Acne vulgaris is an inflammatory disease of hair follicles caused by increased sebum production activated by hormones. Bacteria in hair follicles react with sebum to produce fatty acids that trigger inflammation and combine with keratin to form plugs. Symptoms include whiteheads, blackheads, papules, pustules, nodules and cysts on the face, back and shoulders. Treatment aims to reduce bacteria, sebum production, plugging and inflammation while preventing infection and scarring. Topical treatments include benzoyl peroxide and antibiotics while oral treatments include antibiotics and retinoids. Nursing care involves administering medications, educating patients, and monitoring for side effects and compliance.

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Acne Vulgaris Nursing Care Plan &
Management
Definition
Acne vulgaris is an inflammatory disease of the sebaceous follicles.
Risk Factors
Highest incidence at puberty
Genetics
Hormonal factors
Bacterial infection
Pathophysiology
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
dilated follicles.
Assessment/Clinical Manifestations/Signs and Symptoms
Closed comedones (i.e. whiteheads)
Open comedones (i.e. blackheads)

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Papules, pustules, nodules, cysts
Primarily appear on the face, shoulders, and upper back
Medical Management
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
acne.
Topical Pharmacologic Therapy
Benzoyl peroxide
Topical antibiotics
Systemic Pharmacologic Therapy
Antibiotics
Oral Retinoids
Hormone Therapy
Surgical treatment
Extraction of comedo contents
Drainage of pustules and cysts
Excision of sinus tracts and cysts
Intralesional corticosteroids for anti-inflammatory action
Cryotherapy
Dermabrasion for scars
Laser resurfacing of scars
Nursing Diagnosis
Impaired skin integrity
Deficient knowledge
Disturbed body image
Nursing Management
1. Administer prescribed medications, which may include acne products containing
benzoyl peroxide (explain that these products initially cause skin redness and

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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
twice daily.
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
pregnancy.