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Acne

Emergency department referrals

All urgent cases must be discussed with the on call Surgical Registrar to obtain appropriate prioritisation and treatment. Contact through:

    Urgent cases accepted via phone must be accompanied with a written referral and a copy faxed immediately to the Central Patient Intake Unit: 1300 364 952.

    Does your patient wish to be referred?

    Minimum referral criteria

    Does your patient meet the minimum referral criteria?

    Category 1

    Appointment within 30 days is desirable

    Appointment within 30 days is desirable
    No category 1 criteria

    Category 2

    Appointment within 90 days is desirable

    Appointment within 90 days is desirable

    • Extensive facial and body acne
    • Presence of nodular or cystic changes
    • Inflammatory acne
    • Severe emotional disturbance related to acne

    Category 3

    Appointment within 365 days is desirable

    Appointment within 365 days is desirable

    • Moderate facial or body acne not responding to at least 3 months medical therapy

    If your patient does not meet the minimum referral criteria

    Consider other treatment pathways or an alternative diagnosis.

    If you still need to refer your patient:

    • Please explain why (e.g. warning signs or symptoms, clinical modifiers, uncertain about diagnosis, etc.)
    • Please note that your referral may not be accepted or may be redirected to another service

    Other important information for referring practitioners

    Not an exhaustive list

    • Refer to HealthPathways for assessment and management information if available

    Lifestyle changes

    • Advise re general skin care
      • Avoid overuse of alcohol based skin cleansers
      • Advise against smoking
      • Encourage healthy lifestyle

    Medical management

    • Encourage patient to persevere with acne medication for at least 3 months before considering changing treatment.
    • Select logical regimen of medications starting with topical agents before initiating systemic medication.
    • Base choices on predominant type of acne present

      • Use benzoyl peroxide creams or gels
      • Retinoid creams and gels
        • Tazarotine
        • Adapalene
        • Isotretinoin
        • Tretinoin
      • Azelaic acid
        • Safe in pregnancy, useful in post inflammatory hyperpigmentation
      • Fruit acid gels

      • Antibiotic topical gels/creams
        • Erythromycin gels
        • Clindamycin lotion
        • Zindaclin
      • Oral antibiotics
        • Tetracycline based (doxycycline, minocycline)
        • Erythromycin
        • Co-Trimoxazole
      • Retinoids
        • Only by Specialist prescription
      • Hormonal
        • Cyproterone acetate containing  oral contraceptives (e.g. Diane 35)
      • Prescribing considerations by group

      • Dries skin
      • Bleaches towels
      • Causes minor skin inflammation

      • Minor skin drying

      • Skin drying and peeling
      • Inflammatory reactions
      • Increases potential for sunburn (use at night)

      • Tetracycline
        • Increased pigmentation after sun exposure
        • Increased pigmentation in scarred area especially in darker skinned races
        • Dizziness
        • Interaction with OCP initially
        • Including potential for thrush in women
        • Do not use in combination with oral isotretinoin
        • GI side effects
        • Unsafe in pregnancy
      • Erythromycin
        • GI side effects
        • Initial interference with OCP
        • Including potential for thrush in women
      • Co-Trimoxazole
        • GI side effects
        • Rashes (Stevens Johnson syndrome rarely)
        • Interference with OCP

      • Causes redness and peeling of skin especially around lips
      • Increases sun sensitivity
      • Highly teratogenic
        • Ensure 2 forms of contraception used in females
        • Ensure patient understands need for TOP if pregnancy ensues while taking isotretinoin

    Referral requirements

    A referral may be rejected without the following information.

    Essential referral information

    • Reason for referral e.g. cystic changes, scarring, inflammatory acne.
      • Consideration for isotretinoin treatment
    • History of condition
      • Duration of acne
      • Age of onset
      • Extent of acne
        • Evidence of chronic scarring, inflammation or cystic changes
      • Any emotional considerations e.g. depression etc.
    • Treatments trialled and reasons for failure
    • If previously seen by dermatologist include last two letters
    • Current medication and allergies
    • Other significant medical conditions

    Additional referral information (useful for processing the referral)

    • Family history of severe acne
    • Related co-morbid disorders e.g. PCOS

    Out of catchment

    Metro North Health is responsible for providing public health services to the people who reside within its boundaries. Special consideration is made for patients requiring tertiary care or services that are not provided by their local Hospital and Health Service. If your patient lives outside the Metro North Health area and you wish to refer them to one of our services, inclusion of information regarding their particular medical and social factors will assist with the triaging of your referral.

    • Impact on employment
    • Impact on education
    • Impact on home
    • Impact on activities of daily living
    • Impact on ability to care for others
    • Impact on personal frailty or safety
    • Identifies as Aboriginal and/or Torres Strait Islander

    • To establish a diagnosis
    • For treatment or intervention
    • For advice and management
    • For specialist to take over management
    • Reassurance for GP/second opinion
    • For a specified test/investigation the GP can’t order, or the patient can’t afford or access
    • Reassurance for the patient/family
    • For other reason (e.g. rapidly accelerating disease progression)
    • Clinical judgement indicates a referral for specialist review is necessary

    • Presenting symptoms (evolution and duration)
    • Physical findings
    • Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment
    • Body mass index (BMI)
    • Details of any associated medical conditions which may affect the condition or its treatment (e.g. diabetes), noting these must be stable and controlled prior to referral
    • Current medications and dosages
    • Drug allergies
    • Alcohol, tobacco and other drugs use

    • Full name (including aliases)
    • Date of birth
    • Residential and postal address
    • Telephone contact number/s – home, mobile and alternative
    • Medicare number (where eligible)
    • Name of the parent or caregiver (if appropriate)
    • Preferred language and interpreter requirements
    • Identifies as Aboriginal and/or Torres Strait Islander

    • Full name
    • Full address
    • Contact details – telephone, fax, email
    • Provider number
    • Date of referral
    • Signature

    • Willingness to have surgery (where surgery is a likely intervention)
    • Choice to be treated as a public or private patient
    • Compensable status (e.g. DVA, Work Cover, Motor Vehicle Insurance, etc.)

    Send referral

    Hotline: 1300 364 938

    Medical Objects ID: MQ40290004P
    HealthLink EDI: qldmnhhs

    Mail: 
    Metro North Central Patient Intake
    Aspley Community Centre
    776  Zillmere Road
    ASPLEY QLD 4034

    Health pathways

    Access to Health Pathways is free for clinicians in Metro North Brisbane.

    For login details email:
    healthpathways@brisbanenorthphn.org.au

    Login to Brisbane North Health Pathways:
    brisbanenorth.healthpathwayscommunity.org

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