Acne Vulgaris

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Key Clinical PointsAcne VulgarisThe negative psychological effect of acne vulgaris can be profound and long-lasting.Combination therapy with a retinoid and a benzoyl peroxide–containing antimicrobial agent is used to control mild-to-severe inflammatory acne.For moderate-to-severe cases, an oral antibiotic agent is also recommended, with the duration of use being typically limited to 3 to 4 months. Once clinical improvement occurs, acne control is maintained with a topical retinoid. Benzoyl peroxide may also be continued if needed.Combined oral contraceptive therapy and spironolactone are effective hormonal therapies for inflammatory acne in female patients and may be considered in patients who do not have a response to topical therapies alone.In patients with severe nodulocystic acne or with acne that is unresponsive to combination therapy, the use of isotretinoin should be considered. Because of teratogenicity, prescribers should be familiar with recommended pregnancy-prevention measures and monitoring guidelines and be registered in the iPLEDGE system (in the United States).

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