Acne By Benji Ho - February 20th, 2016 | Updated February 20th, 2016 Some Tid-Bits
- Four factors lead to acne formation: increased sebum production, hyperkeratinization, propionibacterium acnes colonization, and inflammatory reaction.
Treatment Steps (from mild to severe)
- Comedones – Rx Topical Retinoids (Tretinoin, Adapalene, Tazarotene) – generally works about the same. For the following additional symptoms:
- Inflammation – Add Topical Non-Abx (Benzoyl Peroxide, Azelaic Acid) +/- Topical Abx (Clindamycin, Erythromycin)
- Nodules – Add Oral Abx (Erythromycin, Minocycline, Tetracycline)
- Last Resort – Rx Isotretinoin – Pregnancy category X
- Patients and providers need to register with iPledge (both males and females)
- For females, must be on 2 contraceptives for 1 month before, during, and 1 month after treatment.
- For females, must have 2 negative pregnancy test before starting therapy, one of which must be done at a CLIA-certified lab. During therapy, must have monthly pregnancy tests at a CLIA-certified lab.
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