Acne: Myths, Facts and Therapy
Acne, although being a very common skin problem, leads to a lot of heartache and corresponding increase in expenditure on off the self-cosmetic products, which may or may not help. The present paper throws the light on the acne, its cause, facts, myths and finally the drug therapy, which are used in suppressing the acne. Also, attempt was done to collect the herbal therapy for the acne since they are safe, easily available and free fron major side effects.
ACKING ACNE: MYTHS, FACTS AND THERAPY
KAUL, SHEFALI 1* DUBEY, RAGHVENDRA2 AND DWIVEDI, SUMEET 2
1, QC DEPTT. PLETHICO PHARMA LTD., INDORE, MP-INDIA
2, CHORDIA INSTITUTE OF PHARMACY, INDORE, MP, INDIA
* CORRESPONDING AUTHOR
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Mob. No. 09893156578
ABSTRACT
Acne, although being a very common skin problem, leads to a lot of heartache and corresponding increase in expenditure on off the self-cosmetic products, which may or may not help. The present paper throws the light on the acne, its cause, facts, myths and finally the drug therapy, which are used in suppressing the acne. Also, attempt was done to collect the herbal therapy for the acne since they are safe, easily available and free fron major side effects.
INTRODUCTION
Acne is an inflammatory disease of the hair follicle and their associated sebaceous or oil glands. Acne appears not only on the face, but also on the neck, chest, back, upper shoulder, scalp, upper arms and legs or other areas of the body, where there is a large concentration of oil glands. It is related primarily to hormonal changes that occur during adolescence. These hormonal factors play a significant role in the onset of acne and since oil gland activity and sebum production are under the controls of androgens, the role of these hormones are crucial. There are factors, such as physiological factors as in puberty, pregnancy and menophase; pathological factors, as in ovarian cysts, adrenal hyperplasia; drug induced e.g., cortisone bodies, iodides, anabolic steroids for body building, antileptics, antituberculosis treatments etc. then there are mechanical factors such as infrequent washing and thus clogging on the pores, drandruff, constipitation etc.
TYPES & OCCURRENCE
Adolescent, heredity and hormonal imbalance are three different and major types of the acne. Acne can occur right from the pre-puberty stage up to adult, till the late 4th day, which is because of the dip in the estrogen levels because of which the circulating male hormone brings about this break out. The teenage acne appears between 12 and 16 and is again due to androgen activity on the oil glands during the puberty. The skin becomes very oily because of which the pores open wide, may get clogged with sweat. This leads to formation of black head, which latter on may become pustular lesions. This type is normally treated with topical application of adapelene, benzoyl peroxide or certain erythromycin gel or if severe, with the oral antibiotics. The scars and acne fade away with the time. The adult acne is usually concentrated around the jaws, chin and upper neck and usually cystic and nodular and takes very long to fade.
MYTHS ABOUT ACNE
1. Caused by poor diet
In most cases, diet and hygiene has no influence on the acne, but certain things like not taking tetracycline along with milk product should be remembered. Otherwise there is no need to avoid milk products. Hygiene is very important from head to toe and from with in control acne.
2. Role of stress in acne
Stress brings about certain hormonal changes which in turn activate the oil gland or even cause syndrome like polycystic ovarian disease which results in a nodular cystic acne, unwanted body and facial hair and may be irregular periods.
SOME FACTS ABOUT ACNE
- Acne is a disease of adolescence, but can develop in women up to there forties.
- Acne is more common in girls and can afflicts young men and women alike, as a matter of facts; the severe cystic form of acne is more common in men.
- Acne increases before periods, due to the peak in hormone, which stimulates the oil glands and there is a flare up of the exciting acne.
- Acne lessens during the pregnancy, if pre-pregnancy acne is due to a hormonal imbalance, the change in hormone and that happened during pregnancy act as treatment for the problem.
- Hormonal treatment or birth control pills can treat acne.
- Moisturizer can worsen acne.
MODERN ALLOPATHIC THERAPY
Mild cases may not require any medical therapy; moderate cases may require treatment with topical application and severe cases are usually treated with both topical agents and systemic corticosteriods.
1. In moderate cases with open and closed comedones and a few papoles and pustles are effective treated with topical agents of Vitamin A as isotretinoin 0.05% gel or cream applied sparingly 1 or 2 daily for 6-8 weeks.
2. Resorcinol 2% + sulphur 8% applied sparingly once daily.
3. Bacteriostatic and comedolytic agents benzoyl peroxide, 2.5 %-10% gel BD.
4. Salicylic acid 2% with warm water and then massage as to skin 2-3 times daily and then rinse.
5. Topical antibiotics as erythromycin, clindamycin and tetracycline.
6. In severe cases with postules, cysts nodules and scarring, the patient is given systemic abouts such as tetracycline or erythromycin 500 mg 2 BD orally.
