Acne Vulgaris Treatment

Question 1

What is Mild Acne?

Answer 1

Mainly blackheads/whiteheads

A few papule/pustules may be present

Question 2

1st line in mild acne?

Answer 2

Topical Benzoyl Peroxide; OR
Topical Retinoid (e.g. isotretinoin - avoid in pregnancy)

Question 3

1st line acne if normal poorly tolerated?

Answer 3

Azelaic acid

Question 4

If poor response to 1st line mild acne treatments?

Answer 4

Topical Clindamycin/Erythromycin combined with topical Benzoyl Peroxide

Question 5

How long may it take for treatment to work in mild acne?

Answer 5

8 weeks

Question 6

What is moderate acne?

Answer 6

Mainly papules and pustules, affects face +/- torso

Question 7

1st line treatment in moderate acne?

Answer 7

Topical antibiotic (clindamycin/erythromycin) combined with topical Benzoyl Peroxide OR topical Retinoid

MAX 12 WEEKS

Question 8

2nd line in moderate acne

Answer 8

Oral antibiotic: tetracycline/oxytetracycline/doxycycline/lymecycline (erythromycin if pregnant)

Combined with topical Benzoyl Peroxide

Question 9

How long may 2nd line treatment in moderate acne take to see benefit?

Answer 9

4-6 months

Question 10

What treatment can be considered for women in moderate acne?

Answer 10

Combined Oral Contraceptive Pill with anti-androgen e.g. co-cyprindiol (Dianette)

Question 11

What is severe acne?

Answer 11

Nodules, cysts, scars, inflammatory papules and pustules, affects face, back and torso

Question 12

Management of severe acne?

Answer 12

Refer to specialist:

Oral Isotretinoin (reduces sebum + pituitary hormones)

Question 13

Side effects of isotretinoin?

Answer 13

TERATOGENIC

Dry skin and mucosal surfaces, joint pain, depression