Management strategies for acne vulgaris
Kristen M Whitney1, Chérie M Ditre2
1Philadelphia College of Osteopathic Medicine, Philadelphia, PA, USA; 2Skin Enhancement Center and Cosmetic Dermatology, Department of Dermatology, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
Date of preparation: 30th November 2010
Conflicts of interest: None declared
Clinical question: What are the most effective treatment(s) for mild, moderate, severe, and hormonally driven acne?
Results: Mild acne responds favorably to topical treatments such as benzoyl peroxide, salicylic acid, and a low-dose retinoid. Moderate acne responds well to combination therapy comprising-topical benzoyl peroxide, antibiotics, and/or retinoids, as well as oral antibiotics in refractory cases and oral contraceptive pills for female acne patients. Severe nodulocystic acne vulgaris responds best to oral isotretinoin therapy. In female patients with moderate to severe acne, facial hair, loss of scalp hair and irregular periods, polycystic ovarian syndrome should be considered and appropriate treatment with hormonal modulation given. Adjunctive procedures can also be considered for all acne patients.
Implementation: Pitfalls to avoid when treating acne: treatment of acne in women of childbearing age; familiarization of all acne treatments in order to individualize management for patients; indications for specialist referral.
Keywords: acne vulgaris, benzoyl peroxide, retinoids, antibiotics, light and laser therapy, photodynamic therapy, photopneumatic therapy, chemical peels
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