According to The Acne Global Alliance, acne is now classified as a chronic disease that needs appropriate diagnosis and long term strategies to effectively treat.
The Alliance says that acne effects 85% of the World's Population in the age of 12 to 24.
So how do you treat this disease? The Alliance recommends the following (and I am paraphrasing).
Mild Acne - 1st Choice - Topical retinoid - 2nd Choice - Azelaic acid, salicyclic acid, physical extraction - Alternative for women - see 1st choice - Maintenance - Topical retinoid
Moderate Acne - 1st Choice - Topical retinoid + topical antimicrobial - 2nd Choice - Azaelaic acid, physical extraction - Alternative for women - see 1st choice - Maintenance - Topical retinoid
Severe Acne - 1st Choice - Oral antibiotic + topical retinoid and/or benzoyl peroxide - 2nd Choice - No consensus among experts so they default to first choice and azelaic - Alternative for women - Oral antiandrogen + Topical retinoid and/or topical antimicrobial -Maintenance - Topical retinoid and/or benzoyl peroxide
Disfiguring Acne - 1st Choice - oral isotretinoin - 2nd Choice - high dose oral antibiotic + topical retinoid and/or benzoyl peroxide - Alternative for women - High dose oral antiandrogen + topical retinoid and/or topical antimicrobial - Maintenance - Topical retinoid and/or benzoyl peroxide
This is alot of information to digest, but the bottom line is that a topical retinoid is your best weapon when fighting acne.
Please do not use this information to self diagnose and treat your acne. But, use this information to talk to your dermatologist as the best ways to treat your condition.
I often hear from frusterated people that lament they have tried man of these therapies and are not getting results or that they cannot tolerate the retinoid. There is no one best way to treat everyone's acne, but requires a trial by fire mentality to best approach your condition. Your doctor has the insight and training to help your search for the best path to treatment....so, don't lose faith after a couple of visits!
At the American Academy of Dermatology Annual Meeting in San Francisco, Dr. Sewon Kang presented some of his prolific research on retinoids. The thing that I liked the most about his speech was his definition of a topical retinoid:
"any molecule that, by itself or through metabolic conversion, binds to and activates the retinoic acid receptors, thereby eliciting transcriptional activation of retinoic acid-responsive genes that results in specific biologic responses (Kang & Voorhees. Fitzpatrick's Dermatology in General Medicine [7th Ed.]. 2008)."