My enthusiasm as a dermatologist for the diagnosis and treatment of acne is determined by several reasons.
First of all, because I suffered from intense acne during adolescence and young adulthood, which was difficult to treat and left several scars that are still visible as a result. Probably, knowing how acne can affect the life of a teenager has prompted me to become an acne specialist as a dermatologist in Barcelona. It should be noted that acne is the most common skin disease.
Secondly, because the management of this disorder can be more complex than it seems. It is true that isotretinoin has marked a before and after in the treatment of acne, although it is also unquestionable that not all types of acne respond to this drug. Its use in acne caused by hyperandrogenism (excess action of male hormones) is not usually effective. Therefore, it is necessary to take a medical history and a complete examination in patients with persistent acne or acne that occurs in adulthood (especially women).
The diagnostic algorithm for acne in young women is particularly interesting and sometimes makes it possible to find underlying disorders, such as polycystic ovary syndrome, SAHA syndrome or congenital adrenal hyperplasia. Acne is therefore an intellectually stimulating disorder for the dermatologist and can be an external sign of an internal disease that requires treatment.
Thirdly, and following the thread of the second point, the therapeutic management of acne is wide and varied. Although isotretinoin allows the cure of common acne in a very high percentage of cases, the treatment of this disorder does not end here, nor is it effective for all types of acne. Thus, it is important to determine if there is an underlying hormonal cause and to know the management of other therapeutic options such as oral contraceptives, metformin or spironolactone, in girls in whom isotretinoin would most likely fail.
Finally, it should be said that acne can be associated with an increased risk of some diseases, such as hypercholesterolemia, insulin resistance, obesity or inflammatory bowel disease. Therefore, considering it as a phenomenon of adolescence and maintaining a passive attitude towards it thinking that it will disappear spontaneously, can be harmful to the patient. It is necessary to diagnose and treat it early to avoid any of the diseases mentioned and to prevent scars from remaining. Acne scars are extraordinarily common in the population and can have a significant impact on self-esteem. If we do not treat acne early, we exponentially increase the probability of suffering acne scars.
And, precisely because I am also passionate about the treatment of scars, I focus my maximum effort so that patients suffering from acne do not suffer these aesthetic sequelae.