What is the first-line treatment for acne vulgaris?

Updated: Mar 26, 2019
  • Author: Jaggi Rao, MD, FRCPC; Chief Editor: William D James, MD  more...
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Answer

Current consensus recommends a combination of topical retinoid and antimicrobial therapy as first-line therapy for almost all patients with acne. [2] The superior efficacy of this combination, compared with either monotherapy, results from complementary mechanisms of action targeting different pathogenic factors. Retinoids reduce abnormal desquamation, are comedolytic, and have some anti-inflammatory effects, whereas benzoyl peroxide is antimicrobial with some keratolytic effects and antibiotics have anti-inflammatory and antimicrobial effects. [2]

Note the images below.

Acne with reactive hyperpigmentation; before treat Acne with reactive hyperpigmentation; before treatment.
Acne with reactive hyperpigmentation; after treatm Acne with reactive hyperpigmentation; after treatment.

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