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.
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.
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.
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.
This article is a brief overview of OTC (over the counter) treatment options for acne, which are available to patients without a prescription. Glycolic acid, salicylic acid, and benzoyl peroxide treatments are discussed, as well as other management of other factors like dry skin.
Treatment objectives and pharmacoeconomic considerations are important when developing guidelines that are effective and rational. Canadian Acne Treatment Guidelines were last published in 1995. New guidelines were recently developed to incorporate therapeutic advances and data from more recent studies.
Acne vulgaris is a multifactorial disease characterized by different types of lesions at various stages of development. The most frequently used therapeutic agents for acne are topical. This article focuses on the role of vehicles and advancements in this area.
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.
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 (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.
Tazarotene 0.045% lotion is a novel formulation which utilizes polymeric emulsion technology to improve tolerability and epidermal penetration. Despite the lower concentration of tazarotene in the lotion formulation, which likely also contributes to improved tolerability, tazarotene 0.045% lotion is at least as effective as tazarotene 0.1% cream.
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.
Platelet-rich plasma (PRP) is an autologous serum containing high concentrations of platelets and growth factors. PRP continues to evolve as an important treatment modality with many applications in dermatology, particularly in the areas of hair restoration, skin rejuvenation, acne scars, dermal augmentation, and striae distensae.
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.
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.
Topical acne treatment can positively benefit patients with acne. This review summarizes clinical and prescribing information on currently available topical agents. The efficacy of the medications included in this report is supported by properly designed randomized clinical trials.
This article organizes contraceptive pills is to compare the effects that the progestins that are used will have on acne.
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.
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.
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.
A new topical retinoid, trifarotene, the first fourth-generation retinoid, is now available in Canada for the treatment of moderate facial and truncal 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.
Progestins have multiple influences on acne. Cyproterone acetate, found in Diane-35® seems to be an exception in that it is not affected by estrogen.
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.