Guidelines to help treat Canadian children and adults with acne received a facelift after 15 years thanks to one Western professor.
Management of acne: Canadian clinical practice guidelines, published last month in the Canadian Medical Association Journal, offer health-care professionals an updated roadmap to dealing with the common ailment impacting 85 per cent of young people, aged 12-24.
“The vast majority of patients who have acne during those young adult and adolescent age groups have relatively mild forms. But at some point, almost all young people will have acne,” said Dr. Jerry Tan, Department of Medicine professor (Windsor Campus), who spearheaded the effort as the coordinating national investigator. “With early diagnosis, treatment of active lesions and prevention of adverse potential scarring, the health of the many Canadians with acne may be improved.”
In Canada, there is no independent funding for evidence-based guideline development, Tan said. If a group wishes to do so, they either incur the financial cost and time commitment themselves, or apply and adapt guidelines from other places to Canada.
Tan went the latter route. He waited on a high-quality set of guidelines to be produced and evaluated elsewhere, and then transformed them into guidelines applicable for Canada. In this case, the European Evidence-based (S3) Guidelines, published in 2012, formed the basis for the new Canadian set.
A panel of expert dermatologists in acne across the country evaluated the latest evidence and provided treatment recommendations for three forms of acne:
- Comedonal (characterized by blackheads and whiteheads);
- Mild-to-moderate papulopustular (superficial red blemishes and pimples); and
- Severe inflammatory (deep pustules or nodules).
Treatments have changed over the last decade and a half. Tan noted the combination of topical medications and anti-inflammatory topical medications were unavailable in 2000. The new guidelines are also updates on how to manage severe acne in patients who are unable to, or unwilling to, use oral medication, used to treat severe, disfiguring nodular acne.
Tan stressed the presence of acne can lead to a number of issues.
“There are psycho-social impacts and mental health concerns, including depression,” he said. “Even if it’s a brief episode of acne – six months or a year or two – it can lead to scarring, which is long term.
“For a lot of young people, if they find the acne is not bothersome to them, and they can manage it easily enough with over-the-counter products or lifestyle modification, that’s great,” said Tan, adding there are others whose acne may not bother them, but the severity of the outbreak needs to be addressed. “In those cases, you do want to be providing them the input that, if not treated, they could have these long-term scarring consequences. Some people don’t realize that.”
The cure for acne can start and end with a pharmacist or family doctor. If everything is settled appropriately, a dermatologist doesn’t need to get involved.
To ensure health-care professionals are aware of the guidelines, the authors are creating recommendation summaries for physician, nursing, pharmacy and other medical organizations.
“We hope that these guidelines will help health-care professionals address the common scourge of acne in patients of various ages,” Tan said.