Benzoyl peroxide is one of the most widely used topical agents for acne. This article discusses the anti-inflammatory and comedolytic effects of benzoyl peroxide.
Physicians will be particularly reassured if the suggested guidelines are supported by scientific evidence. This new Canadian clinical guideline for the treatment of acne was developed taking into account new data published up to March 2015, as well as expert opinion and clinical experience.
Propionibacterium acnes (P. acnes) is an anaerobic bacteria implicated in the pathogenesis of acne. Current treatment guidelines offer strategies to limit the potential for resistance while achieving optimal outcome in the management of inflammatory and non-inflammatory acne.
Cystic acne is characterized by the formation of cysts enclosing a mixture of keratin and sebum in varying proportions. It is the most severe of the four main types of acne, which are comedonal, papular, pustular, and cystic. Identification and treatment options are discussed.
There have been important advances in our understanding of acne scarring. Acne scars can resolve, and their evolution is determined by a balance between matrix repair and degradation. Timely, effective management of acne can minimize risk of subsequent acne scarring.
Topical products commonly used to treat acne include retinoids and antimicrobials, due to their effects on different components of pathogenesis. Accordingly, a fixed combination of adapalene 0.1% and benzoyl peroxide (BPO) 2.5% was developed (Epiduo™, Galderma) and was approved by the US FDA for the treatment of acne.
Current practice guidelines recommend administration of oral isotretinoin with high-fat meals, which may pose issues with patient compliance. This article discusses Isotretinoin-Lidose (Epuris™), pharmacokinetics, bioavailability, and increased drug absorption rate, and how it may improve patient compliance.
Acne treatment success involves a comprehensive approach that addresses diagnostic confounders, appropriate therapeutic options and patient adherence. Ongoing education and counselling will assist in meeting patient expectations and establishing a favourable rapport that promotes adherence.
This paper reviews current evidence presented by recent studies on the impact of acne on psychosocial health. Effective treatment of acne was accompanied by improvement in self-esteem, affect, obsessive-compulsiveness, shame, embarrassment, body image, social assertiveness and self-confidence.
Acne vulgaris is the most common skin disorder affecting children and young adults in North America. This article discusses combination therapy, and simplifying treatment plans in order to increase patient adherence, which is often a critical problem in treating acne.
Acne is a multifactorial disease of the pilosebaceous unit in the skin. Four contributing pathogenic factors need to be elucidated and include excess sebum production, follicular hyperkeratinization, colonization of the pilosebaceous unit by Propionibacterium acnes.
In two large randomized vehicle-controlled 12-week trials and in a 52-week open label study of moderate-to-severe acne at the face and trunk in subjects aged 9 years and older, trifarotene 50 μg/g cream demonstrated efficacy, safety, and cutaneous tolerability.
A new topical retinoid, trifarotene, the first fourth-generation retinoid, is now available in Canada for the treatment of moderate facial and truncal acne.
Evolving understanding of the role of hormones in acne, along with a growing body of data from clinical trials, calls for a reappraisal of the role of hormonal therapy for acne.
Administration of antibiotics, often for prolonged periods, has become the standard of care for acne. The authors provide current evidence to suggest that dermatologists should consider a departure from standard operating procedure by curtailing, if not discontinuing, the routine and regular use of antibiotics for acne.
A vast spectrum of topical anti-acne agents has emerged in response to new insights that have been gained through the understanding of disease pathophysiology and the need for clinicians to adopt an individualized therapeutic approach.
Acne vulgaris (AV) is among the most common dermatological disorders seen by dermatologists. Emerging evidence suggests that acne is associated with epidermal barrier impairments, and this article reviews the role of moisturizing, sun protection, and patient specific skincare advice for acne patients.
Moisturizers and Cleansers in the Management of Skin Conditions Caused by Personal Protective Equipment and Frequent Handwashing
Routine moisturization with non-irritating, pH-adjusted, ceramide-based products and gentle cleansing with a pH-adjusted cleanser can treat the unique dermatological challenges posed by COVID-19.
Oral contraceptives (OCs) can reduce acne by lowering the production of adrenal and ovarian androgens, by inhibiting 5- alpha-reductase, which in turn, reduces the levels of dihydrotestosterone, and by stimulating sex hormone binding globulin (SHBG), thus reducing the levels of free testosterone.
Clascoterone 1% cream represents a novel and promising therapeutic agent in the management of acne vulgaris for individuals ≥12 years of age. Notably, this topical agent was not observed to have significant systemic effects seen with systemic anti-androgenic agents.
Dapsone 5% gel for the topical treatment for acne represents the first new anti-acne agent to gain North American regulatory approval in the past decade. Dapsone's utility is attributable to its anti-inflammatory and antimicrobial properties, with more prominent effects occurring in inflammatory lesions.
Acne vulgaris is a common chronic inflammatory cutaneous disease involving the pilosebaceous unit. This article discusses the multifactorial nature of acne pathophysiology, therapeutics, and mechanism of action.
Clindoxyl® Gel (Stiefel) is a combination of 1% clindamycin phosphate and 5% benzoyl peroxide in a gel vehicle that is well tolerated and more efficacious than either active agent alone or the vehicle in reducing lesion counts and improving global scores in patients with moderate acne.
Oral isotretinoin, since its introduction more than 20 years ago, has been and still is the 'gold standard' in the treatment of acne and its variants. This is the only approach to acne with the possibility of a permanent “cure” or long term remission.
Since patient compliance is a concern, a great deal of attention must be given to the methods available to minimize the chance of irritation. In the opinion of the author, this may be the single most important factor influencing the success of topical therapy in acne.
There is compelling evidence that oral contraceptives (OCs) are effective in the management of mild-moderate acne vulgaris, as well as cumulative evidence that elevated levels of androgens in acne patients, relative to appropriate controls, are an underlying pathophysiological factor in acne.
Acne scarring is often challenging to manage. This article discusses various laser treatments that are helpful in addressing abnormal color and texture in order to improve the appearance of an acne scar as well as review the appropriate use and side-effects of these treatments.
Oral contraceptives (OCs) are a valuable option for the treatment of women with acne. The use of OCs can be considered across the spectrum of acne disease severity in women. In Canada, three preparations are approved for mild-to-moderate acne, and a fourth is indicated for severe acne.
Acne scarring is common but surprisingly difficult to treat. Scars can involve textural change in the superficial and deep dermis, and can also be associated with erythema, and less often, pigmentary change. In general, treatment of acne scarring is a multistep procedure.
Acne vulgaris is a multifactorial disease characterized by different types of lesions at various stages of development. Treatment options, such as light based therapy and systemic therapy, as well as CIS-Isotretinoin (Epuris™) that increases absorption are discussed as well as patient adherence.