After spending pretty much the entire month of September overseas in the US and the UK, Daniel and I were really looking forward to a month at home in good weather and enjoying the dogs. That was the plan. I had the International Menopause Society meeting in Melbourne which was terrific (although tragically skin wasn’t mentioned!). And Daniel and Jessica from ESK headed to Orlando to the American Society Of Dermatological Surgeons’ conference to introduce our skincare brand to dermatologists in the US. Apparently it was terrific. This month I had more time to really dig deep into the skin research and for October, we’re focusing on new studies on acne;

I was really interested in a new opinion piece by Canadian dermatologist Catherine Zip, all about the management of acne in the journal, Skin Therapy Letter. She writes that acne vulgaris is the most common skin condition seen by dermatologists and that managing it effectively involves not only choosing the right medications but also the right skincare. She re-emphasizes the importance of topical vitamin A as the mainstay of acne treatment. Acne is linked to a weakened skin barrier and underlying dry skin, even though sufferers produce more sebum or oil. Some acne treatments, like benzoyl peroxide and certain retinoids, can worsen this issue by damaging the skin barrier, meaning protecting this is key. Regular cleansing twice daily with a mild cleanser is ideal. Over-washing (more than twice a day) doesn’t necessarily worsen acne, but aggressive scrubbing can inflame the skin. Because acne-prone skin has a compromised skin barrier, using a non-comedogenic moisturiser is essential. However, she points out that each person’s skin reacts differently and sometimes extra breakouts do happen despite the labels. A reminder that sun protection is advised for all acne patients. Especially if you’re using treatments like doxycycline and oral isotretinoin which can increase sun sensitivity, and using sunscreen can prevent sun-induced skin damage. Plus, sunscreen may help prevent post-inflammatory hyperpigmentation, particularly in people of colour.

Laser therapy for acne?

During the recent Controversies and Conversations in Laser and Cosmetic Surgery annual symposium, Beverly Hills plastic surgeon Dr. Arash Moradzadeh presented a paper. He treated 100 consecutive patients with mild to severe acne vulgaris using the 1726-nm AviClear laser. This laser, cleared by the FDA in 2022 and widely used in Australia, was combined with skincare comprising vitamins C and E. At the one-year follow-up, 90% of the patients had clear skin, and 80% remained clear at 1.5 to 2 years. The poorer responders? Women with hormonal acne. They ended up needing tretinoin- which did ultimately clear their acne.

Dr Moradzadeh said that laser devices were still not used much by general dermatologists, partly due to the high out-of-pocket costs for patients and a preference for traditional acne treatments. But I suspect that the true reason that the American Academy of Dermatology's updated guidelines in 2024 did not recommend laser treatment for acne, is because there are still no randomised controlled trials available for evaluation.

A new study published in the journal Pharmaceuticals explored whether metformin, a medication usually used to treat diabetes, could be effective for managing acne. Well, to be clear, we already know it works a treat for people with polycystic ovarian syndrome (aka PCOS) and acne. What we didn’t know was whether it would work for people with acne but no PCOS. This study found that metformin actually helps reduce acne by lowering insulin levels and decreasing inflammation, which are both linked to acne development. The people in the study who took metformin showed a noticeable improvement in their acne compared to those who didn’t. This suggests that metformin could be a helpful addition for people with acne, even without PCOS. However, the researchers said that more research is needed to confirm these findings and establish its safety and effectiveness for long-term acne treatment.

See you next month!