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TREATMENT

A thorough history and physical examination are key to organizing an appropriate and maximally effective treatment plan (Table 37.2). The physician should review with the patient all prescription and over-the-counter medications used for acne or other conditions, and note the clinical responsiveness to them. A review of cosmetics and sunscreens is also helpful. In female patients, a menstrual and oral contraceptive history is important in determining hormonal influences on acne. On physical examination, careful note should be taken of lesion morphology, including the presence of comedones, inflammatory lesions, nodules and cysts. Secondary changes such as scarring and postinflammatory pigmentary changes are also important clinical findings. The patient's skin color and type can influence the chosen formulation of a topical medication. Patients with oily skin tend to prefer the more drying gels and lotions, whereas those with drier skin types may prefer creams.

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Common therapies …