What is the next recommended treatment step for a 13-year-old boy with acne who has used OTC treatments without sufficient results?

In the management of acne, particularly when over-the-counter (OTC) treatments have not provided adequate results, the next step typically involves the use of topical prescription therapies. The recommendation for Retin A (tretinoin) 0.25% gel is appropriate because it is a topical retinoid that helps to unclog pores, reduce inflammation, and promote cell turnover, making it effective for treating acne.

Tretinoin is beneficial for both mild to moderate acne and can also assist in preventing new acne lesions from forming. It is often well-tolerated in the adolescent population and provides a foundation for more comprehensive acne management strategies, including potential adjuncts like antibiotics if needed.

In contrast, the use of systemic treatments such as isotretinoin (Accutane) is generally reserved for more severe or resistant cases of acne due to its significant side effects and the need for close monitoring. Tetracycline may also be effective, but it is typically used when topical treatments fail after a considerable period; hence, starting with topical retinoids like Retin A is more common.

Washing the face with medicated soap is a basic hygiene measure, but it may not provide sufficient therapeutic benefit on its own if more potent treatments are