Acne vulgaris

Question 1

What is acne vulgaris?

Answer 1

A disorder of the pilosebaceous unit (hair follicle and associated sebaceous gland)

Question 2

What causes acne vulgaris?

Answer 2

• Increased sebum production due to androgenic hormones (PCOS, puberty, steroids)
• Bacterial colonisation
• Inflammatory mediators
• Family history

Question 3

What medications can cause acne vulgaris?

Answer 3

• Steroids
• Anti epileptics
• EGRF inhibitors

Question 4

Describe the rash of acne vulgaris

Answer 4

- Affects the face, chest, upper back
Non inflammatory - 
- Closed and open comedones
Inflammatory - 
- Papules (<1cm, elevated, solid, erythematous)
- Pustules (pus filled, erythematous epidermal lesions)
- Nodules 
- Cysts
Scarring - 
- Pigmented malcules
- Keloid scarring

Question 5

What is the general advise you can give to treat acne vulgaris?

Answer 5

• Avoid overcleaning the skin as acne is not caused by poor hygiene, clean twice a day with gentle soap and fragrance free cleanser
• Non comedogenic makeup
• Avoid picking and squeezing
• Healthy diet, low in dairy and sugar

Question 6

What topical treatments can you prescribe?

Answer 6

• Topical retinoids (adapalene) alone or in combination with benzoyl peroxide
• Topical antibiotic (clindamycin 1%) in combo with benzoyl peroxide
• Azelaic acid

Question 7

What medication can you prescribe?

Answer 7

• Tetracycline (lymecycline or doxycycline) for a max of 3 months
• Refer to dermatologist if that doesnt work
• Offer contraceptive options in women as an alternative