Reduce Sebum Production Naturally
Fordyce granules are ectopic sebaceous glands in the oral mucosa 39, 119 . They appear as soft, creamy white or yellowish spots or clusters, typically a few millimetres in diameter. They are symmetrically distributed and tend to increase in size and number with age. The main site is the buccal mucosa, but they may also involve the vermilion border and labial mucosa, particularly in the upper lip. More rarely, the tongue, palatoglossal fold, tonsil and other intraoral sites may be affected, and the condition can then be confused with other lesions. Microscopy shows typical sebaceous glands opening directly onto the surface by short, keratinised ducts with no associated hair follicles.
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. It is important to keep the skin clean and free from oil. Facial steaming opens blocked skin pores and clears out sebum. Do not squeeze acne spots as they may become infected and leave scars. Reduce stress and avoid refined sugar and foods. For mild cases of acne, topical exfoliants and face washes are usually sufficient for medium cases, beneficial preparations should contain benzoyl peroxide or salicylic acid for severe acne, topical or oral antibiotics may be necessary or vitamin A...
Hairy polyps (or dermoids) are found in the naso- and oropharynx of neonates or young infants. About 60 of the roughly 140 reported cases arose as single, pedunculated or sessile, 0.5 to 6 cm polyps in the lateral vault of the nasopharynx near the Eustachian tube orifice and very rarely within the Eustachian tube and middle ear 17, 78, 109 . The remaining cases occurred in the tonsillar region (for tonsillar and bilateral location see Sect. 6.3.2). Hairy polyps cause respiratory distress or feeding problems. Simultaneous congenital abnormalities such as cleft palate are more common than ipsilat-eral branchial sinus, congenital atresia of the carotid artery, osteopetrosis and malformations of the auricle 36, 68 . Treatment is simple surgical resection. A hairy polyp is covered by keratinised or glycogenated squamous epithelium containing hair with sebaceous glands and sweat glands. The mesenchymal core consists of mature fibroadipose tissue and blood vessels with oc
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).
The dermis has two layers the papillary layer, which is next to the epidermis and the reticular layer, which is the deeper layer of the dermis. Dermal layers are comprised of fibroblasts, collagen fibers, and elastic fibers. Collagen and elastic fibers give the skin strength and elasticity. The dermal layer contains sweat glands, hair follicles, sebaceous glands, blood vessels, and sensory nerve terminals.
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.
Structure of the conjunctiva (Fig.4.1) The conjunctiva is a thin vascular mucous membrane that normally of shiny appearance. It forms the conjunctival sac together with the surface of the cornea. The bulbar conjunctiva is loosely attached to the sclera and is more closely attached to the limbus of the cornea. There the conjunctival epithelium fuses with the corneal epithelium. The palpebral conjunctiva lines the inner surface of the eyelid and is firmly attached to the tarsus. The loose palpebral conjunctiva forms a fold in the conjunctival fornix, where it joins the bulbar conjunctiva. A half-moon-shaped fold of mucous membrane, the plica semilunaris, is located in the medial corner of the palpebral fissure. This borders on the lacrimal caruncle, which contains hairs and sebaceous glands.
Patients who require skin grafting are predisposed to infection and accumulation of debris. Skin grafts do not contain the normal apocrine and sebaceous glands, which normally cleanse and protect the ear canal from infection. In addition, patients with soft tissue stenosis may be prone to postoperative infection because of their previous history of chronic otitis externa. Therefore, patients undergoing canaloplasty for acquired stenosis should be examined at least every 6 months for the first 2 years after the ear canal is healed.
