Acne - a global problem for adolescents and young adults

Is acne just a nuisance cosmetic problem? Certainly not. It affects nearly 85% of teenagers and young adults, making it one of the most common skin diseases in the world. Acne vulgaris is a complex inflammatory skin disease whose etiopathogenesis involves dysfunction of the microbiome, excessive sebum secretion, and local inflammation.

Treatment of this ailment is challenging. Although topical antibiotic therapies are effective in most patients, they face limitations related to antibiotic resistance. Innovative formulations, such as those described by researchers from the Wroclaw Medical University in the latest issue of the journal Polymers in Medicine, may be the answer to these problems.

Developing innovative hydrogels

Agnieszka Kostrzębska, who heads the research team, stresses that tetracycline - a key formulation component - is an extremely sensitive antibiotic. 

"Tetracycline is particularly susceptible to degradation in an environment with an inappropriate pH. Both an overly acidic and overly alkaline reaction of the formulation can lead to its degradation, visible as a color change from light yellow to brown, maroon to black" the researcher says.

The researchers created more stable formulations by using azeloglycine, a derivative of azelaic acid. Azeloglycine proved not only more compatible with tetracycline than azelaic acid, but also easier to apply due to its ability to maintain high hydrogel viscosity.

Why azeloglycine?

Azeloglycine is a derivative of azelaic acid created by modifying its chemical structure. The compound not only takes over all the beneficial properties of the acid but is also characterized by greater stability, versatility, and ease of use in new cosmetic and therapeutic formulations.

"The pH neutrality of azeloglycine is one of its greatest assets" explains Agnieszka Kostrzębska, author of the study.

Unlike azelaic acid, which can require complex stabilization processes, azeloglycine easily integrates with other ingredients, creating skin- and pharmacist-friendly formulations. Thanks to this property, scientists have avoided the problems associated with the degradation of tetracycline - an extremely sensitive antibiotic that can lose its therapeutic properties in the wrong environment.

No less important is that hydrogels with azeloglycine have achieved exceptional viscosity - a characteristic that may seem insignificant to the non-specialist but is of great practical importance. Formulations with the proper viscosity adhere better to the skin and release active substances evenly, which translates into their effectiveness. As a result, azeloglycine becomes a good additional ingredient for tetracycline. It maximizes its effect while minimizing the risk of bacterial resistance.

Moreover, azeloglycine retains all the key properties of azelaic acid: its anti-inflammatory and antibacterial properties help reduce active acne lesions. At the same time, its ability to lighten hyperpigmentation gives the skin a more uniform appearance. This is multifunctional for today's dermatological challenges.  

Prospects and challenges

The development of topical therapy with tetracycline, traditionally used orally, requires detailed clinical evaluation. Studies must demonstrate whether combining azeloglycine with tetracycline leads to unexpected interactions affecting treatment efficacy or patient safety. It will be particularly important to investigate the durability of the therapeutic effects and monitor whether long-term use of the formulation increases the risk of developing bacterial resistance—a problem that has been a major concern in the medical world for years.

However, the application potential of these formulations goes beyond the treatment of acne vulgaris. "Azeloglycine, with its anti-inflammatory and antimicrobial properties, can be effective in treating other dermatological conditions, such as rosacea, psoriasis, and skin hyperpigmentation" Kostrzębska notes. 

On the other hand, tetracycline, known for its efficacy against bacteria such as Cutibacterium acnes and Staphylococcus aureus, could be used to treat purulent skin infections, hair follicle infections, and even chronic inflammation. 

Another area of research is optimizing formulations with other antibiotics.   

"We are analyzing the possibility of using chlorotetracycline, which has shown high efficacy in treating purulent skin infections, and clindamycin, one of the most commonly used antibiotics in topical acne therapy" the researcher explains.

Tests on a larger group of patients are also planned to study the formulations' effectiveness and potential effects on skin irritation. Such tests will allow complete verification of the safety and versatility of these innovative hydrogels in clinical practice.

"The proposed hydrogel formulations offer a novel therapeutic approach. Our goal is to create a product that not only treats but also prevents acne recurrence and the formation of acne blemishes" Kostrzębska concludes.

The results of this research could open up new opportunities in dermatology, not only for the treatment of acne but also for other skin conditions. The combination of the effectiveness of antibiotics with the soothing and stabilizing properties of azeloglycine could find application. The road to the commercialization of these preparations is still long, but the studies' conclusions so far indicate this therapy's potential.

D. Sikora