40.2 Acne Drugs
3 min read•june 18, 2024
Acne medications come in topical and oral forms, each targeting different aspects of acne formation. Topical treatments like and work locally, while oral medications like and provide systemic effects.
Nurses play a crucial role in patient education and monitoring. They must assess acne severity, teach proper application techniques, and watch for side effects. Patient education focuses on consistent use, realistic expectations, and managing potential skin irritation.
Acne Medications
Main types and mechanisms of action
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- Topical treatments target acne locally
- Retinoids (, ) normalize follicular keratinization prevents comedone formation and reduces inflammation
- has antibacterial properties reduces () and has mild and effects unclogs pores
- Topical antibiotics (, ) reduce P. acnes and inflammation
- is a keratolytic agent unclogs pores and has mild anti-inflammatory properties
- Oral treatments work systemically
- Oral antibiotics (tetracyclines, macrolides) reduce P. acnes and inflammation commonly prescribed are and
- Hormonal therapies (combined oral contraceptives, spironolactone) decrease androgen production and secretion
- Isotretinoin reduces sebum production normalizes follicular keratinization and has potent anti-inflammatory effects
Effectiveness and potential side effects
- Topical treatments
- Effectiveness for mild to moderate acne provides localized treatment may take several weeks to show improvement
- Side effects include skin irritation dryness peeling and redness benzoyl peroxide may bleach fabrics
- Oral treatments
- Effectiveness for moderate to severe acne provides systemic treatment may take several weeks to months to show improvement
- Side effects include gastrointestinal upset photosensitivity (antibiotics) hormonal side effects thromboembolism risk (hormonal therapies) dry skin and mucous membranes elevated liver enzymes hypertriglyceridemia (isotretinoin)
Key nursing considerations
- Patient assessment
- Evaluate acne severity and type (comedonal, inflammatory, nodulocystic)
- Assess for contraindications and drug interactions
- Medication administration
- Educate patients on proper application techniques for topical treatments
- Emphasize the importance of consistent use and patience for results
- Monitor for adverse effects and treatment response
- Special considerations for oral treatments
- Obtain baseline liver function tests and lipid panel before starting isotretinoin
- Counsel female patients on teratogenic risks and pregnancy prevention (isotretinoin, hormonal therapies)
- Advise patients on photosensitivity and sun protection (antibiotics)
Patient education plan
- Topical treatments
- Demonstrate proper application techniques start with a small amount and gradually increase as tolerated
- Apply to entire affected area not just individual lesions
- Use non-comedogenic and oil-free moisturizers (CeraVe, Neutrogena) and sunscreens (Elta MD, La Roche-Posay)
- Expect mild irritation and dryness which usually subsides with continued use
- Oral treatments
- Take medications as prescribed with food if needed to minimize gastrointestinal upset
- Use sun protection (SPF 30+) and avoid excessive sun exposure (antibiotics)
- Be aware of potential side effects and report any concerns to the healthcare provider
- For isotretinoin emphasize the importance of pregnancy prevention and monthly monitoring with pregnancy tests and contraception
- General advice
- Maintain a gentle skincare routine avoiding harsh scrubs or excessive washing
- Be patient as improvement may take several weeks to months
- Follow up with the healthcare provider regularly to assess progress and adjust treatment as needed
Key Terms to Review (67)
Accutane: Accutane, also known as isotretinoin, is a powerful medication used to treat severe, recalcitrant acne. It works by reducing the production of sebum, the oily substance that can clog pores and lead to acne breakouts, making it an effective treatment for those with persistent, hard-to-treat acne conditions.
Acne vulgaris: Acne vulgaris is a common skin condition characterized by the presence of comedones, papules, pustules, and sometimes cysts. It primarily affects areas with a high density of sebaceous glands such as the face, back, and chest.
Acnecycline: Acnecycline is an antibiotic used to treat severe acne by inhibiting bacterial protein synthesis. It belongs to the tetracycline class of antibiotics.
Adapalene: Adapalene is a topical retinoid used primarily for the treatment of acne. It modulates cell differentiation, keratinization, and inflammatory processes.
Adolescents: Adolescents are individuals in the transitional stage of development between childhood and adulthood, typically ranging from ages 10 to 19. This period is marked by significant physical, emotional, and psychological changes.
Anthracyclines/Antitumor Antibiotics: Anthracyclines are a class of antitumor antibiotics used in cancer therapy. They work by intercalating DNA, inhibiting topoisomerase II, and generating free radicals to kill cancer cells.
