ACNE

  • Can occur in infants and during puberty.
  • Most babies do not need any treatment. It gets better over 6 months time.
  • If any s/o infections or suspicion in a baby, do a swab for culture/ sensitivity and start oral flucloxacillin ( or clarithromycin if allergic) for a week

 

MANAGEMENT

  • Early treatment helps control acne symptoms and scarring
  • The therapy needs to be continued till disease process stops
  • Initial control of disease may take up to 8 weeks after continued treatment.

 

Diet changes

  • If a parent notices any particular food making acne worse, advise to avoid.

Cleansing skin

  • Cleansing with any mild soap and water may help by removing the oil from skin ( up to 2 times a day)
  • Repetitive cleaning may cause excessive drying of skin

 

  • Avoid oily or greasy face and hair creams as it worsens acne
  • Avoid squeezing the acne as it worsens the inflammation

 

Treatment options

MANY OF THE BELOW MEDICATIONS HAVE DELETERIOUS EFFECTS DURING PREGNANCY. MAKE SURE THE TEENAGER IS NOT PREGNANT.

 

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TOPICAL TREATMENTS (Retinoids and antibacterial applications)

  • use at least 8 weeks before changing

a) Retinoids ointments

  • First line of treatment
  • Start every alternate day and increase the dose as tolerated

example for retinoid ointments-

  • Tretinoin- 0.05 to 0.1% ointments . to apply once at night
  • Adapalene- 0.01% cream to apply at night

 

b) Antibacterial ointments

example-

Benzoyl peroxide with zinc-

  • Use twice daily
  • Lotions and body wash can be used in acne over chest/ back

Clindamycin/ erythromycin ointment

  • Use twice daily

 

ORAL MEDICATIONS

  • Used in severe cases or in the failure of topical management after 6-8 weeks
  • Oral antibiotics should be given with local retinoid treatment always
  • Use for 8 weeks at least and tape the dose

Examples

Tetracycline – ( in 12-17 years,: 500 mg twice daily for 3 months at least, up to 2 years)

Doxycycline – ( in children 12-17 years: 100 mg once daily)

Erythromycin – ( child age 1 month to 2 years- 250 mg once daily/ in children 12- 17 years: 500 mg twice daily)

 

Oral retinoid

  • 0.5 to 1 mg/kg/day in divided doses
  • The treatment goes on for 5 months
  • AVOID IN PREGNANCY

 

In the failure of above measure, refer to a dermatologist.

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