by: James Vond
A detailed and comprehensive discussion of acne scars starts with causes of scarring, prevention of scarring, types of scars, and treatments for scars.
Before talking about scars, a word about spots that may look like scars but are not scars in the sense that a permanent change has occurred. Even though they are not true scars and disappear in time, they are visible and can cause embarrassment.
Macules or "pseudo-scars" are flat, red or reddish spots that are the final stage of most inflamed acne lesions. After an inflamed acne lesion flattens, a macule may remain to "mark the spot" for up to 6 months. When the macule eventually disappears, no trace of it will remain—unlike a scar.
Post-inflammatory pigmentation is discoloration of the skin at the site of a healed or healing inflamed acne lesion. It occurs more frequently in darker-skinned people, but occasionally is seen in people with white skin. Early treatment by a dermatologist may minimize the development of post-inflammatory pigmentation. Some post-inflammatory pigmentation may persist for up to 18 months, especially with excessive sun exposure. Chemical peeling may hasten the disappearance of post-inflammatory pigmentation.
Causes of Acne Scars
In the simplest terms, scars form at the site of an injury to tissue. They are the visible reminders of injury and tissue repair. In the case of acne, the injury is caused by the body’s inflammatory response to sebum, bacteria and dead cells in the plugged sebaceous follicle. Two types of true scars exist, as discussed later: (1) depressed areas such as ice-pick scars, and (2) raised thickened tissue such as keloids.
When tissue suffers an injury, the body rushes its repair kit to the injury site. Among the elements of the repair kit are white blood cells and an array of inflammatory molecules that have the task of repairing tissue and fighting infection. However, when their job is done they may leave a somewhat messy repair site in the form of fibrous scar tissue, or eroded tissue.
White blood cells and inflammatory molecules may remain at the site of an active acne lesion for days or even weeks. In people who are susceptible to scarring, the result may be an acne scar. The occurrence and incidence of scarring is still not well understood, however. There is considerable variation in scarring between one person and another, indicating that some people are more prone to scarring than others. Scarring frequently results from severe inflammatory nodulocystic acne that occurs deep in the skin. But, scarring also may arise from more superficial inflamed lesions. Nodulocystic acne that is most likely to result in scars is seen in these photos:
National Library of Dermatologic Teaching Slides)
The life history of scars also is not well understood. Some people bear their acne scars for a lifetime with little change in the scars, but in other people the skin undergoes some degree of remodeling and acne scars diminish in size.
People also have differing feelings about acne scars. Scars of more or less the same size that may be psychologically distressing to one person may be accepted by another person as "not too bad." The person who is distressed by scars is more likely to seek treatment to moderate or remove the scars.
Prevention of Acne Scars
As discussed in the previous section on Causes of Acne Scars, the occurrence of scarring is different in different people. It is difficult to predict who will scar, how extensive or deep scars will be, and how long scars will persist. It is also difficult to predict how successfully scars can be prevented by effective acne treatment.
Nevertheless, the only sure method of preventing or limiting the extent of scars is to treat acne early in its course, and as long as necessary. The more that inflammation can be prevented or moderated, the more likely it is that scars can be prevented. (Click on Acne Treatments for more information about treatment of mild, moderate and severe acne). Any person with acne who has a known tendency to scar should be under the care of a dermatologist. (Click on Find a Dermatologist to locate a dermatologist in your geographic area).
Types of Acne Scars
There are two general types of acne scars, defined by tissue response to inflammation: (1) scars caused by increased tissue formation, and (2) scars caused by loss of tissue.
Scars Caused by Increased Tissue Formation
The scars caused by increased tissue formation are called keloids or hypertrophic scars. The word hypertrophy means "enlargement" or "overgrowth." Both hypertrophic and keloid scars are associated with excessive amounts of the cell substance collagen. Overproduction of collagen is a response of skin cells to injury. The excess collagen becomes piled up in fibrous masses, resulting in a characteristic firm, smooth, usually irregularly-shaped scar. The photo shows a typical severe acne keloid:
National Library of Dermatologic Teaching Slides)
The typical keloid or hypertrophic scar is 1 to 2 millimeters in diameter, but some may be 1 centimeter or larger. Keloid scars tend to "run in families"—that is, abnormal growth of scar tissue is more likely to occur in susceptible people, who often are people with relatives who have similar types of scars.
Hypertrophic and keloid scars persist for years, but may diminish in size over time. Scars Caused by Loss of Tissue Acne scars associated with loss of tissue—similar to scars that result from chicken pox—are more common than keloids and hypertrophic scars. Scars associated with loss of tissue are:
Ice-pick scars usually occur on the cheek. They are usually small, with a somewhat jagged edge and steep sides—like wounds from an ice pick. Ice-pick scars may be shallow or deep, and may be hard or soft to the touch. Soft scars can be improved by stretching the skin; hard ice-pick scars cannot be stretched out.
Depressed fibrotic scars are usually quite large, with sharp edges and steep sides. The base of these scars is firm to the touch. Ice-pick scars may evolve into depressed fibrotic scars over time.
Soft scars, superficial or deep are soft to the touch. They have gently sloping rolled edges that merge with normal skin. They are usually small, and either circular or linear in shape.
Atrophic macules are usually fairly small when they occur on the face, but may be a centimeter or larger on the body. They are soft, often with a slightly wrinkled base, and may be bluish in appearance due to blood vessels lying just under the scar. Over time, these scars change from bluish to ivory white in color in white-skinned people, and become much less obvious.
