Clear Protocols, Clear Skin: An Acne Update for Primary Care

madman · 2026-04-08T16:27:35-0500

Neil Skolnik, MD, discusses the latest evidence-based guidelines from the Primary Care Dermatology Society regarding the treatment of acne. The video outlines a streamlined clinical pathway, beginning with topical retinoids and fixed-dose combination therapies for mild-to-moderate cases, and progressing to systemic antibiotics or isotretinoin referrals for more severe, nodular acne.

Neil Skolnik, MD, also addresses the biological causes of acne, including the role of C. acnes bacteria and keratinocyte turnover, while offering practical advice on lifestyle modifications and proper medication application techniques to minimize skin irritation. This overview serves as a comprehensive guide for healthcare professionals to effectively assess, treat, and monitor patients through every stage of acne severity.

Chapters

00:00 - Introduction to Acne Treatment Guidelines
00:34 - Defining Key Features of Acne
00:49 - Understanding the Causes of Acne
01:13 - Lifestyle and Diet Recommendations
01:35 - First-Line Topical Retinoids
01:56 - Combination Therapies for Papular and Pustular Acne
02:38 - Best Practices for Applying Topical Treatments
03:06 - When to Escalate to Systemic Antibiotics
04:20 - Management of Severe and Nodular Acne
04:33 - Summary of the Evidence-Based Treatment Pathway

madman · 2026-04-08T16:30:29-0500

Thread 'The primary role of sebum in the pathophysiology of acne vulgaris'

Dec 26, 2023

ABSTRACT

Background

Sebum physiology and its contributions to acne vulgaris (AV) pathophysiology have been long debated. Within the pilosebaceous unit, androgens drive sebocyte production of sebum, comprising mono-, di-, and triglycerides (the latter converted to fatty acids); squalene; cholesterol; cholesterol esters; and wax esters. Upon release to the skin surface, human sebum has important roles in epidermal water retention, antimicrobial defenses, and innate immune responses.

Aims

Alterations in sebum alone and with other pathogenic factors (inflammation...