Table VI.

Additional factors to consider for patients with specific clinical presentations

Patients with specific clinical presentations	Consider
Children aged <10 years∗ (12/13)	•Lack of established skin care routine and potential hormonal conditions∗ (11/13)
Patients with darker skin phototypes (Fitzpatrick scale IV-VI)∗ (13/13)	•Acne-induced macular hyperpigmentation∗ (13/13)
	•Additional hyperpigmentation caused by irritation from topical medication∗ (11/13)
	•Potential inappropriate use of bleaching creams∗ (10/13)
	•Cultural cosmetic practices that may influence acne (eg, the use of oils in hair)∗ (11/13)
Patients with hormonal conditions∗ (13/13)	•Difficulty in counteracting the effects of exogenous androgens∗ (12/13)
	•The need for interdisciplinary management with an endocrinologist∗ (11/13)
	•Requirements for laboratory examinations∗ (12/13)
Heavy exercisers/athletes∗ (11/13)	•Potential use of anabolic steroids or supplements∗ (12/13)
Patients at risk of psychiatric issues∗ (10/13)	•The potential to be engaging in harsh cleaning routines or excoriation/manipulation of lesions∗ (12/13)
	•Drug-induced acne∗ (10/13)
	•The need for interdisciplinary management with a psychiatrist or other allied health care professionals∗ (12/13)
Women who are pregnant or breastfeeding (11/13)	Recommendations for considerations not explored further
Transgender patients∗ (12/13)	Recommendations for considerations not explored further
Patients with medication-induced acne∗ (10/13)	•Patients with medication-induced acne (including those receiving cancer treatment, eg, epidermal growth factor receptor inhibitors)∗ (10/13)
Adult male patients	•Steroid or supplement-induced acne∗ (11/13)
Adult female patients	•Use of hormonal treatments (eg, contraception)∗ (13/13)
	•Potential polycystic ovary syndrome∗ (12/13)
	•Use of make-up and other cosmetic skincare products∗ (11/13)
	•Pregnancy and lactation∗ (12/13)
Specific populations of acne patients may benefit from an interdisciplinary approach to management (11/12)

^∗Indicates topics that were voted on via the Delphi process (Comprehensive list of statements available as Supplementary Material via Mendeley at https://data.mendeley.com/datasets/fy6mnvt7t7/1).