Follicular macular atrophy is more likely to occur on the chest or back of a person with acne. These are small, white, soft lesions, often barely raised above the surface of the skin—somewhat like whiteheads that didn’t fully develop. This condition is sometimes also called "perifollicular elastolysis." The lesions may persist for months to years.
Treatments for Acne Scars
A number of treatments are available for acne scars through dermatologic surgery. The type of treatment selected should be the one that is best for you in terms of your type of skin, the cost, what you want the treatment to accomplish, and the possibility that some types of treatment may result in more scarring if you are very susceptible to scar formation.
A decision to seek dermatologic surgical treatment for acne scars also depends on:
* The way you feel about scars. Do acne scars psychologically or emotionally affect your life? Are you willing to "live with your scars" and wait for them to fade over time? These are personal decisions only you can make.
* The severity of your scars. Is scarring substantially disfiguring, even by objective assessment?
* A dermatologist’s expert opinion as to whether scar treatment is justified in your particular case, and what scar treatment will be most effective for you.
Before committing to treatment of acne scars, you should have a frank discussion with your dermatologist regarding those questions, and any others you feel are important. You need to tell the dermatologist how you feel about your scars. The dermatologist needs to conduct a full examination and determine whether treatment can, or should, be undertaken.
The objective of scar treatment is to give the skin a more acceptable physical appearance. Total restoration of the skin, to the way it looked before you had acne, is often not possible, but scar treatment does usually improve the appearance of your skin.
The scar treatments that are currently available include: Collagen injection. Collagen, a normal substance of the body, is injected under the skin to "stretch" and "fill out" certain types of superficial and deep soft scars. Collagen treatment usually does not work as well for ice-pick scars and keloids. Collagen derived from cows or other non-human sources cannot be used in people with autoimmune diseases. Human collagen or fascia is helpful for those allergic to cow-derived collagen. Cosmetic benefit from collagen injection usually lasts 3 to 6 months. Additional collagen injections to maintain the cosmetic benefit are done at additional cost.
Autologous fat transfer. Fat is taken from another site on your own body and prepared for injection into your skin. The fat is injected beneath the surface of the skin to elevate depressed scars. This method of autologous (from your own body) fat transfer is usually used to correct deep contour defects caused by scarring from nodulocystic acne. Because the fat is reabsorbed into the skin over a period of 6 to 18 months, the procedure usually must be repeated. Longer lasting results may be achieved with multiple fat-transfer procedures.
Dermabrasion. This is thought to be the most effective treatment for acne scars. Under local anesthetic, a high-speed brush or fraise used to remove surface skin and alter the contour of scars. Superficial scars may be removed altogether, and deeper scars may be reduced in depth. Dermabrasion does not work for all kinds of scars; for example, it may make ice-pick scars more noticeable if the scars are wider under the skin than at the surface. In darker-skinned people, dermabrasion may cause changes in pigmentation that require additional treatment.
Microdermabrasion. This new technique is a surface form of dermabrasion. Rather than a high-speed brush, microdermabrasion uses aluminum oxide crystals passing through a vacuum tube to remove surface skin. Only the very surface cells of the skin are removed, so no additional wound is created. Multiple procedures are often required but scars may not be significantly improved.
Laser Treatment. Lasers of various wavelength and intensity may be used to recontour scar tissue and reduce the redness of skin around healed acne lesions. The type of laser used is determined by the results that the laser treatment aims to accomplish. Tissue may actually be removed with more powerful instruments such as the carbon dioxide laser. In some cases, a single treatment is all that will be necessary to achieve permanent results. Because the skin absorbs powerful bursts of energy from the laser, there may be post-treatment redness for several months.
Skin Surgery. Some ice-pick scars may be removed by "punch" excision of each individual scar. In this procedure each scar is excised down to the layer of subcutaneous fat; the resulting hole in the skin may be repaired with sutures or with a small skin graft. Subcision is a technique in which a surgical probe is used to lift the scar tissue away from unscarred skin, thus elevating a depressed scar.
Skin grafting may be necessary under certain conditions—for example, sometimes dermabrasion unroofs massive and extensive tunnels (also called sinus tracts) caused by inflammatory reaction to sebum and bacteria in sebaceous follicles. Skin grafting may be needed to close the defect of the unroofed sinus tracts.
Treatment of keloids. Surgical removal is seldom if ever used to treat keloids. A person whose skin has a tendency to form keloids from acne damage may also form keloids in response to skin surgery. Sometimes keloids are treated by injecting steroid drugs into the skin around the keloid. Topical retinoic acid may be applied directly on the keloid. In some cases the best treatment for keloids in a highly susceptible person is no treatment at all.
In summary, acne scars are caused by the body’s inflammatory response to acne lesions. The best way to prevent scars is to treat acne early, and as long as necessary. If scars form, a number of effective treatments are available. Dermatologic surgery treatments should be discussed with a dermatologist.
Monday, July 30, 2007
Saturday, July 28, 2007
Acne Scars: How to find the best dermal filler to correct deep acne scarring
by: Naweko Nicole Dial
Softening deep acne scars resulting from severe bouts of cystic or nodular lesions requires a well thought out cosmetic corrective plan. And according to reports in Dermatologic Surgery, popularized scar removal options like laser resurfacing may not satisfactorily smooth away deep acne scars. Yet, patients can readily witness scar depth reductions in indented acne scaring using aesthetic therapies such as dermal fillers.
