Guidelines of care for the management of acne vulgaris

Zaenglein, Andrea L.; Pathy, Arun L.; Schlosser, Bethanee J.; Alikhan, Ali; Baldwin, Hilary; Berson, Diane; Bowe, Whitney P.; Graber, Emmy; Harper, Julie; Kang, Sewon; Keri, Jonette; Leyden, James J.; Reynolds, Rachel V.; Silverberg, Nanette B.; Gold, Linda F Stein; Tollefson, Megha M.; Weiss, Jonathan S.; Dolan, Nancy C.; Sagan, Andrew A.; Stern, Mackenzie; Boyer, Kevin; Bhushan, Reva

doi:10.1016/j.jaad.2015.12.037

Cited by 1,180 publications

(1,701 citation statements)

References 277 publications

(263 reference statements)

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“…Moreover, acne improved and Propionibacterium decreased after treatment, while the microbial diversity increased 54, 55. Taking into account that a clear pathophysiological role of P. acnes exists and antimicrobial interventions are effective in AV 72, 73, the adoption of the skin microbiome as biomarker in acne drug development programmes is, although still in its infancy, suggested by our review (Table 2). Lesion clearance often takes a long time; therefore, the inclusion of microbiota is a valid option to monitor subclinical treatment effects and restoration of normal bacterial profile, i.e.…”

Section: Discussionmentioning

confidence: 84%

A systematic literature review of the human skin microbiome as biomarker for dermatological drug development

Kolk

Wall

Balmforth

et al. 2018

Brit J Clinical Pharma

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AimsTo explore the potential of the skin microbiome as biomarker in six dermatological conditions: atopic dermatitis (AD), acne vulgaris (AV), psoriasis vulgaris (PV), hidradenitis suppurativa (HS), seborrhoeic dermatitis/pityriasis capitis (SD/PC) and ulcus cruris (UC).MethodsA systematic literature review was conducted according to the PRISMA guidelines. Two investigators independently reviewed the included studies and ranked the suitability microbiome implementation for early phase clinical studies in an adapted GRADE method.ResultsIn total, 841 papers were identified and after screening of titles and abstracts for eligibility we identified 42 manuscripts that could be included in the review. Eleven studies were included for AD, five for AV, 10 for PV, two for HS, four for SD and 10 for UC. For AD and AV, multiple studies report the relationship between the skin microbiome, disease severity and clinical response to treatment. This is currently lacking for the remaining conditions.ConclusionFor two indications – AD and AV – there is preliminary evidence to support implementation of the skin microbiome as biomarkers in early phase clinical trials. For PV, UC, SD and HS there is insufficient evidence from the literature. More microbiome‐directed prospective studies studying the effect of current treatments on the microbiome with special attention for patient meta‐data, sampling methods and analysis methods are needed to draw more substantial conclusions.

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Section: Discussionmentioning

confidence: 84%

A systematic literature review of the human skin microbiome as biomarker for dermatological drug development

Kolk

Wall

Balmforth

et al. 2018

Brit J Clinical Pharma

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“…Only a small percentage of acne patients are treated by a dermatologist or prescribed medications [3]. While there is no associated mortality with acne, suffering mainly is due to permanent scarring, post inflammatory hyperpigmentation and poor self-image [4]. Various studies on acne prevalence showed that patients have a greater degree of acne severity if there is first-degree relative's acne history [5] [6].…”

Section: Introductionmentioning

confidence: 99%

Acne Vulgaris in Jeddah Medical Students: Prevalence, Severity, Self-Report, and Treatment Practices

