From the Guidelines
For body acne, a combination of topical treatments and lifestyle changes is recommended, with benzoyl peroxide and topical retinoids being strongly recommended as first-line treatments, as per the guidelines of care for the management of acne vulgaris 1.
Recommended Treatments
- Start with benzoyl peroxide washes (4-10%) applied to affected areas during showers, leaving on for 2-3 minutes before rinsing, as it is a strong recommendation for patients with acne 1.
- Use a salicylic acid body wash (2%) on alternate days to prevent excessive drying, although it is conditionally recommended due to low certainty of evidence 1.
- After showering, apply adapalene gel 0.1% or tretinoin 0.025% to affected areas nightly, as topical retinoids are strongly recommended for patients with acne 1.
Lifestyle Changes
- Wear loose-fitting, breathable cotton clothing and shower promptly after sweating to reduce friction and moisture that can exacerbate acne.
- Change bed sheets weekly and use fragrance-free laundry detergent to minimize irritation and allergic reactions.
Oral Antibiotics
- For more severe cases, consider oral antibiotics like doxycycline (100mg daily for 8-12 weeks) or isotretinoin for persistent, severe cases under dermatologist supervision, as doxycycline is strongly recommended for patients with acne 1.
- Isotretinoin is recommended for severe nodular acne, moderate acne that is treatment-resistant, or acne that produces physical scarring or significant psychosocial distress, with careful monitoring of liver function tests, serum cholesterol, and triglycerides 1.
Important Considerations
- Consistency is key, and improvements typically take 4-8 weeks to become noticeable.
- If over-the-counter treatments don't help after 2-3 months, consult a dermatologist for prescription options.
- It is essential to follow the recommended treatments and lifestyle changes to minimize the development of antibiotic resistance and other antibiotic-associated complications, as well as to reduce the risk of side effects associated with oral antibiotics and isotretinoin 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Recommended Treatments for Body Acne
- Topical therapies such as retinoids (eg, tretinoin, adapalene), benzoyl peroxide, azelaic acid, and/or combinations of topical agents are first-line treatments for body acne 2, 3, 4, 5
- Combinations of topical agents with systemic agents (oral antibiotics such as doxycycline and minocycline, hormonal therapies such as combination oral contraception [COC] or spironolactone, or isotretinoin) are recommended for more severe disease 2, 6
- Oral antibiotics are an important therapy for inflammatory acne unresponsive to topical therapy, but should not be used as monotherapy 2, 6, 5
- Oral contraceptives and/or spironolactone are useful for many women with acne 2, 6
- Oral isotretinoin is the drug of choice for severe, extensive, nodular acne vulgaris, but is also often used in moderate cases where scarring is evident, acne-related psychosocial distress is significant, or other treatment modalities have failed 2, 6
Topical Treatments
- Benzoyl peroxide is effective in preventing bacteria resistance and is available in 2.5, and 10% formulations 4, 5
- Topical retinoids address primarily the comedonal but also the inflammatory lesions of acne 2, 4, 6
- Azelaic acid is useful in treating acne lesions and for lightening postinflammatory hyperpigmentation that may accompany inflammatory acne lesions 4, 5
- Combinations of agents that address different aspects of acne pathogenesis may offer higher benefit to acne patients 3, 4, 5
Systemic Treatments
- Oral antibiotics such as doxycycline and minocycline are effective in treating moderate to severe acne 2, 6
- Hormonal therapies such as combination oral contraception or spironolactone are useful for many women with acne 2, 6
- Isotretinoin is approved by the US Food and Drug Administration for treating severe recalcitrant nodular acne, but is often used to treat resistant or persistent moderate to severe acne, as well as acne that produces scarring or significant psychosocial distress 2, 6