Jul
2
Acne: Prescription Lotions and Gels
July 2, 2009 | Leave a Comment
Prescription Lotions and Gels for Acne Treatment
If treatment with benzoyl peroxide doesn’t get your pimples under control within a couple of months, check with a physician. Dermatologists often prescribe topical antibiotic gels or lotions in addition to or instead of benzoyl peroxide. Erythromycin and clindamycin are old standbys. Because they have been so widely used however, bacteria have begun to develop resistance to them. As a result, dermatologists have been restricting their use and instead turning to other approaches.
One other medication that is being prescribed is azelaic acid (Azelex, Finevin). Like benzoyl peroxide, this topical treatment seems to keep pores from clogging and to discour-age the multiplication and spread of bacteria. It too may result in burning, stinging, redness, or dryness of the skin. In rare instances, dark skin exposed to azelaic acid may develop lighter patches. If you have a cold sore or fever blister that gets worse while you are using an azelaic acid product, notify the prescribing physician immediately.
Isotretinoin or a similar compound in the vitamin A family can be very effective in treating acne and reducing the inflammation associated with severe acne. Using topical vitamin A–like compounds (retinoids) early in the course of acne lessens the likelihood of scarring, a complication of the condition. Some doctors prescribe tretinoin together with benzoyl peroxide or with an oral antibiotic such as doxycycline to clear the skin faster.
Clindamycin Gel (Cleocin T, Clinda-Derm, Evoclin Topical Foam
Clindamycin is an antibiotic that can be applied to the skin to fight acne-causing bacteria. It may take 2 months to see significant improvement, but generally this treatment is effective. Other topical antibiotics such as erythromycin gel are also effective. Some prescription products combine an antibiotic with benzoyl peroxide for greater effectiveness. These include BenzaClin and Duac Gel (clindamycin plus benzoyl peroxide) and Benzamycin (erythromycin plus benzoyl peroxide). These are effective but expensive because no generic equivalents are available.
Side effects: Itching, burning, dryness, and peeling. A rare but very serious and dangerous side effect of clindamycin that is extremely unlikely to occur but still possible with the topical form is pseudomembranous colitis. Notify your doctor immediately if you develop persistent or bloody diarrhea.
Downside: Skin bacteria (P. aches) are beginning to develop resistance to topical clindamycin.
Cost: Approximately $50 for a 60-gram tube Tretinoin Gel (Retin-A).
Retin-A speeds up cell turnover and normalizes the lower levels of the skin. With 6 weeks or more of treatment, it is frequently very helpful against acne.
Side effects: Stinging, dryness, redness, flaking, and irritation.
Downside: Retin-A makes skin more sensitive to sunburn and sun damage, so stay out of the sun and use effective protection against ultraviolet rays.
Cost: $35 to $50 for 15 grams.
There is another prescription gel or cream that is based on a vitamin. Nicomide-T gel or cream contains nicotinamide, a form of niacin. Like Retin-A, it is topical but not an antibiotic, so theoretically bacteria should not develop resistance to it. A preliminary study showed that Nicomide-T gel is as effective as clindamycin gel in reducing blemishes.” Other research confirmed that it can protect the skin and is less likely to dry it than a number of other acne treatments. It is not clear whether Nicomide-T is as effective as Retin-A, though some studies conducted by the manufacturer, Sirius Laboratories, suggest that adding it to other treatments boosts the effectiveness of both.
Jul
2
Acne Overview and FAQs
July 2, 2009 | Leave a Comment
ACNE
• Avoid sugar and refined Garbs and cut back on milk
• Try an over-the-counter product with benzoyl peroxide
• Ask your MD about a prescription for clindamycin gel
• Apply prescription-strength tretinoin gel
• Discuss Nicomide-T gel with your doctor
• Ask your doctor about isotretinoin
• Ask your doctor about photodynamic therapy
Acne is usually thought of as an adolescent problem, but dermatologists have been treating adults with blemishes for years. The technical term for such outbreaks of pimples is acne vulgaris. Common skin bacteria (mostly Propionibacterium acnes), the production of oils by the skin, and even the impact of hormones all seem to play a role in determining who gets acne and how severe it will be. When an oil-producing hair follicle becomes plugged up and the bacteria go to work feasting on the fatty acids trapped inside it, the body often reacts with inflammation. That’s what makes the pimple so sore and red.
