randomized clinical trial.

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