Acne vulgaris

Common age: adolescent age 12-25 years.

But it can affect newborns and old aged patients. 

Cause: hormone imbalance is the main cause for development of acne

Types:

1] comedones : white heads or black heads

(mild variety)

2] papulopustular acne are of moderate variety

3] nodulocystic acne is severe form of acne

4] acne fulminans and

5]pyoderma faciale 

last two forms of acne which require aggressive treatment.

How is this treated?

1] Topical treatments: 

Tretinoin 0.025% cream at bedtime is effective in most of patients.

Others: adapalene gel 0.1%, brevoxyl cream, niacinamide gel, clindamycin cream, glycolic acid cream

These creams are useful for mild to moderate acne.

2] systemic/ oral treatments:

Tab azithromycin 500mg once a day for 3 days in a week for 1-3 months

Tab doxycycline 100 mg once daily for 1-3 months.

Tab minocycline 50mg once daily 

Tab isotretinoin 0.5-1 mg/kg once daily for 1-6 months

(Isotretinoin treatment is very effective in reducing acne eruption but careful monitoring of liver function and lipid profile is advised). One more important note: Isotretinoin is contraindicated in pregnancy.

Nodulocystic acne can be treated with intralesional triamcinolone acetonide 10 mg/ml.

Treatment of acne fulminans:
Systemic steroids at the beginning to control inflammation and then start antibiotics or isotretinoin.