Treatment options

For people with mild to moderate acne, NICE suggests a 12-week course of one of the following first-line options to be applied once daily in the evening:

• A fixed combination of topical adapalene with topical benzoyl peroxide (0.1% or 0.3% adapalene with 2.5% benzoyl peroxide)
• A fixed combination of topical tretinoin with topical clindamycin (0.025% tretinoin with 1% clindamycin)
• A fixed combination of topical benzoyl peroxide with topical clindamycin (3% or 5% benzoyl peroxide with 1% clindamycin).³

Consider topical benzoyl peroxide as an alternate monotherapy if these options are contraindicated or if the person wishes to avoid using a topical retinoid or an antibiotic. Creams or lotions may be preferable for people with dry or sensitive skin. Gels that are water-based may be preferable for people with oily skin. The concentration or application frequency of topical treatments may need to be reduced or lowered if skin irritation occurs. Advise the person that application frequency can be gradually increased from once or twice a week to daily if tolerated.³ When discussing treatment options with a person who is able to get pregnant, advise that topical retinoids and oral tetracyclines are contraindicated during pregnancy and when planning a pregnancy, and that they will need to use effective contraception, or choose an alternative treatment to these options.⁴