Case scenario

Imogen is a 15-year-old girl who comes into the pharmacy with her mother. She states that she started to develop acne about 1 year ago. Recently her acne has become worse and she is now embarrassed about the appearance of her skin. You notice that she has some comedones and a few pustules on her nose and chin. She wants to know what she can apply to clear up her pimples. Imogen has not previously used any products on her acne and is not on any other medicines.

Learning objectives

After successful completion of this CPD activity, pharmacists should be able to:

  • Identify and classify mild, moderate and severe acne
  • Summarise topical treatment options and non-pharmacological measures in the management of acne
  • Describe the topical treatment algorithm and when referral is appropriate.

Competency standards addressed (2016): 1.1, 1.4, 2.3, 2.4, 3.1

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Introduction

Acne vulgaris is defined as a chronic inflammatory disease of the pilosebaceous follicles of the skin, with comedones, papules, pustules, nodules and cysts.1 Comedones are keratin-filled plugs that can be described as open or closed. Closed comedones are commonly referred to as whiteheads while open comedones, also known as blackheads, appear as an open pore with a black plug; the black appearance is due to oxidisation of keratin plugs. Papules are comedones that have become inflamed forming small red lesions that may be tender to touch; pustules are also inflamed lesions and resemble whiteheads except they have a red ring around the bump and a white, yellowish tip caused by puss. If the acne becomes more inflamed, larger, redder, deeper nodules and cysts may develop. These very inflamed lesions can lead to sca

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