{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T05:13:56Z","timestamp":1769922836461,"version":"3.49.0"},"reference-count":50,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,5,4]],"date-time":"2022-05-04T00:00:00Z","timestamp":1651622400000},"content-version":"vor","delay-in-days":123,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Dermatology Research and Practice"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:p>Stress plays an important role in the causation and aggravation of psychodermatological conditions such as acne vulgaris. Alpha casein hydrolysate (<jats:italic>\u03b1<\/jats:italic>s1\u2010casein hydrolysate; Lactium) has been shown to decrease serum cortisol levels, reduce stress\u2010related symptoms, and promote relaxation. \u201cThis study aimed to compare the efficacy and safety of Lactium\u2122 plus standard care to those of standard of care alone in reducing stress levels and acne severity in patients with acne vulgaris.\u201d The C.E.R.T.A.I.N trial (Name registered with Clinical Trials Registry\u2010India\u2010No. <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/clinicaltrials.gov\/ct2\/show\/CTRI\/2019\/01\/017172\">CTRI\/2019\/01\/017172<\/jats:ext-link>) is a randomized, controlled, multicenter, open\u2010label, two\u2010arm, investigator\u2010initiated clinical trial. A total of 100 patients with moderate\u2010to\u2010severe acne vulgaris were enrolled and randomly assigned to one of the two groups: Lactium\u2122 plus standard care or standard care alone. Stress levels were assessed using serum cortisol levels, Investigator\u2019s Global Assessment (IGA) acne severity scale scores, Perceived Stress Scale (PSS) scores, and the Hamilton Anxiety Rating Scale (HAM\u2010A) scores. The Dermatology Life Quality Index (DLQI) was also used to assess the impact of the skin disease on patients\u2019 quality of life. At 12 weeks, stress levels were significantly lower in group A (Nixiyax plus standard of care) than that in group B(only standard care), as measured by the change in serum cortisol levels (4.75\u2009\u00b1\u20094.46 vs. \u22120.24\u2009\u00b1\u20095.22). Furthermore, the mean change in PSS scores (3.09\u2009\u00b1\u20092.04 vs. 0.90\u2009\u00b1\u20092.76) and HAM\u2010A scores (5.11\u2009\u00b1\u20091.94 vs. 1.25\u2009\u00b1\u20093.13) was significant. Patients in both arms had a significant decrease in total, inflammatory, and noninflammatory acne lesions, as well as a significant improvement in DLQI and IGA scores. In patients with moderate\u2010to\u2010severe acne vulgaris, Lactium\u2122 was found to be both safe and well\u2010tolerated. Lactium\u2122 plus standard care is more effective than standard care alone in reducing acne severity through stress reduction.<\/jats:p>","DOI":"10.1155\/2022\/2916317","type":"journal-article","created":{"date-parts":[[2022,5,4]],"date-time":"2022-05-04T23:20:09Z","timestamp":1651706409000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Role of Lactium\u2122 in Psychodermatology: The CERTAIN Trial<sup>#<\/sup> on Patients with Acne Vulgaris"],"prefix":"10.1155","volume":"2022","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8797-0015","authenticated-orcid":false,"given":"Amit Shivaji","family":"Kerure","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satish","family":"Udare","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chetan","family":"Vispute","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,5,4]]},"reference":[{"key":"e_1_2_10_1_2","first-page":"1652","article-title":"Psychosomatic disorder and functional somatic syndrome","volume":"67","author":"Yoshihara K.","year":"2009","journal-title":"Nihon Rinsho"},{"key":"e_1_2_10_2_2","first-page":"1873","article-title":"Psychodermatology: the mind and skin connection","volume":"64","author":"Koo J.","year":"2001","journal-title":"American Family Physician"},{"key":"e_1_2_10_3_2","doi-asserted-by":"publisher","DOI":"10.4103\/0378-6323.107632"},{"key":"e_1_2_10_4_2","doi-asserted-by":"publisher","DOI":"10.5314\/wjd.v2.i3.16"},{"key":"e_1_2_10_5_2","first-page":"1","article-title":"Stress as an influencing factor in psoriasis","volume":"16","author":"Heller M. 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