Silicon based dermal fillers
In a 30-year perspective study of using dermal fillers to correct acne scars, doctors Jay Barnett and Channing Barnett deemed medical-grade liquid silicone the only filler substance that permanently and precisely corrects acne scars. During their investigation, the researchers reviewed the lives of five patients with a history of acne scarring. Each patient showed improvements from injections of liquid silicone at the initial treatment session and at 10-, 15-, and 30-year follow-up sessions.
Hyaluronic acid dermal fillers
Even though silicon based dermal fillers work, heavily marketed fillers made of hyaluronic acid also present a potential deep acne scarring corrective. While the results from dermal fillers can prove pleasantly dramatic, in the case of hyaluronic acid, the enhancements may only last six months. Moreover, most Food and Drug Administration approved dermal fillers like Perlane have only been tested on and prescribed for correction of nasal labial folds, not acne scars that can arise on multiple areas of the face.
Calcium-based dermal fillers
In a study published in the Journal of Cosmetic and Laser Therapy, investigators tested a dermal filler composed of calcium hydroxylapatite to treat acne scars. Researchers used the filler to correct both round or saucerized acne scars, and deep acne scars with a sharp triangular shaped called "ice-pick" scars. After administering the dermal filler to ten patients with various types of acne scarring, the investigators found that only saucerized acne scars responded well to the treatment. Scar improvements lasted up to twelve months in some volunteers.
How to select a dermal filler
While dermal fillers offer dazzling results, they aren't cheap. And typically, the longer the filler lasts, the more expensive the treatment. Dermal injections can run from $300 to $2000 for treated area so plan to spend smartly. Moreover, a dermal injection is only as aesthetically beautiful as the professional delivering the shot.
When seeking a dermal injection, seek a professional possessing experience with correcting deep acne scars with dermal fillers. Finally, when using a dermal injection, make certain that you have your acne outbreaks under control because dermal injections are contraindicated for facial areas experiencing pain or inflammation, including pimples.
Sources: Barnett, Jay & Channing Barnett. Treatment of Acne Scars with Liquid Silicone Injections: 30-Year Perspective. Dermatologic Surgery, November 2005; vol 31, no 4, pp 1542-1549.
Food and Drug Administration. Perlane Injectable Gel – P040024s006 Labeling. May 2, 2007. http://www.fda.gov/cdrh/pdf4/p040024s006c.pdf
Goldberg, David; Snehal Amin & Mussarrat Hussein. Acne scar correction using calcium hydroxylapatite in a carrier-based gel. Journal of Cosmetic and Laser Therapy, September 2006; vol 8, no 3, pp. 134-136.
Woo, S; J Park & & Y Kye. Resurfacing of Different Types of Facial Acne Scar With Short-Pulsed, Variable-Pulsed, and Dual-Mode Er:YAG Laser. Dermatologic Surgery, April 2004; vol 30, no 4, pp 488-493.
Softening deep acne scars resulting from severe bouts of cystic or nodular lesions requires a well thought out cosmetic corrective plan. And according to reports in Dermatologic Surgery, popularized scar removal options like laser resurfacing may not satisfactorily smooth away deep acne scars. Yet, patients can readily witness scar depth reductions in indented acne scaring using aesthetic therapies such as dermal fillers.
Silicon based dermal fillers
In a 30-year perspective study of using dermal fillers to correct acne scars, doctors Jay Barnett and Channing Barnett deemed medical-grade liquid silicone the only filler substance that permanently and precisely corrects acne scars. During their investigation, the researchers reviewed the lives of five patients with a history of acne scarring. Each patient showed improvements from injections of liquid silicone at the initial treatment session and at 10-, 15-, and 30-year follow-up sessions.
Hyaluronic acid dermal fillers
Even though silicon based dermal fillers work, heavily marketed fillers made of hyaluronic acid also present a potential deep acne scarring corrective. While the results from dermal fillers can prove pleasantly dramatic, in the case of hyaluronic acid, the enhancements may only last six months. Moreover, most Food and Drug Administration approved dermal fillers like Perlane have only been tested on and prescribed for correction of nasal labial folds, not acne scars that can arise on multiple areas of the face.
Calcium-based dermal fillers
In a study published in the Journal of Cosmetic and Laser Therapy, investigators tested a dermal filler composed of calcium hydroxylapatite to treat acne scars. Researchers used the filler to correct both round or saucerized acne scars, and deep acne scars with a sharp triangular shaped called "ice-pick" scars. After administering the dermal filler to ten patients with various types of acne scarring, the investigators found that only saucerized acne scars responded well to the treatment. Scar improvements lasted up to twelve months in some volunteers.
How to select a dermal filler
While dermal fillers offer dazzling results, they aren't cheap. And typically, the longer the filler lasts, the more expensive the treatment. Dermal injections can run from $300 to $2000 for treated area so plan to spend smartly. Moreover, a dermal injection is only as aesthetically beautiful as the professional delivering the shot.
When seeking a dermal injection, seek a professional possessing experience with correcting deep acne scars with dermal fillers. Finally, when using a dermal injection, make certain that you have your acne outbreaks under control because dermal injections are contraindicated for facial areas experiencing pain or inflammation, including pimples.
