Acne vulgaris – an inflammatory disease of the pilosebaceous unit of the skin, primarily involves the face and trunk and affects nearly 9% of the global population and approximately 85% of individuals aged 12 to 24 years. This condition has been associated with permanent physical scarring, psychological distress and reduced quality of life. 

Only in some cases, a medical work-up is warranted. Topical therapies are recommended in the first-line, for instance, retinoids – tretinoin and adapalene; benzoyl peroxide, azelaic acid and/or combinations of topical agents. Tretinoin 0.025% gel for 12 weeks has shown to reduce acne lesion counts by 63%.

To manage more severe symptoms, combinations of topical agents with systemic agents, such as oral antibiotics – doxycycline and minocycline; hormonal therapies – combination oral contraception; spironolactone; or isotretinoincan be advised. Isotretinoin is approved by the US Food and Drug Administration (FDA) for treating severe recalcitrant nodular acne. This drug is usually used to treat resistant or persistent moderate-to-severe acne, and acne that produces scarring.

Source: JAMA. 2021;326(20):2055-67.