J Korean Med Assoc.  2018 Nov;61(11):680-686. 10.5124/jkma.2018.61.11.680.

Pharmacological treatment options for acne

• Park KY

• KMID: 2426478
• DOI: http://doi.org/10.5124/jkma.2018.61.11.680

Abstract

Acne vulgaris is a very common condition affecting up of about 80% to 90% of adolescents. The patients with acne have been shown to be adversely impacted by the effect of acne on their quality of life. Four factors are believed to play a key role in the development of acne lesions: excess sebum production, disturbed keratinization within the follicle, colonization of the pilosebaceous duct by Propionibacterium acnes, and the release of inflammatory mediators into the skin. Consequently, the target for acne therapy is these well-known pathogenic factors responsible for this disease state. Topical retinoids correct abnormal keratinization, but it should be applied cautiously because of irritation. Benzoyl peroxide is an effective bactericidal agent against P. acnes. Main topical antibiotics are erythromycin and clindamycin. Fixed combination topical products with retinoids, benzoyl peroxide and antibiotics have been introduced. Use of systemic antibiotics, including tetracyclines and macrolides rapidly improves inflammatory acne lesions. Oral isotretinoin is effective against all of the main pathogenic features of acne but is contraindicated in pregnant women and has been associated with cheilitis and dry skin. Hormonal therapy has been found to improve acne in some selective patients and should be considered for appropriate candidates. This review will present the general aspects of the pharmacological treatments for acne.

Keyword

Acne vulgaris; Etiology; Drug therapy; Severity

MeSH Terms

Acne Vulgaris*
Adolescent
Anti-Bacterial Agents
Benzoyl Peroxide
Cheilitis
Clindamycin
Colon
Drug Therapy
Erythromycin
Female
Humans
Isotretinoin
Macrolides
Pregnant Women
Propionibacterium acnes
Quality of Life
Retinoids
Sebum
Skin
Tetracyclines
Anti-Bacterial Agents
Benzoyl Peroxide
Clindamycin
Erythromycin
Isotretinoin
Macrolides
Retinoids
Tetracyclines

Figure

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  Figure 1 New strategies to conserve the utility of oral antibiotics for treating acne vulgaris. Adapted from Leyden J et al. Dermatol Ther (Heidelb) 2017;7:293–304 [3].

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  Figure 2 Indications of hormone treatment in acne patient.

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