management of acne : part - 4

Management of Acne – 4Management of Acne – 4 where do we stand ? where do we stand ?

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Anti androgens in acneAnti androgens in acne

• Late onset acne not responding to Late onset acne not responding to conventional therapy for 3monthsconventional therapy for 3months

Steroids in acneSteroids in acne

• Acne fulminansAcne fulminans• Pyoderma facialePyoderma faciale• Acne conglobataAcne conglobata• Acne over malar areaAcne over malar area

Unconventional treatment for acneUnconventional treatment for acne

• MacrocomedonesMacrocomedones• OpencomedonesOpencomedones• Acne excorieeAcne excoriee• Nodulo cystic acneNodulo cystic acne

Isotretinoin -AcneIsotretinoin -Acne

Predicting response of IsotretinoinPredicting response of Isotretinoin

• Slow responseSlow response

• Macro comedones-(70%)Macro comedones-(70%)

• Nodular acne-(15%)Nodular acne-(15%)

• Unknown-(5%)Unknown-(5%)

• Deeper pustulesDeeper pustules

• Associated PCODAssociated PCOD

Isotretinoin –acne flare upIsotretinoin –acne flare up

• Occurs in <5%Occurs in <5%• Macro comedones :-two-thirdMacro comedones :-two-third• Nodular lesion :– one-thirdNodular lesion :– one-third

Acne needing investigation

• Lesions on the jaw line, facial hair, androgenic Lesions on the jaw line, facial hair, androgenic

type of hair loss, masculine body in femaletype of hair loss, masculine body in female

• Testosterone, DHEAS, AndrostenodioneTestosterone, DHEAS, Androstenodione

• Ultrasonography - lower abdomenUltrasonography - lower abdomen

Cystic acneCystic acne

• Cryotherapy- >7 daysCryotherapy- >7 days

• Aspiration & Intralesional steroid-<7 daysAspiration & Intralesional steroid-<7 days

ApproachApproach

• HistoryHistory

• Types of lesionsTypes of lesions

• Sequel of acneSequel of acne

• Presence of scarsPresence of scars

Management of Acne Part – 5 (Coming Soon) Management of Acne Part – 5 (Coming Soon)

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