An adolescent has acne characterized by papules and pustules mostly on the forehead and chin. Which prescription is most appropriate?

An adolescent has acne characterized by papules and pustules mostly on the forehead and chin. Which prescription is most appropriate?

• A. Azelaic acid applied daily at nighttime
• B. Benzoyl peroxide applied twice daily
• C. Topical erythromycin with benzoyl peroxide
• D. Tretinoin applied nightly after washing the face

Answer: (C)

Inflammatory acne in teens is driven by bacteria in clogged pores and by local inflammation. The most effective first-line approach targets both aspects: reduce the bacterial load and calm the inflammation. A topical antibiotic like erythromycin tackles Propionibacterium acnes, while benzoyl peroxide boosts the antibiotic’s effect and helps prevent the development of antibiotic-resistant strains. This combination addresses the papules and pustules seen on the forehead and chin more robustly than either component alone. Azelaic acid can help but is typically less potent for active inflammatory lesions. Tretinoin is excellent for comedones and prevention but can irritate and isn’t the strongest option for active inflammation when used alone. Benzoyl peroxide alone works for bacteria but doesn’t provide the targeted antibiotic action; pairing it with an antibiotic yields better control of the inflammatory process.

Inflammatory acne in teens is driven by bacteria in clogged pores and by local inflammation. The most effective first-line approach targets both aspects: reduce the bacterial load and calm the inflammation. A topical antibiotic like erythromycin tackles Propionibacterium acnes, while benzoyl peroxide boosts the antibiotic’s effect and helps prevent the development of antibiotic-resistant strains. This combination addresses the papules and pustules seen on the forehead and chin more robustly than either component alone.

Azelaic acid can help but is typically less potent for active inflammatory lesions. Tretinoin is excellent for comedones and prevention but can irritate and isn’t the strongest option for active inflammation when used alone. Benzoyl peroxide alone works for bacteria but doesn’t provide the targeted antibiotic action; pairing it with an antibiotic yields better control of the inflammatory process.