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Acne Products>Acne Treatments>
Acne Treatment
Several factors contribute towards the formation of Acne lesions.It is not really well understood why a switch is turned ON at puberty in both males and females to cause acne but in most cases acne appears to be switched OFF in a similar mysterious fashion. What is well known is the fact that people who have acne also have a very high rate of sebum(oil) production on to the surface of their skin.Sebum production is controlled by the male hormone testosterone which is produced by the gonads in men and the ovaries and adrenal glands in women. The increased sebum excretion is due to an over sensitivity of the sebaceous glands which produce the sebum, to the hormone Testosterone and other androgenic substances.
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How to get rid of Acne
The treatment of acne usually involves addressing the causative factors,which includes:1.Excessive Sebum production
2.Bacteria on the skin,which breakdown the Sebum into fatty acids which cause an inflammatory reaction in the follicle(skin pores).
3.Blockage of skin pores with sticky plugs made up of a mix of dead skin cells,Bacteria and Sebum.back to top
Over the counter products for Acne treatment
Most teenagers choose to treat the odd spot,pimple or blemish with an over the counter product available from the Pharmacist.
These products fall into three basic categories:
Antiseptic,exfoliating skin washes and cleansing agents (detergents and Alcohol)which help remove excess sebum and loose cells from the skin`s surface and so help prevent the formation of the MICROCOMEDONE and spots.Hygiene is important and simple washing with soap and water (an antibacterial soap is preferable)will help manage the condition.Drying vigorously with a towel(an EXFOLIATING action) removes oil and helps break up any blackheads.It helps to avoid lots of greasy make-up as this will make the condition worse.
Products containing Keratolytics such as Benzoyl peroxide,salicylic acid,resorcinol and sulphur.
Antibacterial creams and lotions based on antiseptics such as Triclosan,Benzoyl peroxide,Povidone Iodine and Tea tree oil.
If you choose to use over the counter products,it will help to follow the following guidelines:
A regular washing programme and good hygiene is the best method of removing excess sebum.Wash your face atleast twice a day with an antiseptic soap and warm water.Wash your hair twice a week or more often if it is very oily and avoid wearing the hair over your forehead.DO NOT pick at or SQUEEZE spots as this will lead to scarring.
Remember that products containing Benzoyl peroxide will BLEACH fabrics,so it might be best to use these during the day(waking hours to avoid ruining the pillow,duvet,bed linen or your latest designer pyjama set!Benzoyl peroxide and other Keratolytics will also cause redness and peeling on first use but this should subside after a few days.
Some Asthmatics can be allergic to Aspirin and related agents and should avoid products containing SALICYLIC ACID.
ON no account should you use creams containing HYDROCORTISONE to treat your acne.
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A list of over the counter products for acne follows
Acnecide is a water based product containing Benzoyl peroxide in 5% and 10% strengths.The 5% strength is suitable for most users.
Acnidazil is a non greasy vanishing cream without any nasty smell and contains 5% Benzoyl peroxide and 2% Miconazole which is really an anti fungal agent with mild antibacterial properties.This product is best applied once a day for the first week and then twice a day thereafter.Washing with warm water and soap will enhance the effect.
Acnisal is a face wash containing 2% Salicylic acid in an emollient base.It is suitable for mild to moderate acne and hels remove and prevent blackheads and whiteheads.This is a good product to use even after your acne has gone as it prevents formation of MICROCOMEDONES by helping to keep PORES OPEN.For optimumbenefit it is best used 2 to 3 times a day and is used by lathering with warm water,massaging into the skin and leaving it a few minutes before rinsing and drying.
Betadine Skin Cleanser is a golden brown solution containing 4% povidone Iodine,an antiseptic agent.It is suitable for use on any part of the body,including face,back,neck and shoulders.It is best used as you would use a liquid soap.Remember to leave it on the skin for a few minutes before rinsing.
Cepton Medicated Skin Wash is a clear red liquid containing an antiseptic substance called CHLOEHEXIDINE.It is best used undiluted by applying on to the face and washing.Repeat the process,leaving it for a few minutes before lathering and rinsing.
Cepton medicated Cleansing Lotion is a similar product containing the same antiseptic.Apply to clean skin and keep out of eyes and ears.
Clearasil
is a large range of acne and spot treatment products based on cleansing,exfoliating and antiseptic agents.
