Acne comedonicaL70.01

Form of Acne vulgaris with a predominant formation of comedones. It should be noted that acne comedonica may be caused by cosmetics in terms of acne venenata.

The transition to acne papulopustulosa is fluid.

The diagnosis "acne comedonica" is defined by the dominant type of efflorescence, the non-inflammatory comedones.

• Grade I: < 10 comedones/half of face
• Grade II: 10-25 comedones/half of face
• Grade III: 25-50 comedones/half of face
• Grade IV: > 50 comedones/face half.

In the seborrhoeic zones, especially on the face, shoulders and back, in the upper sternal region, there are disseminated comedones which are thickening towards the body axis (centrofacial, middle of the back); next to them, in lower expression or even missing, inflammatory red papules and papulo-pustules. Few blackheads define a light form, numerous blackheads define a severe form of acne comedonica.

• Especially vitamin A acid: For seborrhoeic skin 0.05% isotretinoin gel(Isotrex gel or cream) once in the evening or tretinoin 1-2 times/day in an ointment base (e.g. Cordes VAS) or as an alcoholic solution (e.g. 0.05%: airole solution), adapalene 0.1% (differin gel). For normal skin 0.05% isotretinoin (Isotrex) once/day in the evening or tretinoin 0.05% in cream base (e.g. Cordes VAS cream). For sensitive skin: Adapalene 0.1% (Differin Gel) or Azelaic Acid 20% (Skinoren) once/day in the evening. As an extended therapy, the retinoids mentioned above can be used in combination with azelaic acid 20% or benzoyl peroxide 2.5-10% (e.g. acne oxide gel 5-10%) in the evening. Chemical peeling if necessary. The acne toilet in treatment of an experienced cosmetician is recommended.

• Notice! Topical retinoids are suitable for a maintenance therapy due to their anticomedogenic effects which may reduce the formation of microcomedones.