1. Daily care

Wash your face with warm water once or twice a day to clean your skin, and avoid squeezing or scratching skin lesions with your hands. Avoid oils and powders, cosmetics and ointments and creams containing glucocorticoids.

2. Common methods for acne treatment

(1) Topical drugs such as tretinoin (tretinoin cream, adapalene gel, tazarotene gel), benzoyl peroxide, antibiotics (clindamycin, erythromycin, chloramphenicol, etc.), azelaic acid, sulfur lotion, etc.

(2) Tetracyclines (minocycline, doxycycline, etc.) are the first choice for oral antibiotics, followed by macrolides (erythromycin), and antibiotics commonly used to treat systemic infections such as levofloxacin should be avoided. The course of antibiotic treatment is usually 6 ~ 12 weeks.

(3) Oral isotretinoin is the standard therapy for severe acne, and it is also the most effective method to treat acne at present. The course of treatment aims at achieving the minimum cumulative dose of 61mg/kg.

(4) Anti-androgen therapy, such as oral contraceptive compound cyproterone acetate tablets, is suitable for female patients with moderate and severe acne, accompanied by high androgen level (such as hirsutism and seborrhea) or polycystic ovary syndrome. Female patients with delayed acne and acne before menstruation can also consider using oral contraceptives.

(5) Oral glucocorticoids are mainly used for fulminant or polymeric acne, following the principle of short-term, low-dose and combined application with other methods.

(6) Other patients who can't tolerate or don't want to receive medical treatment can also consider physical therapy, such as PDT, fruit acid therapy and laser therapy.

3. Graded treatment of acne

(1) Grade 1 is generally treated locally, and tretinoin preparations are the first choice for external use.

(2) Grade 2 is combined with topical retinoids and benzoyl peroxide or antibiotics, and oral antibiotics if necessary.

(3) Grade 3 often requires combined therapy, and oral antibiotics combined with benzoyl peroxide and/or retinoids are the first choice. Female patients with indications may also consider antiandrogen therapy.

(4) Grade 4 oral isotretinoin is the most effective treatment and can be used as first-line treatment. For those with more inflammatory papules and pustules, antibiotics combined with benzoyl peroxide can be used systematically first, and then oral isotretinoin can be used for sequential treatment after the skin lesions are obviously improved.

4. Maintenance treatment of acne

No matter what treatment method is adopted, maintenance treatment should be continued after the skin lesions have obviously subsided. Tretinoin drugs are the first choice for external use for 6 ~ 12 months, and benzoyl peroxide can be combined if necessary.