Summary points

Do not underestimate the impact of acne on patient quality of life and mental health

Topical retinoids are now a mainstay of treatment

Avoid prolonged antibiotic courses and antibiotic monotherapy because of the risk of bacterial resistance

For women with refractory acne or lesions confined to the lower half of the face, consider the addition of combined oral contraceptives

Oral isotretinoin is the most effective treatment for severe acne

Assess treatment adherence, which may be limited by irritation or regimen complexity.

ref: British Medical Journal May 2013;346.

G.Mohan.