- Acne is the most common of all skin conditions.
- It is almost universal during puberty.
- Acne affects almost 90% of people at some stage during their life.
- Comedones are the hallmark of acne vulgaris.
- Acne vulgaris is more common among teenagers and more severe in males.
- Acne Treatment should be commenced early to prevent scarring.
- The patient should be counseled that the improvement may not be seen immediately for at least a few months.
- Mild to moderate acne is treated with topical preparations.
- Moderate to severe acne is treated with systemic antibacterial preparations.
- Hormonal treatment with co-cyprindiol (cyproterone with ethinylestradiol) is only used in women.
What is Acne?
Acne vulgaris is a common, usually self-limiting, multifactorial disease that involving inflammation of the sebaceous follicles of the skin in the face and upper trunk.
Acne is a chronic, inflammatory skin condition that results in spots and pimples, especially on the face, shoulders, back, neck, chest, and upper arms.
What are the types of Acne?
The following are the most common types of acne;
- Blackheads – These are small black or yellowish bumps that develop on the skin.
- Whiteheads – These are Similar in appearance to blackheads, but more firm and they do not empty when squeezed
- Pimples (pustules) – These are small red bumps that may feel tender or sore.
- Papules – These are similar to papules, but they have a white tip in the center due to pus formation.
- Cysts – These are large pus-filled lumps with the greatest risk of forming a scar.
- Nodules – These are painfully hard and large lumps that build up beneath the skin
During puberty, the sebaceous gland is activated so there are more chances of developing acne in that stage, but it can occur at any age. It is not dangerous, but it can cause;
- Skin scars
- Oily skin
- Sensitive skin that’s hot or painful to touch
How Acne occurs?
Acne usually occurs when hair follicles become plugged with oil and dead skin cells. Bacteria worsen the condition by causing infection and inflammation.
- Small gland known as Sebaceous glands is present near the surface of the skin. The glands are attached to hair follicles.
- Sebaceous glands secrete an oily substance called sebum which lubricated the hair and skin.
- In acne, there is over secretion of sebum from sebaceous glands. This excess sebum along with dead skin cells, debris and bacteria forms a plug in the follicle, which results in acne.
During puberty increased androgen activity triggers the growth of sebaceous glands which results in enhanced sebum production.
What are the factors involved in Acne?
The four primary factors involved in the formation of acne are;
- Increased sebum production
- Sloughing of keratinocytes
- Bacterial growth
What are the Risk Factors?
The most common Risk factors for acne are as follows;
- Genetics – Family history
- The menstrual cycle
- Hormonal changes
- Anxiety and stress
- Hot and humid climates
- Using oil-based makeup more frequently
- Squeezing pimples will worsen the condition
- Medications like steroids, lithium, androgens
- Continues Friction against the skin
Acne in males
During puberty, there are more levels of testosterone in the body. Testosterone enhances the production of sebum from a sebaceous gland that results in acne.
Acne in females
Hormonal changes in female occur during;
- Periods (menstrual cycle)
- Polycystic ovary syndrome (POS)
How Acne Can be Prevented?
- Wash face with soap and water twice daily can help prevent acne. Particularly when you face more sweating and dirt.
- Avoid picking, popping, and squeezing pimples, as it may lead to infection and scarring.
- Avoid skin rubbing and scrubbing
- Use sunscreen when going outdoors, as too much sunlight has damaging effects on the skin.
- Avoid oily skincare products.
- Avoid stressful conditions.
Diagnosis of Acne
Diagnose of acne can be done by careful examination of the skin. It involves examination of face, chest or back for the different types of spots, such as blackheads or sore, red nodules.
The doctor also looks for different signs and symptoms;
- Mild soreness
- Lesions over the;
- Upper chest
- Comedones, that are the hallmark of acne vulgaris
- Inflammatory papules
- Ecstatic pores
- Acne cysts
What is the Treatment for Acne?
Treatment of acne involves the use of Topical and Oral preparations. The goal of treatment is to prevent the formation of new acne lesions, heal existing lesions, and prevent or minimize scarring.
