Mitigate acne scarring by treating it immediately
For acne patients with skin of colour, Dr. Catherine Maari talks about treating punch-out scares aggressively. (770 words, 3 min)
It is important to treat acne immediately to mitigate potential scarring, especially for patients with skin of colour. This was a point made by Dr. Catherine Maari during her presentation at Skin Spectrum Summit in Montreal.
“Why do we treat acne? We treat acne so it does not scar,” stated Dr. Maari. “Even if the acne is not severe, we need to intervene and treat aggressively because once there are scars, it is very difficult, if not impossible, to treat.”
During her presentation, Dr. Maari described the case of a patient she was not initially seeing for acne but who had acne with scarring that had not been treated. The patient was initially resistant to treatment.
However, after completing a course of isotretinoin, his acne cleared, but he was still left with scars. “I wish I had seen this patient earlier,” said Dr. Maari. “Any time you see severe acne scarring but are not comfortable prescribing isotretinoin, make sure to refer the patient [to a dermatologist] right away.”
It is also important to treat punch-out scars aggressively, according to Dr. Maari, especially in patients with skin of colour.
“In patients with darker skin, punch-out scars can cause hyperpigmentation,” she stated. “Even if the scars are not punch-out, hyperpigmentation, once there, can last for months or even years.”
The importance of treating acne in the skin that is prone to hyperpigmentation, regardless of the severity, was emphasized by Dr. Maari. “If the patient has one to two papules or pustules, it leaves a hyperpigmented scar. This is something that we want to treat earlier to try and control the acne better. I will be more aggressive with these patients to try and control pigmentation.”
The takeaway: Dr. Maari outlined potential treatment options for various types of acne. For comedonal lesions, she recommended the use of topical retinoid. For inflammatory lesions, she suggested either antibiotics or benzoyl peroxide. Patients who have sebum secretion should be treated with isotretinoin, and patients who have a mixed acne can be treated with a combination treatment, such as clindamycin-tretinoin.
Dr. Maari’s presentation was supported through an unrestricted educational grant from Bausch Health.
FROM THE LITERATURE ON ACNE IN PATIENTS WITH SKIN OF COLOUR
Treatment of acne and acne-related scarring with fixed combination clindamycin phosphate and benzoyl peroxide gel (1.2%/3.75%) and tretinoin gel microsphere 0.06% in an Asian American transgender female
In a case study of an Asian American transgender female with acne-related scarring, researchers found that therapy with clindamycin phosphate and benzoyl peroxide gel 1.2%/3.75% and tretinoin gel microsphere 0.06% was a successful treatment. According to the authors, due to the different mechanisms of action, this combination may offer better clinical results.
A clinical study evaluating the efficacy of topical bakuchiol (UP256) cream on facial acne
Monotherapy with UP256 cream containing 0.5% bakuchiol may improve mild-to-moderate acne and may be well suited for patients with skin of colour. The study was conducted over the course of 12 weeks on 13 subjects with skin types III-VI.
Adolescent acne and disparities in mental health
Female patients and patients with skin of colour may be disproportionately affected by the psychological aspects of acne, such as depression and self-esteem issues, according to a recent study. Taking into account the effects of acne shaped by culture and health care disparities is a necessary next step, the authors wrote.
VIDEO: Genetic factors related to pore and hair follicle size may contribute to acne severity
AT THE INTERSECTION OF SKIN AND SOCIETY
Touted as the first skincare product line to be developed specifically for Black men, “Ceylon” was recently profiled by The Guardian newspaper. The company, created by Patrick Boateng (pictured below), focuses on skin issues faced by individuals with skin of colour, including hyperpigmentation and acne scarring, according to the report. “There are issues of structural racism in the grooming industry,” said Boateng in an interview for the report. “There appears to be the strange belief that if you make products centering on a diverse audience that these products somehow won’t work equally well for anyone else or don’t have growth potential. We’re expected to accept and appreciate existing mainstream products built with no thought of people like us in mind,” he said. Read the full article here.
This Week
April is Rosacea Awareness Month
April is IBS Awareness Month
Friday, April 2 is World Autism Awareness Day
Something to think about during the week ahead…
Next Week
Dr. Isabelle Delorme discuses how some patients with atopic dermatitis are genetically predisposed to it.
Thank you to our panellists and delegates for making the Indigenous Skin Spectrum Summit a great success. Conference highlights will soon be posted to the Skin Spectrum website. As always, we welcome your questions and comments on topics in Ethnodermatology.