After  the initial interview, decisions are made as to which treatment should be prescribed (these will be discussed in detail in subsequent sections). However, certain factors  must be considered  in the choice of treatment and in the approach of the physician to the patient.

 

  For example, patients with mild acne will do well just with topical therapy; those with more severe acne need oral therapy. Further, the physician should not underpatients with acne excoiree require the early use of oral therapy as they are often intolerant of topical treatment. estimate  the  psychological effect of the acne on the individual. The physical and psychological  trauma of acne should be well  appreciated and  a sympathetic approach is essential. It should be remembered that there is a significant incidence of unemployment among subjects with clinical acne.

  Patients  born with  a  coloured skin  may produce considerable  postinflammatory pigmentation  which can be as disturbing as the active inflammatory lesions. Thus, a subject with coloured skin and mild acne who is developing many postinflammatory macules must be  treated aggressively.