Acne guidelines: practice update
What current AAD and NICE guidance prioritises in acne treatment and antimicrobial stewardship.
Updated: 2026-09-13
Written for clinicians and medical students
This section is a teaching reference for doctors, residents and medical students. It is not patient guidance and not a substitute for clinical examination, and it must not be used for self treatment.
Practice points
- Combine topical therapies with different mechanisms, such as a retinoid plus benzoyl peroxide, to improve efficacy. Benzoyl peroxide should accompany topical or oral antibiotics to limit resistance [1,2].
- Avoid antibiotic monotherapy and limit systemic antibiotic duration. Review response around 12 weeks and maintain improvement with non-antibiotic topical therapy [1,2].
- Oral isotretinoin is recommended for severe acne, scarring, major psychosocial burden or failure of standard therapy, with rigorous pregnancy prevention and monitoring [1].
- Hormonal options can benefit appropriate female patients. Treatment choice should account for pregnancy potential, comorbidity, skin sensitivity and access.
What changed
Recent guidance places stronger emphasis on multimodal topical treatment, stewardship of antibiotics, shared decision-making and earlier use of isotretinoin when severe disease or scarring justifies it. Local formularies and pregnancy-prevention requirements remain controlling [1,2].