Oxy5, Oxy10, Panoxyl5 Acne gel, Panoxyl10 Acne gel, Panoxyl Aquagel, Quinoderm cream are products based on Benzoyl peroxide.
Valderma cream and soap is a white,nongreasy cream containing an antiseptic agent called potassium hydroxyquinoline and chlorocresol.It is suitable for spots and minor skin problems.Apply the cream morning and night after washing with warm water and Valderma soap.
Other products available are best categorised as COSMECEUTICALS because they act more as hygiene products to keep the skin clean and free of excess sebum.
The T-Zone rangeof products is based on natural Tea tree oil.
Neutrogenamake a large range of products which help to keep pores open.These are based on cleansers,toners and facial as well as body washes.
For those with sensitive skin there is the SIMPLE range of products.
Types of Acne
To make treatment easier and more appropriate, Acne is generally devided into four types,depending on the severity of the condition. Comedonal acne is, as the name suggests, predominantly whiteheads and blackheads that are non inflammatory. This type of acne responds very well to topical treatment with Retinoids and retinoid like drugs in addition to a Salicylic acid wash and regular exfoliating.
back to topMild acne
| Photograph showing mild acne on chin |
Photograph showing mild acne on chest |
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Mild acne can be described as spots that can be easily treated with over the counter preparations such as Benzoyl peroxide preparations and Salicylic acid wash. Further deterioration of the condition can be prevented by regular exfoliating to prevent infection and inflammation.
back to topModerate acne
| Photograph showing moderate acne on chin |
Photograph showing moderate acne on back |
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Moderate acne is usually associated with inflammation and infection in the follicle.This type of acne responds well to Topical Antibiotic preparations or better still when combined with Benzoyl peroxide,Zinc acetate or Isotretinoin.Regular exfoliating with gentle products that will not scratch the skin is essential.Abrasive scrubs should be avoided.
back to topSevere Acne
| Photograph showing severe acne on chin |
Photograph showing severe acne on back |
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Severe acne can be due to infection and inflammation in the follicle and is often a result of delaying treatment in the early, mild to moderate phase of the condition. To avoid scarring and Severe cystic acne, treatment should always be started early. acne often results in some people who fail to respond to Benzoyl peroxide and other antibiotic preparations. This type of acne is best treated with oral antibiotics and topical Retinoids.Other preparations may also be used to augment the treatment chosen. In very severe acne that can lead to nodular cystic acne and scarring and does not respond to conventional treatment, oral isotretinoin is an option. This treatment can be severe and is best started by your Dermatologist who can monitor response to the treatment and side effects. More than 90% 0f those treated with this preparation achieve total clearance of their acne within 4 to 5 months.
| Photograph showing very severe acne on chest |
Photograph showing very severe acne on back and neck |
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Microcomedones
| Photograph showing blackheads on cheek |
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A microcomedone is a plugged pore and it`s formation is a necessity before acne can develop.
When cells called KERATINOCYTES are abnormally formed and layered inside the lining of the follicular duct(the tube leading up to the skin surface to deliver sebum), enlargement of the follicle occurs.
Accumulation of dead KERATINOCYTES inside the duct leads to a partial blockage of the follicle(pore). When these dead cells come into contact with Bacteria and Sebum, a sticky plug is formed and this leads to complete blockage of the follicle. The flow of Sebum to the surface of the skin is restricted because of the MICROCOMEDONE and this leads to accumulation and stagnation of Sebum within the follicle. This leads to the formation of BLACKHEADS(open comedones) and WHITEHEADS(closed comedones). The black of the blackhead is from the pigment MELANIN and the whiteheads appear white because they are blocked pores with a very thin, transparent layer of cells that reveal the pussy, thick and greasy material within the follicle. Enlargement of the follicle due to this filling up and blockage leads to the appearance of the LARGE PORES on the skin surface and the characteristic coarse texture in this area. INFLAMMATION occurs within the follicle due to the action of irritant fatty acids which are formed by the action of the Bacteria on the Sebum plug in the follicle. This leads to Acne lesions.
