Latest Acne Guidelines

types_of_acne_pimplesThe American Academy of Dermatology has issued its latest guidelines on acne treatment.  These guidelines will help doctors and patients deal with this frequently difficult-to-treat and most common skin problem.

The biggest point of the report is that monotherapy, or the sole use of one single approach, is not recommended.  As I have discussed in multiple other blog posts in the past, there are multiple factors that cause acne breakouts, and treating just one of those factors alone is unlikely to be successful.

Another important point the writers of this report made is that although antibiotics can be very helpful both topically and by pill, attention must be paid to the risks of antibiotic resistance.  Such risks pose an ongoing threat in treatment of all bacterial diseases.

I will summarize some of the major points of the panels that drew up these guidelines:

  1. Topical Therapy
    benzoyl_peroxide_gelBenzoyl peroxide remains the first-line of therapy for acne, as it helps to fight the acne bacteria by itself but also lessens the development of antibiotic resistance.  Topical antibiotics do work in the short term to decrease acne bacteria, but should not be used alone.
    The most effective topical agents use combinations of antibiotics and either benzoyl peroxide or a retinoid (vitamin A derivative).  These combination topicals helps reduce the chances of antibiotic resistance and attack the acne problem from multiple different perspectives.
  2. Oral Antibiotics
    Generally, the tetracycline family of antibiotics has been used for acne treatment.  Minocycline and doxycycline are the most commonly prescribed and with the least amount of side effects.  Since antibiotics for acne have been used longer than antibiotics and are traditionally used for other bacterial conditions, doctors are always concerned about the development of resistance to these antibiotics within the body.
    Oral antibiotics can be limited in their length and dosage when combined with topical agents.  In general, when antibiotics are stopped, the successful topical therapy needs to be maintained.
  3. Hormone Therapy
    Since the earliest development of oral contraceptives, they have been known to help the female acne patient reduce acne breakouts.  This effect occurs because the hormones taken further decrease the production of the limited amounts of testosterone produced by the female body, which aggravate the acne process.
    No particular oral contraceptive has been shown to produce the best results, so patient preference and the individual doctor’s judgement are both considered the major factors in choice.  As with other aspects of acne care, use of hormones should be used as part of a comprehensive treatment program of products.
  4. Diet
    high_sugar_dietUnfortunately, studies on the association of diet with acne have not been helpful.  However, more and more evidence does show an association of acne breakouts with diets high in sugar.  Low sugar diets have been shown to decrease sebum or skin oil production and associated inflammation.  Some studies have also linked association of acne with ingestion of milk products.
    Again, the emphasis is on the use of other products with dietary changes.  Elimination of dairy products and reduction of high sugar foods are just a few simple steps in beginning to reduce acne.
  5. Light Therapy
    laser_treatmentThe use of laser therapies for acne is now over a decade old and has shown significant progress, especially for treatment of moderate to severe acne that is resistant to other forms of therapy.  Lasers combine to improve multiple aspects of the acne cascade.
    The particular laser I employ here at Maine Laser Skin Care penetrates deep enough in the skin to effect the oil glands that produce the sebum that will combine with dead skin cells to plug the pores.  The heat produced with the skin layers also will decrease the number of bacteria within the pores without resorting to use of antibiotics.

acne_stressWhile all acne patients are obviously distinct and unique in their needs and response to treatment, these guidelines take such differences into account.  They emphasize that one size does not fit all, and that various combinations will work best.

That overview of these guidelines has been my experience in my several decades of treating acne.  Plus, the newer technologies continue to help increase the success rate for treatment of this common and troublesome condition.

If you have any questions about acne or what treatment might help you the best, call us at (207) 873-2158 to arrange a free and confidential consultation.  There is nothing like a clear face to help anyone’s self-esteem, whether a teenager or an adult.

About Dr. John Burke

John Burke M.D. has practiced medicine for over 25 years, and is the founding partner of MidMaine Internal Medicine. He established Maine Laser Skin Care in 2004 after devoting years to learning the latest in laser and dermatologic technology. Dr. Burke has treated patients from all over the United States. He is one of Maine's busiest practitioners in laser treatments, and in the use of Botox for upper facial lines and excessive sweating.
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