acne

Question 1

what is acne

Answer 1

Acne is characterised by blockage and inflammation of the pilosebaceous unit (the hair follicle, hair shaft and sebaceous gland)

Question 2

what does acne present with?

Answer 2

It presents with lesions which can be non-inflammatory, inflammatory or a mixture of both (usually both)
o Non-inflamed lesions are known as comedones (present as whiteheads or blackheads)
o Inflammatory acne lesions include papules and pustules (5 mm or less in diameter)

Question 3

what are red flag symptoms of acne?

Answer 3

• Severe acne
• Acne which has failed to respond to OTC
treatment
• Immunosuppressed patients
• Children under 12 years
• Pregnancy or breastfeeding patients

Question 4

what is the life style advice for acne/

Answer 4

• To avoid over cleaning the skin (which may cause dryness and irritation) – twice daily with a gentle soap is sufficient
• If make-up, cleansers and/or emollients are used, non-comedogenic preparations with a pH close to the skin are recommended
• To avoid picking and squeezing spots which may increase the risk of scarring
• Treatment options may take up to 8 weeks to work and can irritate the skin at the beginning of treatment
• To maintain a healthy diet

Question 5

what is first line option for acne?

Answer 5

topical preparations containing benzoyl peroxide that vary in strength
o Sometimes these preparations can cause adverse effects e.g. redness, dryness and burning sensations. However, these effects usually subside over the course of treatment

Question 6

what is an alternative option?

Answer 6

Nicotinamide 4% gel (non-inflammatory) is an alternative product which may be suitable to use where first line treatment has failed in patients with mild/moderate acne

Question 7

what is acne rosacea?

Answer 7

This form of acne presents with no comedones but is diagnosed based on the person having persistent erythema and characteristic changes to their skin (pustules, papules and possible manifestations to the eye e.g. ocular rosacea)