Please enable JavaScript.

Coggle requires JavaScript to display documents.

Acne - Coggle Diagram

- - - - Closed: whitehead
        1st clinical sign of acne
        can rupture
      - Open: Blackhead
        dark-topped/content extruding
        relatively stable
- - - - Cosmatics
  - - - Systemic Agents
        
        oral antibiotics
        
        don't use as monotherapy
        prescribe with topical therapy
        
        tetracyclines are 1st line
        macrolides/Bactrim are alternatives
        
        oral BC
        
        women only
        
        contain ethinyl estradiol and norethindrone (think combined OBC)
        
        MOA based on antiandrogenic properties - decreases androgen production at the level of the ovary & increase sex hormone-binding globulin (binding free testosterone so it cannot bind)
        
        isotretinoin
        
        1st line in males for nodular/cystic acne
        Females will typically combine it with antiandrogenic agent
        
        MOA: metabolite of vitamin A
        reduce sebogenesis
        inhibit sebaceous gland activity
        inhibit growth of P. acnes
        reduce inflammation
        improve follicular epithelial differentiation
        
        iPLEDGE: teratogenic
        
        antisebum agents
        
        estrogens
        
        oral antiandrogens (e.g. cyproterone acetate & spironolactone)
        
        isotretinoin
        
        Oral corticosteroids
    - - Moderate papulopustular inflammatory: fixed-dose combination preferred
      - Alternatives (low strength)
        
        Blue-light monotherapy
        
        Combination form: erythromycin + tretinoin/isotretinoin
        
        oral zinc
      - First choice (high strength)
        
        Combination form: Adapalene + benzoyl peroxide
        
        Benzoxyl peroxide
        
        Topical retinoid
        
        Azelaiz acid
    - - First-line
        
        Topical retinoid: Adapalene
        
        Combination: Adapalene + benzoyl peroxide
      - Alternatives
        
        Azelaic acid
        
        Benzoxyl peroxide
  - - - Benzoxyl Peroxide
      - Topical Retinoids
      - Salicylic Acid
      - Isotretinoin
    - - Isotretinoin
      - Topical/oral Abx
      - Antiandrogens
      - Corticosteroids
      - Estrogens
    - - Topical/oral Abx
      - Isotretinoin
      - Benzoxyl Peroxide
    - - Intralesional corticosteroids
      - Oral corticosteroids
      - Topical/oral Abx