Gone by the wayside?
The Academy’s guidelines are driven by evidence and data; not necessarily on practice patterns, according to Dr. Schlosser.
“Based on the data, it is a little surprising … but there’s very little evidence to support the utilization of topical sulfur or topical sodium sulfacetamide in the treatment of acne,” Dr. Schlosser says.
The same is true for antibiotics in the penicillin family, including cephalosporins. Although, the workgroup notes, these antibiotics can be used in select populations, such as those who are pregnant or who have allergies to other classes of antibiotics, which may have greater utility and greater efficacy in acne, such as the tetracycline class.
Hormonal agent update
Cochrane database reviews comparing combination oral contraceptive pills for the treatment of acne have yielded no clear winner, according to Dr. Schlosser.
“But we do know that combination oral contraceptive pills are better than placebo, based on the data,” she says. “And they do help in terms of not just facial acne, but there’s a study that also shows benefit for truncal acne.”2
The guidelines continue to recommend that acne patients being considered for hormonal therapy be appropriately selected and screened for concomitant morbidities and risk factors, including if they have a family or personal history of blood clotting disorders, hypertension, stroke, etc.