Based on this scenario, there are four ways to tackle the problem of acne: discourage the bacteria, reduce the production of oil, control the hormones, or lower the level of inflammation. In practice, dermatologists mostly focus on bacteria and, oil production. But perhaps trying to lower the level of inflammation is more practical than they think.
The Anti-Acne Diet
Dietary recommendations for acne sufferers have a checkered history. Way back when, teenagers were told to lay off the cheeseburgers and french fries. If they stayed away from high-fat foods like milk shakes and chocolate, they were told, they’d have lovely, clear skin.
We don’t know how many kids with acne in the 1960s and 1970s followed that advice, but eventually dermatologists changed their minds. They did some studies and discovered that the amount of fat in the diet didn’t seem to correlate very well with the severity of blemishes. So they told their adolescent patients, “Never mind.” Diet was not considered a significant risk factor for acne.
Then a few dermatologists began to wonder if that advice was correct. An international team of investigators reported that clinical examination of 1,200 residents of Papua New Guinea (Kitavan Island) and of 115 hunter-gatherers from Paraguay did not turn up a single case of acne.’ Since 70 to 95 percent of adolescents and approximately half of people more than 26 years of age have facial acne in Westernized societies, the difference was striking. The researchers proposed that diet might play an important role. Specifically, they noted that the native peoples consume a diet composed of lowglycemic-index foods, with a minimum of refined foods, especially refined carbohydrates such as sugar and flour. (Presumably, their diets are also low in the unnatural trans fatty acids as well, since these are equally linked to processed foods. 2) Perhaps, the scientists hypothesized, this diet that minimizes insulin spikes might also benefit the skin.
Q. My 14-year-old daughter has had moderate acne for nearly 2 years. There are always 5 to 10 small pimples on her forehead, and now she has 10 to 20 pimples on her cheeks as well.
Clearasil left bleach stains on her clothes. Antibiotics the doctor prescribed didn’t help and even seemed to make matters worse. The doctor suggested birth control pills, but that is not an option we’d entertain. Are there any natural remedies that might work? What about diet?
A. The purported link between acne and diet is controversial. Teens once were told to avoid chocolate and high-fat foods. That turned out to be unhelpful.
Research published in the Archives of Dermatology suggests, however, that diet actually may make a difference. Populations on low-carb diets that don’t make blood sugar rise quickly may be less prone to blem-fishes. Your daughter might try avoiding foods like candy, cookies, french fries, potato chips, sugar, and white flour to see if it helps her complexion.
Not all dermatologists have welcomed this new look at the possible role of diet. The epidemiological comparison suggesting that diet might be relevant in the development of acne triggered a series of comments under titles such as “Diet and Acne Revisited”.
It isn’t altogether clear why this development should be so unwelcome. Nutrition science is gradually reaching a consensus that a low-glycemic diet, one with the least amount. of trans fats as well as saturated fat, is probably preferable for long-term health in many respects. Such a dietary pattern seems to lower the risk of diabetes and heart disease. Encouraging young people to adopt healthy dietary habits at a time when they would be motivated by the short-term benefit of clearer skin might be a good public health strategy. Most patients seem to think that diet is important in treating acne, and they expect dietary recommendations from their doctor. In the meantime, dermatologists should be conducting research to determine if this dietary hypothesis is solid or if it is as far-out as many doctors think. Refined carbohydrates and trans fats like margarine might not be the only dietary culprits. A different study reviewed the dietary and dermatological histories of 47,355 female nurses and concluded that the more milk these women drank in adolescence, the more likely they were to have had severe acne as teenagers. The Harvard scientists who conducted this research suggest that hormones and growth factors found in milk might contribute to this problem. It appears that a good deal more research is needed before there will be a clear answer to the question of whether diet affects acne. In the meantime, motivated acne sufferers can do their own experimentation to find out if including less processed food and less milk in their diet might result in fewer blemishes. My son recently returned from a 5-day camping trip where he didn’t have milk or any of his acne medicine. To my surprise, his face looked beautiful. Maybe there’s a connection between clear skin and no milk. The dermatologist suggested eliminating milk to see what happens.
