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Acne Vulgaris — SCE Dermatology MCQ

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EasyInflammatory DermatosesAcne VulgarisSCE Dermatology

A 22-year-old woman with severe acne is prescribed combined Adapalene 0.1%/Benzoyl peroxide 2.5% gel. She develops significant facial dryness and irritation after 1 week. What is the most appropriate advice?

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Correct answer: A — Reduce frequency to alternate nights with emollient use and gradually increase

Retinoid dermatitis (irritation from topical retinoids) is common in the first 2-4 weeks of treatment. The appropriate management is gradual dose titration: reducing application frequency (alternate nights or every third night initially), using a non-comedogenic emollient to manage dryness, and slowly increasing frequency as tolerance develops. Stopping permanently wastes an effective treatment. The irritation typically subsides after 2-4 weeks of continued use ('retinisation'). Applying emollient 15-30 minutes before the retinoid can help reduce irritation. This approach maximises adherence and treatment effectiveness.

Reference: BAD 2023 Acne Guidelines; NICE CKS