The oxidative stress, vitamin A levels, vitamin E levels and quality of life index in patients with moderate and severe acne

Acne vulgaris is a common and multifactorial skin disease that may have a considerable psychological impact. Some recent studies proposed that oxidative stress, which is produced by inflammatory mediators, may play an important role in the pathogenesis. Despite the well-known therapeutic effects of vitamin A and vitamin E, their roles in the acne pathogenesis have not been understood exactly. In this study, we investigated the impact of the severity of acne on the quality of life. We studied also the possible roles of the oxidative stress parameters and serum levels of vitamin A and vitamin E on the pathogenesis of moderate and severe acne.We performed Acne Quality of Life Scale (AQOLS) in a total of 75 patients with moderate (n: 39) and severe (n: 36) acne. Serum levels of total oxidant status (TOS) and total antioxidant status (TAS) as well as serum levels of vitamin A and vitamin E were analysed in a total of 60 patients with moderate (n: 30) and severe (n: 30) acne and 30 healthy control subjects. Serum levels of TAS and TOS were determined by an automatic colorimetric method. Serum vitamin levels were analyzed by High Performance Liquid Chromatography. The ratio of TOS level to TAS level in each subject was regarded as oxidative stress index (OSI).Mean AQOLS score was calculated as 6.69. As this value is lower than the cut point of 9, we concluded that moderate and severe acne may not have any negative impact on the quality of life. Serum levels of TAS and TOS and OSI values from 60 patients with acne were significantly higher than controls. Serum levels of vitamin A and E were also significantly lower in patients. There was a significant positive correlation between levels of TAS and vitamin A levels in acne patients. Both the levels of vitamin A and vitamin E were significantly lower in patients with severe acne than those with moderate acne. Serum levels of vitamin A and TAS were significantly lower in female compared to males. Serum TOS levels and OSI values were significantly higher in females than males.We observed that severe and moderate acne did not affect significantly the quality of life. However, the usage of disease-specific quality of life measures in routine practice would be beneficial in determining treatment options and priorities. Increased oxidative stress and decreased serum levels of both vitamin A and vitamin E may have important roles in the pathogenesis. Vitamin A deficiency or its reduced bioavailability might especially lead to progression of acne. As the lack of the correlation of oxidative stress parameters with the severity of acne, other factors may also play important roles in the acne pathogenesis and its progression, additionally to the decreases in the serum levels of vitamin A and E. To elucidate the acne pathogenesis, more comprehensive and controlled studies are required.