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For a 13-year-old boy with acne, what is the recommended next step after topical treatments?

  1. Retinoic acid (Accutane)

  2. Tetracycline

  3. Retin A 0.25% gel

  4. Wash face with medicated soap at bedtime

The correct answer is: Retin A 0.25% gel

The recommended next step after topical treatments for a 13-year-old boy with acne is the use of Retin A (tretinoin) 0.25% gel. Tretinoin is a topical retinoid that has been shown to be effective in treating acne by promoting cell turnover, preventing the formation of new comedones (clogged pores), and reducing the overall appearance of acne lesions. It helps to unclog pores and also has anti-inflammatory properties, making it useful in managing acne. This choice is particularly suitable for adolescents because it is safe for their age group and can be used in conjunction with other treatments. Topical treatments are typically the first line of management for mild to moderate acne, and a retinoid is often added if there is inadequate improvement. The 0.25% concentration is a good starting point, allowing the skin to adjust to the medication while minimizing the risk of irritation. The other options may not be the most appropriate next steps for a few reasons. For instance, Accutane, or isotretinoin, is usually reserved for severe nodular acne or cases that do not respond to other treatments due to its potential side effects and need for close monitoring. Tetracycline is an