Extemporaneous compounding of some of the preparations listed should only take place at institutions where the competencies and equipment are available.

ACNE

Acne is an inflammatory condition of the pilosebaceous unit. Secondary changes can lead to scarring and inflammation

GENERAL MEASURES

Do not squeeze lesions.

Avoid greasy or oily topical products such as moisturisers that block the hair follicle openings.

Discourage excessive facial washing.

MEDICINE TREATMENT

• Benzoyl peroxide 5%, gel, apply at night to affected areas as tolerated. o Wash off in the morning. o If ineffective and tolerated, increase application to 12 hourly. o Avoid contact with eyes, mouth, angles of the nose and mucous membranes.

AND/OR

For inflammatory acne:

• Doxycycline, oral, 100 mg daily for 3 months.
  • Review patient after 3 months of treatment.

Topical retinoids

Indicated in non-inflammatory acne and where benzoyl peroxide is ineffective.

The main action is to control comedone formation.

Introduce topical retinoids gradually as a night-time application to limit skin irritant effects, which are worse if used during day (UVL aggravation).

Do not use topical retinoids in pregnant women.

• Tretinoin, topical, apply at night to affected areas for at least 6 weeks.
  • Review patient after 6 weeks’ treatment. o Minimise exposure to UV light.
  • Acne may worsen during the first few weeks.