Foods to avoid if you have Acne
Patients should be advised to eat a well-balanced diet and to avoid foods which consistently result in acne flare-ups. B. Cleanliness. Development of acne is not related to dirt. Excessive scrubbing may worsen the condition. Patients should be encouraged to wash affected areas with any standard soap once or twice a day and after strenuous physical activities. C. Medications that worsen acne include oral contraceptives, corticosteroids, anabolic steroids, phenytoin, lithium, and isoniazid.
Acne vulgaris, commonly called acne, is inflammation of the pilosebaceous glands. These are the glands which produce oil for the hair. Acne is more likely to occur in adolescent males and is associated with testosterone level and the ingestion of greasy foods food containing trans-fatty acids (TFA). TFA are synthetic alterations of naturally fatty acids and are present in processed foods, candies, and potato chips. The increase in androgen production that occurs during adolescence increases the production of sebum, an oily skin lubricant. Sebum combines with keratin to form a keratin plug. An individual has little control over acne except to eat a nutritionally healthy diet and practice good hygiene. Acne is significantly influenced by age, heredity, stress, hormonal changes, and onset of puberty. All of these are beyond the patient's control. Acne is treated by gently applying a cleansing agent several times a day to the skin. Vigorous scrubbing should be avoided. In addition, the...
There is little commonality in the scientific methods, processes, and formulations required for the wide variety of cosmetics and toiletries in the market. Products range from preparations for hair, oral, and skin care to lipsticks, nail polishes and extenders, deodorants, body powders and aerosols, to quasi-pharmaceutical over-the-counter products such as antiperspirants, dandruff shampoos, antimicrobial soaps, and acne and sun screen products.
The effectiveness of steroids in the long-term treatment of MS was investigated in one systematic review (Ia), six RCTs (Ib) and one CCT (IIa). The review117 included four placebo-controlled RCTs comparing the effects of ACTH (n 1), prednisolone (n 1) and methyl-prednisolone (n 2) given for 9-18 months. It reported no significant effect on long-term functional improvement or on relapse occurrence. The review also reported the occurrence of both major and minor side effects including herpes simplex, herpes zoster, severe ankle oedema, femur fracture, acute anxiety and severe depression.117 Four of the controlled trials also compared steroids to placebo. Two RCTs, one of ACTH and the other of two different doses of zinc hydroxide corticotrophin, found no effect of treatment on any of the outcomes investigated.142,143 One reported a greater incidence of adverse effects including steroid diabetes, increased blood pressure, oedema, acne and hirsutism in the intervention groups.142 A...
Acne is a common disorder of the oil glands in the skin and can appear on the face, back, shoulders, chest, and arms. In adolescents during puberty, sex hormones stimulate the sebaceous glands resulting in excess secretion of sebum, a fatty oil that lubricates the skin. The glands become blocked and inflamed, which causes blackheads and pimples. If the glands become infected, sebum and pus build up under the skin and larger pimples and cysts appear which can eventually lead to scarring and pitting. In adults, stress, hormonal fluctuations, and possibly food allergies may be the cause of acne. Oral contraceptives can cause breakouts. Excess dietary iodine irritates the pores and can induce flareups. Iodine is found in iodized salt, shellfish, seaweed, and fast foods in which an average meal can contain 30 times the RDA, and in milk, which can be contaminated from milking equipment and cow medication.10 Acne may be caused by a deficiency in zinc. It is important to keep the skin clean...
Acne comedones are usually found on the forehead and upper cheeks of adolescents. Comedones may progress to inflammatory lesions on the lower cheeks, chin, chest, upper back, and shoulders. C. Acne will often subside during the late teens. However, 20-50 of women seeking acne treatment are in their 20s, and a considerable number have persistent acne into the 30s, 40s, and even 50s.
There are two species of mites in the genus Demodex parasitic on humans, namely, D. folliculorum (in the hair follicles) (Figure 23.6 and D. brevis (in the sebaceous glands). Most people harbour these mites in the face, particularly around the nose. Older persons are more often infested than younger ones. The medical importance of the presence of Demodex is difficult to assess but most infestations appear to be benign and of no or little pathological significance. In rare cases, these mites are thought to be involved in the loss of eye-lashes and in granulomatous acne (Alexander 1984 Varma 1993).
