Contributing Writer

As a contributing writer, I author content for variety of sources. In this sample, I produced a blog post for Dermatologist Lisa Christman, M.D. about discoveries published in the Journal of American Dermatology but framed it in a way so her readers can identify with the subject matter.

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MY REGIMEN ISN’T WORKING: WHAT NOW?

Contributor: Cecilia Gomes

In May 2016, the Journal of the American Academy of Dermatology published new guidelines for acne treatment in adolescents and adults. This is a response to the growing rate of acne bacteria that is becoming resistant to drug treatment.

HOW DO BACTERIA BECOME RESISTANT TO TREATMENT?

Oral antibiotics are commonly used in acne treatment for patients with moderate to severe acne. If the antibiotic is ineffective or if the advised protocols are not followed through to end of treatment, there is a possibility for some bacteria to survive – despite symptoms showing otherwise. The survivors then multiply and the symptoms return. When the same antibiotics are used again to treat it, it has no effect on this resistant strain.

HOW DO DOCTORS COMBAT THE RESISTANCE?

The American Academy of Dermatology suggests that combining different methods of treatment is the most effective in improving acne vulgaris (AV). Depending on the type of acne you have, there are a number of combinations. Ask your doctor for the right treatments for you.

Oral antibiotics are still one of the most effective methods of treatment. However, it should not be used alone and should be limited to a 3-4 month course. The most proven antibiotics are in the cycline family: Doxycycline, minocycline, and tetracycline.

Topical medications, such as a retinoid or benzoyl peroxide, are recommended while taking oral antibiotics. They are effective in preventing bacterial resistance.

Hormonal therapy, such as oral contraceptive pills, is ideal for women with moderate to severe acne and seeking a method for birth control. Just with any drug there are potential risks. Hormonal treatment is associated with cardiovascular side effects in high-risk patients and issues with bone development in young adolescents. The four FDA approved hormonal treatments include:

    • Contraceptive agents
    • Spironolactone
    • Antiandrogens
    • Oral corticosteroids

Oral Isotretinoid, or commonly referred to as Accutane, is reserved for patients with severe acne or for those with moderate acne that is resistance to treatments. It is also a viable treatment option for patients with acne causing scarring and psychological stress. Studies have revealed associations between oral isotretinoid use and depression and Inflammatory Bowel Disease. Although the evidence is inconclusive, patients should follow their doctor’s treatment advice.

Laser treatments and chemical peels may improve acne, but should not be used as routine acne treatments

Alternative medication, such as tea tree oil, may be effective in combatting acne, as suggested by recent studies. This would be comparable to using over the counter benzyl peroxide.

Dietary changes, although not widely proven, may lead to improved symptoms of acne. New data reveals that a high glycemic diet may aggravate acne. There is limited evidence that some dairy contributes to inflammation.

WHAT’S RIGHT FOR ME?

The first step in determining the right treatment for you is to identify the type of acne you have. Talk to your dermatologist today.

MILD MODERATE SEVERE
First Line Treatment Topical Medication Oral Antibiotics + Topical Medication Oral Isotretinoid OR

Oral Antibiotics + Topical Medication

Alternative Treatment Hormonal Therapy Oral antibiotic

OR

Hormonal therapy

Table 1: Treatment Options per Acne Classification

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