The developement of acne therefore can be attributed to The MICROCOMEDONE, which totally occludes the follicular duct(pore), leading to a build up of sebum. The fatty acids from the action of BACTERIA leads to inflammation and pus formation. This process leads to the formation of a PUSTULE. The inflammatory process leads to the destruction of the follicle. SQUEEZING the pustule leads to the pus entering deeper layers of the skin, leading to NODULAR lesions and CYSTS. SQUEEZING of SPOTS will lead to PERMANENT SCARRING of the skin.
| Photograph showing ice-pick scarring |
Photograph showing Keloid scarring |
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How to prevent acne
It is clear that in order to PREVENT acne, the formation of the MICROCOMEDONE needs to be addressed. If skin pores are kept unblocked a microcomedone will not form. This can be achieved by removing the factors that lead to the blockage in the first place.
Removal of excessive sebum from skin surface by washing the skin twice a day.
Removal of Bacterial population (propionibacteria and micrococi) from the skin surface by application of products that will destroy bacteria and prevent their growth.
Removal of the dead skin cells(KERATINOCYTES) that line the follicular duct and contribute towards the formation of a plug. This is achieved by regular EXFOLIATING of the skin using various scrubs, washes, masks and medicated products.
Removal of any MICROCOMEDONAL blockage that does form by using a STRONG peel off face and body mask.back to top
Choice of Treatment and Acne products
Treatment of Acne always begins with topical preparations. These are usually medicated creams, lotions or gels. Topical treatment as preventative measures are suitable for those with mild to moderate Acne.Even when medication in the way of oral antibiotics are prescribed, topical treatment is often encouraged as well. The main advantage of topical treatment over tablets and capsules that you may take by mouth is that they are generally free of serious side effects and do not interact or interfere with any medication you may already be taking for an unrelated condition. For example, most antibiotics will interfere with the contraceptive pill to reduce its efficacy and most oral treatment is unsuitable during pregnancy when a hormone triggered acne flare up is quite common.
Topical preparations for Acne usually contain one or more (in combination) of the following:
Benzoyl peroxide
Azelaic acid
Nicotinamide
Topical retinoids
Topical antibiotics
Salicylic acid
Sulphur
It will help to understand some terms used:
Keratolytics
are chemicals that increase the rate at which skin cells are shed and aid in the removal of dead skin cells from within a follicle and the skin surface. They are commonly used in exfoliating products.
Keratolytics like Benzoyl peroxide,Salicylic acid,Resorcinol and Sulphur are abrasives and act upon Keratin in the skin to break open blocked follicles (pores) and generally increase the skin`s turnover rate .This process helps to keep skin pores open and prevent formation the MICROCOMEDONE.
Microcomedones or Clogged pores
An occlusive sticky plug blocking a hair follicle and usually made up of dead skin cells, sebum and bacteria.
Exfoliating will help removal of this plug out of the skin pore and keep pores open.
Comedones
are clogged pores. (The hair follicle opens up as a pore). The plug can be made up of a sticky mixture of dead skin cells, sebum or its fatty acids and bacteria. These plugs prevent the free flow of sebum or oil out of the follicle on to the surface of the skin, leading to distension (widening) of the follicle and accumulation of the sebum under this plug. When this plug is still covered by a thin layer of skin cells it is called a CLOSED COMEDONE.These comedones often appear white due to the fact that they are filled with a plug that is pussy and cream in colour.
When the plug is not covered by skin cells and open to the air it is called an OPEN COMEDONE. These appear black due to the fact that they are open to Oxygen in the air and also due to the skin pigment Melanin (oxidised) being mixed up in the plug that is blocking the pore.
Open Comedone:
a blackhead
Closed Comedone:
a whitehead
A Spot:
A spot is formed when the pore or follicle being blocked is inflamed or infected by bacteria present on the skin. Inflammation is usually due to acids produced by the bacteria due to their action on the Sebum.The pore appears large and raised due to being filled with the plug and also due to the fact that these acids cause the lining of the hair follicle or pore to produce more skin cells than normal. This is called HYPERKERATINIZATION and merely means that the lining of the follicle thickens abnormally, leading to a larger, raised, inflamed, red looking spot.
A Pimple:
is an inflamed (red) plugged pore
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Comedogenicity and Acnegenicity:
It is a well known fact that certain chemicals and other materials used in the manufacture of cosmetics can cause and aggravate existing ACNE.These substances are called “comedogenic” materials. However, since the end result is the production of an ACNE flare up, these substances are often described as “ACNEGENIC”.
