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Acne

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Acne
  • 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
  • Spots
  • 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
  • Inflammation

 

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)
  • Pregnancy
  • 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
  • Pain
  • Itching
  • Lesions over the;
    • Face
    • Neck
    • Upper chest
    • Back
    • Shoulders
  • Comedones, that are the hallmark of acne vulgaris
  • Inflammatory papules
  • Pustules
  • Ecstatic pores
  • Acne cysts
  • Scaring

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

Topical preparations for acne include;

  • Benzoyl peroxide
  • Azelaic acid
  • Topical Antibacterial like
    • Erythromycin
    • Clindamycin
  • Topical Retinoid
    • Retinoid
    • Adapalene

 

These preparations are used for Mild to moderate acne, comedones, and inflamed lesions.

Benzoyl peroxide

Benzoyl peroxide (Benzac AC, Acnestar ) is effective against;

  • Mild to moderate acne
  • Comedones
  • 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

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 Antibacterial

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

Topical retinoid is effective against;

  • Inflammatory lesions
  • Comedones
  • 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

Oral preparations for acne include;

  • Systemic Antibacterial
    • Oxytetracycline
    • Tetracyclin
    • Doxycyclin
    • Minocycline
    • Clindamycin
    • Erythromycin
  • Oral Hormone
    • Co-Cuprinol
  • Oral Retinoid
    • Isotretinoin

Systemic antibacterial treatment

Systemic antibacterial used for the treatment of acne are as follows;

  • Oxytetracycline
  • Tetracyclin
  • Doxycyclin
  • Minocycline
  • Clindamycin
  • Erythromycin

 

  • 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

Oral Retinoid used for the treatment of acne is isotretinoin.  It reduces sebum secretion. Isotretinoin is used for the systemic treatment of;

  • Scarring
  • 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.

Home Remedies

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.

References

  • 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)

 

 

  • 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
ncbi.nlm.nih.gov/pmc/articles/PMC4507494/

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7 Comments

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HEALTH

How To Get Good Quality Sleep

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How To Get Good Quality Sleep

1. Get Rid of All Electronics from The Bedroom

Most electronic devices (with screens on them) produce blue light, hence they are not recommended in the bedroom. Although you may be aware of this, the blue light produced by these gadgets hinders the production of sleep hormones, hence could affect your sleep patterns.  E-readers, laptops, tablets, game consoles, and cellphones shouldn’t be allowed in the bedroom.

In addition to kicking out all the electronic devices from the bedroom (computers and TVs included), you might also have to adjust the position of the alarm clock as well.  This is particularly important for digital alarm clocks as they produce distractive light as well. Make sure the alarm clock faces away from you as well. This should help eliminate anxiety related to gazing at the watch when you should be trying to sleep. Having the clock face away from you also reduces the risk of anxiety, and particularly if you tend to worry about why you aren’t drifting off. Make sure the alarm clock is as far away from the bed and your reach as possible. This should prevent you from snoozing the alarm when it goes off in the morning.

2. Make Sure the Bedroom Is Dark Enough

We all know how disrupting artificial light can be, and especially when trying to get some sleep. Natural light too can be as distracting, which is why you not only need to keep electronic devices out but also keep the light out as well. You may have to switch to blackout blinds or heavy curtains to block the light, and also remove night lights from the bedroom as well. Always remember to turn the lamp off before drifting off.

If you cannot part ways with your cellphone at night, then consider putting it in silent mode, then flip it over with screen-side down immediately after going to bed. Most phones will light up if there’s email notification, incoming text, or push notifications. Keeping the phone flipped over reduces the chances of seeing the screen come to life, hence sleep without any disruptions/distractions.

3. Keep the Room as Quiet as Possible

Any form of noise can disrupt you from sleep. Noise can make it hard for one to drift to sleep, or even stay asleep, one of the reasons you need to ensure your bedroom is as comfortable and quiet as possible. A calm and quiet bedroom makes it easy to sleep like a baby. Soundproofing the room might be the only viable option if the noises are coming from the traffic outside, or a noisy neighbor down the street.

You could also try investing in a sound machine. The sound machine produces mellow and soothing sounds that help mask noises coming from the outside. The soft, soothing sounds produced makes it easy for the brain to relax, helping you drift to dreamland.

Listening to your favorite, but relaxing music can also help you fall asleep. You, however, need to ensure the volume isn’t too loud and also have a timer to help set it off after you have fallen asleep.  Although it might be relaxing to drift off to sleep with your favorite jams playing in the background, you don’t want to wake up in the middle of the night to blaring sounds of the same music. Have a timer turn it off as soon as you are asleep to avoid disruptions.

