Pharmacy U Presenter Benjamin Barankin: Acne – everything you always wanted to know but were afraid to ask

Benjamin Barankin will be presenting at Pharmacy U Toronto on April 1, 2023.

Acne is a very common skin condition (over 5 million Canadians have it!) with significant psychosocial impact. This presentation reviews the different types of acne: open and closed comedones (non-inflammatory acne), papules and pustules (inflammatory acne), as well as nodules and cysts. The causes of acne are also covered from androgen surge, to increased oil/sebum production, ductal blockage, inflammation and C. acnes bacterial colonization. Various triggers like stress and diet, as well as associated factors such as genetics, age & skin type are also highlighted. Importantly, the various severities of acne are reviewed, as this aids in the determination of the types of therapies that will be used to control acne.  While most cases of acne affect the face (93%), ~50% will have chest or back involvement as well, so it's important to ask about and examine the trunk and treat it as well. Appreciating the chronic nature of acne will be discussed.

The differential diagnosis of acne will be discussed, and most typically acne needs to be differentiated from rosacea and perioral dermatitis. Acne can be chronic in some cases, and unfortunately can result in scarring and hyperpigmentation; different types of acne scarring will be reviewed. Acne is more than just a skin problem - patients often also have lower self-esteem, as well as higher rates of anxiety, depression, and suicidal ideation.

It's important to treat as many causative factors of acne as possible, to treat all the areas that are affected, to treat aggressively enough to prevent scarring and hyperpigmentation, to try and minimize the risk of side effects from both topical and oral therapies, and to minimize the risk of antibiotic resistance.

Various topical therapies are reviewed, from topical retinoids, benzoyl peroxide and antibiotics (and their combinations), to dapsone and azelaic acid as well. Oral therapies include various antibiotics, hormonal therapies like combined oral contraceptives and spironolactone, and isotretinoin. Treatment selection is based on the type and severity of acne and maintenance therapy is also important.

Counselling on how to take care of one’s skin as far as cleansing and moisturizing, as well as minimizing and managing side effects, will be highlighted as well as the importance of adherence and establishing routines. 

Dr. Benjamin Barankin is a dermatologist and the Medical Director & Founder of the Toronto Dermatology Centre. He will be presenting at Pharmacy U Toronto on April 1, 2023.