A new guideline aims to help treat Canadian children and adults with acne, a common disease that can negatively affect quality of life and leave scars. The guideline, published on November 16, 2015 is available online at Canadian Medical Association Journal (CMAJ) http://www.cmaj.ca/content/early/2015/11/16/cmaj.140665 and updates one that is now 15 years old.
“With early diagnosis, treatment of active lesions and prevention of adverse potential sequelae (e.g. scarring, dyspigmentation and psychosocial impact), the health of the many Canadians with acne may be improved,” writes Dr. Jerry Tan, Department of Medicine, Western University, Windsor campus, Ontario, with coauthors. Dr. Tan, a local Windsor dermatologist, spearheaded this effort as the coordinating national investigator.
It is estimated that 85% of young people aged 12–24 years have acne and it can persist well into adulthood. Acne can result in anxiety and depression and permanent scarring of the skin.
A panel of expert dermatologists in acne across the country evaluated the latest evidence and provided treatment recommendations for 3 acne presentations: comedonal acne (characterized by blackheads and whiteheads); mild-to-moderate papulopustular acne (superficial red blemishes and pimples); and severe inflammatory acne (deep pustules or nodules). The guideline developers did not include neonatal or infant acne, late-onset acne, acne rosacea, and other variant forms.
To ensure health care professionals are aware of the guidelines, the authors are creating recommendation summaries for physician, nursing, pharmacy and other medical organizations.
“We hope that these guidelines will help health care professionals address the common scourge of acne in patients of various ages,” states Dr. Tan.
According to Dr. Tan, additional key points are:
- Acne should be treated early and effectively to mitigate adverse psychosocial impact, pigmentary alterations and risk of scarring.
- For all categories of severity, selection of the most appropriate of first-line therapies should be determined based on: (1) previous therapies tried, their efficacy and tolerance; (2) patient skin type and the vehicle; (3) practicality (location of acne, frequency of application); and (4) cost.
- These guidelines are based on the combination of both evidence and experience of the expert panel.
- We have identified gaps in evidence including: uncertainties in durations for use of oral antibiotics to minimize development of antimicrobial-resistant bacteria (at cutaneous and extracutaneous sites), and the lack of higher levels of evidence for often used treatments, including fixed-dose erythromycin/tretinoin, spironolactone, and isotretinoin.
Dr. Jerry Tan and his research group at Windsor Clinical Research Inc., continue to investigate new therapies for acne and other dermatologic conditions. Dr. Tan and Windsor Clinical Research Inc. are dedicated to serving the needs of dermatology patients in Windsor and Essex County. For further information contact us below or visit our website at www.wcri.ca.