Acne is a common skin condition that affects most people at some stage in their life. The aims of acne treatment are to reduce or clear skin lesions and prevent scarring and psychological sequelae. Management of mild, moderate and severe acne is discussed, including topical treatments, antibiotics and isotretinoin.

There are many reasons why sexual health is not discussed during a general practice consultation, such as lack of time and possible embarrassment for both clinician and patient. However sexual health should be discussed with patients at any appropriate opportunity.

A summary of pharmacological treatment and management of common sexually transmitted and other genital infections including chlamydia, gonorrhoea, syphilis, genital herpes, trichomoniasis, bacterial vaginosis, non-specific urethritis, genital warts, candidiasis, pelvic inflammatory disease and epididymo-orchitis.

There is evidence that early use of insulin in people with type 2 diabetes is beneficial. At present insulin is under used in this group, but it should be part of the normal progression of disease management. When insulin is initiated it requires a team approach and close follow-up. The simplest starting regimen is the addition of intermediate acting insulin to existing oral medication.

Bronchiolitis is the most common lower respiratory tract infection seen in infants aged less than one year. The bronchiolitis season is on the horizon and we provide an update with an emphasis on differential diagnosis, treatment options, indications for referral and preventative strategies.
+ Caregiver advice for bronchiolitis

Influenza is a highly infectious acute respiratory disease. Influenza vaccination is the most effective protection. The vaccine is funded for those at high risk of influenza and its complications and recommended for most other people. Administration, dosage and safety are discussed.

While people continue to smoke, they must be aware of the health risk they pose to others. Second hand smoke is considered a significant contributor to disease and death. Some of the volatile components of cigarette smoke may also absorb into surfaces and pose a risk even when the smoker has left. In addition to encouraging people to quit, health professionals are well placed to educate smokers about minimising the risk to others.

Nicotine replacement therapy, nortriptyline, bupropion and varenicline are all effective aids for smoking cessation. These pharmacological treatments are compared and the risks and benefits are explained.

Nicotine replacement therapy (NRT) is not a magic cure but it is effective for smoking cessation when used correctly. It is important that sufficient NRT is used, the correct dose is prescribed and it is used for long enough. NRT is a safe treatment compared to the risks of smoking and it should be used in the way that best suits the needs of the patient.

• Upfront:- The isotretinoin debate
• Correspondence: Are fish oil supplements recommended during pregnancy? CVD and cholesterol