Atualização do tratamento médico da acne vulgar na adolescência

Acne vulgaris in adolescence: an update on medical treatment

Abstract

Objective: To review the treatment options currently available for acne in adolescence, bearing in mind its pathophysiological
basis. Data Sources: A search for journal papers between 1990 and 2010 was performed in the Medline and ScienceDirect
database, with the words “treatment” and “acne” as descriptors, selected on the basis of their abstracts and the relevance
of tinier subject matter. Data Summary: Four main factors are involved in acne pathogenesis: increased sebum production,
follicular hyperkeratosis, infl ammation and bacterial proliferation. Treatment effi cacy depends on the interactions of these
factors. No single treatment is effective against all four factors. Topical therapy is indicated for mild to moderate acne,
with topical antimicrobial agents recommended for treating mild infl ammatory acne. Bacterial resistance to antibiotics is
an increasing problem. For moderate to severe acne, tetracycline and its derivatives are the fi rst-line antibiotic treatment.
Systemic isotretinoin is indicated for patients unresponsive to conventional therapy. New emerging topical and systemic
drugs have been studied, extending the treatment options for these patients. Conclusion: Current recommendations
suggest that treatments should be combined, in order to target as many pathogenic factors as possible. Up to six or eight
weeks of therapy may be required before improvement is evident. Long-term maintenance therapy should use safe and well
tolerated drugs in order to enhance compliance with the treatment.