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 Background & Objectives: Resistance Strains of propionibacterium acnes is one of the most growing problems in acne treatment. Azelaic acid, due to the lack of bacterial resistance, could be a useful alternative in topical treatment of acne. The purpose of this study was to investigate the therapeutic effects and side effects of azelaic acid and its comparison with topical clindamycin in the treatment of acne.

 Methods: This randomized clinical trial study was performed on 100 patients with mild acne. The patients were divided in to two groups. One group was treated with azelaic acid 20% cream and the other one was treated with Dalacin 1% gel twice daily for 4 weeks.

 Results: Both drugs Produced significant reduction in inflammatory Lesions (for azelaic acid p=0/000 and for clindamycin p=0/000) and noninflammatory lesions (for azelaic acid P=0/001 for clindamycin p=0/033). Comparing the mean of decrease in inflammatory and noninflammatory lesions, there was not a significant difference between two groups (of Papule and Pustule P=0/864 of comedons P=0/239). So the efficacy of these two drugs was same. In comparing the sideffects, erythem was more common in azelaic acid users significantly (p=0/031) and skin dryness was more Common in clindamycin users significantly (p=0/000).

 Conclusion: Azelaic acid 20% cream as effective as clindamycin gel 1% in the treatment of mild acne.

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  Background & Objectives: Acne vulgaris is a chronic inflammation of pilosebaceous units. In sever forms it may lead to major scars on the face and trunk, and significant face and trunk scarring, and psychological disorders. Antiandrogen therapy can be used as a suitable and effective remedy for female acne. Furthermore, they can treat, accompanying androgenic problems. Also, there is no under consideration drug resistance against androgens. The aim of this study is to compare the therapeutic effects of flutamide and doxycycline in moderate acne in females .

  Methods: This current study is a randomized and blind evaluation trial. 62 female patients participated at this study. They were divided in two groups (case and control). Case group was received 250 mg/day flutamide, control group 100 mg/day doycycline. Both groups also received topical solution of clindamicin 1% twice daily. The length of study was six months .

  At first visit and the end of the second month of study liver function were tested for the case group patients. Evaluation of resolution in lesions was performed by another physician every two months of therapy. The probable side effects of drugs were recorded. Data were analyzed with SPSS16 software using statistical tests and p ≤ 0.05 considered as significant

  Results: The mean of patients age was 19.27 ± 3.55 years, and the difference was not found to be statistically significant in two groups. Number of comdeons on face was found to be statistically decreased in flutamide group (p<0.0001). Mean of ASI was found to be statistically decreased in flutamide group (p<0.002). In flutamide group the levels of satisfaction was higher than that of other group. Both medications well tolerated by participiants. Only two patients in flutamide group had lightly elevated serum Alkalin phosphatase .

  Conclusion: The results of our study showed that flutamide (250 mg /day) is more effective than doxycycline (100 mg/day) in treatment of acne. Satisfaction of participants in flutamide group was higher than those in doxycycline group. In both groups side effects of drugs were insignificant, but using of flutamide in acne treatment needs laboratory considerations .

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Background & objectives: Acne Vulgaris is a chronic inflammation of pilosebaceous glands. Some studies have indicated the significant decrease of linoleic acid in the sebum composition of the patients with acne. The aim of this study was to determine the probable therapeutic effects of linoleic acid on moderate acne.
Methods: In a double-blind randomized clinical trial, 40 women with moderate acne were divided into two groups, each group with 20 each with 20 samples. After recording the nutritional and demographic factors, the case group received, 100 mg oral doxycycline daily plus 3 gr conjugated linoleic acid and the control group received 100 mg doxycycline daily plus 4-3 oral paraffin capsules as placebo for one month. The number of acne lesions were counted before and after treatment and the mean of   Acne Severity Index (ASI) and Global Acne Grading System (GAGS) were determined for each group. The collected data were analyzed by SPSS software using chi-square, independent t-test and paired t-test.
Results: The mean age was 22.8±5.5, in the case group and21.7±5.1 in placebo group indicating no statistically significant deference (p=0.51). At the end of treatment there was no statistically significant deference between the two groups in decreasing acne (p=0.31). During the treatment, ASI reduced from 129.5±13 to 77±11.6 in the case group and from 132±18.6 to 67.5±11.6 in the placebo group, –but there was no statistically significant deference between the two groups (p=0.37).
Conclusion: It seems using 3 gr oral conjugated linoleic acid daily for 1 month has no effect on remission of acne.

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Background & objectives: In recent years, the hypothesis of using anti-androgens has been increasingly addressed in the treatment of acne in women. One of these drugs is flutamide, which there is no strong evidence of its efficacy in treatment of acne in women. The aim of this study was to compare the effect of combination therapy of flutamide-cyproterone compound with flutamide-doxycycline in severe type of acne in women.
Methods: In an interventional study, patients were divided in to two groups. One group (n=30) received flutamide - cyproterone compound and another group (n=30) received flutamide-doxycycline which were followed for six months. Both groups also received 1% topical clindamycin twice a day. Counting the number of lesions, changes in severity index and grading of acne were used to evaluate the patients. Patient satisfaction was also evaluated.
Results: The mean age in the flutamide-doxycycline group was 19.4±4.67 and in the flutamide-cyproterone compound group was 19.06±11.3. This difference was not statistically significant. The mean of the acne severity index at the onset of intervention between the two groups was not significant (p= 0.7). The mean of the acne severity index at the start of treatment in the flutamide-doxycycline group was 306.07±155.46 and at the end of treatment reached to 19.18±19.5, and also in the flutamide-cyproterone compound group, decreased from 293.21±15.21 to 10.5±21.8 at the end of treatment. This difference was not statistically significant (p=0.1).
Conclusion: Both therapeutic regimen were effective in the treatment of severe type of acne and can possibly be used as an alternative treatment for severe acne.

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Background & objectives: Acne is a chronic inflammation of pilosebaceous units and in severe form reflects a different response to treatment in an oral regime of antibiotics. The purpose of this study is to compare the effect of the combination of erythromycin and low dose oral isotretinoin with erythromycin and low dose flutamide in women suffering from severe acne.
Methods: In a randomized controlled clinical trial, 80 women suffering from severe acne participated in the study and they were studied for 2 months. The first group received 800 mg oral erythromycin, together with 20 mg oral isotretinoin every two days and the second group received 800 mg erythromycin, together with 62.5 mg flutamide daily. The treatment efficiency was evaluated by the count of acne lesions and computing the acne severity index. The data of the study were analyzed using the version 16 of spss software.
Results: In the present study, 40 patients participated in the research in each group. Finally, 61 people completed the study. The mean acne severity index in the flutamide group was 195.9±15 at the beginning of treatment and this index reduced to 52.8±5.8 at the end of treatment. The mean acne severity index in the isotretinoin group was 247.8±19.7 at the beginning of treatment and this index reduced to 76.3±12.5 at the end of treatment. The difference in reduction between the two groups was not statistically significant (p=0.15).
Conclusion: The treatment effectiveness of the above-mentioned methods in female severe acne was acceptable and this combination therapy can be presented as a better alternative compared to treatments with high dose individual treatment including oral isotretinoin and oral flutamide.