Acne vulgaris (AV) is a very common inflammatory condition of the skin that affects as many as 90% of teenagers. Although generally seen as a mild problem that will clear in adult life, half will continue to have symptoms beyond their teens, although most will resolve by the age of 30.1 Mild cases may settle without lasting ill effects, but one in five people with more severe cases will develop nodules and cysts and may be left with permanent, unsightly scarring.2 This article focuses on of the management of severe AV and more moderate cases that have failed to respond to the topical treatments or oral antibiotics.
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