The Role of Guidelines, Patients, and Payers in Acne Management

EP: 1.Evolving Acne Management

Now Viewing

EP: 2.The Role of Guidelines, Patients, and Payers in Acne Management

EP: 3.Selecting Patients for Oral Antibiotic Therapy

EP: 4.Exploring the Anti-Inflammatory Impact of Oral Antibiotics

When prescribing oral antibiotics for acne, external factors such as updated clinical guidelines play a key role. Recent revisions to dermatology guidelines, particularly those from 2024, continue to support the use of oral antibiotics—especially tetracyclines—for moderate to severe acne. However, while antibiotics remain a recommended option, the updated guidance places greater emphasis on smart prescribing through antibiotic stewardship. This means using antibiotics at the right dose, for the right duration, and for the right patient. Importantly, stewardship is not about avoiding antibiotics, but about using them responsibly and effectively.

Patient preferences are another major influence on therapeutic decisions. Acne, like other inflammatory skin diseases, varies widely in how it affects individuals, and so do patient attitudes toward treatment. Some patients prefer oral options, others want to avoid them entirely, and many are deterred by adverse effects such as dryness from topical treatments. Engaging patients in shared decision-making helps ensure that treatment plans align with their expectations and increase adherence. Studies show that patients are more likely to stick with a regimen when they’ve had input in choosing it, underscoring the value of collaborative care in managing acne long-term.

Insurance coverage also impacts treatment options, often limiting access to newer, safer therapies. Despite the clinical benefits of narrow-spectrum antibiotics—such as reduced gut microbiome disruption and fewer systemic adverse effects—some insurers do not cover these medications. This creates a disconnect between clinical best practices and what is feasible in real-world care. Advocating for broader access, supported by evidence of improved safety and effectiveness, may help align insurance policies with stewardship goals. In the end, combining guidelines, patient engagement, and access equity is key to delivering optimal acne care that is both responsible and effective.