Zari¹,

Turkistani²

2017

JCDSA

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Acne is a common skin disorder of teenagers and continues into adulthood. Research has been limited regarding acne prevalence, perception and health care utilization in Saudi Arabia. The objective of this study was to assess acne prevalence in final year female medical students in Jeddah, Saudi Arabia using the global acne grading system (GAGS) compared with student's self-report of their acne. This is a cross-sectional study conducted among 151 students during 2016, in which students were interviewed subjectively and examined objectively by a trained physician. This study showed that acne was reported subjectively by 83.4% of female students compared to 98% of students assessed objectively by the global acne grading system. 14.6% of students claimed having no acne while it was objectively present, which was statistically significant (Χ 2 = 15.4, P < 0.001). 41% visited a dermatologist and 28.5% waited 1 year until seeking a dermatologist. However, 35.8% of students got an overthe-counter drug for their acne. Surprisingly, treatment duration expectation was <1 week in 9.9% compared to >2 months in 39.1% of students. Acne was present in 41.1% of the students parents compared to 83.4% in their siblings. A total of 41.7% of student had trunk acne. 60.9% of students had scarring and 72.8% of them had pigmentation. Moderate to severe acne students had higher siblings acne history of 95.2% (Χ 2 = 5.85, P < 0.05), higher scaring of 73.8% (Χ 2 = 4.05, P < 0.05), and higher pigmentation of 85.7% (Χ 2 = 4.87, P < 0.05) which was statistically significant. Our study confirms that acne is very common in female medical students in Jeddah, Saudi Arabia with a prevalence rate of 98%. Knowledge regarding acne treatment was inadequate demonstrating the need for educational and awareness programs about early treatment that will prevent suffering from acne scarring or pigmentation.

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“…This is of special interest, as recent guidelines confirm the daily use of a combination of topical retinoid and benzoyl peroxide in the evening and if needed an emollient in the morning to reduce potential local side‐effects frequently observed with retinoids and benzoyl peroxide 4, 5. The present results show that, despite these recommendations, a once‐every‐other‐day application of a fixed combination, commonly used by clinicians especially during the initiation of treatment provides in association with daily adjunctive use of the test care similar results to the once daily application of a fixed combination with no difference in efficacy.…”

Section: Discussionmentioning

confidence: 99%

“…A combination of benzoyl peroxide and topical retinoids is proposed in the recent guidelines as the first‐line treatment in women with acne 3, 4, 5, 6…”

Section: Introductionmentioning

confidence: 99%

A skincare combined with combination of adapalene and benzoyl peroxide provides a significant adjunctive efficacy and local tolerance benefit in adult women with mild acne

Bouloc

Roó²,

Imko-Walczuk³

et al. 2017

J Eur Acad Dermatol Venereol

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IntroductionAcne in adult women is an increasing reason for dermatological consultations.ObjectiveThe aim of this study was to assess in adult women with mild acne the efficacy and tolerance of a daily adjunctive application of a skincare (Normaderm®, Laboratoires Vichy, France) to a fixed combination of adapalene/benzoyl peroxide daily or every other evening and a standard emollient.MethodsSubjects were randomized to receive the fixed combination applied either every evening or every other evening and a daily application of the standard emollient and the test care or a once daily application of the fixed combination and the standard emollient alone. Clinical evaluations at Day 0, Day 45 and Day 90 included the count of acne lesions, assessment of clinical improvement and local tolerance. The quantitative lipid profile of the stratum corneum of the forehead was also determined.ResultsAfter 90 days of application, acne had improved in all 299 subjects with a statistically significant difference in favour of the test care regimens (P < 0.05). Moreover, skin quality, subject satisfaction, skin discomfort and sebum composition were in favour of these regimens.ConclusionIn conclusion, the tested skincare combined with a fixed adapalene and benzoyl peroxide combination provides a significant adjunctive efficacy and local tolerance benefit in adult women with mild acne.

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Guidelines of care for the management of acne vulgaris

Cited by 1,180 publications

References 277 publications

A systematic literature review of the human skin microbiome as biomarker for dermatological drug development

A systematic literature review of the human skin microbiome as biomarker for dermatological drug development

Acne Vulgaris in Jeddah Medical Students: Prevalence, Severity, Self-Report, and Treatment Practices

A skincare combined with combination of adapalene and benzoyl peroxide provides a significant adjunctive efficacy and local tolerance benefit in adult women with mild acne

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