Fast Five Quiz: Treatment of Acne in Skin of Color

William D. James, MD


July 24, 2020

All agents that prevent the formation of new inflammatory lesions will prevent additional hyperpigmentation; however, two agents help beyond this general effect. According to the most recent AAD guidelines, azelaic acid 20% has use in patients with Fitzpatrick skin types IV or greater because of the lightening effect of the product on hyperpigmentation. The guidelines report that azelaic acid is a useful adjunctive acne treatment and is recommended in the treatment of postinflammatory hyperpigmentation. Topical retinoids are another commonly used acne medication with similar action.

Salicylic acid preparations are well tolerated; however, clinical trials with these products are limited.

Benzoyl peroxide alone or in combination with topical antibiotics is recommended as monotherapy for mild acne, or in conjunction with a topical retinoid. Systemic therapy may be added as needed for control of moderate to severe acne. Benzoyl peroxide is effective in the prevention of bacterial resistance and is recommended for patients on topical or systemic antibiotic therapy.

Topical dapsone 5% gel is recommended for inflammatory acne.

Learn more about the AAD guidelines on acne vulgaris.


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