Topical preparations for acne include;
- Benzoyl peroxide
- Azelaic acid
- Topical Antibacterial like
- Topical Retinoid
These preparations are used for Mild to moderate acne, comedones, and inflamed lesions.
Benzoyl peroxide (Benzac AC, Acnestar ) is effective against;
- Mild to moderate acne
- Inflamed lesions
Treatment is usually started with low strength; if acne does not respond to the treatment after 2 months then topical antibacterial is recommended.
Azelaic Acid (Aziderm) is effective against;
- Mild to moderate acne
- Comedonal acne of the face
It has antimicrobial and anticomedonal properties. It causes less local skin irritation as compared to benzoyl peroxide.
Topical erythromycin and clindamycin are used against;
- Inflammatory acne
These are usually recommended to avoid the oral use of antibacterial.
To avoid antibacterial resistance;
- Use non-antibiotic antimicrobials (benzoyl peroxide, azelaic acid)
- If one antibiotic is effective then do not change it without any reason
- Do not continue treatment for more than recommended
Topical retinoid is effective against;
- Inflammatory lesions
- Mild to moderate acne
Retinoid (TRETINOIN) and Adapalene (ADACLENE) are used as a topical retinoid.
Treatment with topical retinoid should be continued for several months until no new lesions are formed.
Oral preparations for acne include;
- Systemic Antibacterial
- Oral Hormone
- Oral Retinoid
Systemic antibacterial treatment
Systemic antibacterial used for the treatment of acne are as follows;
- Systemic antibacterial treatment is useful for inflammatory acne when topical treatment is not useful or it may be used with topical treatment.
- If there is no result after 3 months then another oral antibiotic should be used.
- Maximum improvement occurs after 4 to 6 months if treatment
- In severe cases, the treatment can be continued for 2 years.
Oral Hormone Treatment
Co-cyprindiol (an Oral Hormone), is used for the treatment of moderate to severe acne. It has anti-androgen properties. Sebum secretion and hair growth depend on androgen. Co-cyprindiol decreases sebum secretion and it is also used for hirsutism.
Oral hormone treatment is recommended to treat moderate to severe acne in the female.
It is recommended when topical and oral antibacterial therapy does not produce the desired outcome.
Co-cyprindiol also has contraceptive properties.
Oral Retinoid used for the treatment of acne is isotretinoin. It reduces sebum secretion. Isotretinoin is used for the systemic treatment of;
- Severe acne
- Nodulo-cystic and conglobate acne
- Acne which has not responded to a systemic antibacterial
- Acne which is associated with psychological problems
Isotretinoin is useful in women who develop acne in the third or fourth decades of life. Since acne in this age is usually not responsive to antibacterial. Isotretinoin is given for at least 4 months (16 weeks).
Side-effects of isotretinoin include;
- Severe dryness of the skin and mucous membranes
- Nose bleeding
- Joint pains
Isotretinoin is teratogenic and must not be given to pregnant women. Treatment with Isotretinoin should be stopped if psychiatric changes occur during treatment.
Visit https://www.drugscaps.com/product-category/face-care/ to find products online.
Below mentioned are some home remedies for acne;
Tea tree oil – Tea tree extract has natural antibacterial and anti-inflammatory properties. Teat tree oil can be added in creams, gels, or essential oil.
Jojoba oil – Waxy substances in jojoba oil helps to repair skin. Jojoba oil can be added in creams, gels, essential oils, and clay face masks. It can also be applied directly to acne sore with the help of a cotton pad.
Aloe Vera – Aloe Vera has antibacterial and anti-inflammatory properties. Aloe Vera can be added to creams or gels.
Honey – Honey has anti-oxidant properties that help to clear clogged pores from debris. Honey can be directly applied to pimples using a cotton pad or a clean finger.
Green Tea – Green tea contains antioxidants. Green tea extract can be applied to the skin or it can be used as a drink.
Visit https://www.drugscaps.com/product-category/face-care/ to find products online.
- Rosacea and Acne. (2016). In British national formulary 70. London: BMJ Publishing and the Royal Pharmaceutical Society.
