Bill is a 13 year old boy who presents with acne, seeking antibiotics for treatment

Questions
- What severity of acne would you classify this as?
- What is the initial management of this condition?
- If initial management failed, what would be the next step?
- What are the contraindications to retinoids?
Non-pharmacological/lifestyle management of acne
- Eat a healthy diet
- Cease smoking
- Use your prescribed treatment every day.
- Use water-based or oil-free cosmetics and sunscreens.
- Try not to pick and squeeze the spots, because this causes scabs that make the skin look worse.
- Be patient—most treatments take at least 6 to 12 weeks to work.
Pharmacological Management of mild acne
- Over the counter topical benzyl peroxide 5%, or 2.5% if history of atopic dermatitis
If inadequate:
- Adapalene 0.1% cream or gel topically, for 6 weeks
- Tretinoin 0.025% cream topically, for 6 weeks
References