Managing acne vulgaris: an update

Miriam Santer, Esther Burden-Teh, Jane Ravenscroft
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Abstract

Acne vulgaris is very common and can have significant negative impact on people. While sometimes a transient problem, acne may persist for many years and often leads to permanent scars or pigment changes. Guidelines unanimously advise topical treatments as first-line, although differ in recommending either topical benzoyl peroxide or topical retinoid (mainly adapalene) alone or in combination. Guidance published by the National Institute for Health and Care Excellence advises counselling patients regarding avoidance of skin irritation when starting topical treatments and promoting adherence (treatments take 6–8 weeks to work). Oral antibiotics are currently overprescribed for acne but have a role when coprescribed with a non-antibiotic topical treatment. Hormonal treatments, such as the combined contraceptive pill, are also effective and there is growing evidence for the use of spironolactone for women with persistent acne. Recent guidance from the Medicines and Healthcare products Regulatory Agency regarding isotretinoin has implications for specialist prescribing and monitoring, and increasing public awareness of potential risks of mental health problems and sexual dysfunction. Although acne is associated with psychiatric disorder, the mental health effects of isotretinoin remain controversial.
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管理寻常痤疮:最新进展
寻常痤疮很常见,会对人造成很大的负面影响。痤疮有时只是一过性的问题,但可能会持续多年,并常常导致永久性疤痕或色素改变。指南一致建议将外用治疗作为第一线治疗方法,但在建议外用过氧化苯甲酰或外用维甲酸(主要是阿达帕林)单独或联合使用方面存在差异。美国国家健康与护理卓越研究所发布的指南建议,在开始局部治疗时,应指导患者避免刺激皮肤,并促进患者坚持治疗(治疗需要 6-8 周才能见效)。目前,口服抗生素治疗痤疮的处方过多,但如果与非抗生素外用疗法同时使用,口服抗生素还是有一定作用的。荷尔蒙治疗,如联合避孕药,也很有效,而且越来越多的证据表明,螺内酯可用于治疗女性顽固性痤疮。最近,药品和保健品监管局发布了关于异维A酸的指南,这对专业处方和监测产生了影响,并提高了公众对精神健康问题和性功能障碍潜在风险的认识。虽然痤疮与精神障碍有关,但异维A酸对精神健康的影响仍存在争议。
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来源期刊
Drug and Therapeutics Bulletin
Drug and Therapeutics Bulletin Medicine-Pharmacology (medical)
CiteScore
0.80
自引率
0.00%
发文量
69
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