Greater Glasgow and Clyde Medicines
Key to symbols The medicine should be initiated by, or on the advice of a specialist, but is suitable for continuation by a GP The medicine should only be used and prescribed by a specialist Indicates the preferred choice within a class or group of medicines
The medicine should be initiated by, or on the advice of a specialist, but is suitable for continuation by a GP
The medicine should only be used and prescribed by a specialist
Indicates the preferred choice within a class or group of medicines
13. Skin

13.6. Acne and rosacea

13.6.1. Topical preparations for acne

Preferred List
ERYTHROMYCIN AND ZINC ACETATE (ZINERYT) (topical solution)
CLINDAMYCIN AND BENZOYL PEROXIDE (DUAC) (GEL)
BENZOYL PEROXIDE
Total Formulary
AZELAIC ACID (Skinoren) (20% cream)

Prescribing Notes:

The 20% cream (Skinoren®) is used in the management of acne vulgaris.

BNF Link

CLINDAMYCIN AND TRETINOIN (TRECLIN) (gel)
ADAPALENE AND BENZOYL PEROXIDE (EPIDUO) (topical gel)

Restrictions: Restricted to the treatment of mild to moderate facial acne when monotherapy with benzoyl peroxide or adapalene is not considered appropriate.

BNF Link

CLINDAMYCIN (DALACIN T)

Prescribing Notes:

Available as a 1% topical solution or lotion

BNF Link

13.6.2. Oral preparations for acne

Preferred List
Preferred List First Line
LYMECYCLINE
CO-CYPRINDIOL

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.

BNF Link

ERYTHROMYCIN
Total Formulary
Specialist Only
ISOTRETINOIN

Restrictions: Restricted to use in hospitals, under specialist dermatological supervision.

BNF Link

TETRACYCLINE
MINOCYCLINE

Restrictions: Minocycline is reserved for patients who have failed on other tetracyclines.

Prescribing Notes:

Suitable for prescribing in patients with renal impairment (see BNF).

BNF Link

DOXYCYCLINE

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).

BNF Link

OXYTETRACYCLINE

13.6.3. Topical preparations for rosacea

Preferred List
METRONIDAZOLE (ROZEX) (0.75% CREAM, GEL)

Prescribing Notes:

Used in the treatment of rosacea (not acne)

BNF Link

Total Formulary
IVERMECTIN (cream)

Restrictions:

Restricted to the treatment of moderate to severe inflammatory lesions of rosacea where other topical treatments are unsuitable or ineffective.

BNF Link

AZELAIC ACID (FINACEA) (15% gel)

Prescribing Notes:

The 15% gel (Finacea®) preparation is for use in the treatment of rosacea. 

BNF Link

BRIMONIDINE (MIRVASO) (gel)

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.

BNF Link