>Acne
Causes People
with serious cases of acne tend to have a genetic predisposition or
sensitivity to the conditions that cause the outbreak of acne. Acne
is caused when hormones trigger your sebaceous glands. These are the
glands that produce oil. When they enlarge they produce excess oil
which results in acne. This can be triggered by any number of things
including:StressHormonal
Imbalances (usually occuring during adolescense but also occuring
during post menopause)Medications(oral contraceptives, topical steroids,
etc.)Oils (in skin creams and cosmetics which block pores)
Your skin is constantly renewing itself.
Skin cells die and the dead cells come to the surface and shed.
When the cells stick together they can block the skin's hair
follicles. When this happens a comedome is formed. Depending
on what transpires defines the type of blemish that develops.Blackheads
are formed when from open comedonesWhite
heads (pimples) are formed from closed comedonesPustulates
are when pimples come to a headDeep
Cysts can contain blood and can potential cause scaringRosacea
is indicated by enlarged blood vessels around the nose
General Care Be gentle to your skin. Avoid scratching, pickingTreatments Benzonyl Peroxide Benzonyl Peroxide is an oitment that
has been used for years. It comes in a number of different concentrations: Retin-A Tretinoin (Retin-A)
Retinoic acid (Retin-A)
Vitamin A acid (Retin-A)
Retin-A is a topical treatment that was originally developed by Dr.
Kligman to treat acne. It has since been found to be useful in a number
of other skin treatments. The active ingredient is vitamin A, hence
the name Retin-A.It promotes peeling of affected skin areas and unclogs
pores. Tretinoin controls acne but does not cure it.Topical tretinoin
is believed to decrease microcomedone formation by decreasing the
cohesiveness of follicular epithelial cells. Also believed to increase
mitotic activity and increase turnover of follicular epithelial cells
as well as decrease keratin synthesis. Some systemic absorption occurs
(approximately 5% is recovered in the urine).
The mechanism of action for PO use in acute promyelocytic leukemia
(APL) is not known. Absorption is enhanced when the drug is taken
with food. Time to peak levels: 1-2 hr. Is over 95% bound to plasma
proteins (mainly to albumin). Terminal elimination t1/2: 0.5-2 hr
in APL clients. Metabolized by the liver, with about two-thirds excreted
in the urine and one-third in the feces.
Special Concerns: Use with caution during lactation. Safety and effectiveness
have not been determined in children. Excessive sunlight and weather
extremes (e.g., wind and cold) may be irritating. Use Avita and Renova
with caution with concomitant topical medications, medicated or abrasive
soaps, shampoos, cleansers, cosmetics with a strong drying effect,
permanent wave solutions, electrolysis, hair depilatories or waxes,
and products with high concentrations of alcohol, astringents, spices,
or lime. Safety and efficacy of Renova have not been determined in
children less than 18 years of age, in individuals over the age of
50 years, or in individuals with moderately or heavily pigmented skin.
Use of the PO form has resulted in retonic acid-APL syndrome, especially
during the first month of treatment. The safety and efficacy of oral
tretinoin at doses less than 45 mg/m2/day have not been evaluated
in children.
Side Effects: Following topical use. Dermatologic: Red, edematous,
crusted, or blistered skin; hyperpigmentation or hypopigmentation,
increased susceptibility to sunlight, erythema, pruritus, burning,
dryness. Excessive application will cause redness, peeling, or discomfort
with no increase in results.
Following oral use. Retinoic acid-APL syndrome: Fever, dyspnea,
weight gain, radiographic pulmonary infiltrate, pleural or pericardial
effusions. Occasional impaired myocardial contractility and episodic
hypotension; possibility of concomitant leukocytosis. Progressive
hypoxemia with possible fatal outcome. Respiratory symptoms,
including upper respiratory tract disorders, respiratory insufficiency,
pneumonia, rales, expiratory wheezing, lower respiratory tract
disorders, bronchial asthma, pulmonary or larynx edema unspecified
pulmonary disease. Pseudotumor cerebri (especially in children):
Papilledema, headache, N&V, visual disturbances.
