A clinically practical approach to acne. Part 2: Treatment

• Acne may be treated using either topical or systemic therapies, or combinations of these. • For mild to moderate acne, many topical treatments are at least as effective as monotherapy with oral antibiotics. • For more severe or widespread acne, using a topical therapy with another topical therapy or a systemic therapy achieves more rapid and greater control. • Agents with proven efficacy as topical acne therapies include benzoyl peroxide, salicylic acid microgel complex, topical antibiotics and topical retinoids. • Agents with proven efficacy as systemic acne therapies include systemic antibiotics and retinoids, certain combined oral contraceptives, spironolactone and metformin. • Retinoids, tetracyclines and spironolactone are not safe to use during pregnancy. • Poor adherence is a common reason for 'treatment failure', and is often due to side effects (such as irritation), incorrect product use and/or inconvenient regimens.