Because acne is a multifactorial disease, and because most acne treatments (isotre-tinoin excepted) are not completely effective, typical treatment regimens involve one or more medications. Multidrug treatment schemes are an undesirable fact of acne therapy. They make compliance difficult in a patient population that is
Mild-to-moderate inflammatory acne Benzoyl peroxide-clindamycin gel q.d. or b.i.d. Topical clindamycin foam q.d. + benzoyl peroxide wash q.d. Benzoyl peroxide-clindamycin gel q.d. + topical retinoid q.d. Moderate-to-severe inflammatory acne Doxycycline 75-100 mg b.i.d. + topical retinoid q.d. Minocycline 75-100 mg b.i.d. + topical retinoid
Addition of a benzoyl peroxide wash is often useful for resistant areas on the trunk. Women may benefit from addition of androgen blockers such as spironolactone or cyproterone acetate.
fundamentally noncompliant, and add expense. Therefore, regimens should be as streamlined as possible. Table 3 presents useful antibiotic treatment plans for acne of varying severites.
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