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.
Acne vulgaris can represent a therapeutic challenge in terms of managing ongoing symptoms and preventing scar formation. Dermatologists may now have viable new alternatives for treating all grades of acne severity that circumvent the negative side-effects associated with many conventional options.
This article discusses the rationale behind various topical treatments for acne to increase adherence and optimize outcomes. Efficacy, safety, antibiotic resistance, onset of action, and combination therapies are covered.
Since multiple factors are involved in the pathophysiology of acne, treatment that counteracts the majority of them can be expected to achieve the best results. When considering the options for reducing the P. acnes population, it is best to choose those that do not encourage resistance patterns.
Acne vulgaris is a chronic inflammatory cutaneous disease involving the pilosebaceous unit. This article discusses pathophysiology, sebum production, keratinization, and the role of P.acnes in acne formation.
Learn about cannabinoids influence on skin growth control, homeostasis, melanoma, acne, pruritus, inflammation, atopic dermatitis, and other skin conditions.
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.
Adopting a comprehensive approach that takes into account individual preferences, properties of available treatments, and disease severity can encourage patient adherence and lead to improved treatment outcomes. The key to gaining adherence, is the attention devoted by physicians to establishing effective communication with the patient.
Oral contraceptives (OCs) have been available since 1960, and can be useful for treating certain types of acne. Various acne-approved OCs are discussed.
The proven therapeutic benefits of OCs offer a valuable option to physicians for the treatment of acne. The accumulating evidence on the efficacy and safety of recently available drospirenone-containing hormonal preparations provides dermatologists with a new option for the treatment of acne and other hyperandrogenic disorders.
On the 26th of February 1998, Hoffmann-LaRoche, on the instructions of the FDA, sent out more than 210,000 Dear Dr. warning letters to health care providers communicating new safety information about the prescribing of isotretinoin for acne, and citing isolated reports of drug-induced depression, psychosis and rarely, suicidal thoughts and action.
Truncal acne refers to AV affecting the chest and/or back, a common presentation in acne patients. This article offers guidance in clinical differentiation of truncal acne from other acneiform diseases and provides management recommendations.
Educate and counsel. Most patients with acne are teenagers who are very self-conscious about their looks and expect immediate treatment results. However, adult acne is becoming more common, and can be very distressing as well.
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.
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.
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.
Combination therapy is a strategy of combining antibiotic treatments with other treatments with different mechanisms of action to treat acne. This has the effect of preventing or mitigating the unwanted effects of antibiotic resistant bacteria, and may confer other benefits such as lower required dosage as well.
Topical treatment is the mainstay for mild acne, and adjunctive to oral or hormonal therapy for moderate acne. This article explores recent formulary advances and offers clinical strategies that can encourage adherence and improve treatment outcomes.
Acne is among the most common dermatological disorders seen by dermatologists, affecting approximately 85% of people between the ages of 12 and 24 years. The use of adjunctive cleansers and moisturizers can help mitigate treatment side effects and subsequently enhance therapeutic efficacy.
A new topical retinoid, trifarotene, the first fourth-generation retinoid, is now available in Canada for the treatment of moderate facial and truncal acne.
Progestin only and combination pills are discussed in this article. Monophasic, biphasic, and triphasic pills are considered and listed.
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.
Benzoyl peroxide 5% plus erythromycin 3% (Benzamycin. gel, Dermik) will be evaluated. Although it is not known how effective it is compared with benzoyl peroxide and erythromycin prescribed separately, Benzamycin® is simpler to use and likely to improve patient compliance.
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.
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.
Topical retinoids are the cornerstone of acne therapy and they can be used across the entire spectrum of acne severity. Selecting the most suitable retinoid formulation, as well as dispensing proper advice in terms of drug application, can improve patient compliance.
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.
Acne vulgaris is a disease of the pilosebaceous follicle characterized by non-inflammatory (open and closed comedones) and inflammatory lesions. Its pathogenesis is multifactorial - the interplay of hormonal, bacterial, and immunological (inflammatory) factors results in the formation of acne lesions.
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.
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.
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.