Medical Treatment- Medical Surgical Adjunctive Surgical Topical Treatment- Procedures Modalities/Physical Systemic Modalities Mild Acne: Topical retinoid ± BPO ± Comedo Laser: Primarily 2nd line: azelaic acid or Extraction -Potassium titanyl Comedonal salycylic acid phosphate (KTP) laser Mild Acne: Topical retinoid + BPO ± Comedo -Pulsed dye laser Primarily 2nd line: azelaic acid or Extraction -Infrared laser Papulo/Pustular salycylic acid Moderate Acne: Topical antimicrobial and ± Appropriate oral ± Comedo Light Therapy: Primarily topical retinoid ± BPO contraceptive pill Extraction - Broad-spectrum papular and 2nd line: alternative topical /spironolactone for continuous-wave visible pustules retinoid + alternative female patients light sources (red, blue) topical antimicrobial -Intense pulsed light (IPL) Severe Acne: Topical retinoid ± BPO Oral Antibiotic ± Comedo Primarily 2nd line: alt. topical (tetracyclines such Extraction Other: papular and retinoid ± BPO/azelaic as minocycline, -Microdermabrasion pustules acid doxycycline) ± -Superficial chemical appropriate oral peels contraceptive pill /spironolactone for female patients 2nd line: Alternative oral antibiotic Topical retinoid ± BPO Oral Antibiotic ± ± Comedo Severe Acne: appropriate oral Extraction Primarily contraceptive pill ± Intralesional Nodules /spironolactone for corticosteroids 2nd line: alt. topical female patients retinoid ± BPO/azelaic 2nd line: Oral acid isotretinoin or alternative oral antibiotic Conglobata/ Topical retinoid + BPO Oral isotretinoin ± ± Intralesional Fulminans oral corticosteroid corticosteroids ± appropriate oral contraceptive pill /spironolactone for female patients 2nd line: High dose dapsone ± oral antibiotic Maintenance Topical retinoid ± BPO