A nurse is caring for an adolescent client who comes to the provider's office for treatment of acne vulgaris on her cheeks. Which of the following instructions should the nurse reinforce with this client and her parents?

A. Adhere to strict dietary reduction of oily foods: Dietary changes, particularly reducing oily and greasy foods, are often recommended as a measure to manage acne. However, the evidence supporting this recommendation is mixed, and strict dietary restrictions may not be necessary for all individuals with acne. Therefore, while the nurse might mention the potential impact of diet on acne, strict dietary reduction of oily foods is not typically the primary focus of acne treatment. B. Express the larger comedones periodically: Expressing or squeezing comedones (blackheads or whiteheads) can lead to further inflammation, scarring, and infection. It is not recommended to express comedones at home without proper training and technique. Attempting to express comedones can exacerbate acne and may cause more harm than good. C. Minimize sun exposure: Sun exposure can worsen acne and lead to increased inflammation and hyperpigmentation. Therefore, it is important for individuals with acne to minimize sun exposure and use sunscreen with a broad-spectrum SPF of 30 or higher. D. Use friction when washing the face: Excessive friction or aggressive scrubbing when washing the face can irritate the skin and worsen acne. Instead, the nurse should advise gentle cleansing of the face using a mild, non-comedogenic cleanser and lukewarm water. Harsh scrubbing or using abrasive cleansers can disrupt the skin barrier and exacerbate acne symptoms.