Acne vulgaris
Last Updated: 2021-10-15
ICD11: ED80.Z
Last Updated: 2021-10-15
Author(s): Anzengruber F., Navarini A.
ICD11: ED80.Z
Pimples
Common, inflammatory disease of the skin regions rich in hair follicle glands.
Acne fulminans is considered a separate condition, as are multiple other forms of acne, differentiated by age of onset, clinic and/or underlying triggers.
Acne tarda is still prevalent in double-digit percentages, especially in women over 30 years of age.
Basic Therapy
Acne comedonica:
wash solution (benzoyl peroxide), topical retinoids (adapalene)
Acne papulopustulosa light:
wash solution (benzoyl peroxide), topical retinoids (adapalene), azelaic acid, topical antibiotics (erythromycin, clindamycin)
Acne papulopustulosa moderate:
wash solution (benzoyl peroxide), topical retinoids (adapalene), azelaic acid, topical antibiotics (erythromycin, clindamycin), oral tetracyclines (limecycline 300 mg daily, doxycycline 1x 100 mg , minocycline 50mg 2x daily for 12 weeks
Acne papulopustulosa severe:
Isotretinoin: low-dose (10-30mg daily), in severe cases use 1mg per kg body weight.
Consensus therapy algorithm of the German Acne Guidelines Group
light |
medium-difficult |
heavy |
|||
Akne |
comedonica |
papulopustulosa |
papulopustulosa |
papulopustulosa nodosa |
conglobata |
1st choice |
Topical retinoid |
Basic therapeutic Combination of basic therapeutic agents Basic therapeutic & topical antibiotic |
Combination of basic therapeutics Basic therapeutic & topical antibiotic Basic therapeutic & oral antibiotic |
Oral antibiotic & 1-2 basic therapeutics Oral antibiotic & azelaic acid |
|
Alternatives |
Azelaic acid |
Azelaic acid if necessary in combination with basic therapeutics or top. Antibiotics |
Azelaic acid & basic therapeutics oral antibiotic & azelaic acid |
Oral isotretinoin |
Oral isotretinoin |
Women |
s.o. |
s.o. |
Oral antiandrogenic contraceptive & 1st choice |
Oral antiandrogenic contraceptive & 1st choice |
Oral antiandrogenic contraceptive & 1st choice |
In case of pregnancy |
Azelaic acid |
Azelaic acid Top. Erythromycin & BPO |
Oral erythromycin & azelaic acid Oral erythromycin & BPO |
Oral erythromycin & azelaic acid & BPO |
Oral erythromycin & azelaic acid & BPO possibly oral prednisolone short-term |
Maintenance therapy |
Source: Nast, A. (2016). S2 guideline: treatment of acne. Awmf.org. Retrieved 1 June 2016, from http://www.awmf.org/leitlinien/detail/ll/013-017.html
Hormones - prescribed by gynaecologists
Chemical Peels
Pregnancy
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