nemoci-sympt/DERMATOLOGIE/akne/piloti
Aeromedical Concerns - Akne a pilotování letadla
- Wear of protective aviation equipment
- Exacerbation of acne due to rubbing, pressure, exposure to hot and humid environments;
- Psychological factors
- Acne medications that are incompatible with flying duties
- Extended grounding due to a difficult or prolonged treatment course
- Lesions on the face may interfere with mask or respirator seal and helmet wear (chin straps).
- Lesions on the shoulder, chest, and back may cause discomfort and distraction when wearing restraint or parachute harnesses or with prolonged sitting.
- Prolonged rubbing or pressure against the skin can produce or exacerbate an eruption (mechanical acne) with striking inflammation
- Tropical acne may occur, typically after several months’ exposure to a hot, humid environment, can be a major cause of disability. Patients often feel quite ill with tropical acne, antibiotic therapy is not effective, and removal from the environment is often necessary as the only effective treatment.
The aeromedical summary:
- Extent of lesions, locations, and a description of current therapy - all medications including dosage, and frequency, and side effects.
- Comments addressing interference with use of aviation equipment.
- Dermatology consult if individual has recalcitrant moderate to severe inflammatory or severe/nodulocystic acne.
Není možné létat když:
- Acne is controlled on oral antibiotics
- Controlled by oral contraceptives
- Interferes with the wearing of flying equipment
- Waiver will not be granted if acne is controlled on isotretinonin (Accutane®) or minocycline.
Waiver Considerations.
FLYING CLASS TREATMENT OF ACNE POTENTIAL WAIVER
WAIVER AUTHORITY TREATMENT WAITING PERIOD AND SPECIAL REGULATIONS
FC I, IA
- Topical treatment
- Topical retinoids
- Tretinoin
- Adapalene
- Tazarotene
- Benzoyl peroxide
- Salicylic acid
- Azelaic acid
- Topical antibiotics
- clindamycin
- Erythromycin
- Sulfacetamide-sulfur
- Oral contraceptive (female only)
- Oral antibiotics
- Tetracycline
- Erythromycin
- Doxycycline
- Trimethoprim-sulfamethoxazole
- No documented adverse effects from medication
- No difficulty with wearing of aviation equipment
- 7-day ground trial
FC IIC
- Aviator does not have to wear helmet/mask on routine basis
- Minocycline is not approved for flying duties.
- Treatment with approved topical agents does not require a waiver.
- The local flight surgeon must confirm, however, there are no adverse effects and the disease itself does not interfere with use of aviation equipment or safe mission completion.
- Systemic maintenance agents such as
- Oral erythromycin
- Tetracycline
- Doxycycline
- Trimethoprim-sulfamethoxazole
- Require a waiver
- They are compatible with flying once it is confirmed that side effects are absent or acceptable in severity.
- Isotretinoin therapy
- Is not compatible with flying duties
- Would require prolonged grounding (usually 20 weeks) if used when clinically indicated.
- Oral contraceptives may be considered for women.
- In rare cases severe nodulocystic acne or scarring may require a categorical waiver to avoid routine use of a helmet or mask.
