Acne Vulgaris Management

Question 1

1st line acne management?

Answer 1

SINGLE topical therapy - retinoids, benzoyl peroxide

Question 2

2nd line acne management?

Answer 2

COMBINATION topical therapy - antibiotic*, retinoids, benzoyl peroxide

Question 3

3rd line acne management?

Answer 3

Oral antibiotics

Question 4

Oral antibiotics for acne?

Answer 4

Tetracyclines - lymecycline, oxytetracycline, doxycycline
Erythromycin* if pregnant

Question 5

Max length for oral antibiotic for acne?

Answer 5

3 months

Question 6

2 rules of combining therapies in acne management?

Answer 6

Don’t use oral + topical antibiotics
Always co-prescribe topical retinoids + benzoyl peroxide with oral antibiotics to reduce antibiotic resistance

Question 7

Alternative to oral antibiotics in women?

Answer 7

COCP

Question 8

Considerations for COCP in women for acne?

Answer 8

Not longer than 3 months, must counsel about increased risk of VTE (this may just be Dianette?/co-cyrindiol)

Question 9

Dietary modifications for acne?

Answer 9

NONE

Question 10

Last line treatment for acne?

Answer 10

Oral isotretinoin under specialist supervision

Question 11

Full management structure for acne vulgaris?

Answer 11

1st line - single topical - retinoids + benzoyl peroxide
2nd line - combination topical - antibiotic + retinoids + BP
3rd line - oral antibiotics (tetracycline or erythromycin if preg), COCP in women
4th line - oral isotretinoin (specialist supervision)