The Treatment Gap in Acne Care: Guidelines versus Treatment Practices

Dr. Shannon Humphrey,¹ Dr. Joseph Brioux,² Dr. D'Arcy Little,³

Authors' Affiliations

¹Clinical Instructor, Department of Dermatology and Skin Science, University of British Columbia, Vancouver, BC.
²Family Physician in private practice, Woodstock, ON.
³Medical Director, Health Plexus and the Journal of Current Clinical Care, Toronto, ON.

CLINICAL TOOLS

Abstract: Do dermatologists and GPs approach acne care differently? How do these two groups of clinicians approach acne treatment, keep abreast of the latest guidelines, and manage maintenance therapy? How will the availability of a new retinoid combination product in Canada for acne change the way acne is currently treated?
To address these questions, a roundtable discussion was convened, featuring clinicians with a significant number of acne patients in their practices. Dr. Shannon Humphrey, a dermatologist, and Dr. Joseph Brioux, a family physician, and moderator Dr. D'Arcy Little, himself a family physician and radiologist, offered a candid take on guideline-based acne treatment and the effort to improve treatment outcomes among patients.
The discussants addressed how each professional has tended to view acne, pursues acne care differently, and why. They also discussed the latest acne treatment guidelines as well as the depth of the gap between the generalist's versus the specialist's treatment approach.

Key Words: acne, treatment gap, antibiotic resistance, treatment adherence.

Antiobiotic resistance is a key factor to consider when establishing maintenance and treatment regimens.

Combination retinoid-based therapies are first-line treatments for acne; evidence suggests that such regimens achieve faster and more complete clearance, while addressing multiple pathogenic factors simultaneously.

Patients are often prescribed legitimate, evidence-based therapies but may abandon them after a short trial because of lack of perceived, efficacy or side effects. Address patient expectations and advise on the necessity of pursuing a sufficient course of topical therapy (e.g., 12 weeks) before drawing conclusions.

It is advisable to see patients on maintenance therapy for follow-up—attempt at least two office visits per year, and more if there is an increase in flares.

Convey to patients that acne is a chronic condition and that a sound treatment maintenance regimen is essential.

Do not give samples to patients unless supply is sufficient to pursue a 12-week trial of medication.

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