An acnegenic substance has the ability to cause and aggravate both COMEDONES and ACNE (pimples)back to top
If you wish to avoid cosmetic products that may cause or aggravate ACNE look out for any of the following ingredients on the list on any product label for acnegenic materials:
Butyl stearate
Cocoa butter
Coconut oil
Grapeseed oil
Isopropyl isostearate
Isopropyl myristate
Isopropyl palmitate
Isostearic acid
Lanolin
Oleic acid
Oleyl alcohol
Octyl palmitate
1.Treatment of Acne should be started early to prevent any resulting scarring.
2.You must remember that improvement from ANY treatment for acne will take time. There is NO instant treatment. Please allow at least three months to ANY treatment before expecting good results. Patience is very important with any treatment. In this context, it is important to remember that a faster and more effective result may be achieved by COMBINING treatments that address different factors that cause acne.
Complement, augment and enhance existing acne treatment by taking advantage of the fact that by adding a product that addresses a different causative factor to your regime will enhance the existing treatment synergistically (An additive action) by producing FASTER and more EFFECTIVE results. Add DEVINA`S CHOICE peel-off face and body mask to your existing medical treatment for acne to enhance its effects.
3.The choice of treatment will depend on how severe your acne is. Mild to moderate acne may be treated with topical preparations. (Creams, Lotions, Gels, Washes). Antibiotics for oral use is usually reserved for moderate to severe acne or if you fail to respond to topical preparations or find some or all topical preparations too harsh or not tolerated by your skin. In some cases application of a topical preparation in certain body areas may not be possible. In cases of severe acne where prolonged treatment with topical preparations and oral antibiotics has failed and resulted in scarring or psychological problems a Dermatologist may consider treatment with oral Isotretinion. Comedonal acne responds well to topical RETINOIDS. Comedones and inflamed acne responds to preparations containing BENZOYL PEROXIDE or AZELAIC ACID. Inflammatory acne responds well to a topical antibiotic preparation such as ERYTHROMYCIN or CLINDAMYCIN.
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Topical products for acne
BENZOYL PEROXIDE (ACNECIDE, BREVOXYL, QUINODERM, PANOXYL, BENZAMYCIN)
Benzoyl peroxide has been on the market for quite a long time and has been found very effective for mild acne. Most sufferers usually start treatment with a product containing this agent. Benzoyl peroxide works as an antibacterial and a keratolytic.
Preparations containing Benzoyl peroxide are effective in mild to moderate acne. It is best to start with a low concentration (2.5-5%) preparation of these products as they are as effective as the higher concentrations ones (10%). Benzoyl peroxide reduces inflammation BUT an initial skin irritation is usual on first starting treatment and rarely some people may develop a contact allergic dermatitis, which may need treatment with a mild cortisone cream. The skin often goes red and tightens and starts to scale and flake. This can usually be reduced by starting with a weak product and using it every second day before using it once daily before increasing the application to twice a day and using a moisturizing preparation as well .If your acne does not respond to BENZOYL PEROXIDE after about 2 months, you should either ADD another topical acne product to the treatment regime or seek a prescription for a topical Antibiotic preparation.
Caution during use:
You should be careful not to apply this product anywhere near the eyes, mouth and lips. Benzoyl peroxide has a BLEACHING action and so you should be careful with FABRICS (especially clothes, pillows and bedding) and HAIR.You should also avoid strong sunlight after application of this chemical. (Best time to apply Benzoyl peroxide is at bedtime).
How much and how often do I apply?
It is best to apply ALL OVER the treatment area, not just the pimples/zits. Start with a low strength product and gradually build up to the stronger product and apply once a day for a while before increasing frequency to twice a day.
Complement, augment and enhance existing acne treatment by taking advantage of the fact that by adding a product that addresses a different causative factor to your regime will enhance the existing treatment synergistically (An additive action) by producing FASTER and more EFFECTIVE results.
Add DEVINA`S CHOICE peel-off face and body mask to your existing medical treatment for acne to enhance its effects.
