This document summarizes different treatment options for acne. It discusses topical treatments like retinoids and antibiotics. It also discusses systemic treatments like isotretinoin, antibiotics and hormonal therapy. Non-ablative treatments covered include light, laser and radiofrequency. Ablative options discussed are peels and lasers. Surgical treatments are also mentioned. The document emphasizes that combining approaches provides best results and maintenance therapy can decrease relapse. It also notes that effective acne treatment can improve patients' emotional outlook.

1. Prof. Osama B Moawad
By

2. a point prevalence of up to 100%
among adolescents and often
persists into adulthood, with
detrimental effects on self-
esteem.
Sixty percent of all acne cases are so-
called ‘physiologic acne’, the other
40% are those that need continuous
help by a specialist to prevent
physical or psychological scarring

4. Sunlight Improve Acne

5. Up to 15% of acne patients notice that sweating causes a deterioration in their acne,
especially if they live or work in a hot humid environment; for example, for a cook, ductal
hydration may be the responsible factor
Sweating exacerbate Acne

6. PMS Causes Acne Flare

7. High Glycemic and Dairy Products
exacerbate Acne

8. classification/grading
scale (encompassing the
numbers and types of
acne lesions as well as
disease severity) serve
to facilitate therapeutic
decision and assess
response to treatment
What & Where

9. Wood’s light
Polarized Light
Dermatoscopy
White Heads
Black Heads
Clinical Examination

10. Hirsutism
Late Onset Acne
Acanthosis
Alopecia
Obesity

11. Non Inflammatory acne

12. Mild Inflammatory Acne

13. Severe Inflammatory Acne

14. Nodulo-cystic Acne

15. Severe Nodulo-cystic Acne

16. Acne Fulminans

17. Acne Conglobata

18. Hidradenitis supprativa
Follicular Occlusion Tetrade

19. Acne Excoriee Fes Jeunes Filles

20. Acne Mechanica

21. Black Heads
White Heads
Nodulo-cystic AcneInflammatory
Acne ExcorieeAcne FulminansInflammatoryNodulo-cystic Acne Excoriee
FACE and Neck

22. Upper Chest

23. Abdomen

24. Shoulder and Upper Arm

25. BackBack

26. Buttocks

27. Groin

28. Thigh and Legs

29. Less Common
Acne Types
Drug Induced
Occupational
Chloracne
Neonatal
Infantile

30. Topical systemic
Non
ablative
Minimally
ablative
Ablative Surgical
Acne Treatment

31. Topical Acne Treatment is the standard

32. Topical Acne Treatment
•Retinoids
•Benzyol Peroxide
•Antibiotics
•Dapsone
•Combinations
•Miscellaneous

33. Retinoids+ Antibiotics is the Best
Acne Control- Topical

34. Acne Control- Topical
Retinoids+ Antibiotics is the Best

35. Retinoids+ Antibiotics is the Best

36. Mild-Moderate Non Inflammatory Acne
Retinoids+ Antibiotics is the Best

37. Mild-Moderate Non Inflammatory Acne
Retinoids+ Antibiotics is the Best

38. MSI Offers a Better Penetration of
Transdermal Drug Delivery System

39. Transepidermal is the
main route while
transappandageal route
represent only 1% mainly
for ions and large polar
molecules

41. STC Modifier

42. Anti-Acne Masks
STC Modifier

43. It increases the penetration of topical treatment and
Improve wide pores and superficial acne scars
Dermal Roller- STD

44. STD

45. Phonophoresis or Sonophoresis
Cavitation
Heating
Acoustic microstreaming

46. STD

47. No Needle Mesotherapy or Electroporation
It helps the penetration of anti-acne and whitening agents

48. Acne Control- Topical
Mild-Moderate
inflammatory Acne
No Needle Mesotherapy or Electroporation
It helps the penetration of anti-acne and whitening agents

49. Systemic Acne Treatment

50. Systemic Acne Treatment
Oral
Antibiotics
Hormonal
Therapy
Androgen
receptor
blockers
Oral
Isotretinoin

51. Oral
Antibiotics
•Tetracyline
•Doxycycline
•Minocycline
•Lymecycline
•Bactrim
•Clindamycin
•Roxithromycin
•Azithromycin

58. •Oral Contraceptives
•Low-dose corticosteroids
•Spironolactone
•Flutamide
•Gonadotropin-releasing hormone
agonists
•Cyproterone acetate (CPA)
•?????Finesteride
Hormonal
Therapy

59. acne that is producing either
physical or psychological scarring.
Moderate to severe Acne resistant
to Treatment
Severe recalcitrant nodular acne

