Treatment of acne vulgaris

Acne vulgaris is a disorder of the pilosebaceous unit, characterized by comedones, inflammatory lesions and scars on the face and trunk. It presents a significant financial burden to the community and its psychosocial impact can be severe, life-altering and even life-threatening. Effective treatment can reduce the burden of disease but poorly considered therapy can be ineffective, costly and may also worsen non-compliance.In the management of acne, it is important to identify triggers, such as drugs, endocrinopathies and topical agents. Comedonal acne can respond well to topical retinoids. Mild to moderately inflammatory acne is usually initially treated with combination topical therapy, sometimes adding an oral antibiotic. Anti-androgen therapy can be helpful in females with seborrhoea and premenstrual flaring of acne. Isotretinoin remains a very effective treatment for potentially scarring and refractory acne, but new possible adverse effects have been recently described. Treatment regimens should accommodate individual patient considerations, duly noting limitations and potential adverse effects of all therapeutic options.