Antibiotics: Antibiotics are a class of drugs that are used to treat bacterial infections by either killing or inhibiting the growth of harmful bacteria in the body. They work by targeting specific structures or processes within bacterial cells, disrupting their ability to survive and replicate. Antibiotics play a crucial role in the management of various bacterial infections and are an essential component in the nursing process, drug administration, and the treatment of infections caused by bacteria, viruses, and fungi.
Atralin: Atralin is a topical gel containing tretinoin, used to treat acne by promoting cell turnover and preventing the formation of new acne lesions. It is typically applied once daily in the evening.
Azelaic acid: Azelaic acid is a naturally occurring dicarboxylic acid used topically to treat mild to moderate acne. It works by reducing inflammation and bacterial growth on the skin.
Azelex: Azelex is a topical cream containing azelaic acid, used primarily to treat mild to moderate acne. It works by killing bacteria that infect pores and decreasing the production of keratin, which can block pores.
Benzac: Benzac is a topical medication containing benzoyl peroxide, commonly used to treat acne. It helps reduce bacteria on the skin and decreases oil production.
Benzoyl peroxide: Benzoyl peroxide is a topical medication commonly used to treat acne. It works by reducing bacteria and causing the skin to dry and peel.
Benzoyl Peroxide: Benzoyl peroxide is a topical medication primarily used in the treatment of acne. It works by killing acne-causing bacteria, reducing inflammation, and promoting the drying and peeling of the skin to unclog pores. Benzoyl peroxide is a versatile compound that is also used in the management of other dermatological conditions and as a topical antiseptic for burns.
Cleocin: Cleocin, also known as clindamycin, is an antibiotic used to treat various bacterial infections. It inhibits bacterial protein synthesis by binding to the 50S ribosomal subunit.
Clindamycin: Clindamycin is an antibiotic used to treat various bacterial infections by inhibiting protein synthesis. It is commonly prescribed for skin, respiratory, and pelvic infections.
Comedogenesis: Comedogenesis is the process by which comedones, or acne lesions, form on the skin. It is a critical concept in understanding the development and treatment of acne, a common skin condition characterized by the appearance of blackheads, whiteheads, and inflammatory lesions.
Comedolytic: Comedolytic refers to a class of drugs or ingredients that help prevent and treat acne by reducing the formation of comedones, which are clogged hair follicles and pores that can lead to blackheads and whiteheads. These agents work by breaking down the plugs within the pores, allowing for improved skin clearance and reduced acne lesions.
Comedones: Comedones are small, plugged sebum-filled follicles that are the primary lesions of acne. They are the precursor to the development of inflammatory acne lesions and can appear as either open comedones (blackheads) or closed comedones (whiteheads).
Differin: Differin, also known as adapalene, is a topical retinoid used to treat acne. It works by modulating skin cell turnover and reducing inflammation.
Doxycin: Doxycin is an antibiotic medication primarily used to treat acne and other bacterial infections. It belongs to the tetracycline class of antibiotics.
Doxycycline: Doxycycline is a broad-spectrum tetracycline antibiotic used to treat a variety of bacterial infections, as well as certain viral and fungal infections. It is commonly employed in the context of antibiotics, antiviral/anti-COVID-19 drugs, and antifungal medications, and also plays a role in the treatment of sexually transmitted infections and acne.
Doxycycline hyclate: Doxycycline hyclate is a tetracycline antibiotic used to treat bacterial infections, including acne. It works by inhibiting protein synthesis in bacteria, thereby stopping their growth.
Erythromycin: Erythromycin is a macrolide antibiotic used to treat a variety of bacterial infections. It works by inhibiting bacterial protein synthesis, preventing the growth and spread of harmful microorganisms. Erythromycin's versatility makes it an important drug in the treatment of conditions related to calcium channel blockers, statins, ocular anti-inflammatories and anti-infectives, as well as acne drugs.
Finacea: Finacea is a topical gel containing azelaic acid, used primarily to treat inflammatory papules and pustules associated with mild to moderate rosacea. It also has applications in treating acne due to its antibacterial and anti-inflammatory properties.
Finevin: Finevin is a topical medication used for the treatment of acne. It primarily works by reducing inflammation and killing acne-causing bacteria.
Follicular Hyperkeratinization: Follicular hyperkeratinization is a key pathological feature of acne, characterized by the abnormal thickening and accumulation of keratin, the main structural protein in the outer layer of the skin. This process leads to the formation of a plug or plug-like obstruction within the hair follicle, which can trap sebum, bacteria, and dead skin cells, ultimately contributing to the development of acne lesions.
