Author Bios

Publication of this supplement was made possible by an unrestricted educational grant from Galderma Canada Inc.

Maha Theresa Dutil, MD, M.Ed, FRCPC, Assistant Professor of Medicine, Division of Dermatology, University of Toronto, Toronto, ON.

One of the marked changes in the practice of dermatology over the past thirty years has been the increased focus on acne. What was once considered a universal rite of passage that occasionally caused deeply disturbing scars is now considered—by patients and doctors alike—an insufferable condition that must be treated. Perhaps as a sign that available treatments are increasingly successful, acne is showing signs of affecting popular culture. Kid Acne, a British artist (not his real name!), decided to make his affliction his signature so as to stand out in the crowded hip-hop scene. The Uruguayan movie Acné (as you would have guessed, about a thirteen-year-old boy coming of age while enduring acne outbreaks) was a hit of Spanish-speaking cinema in 2008. Acne for Dummies by Dr. Herbert P. Goodheart (a remarkably good book!) ranks a respectable 76th in skin care/ beauty books on Amazon.ca.

Success has bred the desire for even more success. This supplemental publication to Dermatology Times on "Innovations in Acne Care: The Latest Guidelines and Treatment Options" sheds light on new approaches that will be helpful to specialists and GPs alike. Dr. Neil Shear's "Newest Guidelines for the Treatment of Acne" discusses the acne guidelines that were published in a supplement to the May 2009 Journal of the American Academy of Dermatology and offers a discussion of the Global Alliance's latest iteration for acne treatment. He touches on acne pathophysiology, epidemiology, and the latest research findings, as they pertain to the guidelines. Dr. Shear, Professor and Chief of Dermatology at the University of Toronto's Faculty of Medicine, is enthusiastic about the latest paradigm provided by the Global Alliance because it is more concise and more comprehensive than the 2003 version.

Dr. Jerry Tan's "New Treatment Options in Acne Care" discusses novel treatments newly introduced to improve treatment outcomes in acne management. He weighs the pros and cons of retinoids, combination products, and newer agents such as the new fixed-dose combination gel product (adapalene/BPO combination). Dr. Tan, adjunct professor at the Schulich School of Medicine and Dentistry at the University of Western Ontario, pays particular attention to the mechanism and onset of action, efficacy, and tolerability/safety profile. He concludes that adapalene 0.1%/BPO 2.5% (adapalene/BPO) gel, recently approved for use in Canada, is a promising weapon in the arsenal against acne.

Fixed-combination anti-acne agents are becoming increasingly important components of current treatment regimens. Adapalene/BPO gel combines the two agents advocated by an international acne expert group as useful for treating mild-moderate acne. It not only offers complementary mechanisms of action but has also been shown to be an efficacious adjunct to oral doxycycline in treatment of severe facial acne. This combination may be particularly valuable in enhancing adherence, resulting in better patient outcomes. Dryness and cutaneous irritation can be managed by altering treatment frequency and by the addition of an oil-free moisturizer.

The internet has endless resources devoted to this disease, and that sometimes makes managing the condition all the more difficult, with patients drawing their knowledge from the web. A key aspect of acne treatment is understanding how the patient perceives the condition. That perception comes from a mixture of sources, including friends, family, the media, advertising, and not least from their GPs. This publication also contains an enlightening roundtable exchange between Dr. Shannon Humphrey, a Vancouver dermatologist, in dialogue with a GP counterdiscussant, Dr. Joseph Brioux, from Woodstock, Ontario. In "The Treatment Gap in Acne Care: Guidelines versus Treatment Practices" the discussion between specialist and general practitioner highlights how each professional views acne. This frank talk explores how and why GPs and dermatologists have tended to approach acne care differently. It is a revealing look at their respective views on antibiotic treatment, drug combinations, and retinoids, and examines how physicians manage their patients, especially on treatment adherence issues. Finally, both shed light on how they can best follow the latest acne treatment guidelines.

Dermatology continues to be challenged by acne and its victims. Early and effective acne treatments are needed to minimize the profound physical and psychosocial sequelae of this chronic disease. Although the triumphs of the past decades have been undeniable, acne remains a challenge. It is to be hoped that clear guidelines such as those put forward by the Global Alliance, new therapies, and improved conversation between specialists and general practitioners will continue the march of progress … and that one day Kid Acne will practically have the word to himself.

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