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Maintenance Therapy for Acne Vulgaris: The Fine Balance Between Efficacy, Cutaneous Tolerability, and Adherence


John E. Wolf, Jr., MD, Department of Dermatology, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030-3411


Maintenance therapy is defined as the regular use of appropriate therapeutic agents to ensure that acne remains in remission. Topical agents are the mainstay of maintenance therapy. A number of topical therapeutic options are available, including topical retinoids, benzoyl peroxide, and azelaic acid. The choice of topical agents should be based on a number of criteria: efficacy in addressing the subclinical microcomedo, which is the precursor lesion for both comedones and inflammatory lesions; tolerability, due to the need for application to a broader epidermal surface; and other properties that may enhance adherence. Patients may be more motivated to use agents that are easily integrated into their lifestyles and that have potential “skin-repairing” properties.