13.6. Acne and rosacea
13.6.1. Topical preparations for acne
This preparation should be considered when Preferred List combination products are not suitable.
The 20% cream (Skinoren®) is used in the management of acne vulgaris.
Restrictions: Restricted to the treatment of mild to moderate facial acne when monotherapy with benzoyl peroxide or adapalene is not considered appropriate.
Available as a 1% topical solution or lotion
13.6.2. Oral preparations for acne
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.
Restrictions: Restricted to use in hospitals, under specialist dermatological supervision.
Restrictions: Minocycline is reserved for patients who have failed on other tetracyclines.
Suitable for prescribing in patients with renal impairment (see BNF).
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).
13.6.3. Topical preparations for rosacea
Used in the treatment of rosacea (not acne)
Restricted to the treatment of moderate to severe inflammatory lesions of rosacea where other topical treatments are unsuitable or ineffective.
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.
It should be noted that this only provides symptomatic treatment for the erythema component and does not treat the rosacea directly.