Management of acne: Canadian clinical practice guideline

Since the last Canadian acne guideline was published in 2000,17 evidence for multiple additional treatments has been published. Thus, there was an unmet need for an updated, systematically developed, evidence-based Canadian acne clinical practice guideline. This guideline provides recommendations adapted to the Canadian health care system to assist Canadian health care providers in the diagnosis of acne vulgaris, including investigations where appropriate; it also provides updated information on the pathogenesis of acne, outlines methods for evaluating acne severity, provides evidence-based guidance on treatments for acne vulgaris and recommends treatments for acne according to severity. The recommendations in this guideline address acne vulgaris in pediatric and adult age groups, with the following exclusions: neonatal, infantile and late-onset acne; acne fulminans; acne inversa (hidradenitis suppurativa); and acne variants such as gram-negative folliculitis, rosacea, demodicidosis, pustular vasculitis, mechanical acne, oil or tar acne, and chloracne. These conditions were excluded because they have different pathogenic mechanisms. We also wished to maintain congruence with the source guideline for adaptation, the European Evidence-Based (S3) Guidelines for the Treatment of Acne (ES3).16 Competing interests: Yuka Asai has served on an advisory board for GSK. Akerke Baibergenova has served on advisory boards for Galderma, [Valeant] and Astellas. Maha [Maha Dutil] has received speaker's honoraria from Galderma, Valeant, GSK and L'Oréal. [Shannon Humphrey] has received grants and personal fees from Allergan, Galderma and Kythera; and personal fees from GSK, Johnson & Johnson, L'Oréal, Procter & Gamble, Valeant and Revance. [Charles Lynde] has served as a clinical investigator, speaker or consultant for Cipher Pharma, Galderma, Johnson & Johnson, Stiefel/GSK, Valeant and La Roche-Posay. Yves Poulin has received research funding from Galderma, Dermira and Photocure ASA. Neil Shear has acted as a consultant to Valeant and Galderma. [Jerry Tan] has been an advisor to Cipher, Galderma, Stiefel/GSK, Merz, Photocure and Valeant; a consultant for Galderma, Merz and Roche; and a clinical investigator for Allergan, Cipher, Dermira, Galderma, Stiefel/GSK and Photocure. [John Toole] has served as a consultant, speaker and/or clinical investigator for Valeant, Stiefel, Roche and Galderma. Catherine Zip has participated on advisory boards for Valeant and Galderma. No comp