acne

Question 1

how to differentiate mild, moderate, and severe acne

Answer 1

mild - lesions confined to the “T-zone” - forehead, nasal bridge, chin

severe has scarring

moderate is in between

Question 2

medical treatment of mild acne - escalation pathway

Answer 2

• start with benzoyl peroxide 5% or topical retinoid (adapalene 0.1%)
• if no improvement, add the other after 6-12 weeks
• if its mainly inflammatory, use benzoyl peroxide 5% + clindamycin 1%

Question 3

topical retinoids are preferred for what type of acne

Answer 3

non-inflammatory lesions

Question 4

topical antibiotics are preferred for what type of acne

Answer 4

inflammatory lesions

Question 5

what are inflammatory acne lesions

Answer 5

• pustules
• red papules
• nodules
• cysts

Question 6

what are non-inflammatory acne lesions

Answer 6

open and closed comedoes

Question 7

name 2 topical retinoids for acne

Answer 7

tretinoin 0.025%

adapalne 0.1%

Question 8

application regimen for topical retinoids, counselling points (4)

Answer 8

• use every 2nd night after washing for 2 weeks, then progress to every night
• apply to whole area of skin affected by acne lesions
• wash off product in morning
• teratogenic in females, use protection

Question 9

counselling points for benzoyl peroxide 5%

Answer 9

• wash face before use

- follow instructions on bottle

Question 10

treatment options for moderate-to-severe acne - escalation pathway

Answer 10

antibiotics - doxycycline 100mg daily for 6/52, then continue if effective
OR
combined oral contraceptive pill - diane-35 (contains cyproterone) for at least 6/12

if no improvement at 6/12, change to a diff abx (erythromycine) OR add COCP

Question 11

acne - nonmedication advice (8)

Answer 11

do

• oil free sunscreen and make-up
• healthy diet with omega-3
• use low-irritant, non-soap, pH balanced cleanser

don’t

• pick at it
• follow extreme diets
• exfoliate
• use cheap soaps
• moisturise, unless using benzoyl peroxide

Question 12

what are comedones

Answer 12

hyperkeratinised bumps

Question 13

retinoids are chemically related to what vitamin

Answer 13

vitamin A

Question 14

how to choose a base medium for topical retinoids

Answer 14

use a cream for dry skin, gel for oily skin