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Canadian acne guideline suggests updated evaluation, treatment
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A panel of Canadian researchers has published a new evidence-based clinical practice guideline for management of acne that provides updated recommendations for methods of evaluation, diagnosis and treatment of acne in children and adults based on severity.
“Since the last Canadian acne guideline was published in 2000, evidence for multiple additional treatments has been published,” Shannon Humphrey, BSc, MD, associate clinical professor in the department of dermatology and skin science at the University of British Columbia, and colleagues wrote. “Thus, there was an unmet need for an updated, systematically developed, evidence-based Canadian acne clinical practice guideline.”
Shannon Humphrey
The panel was comprised of 11 dermatology and epidemiology experts from across Canada. The researchers developed the updated guidelines in accordance with Appraisal of Guidelines for Research and Evaluation II instrument and the ADAPTE framework for guideline adaptation. To adapt the new guidelines, the researchers reviewed five clinical practice guidelines from 2007 to 2013, ultimately adapting the European evidence-based guidelines (ES3), due to its detailed descriptions and disclosures on how conclusions were reached. Two of the researchers developed and presented recommendations to the research panel that voted on the proposed recommendations.
The researchers identified three categories of acne requiring recommendations for children and adults: comedonal, characterized by small white or gray papules; mild-to-moderate papulopustular, consisting mostly of superficial inflammatory lesions; and severe acne, which can be painful and cause tissue damage.
The guidelines recommend selecting first-line therapies based on the tolerance and efficacy of previously used therapies for treating acne across all categories of severity. Patients should be evaluated within 2 to 3 months of initiating treatment to determine whether to escalate, maintain or taper treatment.
The report on the updated clinical practice guideline also includes:
- specific strategies for treating each category of acne,
- information on how acne is a common and burdensome condition;
- information on the possibility of adverse psychosocial impacts related to acne; and
- gaps in knowledge that must be filled to meet patient needs.
“This guideline was developed to facilitate the efficient diagnosis and effective treatment of acne vulgaris in the Canadian population,” Humphrey and colleagues wrote. “With early diagnosis, treatment of active lesions and prevention of adverse potential sequelae, the health of the many Canadians with acne may be improved.” – by David Costill
Disclosure: Humphrey reports grants and personal fees from Allergan, Galderma and Kythera; and personal fees from GlaxoSmithKline, Johnson & Johnson, L’Oréal, Procter & Gamble, Revance and Valeant. Please see the full study for a list of all other authors’ relevant financial disclosures.
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