INTRODUCTION
Acne vulgaris is a prevalent skin disorder that affects more than 80% of adolescents in the United States.1 Four major pathological processes, increased sebum production, altered keratinization of follicular keratinocytes, colonization
of the skin by the anaerobic Gram-positive bacterium Propionibacterium acnes, and inflammation have been implicated
to be important in the development of acne.1 In addition, colonization
by Staphylococcus aureus, Staphylococcus epidermidis, and Propionibacterium granulosum have been implicated in the pathogenesis of acne.2-4 It was reported that S. epidermidis, P. acnes, and P. granulosum, accounted for 95% of all the sequences
analyzed of sebaceous follicles of two acne-affected patients.3 The current treatment options for acne are of only modest efficacy.
The use of broad-spectrum antibiotics has led to widespread resistance 5,6 and the topical retinoids, currently considered as the first-line treatment of acne, have serious side effects. There is a need and public interest to identify alternative compounds with improved therapeutic properties for acne vulgaris.
Pomegranate juice exceeds the in vitro antioxidant potency of other common commercial fruit juices.7 Pomegranate fruit contains ellagitannins, gallotannins, ellagic acid, and smaller amounts of flavonoids and anthocyanins. The most abundant type of polyphenols in pomegranate juice and pomegranate extracts are ellagitannins.8 POMx extract is a commercially available
dietary supplement that is manufactured from the residual material after the first squeezing of the whole pomegranate fruit for juice production.7 Oral feeding of pomegranate fruit extract to mice afforded protection to mouse skin against the adverse effects of UVB radiation by modulating UVB-induced signaling
pathways.9 Hydroalcoholic extract based-ointment from pomegranate was reported to improve wound healing in vivo.10 Pomegranate extract has been demonstrated to have antimicrobial
activity against Clostridium difficile.11 Investigations using pure bacterial in vitro cultures have shown that pomegranate by-products and punicalagins significantly inhibited the growth of pathogenic clostridia and Staphyloccocus aureus.12
Green tea is derived from the leaves of Camellia sinensis plant. Tea leaves are rich in polyphenols, such as epigallocatechin-3-gallate (EGCG), the major polyphenol in green tea and the most commonly investigated. These polyphenols are maintained