Combination therapy is the standard of care

Acne is a multifactorial disease characterized by abnormalities in sebum production, follicular epithelial desquamation, bacterial proliferation, and inflammation. Despite these multiple pathogenic factors, most current therapies for acne do not target all 4 areas of acne pathophysiology. Combination therapies using agents with complementary mechanisms of action increasingly are recognized as an effective strategy for treating acne. Several common regimens have shown this multiple-target efficacy, including the combination of a topical antibiotic with benzoyl peroxide. In combination, these agents produce greater and faster results than when each is used as monotherapy. For both initial treatment and maintenance therapy, the ideal combination regimen is often a topical antibiotic and benzoyl peroxide product plus a retinoid that is appropriate for the patient's skin type. Combination regimens should be tailored to the individual patient, bearing in mind the number and types of prevailing lesions and the skin type. Because the vehicle for each agent may have an impact on tolerability, one should pay attention to the combination of vehicles and patient care practices to maximize tolerability.