AZELAIC ACID (SKINOREN)
This chemical has antibacterial, anti-inflammatory as well as anticomedonal properties. Azelaic acid appears to normalise the excessive shedding of skin cells within the follicle. It can be used as an alternative to BENZOYL PEROXIDE in cases where this is not well tolerated. Azelaic acid is particularly good for mild to moderate acne on the face. It also causes less skin irritation than Benzoyl peroxide. Azelaic acid is often used to treat pigmentation resulting from inflammatory acne.
Caution during use:
Avoid use if you are pregnant or breast-feeding.
Be careful not to apply too near the eyes.
Avoid strong sunlight after application to reduce risk of a PHOTOSENSITIVE reaction.
Irritation is rare but if you suffer this stop using it for a while before starting again or use it every second day for a while before applying it everyday.
How much and how often do I apply?
For sensitive skin once a day is advisable otherwise twice a day application is usual. You may not see results for a long time after starting treatment (up-to 3 months). However, if after 6 months of continuous treatment you see no improvement, it is time to switch to another product.
back to topTopical Antibacterial Products for Acne
These products have to be prescribed by a qualified medical practitioner or your dermatologist and you may not have a choice about which one or weather one will be prescribed for you. It will depend on the severity of your acne and on which products you have already tried.It is also possible that you may not respond to the topical antibiotic treatment.This is usually due to the fact that most antibiotics used to treat acne are taken up into the excess sebum,leading to a lowering of the active concentration of the antibiotic,making it less effective against the Bacteria.This problem can often be removed by combining the topical antibiotic treatment with a RETINOID such as RETIN-A or a synthetic retinoid like agent such as ADAPALENE.
Please remember, it is not necessary to start with these products. Most mild to moderate cases of acne respond very well to Benzoyl peroxide or Tretinoin.
Topical antibiotics should really be resorted to only if you don’t want to or cannot tolerate ORAL antibiotic preparations. These products generally work by having a strong antibacterial and anti-inflammatory action. Unlike Benzoyl peroxide and Azelaic acid, they do not posess any anticomedonal action. Their main advantage over these two chemicals is that they cause very little irritation and are very effective for an acne flare up that occurs before a period.
ERYTHROMYCIN (Zineryt, Stiemycin, Eryacne, Isotrexin, Benzamycin)
This antibiotic is useful for inflammatory acne and is generally used together with Zinc to prevent any bacterial resistance developing. Erythromycin is a safe agent for the treatment of acne but occasionally it may not work due to antibacterial resistance. It is also available in combination with a retinoid (Isotretinoin) and Benzoyl peroxide (BENZAMYCIN).
CLINDAMYCIN (Dalacin-T, Zindaclin,Duac Gel)
Good for inflammatory acne. Dalacin-T is available in two forms:
Dalacin-T Topical solution, which has a water/alcohol basis and may be suitable for oily skin.
Dalacin-T lotion, which has a water base and may be suitable for sensitive skin.
Zindaclin is a gel form of Clindamycin.It is applied only once a day and is claimed to have a long lasting action.
Duac Once Daily Gel is a new combination product containing Clindamycin and Benzoyl peroxide.Like Zindaclin,it is applied once daily and can be expected to produce good results in a short time due to its combination formulation.
TETRACYCLINE (Topicycline)
Tetracycline is more commonly used by mouth than as a topical preparation. It tends to produce fluorescence under ultra violet light (the type common in DISCOS). Can you imagine your face GLOWING at the disco?
CHLORAMPHENICOL (ACTINAC) and NEOMYCIN (NEO-MEDRONE) are two antibiotics that have been used to treat acne in the past. However these preparations can cause skin sensitisation and are not generally used much these days.
Caution during use:
Rarely, mild irritation may be expected with all the products. A bigger problem is ANTIBACTERIAL resistance of propionibacterium acnes to these antibiotics, which may render these products in-effective. In order to avoid this problem, it is best to use BENZOYL PEROXIDE in-between the topical antibiotic preparations.
How much and how often do I apply?
Apply all over the treatment area. Usually these products are applied twice a day. Zindaclin gel is a new combination product that is released into the skin gradually and requires application only once a day.back to top
Topical Retinoids and other similar products for Acne
RETIN-A, ISOTREX, ISOTRETINOIN, DIFFERIN - These products are generally well tolerated and should form part of the treatment regime of ALL patients.They play a very important role in the management of acne by preventing microcomedone formation.
