Acne Vulgaris & Cold Sores Flashcards
What is acne?
inflammatory disease of the pilosebaceous follicles causing comedones, papules and pustules on the face, chest, upper back
What occurs in response to increased testosterone in males?
sebaeceous glands become oversensitive to testosterone, they produce excess oil and the skin becomes greasy
What causes acne?
Excess keratin and sebum causes the development of comedones as either blackheads (an open comedone) or whiteheads (a closed comedone beneath which inflammation occurs)
What are symptoms of acne?
papules on the surface of the skin in mild cases and cysts in the deeper layers of the skin in more severe cases
Which areas are most commonly affected?
face, neck, centre of the chest, upper back and shoulders
When to refer a pt with acne?
- Acne Rosacea - condition affecting mostly middle-aged or other pts and presents as reddening of cheeks and forehead alongside papules and pustules but is confined to the face only
- Certain drugs may cause acne as an adverse effect e.g. lithium, phenytoin, progestogens, levonorgestrel and norethisterone
- Symptoms unresponsive to 8 weeks tx
What tx options are available for pts suffering from acne?
- Benzoyl peroxide - ketatolytic effects (being mildly comedolytic) with antibacterial properties, and is generally used as a first-line tx.
- Nicotinamide - alternative with anti-inflammatory properties but evidence of its usefulness in acne is limited
What are side effects of the tx for acne?
- Stinging
- Drying
- Soreness
- Peeling of skin can occur especially during initial stages of tx
- Reducing frequency of application or strength of product can be tried
How long should pts used benzoyl peroxide before seeing their GP?
should use for 6 weeks if no improvement
If there is improvement with benzoyl peroxide, how long should you treat?
at least 4-6 months
What are OTC preps can be given to pts with acne?
Acenecide
Freederm
Quinoderm
What are some counselling points that can be given to a pt with acne?
tx takes a while to have an effect and regular use is required
Avoid greasy, oil-based cosmetics
Use water-based ones where possible
Sunlight is reported to reduce acne
No evidence that poor hygiene or certain food can cause acne
What are cold sores?
infection caused by the herpes simplex virus around the mouth
What are prodromal symptoms of cold sores?
Tingling, irritation in the skin 6-24 hours before appearance of any symptoms
What occurs after the prodromal symptoms of cold sores?
minute blisters on top of red, inflamed skin develop and grow into blisters filled with white matter that break down to reveal a raw area underneath and crusting within 4 days
Most lesions heal within 1 week