Acne Flashcards
What is acne vulgaris?
A chronic inflammatory condition of the pilo sebaceous with an onset around 14-20 y/o and normally resolves within 4 to 5 years
What’s does acne affect?
Face, neck, chest, back, arms, legs and buttocks
What is stage 1 acne?
Minor pimples
Blackheads and milia
Whiteheads
No inflammation
What is stage 2 acne?
More blackheads/milia
Papules and pustules
Slight inflammation
Acne breakout may spread from face to other parts of the body
What is type 3 acne?
Significant inflammation
Severe papules and pustules
Cystic nodules present
High risk for scarring and post inflammatory hyperpigmentation
What causes acne?
- Excessive sebum production - testosterone levels are normal
- Abnormal follicular keratinisation - keratinising epithelium and increased production of corneocytes
- Proliferation of propionibacterium acnes - anaerobic bacteria
- Triggers - hormones, stress, hot humid conditions, airborne grease/oils, greasy cosmetics and restrictive clothing
- Papules, pustules, cysts and nodules
- Hyperpigmentation
What drugs can induce acne?
Lithium, phenytoin, steroids, hormones, iodides and bromides
How do you treat acne in primary care?
- A fixed combination of topical adalapene and topical benzoyl peroxide - applied od in the evening
- A fixed combination of topical tretinoin and topical clindamycin - applied od in the evening
- A fixed combination of topical adalapene and topical benzoyl peroxide - applied od in the evening together with either oral lymecycline 408mg or doxycycline 100mg od
- Topical azelaic acid (15 or 20%) applied bd in the evening together with either oral lymecycline 408mg or doxycycline 100mg od
How do topical retinoids work for the treatment of acne?
- Increase epithelial turnover
- Reduce keratinius plug formation
- Increases sebum drainage
- C/I in pregnancy
- S/E skin irritation and peeling
How does systemic isotretinoin work?
See slide