Acne, increased appetite, weight gain, depression, fatigue Weight gain. hirsutism, acne, oily skin, breakthrough bleeding 3. Androgenic effects attributable to progestin include hair growth, male-pattern baldness, nausea and acne. If such side effects develop, a switch to a second- or third-generation agent with lower androgenic potential may resolve these problems. Women who experience nausea may benefit from taking the medication at night.
The most common and debilitating skin problems arise from the long-term use of glucocorticoids. The manifestations include striae, friable skin, ecchymosis, acne-form rash and cushingoid features. In addition, cyclosporine may cause thickening of the skin, hypertrichosis, gingival hyperplasia, epidermal cysts, pilar keratosis, and folliculitis. Treatment includes reducing the dosage of these medications to the lowest level necessary to maintain immunosuppression and topical measures.
Other clinical manifestations include developmental delay, short stature, ocular, dental and skeletal abnormalities, hyperhidrosis, hyperkeratinization of the palms and soles, bullae on minimal trauma, hair loss, sometimes gonadal failure, and features of premature ageing.
Androgen administration to male or female adults, especially at high dosages, results in erythrocytosis and polycythemia, fluid retention, and it may produce or exacerbate edema. This can be serious when associated with congestive heart failure, cirrhosis of the liver, or nephrotic syndrome. Since androgens stimulate the activity of sebaceous glands, oily skin and acne are found in some individuals who are receiving androgen therapy. A change in cholesterol levels can result from androgen therapy, such as decreased levels of high-density lipoprotein cholesterol and increased levels of low-density lipoprotein cholesterol. This change in the distribution of cholesterol may contribute to increased risk of atherosclerosis and coronary artery disease, especially in athletes who are exposed for long periods to high levels of anabolic steroids.
A 47,XYY karyotype is seen in about 1 in 1000 male births, but it is usually found incidentally while looking for something else (amniocentesis for advanced maternal age, as part of a family study after detection of a familially transmitted structural abnormality, as part of a cancer study, etc.). This is because most individuals with 47,XYY are not dysmorphic. They tend to have tall stature and large tooth size, and some do show minor anomalies and have a severe type of acne in adolescence. IQs are near normal, although somewhat lower than siblings. Fertility is normal and 47,XYY individuals do not produce an increased incidence of offspring with sex chromosome abnormalities. Several decades ago the question was raised as to whether the presence of an extra Y chromosome predisposed males to violence, criminality, or aggressive behavior. This has not proved to be the case.
Inhibition of LH and FSH release, which in turn results in decreased ovarian steroidogenesis and regression of endometriomas. Because of the virilizing side effects of danazol, causing acne and hirsutism, its use in en-dometriosis has been largely supplanted by the use of GnRH analogues. Danazol is also approved for use in fi-brocystic breast disease and hereditary angioneurotic edema.
Corticosteroid therapy may cause tachyphylaxis, leading to decreased efficacy with continued use and culminating in an acute flare-up when therapy is terminated. Tachyphylaxis can be minimized by switching to less potent corticosteroids and having them apply the medication less frequently once the lesions have improved. Local side effects include acne and localized hypertrichosis.
Other findings in this patient population are four-limb symmetric complex syndactylies of the hands and feet, with brachydactyly and joint stiffness. Malformations of other joints, including the elbows and shoulders, may also be found. At birth, height and weight are increased however, final height is below average due to deceleration of limb growth. Cardiovascular defects can also occur, as well as other visceral anomalies. Lastly, acne vulgaris, extending to
Warts are a very common illness worldwide. In the United States, children are the most likely targets of the common wart viruses. Warts follow acne and atopic dermatitis in frequency of diagnosis in pediatric dermatology clinics 12, 13 . It is thought that 10-20 of children will at sometime be infected with warts 1, 3, 14 . The peak incidence of disease varies from study to study with some studies showing a peak age grouping of 8-9 years and others pointing to a peak age range between 12 and 18 year olds 1, 14-16 . The incidence of plantar warts has doubled from its incidence in 1968, which was then found in 1.8-2.9 of primary and secondary school children, to currently 4.5 16 . Females and males are equally affected by HPV infections. The leading sites of HPV infection are the extremities, face and body. Hand warts are often transferred to other cutaneous sites including the lips, nose, and face, via autoinoculation. Autoinoculation is generally the route of disease extension or...
