Management of acne: Canadian clinical practice guideline

doi:10.1503/cmaj.140665

Practice Guideline

. 2016 Feb 2;188(2):118-126.

doi: 10.1503/cmaj.140665. Epub 2015 Nov 16.

Management of acne: Canadian clinical practice guideline

Affiliations

¹ Department of Medicine (Asai), Queen's University, Kingston, Ont.; private practice (Baibergenova), Markham, Ont.; Dermatology (Dutil), Women's College Hospital, University of Toronto, Toronto, Ont.; Department of Dermatology and Skin Science (Humphrey), University of British Columbia, Vancouver, BC; Dermatology (Hull), University of Saskatchewan, Saskatoon, Sask.; Department of Medicine (Lynde), University of Toronto, Toronto, Ont.; Centre dermatologique du Québec (Poulin), Laval University, Laval, Que.; Dermatology and Clinical Pharmacology (Shear), Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Department of Medicine (Tan), University of Western Ontario, Windsor, Ont.; Section of Dermatology (Toole), Department of Medicine, University of Manitoba, Winnipeg, Man.; Division of Dermatology (Zip), Department of Medicine, University of Calgary, Calgary, Alta.
² Department of Medicine (Asai), Queen's University, Kingston, Ont.; private practice (Baibergenova), Markham, Ont.; Dermatology (Dutil), Women's College Hospital, University of Toronto, Toronto, Ont.; Department of Dermatology and Skin Science (Humphrey), University of British Columbia, Vancouver, BC; Dermatology (Hull), University of Saskatchewan, Saskatoon, Sask.; Department of Medicine (Lynde), University of Toronto, Toronto, Ont.; Centre dermatologique du Québec (Poulin), Laval University, Laval, Que.; Dermatology and Clinical Pharmacology (Shear), Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Department of Medicine (Tan), University of Western Ontario, Windsor, Ont.; Section of Dermatology (Toole), Department of Medicine, University of Manitoba, Winnipeg, Man.; Division of Dermatology (Zip), Department of Medicine, University of Calgary, Calgary, Alta. jerrytan@bellnet.ca.

PMID: 26573753
PMCID: PMC4732962
DOI: 10.1503/cmaj.140665

Practice Guideline

Management of acne: Canadian clinical practice guideline

Yuka Asai et al. CMAJ. 2016.

. 2016 Feb 2;188(2):118-126.

doi: 10.1503/cmaj.140665. Epub 2015 Nov 16.

Authors

Affiliations

¹ Department of Medicine (Asai), Queen's University, Kingston, Ont.; private practice (Baibergenova), Markham, Ont.; Dermatology (Dutil), Women's College Hospital, University of Toronto, Toronto, Ont.; Department of Dermatology and Skin Science (Humphrey), University of British Columbia, Vancouver, BC; Dermatology (Hull), University of Saskatchewan, Saskatoon, Sask.; Department of Medicine (Lynde), University of Toronto, Toronto, Ont.; Centre dermatologique du Québec (Poulin), Laval University, Laval, Que.; Dermatology and Clinical Pharmacology (Shear), Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Department of Medicine (Tan), University of Western Ontario, Windsor, Ont.; Section of Dermatology (Toole), Department of Medicine, University of Manitoba, Winnipeg, Man.; Division of Dermatology (Zip), Department of Medicine, University of Calgary, Calgary, Alta.
² Department of Medicine (Asai), Queen's University, Kingston, Ont.; private practice (Baibergenova), Markham, Ont.; Dermatology (Dutil), Women's College Hospital, University of Toronto, Toronto, Ont.; Department of Dermatology and Skin Science (Humphrey), University of British Columbia, Vancouver, BC; Dermatology (Hull), University of Saskatchewan, Saskatoon, Sask.; Department of Medicine (Lynde), University of Toronto, Toronto, Ont.; Centre dermatologique du Québec (Poulin), Laval University, Laval, Que.; Dermatology and Clinical Pharmacology (Shear), Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Department of Medicine (Tan), University of Western Ontario, Windsor, Ont.; Section of Dermatology (Toole), Department of Medicine, University of Manitoba, Winnipeg, Man.; Division of Dermatology (Zip), Department of Medicine, University of Calgary, Calgary, Alta. jerrytan@bellnet.ca.

