What's New in the Treatment of Acne?

Acne Treatment

Acne affects nearly 85 percent of all people, making it the most common skin disorder in the United States. Acne is a well-known rite of passage for adolescents and young adults, though some people in their 30s and 40s continue to suffer from this skin problem. While there is no cure for acne, new treatments are targeting the cause of acne and helping patients keep their skin healthy and clear.

Speaking at the American Academy of Dermatology's (Academy) skin academy 2005, dermatologist Wendy E. Roberts, M.D., assistant clinical professor of dermatology at Loma Linda University Medical Center in Loma Linda, Calif., discussed the latest in the treatment of acne.

"Today patients have more choices than ever before to treat acne," said Dr. Roberts. "Since what works for one person may not work for another, it's important for patients to work with a dermatologist who can create an effective individualized treatment plan."

A recent poll conducted by the Academy shows that while people are starting to learn the truth about what causes acne, there are still some areas of confusion. Although 53 percent understand that acne is not caused by poor hygiene, myths still exist about the role of diet and stress. Sixty-two percent of respondents still believe that acne is caused by stress while half the respondents continue to believe acne is caused by diet. In fact, acne is caused by three major factors: the overproduction of oil by enlarged oil glands in the skin; blockage of the hair follicles that release the oil; and a growth of bacteria called P. acnes within the hair follicles. Scientific research has led to many new acne therapies and changes in existing treatment options.

Topical and Systemic Therapy
Depending on the type and severity of the acne, it can be treated with oral or topical antibiotics or topical retinoids. There are a number of ingredients that help unblock the pores and reduce bacteria, including topical retinoids, hydroxy acids, benzoyl peroxide and antibiotics. "These treatments are a cornerstone of therapy and are helpful both initially and in long-term maintenance of acne," said Dr. Roberts. "These ingredients may cause some drying and peeling, but they can achieve good results in patients, even those with moderate to severe inflammatory acne." Since some topical ingredients can stain or bleach, Dr. Roberts recommends applying the treatment before going to bed and using white towels when washing to avoid staining clothes or colored towels.

In some patients, the effectiveness of topical retinoids can be enhanced when combined with oral treatments. These combination therapies allow all of the factors causing acne to be targeted, making the treatment plan more successful. "Combination therapies should be discussed with a dermatologist who can recommend the most effective treatment after evaluating important factors such as the type and degree of acne, the patient's skin characteristics and environmental factors," noted Dr. Roberts.

Cosmetic Procedures
Combination therapies using oral and topical antibiotics or topical retinoids in conjunction with a chemical peel also have been found effective in managing acne. Chemical peel solutions with glycolic acid or salicylic acid are applied to the skin to exfoliate and help to unblock the pores, open the blackheads and whiteheads and stimulate new skin growth. This promotes the penetration of topical medications and also may treat blemishes which result from breakouts.

Similar to chemical peeling, microdermabrasion results in superficial exfoliation of the skin and can improve irregularities in the skin's surface to help enhance the penetration of topical treatments. "Chemical peels and microdermabrasion are minimally invasive, produce almost no discomfort and involve almost no recovery or down-time for the patient," stated Dr. Roberts.

These procedures are best used in combination with other acne treatments. And because these procedures help smooth the skin's surface, they can help diminish scars created by acne.

Laser and Light-based Therapies
New laser and light treatments can specifically target two of the factors that cause acne. Lasers use heat to damage the oil glands. Photodynamic therapy, a light-based treatment, uses the combination of a photosensitizing medication on the skin that is then treated with a light to target the oil glands and P. acnes bacteria. Both of these therapies reduce the overproduction of oil which helps diminish, and in some cases completely remove, acne.

"These therapies are non-invasive and cause minimal pain and discomfort to the patient," said Dr. Roberts. "Lasers also promote collagen formation and renewal which regenerates new skin and also can be used to treat acne scarring."

"To help prevent acne scars, do not pop, squeeze or pick at acne and seek treatment early for acne that doesn't respond to over-the-counter medications," advised Dr. Roberts. "There are many treatments available today and a dermatologist can guide a patient to the most effective treatment for his or her type of acne."

The consumer poll on skin-related health behaviors and attitudes was a Web-based poll fielded in September 2005 by Segmentation Company, a Division of Yankelovich, Inc., in collaboration with the Academy. A total of 1,112 respondents age 18 and over responded to the poll.

For more information, contact the American Academy of Dermatology at 1-888-462-DERM (3376).