- Maxine A. Papadakis
Dermatological Disorders In Current Medical and Diagnosis Treatment. Mc Graw-Hill Education, 55th Edition, 2016. (page: 127-129)
- Joseph T. Dipiro
Acne Vulgaris In Pharmacotherapy Handbook. The McGraw-Hill companies, 7th edition, 2009. (page: 179-185)
- Zaenglein AL, et al. Guidelines of care for the management of acne vulgaris. Journal of the American Academy of Dermatology. 2016;74:945.
- Revol O, et al. Psychological impact of acne on 21st-century adolescents: Decoding for better care. British Journal of Dermatology. 2015;172(suppl.1):52.
- Acne: Tips for managing. American Academy of Dermatology website. aad.org/public/diseases/acne-and-rosacea/acne#tips. Accessed March 11, 2018.
Melnik, B. C. (2015, July 15). Linking diet to acne metabolomics, inflammation, and cosmogenesis: An update. Clinical, Cosmetic, and Investigational Dermatology, 8, 371–388
Arslan Fazal is a student of the Aust Abbottabad University of Science and Technology. He started his graduation in 2016 and graduated in 2020. I’m a professional article and blog writer, has written dozens of content on different topics and worked with professionals all over the globe. Feel free to contact me for any assistance. [email protected]
What You Should Know About Colon Therapy?
If Doctors say it doesn’t help, why does it? There are many studies that have shown Colon Hydrotherapy yields no evidence of treating various diseases, and there is just as much evidence proving harm from Colon Hydrotherapy. Colon Hydrotherapy cannot claim to be a cure for a disease, but the environment it creates in the colon is definitely capable of helping assist in healing and attainment of health check Farid Zarif ND for further details.
Are there any methods of therapy that could be misinterpreted as “Colon Hydrotherapy” that we currently use and that have harmful effects?
Yes. There are different ways that people attempt to cleanse their colon every day. Enemas and laxatives have been on the market for many years. Laxatives are habit-forming and dehydrating. Some laxatives contain chemicals that may cause an imbalance with our natural enzymes and hormones. Ingesting laxatives too frequently may cause the loss of peristalsis (the muscle contractions that move waste) and may force an individual to continue using laxatives to have bowel movements. Most laxatives are osmotic in some way, which means they draw water from surrounding areas in your body into the intestines to carry waste out. This is extremely dehydrating, causing more constipation unless fluids are replenished.
Enemas, like laxatives, should only be used occasionally and it is very important to be careful and follow directions. With enemas, there is a lack of control when it comes to the pressure of fluid intake. This can be damaging. Using enemas can stretch the last portion of the colon, the sigmoid to the rectum, and can cause problems with our natural ability to get rid of waste. I do believe enemas are useful and can be done correctly.
What’s the purpose of cleansing the colon?
The truth is, we have cleansed our colon since 1500 B.C. It was more common for royalty to be regularly given enemas. Physician’s back then had discovered that death starts in the colon and that food is the culprit. Our body needs to properly digest and balance intestinal bacteria in the digestive tract. Your colon can become out of balance because of lifestyle choices. Proper cleansing has been a goal of the human race for thousands of years.
What exactly is Colon Hydrotherapy?
Colon Hydrotherapy is a modernized version of the enema. The goal is the same, but it differs in that it is perfectly safe and reliable. In Colon Hydrotherapy, temperature-regulated water is introduced into the colon at an extremely low PSI. All of these settings are very controlled and precise. If you can imagine turning your sink on a little past the point of a drip, where the drops connect to form a slow and steady line, this can give you an idea of the water pressure in a colon hydrotherapy session. It is between 1/8 and 1/4 PSI on a “fill”.
The water slowly makes its way through the entire large intestine (About 5 feet). This whole time the intestine is being hydrated and toned. Stool that has been trapped can now loosen and make its way out. The client can let the therapist know when they are ready to empty. There is a gentle feeling of fullness that lets your body know when it’s ready to release. Then the therapist will set the device for removal. Water and waste is emptied out of a separate, larger waste tube using the pressure coming from your own body. No suction is used to empty the colon.