No benefits demonstrated may cause testosterone production to decline and shrinking of the testicles may cause light-headedness, aggression, nausea, vomiting, headaches, depression, lethargy, rashes, acne, and virilization in females. Some may increase risk of developing cancer. Andro group and other steroid alternatives are banned by the military.
Individuals with BDD are preoccupied with the idea that some aspect of their appearance is unattractive, deformed, or 'not right' in some way. Concerns usually focus on the face or head but can involve any body area. (5,10 The skin, hair, and nose are most often disliked (e.g. acne, scarring, lines, or pale skin, hair thinning, or a large or crooked nose). Concern with bodily asymmetry (e.g. 'uneven' buttocks) is common. Although the concern usually focuses on specific areas, it may involve overall appearance. An example of this is muscle dysmorphia, in which patients think that their body build is small and puny, when in reality it is large and muscular. BDD by proxy consists of a preoccupation with supposed flaws in another person's appearance, which may lead to insistence that the person have surgery or dermatological treatment.
Sulfur is used as a keratoplastic in the treatment of acne and seborrheic dermatitis. (4) Tretinoin (topical) (Retin A ). This agent is used in the treatment of severe acne. The application of this agent to the skin will produce a horny layer of skin that is more easily removed. It is important that the patient use this preparation as directed by the physician and package directions. This medicine should not be applied to windburned or sunburned skin. It should not be applied to open wounds. Furthermore, the medication should not be applied inside the nose, around the eyes, or around the mouth. While the patient is using the medication, he should avoid exposing the area being treated to too much wind or sun (or sun lamp). When the patient begins using this product, he may find that he is more sensitive to cold temperatures and to wind than before therefore, protection should be worn until the persons sees how he reacts. This product is available in cream,...
Indications for the Use of Keratolytic Agents. Keratolytic agents are used to remove warts and corns. They are also used in the treatment of severe acne. d. Indications for the Use of Keratoplastic Agents. Keratoplastic agents are used in the treatment of acne, eczema, psoriasis, and seborrheic dermatitis.
Steroids are not without side effects. Acne, weight gain, seizures, psychosis, depression, headaches, fatigue, facial hair, nausea, vomiting, and adrenal insufficiency can be very serious adverse events. Thus, the long-term use of steroids is not advised, nor is it effective in MS.
An agent used in the treatment of severe acne and in the removal of warts or corns. d. An agent used in the treatment of acne, eczema, and psoriasis. b. These agents sometimes produce a yellowish and greasy scaling around the mid-parts of the face when they are applied as a treatment for acne. b. A keratolytic agent used in the treatment of severe acne. c. An astringent used in the treatment of acne and seborrheic dermatitis.
Can develop in teenagers who take pill medications (eg, tetracycline or doxycycline), especially with minimal water, and then lie down. Prior history of esophageal dysmotility or stricture will make pain more likely. Doxycycline produces an acidic solution or gel as it dissolves and thus is caustic when it remains in the esophagus. Symptoms may be noted several days after beginning medication, but frequently pain occurs after taking the first dose. Diagnosis relies on a careful history because physical exam is usually unremarkable. Because these medications are chronically used by adolescents for treatment of acne, teenage patients may not reveal they take them unless specifically asked.
Acne vulgaris is a chronic inflammation of the sebaceous glands (oil glands) of the skin, which usually develops during adolescence. Lesions develop rapidly and in crops, located mostly on the face, sometimes on the sternal region, the shoulders, and the back. The lesions may cause considerable scarring on healing. Treatment includes good personal hygiene to help prevent secondary infections, dietary measures, antibiotics, and various skin lotions.
This can be due to lesions of the adrenal cortex, to extrapituitary, ectopic production of ACTH by neoplasms, to excessive corticotrophin-releasing hormone (CRH) production, and to pituitary-dependent ACTH excess. The latter, termed Cushing's disease , was recognized and described by Harvey Cushing in 1932. The syndrome is characterized by centripetal obesity, plethoric moon-shaped facies, hirsutism, acne, diabetes, hypertension, muscle weakness, bruising, mental disorders, amenorrhea and osteoporosis, all due to gluco-corticoid hypersecretion. Hyperpigmentation is associated with ectopic ACTH production and, in severe cases, with pituitary-dependent ACTH excess. This is because the pro-hormone from which ACTH is eventually cleaved (pro-opiomelanocortin) also contains the amino acid sequences for melanocyte-stimulating hormone. Left untreated, Cushing's disease leads to severe complications.
