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Review
. 2021 Oct 11:10:2021-8-6.
doi: 10.7573/dic.2021-8-6. eCollection 2021.

Dermatology: how to manage acne vulgaris

Alexander Kc Leung  1 , Benjamin Barankin  2 , Joseph M Lam  3 , Kin Fon Leong  4 , Kam Lun Hon  5
Affiliations
Review

Dermatology: how to manage acne vulgaris

Alexander Kc Leung et al. Drugs Context. .

Abstract

Background: Acne vulgaris is the most common skin disease that can lead to disfigurement and psychological distress. This article aims to provide a narrative updated review on the management of acne vulgaris.

Methods: A PubMed search was performed with Clinical Queries using the key term "acne". The search strategy included clinical trials, meta-analyses, randomized controlled trials, observational studies and reviews. The search was restricted to articles published in English.

Results: Treatments of acne include proper skin care, topical medications, oral medications and procedural therapies. Topical agents are the first-line treatment for mild-to-moderate acne and can be used as combination therapy for more severe acne. Systemic therapies are usually prescribed for the initial treatment of moderate-to-severe acne as well as for acne that is refractory to topical therapies.

Conclusion: Topical retinoids are the drugs of choice for the treatment and maintenance therapy of patients with mild-to-moderate acne vulgaris. Depending on the severity of the acne, topical retinoids may be used alone or in combination with benzoyl peroxide and topical or oral antibiotics. Oral antibiotics are an important therapy for inflammatory acne unresponsive to topical therapy. Neither topical nor oral antibiotics should be used as monotherapy. Oral contraceptives and/or spironolactone are useful for many women with acne. Oral isotretinoin is the drug of choice for severe, extensive, nodular acne vulgaris but is also often used in moderate cases where scarring is evident, acne-related psychosocial distress is significant or other treatment modalities have failed.

Keywords: acne; antibiotics; benzoyl peroxide; comedones; erythematous papules; oral contraceptives; pustules; retinoids; spironolactone.

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Conflict of interest statement

Disclosure and potential conflicts of interest: AKCL and KLH are associate editors of Drugs in Context and confirm that this article has no other conflicts of interest otherwise. This manuscript was sent out for independent peer review. All authors declare that they have no conflicts of interest relevant to this manuscript. The International Committee of Medical Journal Editors (ICMJE) Potential Conflicts of Interests form for the authors is available for download at: https://www.drugsincontext.com/wp-content/uploads/2021/09/dic.2021-8-6-COI.pdf

Figures

Figure 1
Figure 1
Numerous closed comedones on the forehead of a 16-year-old girl.
Figure 2
Figure 2
Multiple open comedones on the face of a 17-year-old boy.
Figure 3
Figure 3
Multiple inflammatory papules on the cheek.
Figure 4
Figure 4
Closed and open comedones, inflammatory papules and pustules over the forehead of a 13-year-old boy.
Figure 5
Figure 5
Nodulocystic acne on the face.
Figure 6
Figure 6
Acne conglobata presenting as grouped comedones, nodulocystic lesions, abscesses and draining sinus tracts on the back.
Figure 7
Figure 7
A 5-week-old boy with neonatal acne on the face. Note the presence of papules and pustules.
Figure 8
Figure 8
Multiple comedones and inflammatory papules over the cheeks of a 9-month-old boy.
Figure 9
Figure 9
Acne on the chin and neck of a 35-year-old woman presenting predominately with inflamed papules and pustules.
Figure 10
Figure 10
Boxcar scars on the right cheek.
Figure 11
Figure 11
Boxcar scars (close-up view).
Figure 12
Figure 12
Ice pick scars on the chin.
Figure 13
Figure 13
Rolling scar on the left cheek.
Figure 14
Figure 14
Hypertrophic scars over the chest of a 16-year-old boy.
Figure 15
Figure 15
Keloid scars over the left shoulder of a 14-year-old girl.
See this image and copyright information in PMC

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