Sources: Barnett, Jay & Channing Barnett. Treatment of Acne Scars with Liquid Silicone Injections: 30-Year Perspective. Dermatologic Surgery, November 2005; vol 31, no 4, pp 1542-1549.
Food and Drug Administration. Perlane Injectable Gel – P040024s006 Labeling. May 2, 2007. http://www.fda.gov/cdrh/pdf4/p040024s006c.pdf
Goldberg, David; Snehal Amin & Mussarrat Hussein. Acne scar correction using calcium hydroxylapatite in a carrier-based gel. Journal of Cosmetic and Laser Therapy, September 2006; vol 8, no 3, pp. 134-136.
Woo, S; J Park & & Y Kye. Resurfacing of Different Types of Facial Acne Scar With Short-Pulsed, Variable-Pulsed, and Dual-Mode Er:YAG Laser. Dermatologic Surgery, April 2004; vol 30, no 4, pp 488-493.
Thursday, July 26, 2007
Acne Medications for Quick Recovery
by: James Vond
Read this Medication Guide every time you get a prescription or a refill for Accutane (ACK-u-tane). There may be new information. This information does not take the place of talking with your prescriber (doctor or other health care provider).
What is the most important information I should know about Accutane?
Accutane is used to treat a type of severe acne (nodular acne) that has not been helped by other treatments, including antibiotics. However, Accutane can cause serious side effects. Before starting Accutane, discuss with your prescriber how bad your acne is, the possible benefits of Accutane, and its possible side effects, to decide if Accutane is right for you. Your prescriber will ask you to read and sign a form or forms indicating you understand some of the serious risks of Accutane.
Possible serious side effects of taking Accutane include birth defects and mental disorders.
1. Birth defects. Accutane can cause birth defects (deformed babies) if taken by a pregnant woman. It can also cause miscarriage (losing the baby before birth), premature (early) birth, or death of the baby. Do not take Accutane if you are pregnant or plan to become pregnant while you are taking Accutane. Do not get pregnant for 1 month after you stop taking Accutane. Also, if you get pregnant while taking Accutane, stop taking it right away and call your prescriber.
All females should read the section in this Medication Guide "What are the important warnings for females taking Accutane?"
2. Mental problems and suicide. Some patients, while taking Accutane or soon after stopping Accutane, have become depressed or developed other serious mental problems. Symptoms of these problems include sad, "anxious" or empty mood, irritability, anger, loss of pleasure or interest in social or sports activities, sleeping too much or too little, changes in weight or appetite, school or work performance going down, or trouble concentrating. Some patients taking Accutane have had thoughts about hurting themselves or putting an end to their own lives (suicidal thoughts). Some people tried to end their own lives. And some people have ended their own lives. There were reports that some of these people did not appear depressed. No one knows if Accutane caused these behaviors or if they would have happened even if the person did not take Accutane.
All patients should read the section in this Medication Guide "What are the signs of mental problems?"
For other possible serious side effects of Accutane, see "What are the possible side effects of Accutane?" in this Medication Guide.
What are the important warnings for females taking Accutane?
You must not become pregnant while taking Accutane, or for 1 month after you stop taking Accutane. Accutane can cause severe birth defects in babies of women who take it while they are pregnant, even if they take Accutane for only a short time. There is an extremely high risk that your baby will be deformed or will die if you are pregnant while taking Accutane. Taking Accutane also increases the chance of miscarriage and premature births.
Female patients will not get their first prescription for Accutane unless there is proof they have had 2 negative pregnancy tests. The first test must be done when your prescriber decides to prescribe Accutane. The second pregnancy test must be done during the first 5 days of the menstrual period right before starting Accutane therapy, or as instructed by your prescriber. Each month of treatment, you must have a negative result from a urine or serum pregnancy test. Female patients cannot get another prescription for Accutane unless there is proof that they have had a negative pregnancy test.
A yellow self-adhesive Accutane Qualification Sticker on your prescription indicates to the pharmacist that you are qualified by your prescriber to get Accutane.
While you are taking Accutane, you must use effective birth control. You must use 2 separate effective forms of birth control at the same time for at least 1 month before starting Accutane, while you take it, and for 1 month after you stop taking it. You can either discuss effective birth control methods with your prescriber or go for a free visit to discuss birth control with another physician or family planning expert. Your prescriber can arrange this free visit, which will be paid for by the manufacturer.
You must use 2 separate forms of effective birth control because any method, including birth control pills and sterilization, can fail. There are only 2 reasons you would not need to use 2 separate methods of effective birth control:
1. You have had your womb removed by surgery (a hysterectomy).
2. You are absolutely certain you will not have genital-to-genital sexual contact with a male before, during, and for 1 month after Accutane treatment.
If you have sex at any time without using 2 forms of effective birth control, get pregnant, or miss your period, stop using Accutane and call your prescriber right away.
All patients should read the rest of this Medication Guide.
What are the signs of mental problems?
Tell your prescriber if, to the best of your knowledge, you or someone in your family has ever had any mental illness, including depression, suicidal behavior, or psychosis. Psychosis means a loss of contact with reality, such as hearing voices or seeing things that are not there. Also, tell your prescriber if you take medicines for any of these problems.
