Retinoids Salicylic acid (BHA) Alpha hydroxy acids (primarily glycolic and lactic) Azelaic acid in .NET framework

Draw QR Code in .NET framework Retinoids Salicylic acid (BHA) Alpha hydroxy acids (primarily glycolic and lactic) Azelaic acid

Retinoids Salicylic acid (BHA) Alpha hydroxy acids (primarily glycolic and lactic) Azelaic acid
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Oral contraceptives Retinoids (see Step 1)
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3 Applying a sunscreen SPF 45 with moisturizing cream (unless the skin is very oily, in which case the patient should try a lotion or gel)
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tives, are similar in that both contain drospirenone, but differ in the amount of estrogen, with Yaz being the lower estrogen pill (For a more detailed discussion on the effects of hormones on the skin, see 5)
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1 Washing with the same salicylic acid cleanser 2 Applying a topical retinoid The physician might consider adding in-office salicylic acid peels, oral antibiotics and retinoids, and oral contraceptives in recalcitrant cases Some make up foundations contain salicylic acid as an additive to aid in the prevention or amelioration of acne
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retinoids but do well with antibiotics, BHA, and laser treatment of telangiectasias The exact cause is unknown, but rosacea is a condition distinct from acne, although a patient may have both conditions at the same time (see 16)
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The pilosebaceous unit, which comprises the hair follicles, the cells that line them, and nearby sebaceous glands, is the location where acne manifests This disease is a function of a complex interplay of hereditary, hormonal, and occasional exogenous factors A change in the inner lining of the hair follicle cells turn over too quickly and clump together results in an inhibition of the usual passage of sebum and a blockage at the follicular opening This sets the stage for the involvement of P acnes and subsequent inflammation Just as the etiology is complex and multifactorial, the approach to treatment is variable and requires several steps tailored to the individual patient There is not, to date, one isolated cause or a panacea a medication that works for all patients Early intervention and preventative treatment are largely effective in resolving all but the most recalcitrant cases of this common, cosmetically altering, and distressing condition
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MOISTURIZATION AND ACNE
In 1980, Swinyer reported on the differences between treating acne patients in a climate with relatively normal humidity in comparison to treatment in a dry climate He identified skin dryness as an important factor in exacerbating the pathogenetic cycle of acne, thus hampering its treatment25 In a subsequent four-cell study that tested Swinyer s hypothesis, Jackson et al conducted a 3-month evaluation of the influence of cleansing regimens on the effectiveness of acne therapy using 10% benzoyl peroxide lotion, isolating the type of cleanser as the only variable An emollient facial wash clearly outperformed pure soap and a benzoyl peroxide wash in decreasing open comedones, papules, and in overall global assessment26 (Soap and placebo comprised one cell of the study; in each of the others, the variable soap, an emollient, or benzoyl peroxide wash was matched with 10% benzoyl peroxide lotion) Washing the skin with a noncomedogenic agent appears to act against acne and serves as a suitable alternative to cleansing with relatively abrasive products while satisfying the acne patient s typical desire to wash one s face In hydrating while cleansing, use of an emollient facial cleanser will accelerate the pace of acne resolution and contribute to overall response regardless of the patient s treatment regimen26
COSMETIC DERMATOLOGY: PRINCIPLES AND PRACTICE
COMMON ACNE VARIANTS
Acne Cosmetica
Developing acne as a result of cosmetics use is not as common today as it was just a couple of decades ago Manufacturers test their products for comedogenicity now before putting them on the market So, if a person chooses nongreasy, nonocclusive products, the cosmetic choice is unlikely to be a source of acne See 32 for more information
Acne Detergicans
The obsessive use of soaps by patients may lead to acne Many facial cleansers and shampoos contain unsaturated fatty acids that have been shown to be comedogenic27 Other components such as bacteriostatic agents and botanical ingredients may irritate the hair follicle and cause acne as well Therefore, it is important to educate patients that washing does not necessarily improve acne because the detergents used are only capable of removing surface oil and do not affect the sebum in the follicles, where the disease originates (Of course, one exception to this would be cleansers containing salicylic acid, which has been shown to penetrate into the comedones and improve them) Acne detergicans is uncommon but should be considered in patients that wash their face or skin more than 4 times daily28
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