Comprehensive Acne Management: New Insights for Patients in Cape Town
Acne is one of the most common skin conditions seen by dermatologists in Cape Town and around the world. While many people associate acne with teenagers, it can affect adults as well and often becomes a chronic condition requiring ongoing management. As our understanding of acne has evolved, so too have the approaches to treating it effectively. This post will explore some of the latest insights from the NICE Acne Guidelines into comprehensive acne care that patients in Cape Town should be aware of.
Assessing acne severity
One of the first steps in managing acne is accurately assessing its severity. Traditionally, this was done primarily through lesion counts. However, dermatologists in Cape Town are increasingly taking a more holistic approach that considers multiple factors:
Lesion counts and types (comedones, papules, pustules, nodules)
Location of acne (face, chest, back)
Degree of inflammation
Presence of scarring or post-inflammatory hyperpigmentation
Psychosocial impact on the patient
This multi-faceted assessment allows for a more personalized treatment plan. For example, even mild acne that is causing significant psychological distress may warrant more aggressive therapy. Learn more about our acne assessment process.
Treating truncal acne
While facial acne gets the most attention, many patients also struggle with acne on the chest, back, and shoulders. This "truncal" acne affects about 50% of acne patients and can be just as distressing as facial acne. However, it has some unique considerations:
Larger surface area to treat
Thicker skin that may be less responsive to topical treatments
Higher risk of scarring, especially keloid scars
Potential for bleaching clothes with some topical medications
New topical retinoids like trifarotene have shown promising results for both facial and truncal acne. For severe cases, oral medications may be needed. At our clinic in Cape Town, we customize treatment plans to address both facial and truncal acne comprehensively. Read more about truncal acne treatment options.
Preventing and managing acne scars
Acne scarring is one of the most challenging aspects of this condition. Even after active acne clears, scars can leave lasting physical and emotional impacts. The best approach is prevention through early, effective acne treatment. However, for existing scars, we now have more options than ever:
Topical retinoids like adapalene and trifarotene can help reduce the appearance of atrophic (indented) scars over time
Chemical peels
Laser treatments
It's important to note that different types of scars respond better to different treatments. A dermatologist can assess your specific scarring and recommend the most appropriate interventions. Learn about our acne scar treatments.
Addressing post-inflammatory hyperpigmentation
For many patients in Cape Town, especially those with darker skin tones, post-inflammatory hyperpigmentation (PIH) is a major concern. These dark spots left behind after acne heals can be as distressing as the acne itself. Some key points about managing PIH:
Early treatment of acne is crucial to prevent PIH
Sun protection is essential, as UV exposure can worsen pigmentation
Topical treatments like retinoids, azelaic acid, and hydroquinone can help fade PIH
In-office treatments like chemical peels may accelerate improvement
Recent studies have shown that newer retinoids like trifarotene may help prevent and treat PIH. Explore our pigmentation treatments.
Hormonal therapies for adult female acne
Adult female acne is increasingly common and often has a hormonal component. For women who haven't responded well to traditional acne treatments, hormonal therapies may be an option:
Combined oral contraceptives can help regulate hormones that contribute to acne
Spironolactone, an anti-androgen medication, has shown promise in recent studies as an alternative to oral antibiotics for adult women with acne
It's important to note that hormonal therapies are not suitable for all patients and require careful consideration of risks and benefits. Learn about our approach to adult acne.
The importance of a comprehensive skincare routine
While prescription medications are often necessary for managing acne, a good skincare routine is equally important. This typically includes:
Gentle cleansing twice daily
Treatment products (e.g., retinoids, benzoyl peroxide)
Non-comedogenic moisturizer
Daily sunscreen
Patients in Cape Town should be particularly vigilant about sun protection, as our sunny climate can exacerbate acne and PIH. Check out our recommended skincare products.
Looking to the future of acne care
Research into acne management is ongoing, with several promising areas of investigation:
The role of diet in acne
New drug delivery systems for more effective topical treatments
Advanced light-based therapies
Personalized treatment based on genetic factors
As new evidence emerges, treatment guidelines will continue to evolve. That's why it's important to work with a dermatologist who stays up-to-date on the latest advancements in acne care.
Conclusion
Managing acne effectively requires a comprehensive, personalized approach that addresses not just the visible lesions, but also potential scarring, pigmentation issues, and psychosocial impacts. By combining the latest treatments with a consistent skincare routine and lifestyle modifications, most patients can achieve significant improvement in their acne.
If you're struggling with acne in Cape Town, don't hesitate to seek professional help. Dr. Louw can develop a tailored treatment plan to help you achieve clearer, healthier skin. Book a consultation today.
Remember, acne is a medical condition - not just a cosmetic concern. With the right approach, it can be effectively managed, allowing you to feel confident in your skin.
Reference
Layton, A.M., Gupta, G., Seukeran, D., Maruthappu, T., Gaillard, S., Whitehouse, H., Ali, F.R., Razzaque, A., Al-Niaimi, F., & Copperwheat, S. (2024). What's New After NICE Acne Guidelines. Dermatology and Therapy, https://doi.org/10.1007/s13555-024-01275-0