Stop using Accutane and tell your provider right away if you:
- Start to feel sad or have crying spells
- Lose interest in activities you once enjoyed
- Sleep too much or have trouble sleeping
- Become more irritable than usual
- Have a change in your appetite or body weight
- Have trouble concentrating
- Withdraw from your friends or family
- Feel like you have no energy
- Have feelings of worthlessness or inappropriate guilt
- Start having thoughts about hurting yourself or taking your own life (suicidal thoughts)
What is Accutane?
Accutane is used to treat the most severe form of acne (nodular acne) that cannot be cleared up by any other acne treatments, including antibiotics. In severe nodular acne, many red, swollen, tender lumps form in the skin. These can be the size of pencil erasers or larger. If untreated, nodular acne can lead to permanent scars. However, because Accutane can have serious side effects, you should talk with your prescriber about all of the possible treatments for your acne, and whether Accutane's possible benefits outweigh its possible risks.
Who should not take Accutane?
- Do not take Accutane if you are pregnant, plan to become pregnant, or become pregnant during Accutane treatment. Accutane causes severe birth defects. All females should read the section "What are the important warnings for females taking Accutane?" for more information and warnings about Accutane and pregnancy.
- Do not take Accutane unless you completely understand its possible risks and are willing to follow all of the instructions in this Medication Guide.
Tell your prescriber if you or someone in your family has had any kind of mental problems, asthma, liver disease, diabetes, heart disease, osteoporosis (bone loss), weak bones, anorexia nervosa (an eating disorder where people eat too little), or any other important health problems. Tell your prescriber about any food or drug allergies you have had in the past. These problems do not necessarily mean you cannot take Accutane, but your prescriber needs this information to discuss if Accutane is right for you.
How should I take Accutane?
- You will get no more than a 30-day supply of Accutane at a time, to be sure you check in with your prescriber each month to discuss side effects.
- Your prescription should have a special yellow self-adhesive sticker attached to it. The sticker is YELLOW. If your prescription does not have this yellow self-adhesive sticker, call your prescriber. The pharmacy should not fill your prescription unless it has the yellow self-adhesive sticker.
- The amount of Accutane you take has been specially chosen for you and may change during treatment.
- You will take Accutane 2 times a day with a meal, unless your prescriber tells you otherwise. Swallow your Accutane capsules with a full glass of liquid. This will help prevent the medication inside the capsule from irritating the lining of your esophagus (connection between mouth and stomach). For the same reason, do not chew or suck on the capsule.
- If you miss a dose, just skip that dose. Do not take 2 doses the next time.
- You should return to your prescriber as directed to make sure you don't have signs of serious side effects. Because some of Accutane's serious side effects show up in blood tests, some of these visits may involve blood tests (monthly visits for female patients should always include a urine or serum pregnancy test).
What should I avoid while taking Accutane?
- Do not get pregnant while taking Accutane. See "What is the most important information I should know about Accutane?" and "What are the important warnings for females taking Accutane?"
- Do not breast feed while taking Accutane and for 1 month after stopping Accutane. We do not know if Accutane can pass through your milk and harm the baby.
- Do not give blood while you take Accutane and for 1 month after stopping Accutane. If someone who is pregnant gets your donated blood, her baby may be exposed to Accutane and may be born with birth defects.
- Do not take vitamin A supplements. Vitamin A in high doses has many of the same side effects as Accutane. Taking both together may increase your chance of getting side effects.
- Do not have cosmetic procedures to smooth your skin, including waxing, dermabrasion, or laser procedures, while you are using Accutane and for at least 6 months after you stop. Accutane can increase your chance of scarring from these procedures. Check with your prescriber for advice about when you can have cosmetic procedures.
- Avoid sunlight and ultraviolet lights as much as possible. Tanning machines use ultraviolet lights. Accutane may make your skin more sensitive to light.
- Do not use birth control pills that do not contain estrogen ("minipills"). They may not work while you take Accutane. Ask your prescriber or pharmacist if you are not sure what type you are using.
- Talk with your doctor if you plan to take other drugs or herbal products. This is especially important for patients using birth control pills and other hormonal types of birth control because the birth control may not work as effectively if you are taking certain drugs or herbal products. You should not take the herbal supplement St. John's Wort because this herbal supplement may make birth control pills not work as effectively.
- Talk with your doctor if you are currently taking an oral or injected corticosteroid or anticonvulsant (seizure) medication prior to using Accutane. These drugs may weaken your bones.
- Do not share Accutane with other people. It can cause birth defects and other serious health problems.
- Do not take Accutane with antibiotics unless you talk to your prescriber. For some antibiotics, you may have to stop taking Accutane until the antibiotic treatment is finished. Use of both drugs together can increase the chances of getting increased pressure in the brain.
What are the possible side effects of Accutane?
Accutane has possible serious side effects
- Accutane can cause birth defects, premature births, and death in babies whose mothers took Accutane while they were pregnant. See "What is the most important information I should know about Accutane?" and "What are the important warnings for females taking Accutane?"
- Serious mental health problems. See "What is the most important information I should know about Accutane?"
- Serious brain problems. Accutane can increase the pressure in your brain. This can lead to permanent loss of sight, or in rare cases, death. Stop taking Accutane and call your prescriber right away if you get any of these signs of increased brain pressure: bad headache, blurred vision, dizziness, nausea, or vomiting. Also, some patients taking Accutane have had seizures (convulsions) or stroke.
