Acne - Chapter 41 Flashcards
Acne Vulgaris
-A disorder resulting from action of hormones and other substances on the skins sebaceous glands and hair follicles that leads to clogged pores and breakouts
Comedones
-Enlarged, plugged hair follicles
Treatment Goals For Acne
- Heal existing lesions
- Stop new lesions from forming
- Prevent scarring
- Minimize psychological stress and embarrassment
Treatment of Mild Acne
- Mild soap and water with gentle cleansing
- Topical OTC medicines containing keratolytics (salycilic acid, benzoyl peroxide)
Salicylic Acid
- Helps break down blackheads and whiteheads
- helps cut down the shedding of cells lining the hair follicles
Brand: Various OTC products including Clearasil
Generic: salicylic acid
Benzoyl Peroxide
- Most widely used OTC medication
- Prevents closure of the pilosebacious duct
- promotes increased sloughing and resolution of comedones
Brand: Benzac AC, Benzac W, Benzagel, Clearasil, Clean and Clear, Panoxyl, Proactiv
Generic: benzoyl peroxide
Treatment of
Moderate Acne
- Oral and/or topical antibiotics
- prescription strength topical keratolytics
- Vitamin A derivatives
- Oral contraceptives
- Physical methods
- UV light therapy
Oral Antiinfectives for Moderate Acne (Systemic)
- tetracycline
- doxycycline
- minocycline
- clindamycin
- sulfonamides
- erythromycin
Brand: Apprilon, Doxycin, Vibra-Tabs, Vibramycin
Generic: doxycycline
Brand: erythromycin
Generic: erythromycin
Brand: minocin
Generic: Minocycline
Brand: tetracycline
Generic: tetracycline
Topical Antiinfectives for Moderate Acne Examples
- sulfacetamide/sulfur
- clindamycin
- benzoyl peroxide/clindamycin
- benzoyl peroxide/erythromycin
- azelaic acid
Brand: Sulfacet-R
Generic: sulfacetamide/sulfur
Brand: Clindets, Dalacin T
Generic: clindamycin
Brand: Benzaclin, Clindoxyl, Clindoxyl ADV
Generic: benzoyl peroxide/clindamycin
Brand: Benzamycin
Generic: benzoyl peroxide/erythromycin
Brand: Finacea
Generic: azelaic acid
-Keratolytic
Acne Rosacea
- Blood vessels of the face become swollen after repeated exposure to certain triggers
- Starts as simple blushing, but advances into bumps on the face that look like acne
Topical Retinoids for Moderate Acne
-Retinoids are vitamin A derivatives
Topical Retinoids Examples
- tretinoin
- tretinoin/erythromycin
- tretinoin/clindamycin
- adapalene
- adapalene/benzoyl peroxide
- tazarotene
Brand: Retin-A, Retin-A Micro,Stieva-A, Vitamin-A Acid
Generic: tretinoin
Brand: Stievamycin
Generic: tretinoin/erythromycin
Brand: Biacna
Generic: tretinoin/clindamycin
Brand: Differin, Differin XP
Generic: adapalene
Brand: TactuPump, TactuPump Plus
Generic: adapaline/benxoyl peroxide
Brand: Tazorac
Generic: tazarotene
-Retinoid prodrug
Treatment of Severe Acne
- Drainage and surgical excision
- Interlesional corticosteroid injection
- Oral Retinoid
- Oral antibiotics
- Oral contraceptives
Isotretinoin
- Reduces production of sebum and shrinks sebaceous glands
- Stabilizes and prevents comodones
- Alters DNA transcription
Brand: Accutane, Epuris
Generic: isotretinoin
Isotretinoin Restricitons
- NO PREGNANCY
- Category X
- Strongly encouraged to dispense 1 month supply only
- Must have monthly liver function tests
Isotretinoin ADR’s
- Extreme dryness of eyes, mouth, nose, lips, and skin
- Changes in mood and depression
- Poor night vision
- Impaired liver function
- Hyperglycemia
- Photosensitivity
- Fetal deformities
Isotretinoin Warning Labels
- TAKE WITH FOOD
- AVOID PROLONGUES EXPOSURE TO SUNLIGHT
- AVOID PREGNANCY
Treatments for Hormonally Influenced Acne in Women
-In some women acne is caused by an excess of androgen hormones
Hormonally Influenced Acne Drugs Examples
- oral contraceptives
- spironolactone
- ethinyl estradiol/cyproterone
Brand: Aldactone
Generic: spironolactone
Brand: Diane
Generic: ethinyl estradiol/cyproterone