Acne update session reviews proposed changes to guidelines

Bethanee J. Schlosser, MD, PhD: “Acne is one of the most common things dermatologists treat. It is good to say, ‘Let's not deal with lore, but let's talk about evidence-based recommendations.”

Bethanee J. Schlosser, MD, PhD: “Acne is one of the most common things dermatologists treat. It is good to say, ‘Let’s not deal with lore, but let’s talk about evidence-based recommendations.”

The Academy’s updated clinical acne guidelines are not expected to be published until later this year, but six speakers previewed several guideline topics Friday during “Translating Evidence Into Practice: Acne Guidelines.”

Speakers discussed the latest evidence-based treatments researched by the AAD Acne Guidelines Work Group in topics such as topical therapy, oral antibiotic therapy, hormonal therapy, and diet.

“Acne is one of the most common things dermatologists treat. It is good to say, ‘Let’s not deal with lore, but let’s talk about evidence-based recommendations,’” said Bethanee J. Schlosser, MD, PhD, course director and assistant professor in dermatology and obstetrics and gynecology at Northwestern University Feinberg School of Medicine.

The Academy’s first guideline for acne was published in 2007, but guidelines are not considered current after five years. The work group has so far spent 14 months updating “Guidelines of Care for Acne Vulgaris Management,” which are expected to be presented to the AAD Board of Directors in May. If approved by the board, the guidelines would be published later this year in the Journal of the American Academy of Dermatology.

Speakers and their topics presented during the session were:

  • Overview and Recent Advances in Pathogenesis of Acne: Rachel Victoria Sabbag Reynolds, MD, discussed pathogenesis, which is not emphasized in the clinical guideline. The presentation offered an opportunity to learn more about the mechanisms of acne pathogenesis, and thus the rationale for various acne treatments.
  • Use of Antibiotic Therapy for Acne: Jonette Elizabeth Keri, MD, PhD, reviewed when antibiotics are appropriate to treat inflammatory acne and how recent data from clinical trials suggest that the duration of treatment should be limited to three months or less as much as possible. The presentation also addressed the transition to topical therapy, maintenance therapy, and potential adverse effects, such as inflammatory bowel disease and pharyngitis.
  • Use of Isotretinoin for Acne: Megha M. Tollefson, MD, reviewed the latest data and addressed the screening, education, and monitoring of patients.
  • Use of Hormonal Therapy for Acne: Julie Claire Harper, MD, discussed information about prescribing oral contraceptives, the latest literature about the use of hormonal agents in appropriately selected female patients.
  • Role of Diet in Acne: Diane M. Thiboutot, MD, discussed links between diet and acne, including high glycemic index foods, and controversies surrounding the effect of dairy products on acne.

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