- Abdomen (stomach area) problems. Certain symptoms may mean that your internal organs are being damaged. These organs include the liver, pancreas, bowel (intestines), and esophagus (connection between mouth and stomach). If your organs are damaged, they may not get better even after you stop taking Accutane. Stop taking Accutane and call your prescriber if you get severe stomach, chest or bowel pain, trouble swallowing or painful swallowing, new or worsening heartburn, diarrhea, rectal bleeding, yellowing of your skin or eyes, or dark urine.
- Bone and muscle problems. Accutane may affect bones, muscles, and ligaments and cause pain in your joints or muscles. Tell your prescriber if you plan vigorous physical activity during treatment with Accutane. Tell your prescriber if you develop pain, particularly back pain or joint pain. There are reports that some patients have had stunted growth after taking Accutane for acne as directed. There are also some reports of broken bones or reduced healing of broken bones after taking Accutane for acne as directed. No one knows if taking Accutane for acne will affect your bones. If you have a broken bone, tell your provider that you are taking Accutane. Muscle weakness with or without pain can be a sign of serious muscle damage. If this happens, stop taking Accutane and call your prescriber right away.
- Hearing problems. Some people taking Accutane have developed hearing problems. It is possible that hearing loss can be permanent. Stop using Accutane and call your prescriber if your hearing gets worse or if you have ringing in your ears.
- Vision problems. While taking Accutane you may develop a sudden inability to see in the dark, so driving at night can be dangerous. This condition usually clears up after you stop taking Accutane, but it may be permanent. Other serious eye effects can occur. Stop taking Accutane and call your prescriber right away if you have any problems with your vision or dryness of the eyes that is painful or constant.
- Lipid (fats and cholesterol in blood) problems. Many people taking Accutane develop high levels of cholesterol and other fats in their blood. This can be a serious problem. Return to your prescriber for blood tests to check your lipids and to get any needed treatment. These problems generally go away when Accutane treatment is finished.
- Allergic reactions. In some people, Accutane can cause serious allergic reactions. Stop taking Accutane and get emergency care right away if you develop hives, a swollen face or mouth, or have trouble breathing. Stop taking Accutane and call your prescriber if you develop a fever, rash, or red patches or bruises on your legs.
- Signs of other possibly serious problems. Accutane may cause other problems. Tell your prescriber if you have trouble breathing (shortness of breath), are fainting, are very thirsty or urinate a lot, feel weak, have leg swelling, convulsions, slurred speech, problems moving, or any other serious or unusual problems. Frequent urination and thirst can be signs of blood sugar problems.
Serious permanent problems do not happen often. However, because the symptoms listed above may be signs of serious problems, if you get these symptoms, stop taking Accutane and call your prescriber. If not treated, they could lead to serious health problems. Even if these problems are treated, they may not clear up after you stop taking Accutane.
Accutane has less serious possible side effects
The common less serious side effects of Accutane are dry skin, chapped lips, dry eyes, and dry nose that may lead to nosebleeds. People who wear contact lenses may have trouble wearing them while taking Accutane and after therapy. Sometimes, people's acne may get worse for a while. They should continue taking Accutane unless told to stop by their prescriber.
These are not all of Accutane's possible side effects. Your prescriber or pharmacist can give you more detailed information that is written for health care professionals.
This Medication Guide is only a summary of some important information about Accutane. Medicines are sometimes prescribed for purposes other than those listed in a Medication Guide. If you have any concerns or questions about Accutane, ask your prescriber. Do not use Accutane for a condition for which it was not prescribed.
Active Ingredient: Isotretinoin.
Inactive Ingredients: beeswax, butylated hydroxyanisole, edetate disodium, hydrogenated soybean oil flakes, hydrogenated vegetable oil, and soybean oil. Gelatin capsules contain glycerin and parabens (methyl and propyl), with the following dye systems: 10 mg - iron oxide (red) and titanium dioxide; 20 mg - FD&C Red No. 3, FD&C Blue No. 1, and titanium dioxide; 40 mg - FD&C Yellow No. 6, D&C Yellow No. 10, and titanium dioxide.
Read this Medication Guide every time you get a prescription or a refill for Accutane (ACK-u-tane). There may be new information. This information does not take the place of talking with your prescriber (doctor or other health care provider).
What is the most important information I should know about Accutane?
Accutane is used to treat a type of severe acne (nodular acne) that has not been helped by other treatments, including antibiotics. However, Accutane can cause serious side effects. Before starting Accutane, discuss with your prescriber how bad your acne is, the possible benefits of Accutane, and its possible side effects, to decide if Accutane is right for you. Your prescriber will ask you to read and sign a form or forms indicating you understand some of the serious risks of Accutane.
Possible serious side effects of taking Accutane include birth defects and mental disorders.
1. Birth defects. Accutane can cause birth defects (deformed babies) if taken by a pregnant woman. It can also cause miscarriage (losing the baby before birth), premature (early) birth, or death of the baby. Do not take Accutane if you are pregnant or plan to become pregnant while you are taking Accutane. Do not get pregnant for 1 month after you stop taking Accutane. Also, if you get pregnant while taking Accutane, stop taking it right away and call your prescriber.
All females should read the section in this Medication Guide "What are the important warnings for females taking Accutane?"
