The American Academy of Dermatology has released its new “Guidelines of care for the management of acne vulgaris”, including acne treatment recommendations for adults and adolescents.

Dermatologists have found that a combination of 2 or more treatments is the best option for most patients. The new evidence-based guidelines include recommendations on topical therapy, antibiotics, isotretinoin and oral contraceptives. 

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Regarding antibiotic use for treating moderate to severe acne, the guideline recommends concomitant topical therapy. Upon finishing the course of antibiotics, patients should discontinue topical treatments as well. Topical medications (eg, retinoids, benzoyl peroxide) may also be combined with one another for a more effective therapy. Oral contraceptives may also benefit female patients, and can be combined with other treatments.

Oral isotretinoin is recommended for severe acne or moderate acne unresponsive to other therapy. This drug has a high risk of birth defects and all patients must enroll in the iPledge program. The evidence surrounding oral isotretinoin and inflammatory bowel disease or depressive symptoms is inconclusive but patients are to follow their provider’s advice. 

The guidelines do not recommend in-office procedures such as laser treatments or chemical peels for routine acne treatment. In addition, alternative therapies such as tea tree oil are not recommended due to a lack of evidence. Though some studies suggest dairy products may be associated with acne, there is not enough evidence to recommend dietary changes according to the guidelines. 

The full guidelines are published in the Journal of the American Academy of Dermatology.  

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