Managing Acne Well

This transcript has been edited for clarity.

I'm Dr Neil Skolnik, and today I'm going to talk about the National Institute for Health and Care Excellence (NICE) guidelines on the management of acne. We take care of acne all the time in the office, and recommendations have changed in important ways. Moreover, acne is not typically covered in traditional CME programs for primary care.

Let's start with basic skincare for patients with acne. Avoid oil-based moisturizers, makeup, and sunscreens. If makeup is used, take it off at night.

Next is diet. Diet is often mentioned in acne management, but the guidelines clarify that there is no evidence showing that one diet works better than another in regard to treatment of acne.

Let's move on to first-line treatment. It's important to understand that it takes 6-8 weeks to see the effects of treatment once it's started, and a course of therapy is considered 12 weeks long.

First-line therapy no longer comprises a single agent. Start with a fixed-dose topical combination, even for mild acne. Essentially, we choose from one of four classes:

• Benzoyl peroxide

• Retinoids; either tretinoin or adapalene

• Vitamin A derivatives

• Topical antibiotics; Owing to the risk for antimicrobial resistance, erythromycin is no longer recommended.