2. Mental problems and suicide. Some patients, while taking Accutane or soon after stopping Accutane, have become depressed or developed other serious mental problems. Symptoms of these problems include sad, "anxious" or empty mood, irritability, anger, loss of pleasure or interest in social or sports activities, sleeping too much or too little, changes in weight or appetite, school or work performance going down, or trouble concentrating. Some patients taking Accutane have had thoughts about hurting themselves or putting an end to their own lives (suicidal thoughts). Some people tried to end their own lives. And some people have ended their own lives. There were reports that some of these people did not appear depressed. No one knows if Accutane caused these behaviors or if they would have happened even if the person did not take Accutane.
All patients should read the section in this Medication Guide "What are the signs of mental problems?"
For other possible serious side effects of Accutane, see "What are the possible side effects of Accutane?" in this Medication Guide.
What are the important warnings for females taking Accutane?
You must not become pregnant while taking Accutane, or for 1 month after you stop taking Accutane. Accutane can cause severe birth defects in babies of women who take it while they are pregnant, even if they take Accutane for only a short time. There is an extremely high risk that your baby will be deformed or will die if you are pregnant while taking Accutane. Taking Accutane also increases the chance of miscarriage and premature births.
Female patients will not get their first prescription for Accutane unless there is proof they have had 2 negative pregnancy tests. The first test must be done when your prescriber decides to prescribe Accutane. The second pregnancy test must be done during the first 5 days of the menstrual period right before starting Accutane therapy, or as instructed by your prescriber. Each month of treatment, you must have a negative result from a urine or serum pregnancy test. Female patients cannot get another prescription for Accutane unless there is proof that they have had a negative pregnancy test.
A yellow self-adhesive Accutane Qualification Sticker on your prescription indicates to the pharmacist that you are qualified by your prescriber to get Accutane.
While you are taking Accutane, you must use effective birth control. You must use 2 separate effective forms of birth control at the same time for at least 1 month before starting Accutane, while you take it, and for 1 month after you stop taking it. You can either discuss effective birth control methods with your prescriber or go for a free visit to discuss birth control with another physician or family planning expert. Your prescriber can arrange this free visit, which will be paid for by the manufacturer.
You must use 2 separate forms of effective birth control because any method, including birth control pills and sterilization, can fail. There are only 2 reasons you would not need to use 2 separate methods of effective birth control:
1. You have had your womb removed by surgery (a hysterectomy).
2. You are absolutely certain you will not have genital-to-genital sexual contact with a male before, during, and for 1 month after Accutane treatment.
If you have sex at any time without using 2 forms of effective birth control, get pregnant, or miss your period, stop using Accutane and call your prescriber right away.
All patients should read the rest of this Medication Guide.
What are the signs of mental problems?
Tell your prescriber if, to the best of your knowledge, you or someone in your family has ever had any mental illness, including depression, suicidal behavior, or psychosis. Psychosis means a loss of contact with reality, such as hearing voices or seeing things that are not there. Also, tell your prescriber if you take medicines for any of these problems.
Stop using Accutane and tell your provider right away if you:
- Start to feel sad or have crying spells
- Lose interest in activities you once enjoyed
- Sleep too much or have trouble sleeping
- Become more irritable than usual
- Have a change in your appetite or body weight
- Have trouble concentrating
- Withdraw from your friends or family
- Feel like you have no energy
- Have feelings of worthlessness or inappropriate guilt
- Start having thoughts about hurting yourself or taking your own life (suicidal thoughts)
What is Accutane?
Accutane is used to treat the most severe form of acne (nodular acne) that cannot be cleared up by any other acne treatments, including antibiotics. In severe nodular acne, many red, swollen, tender lumps form in the skin. These can be the size of pencil erasers or larger. If untreated, nodular acne can lead to permanent scars. However, because Accutane can have serious side effects, you should talk with your prescriber about all of the possible treatments for your acne, and whether Accutane's possible benefits outweigh its possible risks.
Who should not take Accutane?
- Do not take Accutane if you are pregnant, plan to become pregnant, or become pregnant during Accutane treatment. Accutane causes severe birth defects. All females should read the section "What are the important warnings for females taking Accutane?" for more information and warnings about Accutane and pregnancy.
- Do not take Accutane unless you completely understand its possible risks and are willing to follow all of the instructions in this Medication Guide.
Tell your prescriber if you or someone in your family has had any kind of mental problems, asthma, liver disease, diabetes, heart disease, osteoporosis (bone loss), weak bones, anorexia nervosa (an eating disorder where people eat too little), or any other important health problems. Tell your prescriber about any food or drug allergies you have had in the past. These problems do not necessarily mean you cannot take Accutane, but your prescriber needs this information to discuss if Accutane is right for you.
How should I take Accutane?
- You will get no more than a 30-day supply of Accutane at a time, to be sure you check in with your prescriber each month to discuss side effects.
- Your prescription should have a special yellow self-adhesive sticker attached to it. The sticker is YELLOW. If your prescription does not have this yellow self-adhesive sticker, call your prescriber. The pharmacy should not fill your prescription unless it has the yellow self-adhesive sticker.
- The amount of Accutane you take has been specially chosen for you and may change during treatment.
- You will take Accutane 2 times a day with a meal, unless your prescriber tells you otherwise. Swallow your Accutane capsules with a full glass of liquid. This will help prevent the medication inside the capsule from irritating the lining of your esophagus (connection between mouth and stomach). For the same reason, do not chew or suck on the capsule.
- If you miss a dose, just skip that dose. Do not take 2 doses the next time.
