Mild Acne
< 20 comedones or < 15 inflammatory papules or a lesion count of < 30, 15-50 papules and pustules with comedones and rare cysts. Total lesion count may range from 30-125.
Clinically mild acne has only white or black comedones
Treatment is adapalene 0.1% gel locally. The gel should be applied once a day to affected areas after washing in the evening before retiring. A thin film of the gel should be applied, avoiding eyes, lips, and mucous membranes.
To prevent the retinoid irritation advice patients to use mild soaps, soap substitutes like cetaphil lotion, avoid skin trauma like rubbing, scrubbing of face etc.

Moderate Acne
In between mild and moderate
Clinically in addition to white and black comedones, there are also inflammatory lesions like papules and pustules
Treatment is adapalene and Benzoyl peroxide 2.5%, 5% gel.
Azithromycin 500 mg initial dose and 250 mg daily for a further four days per month for 12 weeks
Azithromycin, 500 mg orally thrice weekly for 8 weeks ( 500 mg once-thrice weekly.)

Severe Acne
Azithromycin 500 mg initial dose and 250 mg daily for a further four days per month for 12 weeks
Azithromycin, 500 mg orally thrice weekly for 8 weeks ( 500 mg once-thrice weekly.)
Inflammatory nodules, comedones, papules, and pustules or total lesion count of greater than 125.
Dermatology referral for isotretinoin therapy

Other management considerations :
1) Management of QOL and emotional dysfunction of Acne
2) Indications for hormonal/contraceptive therapy
3) Indications for oral antibiotics

Microneedling is a common office-based procedure used
to manage post-acne atrophic scarring. Its clinical usefulness
is well established.4-6 A series of 3 to 5 treatment sessions at
2- to 4-week intervals typically results in improvement ranging
from50%to 70%.7 The efficacy of micro-needling has been
compared with other dermatological procedures for post-acne
scars, such as chemical peeling,8 cry rolling,9 or carbon
dioxide laser treatment,10 usually as combination therapies.
However, head-to-head comparative studies with home-based
medical management for acne scars is lacking.