Many therapists practice this type of therapy in different ways. I was trained to use bodywork and massage. There are specific points on the body that can help release waste and improve the flow of energy through various organs as well as the colon. You might find a therapist out there that you don’t like. This shouldn’t make up your mind about Colon Hydrotherapy.
Since it is not a widely accepted therapy, there are bound to be times when someone does not have the proper training. If you went to get your nails done, and the manicurist cuts you and does a horrible job, do you swear off manicures as a dangerous and unhealthy practice? Probably not, the person you got must have been trained poorly or not suited for the job. Be smart about where you receive a colonic, and make sure they are checking for contra-indications like severe cardiac disease, cirrhosis, severe anemia, and severe diverticulitis to name a few.
How often is too much?
Since Colon Hydrotherapy hydrates and tones the walls of the intestine, it is safe for periodic use. It had been a steady passage from alternative to mainstream for colonic irrigation – but that could change after researchers have rubbished the treatment’s benefits, and cautioned about its side effects – including cramps, nausea, vomiting and renal failure.
The process, rebranded from the agricultural sounding colonic irrigation to less intrusive “colonic hydrotherapy”, has become less taboo over the last two decades, having become popular with celebrities desperate to lose weight.
During a normal 45-minute session, which currently costs between $122-$180, about 15.85 gallons of filtered water is used to flush the colon, after which users supposedly benefit from increased wellbeing, better skin, smoother bowel movements, and feeling lighter.
But a new, comprehensive review of research has chronicled the side effects suffered by some users of “the internal bath”, from cramping to renal failure – when the kidneys fail to adequately filter toxins and waste products from the blood.
Medics at Georgetown University School of Medicine, who examined 20 studies published in medical literature during the last decade, expressed concerns over the treatment’s regulation.
They concluded, in a paper published in the Journal of Family Practice, that while there was little evidence of the much-vaunted benefits from the treatment, there were “an abundance of studies noting side effects of using cleansing products including cramp, bloating, nausea, vomiting, electrolyte imbalance and renal failure”.
The same was true of other less intrusive colon treatments which can be widely purchased on the internet, they said. The paper’s lead author Ranit Mishori, a specialist in family medicine at Georgetown, said: “There can be serious consequences for those who engage in colon cleansing whether they have the procedure done at a spa or perform it at home.
“Colon cleansing products in the form of laxatives, teas, powders and capsules… tout benefits that don’t exist.” She added that some treatments had also been associated with aplastic anemia (where bone marrow does not produce sufficient new cells to replenish blood cells) and liver toxicity.
The doctors also expressed concerns colon cleansing services were being offered at some spas and clinics by operators claiming they are “colon hygienists” but who had little or no medical training. They concluded, in a paper published in the Journal of Family Practice, that while there was little evidence of the much-vaunted benefits from the treatment, there were “an abundance of studies noting side effects of using cleansing products including cramp, bloating, nausea, vomiting, electrolyte imbalance and renal failure”.
NHS advice states colonic irrigation is still a complementary therapy, and “there is currently no medical or scientific evidence to prove its effectiveness”. However, it says, the procedure is usually safe. As colonic treatments are mostly undertaken in private, statistics on the number of users are hard to establish.
Anecdotally, doctors have said patients admitted to hospital following colonic irrigation have been diagnosed with a perforated colon – obtained during the procedure caused the tip that injects the water or from overpressure causing failure of a weak spot in the colon wall.
Scottish surgeon Sir William Arbuthnot-Lane, who worked at Guy’s hospital in London, is credited with pioneering treatment for constipation in the early 1900s.His work led him to advocate eating fruit, vegetables and bran cereals as a way to control bowel problems.
His views were dismissed by doctors and media authorities at the time, leading him to ask to have his name removed from the medical register in order to promote the New Health Society, the first organized body to deal with social medicine, in 1925 to publicize his views on healthy diet and life.
Dr. Mishori added there were other ways to increase well-being. She said: “Eat a balanced diet, exercise regularly, get six to eight hours sleep and see a doctor.”