Conclusions
Blemishes are a common part of adolescence, but they also trouble many people well into adulthood. Changes in hormone levels seem to aggravate acne. Most treatments are aimed at killing or slowing down bacteria that are commonly present on and in the skin, and this usually works well until or unless the bacteria develop resistance. Stress seems to make acne worse (which is why college students have more zits during the week of final exams), but given the fact that stress is so hard to avoid, almost no treatments focus on controlling it. There are many approaches to acne treatment; if self-care does not prove effective, a dermatologist should be able to prescribe a therapy that will help.
• Change your diet. A low-glycemic-index diet with very little sugar and other refined carbohydrates might improve skin significantly, and it will have other health benefits as well. Other things to avoid: milk and trans fatty acids, which are found in margarine and shortening. A study of dairy products and acne is currently under way.
• Facial masks of clay may remove excess oil and help clear the skin. Other topical treatments include nutmeg mixed with milk or honey to make a paste for pimples. A tea tree oil gel (5 percent) is worth trying.
• Wash morning and evening with a gentle nonsoap cleanser. Using a harsh or abrasive product may aggravate acne.
• Ask your doctor about applying a topical antibiotic such as clindamycin or erythromycin. They can be helpful, but skin bacteria are developing resistance to these drugs.
• Check with your doctor regarding a prescription for Retin-A. Be vigilant about protecting your skin from the sun or any other source of ultraviolet radiation while you are using this medicine.
• Ask about Nicomide-T gel or cream. This vitamin-based topical medicine can reduce inflammation and may be almost as effective as some topical antibiotics.
• Oral antibiotics may work even when topical antibiotics do not. Be sure to ask your doctor about side effects and interactions, and follow the dosing instructions carefully.
• Women may benefit from birth control pills. Sometimes the diuretic spironolactone provides additional anti-acne power.
• For severe acne that has not responded to other treatments, isotretinoin (Accutane, Sotret, etc) is an option. Discuss the risks and benefits thoroughly with your dermatologist before starting on a 5-month course of these pills. Because isotretinoin causes birth defects, women are required by the manufacturer to verify before taking any of this medication that they are not pregnant, and to confirm it again each month during treatment. They must also use two effective forms of contraception during the course of treatment.
• Ask your dermatologist if Dusa Blue Light (photodynamic therapy) is appropriate for you. It should be administered by a dermatologist or plastic surgeon experienced with its use.
Tags: absorption of amiodarone, acne sufferers, adolescent patients, allegra bronchitis, aralen online, avelox manufacturer, beezeebee finasteride, benzoyl, benzoyl peroxide, blemishes, blood, buy prescription soma without, caffeine vault comparison soft drink, can prednisone cause stomach bleeding, checkered history, cheeseburgers, chocolate, citalopram withdrawal side effects, claritin in non prescription, clear skin, clindamycin, clomid with metformin, clonidine prescribing information, constant dizziness toprol xl, dermatologists, Diabetes, dietary recommendations, elevated phenytoin levels, estrace cream dermal absorption, exelon comed merger, fatty acids, find viagra free sites edinburgh, fosamax dead face, french fries, garbs, generic replacement for nexium, hair follicle, history way, hormone, inflammation, isotretinoin, kamagra 50p per tablet, Kitavan Island, lithium aspartate lithium orotate, mayo clinic lithium causes weight gain, milk shakes, naproxen for goats, Nicomide, oil control, online prescriptions cephalexin monohydrate, pantoprazole thc, Paraguay, paxil withdraw sites, pimple, prednisolone 6 day pack, prescription strength, prilosec otc causing aches pains, primary source of calcitriol, Propionibacterium, prozac for period, schizophrenia estradiol, skin bacteria, soma and beer, sony info lithium np-f550, what is anaprox ds, what is detrol lx, where is fluoxetine absorped