Status Report From the American Acne & Rosacea Society on Medical Management of Acne in Adult Women, Part 2: Topical Therapies
In part 1 of this 3-part series, an overview of the epidemiology, visible patterns, and important considerations for clinical and laboratory evaluation of acne vulgaris (AV) in adult women was provided. Proper selection and integration of skin care products is important in the management of AV in this patient population. Part 2 of this series includes a discussion of over-the-counter and prescription topical therapies for adult women with AV. A summary of key randomized controlled trials also is provided. Further well-designed studies are needed, as data on the use of topical agents in this subpopulation are limited.
Practice Points
- Data from randomized controlled clinical trials (RCTs) of topical agents used for the treatment of acne in adult women has been gleaned through subanalyses of larger pivotal studies with adapalene gel 0.3%, dapsone gel 5%, clindamycin phosphate 1.2%–benzoyl peroxide 3.75% gel, and adapalene 0.1%–benzoyl peroxide 2.5% gel.
- Efficacy and tolerability/safety results from RCTs of these topical agents evaluated outcomes for the clinical pattern of mixed inflammatory, comedonal, and non-nodular acne located on the face above the jawline margin.
- More data are needed on the treatment of acne in adult women with topical agents, systemic agents, and combination regimens, including results for the full spectrum of clinical presentations.
Conclusion
Proper skin care is an important component in the management of AV in adult women. Data for topical therapies in this subpopulation are limited; however, post hoc analyses provide some information regarding their efficacy in treating mixed pattern AV. More well-designed studies are needed to better evaluate the use of topical agents in adult women with AV. Although most topical AV therapies appear to be safe for use during pregnancy when properly used and limited to facial application, their use in women of childbearing potential and during pregnancy warrants individual consideration; topical retinoids are best avoided during pregnancy, especially tazarotene, which is rated category X.44 In part 3 of this series, oral therapies used to treat AV in adult women will be discussed.
