Contemporary therapy for acne. What, when, and how to prescribe.

The use of topical tretinoin (Retin-A) for comedonal lesions, benzoyl peroxide for inflamed papules and pustules, and topical or oral antibiotics for more severe or widespread disease gives excellent results for the majority of patients with acne. At present, oral isotretinoin (13-cis-retinoic acid) (Accutane) should be reserved for patients with severe nodulocystic acne whose condition has not responded to an accepted therapeutic regimen. Good patient rapport and follow-up are essential in the management of this common disease.