Self Care Exam 2 Acne
What drugs induce acne?
(PIMPLES) Phenytoin Isoniazid Moisturizers Phenobarbital Lithium Ethionamide Steroids
Grade 0 Acne is defined by _____ inflammatory ____ noninflammatory lesions
0 0
Grade 2 Acne is defined by _____ inflammatory and _____ noninflammatory lesions
10-25 >1
Grade 1 Acne is defined by _____ inflammatory and no more than _____ noninflammatory lesions
<10 1
Grade 3 Acne is defined by _____ inflammatory and _____ noninflammatory lesions and no more than _____ nodular lesions
>25 10-25 1
Grade 4 Acne is defined by _____ inflammatory and ______ noninflammatory lesions and _____ nodular lesions
>25 >25 >1
What does this define? Acne due to oil-based makeups
Acne cosmetica
What does this define? Acne due to friction from something that rubs against the surface of skin such as chin straps, hats, headbands, etc.
Acne mechanica
What are all of the exacerbating factors of acne?
Acne mechanica (friction from skin rubbing against hats, headbands, etc) Acne cosmetica (acne due to oil based makeups) Occupational acne (working at high greasy places such as mcdonalds) Drug-induced acne (PIMPLES) Stress and emotional extremes (cortisol release) Hormonal alterations High-humidity environments and prolonged sweating Diet
What is the Generic Name for Differin Acne Gel?
Adapalene 0.1%
What are the Normal Adult Dose/Directions for Differin Acne Gel?
Apply to clean, dry skin 1-2 week titration AAA QHS Can take 4 - 6 weeks for full effect
What is the MOA of Benzoyl Peroxide?
Bactericidal- kills P. acnes Comedolytic- loosens plug to unclog pores Keratolytic- promotes softening and peeling of edipermis
What are the Normal Adult Dose/Direction for Clearasil Ultra Rapid Action Treatment Cream, Vanishing?
Begin with 2.5% product, Apply to clean, dry skin 3 day titration AAA daily to TID Increase strength to 5% after 1 week and 10% after 2 weeks Can take 4 - 6 weeks for full effect
What are the Normal Adult Dose/Direction for Neutrogena Clear Pore Cleanser/Mask?
Begin with 2.5% product, Apply to clean, dry skin 3 day titration AAA daily to TID Increase strength to 5% after 1 week and 10% after 2 weeks Can take 4 - 6 weeks for full effect
What are the Normal Adult Dose/Direction for Neutrogena On-the-Spot Acne Treatment, Vanishing Formula?
Begin with 2.5% product, Apply to clean, dry skin 3 day titration AAA daily to TID Increase strength to 5% after 1 week and 10% after 2 weeks Can take 4 - 6 weeks for full effect
What are the Normal Adult Dose/Direction for Oxy Spot Treatment, Vanishing?
Begin with 2.5% product, Apply to clean, dry skin 3 day titration AAA daily to TID Increase strength to 5% after 1 week and 10% after 2 weeks Can take 4 - 6 weeks for full effect
What are the topical nonprescription medications for the use of acne?
Benzoyl Peroxide Adapalene Salicylic Acid
What is the Generic Name for Clearasil Ultra Rapid Action Treatment Cream, Vanishing?
Benzoyl Peroxide 10%
What is the Generic Name for Oxy Spot Treatment, Vanishing?
Benzoyl Peroxide 10%
What is the Generic Name for Neutrogena On-the-Spot Acne Treatment, Vanishing Formula?
Benzoyl Peroxide 2.5%
What is the Generic Name for Neutrogena Clear Pore Cleanser/Mask?
Benzoyl Peroxide 3.5%
What is an open comedo also known as?
Blackhead
What type of acne lesion does this describe? Dilated hair follicle with open orifice to skin
Blackhead (open comedo)
_________ is a dilated hair follicle with open orifice to skin
Blackhead (open comedo)
What is a sign to look for when determining whether a patient has possible rosacea vs acne?
Blood vessels on nose
What are the Special Population with Adapalene?
Can't treat Children under 12 years old
What are the active ingredients in Proactive 3 Step Solution: Cleanse: Renewing Cleasner Tone: Revitalizing Toner Treat: Repairing Treatment
Cleanse = Benzoyl Peroxide (works but can get cheaper at any pharmacy) Tone = Glycolic acid (dead skin remover which doesn't do anything) Treat = Benzoyl Peroxide (works but can get cheaper else where) Allantoin (moisturizer doesn't treat acne)
What are the nonpharmacologic therapy options for the treatment of acne?
Cleanse the skin -clean gently gently 2 times daily -use mild soap or nonsoap cleanser -use hands or soft wash cloth, pat dry Minimize exacerbating factors -avoid touching skin -avoid friction producing clothing -choose oil free cosmetics -don't pick or squeeze lesions Maintain Hydration
What is a whitehead also known as?
Closed comedo
What type of acne lesion does this describe? Enlarged hair follicle plugged with sebum, skin cells and bacteria
Comedo
_________ is an enlarged hair follicle plugged with sebum, skin cells, and bacteria
Comedo
What are the prescription physical treatments for acne?
Comedo extractor Light therapy
What is the MOA of Salicylic Acid?
Comedolytic- loosens plug to unclog pores Keratolytic- promotes softening and peeling of epidermis
What is the MOA of Adapalene?
Comedolytic-loosens plug to unclog pores Keratolytic- promotes softening and peeling of epidermis Anti-inflammatory- decreases swelling and redness
How does stress and emotional extremed induce acne?
Cortisol release
What are the ADE associated with Benzoyl Peroxide?
