Acne Vulgaris Nursing Care Plan &
Acne vulgaris is an inflammatory disease of the sebaceous follicles.
Highest incidence at puberty
Acne eruptions are initiated by increased sebum production activated by
androgenic hormones. Sebum is secreted into dilated hair follicles containing
normal skin bacteria. The bacteria secrete the enzyme lipase, which reacts with
sebum to produce free fatty acids to trigger inflammation. At the same time,
keratin produced by the hair follicles combines with sebum to form plugs in
Assessment/Clinical Manifestations/Signs and Symptoms
Closed comedones (i.e. whiteheads)
Open comedones (i.e. blackheads)
Papules, pustules, nodules, cysts
Primarily appear on the face, shoulders, and upper back
The goals of management are to reduce bacterial colonies, decrease sebaceous gland
activity, prevent the follicles from becoming plugged, reduce inflammation, combat
secondary infection, minimize scarring and eliminate factors that predispose the person to
Topical Pharmacologic Therapy
Systemic Pharmacologic Therapy
Extraction of comedo contents
Drainage of pustules and cysts
Excision of sinus tracts and cysts
Intralesional corticosteroids for anti-inflammatory action
Dermabrasion for scars
Laser resurfacing of scars
Impaired skin integrity
Disturbed body image
1. Administer prescribed medications, which may include acne products containing
benzoyl peroxide (explain that these products initially cause skin redness and
scaling but that the skin adjusts quickly); topical agents, such as vitamin A acid;
and antibiotics such as tetracycline.
2. Provide client and family teaching
o Advise the client that heat, humidity, and perspiration exacerbate acne.
Explain that uncleanliness, dietary indiscretions, menstrual cycle, and
other myths are not responsible for acne.
o Explain that it will take 4 to 6 weeks of compliance with the treatment
regimen to obtain results.
o Instruct the client to wash his face gently (do not scrub) with mild soap
o Instruct the client not to squeeze blackheads, not to prop hands on or rub
the face, to wash hair daily and keep it off the face, and to use cosmetics
cautiously because some may exacerbate acne.
o nstruct the female client to inform her health care provider if she is
possibly pregnant. Some medication, such as systemic retinoic acid, have
teratogenic effects, therefore a pregnancy test is required prior to
treatment and strict birth-control measures are use throughout