Lowering lesional surface pH in acne: A new treatment modality for Herpifix^®

Abstract

The acid skin surface pH has antimicrobial activities. Increased growth of Propionibacterium acnes contributes to the pathogenesis of acne. Therefore, the pH of inflammatory acne lesions was determined prior to and after lesional acidification employing Herpifix (Courage + Khazaka, Cologne, Germany), a microphoretic system. The pH was correlated with the number of acne lesions. A total of 30 volunteers with acne vulgaris participated in this crossover study applying either Herpifix or a dummy to inflammatory lesions. Prior to treatment, the pH of acne lesions was 5.7 +/- 0.2 (mean +/- SD) and 22 lesions (mean +/- 10) were counted in an 8 x 8 cm(2) facial surface area. Fifteen volunteers (group A) used Herpifix first for 3 weeks and then the dummy, while the other group of 15 volunteers (group B) used the dummy first and then Herpifix. In group A, the lesional surface pH and number of lesions decreased (p < 0.01) initially. When the dummy was used over a second 3-week treatment period, the skin surface pH and number of acne lesions increased. Findings for group B were vice versa. When both groups were compared at the end of the study, a significant difference in pH values (p < 0.001) and the number of acne lesions (p < 0.05) was obtained. Herpifix may be considered as a new therapeutic option for inflammatory acne.

A Long-Term Study to Evaluate Acidic Skin Care Treatment in Nursing Home Residents: Impact on Epidermal Barrier Function and Microflora in Aged Skin

“…In addition to aged skin and AD, further inflammatory skin disorders, like seborrhoeic dermatitis [76] and acne [77] , are accompanied by an elevated skin surface pH. Moreover, the skin surface pH is also higher in sensitive skin [78] and after sportive activities [79] .…”

Significant improvement in mild acne following a twice daily application for 6 weeks of an acidic cleansing product (pH 4)

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“…Glycolic acid acts as a proton donor thus lowering the pH of the product containing glycolic acid as well as the pH at the site of application. Therefore, topical cleansing products containing glycolic acid and a subphysiological pH may be used to support acne treatment …”

A 10% glycolic acid containing oil-in-water emulsion improves mild acne: a randomized double-blind placebo-controlled trial

“…Interestingly, recently, it has been shown that the pH of acne lesions is increased as compared to physiological pH and that acne lesions improve by reducing lesional pH to physiological values. 4 Why inflammation occurs either initiated by an excess of sebum with a relative deficiency of linoleic acid or by activation of TLR by a soluble factor of P. acnes is still unclear. 3 Eventually, pustules and papules develop or even nodules and cysts in its most severe form, acne conglobata.…”