The recently refined understanding of acne as a chronic disease, at least for a limited life-time period, requires the definition of long-term therapeutic strategies that are safe and effective and have no negative impact on the individual or the whole population. Systemic or topical antibiotics or retinoids in combination with BPO are undoubtedly highly effective in the initial treatment phase, which is related particularly to their anti-inflammatory effects when administered for 2-3 months. However, the prolonged use of antibiotics beyond 3-4 months is questionable from an epidemiologic viewpoint with regard to antibiotic resistance and safety. Further studies are required to define the role of antibiotics during maintenance treatment with regard to their capacity to prevent microcomedone formation as well as the suitability of subantimicrobial-dose regimens. Topical retinoids are the substance class with the best available evidence for maintenance therapy. However, they are not applicable during pregnancy and lactation, which might be a drawback with regard to the increasing prevalence of late-type acne. The use of photodynamic therapy and lasers showed short-term efficacy for inflammatory acne vulgaris, with the most consistent outcomes for photodynamic therapy but, in our view, their use as alternative acne treatments cannot be recommended until long-term studies are available that rule out a potential irreversible sebaceous gland destruction implicating consequences with regard to their 'whole-life' function as endocrine organs of the skin.
© 2009 Expert Reviews Ltd.
Cite this: Overview of New Therapeutic Developments for Acne - Medscape - Apr 13, 2009.