TOPICAL ANTIMICROBIAL AGENTS USED IN ACNE
1. Azelaic acid 20% cream
2. Benzoyl peroxide 2.5-10% cream, lotion or gels
3. Clindamycin 1%
4. Erythromycin 1.5-2%
5. Metronidazole 0.75% lotion, cream or gel
6. Sulfacetamide 10% lotion
7. Sulphur 5%+ sulfacetamide 10% lotion
NEW ADVANCES
1. Adapalene (differin), a derivative of napthoic acid, solution or gel formulation for topical use.
2. Tazarotene (tazorac)
SOME MARKETED PREPARATION
1. Cleocin-T: Clundamycin
2. Persa-gel: Benzoyl peroxide
3. 5% Benzamycin: Erythromycin
4. Klaron, Sebizon: Sulfacetamide
5. Metrocream, Metrogel: Metronidazole
6. Azelex: Azelaic acid
HERBAL THERAPY
Herbal remedies are without a doubt the number one best selling and most widely used of all the forms of alternative medicine. Herbal remedies can be mixed at home after picking them from the garden or countryside, they can be bought from the health food store, chemist an now the top selling names have hit the supermarket shelf's and of course there is the herbalist. Perhaps the biggest selling point of herbal remedies is the diversity in which they can be used, remedies come in pill form, capsule, in dropper bottles and in essential oils for inhalation. They are also known to treat a wide and varied amount of illnesses, diseases and problems and are also a number one seller when it comes to treating disorders of the nervous system such as panic attacks. While being able to relieve symptoms of major illnesses, herbal medications can also be used to help everyday and the more common ailments that we all suffer from. Acne - almost all teenagers and some adults suffer from acne at some time or another, aloe gel is particularly well known for its astringent properties and as such can be an excellent remedy to help combat acne attacks and to keep the skin healthy.
Because prevention is the best way to protect your skin from the scarring associated with severe acne, many dermatologists recommend that controlling problematic acne through diet, regular cleansing procedures, and herbal remedies, is the most effective way to combat the tendencies of skin that is prone to acne and acne-related scarring.
Treatments that accentuate the regulation of daily habits having to do with diet, physical exercise, mood control, and other activities, are known as holistic treatments. Holistic treatments often include herbal therapies.
Herbalists recommend the following herbal remedies for acne and scarring:
1. Black currant seed oil taken in 500-milligram capsules three times a day for three months or until acne is diminished.
2. Evening primrose oil taken in 500-milligram capsules three times a day for three months or until acne is diminished.
3. Teas made from a combination of echinacea, tea tree oil, goldenseal, nettles, or calendula.
4. Teas made from lavender or chamomile, to help reduce acne-causing stress.
5. Chinese herbs such as cnidium seed and honeysuckle flower.
6. Teas made from cumin, coriander, and fennel, steeped for 10 minutes in hot water and consumed three times a day after meals.
7. Some alternative medicine practitioners recommend using diet as a way to combat acne and acne-related scarring. These practitioners believe that diets high in beta-carotene help to reduce the factors that contribute to severe acne. Orange and yellow foods such as carrots, pumpkin, and cantaloupe are loaded with beta-carotene and should be a regular part of the diet of anyone suffering from acne and scarring.
8. Another dietary recommendation for acne-sufferers is to consume many bland foods such as oatmeal, rice, brown grains, and applesauce. These foods should be eaten instead of spicy foods and fried foods, which are believed by some practitioners to stimulate the hormones and glands that aggravate acne conditions.
9. A daily practice of yoga is commonly recommended as a way to increase the flow of blood to the face. This helps to flush acne-causing toxins and to provide your facial skin with natural nutrients that help to decrease the formation of acne and to heal scar tissue.
10. People who suffer from acne should also take care to perform some simple daily rituals that can help to reduce the occurrence of acne and scarring.
11. Dermatologists and alternative medicine practitioners suggest that acne-sufferers should wash the area twice daily with mild soap. Washing should be gentle. Scrubbing or grating the skin will only aggravate the condition and lead to scarring.
12. Hair should be washed thoroughly and regularly and should be kept away from the face and shoulders.
13. Acne sufferers should also avoid shaving as much as possible. When shaving, take care not to run the blade over blemishes. Always use a new blade so as not to spread infection.
14. Avoid wearing make-up and facial cosmetics. If you must, take care to use make-up that is hypoallergenic.
15. In order to prevent scarring, do not pop or squeeze pimples. Popping and squeezing pimples is tempting, but can easily cause infection and the development of unwanted scar tissue.
16. While many of these holistic therapies can be easily performed at home, it is a good idea to speak with your dermatologist or alternative medicine practitioner about the best holistic measures to take as a way to help with acne and acne-related scarring.
17. Greg Podsakoff is a former acne sufferer, and currently provides information on treating acne, pimples, and zits, via an objective informational skincare website
REFERENCES
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2. Goodman and Gilmans. The pharmacological basis of therapeutics, medical publishing division, 10th ed., 1809-1811.
3. Ross and Wilson. Anatomy and Physiologi in health and illness, Churchill livingstone, 9th ed.,210-210.
4. Tripathi KD. Essential of pharmacology, jaypee publication, 5th ed.
5. Materica medica
6. Indian Herbal Pharmacopoeia