An estimated 40 million to 50 million Americans are affected by some form of
acne, and not just teenagers. Although up to 80% of people aged 11 to 30 say
they've been affected, it turns out that many of us, particularly women, have
acne in our late 30s and even into our 50s, says Jenny J. Kim, MD, PhD,
associate professor of dermatology at the University of California, Los
Angeles, David Geffen School of Medicine.
"Sometimes it is hard for patients dealing with acne to understand why, even
with ongoing treatment, they cannot get rid of their symptoms forever," Kim
says. "I explain that it's similar to having any chronic disease, like diabetes
-- there is no cure yet, but we can control the symptoms," she says.
At the recent meeting of the American Academy of Dermatology in Miami Beach,
Fla., Kim discussed new treatments for acne and how to care for your skin.
Because there are so many different factors involved: plugging of pores and
oil production for starters. Inflammation is really critical; studies are
showing that even on the skin of acne patients where one doesn’t see acne,
there are inflammatory factors on a molecular level. Bacteria called P.
acnes, or Propionibacterium acnes, are also responsible, as well
hormones, particularly androgens (the male hormones present in men and women).
They overstimulate the oil glands and hair follicles in the skin, causing
hormonal acne flares.
What's new in acne treatment?
In the last 10 or 20 years, there's been very slow movement. People are
really concerned about being on antibiotics for a long time, as that can
increase the resistance of bacteria. So one change has been [the use of]
low-dose oral antibiotics that have anti-inflammatory effects but not
antimicrobial effects. Also, we have some slow-releasing antibiotics so you’re
not getting a high dose of antibiotics all at once.
Recently, a new drug that works a little bit differently was developed. It’s
a topical dapsone (a gel applied to the skin). It's mainly an anti-inflammatory
We're seeing more combination therapy. Since there are five different things
going on, we use two or three treatments. It’s really hard for patients to take
three different things in the morning and three different things in the
evening, so drug companies are developing [medicines] where you have two
actives, such as an antibiotic and retinoid (vitamin A derivative that can
unplug follicles and pores) in one drug.
The latest studies say diet may play a role in acne, particularly a high
gylcemic (high-carb) diet and perhaps skim milk. We need better research in
this area, but in the future we might see diet used for regulating and treating