Guidelines of care for the management of acne vulgaris.

Howa Yeung, Carol E Cheng, Andrea L Zaenglein, Rachel V Reynolds, Linda F Stein Gold, Megha M Tollefson, Jonathan S Weiss, Jonette E Keri, Jung Min Han, Fran Cook-Bolden, John S Barbieri, Seemal R Desai, Kelly M Druby, Esther E Freeman, Jerry K L Tan, Peggy A Wu

Journal: Journal of the American Academy of Dermatology 2024;90(5):1006.e1-1006.e30

PMID: 38300170

Full Text on Elsevier Science View on PubMed

Abstract

BACKGROUND

Acne vulgaris commonly affects adults, adolescents, and preadolescents aged 9 years or older.

OBJECTIVE

The objective of this study was to provide evidence-based recommendations for the management of acne.

METHODS

A work group conducted a systematic review and applied the Grading of Recommendations, Assessment, Development, and Evaluation approach for assessing the certainty of evidence and formulating and grading recommendations.

RESULTS

This guideline presents 18 evidence-based recommendations and 5 good practice statements. Strong recommendations are made for benzoyl peroxide, topical retinoids, topical antibiotics, and oral doxycycline. Oral isotretinoin is strongly recommended for acne that is severe, causing psychosocial burden or scarring, or failing standard oral or topical therapy. Conditional recommendations are made for topical clascoterone, salicylic acid, and azelaic acid, as well as for oral minocycline, sarecycline, combined oral contraceptive pills, and spironolactone. Combining topical therapies with multiple mechanisms of action, limiting systemic antibiotic use, combining systemic antibiotics with topical therapies, and adding intralesional corticosteroid injections for larger acne lesions are recommended as good practice statements.

LIMITATIONS

Analysis is based on the best available evidence at the time of the systematic review.

CONCLUSIONS

These guidelines provide evidence-based recommendations for the management of acne vulgaris.

Address: Department of Dermatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts.; Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia.; Division of Dermatology, Department of Medicine, University of California Los Angeles, Los Angeles, California.; Department of Dermatology, Weill Cornell Medicine, New York, New York.; Innovative Dermatology, Plano, Texas; Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, Texas.; Penn State Health Hampden Medical Center, Enola, Pennsylvania.; Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts.; University of Miami, Miller School of Medicine, Miami, Florida; Miami VA Medical Center, Miami, Florida.; Department of Dermatology, Henry Ford Health, Detroit, Michigan.; Western University, London, Ontario, Canada; Windsor Clinical Research Inc., Windsor, Ontario, Canada.; Departments of Dermatology and Pediatrics, Mayo Clinic, Rochester, Minnesota.; Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia; Georgia Dermatology Partners, Snellville, Georgia.; Department of Dermatology, University of California Davis, Sacramento, California.; Departments of Dermatology and Pediatrics, Penn State/Hershey Medical Center, Hershey, Pennsylvania.; American Academy of Dermatology, Rosemont, Illinois. Electronic address: [email protected].; Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts.

DOI: 10.1016/j.jaad.2023.12.017

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MeSH Terms: Humans, Acne Vulgaris, Administration, Cutaneous, Administration, Oral, Adrenal Cortex Hormones, Anti-Bacterial Agents, Benzoyl Peroxide, Contraceptives, Oral, Combined, Cortodoxone, Dermatologic Agents, Dicarboxylic Acids, Doxycycline, Drug Therapy, Combination, Evidence-Based Medicine, Injections, Intralesional, Isotretinoin, Minocycline, Propionates, Retinoids, Salicylic Acid, Spironolactone, Tetracyclines