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Daily Free Practice Question
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Updated on: 12/13/2025
A 19-year-old male on a topical regimen of benzoyl peroxide and adapalene reports improvement in inflammatory lesions but continues to develop new comedones. He showers once daily after workouts and uses a moisturizing sunscreen. What is the most effective strategy to prevent future comedone formation?
Rationale
AANP Domain Level: Plan
ANCC Domain Level: Planning
Focus Area: Dermatology
Salicylic acid is a beta-hydroxy acid that enhances exfoliation and targets follicular hyperkeratinization—one of the primary pathogenic factors in comedone formation. Adding it to an existing regimen of benzoyl peroxide and adapalene offers synergistic benefit without unnecessary escalation. Oral antibiotics or isotretinoin are reserved for more severe, nodular, or refractory cases, and topical corticosteroids are not appropriate due to risk of steroid-induced acne and skin thinning.
Study Tip:
When comedones persist despite standard topical therapy, consider adding a salicylic acid cleanser before escalating to systemic treatment. Combining agents that target different pathways of acne (keratinization, inflammation, and bacteria) improves both prevention and control.