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  • Tx for mild (comedonal to pustular)

    • topical retinoid (tretinoin 0.025-0.1% cream qhs)
    • add topical abx if pustular (erythromycin 3% gel with 2.5% BPO bid)
  • Tx for moderate (pustular to nodular)

    • oral abx (erythromycin 500 mg PO bid)
    • topical retinoid
    • add BPO to decrease abx resistance (BPO 2.5-10% cream bid)
  • Tx for severe (nodular > 1cm to conglobate)

    • isotretinoin 0.5-1 mg/kg/day PO
    • increase abx dose instead of isotretinoin for pregnant or reproductive-age females.
  • Maintenance therapy

    • topical retinoid +/- BPO

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