Treating Acne Vulgaris: Systemic, Local and Combination Therapy

Laura J Savage; Alison M Layton


Expert Rev Clin Pharmacol. 2010;13(4):563-580. 

In This Article

Available Treatments

The choice of acne therapy is largely determined by the severity and extent of the disease, but should be influenced by a number of other factors including disease duration, response to previous treatments, predisposition to scarring and postinflammatory hyperpigmentation, as well as patient preference and economics. In approximately 60% of cases, acne is a self-limiting condition that can be managed with combination treatment followed by topical maintenance therapy.[14] In other cases, acne follows a chronic course that requires treatment for a prolonged period. Even mild acne can persist for 4–6 years, and in severe cases, the natural history could be in excess of 12 years.[15] The reason as to why acne becomes chronic in some patients is not well understood, and predicting which patients will have persistent and/or refractory acne is very difficult. Factors that link to poor prognosis include early onset, hyperseborrhea, truncal acne and scarring.[16] A logical understanding of the pathophysiology of acne and the impact of therapies on these etiological factors should form the foundation of any treatment selection.


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