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Microsoft word - acne 2 meds - east valley dermatology center.doc
SUMMARY OF ACNE & TREATMENT:
A Four-Part Solution
1. Skin cel s multiply too quickly and are too sticky, plugging the fol icular pore (comedone, "whitehead" or "blackhead").
> RETINOIDS make the skin cel s less sticky so they can be exfoliated
2. Excessive sebum production causes accumulation of oil behind and enlarging the plug.
> RETINOLDS, HORMONE PILLS, SPIRONOLACTONE decrease sebum production.
3. Bacteria eat the cel s and sebum, forming a substance toxic to the skin, fatty acids.
> BENZOYL PEROXIDE, TOPICAL AND ORAL ANTIBIOTICS decrease bacteria
4. The breakdown products cause inflammation and result in a big red bump, the ful -blown "pimple." with a head.
> ORAL ANTIBIOTICS are anti-inflammatory and temper the immune system.
Individuals have unique skin types that erupt in different types of acne, some with more comedones and others with moreinflammation. Acne medications require 2 months of faithful use before their benefits can be seen.
1. Use non-comedogenic cleanser 2 to 3 times a day for cleansing.
2. Apply topical ANTIBIOTIC ______________________ in the morning.
Wait 15 minutes after washing the face as it is less irritating on dry skin.
3. Apply RETINOID Retin-A Differin Retin A Micro Tazorac sparingly at bedtime.
a) Apply a pea sized amount to the entire face, not just spot-treating.
b) Expect some light peeling and pinkness for 2 weeks after starting. Initial y, use it every other day for 2 weeks. Then
increase to daily use if irritation is minimal.
c) Wait 15 minutes after washing the face as it is less irritating applied on dry skin.
d) If there's stil too much peeling and redness, wash face at dinnertime & apply the retinoid at bedtime OR go to every
other day application. If severe, stop for 2-3 days.
e) The increased risk of burning in the sun can be taken care of with "NON-COMEDOGEN R" or "OIL-FREE” sunscreen
(i.e. Olay Complete SPF 15 or 30, sensitive skin formula with zinc oxide)
f) Stop All Retin A products 2 weeks prior t o f a c i a l w a x i n g .
g) O n e c a n n o t g e t p r e g n a n t w i t h R e t i n o i d s .
4. Take ORAL ANTIBIOTIC as prescribed, with these instructions. ____________ times a day
a) One CANNOT get pregnant if taking the 3 Tetracycline medications: Tetra-, Doxy-, Mino-cycline.
b) The tetracyclines SHOULDN’T be taken with calcium (milk etc), iron (vitamins), magnesium.
c) Aluminum (antacids) 1 hr after or 2 hrs prior to the pil -- the effect wil be diminished.
d) Tetracycline- take on an empty stomach, without eating food 1 hr after or 2 hrs prior.
e) Doxy- and Mino-cycline can both be taken with food.
f) With Doxy-, do not take less than 1 hr before bedtime or it wil irritate the esophagus lining. Doxy- also produces the
highest risk of sunburns among the "-cyclines".
g) Mino- STOP if one experiences any of the rare side effects of rash, increased headaches, dizziness, and joint pain,
blue and dark pigmentation in acne scars or shins or diffusely on the body.
5. Take HORMONAL THERAPY OR SPIRONOLACTONE Yaz Yasmin Ortho Tri-Cycler
a) Hormone/oral contraceptive Pill- Get a PAP smear if over the age of 18 or if sexual y active.
i. One cannot take the Pill if one's had breast cancer, clots, heart attack or stroke and the risk of these are
increased if one is a smoker, diabetic, hypertensive or has migraines
ii. Common side effects are mood changes, breast tenderness, nausea, and spotting
iii. One should have normal mammograms, & breast exam, and a negative pregnancy test.
b) Spironolactone- One CANNOT get pregnant while on this –wil feminize a male fetus. Also STOP if light-headed (mild
diuretic effect). AVOID potassium-rich foods (i.e. bananas).
Shampoo hair daily and avoid hair spray, gels, mousse, or grease.
Picking or scratching at acne induces scarring.
Women may use oil-free, water-based make-up over acne meds. Loose powder is better than compact powder.
If you have any questions regarding your medications, please contact our office.
East Valley Dermatology Center
, 1100 S. Dobson Rd, Suite 223, Chandler, AZ 85286, (480) 821-8888
Revista Electrónica de Enseñanza de las Ciencias, Vol. 3, Nº 3, 320-338 (2004) O papel das metaciências na promoção da educação para o desenvolvimento sustentável Orlando Figueiredo1, Paulo Almeida2 e Margarida César3 1Escola Básica 2,3 António Bento Franco, Ericeira. E-mail: firstname.lastname@example.org. 2Escola Secundária Leal da Câmara, Rio de Mouro. 3Centro de Investigaçã
13 Walker (JB/D) 9/11/01 1:04 pm Page 435HEALTH POLICY AND PLANNING; 16 (4): 435–443 How to do (or not to do) . . . Allowing for uncertainty in economic evaluations: qualitative sensitivity analysis D WALKER AND JA FOX-RUSHBY Health Policy Unit, London School of Hygiene and Tropical Medicine, London, UK Sensitivity analysis allows analysts to explore the impact of uncertainty on their