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JAMA Dermatology Feb 2024While acne is common in transgender and gender-diverse people and is associated with gender-affirming hormone therapy, little research has examined these factors and...
IMPORTANCE
While acne is common in transgender and gender-diverse people and is associated with gender-affirming hormone therapy, little research has examined these factors and their impact in gender minority groups.
OBJECTIVE
To examine the lived experiences of acne and acne treatment in transgender and gender-diverse participants.
DESIGN, SETTING, AND PARTICIPANTS
This mixed-methods analysis was conducted at a multidisciplinary gender center at a public safety-net hospital and endocrinology and dermatology clinics at a tertiary academic center from January 4, 2021, to April 7, 2022, using semistructured interviews and surveys. Participants were transgender or gender-diverse adults who had received gender-affirming hormone therapy. Data analysis was performed from November 11, 2021, to March 31, 2023.
EXPOSURE
Current diagnosis of acne.
MAIN OUTCOMES AND MEASURES
Interviews exploring the experience of acne and acne treatment were audio recorded, transcribed verbatim, coded using minority stress theory and the socioecological model, and analyzed using thematic analysis. Themes were triangulated with survey data on gender, self-reported acne severity, skin-specific quality-of-life impact, and treatment experience.
RESULTS
A total of 32 participants were included in the study (mean [range] age, 32 [18-57] years; 17 transgender men, 11 transgender women, and 4 nonbinary participants). Ten participants (31%) self-rated their skin as currently clear or almost clear, 11 (34%) reported mild acne, and 11 (34%) had moderate to severe acne. Participants described experiences of rejection and bullying related to acne and admitted avoiding social interactions in which they anticipated acne-related discrimination, which led to feelings of depression and anxiety. Acne worsened body appearance dissatisfaction. Transgender women reported acne interfering with feminine gender expression. Transgender men often normalized acne development, sometimes viewing acne positively as an early sign of testosterone action. Most participants tried over-the-counter acne treatments and commonly sought acne treatment advice from physicians, peers, online forums, and social media. Barriers to acne treatments included cost, lack of multidisciplinary care, mistrust toward the health care system, and lack of transgender-specific acne care education.
CONCLUSIONS AND RELEVANCE
In this mixed-methods study, transgender and gender-diverse individuals reported experiencing acne-related stigma and facing barriers to acne treatment. Multilevel changes, such as developing strategies to reduce acne stigma, providing transgender-specific acne care education, facilitating multidisciplinary acne care, and expanding transgender-friendly clinical environments, are recommended to reduce the impact of acne in transgender individuals.
Topics: Adult; Male; Humans; Female; Transgender Persons; Gender Identity; Sexual and Gender Minorities; Acne Vulgaris; Testosterone
PubMed: 38170514
DOI: 10.1001/jamadermatol.2023.5355 -
Journal of Cosmetic Dermatology Sep 2023The popularity of social media appears to be increasing the acceptance of cosmetic treatments, prompting more consumers to seek cosmetic treatments. As the estimated... (Review)
Review
BACKGROUND
The popularity of social media appears to be increasing the acceptance of cosmetic treatments, prompting more consumers to seek cosmetic treatments. As the estimated prevalence of acne vulgaris among adult women may be as high as 54%, acne is commonly observed among patients presenting for cosmetic treatments. Concomitant treatment of acne in the aesthetic patient population will improve overall clinical outcomes.
AIMS
The goal of this work was to deliver a high-quality ethical and evidence-based educational program to physicians and adjunctive health care providers to advance patient care.
METHODS
This paper is based on a webcam presentation with roundtable discussion by several notable experts in their field.
RESULTS
A range of topical medications, injectable products, chemical peels, and energy-based devices are available for treating acne vulgaris. In most instances, these are compatible with rejuvenation procedures in the aesthetic patient.
CONCLUSION
The growth of social media is raising awareness of aesthetic procedures and appears to be increasing the number of patients seeking aesthetic treatment. Educating patients about the importance of treating acne vulgaris can improve overall treatment outcomes. In most instances, the presence of acne is not a barrier to aesthetic care.
Topics: Adult; Humans; Female; Acne Vulgaris; Chemexfoliation; Dermabrasion; Treatment Outcome; Esthetics
PubMed: 37403516
DOI: 10.1111/jocd.15913 -
Archives of Dermatological Research Dec 2023Atrophic acne scars are the most common type of acne scars and are classified into three main types: icepick, boxcar, and rolling scars. Various procedures and... (Review)
Review
Atrophic acne scars are the most common type of acne scars and are classified into three main types: icepick, boxcar, and rolling scars. Various procedures and techniques for atrophic acne scarring are discussed in detail, with stronger evidence-based support for lasers (non-fractional, fractional, ablative, and non-ablative), platelet-rich plasma as adjunctive treatment, chemical peels (glycolic acid, trichloroacetic acid, and Jessner's solution), dermal fillers such as hyaluronic acid, and microneedling, and lesser quality evidence for microdermabrasion, subcision, and lipoaspirate grafting. Further research is needed to optimize treatment protocols, assess the efficacy of monotherapies, and establish standardized guidelines for clinicians. This paper will provide a comprehensive review of the evidence-based management of atrophic acne scars, including currently commonly utilized therapies as well as more innovative treatment options.