Hormonal Influences: Hormonal influences refer to the regulatory effects of hormones on various physiological processes and functions within the body. Hormones are chemical messengers produced by the endocrine system that play a crucial role in maintaining homeostasis and coordinating the body's response to internal and external stimuli, including the development and treatment of acne.
Inflammatory Mediators: Inflammatory mediators are a diverse group of chemical signaling molecules that play a crucial role in the initiation, propagation, and resolution of the inflammatory response. These mediators are released by various cells, including immune cells, endothelial cells, and damaged tissue, and they orchestrate the complex cascade of events that characterize inflammation.
Isotretinoin: Isotretinoin is a synthetic vitamin A derivative used primarily in the treatment of severe, recalcitrant acne. It works by reducing sebum production, normalizing keratinization, and decreasing inflammation in the skin, leading to the clearing of acne lesions.
Keratolytic: Keratolytic refers to a class of compounds that act on the stratum corneum, the outermost layer of the skin, to promote the shedding or peeling of dead skin cells. These agents are commonly used in the management of various dermatological conditions, including acne, warts, and other skin disorders.
Lincosamide antibiotic: Lincosamide antibiotics are a class of antibiotics primarily used to treat bacterial infections by inhibiting protein synthesis. They are particularly effective against gram-positive bacteria and anaerobic organisms.
Lipid Profile: A lipid profile is a blood test that measures the levels of different types of lipids, or fats, in the bloodstream. These lipids include cholesterol, triglycerides, high-density lipoprotein (HDL), and low-density lipoprotein (LDL). The lipid profile provides important information about an individual's risk of developing cardiovascular disease and other health conditions related to lipid metabolism.
Minocin: Minocin is a brand name for minocycline, an antibiotic commonly used to treat acne. It belongs to the tetracycline class of antibiotics and works by reducing bacteria and inflammation.
Minocycline: Minocycline is a tetracycline antibiotic used primarily in the treatment of acne. It works by inhibiting bacterial protein synthesis, thereby preventing the growth and proliferation of acne-causing bacteria on the skin.
Minocycline hydrochloride: Minocycline hydrochloride is a tetracycline antibiotic used to treat various bacterial infections, including acne. It works by inhibiting protein synthesis in bacteria, thereby stopping their growth.
Oral Capsule: An oral capsule is a solid dosage form that contains a drug or medication enclosed within a dissolvable shell, typically made of gelatin or a synthetic polymer. Oral capsules are designed to be swallowed whole and deliver the active pharmaceutical ingredient (API) to the gastrointestinal tract for absorption into the systemic circulation.
P. acnes: P. acnes, also known as Propionibacterium acnes, is a bacterium that is commonly found on the skin and is a major contributor to the development of acne. It is a gram-positive, anaerobic bacterium that is part of the normal skin flora and plays a crucial role in the pathogenesis of acne vulgaris.
Panmycin: Panmycin is a brand name for tetracycline, an antibiotic used to treat various bacterial infections including acne. It works by inhibiting protein synthesis in bacteria, stopping their growth.
Papules: Papules are small, solid, elevated lesions on the skin that are typically less than 1 centimeter in diameter. They are a common feature in various skin conditions, particularly acne, and are often the primary manifestation of certain dermatological disorders.
Pediatric clients: Pediatric clients are children and adolescents who require medical care, including pharmacological treatments. Special considerations must be made for their unique physiological and developmental needs.
Pediatric dosage: Pediatric dosage is the specific amount of medication prescribed to children, taking into account their age, weight, and developmental stage. It ensures both efficacy and safety in treating various pediatric conditions.
Pregnancy Testing: Pregnancy testing refers to the various methods used to determine if a woman is pregnant, including detecting the presence of human chorionic gonadotropin (hCG), a hormone produced during pregnancy. These tests are crucial in the context of acne drug therapy, as certain medications can have adverse effects on fetal development and must be avoided during pregnancy.
Propionibacterium acnes: Propionibacterium acnes is a gram-positive, anaerobic bacterium that is a common inhabitant of human skin and is closely associated with the development of acne vulgaris. It is a key player in the pathogenesis of acne, contributing to inflammation and the formation of comedones.
Psychologic impact of acne: The psychologic impact of acne refers to the emotional and mental effects that acne can have on an individual, including stress, anxiety, and lowered self-esteem. It is a significant consideration when treating patients with dermatologic disorders.
Pustules: Pustules are small, pus-filled bumps that form on the skin, commonly associated with acne. They are a type of inflammatory lesion that develops when pores become clogged with oil, dead skin cells, and bacteria, leading to the accumulation of pus beneath the skin's surface.