Saira Munsif Masters in chemistry and education from hazara University. I’m a professional articles and blogs writer, have written dozens of content on different topics and worked with professionals all over the glob. Feel free to contact me for any assistance. [email protected]
The impact on painkillers on your gut
Alongside food, oxygen, water, painkillers are also a staple for living nowadays. We have to battle stress-induced headaches, sports-injuries, awful toothaches, infections and whatnot in the daily routine. With old age, things become even worse. Painkillers, on the other hand, bring the much-needed relief in life.
However, with pros comes cons. Painkillers are, after all, medicines and hence they too carry with them side effects that have implications for health in general and gut in particular. The problem starts when painkillers are overly relied upon and consumed in large quantities. Moderate usage and following the dosage guidelines make the painkillers safe to use.
Type of painkiller is important too!
The impact on the body is determined by the type of painkiller chosen. Different types have different potencies and strengths, which then determines the impact on the body as well. The stronger they are, the graver is the impact of their overindulgence on the gut. Following are some commonly used painkillers and their effect on the stomach:
Commonly known as Tylenol, Paracetamol, Panadol etc., this painkiller is perhaps the most frequently used. This over-the-counter painkiller is also present in some of the cold medicines, that too, can sneak into the daily regimen, leading to overconsumption.
The perhaps most profound impact of acetaminophen is on the liver. It is amongst the leading causes of liver failure and toxicity. Common symptoms of this condition include vomiting or nausea with swelling and tenderness in the liver. It is imperative for people who liberally take this painkiller and experience these symptoms to visit a liver expert like Prof. Dr. Altaf Alam for timely intervention.
Moreover, in large doses, it can also lead to nausea and stomach cramps as well.
Opioid analgesics are not an OTC drug. Being a prescriptive painkiller, the chances of its abuse are less, but its impact is severe even when taken within the required dosage. Used for chronic pain management, many people are even unable to complete their regimen, such severe is the impact. It leads Opioid-induced bowl dysfunction that gravely impacts the gastrointestinal health.
The symptoms of OIBD include nausea, vomiting, reflux and bloating. It also decreases the rate of digestion, leading to discomfort. But the most profound impact is constipation. Hard stools get extremely painful to pass. Incomplete evacuation also causes further problems.
Non-steroidal anti-inflammatory drugs are aimed at pain relief and also decreasing inflammation as well. It is very frequently used due to its anti-inflammatory properties as well. It’s different types with different repercussion for the body.
Aspirin comes with a lot of long-term side effects for the gut, and health in general, if and when taken in large quantities. It leads to bleeding in the stomach. Aspirin also leads to the formation of ulcers in the stomach.
Ulcers are the sores in the lining of the stomach. NSAIDS leads to the stripping away of the protective mucosal layer of the stomach. Acid then is able to attack the stomach tissue, leading to the formation of ‘holes’ in the lining.
Although ulcers are easy to treat, undetected ulcers can be dangerous. Moreover, ulcers also lead to a lot of pain and discomfort. Symptoms of this condition includes perpetual stomachache, decrease in appetite, weight loss, heart burn, nausea, bloating etc.
Although, Ibuprofen is better than aspirin as it leaves the body quicker, nonetheless, long-term ibuprofen usage also leads to health issues. It causes stomachache, ulcer, acidity, vomiting and nausea.
Another NSAID with implications for gut health is naproxen. It is available both as OTC and prescription pill. Its side effects include indigestion, heartburn, stomachache, nausea, vomiting, diarrhea.
It can also lead to inflammation in pancreas, which leads to fever alongside stomachache and digestion issues. Naproxen can also lead to gastric ulcers.
Minimizing the danger
Living with pain is not easy and so painkillers are a necessary evil in most of the cases. Some helpful steps can be done to minimize the dire impact of their consumption on the stomach.
Always take as little as possible; do not always resort to painkillers. If the pain is tolerable or if you are eating painkillers to preempt the pain, change this habit. Moreover, it is important that you take them only and as long as the pain persists.
When taking any medicine, be watchful of the impact on your health, in case there is some reaction that aggravates the health. Also, be mindful of which medicines you are taking, in case they too, pack some painkiller, leading to the risk of overdosage.
