Optimizing Non-Antibiotic Treatments for Patients with Acne: A Review

Canavan, Theresa; Chen, Edward; Elewski, Boni E.

doi:10.1007/s13555-016-0138-1

Cited by 31 publications

(53 citation statements)

References 107 publications

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“…At the same time, P. acnes colonizes the pilosebaceous duct, triggering the release of inflammatory mediators into the surrounding tissue and a response by immunocompetent cells, further contributing to the development of comedones . Acne most often occurs in the face, neck, back, and chest, all areas with many pilosebaceous units …”

Section: Pathogenesis Of Acnementioning

confidence: 99%

“…This assertion is supported by the work of Jain and Ahmed, who showed that pretreatment of skin with adapalene enhanced the penetration of topical clindamycin phosphate, thus increasing the efficacy of the antibiotic. Tretinoin, adapalene, and tazarotene are the only retinoids approved for use in the USA . Topical retinoids used alone are an excellent therapy for the treatment of predominantly comedonal acne …”

Section: Treatment Of Acnementioning

confidence: 99%

“…Topical antibiotics that target P. acnes are inexpensive and have minimal local side effects. Use should be limited, however, to changing resistance patterns in P. acnes . Clindamycin antibiotic has the additional advantages of anti‐inflammatory and anticomedogenic effects.…”

Section: Treatment Of Acnementioning

confidence: 99%

“…Topical BPO targets P. acnes and has anti‐inflammatory effects but weak activity against comedones . The advantage of BPO over antibiotics is that it is not associated with antimicrobial resistance . BPO (2.5%‐10%) is available over the counter as a gel, lotion, cream, or wash …”

Section: Treatment Of Acnementioning

confidence: 99%

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Current treatments of acne: Medications, lights, lasers, and a novel 650‐μs 1064‐nm Nd: YAG laser

Gold

Goldberg

Nestor

2017

J of Cosmetic Dermatology

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The treatment of acne, especially severe acne, remains a challenge to dermatologists. Therapies include retinoids, antibiotics, hormones, lights, lasers, and various combinations of these modalities. Acne is currently considered a chronic rather than an adolescent condition. The appropriate treatment depends on the patient and the severity of disease. The purpose of this study was to review current therapies for acne of all severities and to introduce the 650-μs 1064-nm laser for the treatment of acne.

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Section: Pathogenesis Of Acnementioning

confidence: 99%

Section: Treatment Of Acnementioning

confidence: 99%

Section: Treatment Of Acnementioning

confidence: 99%

Section: Treatment Of Acnementioning

confidence: 99%

See 2 more Smart Citations

Current treatments of acne: Medications, lights, lasers, and a novel 650‐μs 1064‐nm Nd: YAG laser

Gold

Goldberg

Nestor

2017

J of Cosmetic Dermatology

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“…The most commonly applied non‐pharmacological therapies are laser and light‐based therapies, chemical peels, microneedling, (micro)dermabrasion and (mechanical) lesion removal. Non‐pharmacological therapies are applied as independent therapies, in combination with conventional therapies or as maintenance therapy, especially in more persistent or chronic types of acne where long‐term therapy is required . However, sufficient evidence‐based support in the efficacy and safety of non‐pharmacological therapies is scarce.…”

Section: Introductionmentioning

confidence: 99%

The efficacy and safety of non‐pharmacological therapies for the treatment of acne vulgaris: A systematic review and best‐evidence synthesis

Vries

Meulendijks

Driessen

et al. 2018

Acad Dermatol Venereol

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Circumstantial evidence was found for non-pharmacological therapies in the treatment of acne vulgaris. However, the lack of high methodological quality among included studies prevented us to draw clear conclusions, regarding a stepwise approach. Nevertheless, our systematic review including a best-evidence synthesis did create order and structure in resulting outcomes in which a first step towards future research is generated.

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Isotretinoin update

Marson

Baldwin

2021

Dermatological Reviews

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Background Acne is a common, chronic inflammatory condition seen in nearly all teenagers and many adult females, with a global lifetime prevalence between 70‐85%. While a majority of individuals with acne can be appropriately managed with a combination of topical therapies, oral antibiotics, and/or oral anti‐androgens, 10‐20% of individuals will have acne severe enough to warrant isotretinoin. When necessary, isotretinoin is highly effective and the only drug to offer the likelihood of a durable response. Aims To review the literature regarding known adverse effects of isotretinoin therapy and nuances during and post‐isotretinoin therapy important to patient care. Materials and Methods A literature search was conducted for original, English‐language case reports, case series, original studies and/or meta‐analyses published between 1982‐2021 on isotretinoin, related adverse effects, and laboratory assessment and treatment nuances during and after a course of isotretinoin. Results Adverse events categories include mucocutaneous (e.g., xerosis, cheilitis, epistaxis), ocular (xerophthalmia, nyctalopia, blepharitis, conjunctivitis), non‐specific gastrointestinal, musculoskeletal (myalgia, pre‐mature epiphyseal plate closure, DISH), neurologic (idiopathic intracranial hypertension, hearing loss, tinnitus). Most adverse events are mild, self‐limiting, and/or resolve with drug discontinuation. Teratogenicity is of utmost concern especially given the risk of patient nonadherence to iPLEDGE precautions. Laboratory testing at baseline and after month 2 of therapy or upon reaching maximum daily dose may be sufficient. Utilizing creatine kinase and gamma‐glutamyl transferase in lieu of aspartate aminotransferase and alanine aminotransferase may better assess hepatic function during treatment. Improved formulations of isotretinoin may improve absorption and decrease reliance on patient adherence to a high‐fat diet. Dermabrasion and fully ablative laser procedures should be avoided in the immediate post‐isotretinoin period. Discussion Although adverse events associated with isotretinoin therapy are common, a majority of side effects are limited, self‐resolving (with completion of treatment course) without long‐term implications, and/or easily managed. Unfortunately, the advent of the internet and social media has given a platform to misleading law‐firm claims and medical pseudoscience inaccuracies that may frighten patients in need of treatment, ultimately delaying or even preventing therapy. Conclusion It is important that physicians are knowledgeable about the nuances of isotretinoin therapy, including efficacy, real potential adverse events, and appropriate laboratory monitoring. By honing this expertise, physicians may confidently counsel and guide patients through a course of isotretinoin to achieve a more permanent solution for their acne and improve their quality of life.

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Optimizing Non-Antibiotic Treatments for Patients with Acne: A Review

Cited by 31 publications

References 107 publications

Current treatments of acne: Medications, lights, lasers, and a novel 650‐μs 1064‐nm Nd: YAG laser

Current treatments of acne: Medications, lights, lasers, and a novel 650‐μs 1064‐nm Nd: YAG laser

The efficacy and safety of non‐pharmacological therapies for the treatment of acne vulgaris: A systematic review and best‐evidence synthesis

Isotretinoin update

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