engleski

Current trends in the treatment of acne vularis

Acne vulgaris is one of the most frequently seen chronic skin disease and most common dermatologic disorder of adolescents. Acne is a disease affecting the pilosebaceous follicles, in which there are four major etiologic factors: increased sebum production, hypercornification, abnormal bacterial function, and inflammation. After the initial interview and clinical assessment of acne, decisions should be made as to which treatment to prescribe. Patients with mild acne will do well with topical therapy, and those with more severe acne need oral therapy. It is essential to stress to the patient that topical therapies will need to be used for the next several years. Most frequently used preparations are: mild keratolytics, benzoyl peroxide, retinoic acid and other retinoids, topical antibiotics such as erythromycin and clindamycin as well as azelaic acid. Oral treatment is indicated in subjects with moderate and severe acne. The three main groups of oral therapy are: antibiotics, hormones and retinoides. Antibiotics are usually the first line of oral therapy and are administered for several months. A first generation tetracycline is the first choice, however, lately further alternatives in the tetracycline group are minocycline or doxycycline. Erythromycin has been shown to be effective too, and so has clindamycin. Hormonal therapy is indicated in those females who are not responding well to conventional therapy. One of the commonest hormonal regimen is estrogen plus cyproteron acetate given for 6-12 months. In acne conglobata, but lately also in less severe acne with scaring and significant psychological stress, the treatment of choice is isotretinoin 0.5-1.0 mg/kg/day for 16-30 weeks with a cumulative dose of 120 mg/kg.

acne vulgaris; treatment

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