The DSM-IV task force considered other refinements to the criteria of social phobia. The parenthetical name 'social anxiety disorder' was added to acknowledge the significant impairment associated with social phobia and its differentiation from specific phobia. The criteria were also modified to include features specific to children 11.) There must be evidence that children are capable of forming social relationships, and anxiety must be evident in peer relationships. It is also acknowledged that children may manifest their anxiety differently than adults they may cry, throw tantrums, freeze, or shrink from interactions with strangers, and they may not acknowledge that their fears are irrational. Also, social anxiety may develop as a result of some medical conditions. For example, persons may become excessively anxious or avoid social situations because of obesity, acne, benign essential tremor, stuttering, or Parkinson's disease. These conditions are not considered exemplars of...
Tetracyclines are the first broad-spectrum antibiotic that was used to halt the growth of many gram-positive and gram-negative bacteria. It is used to treat a variety of infections including acne vulgaris, actinomycosis, anthrax, bronchitis, and other systemic bacterial infections including bacterial urinary tract infections.
Benzoyl peroxide is first-line therapy for mild acne. It is available over-the-counter. The liquids and creams (Benoxyl) are less irritating and are useful for dry skin. The gel (Benzagel, Persa-Gel) is more irritating but more effective for oily skin. Mild redness and scaling occurs during the first week. It may irritate the skin, bleach the clothes, and inactivate simultaneously applied tretinoin and other anti-acne products.
The normal skin flora are important because they help protect against colonization by pathogens. Occasionally, they cause disease when body defenses are impaired. They are responsible for body odor, and probably contribute to acne. if host defenses are impaired. Generally, staphylococci are the most common of the skin bacteria able to grow aerobically. The principal species is Staphylococcus epidermidis. staphylococci, p. 290 Important functions of the skin's staphylococci are to prevent colonization by pathogens and to maintain a balance among the microbial inhabitants of the skin ecosystem. These Gram-positive cocci compete for nutrients with other potential skin colonizers, and they also produce antimicrobial substances highly active against P. acnes and other Gram-positive bacteria.
Adapalene (Differin) is a polyaromatic retinoidlike compound that binds to specific retinoic acid nuclear receptors and is thought to normalize the differentiation of keratinocytes in the sebaceous acroinfundibulum. Adapelene is indicated for topical treatment of acne. Minor local irritation is a common, usually tolerable side effect. In contrast to other drugs of the retinoid group, adapalene has not been shown to be teratogenic in rodents. However, since adequate human studies are lacking, its use in pregnant women should be discouraged until further information is available.
In the United States, tazarotene has been approved for topical treatment of psoriasis (involving up to 20 body surface area) and mild to moderate facial acne. Application site burning, stinging, and desquamation are common side effects, especially with acne. Tazarotene is contraindicated in women who are pregnant.
Azelaic acid (Azelex) is a naturally occurring dicar-boxylic acid produced by the yeast Malassezia furfur. Azelaic acid inhibits tyrosinase, a rate-limiting enzyme in the synthesis of the pigment melanin. This may explain why diminution of melanin pigmentation occurs in the skin of some patients with pityriasis versicolor, a disease caused by M. furfur. Azelaic acid is bacteriostatic against a number of species thought to participate in the pathogenesis of acne, including Propionibacterium acnes. The drug may also reduce microcomedo formation by promoting normalization of epidermal keratino-cytes. Azelaic acid is used for the treatment of mild to moderate acne, particularly in cases characterized by marked inflammation-associated hyperpigmentation.
Side-effects most likely to be associated with non-compliance or discontinuation of the drug include a sense of psychomotor slowing, cognitive dulling, acne or psoriasis, and weight gain. There is preliminary evidence that the anticonvulsant topiramate may help to reverse or stabilize the lithium-related weight gain. Isolated
Oil glands, found in large numbers on the face and scalp, secrete the fatty substance sebum. Oil glands are usually connected by tiny ducts to hair follicles. Sebum coats the surface of the skin and the shafts of hairs, preventing excess water loss and softening the skin and hair. Sebum is also mildly toxic to some bacteria. The production of sebum is controlled by hormones. During adolescence, high levels of sex hormones increase the activity of the oil glands. If the ducts of oil glands become clogged with excessive amounts of sebum, dead cells, and bacteria, the skin disorder acne can result.
