Speaker addresses complexity of acne treatment in women

MIAMI BEACH, Fla. — There are many factors to consider when treating women with acne, according to a speaker at South Beach Symposium.

“A first office visit with an adult female with acne should not be a quick office visit. As dermatologists, we should spend time with the patient and not only examine the types of lesions they have, but also the type of lifestyle they live, whether or not they wear cosmetics and if they spend a lot of time in the sun,” Diane S. Berson, MD, dermatologist at Weill Cornell Medical College in New York, said during her presentation. “These women are very motivated to fix their skin, are often very interested in skincare and knowing which products to use. They will also want to be prescribed medications that are well tolerated and cosmetically acceptable.”

Other factors, such as child-bearing potential, are just as important, Berson added.

“Not only should we ask if they are planning a pregnancy, but we should also ask if they have had trouble getting pregnant in the past, because this could take us toward a hormonal etiology,” she said.

For hormonal flares, oral contraceptives could be prescribed.

“Interestingly, the patch and vaginal ring offer better benefit in acne treatment because there is a steadier state of absorption of active estrogen,” Berson said. “However, this is a theory and has not been fully examined.”

Although managing acne in women may be similar to managing acne in other patients, skincare, such as cosmeceuticals and cosmetics, may play a role, according to Berson.

“When it comes to cosmetics, camouflage is important for these women, and we have to allow them to wear makeup and live their lives,” she said. “I recommend mineral makeup, just as I recommend mineral sunblock. Products that are non-comedogenic and hypoallergenic are key.”

The role of diet in skincare has also come full circle, according to Berson.

“There does appear to be a role of diet in acne treatment. We know that a low-glycemic diet is helpful for our patients with metabolic syndrome, but it may also be helpful for women with acne. ... The microbiome also appears to play a role, so it may be a good idea to prescribe these patients a probiotic,” she said. – by Jennifer Southall

Reference:

Berson D. Acne Diagnosis and Treatment in Women. Presented at: South Beach Symposium; Feb. 6-9, 2020; Miami Beach, Fla.