13.6. Acne and rosacea
13.6.1. Topical preparations for acne
Prescribing Notes:
This preparation should be considered when Preferred List combination products are not suitable.
Restrictions:
Restricted to the treatment of mild to moderate facial acne when monotherapy with benzoyl peroxide or adapalene is not considered appropriate.
13.6.2. Oral preparations for acne
Prescribing Notes:
Brands include Dianette®. Contains a mixture of cyproterone acetate and ethinylestradiol in a 2000:35 part ratio. CSM advice (see BNF for full advice): Prescribers are reminded that the risk of venous thromboembolism is higher in women taking co-cyprindiol than those taking a low-dose combined oral contraceptive. It is licensed for severe acne and moderately severe hirsutism and should not be used solely for contraception though it is occasionally used as a contraceptive (unlicensed indication) when acne is present. It is contraindicated in those with a personal or close family history of venous thromboembolism.
Prescribing Notes:
Suitable for prescribing in patients with renal impairment and would be the preferred tetracycline choice for systemic treatment of acne in these patients (see BNF).
Restrictions:
Minocycline is reserved for patients who have failed on other tetracyclines.
Prescribing Notes:
Suitable for prescribing in patients with renal impairment (see BNF).
13.6.3. Topical preparations for rosacea
Prescribing Notes:
The 15% gel (Finacea®) preparation is for use in the treatment of rosacea.
Restrictions:
Restricted to use in patients with moderate to severe persistent facial erythema associated with rosacea.
Prescribing Notes:
It should be noted that this only provides symptomatic treatment for the erythema component and does not treat the rosacea directly.
Restrictions:
Restricted to the treatment of moderate to severe inflammatory lesions of rosacea where other topical treatments are unsuitable or ineffective.