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  • Presentation

Hot Topics in Acne and Rosacea Management: A to G Approach

Description

The presentation discusses advancements and recommendations in managing acne and rosacea, utilizing an A-G approach. Key updates to acne management guidelines highlight effective treatments for patients aged nine and older, emphasizing strong recommendations for topical antibiotics, retinoids, benzoyl peroxide, and doxycycline. Conditional recommendations involve minocycline and spironolactone, backed by recent trials showing beneficial results. While systemic antibiotics should be limited, combination therapies are encouraged for comprehensive treatment. The discussion includes the safety concerns surrounding benzoyl peroxide and its relationship with benzene, recommending refrigeration for certain products. In terms of rosacea, there's a shift to a phenotypic classification for better personalized care, emphasizing the importance of documenting patient symptoms and possibly utilizing photographic records for tracking changes. The lecture also stressed understanding patients' skincare habits, which are influenced by social media trends, and the need to simplify regimens, especially for teenagers facing acne. Products like salicylic acid pimple patches are recognized for their effectiveness in reducing acne excoriae. Overall, the speaker encourages dermatologists to engage patients in discussions about their skincare to better manage concerns and costs.

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Conclusions

  • The updated guidelines for the management of acne vulgaris recommend a multimodal approach that includes strong recommendations for topical treatments and doxycycline as systemic therapy.
  • Conditional recommendations include minocycline and spironolactone, with potential for updates in the future based on new evidence.
  • Combination topical therapies, particularly those including benzoyl peroxide, clindamycin, and adapalene, show improved efficacy in reducing inflammatory lesions in early treatment.
  • There is insufficient evidence regarding the effects of oral corticosteroids and topical agents like glycolic acid and natural agents for acne treatment, indicating the need for further research.
  • The use of GLP-1 receptor agonists correlates with increased acne diagnosis in non-diabetic obese women, opening discussions on hormonal influences in acne.
  • Concerns regarding benzoyl peroxide thermally degrading into benzene, a potential carcinogen, have not been substantiated by recent studies, showing no increase in blood benzene levels from its use.
  • The guidelines emphasize the importance of patient satisfaction in acne treatment, incorporating a holistic view of treatment efficacy and quality of life.
  • Han JM, Barbieri JS. Guidelines of care for the management of acne vulgaris. J Am Acad Dermatol. 2024 May;90(5):1234-1245. doi: 10.1016/j.jaad.2024.01.004.
  • Thiboutot D, Anderson R, Cook-Bolden F, Draelos Z, Gallo RL, Granstein R, Kang S, Macsai M, Stein Gold L, Tan J. Standard management options for rosacea: The update by the National Rosacea Society Expert Committee. J Am Acad Dermatol. 2020 Jun;82(6):1501-1510. doi: 10.1016/j.jaad.2020.01.008.
  • Cho SW, Sontam T, Chen A, Limmer EE, Tolkachjov SN. GLP-1 Receptor Agonist Use Is Associated with Increased Rates of Acne Vulgaris Diagnosis In Non-Diabetic Obese Women but Not Men: A Retrospective Cohort Study. J Am Acad Dermatol. 2025 Feb 7:S0190-9622(25)00198-7. doi: 10.1016/j.jaad.2025.02.009.
  • Feldman SR, et al. No evidence for an association between benzoyl peroxide use and increased blood benzene levels in the National Health and Nutrition Examination Survey. J Drugs Dermatol. 2025 Jan;24(1):79. doi: 10.36849/JDD.8712.
  • Schaller M, Almeida L, Bewley A, Cribier B, Del Rosso J, Dlova N, Gallo RL, Granstein RD, Kautz G, Mannis MJ, Micali G, Oon HH, Rajagopalan M, Steinhoff M, Tanghetti E, Thiboutot D, Troielli P, Webster G, Zierhut M. Recommendations for rosacea diagnosis, classification and management: update from the global ROSacea COnsensus 2019 panel. Br J Dermatol. 2020 May;182(5):1269-1276. doi: 10.1111/bjd.18420. Epub 2019 Oct 16.