Acne… the dreaded teenage rite of passage photos/ blmiers2/ 6904758951 photos/ blmiers2/ 6904758951

Acne is so commonplace … and it makes being a teenager more difficult.  The AAD (American Academy of Dermatology) has new guidelines for acne therapy.

The key is that monotherapy is not recommended AND that antibiotics should always be coupled with topical therapy (and not used alone).

Topical benzoyl peroxide is the first-line agent that effectively fights Propionibacterium acnes and also discourages the development of antibiotic resistance.  Topical antibiotics (like clindamycin or erythromycin) will also help decrease P acnes populations and exert a mild anti-inflammatory effect.  Topical benzoyl peroxide should be used in combination with another agent like a topical retinoid (gel or cream).  This dual approach helps decrease the chance of antibiotic resistance.

If you NEED an oral antibiotic, the tetracycline-class of antibiotics are still the best option for moderate to severe acne.  Minocycline and doxycycline are equally effective.   Physicians should limit both the DOSE and the LENGTH of therapy of antibiotics.  It is thought that when the oral antibiotic is eventually discontinued that the topical reintoid will fulfill the need for maintenance therapy.

Birth control pills may also help acne by interrupting the pathway of testosterone production.

Accutane is a highly effective treatment for severe acne that is resistant to other treatments.  It decreases sebum production, acne lesion count, and  scarring.  Only certain physicians prescribe accutane as there is a stringent programs and iPLEDGE agreement that are needed.

Low-glycemic diets may help decrease sebum production and decrease inflammation.

About drlesliegreenberg

I have been practicing as a family physician for over 20 years--as both an educator of physicians and clinician. From infancy to the elderly, I perform obstetrics and general medicine. I love my career and am passionate about my field of knowledge and my patients. Follow me on Facebook at Leslie Md Greenberg Medical Disclaimer The content of this website is provided for general informational purposes only and is not intended as, nor should it be considered a substitute for, professional medical advice. Do not use the information on this website for diagnosing or treating any medical or health condition. If you have or suspect you have a medical problem, promptly contact your professional healthcare provider.
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