Please provide a concise patient handout outlining acne management, including skincare routine, topical and systemic therapies, and follow‑up recommendations.

Acne Patient Handout

Start with a topical retinoid (adapalene 0.1–0.3% gel) combined with benzoyl peroxide 2.5–5% applied once daily in the evening as the foundation of your acne treatment, and your dermatologist will add oral antibiotics or hormonal therapy only if your acne is moderate-to-severe. 1, 2

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Your Daily Skincare Routine

Morning

• Cleanse gently with a mild, non-soap cleanser—avoid harsh scrubbing or abrasive products that can worsen inflammation 3, 4
• Apply sunscreen with SPF 30 or higher every morning, as retinoids increase sun sensitivity and can cause photosensitivity reactions 3, 1
• Avoid oil-based cosmetics and hair products that can clog pores 4

Evening

• Cleanse gently again to remove makeup, oil, and debris 3, 4
• Wait 20–30 minutes after washing to allow skin to dry completely 1
• Apply your retinoid + benzoyl peroxide combination using a pea-sized amount for each facial area (forehead, chin, each cheek) 1
• Apply moisturizer after medications dry, as acne-treated skin often becomes dry and irritated 3

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Understanding Your Medications

Topical Retinoid (Adapalene, Tretinoin, or Tazarotene)

• What it does: Unclogs pores, prevents new breakouts, and reduces inflammation by addressing the root cause of acne 1, 5
• How to use: Apply once daily in the evening; adapalene 0.1% is available over-the-counter 1, 2, 6
• Common side effects: Redness, dryness, peeling, and increased sun sensitivity during the first 2–4 weeks 1
• Important: Continue using even after acne clears to prevent recurrence—this is lifelong maintenance therapy 1, 2

Benzoyl Peroxide

• What it does: Kills acne-causing bacteria without causing antibiotic resistance 1, 5
• How to use: Available in 2.5–5% concentrations; lower strengths cause less irritation 1
• Common side effects: Dryness, redness, and bleaching of fabrics (towels, pillowcases, clothing) 7
• Important: Avoid contact with eyes, lips, and mouth; use sunscreen as it increases sun sensitivity 7

Topical Antibiotics (Clindamycin or Erythromycin)—If Prescribed

• What it does: Reduces inflammation and bacteria in moderate acne 1, 2
• How to use: Apply twice daily, but only in combination with benzoyl peroxide—never use antibiotics alone, as bacteria rapidly develop resistance 1, 2, 8
• Important: Cream or lotion formulations are preferred over alcohol-based gels, which can worsen dryness 3

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Oral Medications (For Moderate-to-Severe Acne)

Oral Antibiotics (Doxycycline or Minocycline)

• When prescribed: For moderate-to-severe inflammatory acne with many red, painful bumps 1, 2, 9
• Dosing: Doxycycline 100 mg once daily is the first-line choice 1, 2
• Duration: Limited to 3–4 months maximum to prevent antibiotic resistance, then transition to topical maintenance 1, 2
• Important warnings:
  • Avoid tanning beds and sun lamps completely while taking doxycycline, as severe phototoxic reactions can occur 1
  • Always take with food and a full glass of water to prevent stomach upset 10
  • Must be combined with topical retinoid + benzoyl peroxide—never used alone 1, 2

Hormonal Therapy (For Females)

• Combined oral contraceptives (birth control pills): Reduce inflammatory acne lesions by 62% at 6 months; can be used alone or with topical treatments 1, 2, 5, 9
• Spironolactone 50–100 mg daily: Effective for hormonal acne patterns (jawline breakouts, premenstrual flares); no potassium monitoring needed in healthy patients 1, 2, 5
• Important: Improvement typically takes 3 months, with maximum benefit at 6 months 1

Isotretinoin (For Severe or Resistant Acne)

• When prescribed: For severe nodular acne, acne causing scarring, or moderate acne that hasn't improved after 3–4 months of appropriate treatment 1, 2, 5
• What it does: The only medication that targets all four causes of acne; provides long-term remission in most patients 1, 5, 9
• Monitoring: Requires baseline and 2-month follow-up blood tests (liver function and lipids) 1
• Pregnancy prevention: Mandatory enrollment in the iPledge program for all females of childbearing potential due to severe birth defect risk 1, 10, 9

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What to Expect

Timeline for Improvement

• First 2–4 weeks: Your skin may worsen temporarily with increased dryness, redness, and peeling—this is normal and means the medication is working 1
• 6–8 weeks: You should start seeing noticeable improvement in breakouts 10, 9
• 3–4 months: Maximum benefit from topical treatments; oral antibiotics should be discontinued at this point 1, 2
• 6 months: Peak improvement with hormonal therapies 1, 9

Managing Side Effects

• Dryness and irritation: Use a gentle, fragrance-free moisturizer twice daily; consider reducing retinoid frequency to every other night initially 1, 4
• Peeling: This is expected—do not pick or scrub; apply moisturizer generously 1
• Worsening acne initially: Continue treatment unless severe irritation occurs; contact your provider if concerned 1

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Critical Mistakes to Avoid

• Never stop treatment once acne clears—you must continue topical retinoid maintenance indefinitely to prevent relapse 1, 2
• Never use antibiotics (topical or oral) without benzoyl peroxide, as bacteria develop resistance rapidly 1, 2, 5
• Never extend oral antibiotics beyond 3–4 months without re-evaluation, as this dramatically increases resistance risk 1, 2
• Do not pick, squeeze, or scrub acne lesions, as this worsens inflammation and increases scarring risk 3, 10
• Avoid oil-based cosmetics, hair products, and thick moisturizers that can clog pores 4
• Do not use multiple acne products simultaneously without guidance, as this increases irritation without improving results 7

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Lifestyle Considerations

Diet

• Emerging evidence suggests high-glycemic foods (white bread, sugary drinks, processed snacks) and skim milk may worsen acne in some patients 3
• No specific dietary restrictions are required, but you may consider reducing these foods if you notice a pattern 3

Sun Protection

• Daily sunscreen (SPF 30+) is mandatory when using retinoids, benzoyl peroxide, or oral antibiotics 3, 1, 7
• Avoid tanning beds completely if taking doxycycline 1

Gentle Skin Care

• Use mild, non-soap cleansers and avoid harsh scrubs, astringents, or alcohol-based products 3, 4
• Pat skin dry gently rather than rubbing 1

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Follow-Up Schedule

• First visit (2–4 weeks): Assess tolerability and adjust for side effects 1
• Second visit (8–12 weeks): Evaluate treatment response and adjust therapy if needed 1
• Ongoing: Every 3 months while on oral medications; every 6–12 months for maintenance therapy 1
• Contact your provider immediately if you develop severe irritation, signs of infection, or worsening acne despite treatment 3

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When to Seek More Aggressive Treatment

Your provider may recommend escalating therapy if you have:

• Scarring or permanent skin changes, even with mild acne 1, 5
• Significant emotional distress or impact on quality of life 1, 5, 9
• No improvement after 3–4 months of appropriate treatment 1, 2
• Severe nodular or cystic acne at initial presentation 1, 2