Retin-A: Retin-A is a brand name for tretinoin, a topical retinoid used to treat acne. It works by promoting cell turnover and preventing the formation of new acne lesions.
Retinoids: Retinoids are a class of chemical compounds that are structurally and functionally related to vitamin A. They are known for their diverse therapeutic applications, particularly in the treatment of acne and psoriasis.
Salex: Salex is a topical medication containing salicylic acid used to treat acne and other dermatologic disorders. It works by exfoliating the skin and unclogging pores to reduce acne formation.
Salicylic acid: Salicylic acid is a beta-hydroxy acid (BHA) commonly used in dermatology for its exfoliating and anti-inflammatory properties. It is also utilized in various medical treatments, including the management of acne and other inflammatory skin conditions.
Salicylic Acid: Salicylic acid is a chemical compound that has been widely used in various medical and cosmetic applications, particularly in the context of acne treatment, management of other dermatological conditions, and as a topical agent for burns. This versatile compound has demonstrated its effectiveness in addressing a range of skin-related issues, making it a crucial component in various pharmaceutical and over-the-counter products.
Sebaceous Glands: Sebaceous glands are specialized exocrine glands found throughout the skin, except on the palms of the hands and soles of the feet. These glands produce an oily substance called sebum, which helps to lubricate and waterproof the skin and hair.
Sebum: Sebum is an oily substance produced by sebaceous glands in the skin. It helps to lubricate and waterproof the skin and hair.
Sebum-Suppressing: Sebum-suppressing refers to the ability of certain drugs or treatments to reduce the production and secretion of sebum, the oily substance produced by the sebaceous glands in the skin. This is a crucial mechanism in the management of acne, as excessive sebum production is a primary contributing factor to the development of acne lesions.
Sumycin: Sumycin is a brand name for the antibiotic tetracycline, used to treat bacterial infections, including acne. It works by inhibiting protein synthesis in bacteria, preventing their growth.
Systemic acne drugs: Systemic acne drugs are medications administered orally or via injection to treat moderate to severe acne by targeting underlying causes like hormonal imbalance, bacteria, and inflammation. These drugs work throughout the body rather than just at the site of acne lesions.
Tazarotene: Tazarotene is a topical retinoid used in the treatment of acne and psoriasis. It works by modulating skin cell proliferation and differentiation.
Tazorac: Tazorac is a brand name for tazarotene, a topical retinoid used primarily to treat acne and psoriasis. It works by affecting the growth of skin cells and reducing inflammation.
Teratogenicity: Teratogenicity refers to the ability of a substance, such as a drug or chemical, to cause developmental abnormalities or birth defects in a developing fetus. It is a crucial consideration in the context of various medical conditions and treatments.
Tetracycline hydrochloride: Tetracycline hydrochloride is an antibiotic commonly used to treat bacterial infections, including acne. It works by inhibiting protein synthesis in bacteria, thereby stopping their growth.
Topical acne medications: Topical acne medications are treatments applied directly to the skin to manage and reduce acne symptoms. They typically contain active ingredients such as benzoyl peroxide, salicylic acid, or retinoids.
Topical Gel: A topical gel is a semi-solid preparation that is applied to the skin or other external body surfaces. Topical gels are designed to deliver active ingredients directly to the site of application, often for the treatment of skin conditions like acne.
Tretinoin: Tretinoin is a topical retinoid derived from Vitamin A, commonly used in the treatment of acne. It promotes cell turnover and helps unclog pores to reduce acne lesions.
Vibramycin: Vibramycin is a brand name for doxycycline, a tetracycline antibiotic used to treat various bacterial infections. It is effective against acne, respiratory tract infections, and sexually transmitted infections.
Virasal: Virasal is a topical medication containing salicylic acid used to treat acne and other dermatologic disorders. It works by promoting the shedding of dead skin cells and reducing inflammation.
Xerosis: Xerosis, also known as dry skin, is a condition characterized by a lack of moisture and oil in the skin. It is a common dermatological issue that can lead to flakiness, itchiness, and an overall uncomfortable feeling in the affected areas.
Ximino: Ximino is a brand name for the antibiotic minocycline, used primarily to treat moderate to severe acne. It works by inhibiting bacterial protein synthesis, thus reducing inflammation and bacterial growth.
Zilxi: Zilxi is a topical foam formulation of minocycline, an antibiotic used for treating inflammatory lesions of rosacea. It is applied directly to the skin to reduce inflammation and bacterial growth associated with acne.