recommended as monotherapy because of the risk of bacterial resistanceTopical retinoids as monotherapy in primarily comedonal acne, or in combination with topical or oral antimicrobials for mixed or primarily inflammatory acneTopical adapalene, tretinoin, and benzoyl peroxide can be safely used to treat acne in preadolescent childrenTopical dapsone 5% gel for inflammatory acne, particularly inadult femalesSystemic antibiotics are recommended for moderate and severe acne and forms of inflammatory acne that are resistant to topical treatments; doxycycline and minocycline are both more effective than tetracyclineTopical therapy with benzoyl peroxide or a retinoid should beused with systemic antibiotics and for maintenance after completion of systemic antibiotic therapyMonotherapy with systemic antibiotics is not recommendedSystemic antibiotic use should be limited to the shortest possible duration; to minimize the development of bacterial resistance, reevaluation at 3-4 monthsUse of oral erythromycin and azithromycin should be limited to those who cannot use the tetracyclines (ie, pregnant women or children aged < 8 y); erythromycin use should be restricted because of its increased risk of bacterial resistanceIsotretinoin is recommended for severe acne or moderate acne that does not respond to other therapy; low-dose isotretinoin can be used to effectively treat acne and reduce thefrequency and severity of medication-related adverse effects, but intermittent dosing is not recommended; all patients treatedwith isotretinoin must adhere to the iPLEDGE risk managementprogram; patients should receive routine monitoring of liver function tests, serum cholesterol, and triglycerides at baseline and again until response to treatment is established, but routine monitoring of complete blood count is not recommended; patients should be educated about the potentialrisks and monitored for any indication of inflammatory bowel disease and depressive symptomsCombined oral contraceptives (COC) containing estrogen are effective for treatment of inflammatory acne in females; physicians should follow the World Health Organization (WHO) recommendations for COC usage eligibilityDespite the lack of published data, relying on available evidence, experience, and expert opinion, the guidelines support the use of spironolactone in select womenIn 2015, as part of the Choosing Wisely® initiative from the American Board of Internal Medicine Foundation (ABIM), the AAD released recommendations regarding low-value care that cautioned against the routine use of microbiologic testing in the evaluation and management of acne. The AAD concluded that determining the type of bacteria
present in acne lesions was unnecessary because it did not alter the management of typical acne presentations.Canadian clinical practice guidelines for acne treatment have been updated; the following is a summary of their recommendations[78, 79] :Comedonal acne - Topical retinoids or benzoyl peroxide;
As a current student on this bumpy collegiate pathway, I stumbled upon Course Hero, where I can find study resources for nearly all my courses, get online help from tutors 24/7, and even share my old projects, papers, and lecture notes with other students.
KiranTemple University Fox School of Business ‘17, Course Hero Intern
I cannot even describe how much Course Hero helped me this summer. It’s truly become something I can always rely on and help me. In the end, I was not only able to survive summer classes, but I was able to thrive thanks to Course Hero.
DanaUniversity of Pennsylvania ‘17, Course Hero Intern
The ability to access any university’s resources through Course Hero proved invaluable in my case. I was behind on Tulane coursework and actually used UCLA’s materials to help me move forward and get everything together on time.
JillTulane University ‘16, Course Hero Intern
Stuck? We have tutors online 24/7 who can help you get unstuck.
Ask Expert Tutors
You can ask
You can ask
You can ask
(will expire )