Acne vulgaris treatment : The Current Scenario

Abstract

Acne Vulgaris is one of the most common skin disorders which dermatologists have to treat. It mainly affect adolescent, though may present at any age. In recent years, due to better understanding of the pathogenesis of acne, new therapeutic modalities and various permutation and combinations have been designed. In topical agents; benzoyl peroxide, antibiotics, retinoids, etc are the mainstay of treatment; can be given in combinations. While systemic therapy includes oral antibiotics, hormonal therapy, and isotretinoin, depending upon the need of patients it has to be selected. Physical treatment in the form of lesion removal, photo-therapy is also helpful in few of them. Since various old and new topical and systemic agents are available to treat acne, it sometime confuse treating dermatologist. To overcome this, panel of physicians and researchers worked together as a global alliance and task force to improve outcomes in acne treatment. They have tried to give consensus recommendation for the treatment of acne. Successful management of acne needs careful selection of anti-acne agents according to clinical presentation and individual patient needs.

Development and characterization of a novel antiacne niosomal gel of rosmarinic acid

“…The main limitation of benzoyl peroxide is cutaneous irritation or dryness and bleaching of clothes and hair (Bojor et al, 1995). The main adverse effects with topical retinoid are primary irritant dermatitis, which can present as erythema, scaling and burning sensation (Rathi, 2011). Use of topical antibiotics is also associated with Side effects though minor includes erythema, peeling, itching, dryness and burning, pseudomembranous colitis (Parry & Rha, 1986).…”

A randomized controlled open label comparative clinical study of cephalexin versus doxycycline in patients with acne vulgaris in a hospital based population of South India

“…10,45 Quite recently, an Indian study has documented Doxycycline resistance as high as 44.2% among 52 P. acnes strains isolated from 80 different patients. Very high degree of resistance against macrolides like Azithromycin (100%) and Erythromycin (98%) has been observed in the same study.…”

“…45 Thus, to optimize the use of oral antibiotics in acne vulgaris many guidelines have been developed which dissuade antibiotics monotherapy and subtherapeutic dosing of antimicrobial agents and also recommend the addition of topical agent like Benzoyl peroxide or retinoids. 10,46,47 In order to minimize the risk of antibiotic resistance, long term antibiotics therapy should be limited to maximum three months and effective alternative treatment modalities must be provided whenever necessary.…”

“…Oral Doxycycline has been successfully used at a dose range of 50-200mg per day among the patients of acne. 10 Addition of a topical agent like Benzoyl peroxide (BPO) to long term oral antibiotic regimen is recommended as it reduces the development of antibiotic-resistance. 11 Although conventional systemic antibiotics for acne are often successful, many patients do not improve or are unable to tolerate medications because of the associated side effects.…”

A randomized, open-label, comparative study of efficacy of low-dose continuous versus low-dose intermittent oral isotretinoin therapy in moderate-to-severe acne vulgaris

“…Systemic therapy includes systemic antibiotics, hormonal therapy, and oral isotretinoin. [4] Oral isotretinoin is the most effective choice in the treatment of severe acne. Application of this drug has also been expanded to patients with less severe but scarring acne who are responding unsatisfactorily to conventional treatment.…”