Evidence-Based Recommendations for Acne Management

According to a study published in the Journal of the American Academy of Dermatology, guidelines were formulated to enhance evidence-based recommendations to guide clinicians in effectively managing acne vulgaris.

A work group conducted a systematic review and utilized the Grading of Recommendations, Assessment, Development, and Evaluation, or GRADE, approach to assess the certainty of evidence and formulate recommendations. The guideline includes 18 evidence-based recommendations and 5 good practice statements.

Strong recommendations are made for the use of benzoyl peroxide, topical retinoids, topical antibiotics, and oral doxycycline. Oral isotretinoin is strongly recommended for severe acne, particularly when it causes significant psychosocial burden or scarring, or when standard oral or topical therapies fail.

Conditional recommendations are provided for the use of topical clascoterone, salicylic acid, and azelaic acid, as well as for oral minocycline, sarecycline, combined oral contraceptive pills, and spironolactone. Good practice statements emphasize the importance of combining topical therapies with different mechanisms of action, limiting the use of systemic antibiotics, combining systemic antibiotics with topical therapies, and using intralesional corticosteroid injections for larger acne lesions.

The guidelines were formulated based on the best available evidence at the time of the systematic review, which is acknowledged as a limitation. However, these evidence-based recommendations aim to guide clinicians in effectively managing acne vulgaris to improve patient outcomes and address the condition's physical and psychosocial impacts.

Reference
Reynolds RV, Yeung H, Cheng CE, et al. Guidelines of care for the management of acne vulgaris. J Am Acad Dermatol. 2024;90(5):1006.e1-1006.e30. doi:10.1016/j.jaad.2023.12.017