Topics: Humans; Cicatrix; Dermatology; Acne Vulgaris; Chemexfoliation; Combined Modality Therapy; Atrophy; Treatment Outcome
PubMed: 38059974
DOI: 10.1007/s00403-023-02737-9 -
JAMA Dermatology Dec 2023
Topics: Humans; Isotretinoin; Acne Vulgaris; Dermatologic Agents; Treatment Outcome
PubMed: 37819642
DOI: 10.1001/jamadermatol.2023.2065 -
MMW Fortschritte Der Medizin Jan 2024
Topics: Humans; Acne Vulgaris
PubMed: 38261176
DOI: 10.1007/s15006-023-3531-6 -
The Journal of Dermatological Treatment Dec 2023Patients with moderate-to-severe atopic dermatitis (AD) experience skin lesions and intense itch that substantially affect quality of life. Patients have choices among...
BACKGROUND
Patients with moderate-to-severe atopic dermatitis (AD) experience skin lesions and intense itch that substantially affect quality of life. Patients have choices among systemic AD treatments that offer varied benefit-risk profiles.
OBJECTIVE
Measure patients' willingness to trade off the risks and benefits of systemic treatments among individuals with a physician-confirmed diagnosis of moderate-to-severe AD.
METHODS
Patients participated in a discrete choice experiment online survey with a series of choices between hypothetical AD treatments defined by six attributes reflecting benefits and risks of treatments (itch reduction, time until noticeable itch reduction, chance of clear or almost clear skin, risk of serious infection, risk of developing acne, and need for prescription topical steroids). Data were analyzed with a random parameters logit model to quantify preferences and the relative importance of attributes for treatment alternatives.
RESULTS
Respondents ( = 200) placed the highest relative importance on itch reduction, speed of itch reduction, and skin clearance, and were generally willing to accept clinically relevant levels of risk of serious infection and acne in exchange for treatment benefits.
CONCLUSIONS
Patients with moderate-to-severe AD were willing to trade clinically relevant treatment risks for greater or more rapid itch reduction and skin clearance offered by systemic therapies.
Topics: Humans; Dermatitis, Atopic; Patient Preference; Quality of Life; Skin; Acne Vulgaris
PubMed: 37349865
DOI: 10.1080/09546634.2023.2222201 -
Advances in Skin & Wound Care Feb 2024To review the clinical presentation and treatment of acne vulgaris.
GENERAL PURPOSE
To review the clinical presentation and treatment of acne vulgaris.
TARGET AUDIENCE
This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and registered nurses with an interest in skin and wound care.
LEARNING OBJECTIVES/OUTCOMES
After participating in this educational activity, the participant will:1. Identify a differential diagnosis of acne vulgaris.2. Recognize clinical feature of various acne vulgaris subtypes.3. Specify epidemiologic characteristics of acne vulgaris.4. Select topical, systemic, and nonpharmaceutical treatment options for a patient with acne vulgaris.
Topics: Humans; Acne Vulgaris; Administration, Topical; Education, Continuing; Diagnosis, Differential
PubMed: 38241449
DOI: 10.1097/ASW.0000000000000089 -
Journal of the European Academy of... Dec 2023
Topics: Humans; Depression; Mendelian Randomization Analysis; Risk Factors; Genome-Wide Association Study; Acne Vulgaris; Polymorphism, Single Nucleotide
PubMed: 37467373
DOI: 10.1111/jdv.19370 -
International Journal of Dermatology May 2024Acne excoriée (AE) is a skin picking disorder (SPD) within the group of obsessive compulsive (OCD) and related disorders characterized by the compulsive manipulation of... (Review)
Review
Acne excoriée (AE) is a skin picking disorder (SPD) within the group of obsessive compulsive (OCD) and related disorders characterized by the compulsive manipulation of acne lesions. AE typically appears in females during adolescence or young adulthood and can cause significant disfigurement and psychosocial impairment. This disorder is under-recognized due to patient discomfort to disclose excoriation habits or lack of behavior awareness. It is imperative that dermatologists accurately diagnose and treat this disorder to minimize long-term damage to the skin. This review aims to provide an overview of the diagnosis and treatment options for AE.
Topics: Female; Humans; Acne Vulgaris; Obsessive-Compulsive Disorder; Self-Injurious Behavior
PubMed: 38102842
DOI: 10.1111/ijd.16964 -
Biomedicine & Pharmacotherapy =... Aug 2023Acne vulgaris is a highly prevalent skin condition caused by androgen-induced elevated sebum secretion, abnormal keratinization, bacterial colonization, and... (Review)
Review
Acne vulgaris is a highly prevalent skin condition caused by androgen-induced elevated sebum secretion, abnormal keratinization, bacterial colonization, and inflammation. Current research indicates a link between acne vulgaris and the metabolic syndrome, a group of disorders that includes obesity, insulin resistance, hypertension, and dyslipidemia. This link is thought to be modulated by excessive concentrations of oxidative stress markers and chronic inflammation, which are included in the pathophysiological mechanisms shared by both conditions. Excessive generation of reactive oxygen species damages cellular components and initiates an inflammatory response, hence promoting the development of both disorders. The current narrative review focuses on the molecular implications of inflammatory, hormonal, and environmental factors in the acne-metabolic syndrome correlation. Furthermore, it outlines the current state of knowledge related to the phyto-therapeutic approach to these conditions as an adjuvant strategy to allopathic treatment, but future multicenter and larger-scale research studies are needed establish new algorithms to be included in the future management of patients with these conditions.
Topics: Humans; Metabolic Syndrome; Acne Vulgaris; Oxidative Stress; Inflammation; Dietary Supplements; Phytochemicals; Multicenter Studies as Topic
PubMed: 37315434
DOI: 10.1016/j.biopha.2023.115003