Last month, the American Academy of Dermatology (AAD) outlined its evidence-based recommendations for acne treatment of both adolescents and adults in its “Guidelines of care for the management of acne vulgaris,” published online in the Journal of the American Academy of Dermatology. The guidelines focus on combining modalities.
For example, the writers recommend topical therapy be used at the same time when antibiotics are used for the treatment of moderate to severe acne. Once the course of antibiotics is complete, patients should continue using topical treatments to manage their condition. Topical retinoids and benzoyl peroxide can also be combined with one another to create an effective treatment regimen, and some women may see their acne improve with the use of oral contraceptives, which can be combined with other treatments. For severe or moderate acne that does not respond to other therapy, the guidelines recommend oral isotretinoin, though female patients must take careful steps to prevent pregnancy while on isotretinoin due to the risk of birth defects, and all patients who take the drug must enroll in the federal iPledge program.
In-office procedures, such as laser treatments or chemical peels, are not recommended 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, nor is there enough data to recommend dietary changes for acne patients. “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,” says Andrea Zaenglein, MD, FAAD, dermatologist and co-chair of the expert work group that developed the guidelines.