Cats seemingly produce the most dramatic symptoms in sensitive individuals, particularly in those who are exposed intermittently. Whether this is caused by the concentration of cat allergens in the environs or by the potency of the allergens is unknown. Studies with cat pelts have disclosed a substance called Fel d 1 that appears to be the major allergen, recognized by over 80 of cat-sensitive individuals (195). Fel d 1 is produced mainly in cat saliva, but is also in the sebaceous glands of the skin, the sublingual glands, and even in the brain ( 196,197). The Fel d 1 molecule has been cloned. There is still controversy over the biologic activity of Fel d 1. Rats and other small mammals commonly produce respiratory symptoms in laboratory workers. The airborne level of rat allergens can be high up to 100 pg m 3 Furthermore, urinary allergens are carried in small particles about 7 pm in diameter. Workers with intense exposure to rats develop IgG antibodies to rat urinary protein, but...
Epithelial and Dermoid Cysts The most common developmental cysts occurring in the orbital and periorbital region and having a predilection for the superotemporal quadrant, are the epithelial and dermoid cysts. Dermoid cysts contain one or more epidermal appendages such as hair follicles, sweat glands, and sebaceous glands epithelial cysts contain only stratified squamous cell epithelium. Echographi-cally, epithelial and dermoid cysts appear on B scans as smoothly rounded, echolucent lesions with good sound transmission (Figure 8.2A,B). However, some dermoid cysts show low internal amplitude echoes depending on the number of hair shafts and other appendages
Dermoid cysts range in size from a few millimetres to 12 cm in diameter. On microscopic examination they are lined by stratified squamous epithelium supported by a fibrous connective tissue wall. Ectodermal derivatives may be seen, including dermal adnexa such as hair follicles, sebaceous glands, and sweat glands.
Most drugs that have been incorporated into creams or ointments are applied to the skin for their local effect. The diffusion rate of a drug through the skin is largely determined by the compound's lipid-water partition coefficient. However, the stratum corneum, or outer layer of the epidermis, forms a barrier against the rapid penetration of most drugs. This is due in large part to the relatively close-packed cellular arrangement and decreased amount of lipid in these cells. Thus, even highly lipid-soluble compounds will be absorbed much more slowly through the skin than from other sites. The dermis, on the other hand, is well supplied with blood and lymph capillaries and therefore is permeable to both lipid-soluble and water-soluble compounds. If penetration of the skin by lipid-insoluble compounds does occur, it is probably accomplished by diffusion through the hair follicles, sweat glands, or sebaceous glands.
The skin is a tough, elastic structure covering the entire body (Figure 2-9). It is made up of two principal layers, the epidermis or cuticle and the dermis or true skin. The epidermis, which overlies the dermis, is itself composed of a superficial layer and an inner layer. The superficial or horny layer consists of dead cells that are constantly being worn off. These are replaced from the living cells that form the inner layer. The dermis is the thicker part of the skin, and consists of connective tissue containing blood vessels, nerve endings, sweat glands, sebaceous glands, and hair follicles. The dermis is held in place by a layer of areolar connective tissue. d. Excretion. The excretion of waste products through the skin is a function of the sweat glands that open by a duct onto the skin surface. The opening is called a pore. These glands are distributed in large numbers over the body and secrete an average of a quart of perspiration each day although, the amount varies...
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.
Skin from the buttock is continuous with the anal margin and continues to the lower border of the IAS. This epithelium is keratinized stratified squamous with hair follicles, sweat glands, and sebaceous glands. Proximal to the level of the dentate line, the epithelium is nonkeratinized squamous with no dermal appendages. There is a transition zone where squamous and columnar epithelium are mixed and then the columnar epithelium of the rectum predominates. Vertical mucosal folds known as anal columns are found at the upper anal canal just above the dentate line. Anal valves connect these folds at the inferior margins. Above each valve is the anal pit or sinus, which drains on average eight anal glands.
The rapidly growing list of human tissues that express TRPV1 currently includes human epidermal keratinocytes,47'48 mast cells,49 epithelial cells of hair follicle,48 sweat glands,48 sebaceous glands,48 bladder urothelium,50 kidney,51 cerebral cortex,51 cerebellum,51 and hypothalamus,52 among others. Thus, TRPV1 has been implicated widely in physiology and pathology, as comprehensively reviewed elsewhere.53'54
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.
