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Acne, Inflammatory Bowel Disease, and Photodynamic Therapy

There has been a lot of press lately about acne and side effects of some of the medicines commonly used to treat it.  It’s hard not to have seen one of the many commercials from class action attorneys looking to sue the maker of Accutane for the development of inflammatory bowel disease (IBD) in patients who took the drug.  While Accutane (isotretinoin) is arguably the most effective treatment for severe acne, there are a number of reports suggesting an association with inflammatory bowel disease.

Now there is concern that a class of antibiotics commonly used to treat acne may also be associated with the development of IBD.  A recent study looking at more than 94,000 acne patients who took tetracycline-class antibiotics found that those who took doxycycline had a 2.25-fold greater risk of developing Crohn’s disease, a form of inflammatory bowel disease.  Tetracycline, doxycycline, and minocycline are part of the tetracycline-class antibiotics.

It is not possible to draw definitive conclusions about the risk of developing inflammatory bowel disease after taking Accutane or tetracycline-class antibiotics based on these reports.  However, given these reports and the concern that frequent use of antibiotics may breed resistant organisms, some dermatologists are discouraging the use of oral antibiotics to treat acne.

So, what’s a patient suffering with acne to do? More patients than we realize may be able to be controlled with topical medications alone, and for those who have acne that cannot be controlled by creams, photodynamic therapy continues to evolve.

Photodynamic therapy (PDT) is a type of laser acne treatment that cripples the oil producing glands associated with pimples.  It works by applying a sensitizing solution called aminolevulinic acid to the skin and then irradiating it with a light source.  It is the only treatment other than Accutane that can put acne into remission for an extended period of time.  Now, one of the major pioneers and innovators in using lasers on the skin, Dr. Rox Anderson, is trying to fine tune the treatments to give even better results.  He has hope that this treatment approach may even be able to cure acne in some people.  Let’s all hope for that!

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