treatment guide |
treatment guide Treating acne
Clio Dessinioti and Andreas Katsambas discuss the range of treatment options available for the effective management of acne
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hen facing a patient with acne, there are a plethora of topical and systemic acne treatments
to choose from. Standard topical treatments include retinoids, benzyl peroxide, antibiotics, azelaic acid and fixed-dose combinations, while systemic therapies include oral antibiotics, isotretinoin and hormonal agents1
.
however, acne is a chronic disease and as such, it demands continuous treatment, posing the question of selecting the appropriate treatment for the individual acne patient2
.
Topical and oral treatments Topical fixed-dose combinations are emerging as a first-line treatment for mild to moderate inflammatory acne, as well as comedonal acne, and may be used in combination with an oral antibiotic (mainly doxycycline) in acne not responding to topical treatment2
.
Fixed-dose combination treatments permit the targeting of multiple
Ellipse I2PL ellipse
Description Ellipse Intense Pulsed Light systems offer two modalities for the treatment of inflammatory acne. The Ellipse PR+ applicator can be used in combination with adapalene (Differin gel). Light from the applicator reduces the vascular supply to the pilosebaceous unit, and concurrently
the light excites protoporphyrin IX (found naturally in P. acnes bacteria), releasing a singlet oxygen which destroys the mitochondrial walls of the bacteria. Combination of light from the Ellipse PL-W applicator and a 5-ALA source offers a further interesting research tool for treatment
November/December 2011 |
prime-journal.com
of inflammatory acne. Indications Inflammatory acne.
Availability Worldwide (with the exceptions of South America and Central Africa).
Contact
www.ellipse.org pathogenetic factors
(hyperkeratinisation of the pilosebaceous unit, Propionibacterium acnes hyperc o l o nisa ti o n, inflammation), are easy to apply, and may increase patient
adherence,
especially in teenage acne patients. Hormonal treatments, comprising
mainly combined oral contraceptives
(combination of ethinylestradiol and a progestin with anti-androgenic properties, e.g. drospirenone, cyproterone acetate), are indicated to treat female acne characterised by the onset or persistence into adulthood, premenstrual flares, persistence to conventional acne treatments and/or associated with other clinical signs (hirsutism, androgenic alopecia), or laboratory findings (congenital adrenal hyperplasia, poly-cystic ovary syndrome) of hyperandrogenism3,4,5
.
Oral isotretinoin is FDA (Food & Drug Administration, USA) and EMEA
acne is a chronic
disease and as such, it demands continuous treatment, posing the
question of selecting the appropriate treatment for the individual acne patient.
(European Agency for the Evaluation of Medicinal Products) approved for the treatment of severe cystic acne not responding to adequate courses of systemic
antibiotic treatment6 ; however, it has
been suggested that prognostic
factors,
including a family history of acne, acne scarring,
localisation of acne on the trunk, as well as psychosocial morbidity, should be taken into account when choosing acne treatment and that these factors may influence the use of oral isotretinoin as first-line therapy7
. Available treatments present
disadvantages that limit their use, including the teratogenicity associated with oral isotretinoin, the increased risk of bacterial resistance associated with oral and topical antibiotics, and the inability to effectively target all factors implicated in acne pathogenesis (with the exception of oral isotretinoin), highlighting the need for new acne treatments1
.
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