Acne and Insect Bites Flashcards
Prevalence of acne is significantly higher among…
females in all age groups compared to men
What makes acne develop?
- hormonal triggers
- excessive sebum production
- growth of bacteria
- inflammatory responses
What is a white head also called?
closed comedo
What is a black head also called?
open comedo
OTC medications are only used to treat…
closed and open comedones
What are inflammatory acne?
- papules
- pustules
- nodules
- need rx to treat, so refer
What are some exacerbating factors in acne?
- drug induced
- cosmetic
- occupational
- stress/emotional
- high-humidity/sweating
- hormones
- diet
Which drugs can induce acne?
- pheytoin
- isoniazid
- moisturizers
- phenobarbital
- lithium
- ethionamide
- steroids
Non-pharmacologic approaches to acne:
- wash face twice a day
- eliminate exacerbating factors of acne
- stay well hydrated
How to properly wash your face:
- wash hands and remove makeup
- wet face with warm water
- apply cleanser with fingertips
- rub face for 1-2 minutes
- rinse with cold water
- pat dry
OTC acne products:
- benzoyl peroxide
- salicylic acid
- sulfur
- adapalene 0.1%
Which medication is the most commonly used one for acne?
benzoyl peroxide
Benzoyl peroxide:
- has antibacterial properties
- used as cleanser or as spot treatment
Benzoyl peroxide are available in concentrations of…
- 5-10%
- new users should start at 2.5%
Counseling points for benzoyl peroxide:
- avoid contact w/ clothes/hair because can bleach it
- avoid sun exposure
- use sunscreen
- mild redness in beginning may occur
Examples of benzoyl peroxide:
- PanOxyl
- Persa-Gel
- ProActive
Salicylic acid:
- helps unclog pores by causing slight peeling
- less effective than benzoyl peroxide
- used as cleanser or as spot treatment
Available concentrations of salicylic acid:
0.5%-2%
Counseling points of salicylic acid:
- avoid sun exposure
- use sunscreen
Sulfur:
- not used often due to chalky appearance/unpleasant odor
- not as effective as benzoyl peroxide
Sulfur is usually combined with…
resorcinol
Available concentrations of sulfur:
3-10%
Sulfur should not be given to patients…
who are allergic to sulfa drugs
Examples of salicylic acid:
- Neutrogena oil free wash
- OxyPads
Adapalene 0.1% is also known as…
Differin Gel
Adapalene 0.1% has…
retinoid
Counseling for adapalene 0.1%:
- apply QD all over face
- comes as a moisturizer and cleanser
For acne treatments, don’t expect…
complete resolution
- should have an improvement in acne or decrease in severity
When is an acne treatment considered a failure?
after 6 weeks of adherence
What are the three types of lice?
- head
- body
- pubic
Head lice:
- most common
- spread through personal contact
- not a result of poor hygiene
Body lice:
- lives in clothing
- usually occurs in those that don’t shower or change clothes frequently
Pubic lice:
- high risk sexual contact
- can be spread through toilet seats, shared undergarments, or bedding
RID (synergized pyrethrins) treatment for lice:
- approved for treating head and pubic lice
- available as shampoos, foams, solutions, or gels
Counseling for RID treatment for lice:
- apply to affect areas for 10 min then rinse and follow with lice comb
- repeat treatment in 7-10 days
- can be used in > 2 months old
- increased resistance due to overuse
Nix (permethrins) treatment for lice:
- approved for treating head lice only
- available as cream rinse
Counseling for Nix treatment for lice:
- apply to washed, towel dried hair and let sit for 10 min before rinsing and follow with lice comb
- repeat treatment in 7-10 days not required unless active lice is detected
- can be used in > 2 months old
- increased resistance due to overuse
Follow up for Nix and RID should occur within…
first 10 days
Sklice (ivermectin lotion 0.5%) treatment for lice:
- treats head lice only
- single use lotion on dry hair
- can be used in > 6 months old
Lice shield:
- repels head lice
- doesn’t treat or kill head lice
- blend of natural essential oils
One should avoid _____ and ____ as lice treatments
- petroleum jelly
- mayonnaise
Non-pharmacologic approaches to lice:
- appropriate hair combing
- home vacuuming of carpets, rugs, furniture
- clean personal items
- avoid direct physical contact w/ infected
- don’t share combs, brushes, etc
- complete head shaving
What kind of bites can you not self-treat?
- scabies
- suspected spider bites
- history of tick bite w/ systemic effects
Non-pharmacologic patient counseling tips for bug bites:
- apply ice pack to bite area for up to 10 min
- avoid scratching area
- remove ticks with tweezers and clean area with rubbing alcohol
What concentration of insect repellents is preferred for children?
< 30%
- not for children < 2 months old
Insect repellents should be applied every…
4-8H
Alternative products to insect repellents:
- citronella
- lemon eucalyptus oil
- tea tree oil
OTCs for bug bites and stings:
- local anesthetics
- topical antihistamines
- counterirritants
- hydrocortisone
Examples of local anesthetics:
- benzocaine (solarcaine/lanacane)
- pramoxine and benzyl alcohol (Itch-X)
- lidocaine
- dibucaine (Nupercainal)
- phenol
Which local anesthetics don’t have adverse effects/skin irritation?
- pramoxine
- benzyl alcohol
Example of topical antihistamines:
diphehydramine (Benadryl)
Example of counterirritants:
- camphor
- menthol
- brand: blue star and sarna
Example of hydrocortisone:
- Cortaid
- Cortizone
Hydrocortisone should be used for…
minor skin irritations, itching, and rashes caused by dermatitis, insect bites, poison ivy/oak/sumac
Don’t use hydrocortisone on…
fungal or bacterial infections
Self-treatment is appropriate for bug bites if the reaction is…
confined to site and patient is over 2 YO
Counseling points of analgesic medications:
- apply to bite TID or QID
- max of 7 days
- follow up after 7 days