60. Severe Acne failed to Systemic Antibiotics
Acne Control Systemic- Isotretinoin

61. Acne Control Systemic- Isotretinoin
Severe Acne failed to Systemic Antibiotics

62. Severe Acne failed to Systemic Antibiotics
Acne Control Systemic- Isotretinoin

66. Acne Control Systemic- Isotretinoin
Physical and Psychological scarring

67. Physical and Psychological scarring
Acne Control Systemic- Isotretinoin

68. Physical and Psychological scarring
Acne Control Systemic- Isotretinoin

69. Non Ablative
Minimally
Ablative
Ablative
•Light
•Laser
•Radiofrequency
•Diamond Peel
•Superficial Peels
•PDT
• Medium Depth Peel
TCA
• CO2 Laser

70. Non Ablative Acne
Treatment
Light
PDT
Laser
PDT
Radio-
frequency

71. Blue Light
Medical SPA
kill P. acnes and/or causes disruption of sebaceous gland function,
and anti-inflammatory the effect that it is potentiated in PDT

72. •PhotochemicalP. Acne
•photothermalSebaceous
glands
•photoimmunologicSebaceous
follicules
Light Based Technology

73. These light sources have wavelengths that correspond to an
absorption peak of P acnes endogenous porphyrins causes death
Narrow Band UV
Broad Band IPL
KTP 532nm
Pulsed Dye Laser 595nm
Red light at 610-635nm
90-150u 90-150u
280u 450u
550u

74. RED
Non thermal, non laser light emitted diode (LED)
is a new Acne treatment option

75. BLUE LED
•90u-150u penetration
•Penetrate deeper than UVA
•Confined to the epidermis
•Can Kill Bacteria
•Not effective in PDT
•Prevention rather than treatment
Violet and Blue Light

76. RED LED
Red Light
•Penetrate deep (550u)
•Anti inflammatory
•Healing
•Effective in treating both
inflammatory and non
inflammatory acne

77. Phototherapy with mixed blue-
red light showed better
treatment response than blue
light alone.

78. RED and INFRARED LIGHT
Visible light as monotherapy is not recommended for the treatment of comedonal,
severe papulopustular and conglobate acne.

79. Mild Inflammatory
RED and INFRARED LIGHT

80. 530nm-700nm yielding photothermal/and or photochemical
IPL/ELOS

81. IPL/ELOS/
Mild Inflammatory Acne

82. IPL/ELOS/
Mild Inflammatory Acne

83. IPL/ELOS/
Mild Inflammatory Acne

84. IPL/ELOS/
Mild Inflammatory Acne

85. IPL/ELOS/
Mild Inflammatory Acne

86. IPL/ELOS/

87. IPL/ELOS/
Moderate
Inflammatory Acne

88. IPL/ELOS/
Moderate
Inflammatory Acne

89. IPL/ELOS/
Moderate
Inflammatory Acne

90. IPL/ELOS/
Moderate
Inflammatory Acne

91. IPL/ELOS/
Moderate
Inflammatory Acne

92. And Acne

93. Vascular
Pulsed KTP 532
Pulsed dye 585
LP PDL 595nm
Pigmented
QS 1064nm
Soft Laser
Mid Infrared
Nd:YAG 1064nm &
1320nm
Diode 1450
Erubium glass
1540nm

94. 1064nm Nd YAG, KTP532nm and 590nm Pulsd Dye Laser
Kill P.acnes, reduce vasculairy and modulates inflammatory

95. Vascular Laser
Kill P.acnes, reduce vasculairy and modulates inflammatory response

96. Kill P.acnes, reduce vasculairy and modulates inflammatory response
Vascular Laser

97. Vascular Laser
It heals excoriations

98. Selective Non
Ablative
LASER:
Pigmented
Skin Laser

99. Soft Laser Peel
is a rapid effective treatment for both inflammatory and non
inflammatory can lesions
QS 1064nm Nd: YAG+ Carbon Lotion

100. Soft Laser Peel
Acne Excoriee

101. Soft Laser Peel
Acne Excoriee

102. Soft Laser Peel
Acne Excoriee

103. NEAR INFRA
RED
•1064nm Nd
YAG Laser
MID
INFRARED
•1230 nm Nd
YAG
•1450nm
•1540nm
Erbium
Water is the chromophore but no selective damage to sebaceous gland

104. Mid Infra-red Lasers
1320 nm Nd YAG
1450nm Diode
1540nm Erbium
Destroying sebaceous glands secondary to water heating