The skin is the site of several common disorders that include acne vulgaris, psoriasis, eczema dermatitis, contact dermatitis, drug-induced dermatitis, and burns. Some disorders result from viral infections such as herpes simplex and herpes zoster. Some result from fungal infections such as tinea pedis (athlete's foot) and tinea capitis (ringworm).
Extreme clinical examples of androgen excess include central precocious puberty, the adrenogenital syndromes, and androgen-secreting adrenal, ovarian, or testicular tumors. Less severe problems include idio-pathic hirsutism, premenstrual syndrome, and severe cystic acne.
It is clearly immoral to deny a needy patient the appropriate treatment on grounds of cost alone. But who decides what is meant by needy and which patients are most needy A relevant example of this problem is provided by that company which was advised by the licensing authority to withdraw its anti-acne product on the grounds that the antibiotic contained therein was unsafe and increased resistance when used topically. The company's appeal to the Committee on Safety of Medicines was rejected on the grounds, amongst others, that acne is a trivial condition. This judgement was made by a panel of middle-aged to elderly men who had long forgotten the agonies immature teenage acne patients may suffer when having to confront the world with their disfigured faces. The appeal was taken to the Medicines Commission supported by the live testimony of dermatologists dealing with such patients daily, who pointed out that to such patients acne is no trivial condition and may cause suicide. The...
Topical antibiotics are helpful in acne vulgaris and acne rosacea and probably in reducing the frequency of infections related to intravenous catheters. One drug, mupirocin (Bactroban), is effective in treating impetigo contagiosa. Mupirocin binds to bacterial isoleucyl-transfer RNA synthetase and prevents the incorporation of isoleucine into protein sequences. Mupirocin is most effective against gram-positive bacteria. Toxicity is uncommon. Another topical antibiotic, metronidazole, is effective in the treatment of acne rosacea. Metronidazole is a synthetic nitroimidazole derivative that reduces inflammation by an unknown mechanism. Other selected topical antibiotics are listed in Table 41.2.
Prescription retinoids remain the premier agents for both inflammatory and noninflammatory acne. Tretinoin loosens and removes comedones. The agent is available in six different strengths and formulations a cream (0.025 , 0.05 , 0.1 ), a gel (0.01 , 0.025 ), and liquid (0.05 ). 5. Azelaic acid cream (Azelex) is indicated for the treatment of acne in patients who cannot tolerate topical tretinoin. Azelaic acid is as effective as tretinoin but with less drying side effects. The 20 cream is applied bid 30 gm . B. Treatment of pustular acne 1. Moderate or severe inflammatory acne requires oral antibiotics in addition to topical therapy. Side effects of oral antibiotics include gastrointestinal distress and vaginal candidiasis. 5. Erythromycin. Starting dosage is 250 mg qid or 500 mg bid. Propionibacterium acnes bacteria are more resistant to erythromycin than tetracycline gastrointestinal side effects. 6. Topical Antibiotics. Propionibacterium acnes is often resistant to topical...
Isotretinoin (Accutane) alters keratinization in the acroinfundibulum of sebaceous glands and shrinks them, thereby reducing sebum excretion and comedo-genesis. These features underlie its usefulness in acne vulgaris, since sebum secretion is a hallmark of acne-prone skin. Furthermore, the drug has antiinflammatory activity. Isotretinoin is most useful for the treatment of severe recalcitrant nodular acne vulgaris. It may also be
Topical tretinoin (Retin-A, Renova, Avita), like iso-tretinoin, alters keratinization in the acroinfundibulum. In addition, it reverses certain premalignant and other histological changes associated with the photoaging changes that accompany chronic exposure to ultraviolet radiation. Topically applied tretinoin is indicated in comedogenic and papulopustular acne vulgaris, and its mild exfoliative effects make it sometimes useful in mol-luscum contagiosum, flat warts, and some ichthyotic disorders. It is often prescribed to lessen the clinical signs of photoaging (wrinkling and hyperpigmented macules).
Antibiotics are used in dermatology for both infectious and noninfectious skin eruptions. Noninfectious skin eruptions, such as acne vulgaris and acne rosacea, are often treated with systemic antibiotics. The mechanism of action is not clear, although tetracycline inhibits li-pases derived from resident flora in the sebaceous follicle (Staphylococcus epidermidis, Propionibacterium acnes). These lipases cleave irritating fatty acids from triglycerides in sebum, presumably contributing to cutaneous inflammation.
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