The Australasian College of Dermatologists

Recommendations from the Australasian College of Dermatologists on leg cellulitis, epidermal cysts, urticaria, distorted toenails & acne, advice on systemic non-sedating antihistamines and topical corticosteroids for skin conditions. The Australasian College of Dermatologists (ACD) is the sole medical college accredited by the Australian Medical Council for the training and continuing professional development of medical practitioners in the specialty of dermatology. As the national peak membership organisation, we represent over 550 dermatologist Fellows (FACD) and 100 trainees. We are the leading authority in Australia for dermatology, providing information, advocacy and advice to patients, communities, government and other stakeholders on skin health and dermatological practice.

Monotherapy for acne with either topical or systemic antibiotics should be avoided.

Date reviewed: 31 March 2021

In light of concerns about antibiotic resistance, the treatment of acne with topical or oral antibiotics should be in combination with agents such as benzoyl peroxide or retinoids and prolonged use should be avoided.

Supporting evidence
  • Eady EA, Gloor M, Leyden JJ. Propionibacterium acnes resistance: A worldwide problem. Dermatology 2003;206 (1):54-6.
  • Earnshaw S, Mendez A, Monnet DL, et al. Global collaboration to encourage prudent antibiotic use. The Lancet Infectious Diseases 2013;13(12):1003-4.
  • Archer CB, Cohen SN, Baron SE and on behalf of British Association of Dermatologists and Royal College of General Practitioners. Guidance on the diagnosis and clinical management of acne. Clin Exp Dermatol 2012; 37(s1)1:1-6.
  • Laxminarayan R, Duse A, Wattal C, et al. Antibiotic resistance—the need for global solutions. The Lancet Infectious Diseases 2013;13(12):1057-98.
  • Adler BL, Kornmehl H, Armstrong AW. 2017. Antibiotic Resistance in Acne Treatment. JAMA Dermatol. 2017 Aug 1;153(8):810-811 (Fee for access)
  • Kosmadaki M and Katsambas A. 2017. Topical Treatments for Acne. Clin Dermatol. 2017 Mar-Apr;35(2):173-178. (Fee for access)
  • Barbieri JS, Spaccarelli N, Margolis DJ and James WD. 2019. Approaches to Limit Systemic Antibiotic Use in Acne: Systemic Alternatives, Emerging Topical Therapies, Dietary Modification, and Laser and Light-based Treatments. J Am Acad Dermatol. 2019 Feb;80(2):538-549. (Fee for access)
  • Dreno B. 2016. Bacteriological Resistance in Acne: A Call to Action. Eur J Dermatol. 2016 Apr 1;26(2):127-32. (Fee for access)
  • Farrah G and Tan E. 2016. The Use of Oral Antibiotics in Treating Acne Vulgaris: A New Approach Dermatol Ther. 2016 Sep;29(5):377-384. (Fee for access)
  • Zaenglein A, Pathy AL, Schlosser BJ, et al. Guidelines of care for the management of acne vulgaris. J Am Acad Dermatol 2015;
How this list was made How this list was made

College’s Expert Advisory Committee, comprising seven longstanding Fellows considered four potential recommendations, together with supporting evidence, and agreed to proceed with three of them. The Committee then refined and finalised the recommendations. These were reviewed by the NPS Representatives Committee and finalised in response to the feedback received.

Download ACD Recommendations