What is the first-line treatment for mild to moderate acne that may be exacerbated by hormonal factors?

The first-line treatment for mild to moderate acne, particularly when hormonal factors may contribute, is the use of topical retinoids. These agents work by promoting cell turnover, preventing the clogging of pores, and exhibiting anti-inflammatory properties, which can reduce the number of comedones (clogged pores), inflammatory papules, and pustules associated with acne.

Topical retinoids, such as tretinoin, adapalene, and tazarotene, are effective as they target the initial pathophysiological processes of acne by normalizing the shedding of skin cells and decreasing keratinization, which helps keep pores clear. They are well-tolerated and can be used in conjunction with other treatments, making them a versatile choice in the management of acne.

While hormonal treatments such as oral contraceptives can effectively regulate hormonal influences on acne, they are typically reserved for cases where there is clear evidence of exacerbation due to hormonal changes, such as in females with cyclical acne. Oral isotretinoin is generally reserved for severe cases of acne that have not responded to other therapies. Topical antibiotics can help in managing inflammatory lesions but do not address the underlying causes of acne. Therefore, for mild to moderate acne, particularly