Introduction & module overview

Acne and rosacea are common skin conditions that some people find merely troublesome but others find deeply distressing and even socially disabling. 

Acne is estimated to account for well over 3.5 million visits to primary care a year. Timely use of effective treatment provides relief and reduces the risk of long-term scarring.

Given that many patients with acne stop OTC or prescribed treatments too early and rosacea therapies are often not well understood, community pharmacists can play a greater role in the management of these two conditions. Better adherence with early treatment also contributes to antimicrobial stewardship by reducing the prescribing of long-term antibiotics.

Moderate-to-severe acne is one of the most common indications for long-term and/or repeated antibiotic use. Enabling patients to use first-line NICE treatments for 12 weeks can reduce subsequent antibiotic prescribing.

The potential for community pharmacists to extend their involvement in treatment is reflected in the UK picture, which is complicated by the fact that different arrangements exist for supply of treatments under PGDs and via pharmacist independent prescribers in different parts of England, Scotland and Wales. Moreover, these are likely to change as services continue to develop.

Although previously known as ‘acne rosacea’, rosacea is a different condition from acne. It is a chronic inflammatory skin disease associated with recurrent episodes of facial flushing, persistent erythema, telangiectasia, papules and pustules. It affects about 5 per cent of the population, mainly in the 30-50-year age group.

The available treatments target different aspects of the condition. Pharmacists need to be able to apply established diagnostic criteria to distinguish between mild, moderate and severe cases of acne and rosacea, determine which can be treated via the OTC, PGD or pharmacist independent prescribing (PIP) routes, and which require onward referral.