Acne Exo Shot Study

Acne is a chronic inflammatory disease of the skin involving the sebaceous glands and hair follicles and is characterized by comedones, papules, pustules, cysts, and nodules that appear on the face, chest, back, and shoulders (Williams, Dellavalle, & Garner, 2012). It is known that acne is caused by a combination of various factors such as hereditary, fatigue, or stress, and it is generally known that acne develops by excessive sebum production, Propionibacterium acnes proliferation, and inflammation reaction (Contassot & French, 2014). Particularly, skin damage caused by excessive and repetitive inflamma- tory reactions leaves scars even after complete recovery, which lowers a patient’s selfesteem psychologically, often leading to an unfulfilling social life (Darji, Varade, West, Armbrecht, & Guo, 2017). Various methods have been used for the treatment of acne: inhibi- tion of excessive sebum production using hormone agents; inhibition of proliferation of P. acnes using lasers, antibacterial agents, or antibiotics; prevention of pore blockages through chemical peels, etc. (Fox, Csongradi, Aucamp, du Plessis, & Gerber, 2016). Among these methods, topical agents are most widely used to inhibit the proliferation of P. acnes. It is recommended to use antibacterial materials such as benzoyl peroxide rather than antibiotics such as erythromycin or clindamycin due to tolerance issues (Gollnick & Krautheim, 2003). In particular, in order to maximize the effects of such antibacterial sub- stances, a combination therapy of various components was performed (Gollnick, 2003). To that end, it is required to develop a variety of anti- bacterial materials that are both safe and effective (Fu & Vender, 2011). As a natural medicine, ginseng Panax ginseng C.A. Meyer) is known as a medicinal plant that has minimal side effects on the human body and various biologically active effects. In general, it is typically known that ginseng improves immunity (Sohn et al., 2008), enhances blood flow (Lee et al., 2008) and memory (Zhang et al., 2008), prevents skin damage from ultraviolet rays (Lee et al., 2009), and increases antioxidant effects (Kang, Yokozawa, Yamabe, Kim, & Park, 2007). These physiolog- ically beneficial effects of ginseng are known to be caused by saponin, a main ingredient of ginseng. However, in recent years, many pharmaco- logical effects of nonsaponin components have been reported, too. Polyacetylene, one of the typical nonsaponin components, has been found in about 20 kinds of ginseng and red ginseng (Yeo, Yong, & Popovich, 2017). Polyacetylene reportedly has positive effects such as antiinflammation (Lee et al., 2006), anticancer (Mayer, Steinreiber, Orru, & Faber, 2002), improved blood circulation (Teng et al., 1989), prevention of brain damage (Nie et al., 2008), and antibacterial effects (Bae, Han, Baek, & Kim, 2001). Usually, ginseng refers to white ginseng and is produced by air-drying fresh ginseng. Red ginseng is produced by repeatedly steaming and air-drying fresh ginseng (Im, Kim, & Min, 2016). This study aims to identify the active antimicrobial ingredients from red ginseng (P. ginseng C.A. Meyer) to treat P. acnes Its efficacy is compared with other over‐the‐counter (OTC) ingredients, benzoyl peroxide, and azelaic acid. We also performed a human clinical trial with topical formulation containing antibacterial ingredients and ana- lyzed the in vivo efficacy.