Dermatology Book

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Acne Vulgaris Management

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  1. See Also
    1. Moderate Acne Vulgaris Management
    2. Severe Acne Vulgaris Management
  2. Exacerbating factors to avoid
    1. Medications that exacerbate acne
      1. Androgenic steroids (e.g. Danazol, Testosterone
      2. Corticosteroids
      3. Lithium
      4. Oral Contraceptives
      5. Isoniazid
      6. Phenytoin (Dilantin)
    2. Environment
      1. Hot
      2. Greasy (fast-food kitchen, garage)
    3. Oil based Cosmetics
      1. Cosmetics with Lanolin or petroleum jelly
      2. Oil based Shampoos or Sunscreens
    4. Emotional Stress
    5. Physical Pressure (acne mechanica)
      1. Tight chinstrap
      2. Helmet
  3. Myths (non-causes of Acne Vulgaris)
    1. Foods DO NOT worsen acne
      1. Pizza
      2. Nuts
      3. Sweets
      4. Chocolate
    2. Acne is not a result of poor hygiene
      1. Constant washing does not improve acne
      2. Scrubbing dries and irritates skin further
  4. General recommendations:
    1. Do not squeeze lesions
      1. Forces pus into Dermis
      2. Causes inflammation and scarring
    2. Limit washing face to 2-3 times per day
      1. Avoid abrasive soaps
      2. Gear soap to skin condition
        1. Skin dry: Purpose soap
        2. Skin oily: Dial soap
    3. Change cosmetics to water based products
    4. Change Oral Contraceptive
      1. Increase Estrogen (50ug Ethinyl Estradiol minimum)
      2. Decrease androgenic effects of Progestin
  5. References
    1. Habif (2004) Dermatology, Mosby, p. 162-94
    2. Parker in Noble (2001) Primary Care p. 758-60
    3. Brown (1998) Lancet 351:1871
    4. Feldman (2004) Am Fam Physician 69:2123
    5. Gollnick (2003) J Am Acad Dermatol 49:S1

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