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Treatment of acne in patients with skin of colour can be challenging, mainly due to their propensity to develop cosmetic complications. Topical retinoids are first-line therapy, with alternative topical treatments including antimicrobials, azelaic acid and dapsone. Hydroquinone can be used as a specific treatment for post-inflammatory hyperpigmentation. Oral antibacterials and isotretinoin are effective in the treatment of more severe acne. The early promise shown by lasers and phototherapies as adjunctive therapy for acne requires validation.