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Table of Contents
Editorial
Dr. Shannon Humphrey,1 Dr. Joseph Brioux,2 Dr. D'Arcy Little,3
1Clinical Instructor, Department of Dermatology and Skin Science, University of British Columbia, Vancouver, BC.
2Family Physician in private practice, Woodstock, ON.
3Medical Director, Health Plexus and the Journal of Current Clinical Care, Toronto, ON.
CLINICAL TOOLS
Abstract: Do dermatologists and GPs approach acne care differently? How do these two groups of clinicians approach acne treatment, keep abreast of the latest guidelines, and manage maintenance therapy? How will the availability of a new retinoid combination product in Canada for acne change the way acne is currently treated?
To address these questions, a roundtable discussion was convened, featuring clinicians with a significant number of acne patients in their practices. Dr. Shannon Humphrey, a dermatologist, and Dr. Joseph Brioux, a family physician, and moderator Dr. D'Arcy Little, himself a family physician and radiologist, offered a candid take on guideline-based acne treatment and the effort to improve treatment outcomes among patients.
The discussants addressed how each professional has tended to view acne, pursues acne care differently, and why. They also discussed the latest acne treatment guidelines as well as the depth of the gap between the generalist's versus the specialist's treatment approach. |
| Key Words: acne, treatment gap, antibiotic resistance, treatment adherence. |
| Antiobiotic resistance is a key factor to consider when establishing maintenance and treatment regimens. |
| Combination retinoid-based therapies are first-line treatments for acne; evidence suggests that such regimens achieve faster and more complete clearance, while addressing multiple pathogenic factors simultaneously. |
| Patients are often prescribed legitimate, evidence-based therapies but may abandon them after a short trial because of lack of perceived, efficacy or side effects. Address patient expectations and advise on the necessity of pursuing a sufficient course of topical therapy (e.g., 12 weeks) before drawing conclusions. |
| It is advisable to see patients on maintenance therapy for follow-up—attempt at least two office visits per year, and more if there is an increase in flares. |
| Convey to patients that acne is a chronic condition and that a sound treatment maintenance regimen is essential. |
| Do not give samples to patients unless supply is sufficient to pursue a 12-week trial of medication. |
| To have access to full article that these tools were developed for, please subscribe. The cost to subscribe is $80 USD per year and you will gain full access to all the premium content on www.healthplexus.net, an educational portal, that hosts 1000s of clinical reviews, case studies, educational visual aids and more as well as within the mobile app. |
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Publication of THE LATEST IN ACNE CARE supplement was made possible by an unrestricted educational grant from Galderma Canada Inc.
Jerry Tan, MD, FRCPC,
Department of Medicine, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON.
CLINICAL TOOLS
| Abstract: Adapalene 0.1%/BPO 2.5% (adapalene/BPO) gel is a novel agent for acne therapy that has recently become available in Canada. This fixed-dose combination of a topical retinoid and benzoyl peroxide is efficacious in mild-moderate inflammatory acne and as an adjunct to oral antibiotics for severe acne. Adapalene 0.1%/BPO 2.5% (adapalene/BPO) gel provides synergistic efficacy, whereby efficacy of the combination exceeds the summed efficacy of individual components. Furthermore, adapalene/BPO with oral doxycycline for severe acne increases the rate of global treatment success four-fold beyond that with doxycycline alone. Practical means to abrogate the development of local intolerability have been shown to be effective. |
| Key Words: acne, adapalene, benzoyl peroxide, fixed-dose gel, combination, topical acne medication, retinoids. |
| Three of five pathogenic factors involved in acne can be addressed by topical medications: follicular hyperkeratinization, Proprionibacterium acnes proliferation, and inflammation. |
| The combination of retinoid and BPO in the form of adapalene 0.1%/BPO 2.5% has recently been approved in Canada, and has been advocated by an international acne expert group as a rational standard for treating mild-moderate acne as it offers complementary mechanisms of action. |
| An adapalene/BPO formulation provides greater proportions of global success and reduction in acne lesion counts compared to the vehicle or either agent alone. |
| As topical retinoids and benzoyl peroxide can be irritating, their combination may potentiate this factor. Measures to minimize intolerability include every other night application and daily moisturizer use. |
| For the treatment of mild-moderate acne, the fixed-dose adapalene and BPO gel combination may enhance treatment efficacy and adherence through improved ease of use. |
| Benzoyl peroxide does not induce bacterial resistance. |
| To have access to full article that these tools were developed for, please subscribe. The cost to subscribe is $80 USD per year and you will gain full access to all the premium content on www.healthplexus.net, an educational portal, that hosts 1000s of clinical reviews, case studies, educational visual aids and more as well as within the mobile app. |
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