Acne Vulgaris

Key points

• Acne: follicular occlusion + Cutibacterium acnes — comedones (open = blackheads, closed = whiteheads), papules, pustules, nodules/cysts.
• Mild (comedones/papules): topical retinoid or benzoyl peroxide (± combination).
• Moderate: topical combination (retinoid + benzoyl peroxide) or add oral antibiotic (lymecycline/oxytetracycline — NOT with isotretinoin).
• Severe/scarring: oral isotretinoin (teratogenic — pregnancy prevention programme).
• Late-onset/severe in women: consider PCOS; anti-androgen options (co-cyprindiol).

Decision points in this pathway

• Mild?
• Severe/scarring?

The full step-by-step algorithm, including what to do at each branch, opens in the app for approved members.