Combination treatment for acne may be best in most cases

(HealthDay)—An evidence-based guideline for the management of acne vulgaris has been published online Feb. 17 in the Journal of the American Academy of Dermatology.

Andrea L. Zaenglein, M.D., from the Penn State Hershey Medical Center, and colleagues conducted a systematic literature review to identify clinical questions in the diagnosis and management of acne vulgaris. After evaluating and grading the evidence, they developed clinical guidelines.

The authors note that benzoyl peroxide or combinations with erythromycin or clindamycin are effective for acne. These can be used in conjunction with a topical retinoid. Topical antibiotics should not be used as monotherapy because of the risk of bacterial resistance. Systemic antibiotics are recommended for moderate and severe acne, and for acne that is resistant to topical treatment. Use of systemic antibiotics should be limited to the shortest duration possible, usually three months; monotherapy is not recommended for systemic antibiotics. Oral contraceptives are effective and recommended for females with acne. Isotretinoin is recommended for severe nodular acne, for treatment-resistant moderate acne, or for acne that is producing physical scarring or psychosocial distress. Females of child-bearing potential should be counseled regarding contraceptive methods during isotretinoin use, and routine monitoring of liver function, serum cholesterol, and triglycerides is recommended.

"There are a variety of effective treatments available for acne, and dermatologists have found that combining two or more treatments is the best option for the majority of patients," Zaenglein said in a statement.