 4. Keep the Bedroom Cool and comfortable

Your body temperature will drop naturally as you drift into a deep sleep. Setting the bedroom temperature a few degrees lower than in other rooms can help the body cool off as well. Experts recommend between 60 and 67 degrees in bedrooms for better sleep.

Sleeping naked also makes it easier for the temperature to drop down, and also eliminates the discomfort that comes with sleeping in pajamas or nightgowns. Sleeping naked is fulfilling too. Your mattress can help you keep cool, many mattresses now have breathable materials that help you to regulate your temperature while you sleep. Take a look at these Ikea mattress reviews.

5. Consider Aromatherapy

Introducing certain scents in the bedroom creates a calming and relaxing atmosphere, excellent for winding down and sleep.   These scents will train the brain to enter into relaxation and sleep mode as soon as they hit your nostrils, hence recommended. Some of the best scents to try in the bedroom include vanilla, rosemary, and lavender.

 

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HEALTH

NHS Mental Health Director Claire Murdoch Warns Game Developers Of Loot Box Risks To Children

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NHS Mental Health Director Claire Murdoch

The battle for children and shoes continues while the British NHS Mental Health Director, Claire Murdoch has urged the toy industry to do something to make socks present in video games and available to children.

Gamesindustry.biz covers the ban on Murdoch Loot Fund, where you can find the official statement on the NHS website that details the organization’s ideas about monetization mechanics, gambling and addiction.

But that’s not all, according to the NHS director, he believes socks can affect children and their well-being in a harmful way.

Here is an excerpt from Murdoch pleading with other industry agencies to respond to his call so that other organizations and companies can join the ban on socks in video games to help children:

“Frankly, no company should prepare children for addiction by teaching them to bet on the contents of these socks. No company should sell booty toys to this opportunity item, so yes, these sales should end.

Young people’s health is at risk, and while the national health services are intensifying with these innovative new services available to families through our long-term plan, we cannot do it on our own, so other parts of society must do what they can to reduce risks and protect children. Wellness. “

The publication’s website highlights that this looting ban plays a role in the company’s “long-term plan” to improve mental health. As of now, the health service has a new treatment center that will join 14 other NHS games clinics across the UK in the foreseeable future.

Meanwhile, Murdoch wants the toy industry to ban the use of socks, especially for nicknames that children love, as he wants initial landing rates and “fair and realistic spending limits”.

However, while Murdoch wants parents to be more aware of what their children are playing and the content of such games, she also feels that the gaming committee should classify the Box games as games of chance.

Finally, it is not known whether other companies and organizations will respond to Murdoch’s invitation, but it will certainly determine the time if they will.

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HEALTH

Surrogacy cost: how to establish a profitable cooperation with a surrogate mother

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Surrogacy cost: how to establish a profitable cooperation with a surrogate mother

A couple who have realized the need to engage the services of a surrogate mother needs reliable information. Should I look for a surrogate mother on my own? How much will the costs increase if you entrust this task to a reproductive clinic? What is the cost of a surrogate mother and is there a legal guarantee of getting a child and parental rights to him or her? There are many questions, and answers vary not only from country to country but also among clinics. In this article, we will give answers to them in the context of reproductive services in Ukraine.

Future parents can choose a woman on their own whom they will trust the right to carry a child. In this case, the candidate will need a full medical examination confirming the absence of contraindications to artificial fertilization and surrogacy. Conducting such private surveys has no sense, as clinics providing an opportunity to involve your own surrogate mother insist on the examination made by their own specialists. At the same time, they usually have their own bases of surrogate mothers, whose health is completely satisfactory. As for the costs at this stage, with the cooperation of the Professor Feskov’s Ukrainian Center of Human Reproduction, there is no difference between the cost of surrogate mother services chosen by clients or provided by the clinic (future parents will be able to get acquainted with the provided candidate personally if desired). Examinations and the surrogate mother costs are included in the price of guaranteed programs.

The Feskov Human Reproduction Group programs are guaranteed. This means that by paying a fixed amount, the couple will become the parents of a healthy child. No payment of unsuccessful IVF attempts and surrogate mother’s pregnancy terminations: in case of failures, repeated cycles of procedures are carried out until the result stipulated in the contract (birth of a healthy child) is achieved.

The Civil Code and the Family Code regulate the legal relationship between genetic parents and the woman who carries the child for them: genetic parents have an undeniable right to the child and their data is entered in the birth certificate. There is no way a surrogate mother can keep a child.

You can get more detailed information on the programs of Feskov Human Reproduction Group including accommodation, food, and legal support, from the managers on the company’s website.

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