Expression of interleukins in adult female acne: evaluating the effects of azelaic acid.

Background: Adult female acne (AFA) is a multifactorial skin condition that affects women aged > 25 years, with inflammation playing a central role in its aetiopathogenesis. However, most research has primarily focused on severe acne vulgaris, while the immunological mechanisms underlying AFA remain poorly understood. Objectives: To analyse interleukin (IL)-6 and IL-8 expression in inflammatory lesions of AFA, before and after treatment with topical azelaic acid (AZA) 15% gel, and compare the findings with healthy skin; and to evaluate the efficacy of AZA based on clinical response and histopathological findings. Methods: Twenty women with mild-to-moderate AFA used AZA 15% gel twice daily for 6 months, with monthly follow-ups. Skin biopsies from lesional and healthy facial areas were collected at baseline and at treatment completion to assess IL-6 and IL-8 by immunohistochemistry and to score inflammation. Clinical evaluation, including Visia Results: There was significant overexpression of IL-6 and IL-8 in acne lesions compared with healthy skin, Conclusions: IL-6 and IL-8 expressions are increased in AFA, contributing to its inflammatory process. Therapies that reduce these proinflammatory cytokines, such as AZA, are beneficial. Our findings are consistent with a potential anti-inflammatory effect of AZA, given the observed decrease in IL-6 and IL-8.