These products are useful for treatment of comedonal acne and acne associated with inflammation as well as the non-inflammatory type. By preventing the excessive production and shedding of skin cells in the lining of the duct (follicle) that opens up onto the skin surface as a pore, these products stop the formation of microcomedones. By unblocking and unplugging the pores, theses agents prevent the cascade of events that leads to acne. On starting treatment with these products it is usual to expect some redness and skin peeling. This usually subsides with time and can be reduced by increasing application gradually.
Treatment with these products is long term and several months may pass by before you achieve a good response. It is usual to continue use until no more new pimples are seen. These products are not suitable for acne over LARGE body areas due to the possibility of absorption into the blood stream, resulting in side effects. Application near eyes, nostrils, mouth, lips, and broken or sun burnt skin should be avoided. You must avoid strong sunlight or a sun lamp after applying any of these products. (Or wear protective clothing in the sun and apply a sunscreen on top of the medication). While you are using one of these products you should remember to avoid ABRASIVE cleansers and SCRUBS, comedogenic or astringent cosmetics/makeup.Exfoliate with a peel off mask that does not scratch and will aid removal of the plugs blocking the pores.
Caution during use:
Retinoids are TERATOGENIC (they can cause deformity in the unborn child). Avoid use in pregnancy and during breast-feeding. Expect local skin reactions and redness, burning, stinging, itching, dry or peeling skin, photosensitive reactions. Temporary skin pigmentation may occur. Eye and lip irritation and crusting of the skin may be expected. (Rarely).Best applied at night.
ADAPALENE (Differin gel and cream)
Adapalene has properties similar to those of topical retinoids without the potential for skin irritation. It has anticomedonal and anti-inflammatory properties and can be used to treat mild to moderate acne. Apply thinly once a day before bedtime. You can reduce any initial irritation episodes by applying every second day for a week before applying daily.
TRETINOIN (Retin-A, Acticin)
Apply thinly once to twice a day.Best applied at night to avoid photosensitive reaction.Apply an antibiotic preparation in the morning after washing off the Retinoid.
ISOTRETINOIN (Isotrex, Isotrexin)
Apply thinly once to twice a day.back to top
Other Topical preparations for Acne
SALICYLIC ACID (Acnisal and Eskamel)
Salicylic acid is a very old remedy that is still used today for the treatment and prevention of acne. It is present in low concentrations in a lot of over the counter preparations. At high concentrations it can cause severe skin irritation. Application too near the eyes, mouth and lips should be avoided. Skin irritation may be expected on excessive use. Preparations containing Sulphur and ABRASIVE agents have no value in the treatment of acne and should be avoided. In the past it was used in combination with Salicylic acid (ESKAMEL) but better and safer products have largely replaced this agent.
Eskamel cream was discontinued by Smith Kline Beecham a long time ago in the UK,but it has been re-launched recently by another Company called Goldshield Pharmaceuticals.You should be able to buy it at a Pharmacy.
ACNISAL is a cream wash containing Salicylic acid as the active exfoliating agent.You are supposed to apply it by rubbing it into wet skin and leaving it to work away for a few minutes before washing.It is particularly useful for Acne on the back where removal of oilyness is important and exfoliating helps.ACNISAL is also useful to prevent the formation of microcomedones and works well in combination with other treatments and Devina`s Choice.
NICOTINAMIDE (Papulex)
Topical application of this chemical is useful in mild to moderate inflammatory acne and often shows fast but temporary results. It appears to work by stopping the action of inflammatory chemicals that are produced by blood cells in response to fatty acids that are produced by bacteria by their action on the Sebum/dead skin cell plugs in the follicle/duct. It reduces redness quite rapidly but may also cause the skin to dry out and so cause irritation.
Application near eyes, nose and mouth should be avoided. Dryness of skin, itching, burning and irritation can be expected during use. Apply once a day or on alternate days if dryness of the skin is severe and increase to twice a day application gradually.back to top
Combination Therapy
Each of the topical preparation described works in the treatment and prevention of acne by having a unique property.
The advantages of using more than one topical product in the treatment of acne.
RETINOIDS work to prevent MICROCOMEDONES and keep pores unblocked
BENZOYL PEROXIDE is antibacterial and keratolytic.
ANTIBIOTICS work by reducing inflammation and reducing the bacterial population (propionibacterium acnes) on the skin.
