Acne Vulgaris | Right Decisions

Right Decisions
Antimicrobial prescribing: NHS Forth Valley
Primary Care Guidance
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SKIN INFECTIONS
Acne Vulgaris

Please update your RDS mobile app to version 4.7.1

We are pleased to advise that deep linking capability, enabling users to directly download individual mobile toolkits, has now been released on the RDS mobile app. When you install the update, you will see that each toolkit has a small QR code icon the header area beside the search icon – see screenshot below. Clicking on this icon will open up a window with a full-size QR code and the alternative of a short URL for sharing with users. Instructions are provided.

You may need to actively install the update to install RDS app version 4.7.1 to see this improvement. Installing this update is also strongly recommended to get the full benefits of the new contingency arrangements – specifically, that if the RDS website should fail, you will still be able to download new mobile app toolkits.

To check your current RDS version, click on the three dots bottom right of the RDS app screen. This takes you to a “More” page where you will see the version number. To install latest updates:

On iPhones – go to the Apple store, click on your profile icon top right, scroll down to see the apps waiting to be updated and update the RDS app.

On Android phones – these can vary, but try going to the Google Play store, click on your profile icon top right, click on “Manage apps and device”, select and update the RDS app.

Please get in touch with ann.wales3@nhs.scot with any questions.

Acne Vulgaris

CKS Acne Vulgaris

Avoid concomitant use or oral and topical antibiotics.

Co-prescription of a topical retinoid or benzyl peroxide (BPO) with oral antibiotics reduces the risk of antimicrobial resistance.

Topical antibiotics alone (e.g. clindamycin) should not be used.

Resistance to P.acnes to erythromycin is much more common than with tetracyclines so avoid unless tetracycline contra-indicated (e.g. children < 12 years or pregnancy).

Drug details

Comedonal Acne - responds best to topical retinoids (e.g. Adapalene) or retinoids plus benzoxyl peroxide (BPO) (e.g. Epiduo)

Adapalene - Apply thinly OD

Epiduo - Apply thinly OD

Topical BPO + Clindamycin (Duac) - Apply thinly OD

Duration: 6-8 weeks

Reduce frequency if topical irritation occurs

Inflammatory Acne: Mild to moderate papulopustular disease may respond to topical therapy (see above). Add oral antibiotics if unresponsive to topical therapy.

2nd line:

Lymecycline 408mg OD

or

Doxycyline 100mg OD

6- 12 weeks

Severe nodulocystic disease: Start oral antibiotics (see above) and refer to dermatology.

Continue antibiotics until clinic review - if no response after 12 weeks, consider switching to alternative tetracycline or erythromycin