Combination of painkiller is also important. Do not eat NSAIDS in combination, take them with an acetaminophen if need be, but don’t eat multiple NSAIDS at the same time. When you eat NSAIDs and other high-potency pain killers, take them with food so that stomach suffers as little as possible.
Most importantly, take painkillers at the discretion of the doctor. If you are suffering from bodily aches etc., visit a credible doctor like Assist. Prof. Dr. Mujahid Israr for help with pain management rather than chugging back painkillers like candy!
How long do succulents live?
It is a tough question because succulents are so diverse. There are thousands of different varieties with their own needs and habits. As a gardener, it is important to know the plants about their life span, how fast they grow, and what they need in terms of sun, water, pots, soil, and the like.
Lifespan of succulents
There are many plants with unknown ages, simply because they haven’t been observed in nature long enough. Here are a few succulents with known life spans:
Jade Plant (70-100 years), Hens and Chicks (3+ years), Aloe Vera (5-25 years), Barrel Cactus (Centuries), Living Stones (40-50 years), Christmas Cactus (30+ years). You can buy succulents online.
Some succulent plants have factors at play that drastically affect how long they live. For example, many hybrids, such as Echeveria Perle von Nurnberg, have short lifespans. Some succulents don’t live long but grow offsets to replace themselves. The main plant only lives around 3-4 years but sends out lots of offsets in a lifetime.
Aeonium kiwi is a monocarpic plant that dies after flowering. Depending on how fast the succulent matures, it may live for many years before it blooms. If the succulent begins to flower, the best thing to do is take some cuttings for propagation. It carries the generation forward.
Growing condition of succulents
Succulents are typically slow growers. That doesn’t mean their growth is all the same, though. The majority of succulents cycle between dormancy and a growing season each year. Plant dormancy is very similar to hibernation in animals. During a certain season, succulents go into survival mode to make it through extreme weather conditions. They slow or stop their growth in order to conserve energy. Because of this, succulents usually don’t need as much water or sun while dormant. The growing season is when succulents get to work. This is when they’ll form new leaves, send out offsets, and flower. Succulents typically appreciate extra water, sunlight, and even fertilizer during this time.
Succulents native to the Northern Hemisphere usually go dormant during the winter and grow in the spring and summer. On the other hand, native southern plants typically shut down when it’s hot outdoors in the summer. Plenty of sunlight is needed. However, most species cannot tolerate direct sun. Indirect or bright, filtered light is usually the best. If it doesn’t receive enough sunlight, the plant may begin to fade.
The soil must be well-draining. There are many specialty succulent and cactus mixes that are perfect. A mix can be prepared by mixing one part potting soil with one part perlite. If the mix retains too much water, the roots will begin to rot. Fertilizer depends on the variety of the succulent. Some appreciate multiple doses a year while others don’t need it at all. Plants that do need fertilizing usually prefer one that’s balanced or low nitrogen.
Keeping pests and diseases well away from the plants is crucial. Knowing the signs for common succulent pests such as mealybugs, aphids, and scale insects. Diseases are usually rare in succulents, but nearly all are prone to root rot. Prevent this by watering properly and keeping the stem and leaves dry.
It should be remembered that these care tips are general and vary from plant to plant. For the best instructions, it is better to know the succulent’s specific needs. Proper care definitely will be beneficial for the succulents. To really extend their life span though, the following things are to be done:
Keeping a consistent watering schedule, Using good quality soil, repotting into new pots as needed, acclimatization of succulents when moving them to a new location, taking good care of the roots, Propagation of plants so that it can live on through its descendants.
A new succulent should be known very correctly, as its care can make a huge difference. So learning about that plant, track its progress. The succulent is dependent on its grower to a great extent as it can not speak out about its requirements.
Umar Nisar was born and raised in the busy city of Abbottabad. As a journalist, Umar Nisar has contributed to many online publications including PAK Today and the Huffing Post. In regards to academics, Umar Nisar earned a degree in business from the Abbottabad UST, Havelian. Umar Nisar follows the money and covers all aspects of emerging tech here at The Hear Up.
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