Acne

Source: CME talk by Dr Alexander Wong Shing Yip | Beacon medical group

Acne requires long term treatment: need to counsel patient

2 Main mechanisms

• Occlusion of pores
• Infection-inflammation cycle: cutibacterium acne

Consider these mechanisms in the treatment and what the drugs target.

Treatment options

Benzoylperoxide (BP) : Good basic and good for body odours

Some of the preparations are hard to find, and have to contact the compounding pharmacies.

Hormonal acne

• Worse during menses
• "All acne are hormonal"
• OCP, Spironolactone (off label)
• Winlevi (Clascoterone) --> inhibit sebum production, ↓ C. Acne, ↓ Hyperkeratinisation

PO Isotretinoin

Dr Alex personal formula

• Clindamycin topical short course
• Face wash: chlorhexidine: for cost
• Topical tretinoin
• Winlevi: BD 3/12 (if >12 y/o), usually 1 tube/month, avoid direct sun/heat exposure to tube