Changing the topography of acne with topical medications

Acne vulgaris is a common skin condition that affects approximately 40-50 million Americans annually. The peak incidence of acne occurs during adolescence and young adulthood, with approximately 80% of persons aged 11-30 years having at least minor acne. Because the onset of acne is typically in early adolescence, pediatricians are often at the front-lines in terms of caring for patients with this chief complaint.

Over the last 2 years, new acne therapies have become available. These include new combination fixed-dose products, which may allow for greater flexibility in treatment and greater patient compliance. New topical antibiotics have also come to the market, providing more therapeutic options for mild to moderate inflammatory acne. Lastly, acne therapies involving the use of light sources and photosensitizers are currently being developed, which may provide a whole new modality for managing complicated patients.

Successful management of acne requires the physician to make a thorough assessment of the patient's acne severity, predominant lesion type, skin type, and lifestyle in order to pair each individual patient's needs with the appropriate anti-acne therapy. This article provides an overview of the pathophysiology of acne and pre-existing topical therapies. It then discusses some novel acne therapies and outlines how they might fit into a physician's treatment strategy.