Acne (Bellanger) Flashcards
I - mild:
- mainly ____
- generally in one area (face, back..)
- occasional ____
- no ____, no ____
- mostly non-inflammatory
- comedones
- papules
- nodules; scarring
II - moderate:
- -comedones, more ____ & ____
- -mainly ____
- -mild scarring
- -____ lesions
- papules; pustules
- facial
- inflammatory
III - moderate:
- numerous & extensive comedones, papules, pustules and ____
- facial, back, chest, shoulders
- occasional ____ or nodule
- ____ scarring
- nodules
- cyst
- moderate
IV - severe:
- numerous ____ cysts or nodules on face, neck and upper trunk
- ____ scarring
- persistent pustulocystic OR
- recalcitrant cystic
- large
- severe
Acne treatment goals:
- SCHOLAR-MAC
- discontinue ____ factors
- alleviate discomfort
- control acne lesions and prevent ____/____
- prevent new lesions (may take up to __ weeks or more for results
- minimize ____ -____ can be used for mild or in combo with ____
- aggravating
- pitting/scarring
- 6
- ADRs
- OTC; Rx
Acne treatment options: (8)
- topical agents
- systemic antibiotics
- hormonal agents
- isoretinoin
- intra-lesional steroids*
- chemical peels*
- comedo removal*
- complimentary therapy
(*should be done by a dermatologist)
Oily to normal skin types should use what formulations? (3)
gels, solutions and lotions
Normal skin types should use what formulations? (4)
gels, solutions, lotions and creams
Normal to dry skin types should use what formulations? (2)
lotions and creams
____ and ____ (formulations) are not usually recommended.
ointments & bars
Acne OTC topicals: (3) Which is first line?
- benzoyl peroxide (first line)
- salicylic acid
- sulfur
Describe the following properties of benzoyl peroxide:
- bacericidal?
- keratolytic?
- comedolytic?
- formulations
- pregnancy category
- ADEs
- yes
- slight
- no
- wash, liquid, lotion, cream, gel
- C
- bleached hair & clothing; drying; photosensitivity
Describe the following properties of salicylic acid:
- bacericidal?
- keratolytic?
- comedolytic?
- formulations
- pregnancy category
- ADEs
- no
- yes
- yes
- cleansing pads, cream, gel
- C
- potent keratolytic at high concentrations; drying; photosensitivity
Describe the following properties of sulfur:
- bacericidal?
- keratolytic?
- comedolytic?
- formulations
- pregnancy category
- ADEs
- yes
- yes
- yes
- cream, lotion
- C
- color; malodorous; drying
Acne OTC application is used as a ____ treatment. There will be visible improvement in a few days but will take ___ weeks of continued used to see the effectiveness. ____ are generally not effective because there is not enough contact time with the skin.
long-term; 6; washes
Retinoids are ____ __ derivatives. Some examples are: ____, ____ and ____. They are for ____ to ____ acne. Apply to dry, clean skin and avoid skin near ____, mucous membranes and abrasions. They cause photosensitivity, so wear sunscreen but wait __-__ minutes after applying retinoid. It [is/is not] safe to use with benzyl peroxide cleansers.
vitamin A; tretinoin; adapalene; tazarotene; moderate; severe; eyes; 15-20; is
Examples of topical antibiotics (macrolides) are ____ and ____. Apply to dry, clean skin. Formulations come in gel, pledget, lotion, solution to be applied ____ and foam (clindamycin) to be applied ____. Wait __ minutes to shave area or apply makeup.
erythromycin; clindamycin; BID; daily; 30
____ antibiotics are the standard of care for moderate to severe acne. ____ is the best at reducing P. acnes. There is also ____ and ____. Bacterial ____ is an increasing problem. Adverse effect ____ should be developed.
Systemic; Minocycline; erythromycin; trimethoprim; resistance; profiles
Hormonal agents:
- ____ containing oral contraceptives can decrease acne in some women
- oral anti-androgenic agents: ____ and ____ ____ (be careful with males)
- estrogen
- spironolactone; cyproterone acetate
Hormonal agents: oral corticosteroids have limited data but have shown temporary benefit for severe ____ acne and low doses may benefit those with ____ hyperandrogenism
inflammatory; adrenal
Spironolactone ADEs (2)
- hyperkalemia
- may cause menstrual irregularity
Isoretinoin (oral):
- use in severe ____ nodular acne
- useful for ____ resistant acne
- potent ____
- ____ program
- lab monitoring (triglycerides, cholesterol, LFTs and CBC)
- potential ____ adverse effects
- recalcitrant
- treatment
- teratogen
- iPledge
- psychiatric
CAM - tea tree oil
- essential oil
- may have ____ properties
- may be irritating if applied ____, so add to a ____ or gel vehicle
- antiseptic
- directly; moisturizing
Acne non-pharmacologic therapy:
- do not ____/____/____ acne
- do not ____ the skin
- wash face with ____ water and a ____ cleanser no more than ____ daily
- wait __ minutes after washing face to apply medications
- avoid ____ factors (use only ____ skincare and hair care products, cleanse skin after sweating, keep hair and hands away from affected areas)
- pop/squeeze/pick
- scrub
- lukewarm; mild; twice
- 15
- exacerbating; oil-free
Lifestyle modifications:
- increase intake of (3)
- decrease intake of (2)
- fluids, fish oil, probiotics
- glycemic load/sugar, dairy
