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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

Source: http://evderm.com/Documents/Acne%202%20Meds%20-%20East%20Valley%20Dermatology%20Center.pdf

Publicaties 2009

Aantal in PubMed geciteerde artikelen in 2009 van medische stafleden van het Kennemer Gasthuis, het Spaarne Ziekenhuis en het Streeklaboratorium voor de Volksgezondheid Kennemerland. De vermelding van de artikelen is conform de weergave van de meeste andere STZ-ziekenhuizen: artikelen worden geaccepteerd wanneer de printversie uit is ( ahead of print wordt in het jaardocument 2010 meegenomen);

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DOGV - Núm. 4.668 13 01 2004 Que el secretari expedisca testimoni de la present resolució, elExpídase testimonio de la presente resolución por el secretario,qual s’unirà a les actuacions en què es va dictar, i es portarà l’origi-el cual se unirá a los autos en los que se dictó, llevando su originalnal al llibre de sentències (d’acord amb l’establit en l’article 265 de

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