International Guidelines for Treatment of Mild to Moderate Acne: An Overview

Woman with Acne_MI_01AQ1WCE
Woman with Acne_MI_01AQ1WCE
Common and alternative treatment options for mild to moderate acne, as noted by 3 widely distributed guidelines, are reviewed.

An overview of treatment options for mild to moderate acne as described by the American Academy of Dermatology (AAD), European Academy of Dermatology and Venereology (EADV) and Italian Society of Dermatology and Venereology (SIDeMaST) guidelines has been created by dermatologists from Italy. The overview was published in Dermatologic Therapy.

Based on the 3 guidelines, the authors of the review state the AAD, EADV, and SIDeMaST organizations generally agree on which products should be used for mild to moderate acne. The AAD guideline, however, does not differentiate the comedonic type from the papulopustular type in mild acne. Topical retinoid is the treatment of choice in the comedonic form, whereas a combination topical regimen consisting of retinoids, benzoyl peroxide, and antibiotics is recommended for the papulopustular form.

Overall, all 3 guidelines agree that topical retinoids should be used as first-line therapy, either alone or in combination with other agents, in mild and moderate acne. Oral isotretinoin is recommended as a second-line therapy for papulo-pustular and nodular lesions that do not respond to topical treatments. In mild acne, any of the topical retinoids can be used, the authors noted. For severe forms of acne, however, topical retinoids may be combined with topical antimicrobials and/or oral antibiotics to ensure effective clearance.

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Alternative treatments were highlighted in the review, but these approaches, although potentially effective for improving some acne measures, appear to have less conclusive evidence to support their use as primary therapies for acne. These alternative therapies include herbal extracts, chemical peels, phototherapy, and laser treatments.

The authors wrote that “the choice of the best treatment option should consider the clinical extent of the disease, skin phototype, eventual skin reactivity, and also patient compliance.”

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Conforti C, Chello C, Giuffrida R, di Meo N, Zalaudek I, Dianzani C. An overview of treatment options for mild-to-moderate acne based on American Academy of Dermatology, European Academy of Dermatology and Venereology, and Italian Society of Dermatology and Venereology (SIDeMaST) guidelines [published online May 8, 2020]. Dermatol Ther. doi: 10.1111/dth.13548