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Adjunctive Acne Vulgaris Management

Management: Options for women
1. Oral Contraceptive with low androgenic Progestin
  1. Norgestimate
    1. Ortho-Cyclen
    2. Ortho Tri-Cyclen
  2. Norethindrone
    1. Norlutin
    2. Aygestin
  3. Desogestrel
    1. Desogen
    2. Ortho-Cept
  4. Ethynodiol Diacetate
    1. Demulen
    2. Zovia
2. Spironolactone
  1. Indications: Women with androgen hypersecretion
    1. Free Testosterone increased
    2. DHEA-S increased
  2. Dose: 50 to 200 mg orally daily
Management: Inflammatory Acne
1. Visible Light Therapy decreases inflammatory acne
2. Topical Corticosteroids
  1. Moderate to high potency agents (Triamcinolone or Clobetasol)
  2. Limit to short-term use (less than 14 days) only
3. Inflammatory lesions needing quick cosmetic therapy
  1. Indications
    1. Photo or modeling session
    2. Wedding or other life-event
  2. Technique
    1. Dilute Triamcinolone 10 mg/ml to 2-3 mg/ml
    2. Inject 0.1 cc into inflammatory acne lesion
    3. May repeat in 3-4 weeks up to one month
References
1. Habif (2004) Dermatology, Mosby, p. 162-94
2. Kaplan (2001) CMEA Medicine Lecture, San Diego
3. Parker in Noble (2001) Primary Care p. 758-60
4. Brown (1998) Lancet 351:1871
5. Feldman (2004) Am Fam Physician 69:2123
6. Gollnick (2003) J Am Acad Dermatol 49:S1

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This page was written by Scott Moses, MD. This page was last revised on 5/28/2009 4:00:39 PM. This page was last published on 3/22/2010. Please send comments and questions to the editor. Contact information may be found on the page About the Family Practice Notebook. These pages are best viewed with Microsoft Internet Explorer 6.0.