In this episode of Dermbusters, host Nicholas Brownstone, MD, chats with acne and rosacea expert Emmy Graber, MD, MBA, about some common misperceptions they often hear from their patients. 

Dr Graber shares some tips on counseling patients on 2 topics: how diet impacts acne and advising patients on isotretinoin to wait 6 to 12 months before getting cosmetic procedures. 

Myth 1: Fried and fatty foods cause acne. 

Dr Graber addresses the widespread belief among patients that fried and fatty foods can induce acne. She acknowledges the challenges of studying diet’s impact on acne but shares a few tips on counseling patients based on published data. 

Tips for counseling your patients: 

• Explain to patients that while some studies suggest a correlation between high-glycemic foods and acne for some individuals, the association is not universal 
• Emphasize the role of dairy products, particularly skim milk products, in exacerbating acne for some patients 
• For patients who can identify specific dietary triggers, give them the option of avoiding that food 
• Emphasize the uniqueness of individual responses to dietary triggers rather than making blanket statements 

Myth 2: Patients must wait at least 6 months following the use of isotretinoin before having any cosmetic or surgical procedures. 

Dr Brownstone and Dr Graber then discuss advising patients on isotretinoin on the often-recommended waiting period before undergoing any cosmetic or surgical procedures. Dr Graber challenges the traditional notion of waiting 6 to 12 months, relating a few discussion points to share with patients. 

Tips for counseling your patients: 

• Cite a systematic review of over 32 studies and 1400 procedures¹ that found no evidence supporting the need for a prolonged delay for cosmetic procedures following isotretinoin use 
• Advise patients that procedures like visible light lasers, hair removal, superficial chemical peels, and fractional and ablative lasers are safe while on isotretinoin 
• Counsel patients to follow the waiting period and delay more intense procedures like nonfractional lasers, deep dermabrasions, and deep chemical peels until there is more data available to support the safety of such procedures while on isotretinoin 
• Mention potential benefits of pulsed dye laser treatments for acne for patients concurrently on isotretinoin, noting not only safety but potentially improved outcomes 

Tune in to the episode to hear the full details on Dr Graber’s informed approach to counseling patients that embraces evidence-based practices to optimize care. 

Reference 

1. Spring LK, Krakowski AC, Alam M, et al. Isotretinoin and timing of procedural interventions: a systematic review with consensus recommendations. JAMA Dermatol. 2017;153(8):802-809. doi:10.1001/jamadermatol.2017.2077