Darcy Russell,1 Joseph M. Lam, MD, FRCPC,2

1Medical Undergraduate Program, University of British Columbia, Vancouver, BC.
2Clinical Assistant Professor, Department of Pediatrics and Dermatology, University of British Columbia, BC.

CLINICAL TOOLS

Abstract: Acne vulgaris is a common skin condition encountered in family practice and can cause significant distress during adolescence. Treatment options discussed include topical benzyl peroxide, topical retinoids, oral and topical antibiotics, hormonal therapy, and isotretinoin. The following review article provides up-to-date recommendations for treating mild to severe pediatric acne.
Key Words: acne vulgaris, adolescence, treatment, pathogenesis.
The differential diagnosis for acne in adolescence includes corticosteroid induced acne, folliculitis, keratosis pilaris, papular sarcoidosis, perioral dermatitis, pseudofolliculitis barbae, and tinea faceie.
Acne may be classified as mild, moderate or severe based on the number and type of lesions involved as well as the total surface area involved.
Acne therapy is targeted at treating as many pathogenic factors as possible.
Topical fixed-dose combination therapies can be used for all types and severities of acne in children 9 years of age and older.
Both topical and oral antibiotics work by inhibiting P acnes protein synthesis and decreasing inflammation.
Do not be afraid of isotretinoin. It can be used first line in patients with severe nodular and/or inflammatory acne, acne conglobata, and recalcitrant acne.12 It is the only treatment that targets all four pathogenic factors implicated in acne vulgaris and can permanently decrease acne.
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