Excessive redness, dryness, peeling, burning May bleach hair or fabric Sun sensitivity (wear sunscreen)
What are the ADE associated with Adapalene?
Excessive redness, dryness, peeling, burning Sun sensitivity (wear sunscreen)
What grade of Acne does this describe? No inflammatory or noninflammatory lesions
Grade 0 Acne (Clear skin)
What grade of Acne does this describe? Rare noninflammatory lesions (<10) with no more than one small inflammatory lesion
Grade 1 Acne (Almost clear skin)
What grade of Acne does this describe? Some noninflammatory lesions (10-25) with no more than a few inflammatory lesions (papules/pustules only, no nodular lesions)
Grade 2 Acne (Mild)
What grade of Acne does this describe? Up to many noninflammatory lesions (>25) and may have some inflammatory lesions, but no more than one small nodular lesion
Grade 3 Acne (Moderate)
What grade of Acne does this describe? Up to many noninflammatory lesions and inflammatory lesions, but no more than a few nodular lesions
Grade 4 Acne (Severe)
What Grades of Acne Severity can we treat with OTC?
Grades 1 and 2
Comedo is an enlarged ______ _______ plugged with sebum, skin cells, and bacteria
Hair follicle
What are the Clinical Pearls of Benzoyl Peroxide?
Have to titrate for 30 minutes first day, 1 hour second day, and then 1.5 hours third day
What are the physical treatments for acne?
Heat treatment Pore Strip Oil Absorbing Sheets Comedo Extractor Light therapy
What are the nonprescription physical treatments for acne?
Heat treatment Pore strip Oil absorbing sheets
Describe the pathophysiology of acne.
Increased production of androgens during adolescence leads to: -Increased sebum production -Increased turnover of follicular epithelial cells -Accelerated growth of P. Acnes -Inflammatory response Can occur on face, neck, back, chest, and shoulders
What are the ADE associated with Salicylic Acid?
Irritation Dryness
Nodules are large, painful, solid lesions that are _______ deep in the skin
Lodged
What are the goals of therapy for the treatment of acne?
Long term, continuous, and consistent treatment -prevent new lesions, prevent scarring and decrease morbidity associated with psychological implication -identify and avoid exacerbating factors -relieve physical and social discomfort Refer patients after 6 weeks of self-treatment or with diet change
What type of acne lesion does this describe? Initial lesion of acne not visible to the eye
Micro-comedo
_________ initial lesion of acne not visible to the eye
Micro-comedo
___________ is an initial lesion of acne not visible to the eye
Micro-comedo
What are all of the Non-inflammatory lesions?
Micro-comedo Comdeo (whiteheads and blackheads)
What is the indication of Salicylic Acid?
Mild acne
What is the indication of Adapalene?
Mild to moderate acne
What is the indication of Benzoyl Peroxide?
Mild to moderate acne
What are the Exclusions for Self-treatment of Acne?
Moderate to severe acne (Grades 3-4: presence of papules, pustules, nodules, cysts and/or scarring) Exacerbating factors (Comedogenic medications, mechanical irritation) Possible rosacea (red, rashy, bands on cheeks and nose, chin as well that mimics acne)
What type of acne lesion does this describe? Large, painful, solid lesions that are lodged deep in the skin (disruption and release of cellular contents into surrounding tissue)
Nodules
_______ are large, painful, solid lesions that are lodged deep in the skin (disruption and release of cellular contents)
Nodules
What are the Drug-Disease interactions with Adapalene?
None
What are the Drug-Disease interactions with Benzoyl Peroxide?
None
What are the Drug-Drug interactions with Adapalene?
None
What are the Drug-Drug interactions with Benzoyl Peroxide?
None
What are the Special Populations with Benzoyl Peroxide?
None
Whitehead is a dilated hair follicle with _________ opening to the skin
Obstructed
Counsel patient that is initiating acne treatment with adapalene.
Ok
Counsel patient that is initiating acne treatment with benzoyl peroxide.
Ok
Counsel patient that is initiating acne treatment with salicylic acid.
Ok
Blackhead is a dilated hair follicle with _______ orifice to skin
Open
What is blackhead also known as?
Open comedo
What type of acne lesion does this describe? Red and inflamed lesions
Papules
________ are red and inflamed lessions
Papules
What are all of the Inflammatory lesions?
Papules Pustules Nodules
Pustules are red and inflamed lesions filled with _____
Pus
What type of acne lesion does this describe? Red and inflamed, pus-filled lesions
Pustules
______ are red and inflamed lesions filled with pus
Pustules
Papules are ______ and ______ lesions
Red Inflamed
What is the Generic Name for Stridex Daily Care Acne Pads for Sensitive skin?
Salicylic Acid
What is the Generic Name for Oxy Cleansing Pads, Maximum Strength?
Salicylic Acid 2%
What are the oil producing glands responsible for acne?
Sebaceous glands
Comedo is an enlarged hair follicle plugged with _______, _______, and ______
Sebum Skin cells Bacteria
What are the Normal Adult Dose/Direction for Oxy Cleansing Pads, Maximum Strength?
Use as a cleanser, then rinsed off AAA daily to TID
What are the Normal Adult Dose/Directions for Stridex Daily Care Acne Pads for Sensitive skin?
Use as a cleanser, then rinsed off AAA daily to TID
What is closed a comedo also know as?
Whitehead
What type of acne lesion does this describe? Dilated hair follicle with obstructed opening to the skin
Whitehead (closed comedo)
_________ is a dilated hair follicle with obstructed opening to the skin
Whitehead (closed comedo)