The American Academy of Dermatology released evidence-based guidelines with acne treatment recommendations for both adolescents and adults, which were published online in theJournal of the American Academy of Dermatology (Feb. 17, 2016).
“There are a variety of effective treatments available for acne, and dermatologists have found that combining two or more treatments is the best option for the majority of patients,” said Hershey, Pa.-based dermatologist Dr. Andrea Zaenglein, who is the co-chair of the expert work group that developed the guidelines, in a press release. “Recommended treatments include topical therapy, antibiotics, isotretinoin, and oral contraceptives.”
When antibiotics are used for the treatment of moderate-to-severe acne, the guideline recommends that topical therapy be used at the same time. Once a course of antibiotics is complete, patients should continue using topical treatments to manage their condition. Topical medications, such as retinoids and benzoyl peroxide, also may be combined with one another to create an effective treatment regimen. Additionally, some female patients may see their acne improve with the use of oral contraceptives, which can be combined with other treatments.
For severe acne or moderate acne that does not respond to other therapy, the guidelines recommend oral isotretinoin. Because this medication carries a high risk of birth defects, females must take careful steps to prevent pregnancy while on isotretinoin. While some studies have suggested a connection between oral isotretinoin and inflammatory bowel disease or depressive symptoms, the evidence is not conclusive; however, dermatologists should inform their patients of these potential risks.
Although limited data has shown that in-office procedures like laser treatments or chemical peels may improve acne, the guidelines do not recommend such procedures for routine acne treatment. The guidelines also indicate that there is not enough evidence to recommend treating acne with alternative therapies like tea tree oil.
Some research suggests that dairy products, particularly skim milk, and diets with a high glycemic index may be linked to acne. According to the guidelines, however, there is not enough data to recommend dietary changes for acne patients.
“Acne is a highly visible condition that can have a major impact on patients’ quality of life,” says board-certified dermatologist Dr. Mark Lebwohl, president of the AAD and professor and system chair of dermatology at Mount Sinai Hospital in New York City. “Teens and adults who are struggling with acne should visit a board-certified dermatologist, who can help them find a safe and effective treatment option that works for them.”