Since  the difficult acne  patient is a very important management problem certain salient features are discussed under this heading, though some of the items in this chapter  have been  dealt with elsewhere. The following types of patients need to  be considered:

1 The patient who is difficult because of the doctor's inappropriate management or lack of interest.

2 The patient who may  genuinely fail to respond to  adequate therapy despite maximum compliance.

3 The patient who may develop one or more problema  tic side-effects.

4 The patient who has severe acne or a severe variant of acne.

5 The patient who has many cysts.

6 A miscellaneous group of problem patients.

7 The scarred patient.