Doctors insist that acne should be treated with retinoids and maintain the use of that drug, even if other treatments are added to the therapy, and caution against overuse of oral antibiotics, according to new guidelines for the treatment of acne developed by the Global Alliance to Improve Outcomes in Acne.

The guidelines emphasize the importance of topical retinoid agents in treating not only acne lesions, but also acne precursors, and caution against overuse of oral antibiotics.

"The bottom line is that topical retinoids work on all classes of acne," Dr. Ghali said. "Doctors want to abandon the topical retinoids too early."

Patients with mild comedonal acne should be started with a retinol, he said, which target microcomedo - microscopic precursors to the more-familiar acne blackheads and whiteheads.

 

Only for patients with moderate acne do the guidelines suggest the use of oral antibiotics - once the mainstay of acne therapy - and then only as long as systems persist.

"Long-term use of antibiotics should be minimized," he said.

Dr. Ghali presented data showing that acne therapy with a retinol and benzoperoxide/topical antibiotic regimen was significantly better than benzoperoxide therapy alone.

Isotretinoin remains the treatment of choice for severe nodular acne, he said.

Improvements in the topical acne retinoids have made this treatment more tolerable and effective, he said.

Adapalene appears less irritating than older members of the class, he added, and is more stable in light, so that acne patients do not have to worry about exposure to the sun. 

 Other news