Overview of the treatment of acne vulgaris with topical retinoids.

Acne vulgaris is a common skin disease that is most effectively treated with a combination of topical products and, in some cases, systemic antibiotics. While it is important to treat papules, pustules, nodules, and cysts with topical or systemic antibiotics to suppress bacterial infection, all of these lesions develop from microcomedones. In fact, comedolytic agents enhance the effectiveness of antibiotics and limit the potential for recurrent acne lesions. Because of the superior comedolytic effects of topical retinoids, most patients with acne should be treated with a retinoid unless there is a specific contraindication. Interestingly, only 55% of patients with acne who are treated by dermatologists and 10% of patients with acne who are treated by primary care physicians receive a topical retinoid as a component of their acne regimen. Evidence is provided to buttress the contention that clinical outcomes will be improved if topical retinoids are utilized in patients with acne vulgaris.