Best Acne Treatment Practices

Pimples: Education, Goals and Choice of Therapy

Nov 21, 2009 Hanish Babu

The best acne treatment practices include education, clear-cut management goals and evidence based treatment protocols.

Managing acne patients involves proper education to dispel the acne myths, defining the goals of therapy and instituting evidence based therapeutic measures.

Education of Acne Patients

Most adolescents affected by acne bumps are anxious and worried about the after-effects of acne bumps, acne scars and blemishes. Proper education is necessary to reassure the patients about the natural course of acne. But care should be exercised not to trivialize the condition so that proper treatment is delayed or ignored.

Education is based on various aspects of acne and its management, including the following:

The prevalence of acne: Acne is a common disorder of adolescents, affecting almost everyone at least once during their lifetime.
The natural course of the pimples: There are different types of acne and most cases of mild acne improve without causing scars. Moderate to severe types of acne require therapy for longer duration to avoid scarring.
The common acne myths: There are many prevailing and they should be clarified during the first visit.
Treatment options for acne: Treatment differs according to the types of acne.
Lifestyle adjustments are required to reduce the chances of recurrences.
Follow up and maintenance therapy: Regular follow up and maintenance therapy with topical retinoids is necessary to keep the acne eruptions under control.

Goals of Acne Treatment

Treatment will not cure acne. The following are the goals of acne treatment:

to get rid of acne bumps
to prevent the inflammation from becoming deep and extensive
to prevent acne scars
to improve the compliance of patients
to reduce anxiety and stress associated with pimples
to improve self esteem in affected teens

Choice of Acne Medications

Choice of acne medications depends on the type and extent of the acne eruptions. Following is a list of the different types of acne and the medications best suited for each:

Mild comedonal acne: Topical retinoids alone or in combination with topical clindamycin or benzoyl peroxide. Acne topical medications alone will suffice in this type of acne.
Moderate papular and pustular acne: Combination of topical antibiotics and benzoyl peroxide. If inflammation is extensive, add systemic antibiotics.
Severe pustular and nodular acne: Systemic retinoids alone or a combination of systemic and/or topical antibiotics and/or benzoyl peroxide. Laser and blue light therapy may be useful in this type of acne.
Very severe nodulo-cystic acne: Systemic isotretinoin for the first 12-16 weeks, then shift to combination of systemic antibiotics and topical retinoids if necessary. Surgical intervention and intralesional steroids may be necessary.
Acne scars need to be dealt with according to the individual characteristics and types of scarring.

Maintenance of Acne Therapy

Most acne sufferers are free of the disease by the age of 25 years. About 3% males and 12% females may still get periodic acne eruptions beyond 25 years.

Maintenance therapy, usually with topical retinoids, is necessary to prevent acne recurrences.

Adherence to these best acne treatment practices will not only help get rid acne, prevent scarring, but also ensure better patient compliance.

Sources:

Diane T, Gollnick H et al. New insights into the management of acne: An update from the Global Alliance to Improve Outcomes in Acne Group. J Am Acad Dermatol, 2009;60:S1-50.
Breathnach SM et al. Systemic Therapy in Rook’s Textbook of Dermatology. 2004; 4:72.15-17.

Disclaimer

The information given in this article is for educational purposes only so that patients are aware of the options available. No diagnosis should be made or treatment undertaken without first consulting your doctor. If you do so, Dr.Hanish Babu, MD or Suite101 will not be responsible for any consequences. The images provided are for illustration purposes only.

The copyright of the article Best Acne Treatment Practices in General Medicine is owned by Hanish Babu. Permission to republish Best Acne Treatment Practices in print or online must be granted by the author in writing.

Best Acne Treatment Practices