Acne Vulgaris

Question 1

What is the severity of Acne?

Answer 1

Mild- mostly non-inflammatory (comedones)
Moderate- more widespread with papules and pustules
Severe- widespread inflammation with large papules/putules/cysts, with evidence of scarring

Question 2

What is the management of mild to moderate acne?

Answer 2

Prescribe 12 week course of topical treatment of any of the following

1) Adapalene with benzoyl peroxide
2) Topical Tretinoin with clindamycin
3) Benzoyl Peroxide with clindamycin

Question 3

What is the management of moderate to severe acne?

Answer 3

12 week course of

1) Topical adapalene with benzoyl peroxide
2) Topical tretinoin with clindamycin
3) Topical adapalene with benzoyl peroxide and oral tetracycline
4) Topical azelaic acid and oral tetracycline

COCP and topical agents can be considered in women as an alternative to abx

Question 4

When should someone be referred to dermatology?

Answer 4

Mild-Moderate has not responded to 2x complete course treatment
Moderate-Severe not responding to treatment including abx
Scarring/pigment changes or psychological distress

Normally treat with isotretinoin