A teenager girl with moderate acne is also complaining of irregular menses. Drug of choice will be:
**Core Concept**
The management of acne in a teenager involves a combination of topical and systemic therapies. In cases where acne is accompanied by irregular menstrual cycles, hormonal imbalances are a significant concern. Therefore, the treatment should ideally address both acne and menstrual irregularities.
**Why the Correct Answer is Right**
The drug of choice in this scenario is likely a combination of hormonal therapy and anti-acne medication. **Spironolactone**, a potassium-sparing diuretic, has anti-androgen properties that can help regulate menstrual cycles and reduce androgen-induced acne. Additionally, spironolactone can help decrease sebum production, which is beneficial for acne management. This dual action makes it an effective treatment option for this patient.
**Why Each Wrong Option is Incorrect**
**Option A:** Other anti-acne medications like isotretinoin or azelaic acid may be effective for acne management but do not address the underlying hormonal imbalance causing irregular menstrual cycles.
**Option B:** Topical retinoids are beneficial for acne but may not be sufficient to regulate menstrual cycles.
**Option C:** Oral contraceptives can help regulate menstrual cycles but may not be the first-line treatment for acne in this scenario.
**Clinical Pearl / High-Yield Fact**
When managing acne in teenagers, it's essential to consider the potential impact of hormonal imbalances on menstrual cycles. This can be achieved by using medications like spironolactone, which have both anti-acne and anti-androgen properties.
**Correct Answer:** C. Spironolactone.