Acne Vulgaris: One Dermatologist's Perspective on Topical Treatments

Brought to you by Sun Pharma CanadaAcne vulgaris: One dermatologist’s perspective on topical treatments and helping patients navigate the online environment for acne informationAcne vulgaris is a chronic, inflammatory skin condition associated with excess sebum production, epithelial hyperkeratinisation and Cutibacterium acnes colonization.1 We spoke to Dr. Geeta Yadav (she/her), a board-certified dermatologist and founder of FACET Dermatology in Toronto, Ont., about her experience treating this condition. Dr. Yadav talks about the pathogenesis of acne vulgaris, topical acne treatments, and how to help patients navigate the proliferation of skincare information on the web and identify credible sources.Is self-medicating for acne vulgaris a concern with the patients you see in your practice?Not all patients have access to dermatologists, nor, in my experience, do many have primary care providers (PCPs) that have the background to diagnose complex or severe forms of acne. Too many patients that I see use unreliable sources or unqualified individuals to help them treat their acne. They often end up turning to social media “skin experts”, most of whom are not remotely qualified to speak to medical conditions. This has led to many patients spending hundreds of dollars on products that don't work or make their skin worse. I know of some truly terrible cases where patients have created their own treatments using raw materials they've bought online. There is so much emotion involved when it comes to acne2 that it's understandable that a patient would try do everything they can in the hope of finding relief. Too often, however, they just make things worse.Is the online environment impacting the way patients navigate their skincare for acne?The internet can be a tricky source of information. In some cases, patients find accurate and helpful information. For example, I know from talking to my patients that many of them are learning about common topical acne treatments, like retinoids and benzoyl peroxide2, and how they work. They then ask for products with these ingredients in stores or order them online. However, even if they have good information, it doesn't mean that the information applies to their specific case of acne.Also, there are plenty of patients who are misinformed through social media, which has no obligation to provide evidence for statements and claims. It’s so easy to get caught up in the hype and not take the time to verify the source or accuracy of the information. As a healthcare professional, I believe one of my responsibilities is to educate my patients about the importance of fact checking, especially as the internet is now a part of everyday life.What is the pathogenesis of acne?The pathogenesis of acne is multifactorial, involving excess sebum production, epithelial hyperkeratinisation, Cutibacterium acnes colonization and complex inflammatory mechanisms, including neuroendocrine mechanisms.1 Hormones, including androgens, such as testosterone and dihydrotestosterone, have a central role in the pathogenesis of acne.1 Acne is most common between the ages of 12 and 24 years—85% of those affected are in this group—however, it can also affect older adults.2 What are the recommended topical treatments for acne?Topical therapies are the foundation of acne treatment.1 According to the Canadian Medical Association 2016 and American Academy of Dermatology 2024 treatment guidelines for acne, recommended topical treatments include benzoyl peroxide, topical retinoids, topical antibiotics, clascoterone, azelaic acid and salicylic acid.1,2 Topical antibiotics can also be used in combination with benzoyl peroxide or with a topical retinoid; however, they should not be used as monotherapy. 1,2 When recommending treatment, the severity of symptoms should be taken into consideration.1,2 Do you have any advice for PCPs (Primary Care Providers) to help them support their patients with acne?PCPs can help patients understand their treatment options and the associated side effects. PCPs should stay informed about developments in acne treatments so that they can recommend the most effective one for each patient. PCPs can also help patients navigate the wealth of acne information—and misinformation—particularly online. Explain to patients that they should only trust credible websites that post accurate and reliable scientific information.

Register for free access or login.

Related Topics