PRACTICAL TIPS TO HELP ENSURE SUCCESSFUL ACNE TREATMENT
Remove makeup, dirt, and excess oil without irritating or disrupting the skin barrier. Typically, washing with a gentle soap-free, pH-balanced cleanser is recommended.
Choosing the right cleanser
(e.g., Cetaphil®, Cerave®, Spectro®, Avene®)
Provide a soothing, protective film to improve water content, restore barrier function and minimize the risk of irritation.
Choosing the right moisturizer
(e.g., Cetaphil®, Cerave®, La Roche Posay®, Avene®)
Choosing the right sunscreen—one with a minimum of 30 SPF (e.g., Cetaphil®, Cerave®, Colour Science Mineral Powder)
These are available at the Sudbury Skin Clinique.
ADDITIONAL TIPS TO HELP REDUCE SKIN IRRITATION FROM TOPICAL ACNE TREATMENT
Use only a small, pea-sized amount and cover the entire face—do not spot treat
Apply moisturizer before the application of topical acne treatment
Stagger application of topical acne treatment to every other day and gradually increase as tolerated
A topical regimen takes time to work, so be patient
Applying more than the recommended amount will not make it work faster or better
A MESSAGE FROM YOUR LOCAL DERMATOLOGIST
Acne (acne vulgaris) is a common, and sometimes chronic, skin disease characterized by non-inflammatory lesions (open and closed comedones) and inflammatory lesions (papules, pustules and nodules). A common sequela of these lesions is acne scarring.
Acne and acne-associated scarring can be associated with adverse psychosocial impacts on our patients’ quality of life. These include:
Dr. Lyne Giroux
“Acne can lead to poor self-esteem, which can have a long lasting negative effect on a person’s life, especially in their teenage years.”
THE PATHOGENESIS OF ACNE SCARRING
ATROPHIC ACNE SCARRING
Acne, at all levels of severity, can lead to scars or postinflammatory lesions known as macular erythema and hyperpigmentation (PIH).
Postinflammatory lesions can further progress to atrophic acne scars, which are textural irregularities involving the loss of dermal tissue.They can come in a variety of shapes, sizes, and degrees.
Scarring is an important consideration in the treatment of acne. The risk factors involved in the development of acne scars include:
- Acne severity
- Time to effective treatment of acne
- Manipulation of existing lesion
- Extent and duration of inflammation
- Onset of acne at a young age
- Frequent relapses
- Family history
THE PATHOPHYSIOLOGY OF ACNE SCARRING
There are two main steps involved in the formation of acne scars:
Inflammation: This step involves an immune response and the synthesis of granulation tissue.
Remodelling: This step involves extensive remodelling of the dermis, which gives rise to scarring.
Reducing the inflammatory response may help reduce new acne lesions and acne scars from forming.
“It is important to note that darker skin types are more likely to get scarring and less cosmetic options are available.” – Dr. Giroux
TREATMENT OPTIONS AND CONSIDERATIONS FOR ACNE
PREVENTION IS THE PRIMARY STRATEGY FOR REDUCING THE RISK OF ACNE SCARRING
Early and effective treatment of acne is crucial, since treatment delay is a key modifiable risk factor for scarring!
The evidence-based Canadian acne guidelines recommend effective treatment options for all severities of acne.
Retinoids are an important aspect of treatment at all levels of acne. They not only act as comedolytic agents and decrease follicular hyperkeratinization, but they have also been shown to reduce inflammation and have direct immunomodulatory effects.
Systemic therapy can also be considered in the treatment of acne. These treatments are usually reserved for moderate to severe papulopustular/nodular acne. There are three main classes of systemic options used in Canada:
- Oral antibiotics such as tetracyclines, macrolides, clindamycin, and trimethoprim
- Hormonal therapy such as combined oral contraceptives
- Oral isotretinoin
“Remember: It is important to review options with patients as they are more likely to adhere to a regimen if they are comfortable with their choice.” – Dr. Giroux