Acne is one of the greatest skin equalizers—you’ll be hard-pressed to find a single person who hasn’t struggled with it, be it as an adolescent or adult. According to the American Academy of Dermatology, acne is the most common skin condition in the U.S., but misinformation about how to treat it is rampant (we’re looking at you toothpaste-on-pimple YouTube videos). So, this month the AAD officially released a set of formal guidelines for treatment, based off of cold, hard scientific evidence.
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The paper, titled “Guideline of Care for the Management of Acne Vulgaris” released in the Journal of American Academy of Dermatology, states that the best evidence has shown that the key to beating pimples is with combination treatment—in other words, attacking them from all angles: topical treatments, antibiotics, oral contraceptives (for women), and when all else fails, isotretinoin (aka Accutane). According to the guidelines, the first three categories of treatments can be used simultaneously, and various topical treatments such as retinol and benzoyl peroxide can also be combined.
“Because acne is a skin condition that is a culmination of issues (such as oil production, clogged pores, bacterial overgrowth and systemic inflammation), it makes sense to treat it with a combination approach,” says Washington D.C. dermatologist Elizabeth Tanzi, MD, and founder and director of Capital Laser & Skin Care.
“Combination treatment has been the standard for treating acne for a very long time,” agrees New York dermatologist Neal Schultz, MD, and creator of BeautyRX. “They are just formally reinforcing it.”
But, the new guidelines do also list a host of treatments that they don’t particularly recommend—ranging from in-office procedures such as laser treatments and chemical peels to natural therapies like tea tree oil and diet adjustments. Here’s where doctors say the most effective treatments might be more individualized than the guideline’s blanket recommendation.
“I disagree about in-office treatments,” says Dr. Schultz. “Superficial peels (glycolic or salicylic or combination peels) are always helpful as is opening and injecting cysts (with cortisone) to relieve pain and heal faster.”
“In my opinion, for certain acne-prone individuals, diet does play a role in the severity of their acne,” adds Dr. Tanzi. “Particularly a high-glycemic diet for some people. But that’s why there is no single treatment to cure acne for everyone; there are different triggers depending on the person. There is no one-size-fits-all treatment for acne.”
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