Acne in women can be associated with depression or anxiety. The conditions may persist from the stage of adolescence and when a person transitions to an adult. Acne’s etiopathogenesis is caused by hormonal or genetic factors (Poli, 2017). Maintenance treatment is required and can take a long duration due to its medical evolution. Additional information that can confirm Janie has acne is the existence of comedones such as whiteheads and blackheads, papules and nodules seen on her face, and the skin being greasy in appearance.
The differential diagnosis for Janie is folliculitis and Rosacea because the symptoms she has are conforming to the two infections. The patient may be having Rosacea because she has facial flushing skin roughness that resembles acne. The other diagnosis related to folliculitis is the presence of pustules due to the presence of inflammatory cells within her hair follicles (Farah, 2016). The lab test results may reveal that the lumps present on her face may contain pus under her skin, with a swollen face, especially near the nose. From the acne infection knowledge, the differential diagnosis of acne that Janie is having may be provocative and rubbery responses of hair cavities.
The likely diagnosis for Janie is acne that is characterized by blackheads. The reason is that Janie has common spots around her T-face. That means she is suffering from a blockage of hair follicles, tiny holes in her skins found near the surface (Zang & Xu, 2021). Her sebaceous glands are not lubricating the hair to stop drying and there seems to be too much sebum production, which has mixed with her dead skin cells, forming a plug in the tiny holes. The suspected pathogens for acne which Janie suffers from is Propionibacterium acnes (P. acnes). The reason is that P. acnes is certain bacterium that lives in the skin and leads to infection of pimples. The frequency and severity of acne infection depend on the strain of the bacteria.
The desired treatment outcomes for Janie’s T-face’ acne are that there will be increased production of sebum, low visibility of psychological morbidity and resolution of lesions on her face. Benzoyl Peroxide’s application will remove the bacteria and remove dead skin cells that have clogged in Janie’s pores. However, she might have her skin bruised when the drug eliminates dead skin cells. That can lead to dryness, excessive peeling, and general irritation in her face.
Janie should be recommended to use common non-pharmacological therapies such as laser and light-based like Carex Day- Light Classic Plus, chemical peels, mechanical removal of the lesions, and slight dermabrasion. The above therapies will suit Janie since her acne may need attention for a long duration (Hazra, 2019). However, Janie should major in Fractional ‘micro needling’ radio frequency (FMRF) because it is beneficial for acne that affects her ‘T-face.’ Other non-pharmacological therapies that Janie can try are the application of apple cider vinegar and taking of Zinc supplements.
Pharmacotherapeutic plans for acne would differ for patients depending on the type of patient. Special groups of people such as children and pediatrics are prescribed according to specific regulatory laws (Hazra, 2019). The care plan and therapy would be different for the special population since the goals are not the same. For example, it is not logical to recommend mechanical removal of lesions on children since their skin might have long-term effects as it is under development (Zang & Xu, 2021). Additionally, on obstetrics, having the children apply chemical peeling would be endangering the lives of the unborn since pregnancy involves delicate handling of the unborn child.
Apart from Benzoyl Peroxide’s application, there are other medical prescriptions that Janie can use. The Pharmacotherapeutic plan aims to limit bacterial development and encourage unclogging of skin pores (Poli, 2017). The medical treatment can have side effects and therefore, Janie should proceed with caution when trying the following treatment. The non-prescription treatment for acne to use is soap and water. That ensures there is gentle cleansing of the face, and she should know soap and water usage should be no more than two times per day. She can also have cleansers such as glycolic acid, salicylic acid alongside the current Benzoyl peroxide she has been using (Zang & Xu, 2021). Other non-prescription treatment includes topical retinol creams that alter pimples’ formation, application of acetone that can remove clogged oil from her skin and herbal medicine.
Prescription drugs for treating acne that Janie may utilize include antibiotics that can be applied on top of the skin or taken orally, and it should be once per day. Antibiotics can be either systemic or topical and therefore, Janie should be encouraged to have topical clindamycin and erythromycin to eradicate her skin’s bacterial formation. Others are oral anti-inflammatory antibiotics such as doxycycline, tetracycline, and minocycline (Farrah, 2016). The antibiotics are supposed to be administered twice per day in the morning while the other one in the evening before she sleeps. Another solution would be by using retinoids for lowering acne infection by altering the way her skins sheds.
The clinically significant adverse effects and drug interaction for the agents described above include skin dryness and irritation caused by topical clindamycin when applied together with retinoids. Increased sensitivity to the sun where Janie might suffer from severe sunburns, dizziness by taking the antibiotics, and non-prescription treatment may alter her skin cell forms naturally (Zang & Xu, 2021). Additionally, the damage of some organs such as the tiny poles when the dosage is taken without adhering to the prescription, and severe birth defects if in any case, Janie uses it while pregnant.
To monitor Janie’s response to acne therapy, there is need to track the difference in her skin appearance in six weeks. During that time, there should be an improvement where the lesion’s visibility is expected to be low. The pimples around her ‘T-face’ should be moderate and expected to be completely out in three months (Poli, 2017). The other important thing to monitor is her body’s reaction to the non-prescription and prescription drugs. If the condition worsens at any given moment, Janie should visit the laboratory for further diagnosis as the antibiotics might be generating other complications in her body (Hazra, 2019). To ascertain whether the acne is over, there is a duration of three or six months where Janie should be presented for tests and other possible last therapies.
Janie should be counselled about some of pharmacotherapeutic plans; first, one of her parents or guardians is needed since she is a teenager. Janie and the parent/guardian need to be advised about what to do about her condition, and also it helps improve her psychological view on acne (Hazra, 2019). Lastly, counseling on the patient’s expectations is important as it will make her prepare for a long-term battle with acne only if she pays attention to the medication. From the analysis, Janie suffers from acne which can be treated by taking antibiotics, using therapies and other prescription information and it appears that the patient will benefit highly if she uses Benzoyl Peroxide.
References
Farrah, G., & Tan, E. (2016). The use of oral antibiotics in treating acne vulgaris: A new approach.Dermatologic Therapy, 29(5), 377-384. Web.
Hazra, M. (2019). A rational pharmacotherapeutic study of comparative safety among topical anti-acne 1% nadifloxacin monotherapy, 0.1% adapalene monotherapy, 0.025% tretinoin monotherapy, 1% nadifloxacin and 0.1% adapalene combination therapy and 1% nadifloxacin and 0.025% tretinoin combination therapy, in mild to moderate acne vulgaris, in tertiary care hospitals.International Journal of Basic & Clinical Pharmacology, 8(9), 8-14. Web.
Poli, F. (2017). Differential diagnosis of facial acne on black skin. International Journal of Dermatology, 51, 24-26. Web.
Zang, H., & Xu, Y. (2021). Effectiveness of CO2 laser therapy in treating acne depressed scar.Medicine, 100(3), e23732. Web.