Acne Flashcards
Types of spots in acne
Open comedones - whiteheads - flesh coloured papules
Closed comedones - blackheads
Pustules
What is mild acne?
Predominantly non-inflamed lesions with few inflamed ones
Moderate acne
More widespread and increased number of inflammatory lesions
severe acne
Widespread inflammatory papules, pustules, nodules or cysts
May have scarring
Other sx to ask about in acne
PCOS symptoms - hirsutism, oligomenorrhoea, amenorrhoea
Cushing’s symptoms - central weight gain, abdominal striae, moon face
Mental health symptoms
Non-pharm treatment advice
Leaflet Healthy diet Wash with soap and water twice daily Use non oil-based/no-greasy skin care products/makeup Remove makeup at the end of the day Dont pick spots
Which pharm treatment drugs for mild and how long treatment for
3 drugs - benzoyl peroxide, topical retinoid (adapalene), topical antibiotic (clindamycin)
12 week treatment
Which drug combinations can be used in mild/moderate acne
BPO + adapalene (ret)
BPO + Clindamycin
Ret +Clindamycin
What can be used as an alternative to systemic antibiotics in women
COCP in women
BPO advice to give
Use once daily in the evening sparingly
S/E - irritation of skin - burning, itchy skin, dry skin and redness/peeling
Can also bleach fabric so avoid hair and clothes
Makes more sensitive to sunlight so avoid sun or use SPF50 protection and hat
Retinoid advice to give
Highly teratogenic - need to use effective contraception (CI in pregnancy and breastfeeding)
Use sparingly - can irritate the skin - stinging sensation
Use sun protection - increases sensitivity to UV light
General advice to give about medications used to treat acne
they can take 6-8 weeks to work - so stick with it
Follow up?
In 2-3 months
Safety netting
If scarring or have nodulo-cystic acne or not responded after 3m come back
Also if causing you significant psychological distress
Refer if…
Nodulo-cystic acne
Scarring
Significant psychological distress
not responded to 2 courses of treatment from GP