Acne is best treated and prevented by addressing ALL the factors that lead to the formation of lesions.
Therefore it is logical to combine treatment with products that address different causative factors. The action of each preparation will be ADDITIVE and lead to a more effective and faster result than can be achieved by a single product alone. It is usual to apply one product in the morning and a different one in the evening. However there are also products available that contain TWO of the active agents in the one application. Complement, augment and enhance existing acne treatment by taking advantage of the fact that by adding a product that addresses a different causative factor to your regime will enhance the existing treatment synergistically (An additive action) by producing FASTER and more EFFECTIVE results. Add DEVINA`S CHOICE peel-off face and body mask to your existing medical treatment for acne to enhance its effects.
ISOTREXIN GEL contains the antibiotic Erythromycin in combination with the retinoid Isotretinoin and is very effective.
BENZAMYCIN gel is a product containing the antibiotic Erythromycin in combination with Benzoyl peroxide.
Combination therapy is very effective and also allows lower concentrations of the active agent to be used, thus reducing the chances of side effects such as skin irritation. back to topOral Preparations for acne
Oral Anti-Androgens
Hormonal treatment (anti-androgen treatment). Sebum production and its excretion is under the control of TESTOSTERONE and its more effective metabolite DIHYDROTESTERONE.Acne may be controlled by reducing the androgenic drive. This treatment path usually reserved for females only.
CYPROTERONE acetate is used as an anti-androgen in combination with ethinyloestradiol as a combined oral contraceptive pill.This type of combination is often a very useful treatment option for women who fail to respond to oral antibiotics.Acne usually flares up during the first month of treatment,but a good response is achieved within 3 months of starting treatment.back to top
Oral Antibiotics
Oral antibiotics are used for moderate to severe acne and in cases where topical preparations alone have been inadequate. These preparations are prescription only medicines and should not be taken unless prescribed by your physician/dermatologist. Side effects from these preparations can be severe and you may have to stop taking them for this reason. Stomach upset is the most common side effect with all the antibiotics and they may interfere with your existing medication (for example, the oral contraceptive pill and some anticoagulants). They may have to be taken for long periods. (6 months to a year is quite common). A lot of people find that their acne returns as soon as they stop therapy with an antibiotic.
OXYTETRACYCLINE
This appears to be the preparation of choice when an antibiotic is first considered. Some metals tend to bind with this antibiotic and form a complex that prevents its absorption into the body. It is therefore important to avoid taking this antibiotic with iron, calcium and some antacids that may contain calcium and aluminium. Dairy products containing calcium also need to be avoided with the antibiotic. However you should know that any of these products may be used/taken ONE hour before or TWO hours after taking the antibiotic. It is important to avoid them TOGETHER.This antibiotic is usually prescribed to be taken FOUR times a day, at least half to one hour before any food and can be quite difficult to achieve. Some doctors prescribe the total dose as a single dose in the morning, before breakfast.
TETRACYCLINE
Very similar profile to Oxytetracycline.
DOXYCYCLINE
This antibiotic works in a similar way to oxytetracycline but has the advantage of a ONCE daily dosage. It may cause a photosensitive reaction on a bright day during the summer months. It tends to be more expensive than oxytetracycline.
LYMECYCLINE
This is an improved version of Tetracycline with the advantage of having a convenient ONCE a day dosage. It has a similar profile to MINOCYCLINE and is slightly cheaper. (Although more expensive than Tetracycline or Oxytetracycline)
MINOCYCLINE
This antibiotic is commonly used in the treatment of Acne and has been found very effective in most cases. It may be taken as a single once a day dose but is often prescribed at a lower dose twice a day. Very high doses of this antibiotic may cause skin pigmentation (Blue-black, slate-grey, purple or brownish colouration).
ERYTHROMYCIN
Erythromycin is rarely used to treat acne before the other antibiotics have been tried. However it is one antibiotic which is safe during pregnancy. The main disadvantage with this antibiotic is that it interacts with a lot of other medications and may not be suitable for long-term treatment in some cases.
