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This updated table reflects the stepwise approach to acne treatment, considering various options and alternative treatments based on individual circumstances as recommended by NICE.
| Step | Treatment Options |
|---|---|
| 1 | Offer a 12-week course of treatment based on acne severity and preferences after discussing advantages and disadvantages. |
| 2 | For any acne severity, consider: |
| - Fixed combination of topical adapalene with topical benzoyl peroxide | |
| - Fixed combination of topical tretinoin with topical clindamycin | |
| - Consider topical benzoyl peroxide monotherapy as an alternative treatment if these options are contraindicated or if the person wishes to avoid using a topical retinoid or antibiotic (topical or oral). | |
| 3 | For mild to moderate acne, consider: |
| - Fixed combination of topical benzoyl peroxide with topical clindamycin | |
| 4 | For moderate to severe acne, consider: |
| - Fixed combination of topical adapalene with topical benzoyl peroxide, along with either oral lymecycline or oral doxycycline | |
| - If the person cannot tolerate or has contraindications to oral lymecycline or oral doxycycline, consider replacing these medicines with trimethoprim or an oral macrolide (e.g., erythromycin) in the combination treatments from Table 1 | |
| 5 | For moderate to severe acne, consider: |
| - Topical azelaic acid with either oral lymecycline or oral doxycycline |
Reference: Recommendations | Acne...
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