Guidelines of care for the management of acne vulgaris

Analysis of the evidence from this systematic review based on 9 clinical questions resulted in 18 evidence-based recommendations and 5 good practice statements for the treatment of acne. Strong recommendations are made for benzoyl peroxide, topical retinoids, and topical antibiotics, as well as for oral doxycycline. Oral isotretinoin is strongly recommended for acne that is severe, causing psychosocial burden or scarring, or failing standard oral or topical therapy. Conditional recommendations are made for topical clascoterone, salicylic acid, azelaic acid, as well as for oral minocycline, sarecycline, COC pills, and spironolactone. Combining topical therapies with multiple mechanisms of action, limiting systemic antibiotic use, combining systemic antibiotics with topical therapies, and adding intralesional corticosteroid injections for larger acne lesions are recommended as good practice statements (Table III).