Practical management of treatment-resistant acne cases

Treatment-resistant acne can be challenging and often requires a comprehensive reassessment of the diagnosis, contributing factors, and treatment adherence. From a clinician’s perspective, management begins with identifying potential causes of poor response, including hormonal influences, inappropriate skincare practices, medication non-compliance, or underlying conditions such as polycystic ovary syndrome (PCOS). Treatment strategies may involve optimizing topical and systemic therapies, introducing hormonal treatments where appropriate, or considering oral isotretinoin for severe or refractory cases. Equally important is patient education regarding realistic treatment expectations and the need for long-term maintenance. An individualized, evidence-based approach is key to achieving sustained control and minimizing the risk of scarring and recurrence.