Which therapy targets abnormal keratinization in acne treatment?

• A. Benzoyl peroxide
• B. Topical antibiotics
• C. Vitamin A cream
• D. Tea tree oil

Answer: (C)

Abnormal keratinization in acne refers to the excessive shedding and plugging of the follicular opening, which leads to comedone formation. The best way to address this underlying process is to normalize keratinocyte differentiation and desquamation within the pilosebaceous unit. Vitamin A cream, a topical retinoid, does exactly that. Retinoids bind to receptors in keratinocytes and regulate their maturation and shedding, reducing follicular occlusion and preventing new comedones from forming. They also have anti-inflammatory benefits and help clear existing comedones.

Benzoyl peroxide mainly reduces bacterial load and has some keratolytic effect, but it does not normalize the keratinization process. Topical antibiotics target bacteria and inflammation rather than the keratinization defect. Tea tree oil has antimicrobial properties but does not specifically correct abnormal keratinization.