MILD MODERATE SEVERE

Lampiran 2.

INITAL PHASE OF TREATMENT: INITAL PHASE OF TREATMENT:

INITAL PHASE OF TREATMENT
1st - Line Agents: 1st - Line Agents:
MILD: NO ORAL TREATMENT - Retinoic acid - Retinoic acid
Acne Vulgaris 1st - Line Agent: - Benzoyl peroxide - Benzoyl peroxide
- Topical retinoic acid 0.05% - 0.1% - Antibiotic topical - Antibiotic topical
- Mild non inflammation:
ADJUVANT THERAPY: Keratolytic agent (Salicylic Acid, Sulphur) +ORAL ANTIBIOTIC +ORAL ANTIBIOTIC
- Doxyciclin, Erytromycin, Others - Doxyciclin, Erytromycin, Others
Patient presents w/ complaints of acne - CIE (Communication, - Pregnant women / feeding baby:
ADJUVANT
Information, and Benzoyl peroxide
THERAPY:
Education)
- CIE If necessary
- Skin Care - Skin Care
- Skin Peeling - Skin Peeling Does acne improve after
If necessary YES
- Cosmeceutical - Keratolytic agent 6-8 weeks of treatment?
1 DIAGNOSIS - Cosmeceutical
(Nicotinamide, ABA,
NO ALTERNATIVE Zinc PCA,
Does acne (Nicotinamide, Does acne improve after
Does clinical presentation improve after ABA, Zinc PCA, 6-8 weeks of treatment?
YES
confirm acne? DIAGNOSIS Hypoallergenic and YES Hypoallergenic and
Non Comedogenic 6-8 weeks NO
Non Comedogenic
Sunscreen) of treatment? Sunscreen) NO

YES
NO
ADJUVANT THERAPY: ADJUVANT 2nd - Line Agents: 2nd - Line Agents:
- CIE (Communication, THERAPY: - Azelaic Acid - Triamcinolone acetonide inj i.l.
Information, and - CIE - Salicylic acid +ANTI ANDROGEN (FEMALE)
2nd - Line Agent:
2 EVALUATION Education) - Skin Care
+OTHER ORAL AB +ORAL ISOTRETINOIN (MALE)
- Azelaic Acid - Skin Peeling
- Skin Care
Categorize acne based on - Skin Peeling
- Keratolytic agent
- Cosmeceutical
type & severity - Cosmeceutical If necessary (Nicotinamide, If necessary
(Nicotinamide, ABA, ABA, Zinc PCA,
Zinc PCA, Does acne Hypoallergenic and Does acne improve after
YES
Hypoallergenic and improve after
Non Comedogenic 6-8 weeks of treatment?
TYPE/SEVERITY MILD MODERATE SEVERE Non Comedogenic YES Sunscreen)
6-8 weeks Does acne improve after
Sunscreen) YES
of treatment? 6-8 weeks of treatment?
Comedones <20 20 - 100 >100
NO
Papules/pustules <15 15 - 50 >50 ADJUVANT THERAPY: NO NO
- CIE (Communication, ADJUVANT
Nodule/cysts 0 <5 >5 Information, and THERAPY:
Education) 3rd - Line Agent: - CIE 3rd - Line Agents: 3rd - Line Agents:
Total <30 30 - 125 >125 - Skin Care - Topical retinoic acid + Benzoyl peroxide - Skin Care - Retinoic acid + Benzoyl peroxide - Retinoic acid + Benzoyl peroxide
- Skin Peeling - Topical antibiotics - Skin Peeling - Antibiotic topical - Antibiotic topical
- Keratolytic agent
- Cosmeceutical +OTHER ORAL AB +ORAL ISOTRETINOIN (FEMALE)
- Cosmeceutical
Patient Education (Nicotinamide, ABA, If necessary MAINTENANCE (Nicotinamide,
Zinc PCA, THERAPY ABA, Zinc PCA,
Hypoallergenic and - CIE Hypoallergenic and If necessary MAINTENANCE
Non Comedogenic - Skin Care Non Comedogenic THERAPY
Sunscreen) Sunscreen)
- Topical retinoic acid - CIE
Does acne low concentration - Skin Care
improve after (0.01% - 0.025%) - Topical retinoic acid
TREATMENT See page 3 NO YES CONSIDER low concentration
6-8 weeks - Cosmeceutical Does acne improve after
EXPERT NO YES (0.01% - 0.025%)
See page 2 of treatment? (Nicotinamide, ABA, 6-8 weeks of treatment?
REFERRAL - Cosmeceutical
Zinc PCA) (Nicotinamide, ABA,
Zinc PCA)

Indonesian Acne Expert Meeting - IAEM 2015.