He recommends beginning with a low strength or low concentration topical retinoid.
Acne patients using topical retinoids should be encouraged to stop the use of scrubs and other over-the-counter acne products.
When applying topical retinoids, only a pea-sized dab is needed for the entire face.
To limit or to avoid irritation, acne patients should be encouraged to wash off the topical retinoid medication after one to a few hours.
When irritation occurs, then topical retinoid application should be decreased to every second or third day.
If the reaction to a topical retinoid is severe, then a different acne treatment should be considered.
Acne treatment should be initiated at the earliest opportunity and continue as long as it is needed, said Dr. Kircik, clinical associate professor of dermatology at Indiana University School of Medicine in Louisville, Ky. and Mount Sinai Medical Center in New York.
To improve patient adherence to acne treatment, the choice of therapy should be centered around the patient based on their symptoms, skin type and skin sensitivity, the risk of adverse effects and patient preferences, he said.
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