Is TCD still relevant for acne treatment?
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TCD is a popular treatment modalities for acne. The steroid component of TCD presents potential problem in the long-term management of acne.
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Is TCD still relevant for acne treatment?
- 1. IS TCD STILL RELEVANT FOR ACNE TREATMENT? Peter Nugraha Soekmadji Department of Dermatovenereology Faculty of Medicine Maranatha Christian University Bandung
- 2. Conflict of Interest Statement • NO support or commercial funding for this presentation or for any products mentioned here
- 4. Corticosteroids use in acne is limited to certain indications
- 5. INDICATIONS FOR ORAL STEROID USE IN ACNE Acne conglobata Acne fulminans Hormonal imbalance
- 6. Krakowski AC, Stendardo S, Eichenfield LF. Practical Considerations in Acne Treatment and the Clinical Impact of Topical Combination Therapy. Pediatric DermatologyVol. 25 Suppl. 1 1–14, 2008 Congenital adrenal hyperplasia Polycystic ovarian syndrome
- 7. Local adverse effects of topical corticosteroids use are more prevalent than systemic reactions
- 8. Local Adverse Effects Saraswat A et al. Topical corticosteroid abuse on the face: a prospective multicenter study of dermatology outpatients. Indian J Dermatol Venereol Leprol 2011;77:160-6 ACNE, 57.5 ROSACEA, 21.8 ATROPHY, 16.4 STEROID ADDICTION, 15 HYPOPIGME NTATION, 9 PERIORAL DERMATITIS , 8.4 TINEA INCOGNITO, 6.7 HIRSUTISM, 6.3
- 9. Mahar S, Mahajan K, Agarwal S et al. Topical Corticosteroid Misuse - The Scenario in Patients Attending a Tertiary Care Hospital in New Delhi. Journal of Clinical and Diagnostic Research. 2016 Dec, Vol-10(12): FC16-FC20 STEROID ACNE
- 10. Mahar S, Mahajan K, Agarwal S et al. Topical Corticosteroid Misuse - The Scenario in Patients Attending a Tertiary Care Hospital in New Delhi. Journal of Clinical and Diagnostic Research. 2016 Dec, Vol-10(12): FC16-FC20 STEROID ROSACEA
- 11. SKIN ATROPHY
- 12. HYPOPIGMENTATION
- 14. TINEA INCOGNITO
- 15. HYPERTRICHOSIS
- 16. 0 5 10 15 20 25 30 1 w-1 mo 1-3 mo 3-6 mo 6 mo-1 y > 1 year Duration of Use Saraswat A et al. Topical corticosteroid abuse on the face: a prospective multicenter study of dermatology outpatients. Indian J Dermatol Venereol Leprol 2011;77:160-6
- 17. Reasons For Misuse Acne , 29.2 Itch, 13.2 Lightening, 18.4 Melasma, 7.2 Infection, 3.6 Mahar S, Mahajan K, Agarwal S et al. Topical Corticosteroid Misuse - The Scenario in Patients Attending a Tertiary Care Hospital in New Delhi. Journal of Clinical and Diagnostic Research. 2016 Dec, Vol-10(12): FC16-FC20
- 19. Coman GC, Holliday AC, Mazloom SE et al. A randomized, split-face, controlled, double-blind, single-center clinical study: Transient Addition of a Topical Corticosteroid to a Topical Retinoid in Acne Patients to Reduce Initial Irritation.
- 20. Coman GC, Holliday AC, Mazloom SE et al. A randomized, split-face, controlled, double-blind, single-center clinical study: Transient Addition of a Topical Corticosteroid to a Topical Retinoid in Acne Patients to Reduce Initial Irritation. 20 patients enrolled 4 patients dropped-out Triamcinolone 0.025% cream Emollient (Eucerin) Tretinoin 0.05% cream 16 patients analyzed
- 21. Coman GC, Holliday AC, Mazloom SE et al. A randomized, split-face, controlled, double-blind, single-center clinical study: Transient Addition of a Topical Corticosteroid to a Topical Retinoid in Acne Patients to Reduce Initial Irritation.
- 22. Subject Preference 0 10 20 30 40 50 60 70 80 90 100 Week 2 Week 4 CS Emollient Coman GC, Holliday AC, Mazloom SE et al. A randomized, split-face, controlled, double-blind, single-center clinical study: Transient Addition of a Topical Corticosteroid to a Topical Retinoid in Acne Patients to Reduce Initial Irritation.
- 23. TAKE HOME MESSAGE • There is limited indication for topical corticosteroid use in acne • Better to use another method to reduce irritation – Use mild cleanser – Delay retinoids application after washing face – Use less irritating formulations of retinoids – Gradual introduction of retinoids – Short contact application regimens – Alternate day applications of retinoids Coman GC, Holliday AC, Mazloom SE et al. A randomized, split-face, controlled, double-blind, single-center clinical study: Transient Addition of a Topical Corticosteroid to a Topical Retinoid in Acne Patients to Reduce Initial Irritation.