Refractory acne: When standard protocols fail

The provided audio excerpt features Dr. Pawan discussing the management and treatment of refractory acne, which occurs when standard protocols fail. He first emphasizes the importance of revisiting the initial diagnosis to rule out other conditions such as rosacea or perioral dermatitis. A major point of failure is often patient non-compliance, so proper adherence to the prescribed medication must be confirmed. For active treatment, the doctor suggests optimizing medication dosages, possibly increasing isotretinoin based on body weight, and sometimes adding adjuncts like antibiotics or spironolactone. Furthermore, lifestyle adjustments, including dietary changes and physical activity, are recommended, and when these steps are insufficient, procedural therapies such as intense pulsed light (IPL) devices or chemical peels are considered.