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Acne First-Line Treatment — RACP Paediatrics MCQ

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EasyDermatologyAcne First-Line TreatmentRACP Paediatrics

A 16-year-old boy has acne vulgaris with comedones and inflammatory papules affecting his face and back. He has not tried any treatment. What is the appropriate first-line topical therapy?

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Correct answer: A — Topical retinoid (adapalene) plus benzoyl peroxide

For mild-moderate acne, first-line treatment is combination topical therapy: a retinoid (adapalene) to normalise follicular keratinisation plus benzoyl peroxide (antimicrobial and anti-inflammatory). Topical antibiotics should not be used as monotherapy due to resistance risk. Oral antibiotics are reserved for moderate-severe inflammatory acne.

Reference: Therapeutic Guidelines – 2024 – Dermatology: Acne