Case 1
Skin Care Routine
LM is a 16-year-old girl who comes to the pharmacy complaining of acne. She recently developed a few pimples on her forehead and chin. As a high school student, she is concerned about her skin and wants to improve it. She has mild acne, which consists of a few whiteheads and blackheads. Currently, she washes her face with regular soap but does not use any other skin care products.
Q: What recommendations do you have for LM?
A: LM appears to have mild acne, which typically consists of comedones (whiteheads and blackheads) with minimal inflammation. This type of acne can be managed effectively with OTC treatments. Two common options are benzoyl peroxide and salicylic acid. Benzoyl peroxide, available in strengths ranging from 2.5% to 5%, helps reduce bacteria and inflammation, making it an effective first-line treatment. Salicylic acid, available in 0.5% to 2% strengths, works by gently exfoliating the skin and unclogging pores.1,2
About the Author
Rupal Patel Mansukhani, PharmD, FAPhA, NCTTP, is a clinical professor of pharmacy practice and administration at Ernest Mario School of Pharmacy at Rutgers, The State University of New Jersey, in Piscataway and a transitions-of-care clinical pharmacist at Morristown Medical Center in New Jersey.
Sneha Baxi Srivastava, PharmD, BCACP, CDE, is associate director of skills education at Rosalind Franklin University of Medicine and Science College of Pharmacy in North Chicago, Illinois. She is deeply passionate about embracing the pillars of lifestyle medicine, selfcare, effective communication, and inclusivity to create lasting positive health and wellness outcomes.
Because LM is new to acne treatments, she should begin with a lower-strength product to minimize the risk of irritation.
A proper skin care routine is essential for acne management. LM should establish a habit of washing her face twice daily, once in the morning and once in the evening, using a mild, nonirritating cleanser. After cleansing, she can apply a benzoyl peroxide or salicylic acid treatment. It is important to use a lightweight, oil-free moisturizer to prevent excessive dryness because some acne treatments can be drying. Additionally, she should apply sunscreen daily because acne treatments can make the skin more sensitive to the sun. If she remains consistent with her regimen, she should begin to see improvement within 4 to 6 weeks. If her acne does not improve or worsens, she may need to explore other options, such as adding a topical retinoid or consulting a dermatologist for further evaluation.1,2
Case 2
Persistent Breakouts
RD is a 22-year-old man who comes to the pharmacy looking for help to treat his acne. He reports experiencing persistent breakouts despite following a consistent skin care routine that includes benzoyl peroxide 5% for the past 3 weeks. Upon inspection, you notice redness and irritation on his skin.
Q: What recommendations do you have for RD?
A: Because RD has already been using benzoyl peroxide without satisfactory results, the next step would be adding adapalene 0.1% gel, an OTC topical retinoid. Adapalene works by promoting cell turnover, preventing clogged pores, and reducing inflammation. RD should continue using his benzoyl peroxide wash twice daily and apply a thin layer of adapalene in the evening. However, because adapalene can cause dryness and irritation, it may be beneficial for him to start by applying it every other night for the first 2 weeks. If his skin tolerates it well, he can increase the application to once daily.
