Treatment of Teenage Acne in Adolescent

Treatment of Teenage Acne in Adolescent: For the treatment of acne in adolescent, the choice of therapy should be based on the type of lesion and severity of acne but psychosocial disability relating to the disease and presence of scarring may also influence the approach to treatment.

Mild acne generally requires topical treatment only. Benzoyl peroxide, azelaic acid and antibacterials are generally used for inflammatory lesions.

Topical retinoids are particularly effective for non-inflamed lesions and combination therapies are useful for mixed lesions. Moderately severe acne generally requires oral anti bacterials, tetracycline/oxytetracycline and erythromycin are the first line antibacterials.

Second generation tetracycline such as lymecycline, doxycycline and minocycline showed improved absorption. Minocycline has the advantage of being rarely associated with Propionibacterium acnes antibacterial resistance but can occasionally lead to potentially serious adverse effects.

Trimethoprim is a useful third line antibacterial therapy for patients resistant to other antibacterial therapies. Benzoyl peroxide should generally be used in combination with oral antibacterials.

For severe nodular acne, isotretinoin is the choice of treatment. In addition over recent years dermatologists have increasingly used this drug to treat patients with moderate acne which has not responded to other systemic therapies particularly associated with scarring or significantly with psychological disability.

Isotretinoin is associated with a number of severe adverse effects and careful monitoring of patients during therapy is required. Physical therapies for treatment of acne nodules and macrocomedones are also important adjuncts to drug therapies [1]. Treatment of teenage acne with aminopenicillins has also been reported [2].

However, in case of treatment for teenage to adult patients with recalcitrant comedonal inflammatory or cystic acne of various degrees of severity photo dynamic therapy with combination of 5- aminolevulinic acid with activation by long pulsed – pulsed dye laser (595 nm) energy appears to be safe and effective treatment with minimal side effects.

Long pulsed – pulsed dye laser mediated photodynamic therapy may serve as an important alternative to isotretinoin, an effective treatment coming under strict regulation due to risk of significant side effects. Cosmetically, well adapted long pulsed – pulsed dye laser photodynamic therapy combined with topical therapy is the first photodynamic therapy modality to achieve complete clearance with long term follow up [3].

[1] Pediatric Drugs, 2003, 5(5) : 301-313 [2] Drug therapy, 1991 : 56-60 [3] J. Drugs Dermatol., 2006, 5(1) : 45-55

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