Question

An 18-year-old college student comes to seek help for her acne over the face.
How will you manage a patient with acne?

Hint:

Start with topical treatments for mild acne, and escalate to oral medications if necessary. Isotretinoin is reserved for severe cases due to its potential side effects.

Answer 1

Acne management should be tailored to the severity of the condition. Mild acne can often be managed with topical treatments, while moderate to severe cases may require systemic medications or advanced therapies. Lifestyle modifications like proper skincare routines and dietary adjustments also play an important role in long-term management.
Management of acne involves a combination of topical and systemic treatments, lifestyle modifications, and sometimes advanced therapies. The approach includes:
1. Topical Treatments
- Topical Retinoids (e.g., Tretinoin): Help with skin cell turnover and prevent clogging of pores.
- Benzoyl Peroxide: Reduces bacterial load and helps in the reduction of inflammation.
- Topical Antibiotics (e.g., Clindamycin): Used for mild to moderate acne to reduce bacteria and inflammation.
- Salicylic Acid: Helps exfoliate the skin and unclog pores.

2. Systemic Treatments
- Oral Antibiotics (e.g., Doxycycline, Minocycline): Used for moderate to severe acne with inflammation.
- Oral Contraceptives: In females, hormonal therapy can help regulate androgen levels and reduce sebum production.
- Isotretinoin: A potent oral retinoid used for severe, cystic acne. It is reserved for patients with unresponsive or scarring acne.

3. Lifestyle Modifications
- Dietary Changes: Reducing intake of high-glycemic foods, dairy, and chocolate may help some individuals.
- Good Skin Care Practices: Gentle cleansing, avoiding scrubbing, and using non-comedogenic products to prevent clogging of pores.

4. Advanced Therapies
- Chemical Peels: Used for moderate acne to remove layers of dead skin and reduce scarring.
- Laser Therapy: Can reduce inflammation and improve skin texture in patients with scarring.