Connect
MJA
MJA

Modern management of acne

Victoria Rebecca Harris and Alan J Cooper
Med J Aust 2017; 206 (1): 41-45. || doi: 10.5694/mja16.00516
Published online: 16 January 2017

Summary

  • Acne is a chronic inflammatory disease of the pilosebaceous unit resulting from androgen-induced increased sebum production; altered keratinisation; bacterial colonisation of hair follicles on the face, neck, chest and back by Propionibacterium acnes; and an inflammatory response in the skin. The exact way these processes interact and the order in which they occur in the pathogenesis of acne are still unclear.
  • Scarring that occurs from acne, particularly severe acne, can persist a lifetime and have long lasting psychosocial effects. Depression, social isolation and suicidal ideation are frequent comorbidities in acne.
  • Despite the plethora of topical and systemic treatments available for acne, there is a relative lack of quality evidence for its application. Of the systemic treatments available, oral isotretinoin remains the most effective well established treatment for acne that targets all the aetiological factors.
  • Current guidelines for the treatment of acne are based largely on expert consensus and advocate a combination of topical agents in mild to moderate cases and reserve the use of systemic therapies for moderate to severe or refractory cases of acne. However, given the psychosocial impacts of acne, there is a strong argument for early, effective treatment with systemic therapy when topical and general measures have failed.

  • Victoria Rebecca Harris
  • Alan J Cooper

  • Royal North Shore Hospital, Sydney, NSW

Correspondence: alanjco@tpg.com.au

Competing interests:

Alan Cooper was a member of the Roaccutane Advisory Board, a group of Australian dermatologists brought together by Roche Products Pty Ltd. The preparation of this document was not supported in any way by Roche Products Pty Ltd.

Author

remove_circle_outline Delete Author
add_circle_outline Add Author

Comment
Do you have any competing interests to declare? *

I/we agree to assign copyright to the Medical Journal of Australia and agree to the Conditions of publication *
I/we agree to the Terms of use of the Medical Journal of Australia *
Email me when people comment on this article

Responses are now closed for this article.