A young person is having comedones and papulopustular acne over face and trunk and back. How will you manage the patient ?
systemic antibiotics are mainstay in the Rx of acne vulgaris. Tetracycline group is commonly prescribed of which more lipophilic antibiotics like doxycycline and minocycline are more effective. Topical Retinoids are comedolytic and anti inflammatory. They act by restoring the altered follicular keratinisation. Grade 1 acne - comedones, occasional papules Grade 2 acne - papules, comedones, few pustules Grade 3 acne - predominant pustules, nodules, abscesses Grade 4 acne- mainly pseudocysts, abscesses, widespread scarring Rx Grade 1- topical retinoids Grade 2 - depending on the type of predominant lesions present, combined use of topical benzyl peroxidase, retinoids, and antibacterials Grade 3- oral antibiotics Grade 4- oral retinoids,isotretinoin Reference Harrison20th edition pg 1208
Topical retinoic acid
Oral doxycycline + topical retinoic acid
Topical clindamycin
Oral retinoic acid
Anatomy of skin