Statewide referral criteria have been developed for this condition. For more information, please see the Department of Health :Acne
Introduction
This guideline relates to acne in paediatric
patients. Acne is a condition of psychological and medical significance which
is treatable. This guideline is to assist GPs to manage their patients in a
primary care setting until clinical thresholds indicate that tertiary care is
required. The Royal Children's Hospital (RCH) Acne Clinic aims to provide dermatology care for teenagers
with severe acne who are otherwise unable to access private dermatologist care.
When to refer
- Evidence of nodular/cystic or scarring acne
- Appropriate skin care measures, including
prescription topical treatments, have not been effective
- Patients with pustular acne who have failed 3 months
of oral antibiotics
- Patients for who the acne is causing significant
mental health issues or concerns
Wait time for appointments
Specialist Clinic wait times
Services available closer to home
There is no restriction on location, therefore
referrals are accepted from throughout Victoria. Face to face appointments are
preferred. Tele-health will be considered based on individual circumstances.
Statewide referral criteria must be met: Acne
- Treatment to date
- Impact of symptoms
- History of presenting complaint, associated
symptoms and risk factors
Specialist Clinics referral
Please complete the above and submit via:
- Facsimile (03)
9345 5034 or
- Email screferrals@rch.org.au
- Urgent
referral or clinical query call
ED or Registrar on-call
(03) 9345 5522
Suggested
- Address potential triggers which may include the
following; Diet i.e. > 500ml low fat milk per day; high GI; whey protein
supplements or shakes; Not washing out hair product; Changing the pillow case
less than once a week; Not showering after sweating; Squeezing or picking the
skin; Not removing make up
- Implement general skin care measures. Wash the
affected area with soap free wash morning and night i.e. QV Gentle Wash, CeraVe
Hydrating Cleanser. Consider adding a salicylic acid cleanser twice a week if the
skin is not improving i.e. La Roche Posay Effaclar Micro Peeling Purifying Gel
Cleanser, CeraVe Blemish Control Cleanser. Avoid oil based or occlusive
products. Minimise actives and reduce the number of products used
- Commence topical treatment as appropriate i.e.
topical retinoid, benzyl peroxide, clindamycin or a combination product
- Consider hormonal therapy for females with acne
and other problems around menstruation i.e. Yasmin, Yaz, Dianne/Brenda/Estelle
- If failed 8 weeks of topical treatment, commence
oral treatment i.e. Doxycycline 50mg- 100mg mane (8 years +); Erythromycin BD
(< 8 years age)
- Assess how much acne is affecting mental health
and self-esteem – may require more urgent referral to dermatology or a mental
health provider
Information for families
- Start prescription topical treatments slowly.
Apply to commonly affected areas two nights per week, increasing to every night
as tolerated. Wash off in the morning. If the skin becomes dry or irritated,
decrease the frequency of application
- Apply to completely dry skin. When applying
topical medications use the 5 dot method - place a small pea size amount of the
medication in each of the 5 locations on the face: mid forehead, each cheek,
nose and chin. The medication should be rubbed into the entire area
- After 30 minutes, apply a moisturising lotion or
cream over the top of the prescription cream i.e. CeraVe Lotion, Cetaphil
Lotion, QV Lotion or if very dry QV Cream, CeraVe Cream, La Roche Posay Lipikar
AP+M
Prescription topical and oral treatments
may cause increased sensitivity to the sun. Always apply a non- greasy light
sunscreen to exposed areas i.e. La Roche Posay Anthelios 50+, Ego SunSense
Ultra 50+, Neutrogena Ultra Sheer Fluid Sunscreen 50+.
Resources and links
The
development of this guideline
was coordinated by the Department of Dermatology. Guideline reviewed in February 2025.