For moderate acne vulgaris, which regimen is appropriate?

• A. Topical Therapy Alone
• B. Oral Isotretinoin
• C. Topical Therapy Plus Oral Antibiotics
• D. Azelaic Acid Only

Answer: (C)

Moderate acne vulgaris typically needs both a topical regimen and systemic treatment to control different aspects of the disease. The topical part tackles abnormal desquamation and bacterial colonization at the skin surface, helping to prevent new comedones and reduce localized inflammation. Adding an oral antibiotic provides systemic anti-inflammatory and antibacterial effects, reducing inflammatory lesions more effectively than a topical approach alone. This combination targets both the comedonal component and the inflammatory component, offering better overall clearance in moderate cases.

Oral isotretinoin, while highly effective, is generally reserved for severe, nodulocystic, or refractory acne due to its potential for significant adverse effects and teratogenicity. Azelaic acid, although beneficial, is often not sufficient on its own for moderate disease and is more commonly used as an adjunct rather than the primary approach in this severity.