Topical treatments for acne: a bibliographic review/Tratamentos tópicos para acne: uma revisão bibliográfica

Objective: To relate the existing topical therapeutic approaches to combat acne and their mechanisms of action and particularities through bibliographic review. We shall analyze the antibacterial, anti-inflammatory and anti-seborrheic activities of these substances. Methods: The bibliographic review was based on research of published and unpublished articles, in English or Portuguese, in the Cochrane, Pubmed and Scopus databases, in vitro , in vivo and bibliographic reviews demonstrating the topical treatment methods in the fight against Acne vulgaris , considering data from 2010 to August 2020. Results: Topical therapy is based on the type and severity of acne. Despite the severity, it is often treated with topical retinoids or a variety of different substances, such as antibiotics, azelaic acid, salicylic acid, benzoyl peroxide, niacinamide and others, in addition to complementary and alternative medicines (CAM), such as resveratrol, vitamin C, tea tree oil, among others. Topical treatment has the advantage of reducing systemic absorption and increasing exposure of pilosebaceous follicles to treatment. Conclusions: Topical retinoids have been used in acne therapy for over forty years, due to both their efficacy (demonstrated in several clinical trials) and the development of third generation retinoids, which allowed for the reduction of side effects, better chemical compatibility and better stability of formulations. Other topical treatments adopted sought to complement the retinoids and antibiotics with mechanisms of antiseptic, anti-inflammatory, comedolytic and keratolytic action. They are often used as a second line of treatment; and in some special cases for sensitive patients and pregnant women. Acne vulgaris is a chronic disease that affects not only the skin; it has a great psychological and financial factor in affected patients. Clinical follow-up is important because it is an exclusive long-term treatment, and awareness of this fact is important.