Typical retinoid toxicity (similar to ingestion of high doses of vitamin
A): Headache, fever, dryness of skin and mucous membranes, bone pain,
N&V, rash, mucositis, pruritus, increased sweating, visual
disturbances, ocular disorders, alopecia, skin changes, changed
visual acuity, bone inflammation, visual field defects. Body
as a whole: Malaise, shivering, hemorrhage, DIC infections, peripheral
edema, pain, chest discomfort, edema, weight increase, anorexia,
weight decrease, myalgia, flank pain, cellulitis, facial edema,
fluid imbalance, pallor, lymph disorders, acidosis, hypothermia,
ascites. GI: GI hemorrhage abdominal pain, various GI disorders,
diarrhea, constipation, dyspepsia, abdominal distension, hepatosplenomegaly,
hepatitis, ulcer, unspecified liver disorders. CV: Arrhythmias,
flushing, hypotension, hypertension, phlebitis, cardiac failure,
cardiac arrest, stroke MI, enlarged heart, heart murmur, ischemia,
myocarditis, pericarditis, pulmonary hypertension, secondary
cardiomyopathy. CNS: Dizziness, paresthesias, anxiety, insomnia,
depression, confusion, cerebral hemorrhage, intracranial hypertension
agitation, hallucinations, abnormal gait, agnosia, aphasia, asterixis,
cerebellar edema, cerebellar disorders, convulsions, coma CNS
depression, dysarthria, encephalopathy, facial paralysis, hemiplegia,
hyporeflexia, hypotaxia, no light reflex, neurologic reaction,
spinal cord disorder, tremor, leg weakness, unconsciousness,
dementia, forgetfulness, somnolence, slow speech. GU: Renal insufficiency,
dysuria, acute renal failure, micturition frequency, renal tubular
necrosis, enlarged prostate. Otic: Earache, feeling of fullness
in the ears, hearing loss, unspecified auricular disorders, irreversible
hearing loss. Other: Erythema nodosum, basophilia, hyperhistaminemia,
Sweet's syndrome, organomegaly, hypercalcemia, pancreatitis,
myositis.
Drug Interactions: Concomitant use with sulfur, resorcinol, benzoyl
peroxide, or salicylic acid may cause significant skin irritation.
Dosage
•Cream, Gel, or Liquid Acne vulgaris.
Apply lightly over the affected areas once daily at bedtime. Beneficial
effects many not be seen for 2-6 weeks.
•Cream, 0.025%, 0.05%, 0.1% Palliation for skin conditions.
Apply a pea-sized amount once daily at bedtime, using only enough
to lightly cover the entire affected area. Up to 6 months of therapy
may be needed before effects are seen.
•Capsules APL.
Adults: 45 mg/m2/day given as two evenly divided doses. Given until
complete remission is obtained. Discontinue 30 days after achieving
complete remission or after 90 days of treatment, whichever comes
first.
I. Definition:
Tretinoin skin preparations are a family of
drugs all similar to Vitamin A. In general, tretinoin gels are stronger
than tretinoin creams because the medicine penetrates better when
in a gel form. Tretinoin is used to treat acne and aged, sun damaged
skin. Tretinoin works best when used in combination with alpha hydroxyacid
preparations. If used over a period of years, tretinoin will continue
to reverse aging of the skin and can continue improving the skin’s
appearance even ten years after starting treatment.
A study in the Archives of Dermatology, May
1996, shows that 0.1% tretinoin significantly improves the appearance
of early stretch marks. Tretinoin works best on stretch marks that
are new or enlarging.
II. Action:
Unplugs acne follicles and brings acne pimples
(comedones) to the surface. This is why tretinoin makes acne look
worse in the first few weeks of treatment.
Will reverse some of the changes of photoaging. Causes lightening
of brown sun spots and leads to the disappearance of fine lines
and wrinkles.
Caution: Retin-A does not be used simultaneously with Benzoyl Peroxide Oral Antibiotics Oral antibiotics are available by prescription
only. One of the most popular antibiotics used for treating acne
is tetracycline. While tetracycline is effective, it increases your
skins sensitivity to the sun. If you are using tetracycline you
need to be very careful about exposing your skin to the sun. Extra
care should be taken by wearing sunscreens whenever you are outdoors.
Topical Antibiotics While some topical antibiotics can be
bought over the counter, the most effective ones are available by
prescription only.AHA (Alpha
Hydroxy Acid)AHA works as an exfoliant.
It comes in solutions concentrated from 5-70%.
Chocolate
Can Cause Acne [False] There is actually no evidence
that chocolate causes the skin to break out. This myth is used by
most mothers to stop their kids eating chocolate. Unfortunately it
is not correct. Dairy products are actually closer linked to breakouts
on the chin and jaw and citrus to breakouts on the cheeks.
Wear
sunscreen all year Although the Suns UVB rays
(that cause sun burn) are not as strong in the winter, the UVA rays(those
the ones that cause skin aging and cancer) are just as strong all
year round. You should always protect your skin with SPD30 sunblock
whenever you are going to spend any time outdoors.