What is your approach to young teenagers with acne who have extremely sensitive skin, cannot tolerate typical acne regimens, cannot tolerate oral antibiotics, and refuse Accutane?

The formulation of benzoyl peroxide encapsulated in silica shells is extremely well tolerated by sensitive-skinned individuals. I was involved in pre-approval studies and found it remarkably well tolerated in such patients.

In regard to the Accutane refusal and the concern for potential adverse effects, I frequently discuss alternative dosing regimens that start with lower doses and intermittent doses (i.e., 2 to 3 days a week).

Additionally, I discuss ways to help mitigate the potential for the initial worsening of the acne (i.e., antihistamines, 2-week prednisone tapers, etc).

Many patients and their parents have been receptive to a low dose + intermittent dose routine with a plan to gradually increase the dose amount or days taken each week, and an understanding that it will take longer to achieve a clinical endpoint.

I personally do not have experience with lasers such as Aviclear, but I do take a moment to discuss this as well.

This is a great case to consider 1726 acne lasers. There are 2 lasers in this category. AviClear and Accure. I was part of the Accure FDA trial, and I saw some really nice improvements and had the most patients among the 5 sites. I treated 29 patients during the study. Patients received 4 treatments (1 tx a month, for 4 months). The patients showed continued improvement over time, documented at 3m, 6m, 9m, and 12m, and that was obviously monotherapy with laser alone. In reality of clinical practice, we have patients do the topicals that they can tolerate during the course of these treatments, and surprisingly, the lasers don’t tend to make people dry or irritant prone. And they can do oral agents at the same time as well, including antibiot...