All information is correct at time of printing and is subject to change without notice. The Devon Formulary and Referral Website is not in any way liable for the accuracy of any information printed and stored by users. For the most up-to-date information, please refer to the website.
November 2024: Management of acne update
News
November 2024: Management of acne update
Management of acne: updated guidance based on NICE guideline (NG198) Acne vulgaris: management.
For initial treatment, the Devon Formulary now recommends a 12-week course of one of the following first-line treatment options:
- Mild to moderate acne:
- Benzoyl peroxide plus clindamycin gel once daily in the evening, or
- Epiduo (adapalene plus benzoyl peroxide) gel once daily in the evening, or
- Treclin (clindamycin plus tretinoin) gel once daily in the evening.
- Moderate to severe acne:
- Epiduo or Treclin (as above), or
- Epiduo (as above) or azelaic acid (15% gel or 20% cream) twice daily, PLUS oral antibiotic (lymecycline or doxycycline) (refer to formulary guidance for second line oral antibiotic options and information regarding combined oral contraceptives).
- Benzoyl peroxide 5% gel (monotherapy) applied once or twice daily can be considered as an alternative treatment to any of the options above, if these treatments are contraindicated, or the person wishes to avoid using a topical retinoid, or an antibiotic (topical or oral).
Where maintenance treatment is indicated:
- Epiduo (adapalene plus benzoyl peroxide) gel once daily in the evening is first line.
- If this is contraindicated or not tolerated alternative maintenance options include topical adapalene, azelaic acid, benzoyl peroxide or trifarotene.
See here for the formulary guidance.
Additions to the formulary:
An additional (higher) strength Epiduo (adapalene 0.3% / benzoyl peroxide 2.5%) gel has been added as a green (first line) option for the initial treatment for acne (as monotherapy or in combination with oral lymecycline or doxycycline) (for 12 weeks) and for the maintenance treatment for acne (as monotherapy).
An additional (lower) strength Benzoyl peroxide plus clindamycin (3% / 1%) gel has been added as a green (first line) option for the initial treatment for mild to moderate acne (for 12 weeks).
Trifarotene 50micrograms/g cream (a topical retinoid) has been added as a blue (second line) option for the maintenance treatment of acne where Epiduo is contraindicated or not suitable.
See here for the formulary entry.