Of the oral cavity where pilo-sebaceous rudiments are rarely seen (e.g. gingiva). However, there are also cases reported in areas such as the buccal mucosa, which is a preferential site for the ectopic sebaceous glands (Fordyce spots). In addition, as also suggested for skin lesions, preprogrammed progenitor cells of the most superficial (intraepidermal) parts of the pilosebaceous unit may be sufficient as a source of (intraoral) kera-toacanthoma.
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 conjunctiva is a thin mucous membrane, covering most of the anterior surface of the eye and the inner surface of the eyelids. The conjunctiva is composed of two to five layers of stratified columnar epithelium containing mucin-secreting goblet cells. At the corneo-scleral junction, the limbus, a gradual transition from stratified columnar to stratified squamous corneal epithelium is seen. At the palpebral margins, a relatively abrupt transition into the epidermis is present. The basal layer contains melanocytes and Langerhans cells. The conjunctival stroma is composed of fibrous connective tissue containing fibroblasts, some inflammatory cells, blood vessels, smooth muscle, nerves and lymphatic channels. In the fornices the conjunctival epithelium contains more goblet cells and the stroma can additionally contain cartilage. In the medial inter-palpebral area of the eye, a nodular mass is present the caruncle. The caruncle is covered by stratified non-ke-ratinised squamous...
The principle means of defense against dermatophytes identified at present involve both non-immunological processes such as the interaction between fungi and unsaturated transferrin, activation of epidermal peptides, the inhibitory effect of fatty acids in sebum, and immunological processes including fungal killing by polymorphonuclear leucocytes attracted into the area of infection as well as the activation of T lymphocytes. The first of these are nonspecific mechanisms of defense against dermatophytosis. with similar structures, such as undecylenic acid, have antifungal inhibitory activity. These are found in a high concentration in post pubertal sebum, a fact that may account for the rarity of tinea capitis after puberty. Unsaturated transferrin inhibits the growth of dermatophytes by a direct mechanism involving its binding to the fungal cell membrane (King et al., 1975). As might be expected there is a similar effect of lactoferrin in experimental infections, although there is...
Fair-skinned patients may begin by applying the 0.025 cream shortly after washing nightly. The quantity of tretinoin applied may be gradually increased as tolerated, and twice-daily applications may be appropriate. The cream is best for dry skin the gel is best for oily skin. a. Isotretinoin is the most potent agent available for treating acne. It decreases sebum production and reverses abnormal epithelial desquamation. Usage is restricted to acne that has not responded to other agents.
The space bordered by the teeth and gin-givae is the oral cavity proper. It is bounded inferiorly by the floor of the mouth and tongue and superiorly by the hard palate. The buccal mucosa extends from the commissure of the lips anteriorly to the palatoglossal fold posteriorly. It is lined by thick, non-keratinized stratified squamous epithelium and contains variable numbers of sebaceous glands (Fordyce spots or granules) and minor salivary glands. The duct of the parotid gland (Stensen's duct) opens on a papilla or fold opposite the upper second permanent molar tooth. The mucous membrane related to the teeth is the gingiva. The gingival mucosa surrounds the necks of the teeth and the alveolar mucosa overlies the alveolar bone and extends to the vestibular reflections. The junction between these two parts is marked by a faint scalloped line called the mucogingival junction. The gingival mucosa is pink and firmly attached to the underlying bone and necks of the teeth (attached gingiva)...
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.
The parotid gland is almost purely serous and the parenchyma is divided into lobules by fibrous septa. There is abundant intralobular and extralobular adipose tissue which increases in relative volume with age. The parotid gland contains randomly distributed lymphoid aggregates and lymph nodes that range from one to more than 20 in number. Not infrequently the lymph nodes contain salivary gland ducts or occasionally acini (Neisse Nicholson rests). Sebaceous glands, either individually or in small groups, are commonly seen if the tissue is widely sampled.
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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