What are the GEA acne severity grades?

GEA 0: clear; GEA 1: almost clear (few scattered comedones, rare inflamed papule); GEA 2: mild (easily recognizable lesions, few inflammatory lesions); GEA 3: moderate (numerous comedones and papulopustules); GEA 4: severe (widespread + nodules); GEA 5: very severe (extensive inflammatory + nodules + cysts).

What is the first-line treatment for mild-moderate acne?

EDF/BAD guidelines: fixed combination adapalene 0.1-0.3% + benzoyl peroxide 2.5% (Epiduo) for all acne grades; benzoyl peroxide prevents antibiotic resistance; topical retinoids alone for comedonal acne; add oral antibiotic for moderate-severe inflammatory acne.

How long should oral antibiotics be used for acne?

Maximum 3-6 months oral antibiotic (doxycycline 100 mg/day or lymecycline 408 mg/day); never use oral antibiotic monotherapy; always combine with BPO; review at 3 months; tetracyclines first-line; avoid minocycline (drug-induced lupus, hyperpigmentation).

When should female patients be offered combined OCP for acne?

Combined OCP (ethinyl estradiol + anti-androgenic progestogen: cyproterone acetate, drospirenone, or desogestrel) for moderate-severe acne in females; requires no contraindications to estrogen; effective by 3-6 months; can combine with topical retinoids.

What is the mechanism of post-inflammatory hyperpigmentation in acne?

PIH results from melanocyte stimulation by inflammatory mediators; more common in Fitzpatrick types IV-VI; prevention: topical retinoids accelerate keratinocyte turnover; azelaic acid 20% reduces tyrosinase activity; sunscreen essential; fades over 6-24 months.

Acne Severity Grading and Treatment Algorithm (Leeds/GEA Scale)

Grades acne severity using the Leeds revised acne grading and Global Evaluation of Acne (GEA) scales, guides topical retinoid/benzoyl peroxide/antibiotic combination selection, and oral antibiotic duration limitation.

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Frequently Asked Questions

What are the GEA acne severity grades?

What is the first-line treatment for mild-moderate acne?

How long should oral antibiotics be used for acne?

When should female patients be offered combined OCP for acne?

What is the mechanism of post-inflammatory hyperpigmentation in acne?