TRIMETHOPRIM
This antibiotic is quite effective for the treatment of acne but has to be used at a high dose to be effective. With the high dose comes side effects and so is rarely prescribed.back to top
Oral Retinoids for Acne. (ISOTRETINOIN)
Usually reserved for severe acne, especially on the back and chest and when all other avenues have been tried without much success. It may also be prescribed in less severe acne if this is associated with scarring or psychological stress. Retinoids when used orally address the processes involved in the cause of acne and have been found very effective. They really have revolutionized the treatment of severe acne. Retinoids reduce SEBUM production. Retinoids reduce the hypercornification (the excessive production of skin cells in the lining of the follicle) of the pilosebaceous duct. Retinoids do not have any antibacterial properties but appear to reduce the bacterial population on the skin by removing some of the factors that allow their growth on the skin. Retinoids reduce the inflammation associated with the fatty acids that are produced by bacterial action on the plugs in the skin pores. (These plugs are a mixture of dead skin cells, sebum and bacteria) Retinoid therapy is expensive and is available only via the supervision of a dermatologist. Regular blood tests to check on liver function are quite common.
Side effects in some cases can be quite severe. Retinoids are TERATOGENIC and appropriate contraceptive precautions need to be taken in the female patient. Treatment can last for up to 16 weeks and if there is a relapse, a second course of treatment may be prescribed by your dermatologist. Retinoids when taken by mouth can produce dyness of the facial skin. Itching and peeling of the skin is quite common. Dryness around the mouth, lips and nose is common. Fissures on the lips may develop and can be treated with moisturizing lip balms, especially those containing a sunscreen. Nosebleeds are also quite common and the application of petroleum jelly is recommended.
Irritation in the eyes and on eyelids is also to be expected. This may be alleviated by using lubricating eye ointments such as LUBRIDERM, VIDISIC GEL, TEARS NATURAL, GEL TEARS or a similar product. Pigmentation and sensitivity to the sun can develop but is very rare. There have been reports of oral Retinoids causing depression but this link has not been conclusively proven. One must remember that severe acne itself can cause anxiety and depression. On first starting treatment with a Retinoid you may experience headaches or body/muscle aches.
Photograph showing Chelitis:Dryness and skin peeling around the mouth,lips and nose back to top
PHOTOTHERAPY http://www.theskinhealthclinic.com
Acne improves during the bright summer months. Light therapy has been used to treat acne for a long time but has recently been much improved with better success by identifying the light frequency for maximum benefit and improving on the lamps that produce this light.
UNCONVENTIONAL AND UNUSUAL TREATMENTS
SPIRONOLACTONE is diuretic agent used in cardiovascular medicine. It has mild ANTI-ANDROGENIC action and has been known to be used to reduce sebum production.It is often used in combination with an antibiotic in women who fail to respond to a course of antibiotics.Spironolactone has mild hormonal activity and may cause menstrual disturbances so it may not be suitable for everybody.
SAW PALMETTO is a natural herb and its extracts have an inhibitory action on the enzyme that converts TESTOSTERONE to the more active DIHYDROTESTERONE.It is thought that in acne the receptors in the skin that respond to DIHYDROTESTERONE are over sensitive to this substance and produce excessive amounts of sebum when activated. A reduction in the production of DIHYDROTESTERONE would cause a reduction in sebum production and so improve/prevent acne. An oily product called REGUSEB is claimed to contain an extract of the herb and reduce sebum production. These products alter hormonal balance and should NOT be used without medical supervision,especially Female patients.
Zinc is often claimed to help in the treatment of acne. It is often used in acne preparations to reduce the chances of antibiotic resistance but Zinc has not been proven to have any beneficial action on acne when either taken orally or applied as a cream/ointment.back to top
Add Devina`s choice to your skin care regime
Acne is best treated and prevented by addressing ALL the factors that lead to the formation of lesions. Therefore it is logical to combine treatment with products that address different causative factors(sebum, bacteria, dead skin). The action of each preparation will be ADDITIVE and lead to a more effective and faster result than can be achieved by a single product alone. It is usual to apply one product in the morning and a different one in the evening. However there are also products available that contain TWO of the active agents in the one application. All sufferers want instant results. You can help yourself by using this technique.
Complement, augment and enhance your existing acne treatment by taking advantage of the fact that by adding a product that addresses a different causative factor to your regime will enhance the existing treatment synergistically (An additive action) by producing FASTER and more EFFECTIVE results. Add DEVINA`S CHOICE peel-off face and body mask to your existing medical treatment for acne to enhance its effects.back to top |
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