PMID: 26573753
PMCID: PMC4732962
DOI: 10.1503/cmaj.140665

No abstract available

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Figures

**Figure 1:**
Representative photos of acne categories. (A) Comedonal facial acne. (B) Moderate inflammatory facial acne. (C) Moderate inflammatory acne of the back. (D) Severe facial acne. (E) Severe inflammatory acne of the back.

**Figure 2:**
Clinical treatment algorithm for acne. A complete list of recommendations is available in the full guideline (Appendix 4, available at www.cmaj.ca/lookup/suppl/doi:10.1503/cmaj.140665/-/DC1). BPO = benzoyl peroxide, clinda = clindamycin, dashed line = optional path. *Blue light and oral zinc may be considered for mild-to-moderate papulopustular acne (low strength of recommendation). †Best evidence is for adapalene and tazarotene. ‡Lower-quality evidence available for clindamycin–tretinoin gel. §Evaluate after 2–3 months. For women only. **Evaluate monthly for isotretinoin.

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References

1. White GM. Recent findings in the epidemiologic evidence, classification, and subtypes of acne vulgaris. J Am Acad Dermatol 1998;39:S34–7. - PubMed
1. Perkins AC, Cheng CE, Hillebrand GG, et al. Comparison of the epidemiology of acne vulgaris among Caucasian, Asian, continental Indian and African American women. J Eur Acad Dermatol Venereol 2011;25:1054–60. - PubMed
1. Tan JK. The Canadian acne epidemiological survey: baseline demographics and interim analysis. J Am Acad Dermatol 2004;50:15. - PubMed
1. James WD. Clinical practice. Acne. N Engl J Med 2005;352:1463–72. - PubMed
1. Gollnick H. Current concepts of the pathogenesis of acne: implications for drug treatment. Drugs 2003;63:1579–96. - PubMed

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[1] White GM. Recent findings in the epidemiologic evidence, classification, and subtypes of acne vulgaris. J Am Acad Dermatol 1998;39:S34–7. - PubMed

[2] White GM. Recent findings in the epidemiologic evidence, classification, and subtypes of acne vulgaris. J Am Acad Dermatol 1998;39:S34–7. - PubMed

[3] Perkins AC, Cheng CE, Hillebrand GG, et al. Comparison of the epidemiology of acne vulgaris among Caucasian, Asian, continental Indian and African American women. J Eur Acad Dermatol Venereol 2011;25:1054–60. - PubMed

[4] Perkins AC, Cheng CE, Hillebrand GG, et al. Comparison of the epidemiology of acne vulgaris among Caucasian, Asian, continental Indian and African American women. J Eur Acad Dermatol Venereol 2011;25:1054–60. - PubMed

[5] Tan JK. The Canadian acne epidemiological survey: baseline demographics and interim analysis. J Am Acad Dermatol 2004;50:15. - PubMed

[6] Tan JK. The Canadian acne epidemiological survey: baseline demographics and interim analysis. J Am Acad Dermatol 2004;50:15. - PubMed

[7] James WD. Clinical practice. Acne. N Engl J Med 2005;352:1463–72. - PubMed

[8] James WD. Clinical practice. Acne. N Engl J Med 2005;352:1463–72. - PubMed

[9] Gollnick H. Current concepts of the pathogenesis of acne: implications for drug treatment. Drugs 2003;63:1579–96. - PubMed

[10] Gollnick H. Current concepts of the pathogenesis of acne: implications for drug treatment. Drugs 2003;63:1579–96. - PubMed

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Management of acne: Canadian clinical practice guideline

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Management of acne: Canadian clinical practice guideline

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