Acne Vulgaris

Gary I. Levine, MD Reviewed 06/2018
 


BASICS

DESCRIPTION

  • Acne vulgaris is a disorder of the pilosebaceous units. It is a chronic inflammatory dermatosis notable for open/closed comedones, papules, pustules, or nodules.

  • Systems affected: ski...

DIAGNOSIS

HISTORY

  • Ask about duration, medications, cleansing products, stress, smoking, exposures, diet, and family history.

  • Females may worsen 1 week prior to menses.

PHYSICAL EXAM

  • Closed comedones (whit...

TREATMENT

  • Comedonal (grade 1): keratinolytic agent (see as follows for specific agents)

  • Mild inflammatory acne (grade 2): benzoyl peroxide or topical retinoid or benzoyl peroxide +/− topical antibiotic...

ONGOING CARE

FOLLOW UP RECOMMENDATIONS

Use oral or topical antibiotics for 3 months; taper as inflammatory lesions resolve. 

DIET

Data suggests that high-glycemic index foods and skim milk may influence ...

REFERENCES

1 Chien AL, Qi J, Rainer B, et al. Treatment of acne in pregnancy. J Am Board Fam Med.  2016;29(2):254–262.  [View Abstract]
2 Admani S, Barrio VR. Evaluation and treatment of acne f...

ADDITIONAL READING

  • Asai Y, Baibergenova A, Dutil M, et al. Management of acne: Canadian clinical practice guideline. CMAJ.  2016;188(2):118–126.  [View Abstract]

  • Fisk WA, Lev-Tov HA, Sivamani RK....

SEE ALSO

  • Acne Rosacea

  • Algorithm: Acne

CODES

ICD10

  • L70.0 Acne vulgaris

  • L70.4 Infantile acne

  • L70.1 Acne conglobata

  • L70.8 Other acne

ICD9

  • 706.1 Other acne

  • 706.0 Acne varioliformis

SNOMED

  • 88616000 Acne vulgaris (disorder)

  • 238744006 Comedonal acne

  • 422280...

CLINICAL PEARLS

  • Full results for changes in therapy take 8 to 12 weeks.

  • Decrease topical frequency to every day or to every other day for irritation.

  • Use BP every time a topical or oral antibiotic is us...

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