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Terms in this set (181)

Management:
-Not a problem with washing, do not over-exfoliate or overdry
-Diet is controversial (low glycemic index may be better. avoid skim milk)
-Adhere to treatment plan

Therapies:
Benzoyl Peroxide: (BPO)
-MOA: antibacterial, comedolytic, mild anti-inflammatory
-Decreases P.acnes resistance to topical abx
-Combo with abx is synergistic
-Should almost always be a part of acne regimen
-ADRs: skin irritation, fabric bleaching

Topical retinoids
-MOA: Vitamin A derivatives that normalize follicular keratinization, clear existing comedomes, prevent new comedomes
-Best used as preventative all over the face
-Different strengths and vehicles
-Fringe anti-aging benefits
-ADRs: Irritation, dryness, photosensitivity. DO NOT use in pregnancy

Topical Abx:
-MOA: reduce P. acnes, mild anti-inflammatory
-Common: erythromycin, clindamycin, dapsone/aczone
-Many combo products with BPO
-ADRs: skin irritation, dryness

Systemic Abx: (moderate to severe inflammatory acne)
-Common: tetracycline (minocycline and doxycycline), erythromycin, bactrim (severe acne), amoxicillin (pregnancy)
-6 to 8 weeks for improvement
-Tetracycline class is the gold standard
-ADRs: GI upset (take with food), Pseudotumor cerebri, photosensitivity, esophagitis (don't lie down for 30 ), serum sickness-like reaction, drug-induced lupus, autoimmune hepatitis

Hormonal therapy (estrogen-containing OCPs)
-MOA: block ovarian production, reduce serum androgens, reduce free testosterone by increasing SHBG, decrease sebum production
-Common: ethinyl estradiol/norgestimate or drospirenone
-ADRs: N/V, weight gain, abnormal menses, migraine, increased risk fo thromboembolism

Spironolactone
-MOA: anti-androgen and blocks effects on skin
-ADRs: menstrual irregularity, breast tenderness, lightheadedness, hyperkalemia, DO NOT use in pregnancy

Isotretinoin (oral)
-MOA: retinoic acid derivative that targets all 4 of pathogenic factors involved in acne
-When to use: severe nodulocystic acne or acne that failed other therapies
-Treatment: 5 to 6 months
-ADRs: MAJOR birth defects (Ipledge program), xerosis, dry everything, muscle/joint aches/pains, hypertriglyceridemia, elevated LFTs, depression/anxiety exacerbation, pseudotumor cerebri, IBS (questionable)