105. Moderate
Inflammatory Acne
Mid Infra-red Lasers
Acne Control

106. Mid Infra-red Lasers
Moderate
Inflammatory Acne
Acne Control

107. Mid Infra-red Lasers
Moderate
Inflammatory Acne
Acne Control

108. Moderate
Inflammatory Acne
Mid Infra-red Lasers
Acne Control

109. Moderate
Inflammatory Acne
Mid Infra-red Lasers
Acne Control

110. Photodynamic Therapy
Photosensitizer
Red light
Infra-red
light
LED Laser IPL

111. Short acting photosensitizer multiple sessions

113. Nonablative radiofrequency (NARF)
Moderate-Severe Inflammatory acne and its scars

114. Reduction of sebaceous gland activity and promotion of
dermal remodeling by bulk heating of the dermis
NARF

115. Acne Control
Nodulocystic Acne
Nonablative radiofrequency (NARF)

116. Nodulocystic Acne
Nonablative radiofrequency (NARF)
Acne Control

117. Acne Control
Nonablative radiofrequency (NARF)
Nodulocystic Acne

118. Acne Control
Nodulocystic Acne
Nonablative radiofrequency (NARF)

119. Acne Control
Nodulocystic Acne
with Scarring
Nonablative radiofrequency (NARF)

120. Acne Control
Nonablative radiofrequency (NARF)
Nodulocystic Acne
with Scarring

121. Acne Control
Nonablative radiofrequency (NARF)
Nodulocystic Acne
with Scarring

122. Diamond Peel
Salicylic acid Peel
Soft Laser Peel
Photodynamic Therapy

123. STD

124. Salicylic Acid Peels
Effective in both inflammatory and comedonal acne. It lessen post
inflammatory hyperpigmentation
An excellent keratolytic
agent, useful against
comedones due to its
strong lipophilicity and
ability to penetrate the
pore

126. Salicylic acid peel

127. Acne Excoriee
Salicylic Acid Peels
Acne Control

128. Salicylic acid peel
Acne Excoriee
Acne Control

129. Salicylic acid peel
Acne Excoriee
Acne Control

130. Post inflammatory
Hyperpigmentation Salicylic acid peel
Acne Control

131. •Medium depth TCA
•Ablative Laser
•Ablative Fractional laser
Ablative Acne Treatment

132. Medium Depth TCA Chemical Peel
Moderate Acne
Stage II TCA

133. Medium Depth TCA Chemical Peel
Stage II TCA

134. Acne Control
TCA Peel
Moderate Acne

135. TCA Peel
Acne Control
Moderate Acne

136. TCA Peel
Acne Control
Moderate Acne

137. TCA Peel
Acne Control
Post inflammatory Hyperpigmentation

138. TCA Peel
Acne Control
Post inflammatory Hyperpigmentation

139. TCA Peel
Acne Control
Active Acne

140. Acne Control
TCA Peel
Post inflammatory Hyperpigmentation

141. TCA Peel
Acne Control
Acne Excoriee

143. STD

145. Allows better penetration of PRP improving both active acne and long ternm
acne scars
Fractional C02 Ablative Laser

146. Fractional CO2 Ablative Laser
Active Acne
It improves, active lesions, red spots, dark spots and scars

147. Fractional CO2 Ablative Laser
Active Acne
It improves, active lesions, red spots, dark spots and scars

148. Fractional CO2 Ablative Laser+ PRP
Moderate Acne

149. Fractional CO2 Ablative Laser+ PRP
Mild Acne

150. Oxygen treatment can kill bacteria, push active ingredients, speed post
chemical peel or fractional lasers healing time as well as erythema

151. Surgical Treatment
•Incision
•Drainage
•Intralesional
•Comedone Extraction

152. Conclusion

153. Acne is a Chronic Disease
Conclusion

154. Oral isotretinoin is
the most effective
acne treatment
developed to date

155. Newer methods include radiofrequency, light or laser, PDT
represent treatment alternatives for systemic medications

156. Topical
Treatment
Retionds
Antibiotics
Benzyol
peroxide
Dapsone
Miscellaneous
Systemic
Isotretinoins
Antibiotics
Hormonal
Non
ablative
Laser
Light
Radiofrequ
ency
Minimal
ablative
Superficial
peels
PDT
Minimal
ablative
laser
Ablative
Medium
depth
peels
Lasers
Surgical
Comedon
extraction
Incision
Excision
Intralesional
Combined Approaches= Best Results

164. Maintenance decrease relapse rate

165. Effective acne treatment can improve the emotional outlook of patients