Introduction:
Acne is one of the common skin conditions worldwide. It is medically known as Acne vulgaris. It is usually seen in puberty and adults equally. It appears with lesions typically appearing on the face, chest, and back. Being one of the front line service people of the healthcare sector, pharmacists, especially those who are preparing for competitive exams like OPRA, understanding the basics of these commonly seen conditions are essential. In this guide we will discuss the causes of acne, clinical significance, and therapy for this condition. It will include the details of pharmacology, dermatology, and patient counseling skills.
Understanding Acne Vulgaris
It is an inflammatory condition that happens due to the blockage of skin pores, excessive production of sebum,or due to any bacterial infection. Common clinical features of acne include:
- Presence of Blackheads and whiteheads
- filled with Pustules and papules, which are sometimes painful
- Presence of excess oil on the skin
- Chances of skin scarring in severe cases
The pathophysiology involves:
- Excessive production of sebum happens due to certain conditions like hormonal imbalance during puberty
- accumulation of dead skin cells which will eventually clogs the pores, which is known as Follicular hyperkeratinization
- Due to some Bacterial infection such as Cutibacterium acnes, acne can be formed
What are the types of acne?
| Type | description |
| Cystic acne | Deep, pus-filled nodules causing scarring |
| Fungal acne | Itchy, inflamed bumps caused by yeast overgrowth in hair follicles |
| Hormonal acne | Androgen-mediated sebum overproduction clogs pores |
| Nodular acne | Tender, deep lumps under the skin, often resistant to topical therapy |
Severity Classification
- Grade 1 (Mild): Mostly blackheads and whiteheads, few papules
- Grade 2 (Moderate): Multiple pustules on the face
- Grade 3 (Moderately Severe): Occasional inflamed nodules on back or chest
- Grade 4 (Severe Nodulocystic): Numerous painful nodules and pustules
Stepwise Treatment of Acne Vulgaris
1. General Measures
- Clean the skin with mild soap twice daily
- Patients should avoid scrubbing or picking lesions to prevent infection and scarring
- Gentle sunscreen or mild moisturizers should be used.
2. First-Line Treatment for Mild to Moderate Acne: Topical Therapy
- Topical retinoids (e.g., tretinoin, adapalene): Reduce comedone formation and inflammation
- Benzoyl peroxide: Antibacterial, prevents antibiotic resistance when used with topical antibiotics
- Topical antibiotics (e.g., clindamycin, erythromycin): Reduce bacterial load, always combined with benzoyl peroxide
3. Oral Therapy for Moderate to Severe Acne
- To reduce inflammation and bacterial infection oral antibiotics such as doxycycline, minocycline can be used for 3-4 months
- Patients should use oral isotretinoin which is an effective retinoid for severe acne. This therapy will reduce sebum production and inflammation. But before using the isotretinoin, liver function test and lipid monitoring should be done. It is highly contraindicated in pregnancy
- There are hormonal therapy for females:
Combined oral contraceptives with anti-androgenic properties
4. Treatment for Severe/Nodulocystic Acne
- Oral isotretinoin is the main therapy used to treat severe acne. It is often combined with adjunctive therapies to resist the recurrence
- Intralesional corticosteroids: Reduce inflammation in nodules
- Advanced therapies: Light-based treatments such as lasers or photodynamic therapy
5. Maintenance Therapy
After clearing acne, continuing topical retinoids with or without benzoyl peroxide is essential to prevent relapse.
Patient Counseling Points
Pharmacists play a vital role in counseling acne patients:
- They can counsel the patients to maintain compliance and use perfectly
- pharmacists should make it clear that the treatment will take 8–12 weeks to show results
Patients should avoid picking or squeezing lesions which will eventually cause scaring - Pharmacist can Recommend using gentle cleansers, moisturizers, and sunscreen
- Pharmacists should explain the side effects of treatment, especially with the oral isotretinoin to the patients
Conclusion
For pharmacy aspirants preparing for competitive exams like OPRA, it is crucial to understand the topics commonly discussed in the community. Some common skin conditions, like acne vulgaris, are a high-weightage topic for such exams. Pharmacists are the first line of healthcare service providers whom patients rely on for common, mild diseases.
Always consider that patient education and knowledge about standard therapies are essential for a pharmacist. The OPRA exam evaluates the knowledge of a pharmacist to practise in Australia safely and effectively.
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