RTS - Acne, Rosacea

Question 1

What is acne? Where does it affect? How is it categorised?

Answer 1

is a chronic inflammatory skin condition
- mainly affects face (99% of cases), back (60%) and chest (15%)

categorised by lesion type and severity

mild - mostly non-inflamed lesions, few inflammatory lesions

moderate - more widespread with increased number of inflammatory lesions

severe - widespread inflammatory lesions, scarring may be present

Question 2

What are the triggers for acne?

Answer 2

Polycystic ovary syndrome (PCOS) can increase level of male hormones in females

Chemicals e.g. halogenated hydrocarbons
Hormonal changes
Make up
Hair oil/products
Picking spots
Sweating heavily

Medicines
- phenytoin
- steroids
- lithium
- POC
- testosterone

Question 3

What are the symptoms of acne?

Answer 3

Red papules (may appear as darker spots in darker skin)
Blackheads
Pustules
Whiteheads
Greasy skin – T zone

Question 4

What is rosacea? What are the symptoms?

Answer 4

a skin condition that makes your skin look flushed or red

symptoms
- redness (blushing) across the nose, cheeks, forehead, chin, neck and chest that comes and goes
- burning and stinging sensations
- spots (papules and pustules)
- small blood vessels in the skin becoming visible
- enlarged nose

Question 5

How can rosacea be treated?

Answer 5

avoiding triggers
- alcohol, caffeine, cosmetic products, temperature

antibiotics
- tetracycline, doxycycline, erythromycin

Question 6

What are the treatment options for mild-moderate acne?

Answer 6

12 week course of:

Topical adapalene (0.1% or 0.3%) with topical benzoyl peroxide (2.5%)

Topical tretinoin (0.025%) with topical clindamycin (1%)

Topical benzoyl peroxide (3% or 5%) with topical clindamycin (1%)

Question 7

What preparations are suited for oily and dry skin?

Answer 7

Creams/lotions may be preferable for dry or sensitive skin

Less greasy gels may be preferable for oily skin

Question 8

What are the treatment options for moderate-severe acne?

Answer 8

12 week course of:

Topical adapalene (0.1% or 0.3%) with topical benzoyl peroxide (2.5%) od in evening

Topical tretinoin (0.025%) with topical clindamycin (1%) od in evening

Topical adapalene with topical benzoyl peroxide (od in evening) + oral lymecycline 408mg or oral doxycycline 100mg od

Topical azelaic acid (15% or 20%) bd + oral lymecycline 408mg or oral doxycycline 100mg od (oral tetracycline)

can use oral contraceptives in combination with topical agents as an alternative to systemic antibiotics

Question 9

Who should be in the pregnancy prevention programme? What should be done?

Answer 9

in child bearing people taking oral retinoids
- isotretinoin

effective contraception must be used for at least 1 month before starting tx, during and at least 1 month after stopping tx

oral POC not considered effective