- You should return to your prescriber as directed to make sure you don't have signs of serious side effects. Because some of Accutane's serious side effects show up in blood tests, some of these visits may involve blood tests (monthly visits for female patients should always include a urine or serum pregnancy test).
What should I avoid while taking Accutane?
- Do not get pregnant while taking Accutane. See "What is the most important information I should know about Accutane?" and "What are the important warnings for females taking Accutane?"
- Do not breast feed while taking Accutane and for 1 month after stopping Accutane. We do not know if Accutane can pass through your milk and harm the baby.
- Do not give blood while you take Accutane and for 1 month after stopping Accutane. If someone who is pregnant gets your donated blood, her baby may be exposed to Accutane and may be born with birth defects.
- Do not take vitamin A supplements. Vitamin A in high doses has many of the same side effects as Accutane. Taking both together may increase your chance of getting side effects.
- Do not have cosmetic procedures to smooth your skin, including waxing, dermabrasion, or laser procedures, while you are using Accutane and for at least 6 months after you stop. Accutane can increase your chance of scarring from these procedures. Check with your prescriber for advice about when you can have cosmetic procedures.
- Avoid sunlight and ultraviolet lights as much as possible. Tanning machines use ultraviolet lights. Accutane may make your skin more sensitive to light.
- Do not use birth control pills that do not contain estrogen ("minipills"). They may not work while you take Accutane. Ask your prescriber or pharmacist if you are not sure what type you are using.
- Talk with your doctor if you plan to take other drugs or herbal products. This is especially important for patients using birth control pills and other hormonal types of birth control because the birth control may not work as effectively if you are taking certain drugs or herbal products. You should not take the herbal supplement St. John's Wort because this herbal supplement may make birth control pills not work as effectively.
- Talk with your doctor if you are currently taking an oral or injected corticosteroid or anticonvulsant (seizure) medication prior to using Accutane. These drugs may weaken your bones.
- Do not share Accutane with other people. It can cause birth defects and other serious health problems.
- Do not take Accutane with antibiotics unless you talk to your prescriber. For some antibiotics, you may have to stop taking Accutane until the antibiotic treatment is finished. Use of both drugs together can increase the chances of getting increased pressure in the brain.
What are the possible side effects of Accutane?
Accutane has possible serious side effects
- Accutane can cause birth defects, premature births, and death in babies whose mothers took Accutane while they were pregnant. See "What is the most important information I should know about Accutane?" and "What are the important warnings for females taking Accutane?"
- Serious mental health problems. See "What is the most important information I should know about Accutane?"
- Serious brain problems. Accutane can increase the pressure in your brain. This can lead to permanent loss of sight, or in rare cases, death. Stop taking Accutane and call your prescriber right away if you get any of these signs of increased brain pressure: bad headache, blurred vision, dizziness, nausea, or vomiting. Also, some patients taking Accutane have had seizures (convulsions) or stroke.
- Abdomen (stomach area) problems. Certain symptoms may mean that your internal organs are being damaged. These organs include the liver, pancreas, bowel (intestines), and esophagus (connection between mouth and stomach). If your organs are damaged, they may not get better even after you stop taking Accutane. Stop taking Accutane and call your prescriber if you get severe stomach, chest or bowel pain, trouble swallowing or painful swallowing, new or worsening heartburn, diarrhea, rectal bleeding, yellowing of your skin or eyes, or dark urine.
- Bone and muscle problems. Accutane may affect bones, muscles, and ligaments and cause pain in your joints or muscles. Tell your prescriber if you plan vigorous physical activity during treatment with Accutane. Tell your prescriber if you develop pain, particularly back pain or joint pain. There are reports that some patients have had stunted growth after taking Accutane for acne as directed. There are also some reports of broken bones or reduced healing of broken bones after taking Accutane for acne as directed. No one knows if taking Accutane for acne will affect your bones. If you have a broken bone, tell your provider that you are taking Accutane. Muscle weakness with or without pain can be a sign of serious muscle damage. If this happens, stop taking Accutane and call your prescriber right away.
- Hearing problems. Some people taking Accutane have developed hearing problems. It is possible that hearing loss can be permanent. Stop using Accutane and call your prescriber if your hearing gets worse or if you have ringing in your ears.
- Vision problems. While taking Accutane you may develop a sudden inability to see in the dark, so driving at night can be dangerous. This condition usually clears up after you stop taking Accutane, but it may be permanent. Other serious eye effects can occur. Stop taking Accutane and call your prescriber right away if you have any problems with your vision or dryness of the eyes that is painful or constant.
- Lipid (fats and cholesterol in blood) problems. Many people taking Accutane develop high levels of cholesterol and other fats in their blood. This can be a serious problem. Return to your prescriber for blood tests to check your lipids and to get any needed treatment. These problems generally go away when Accutane treatment is finished.
- Allergic reactions. In some people, Accutane can cause serious allergic reactions. Stop taking Accutane and get emergency care right away if you develop hives, a swollen face or mouth, or have trouble breathing. Stop taking Accutane and call your prescriber if you develop a fever, rash, or red patches or bruises on your legs.
- Signs of other possibly serious problems. Accutane may cause other problems. Tell your prescriber if you have trouble breathing (shortness of breath), are fainting, are very thirsty or urinate a lot, feel weak, have leg swelling, convulsions, slurred speech, problems moving, or any other serious or unusual problems. Frequent urination and thirst can be signs of blood sugar problems.
Serious permanent problems do not happen often. However, because the symptoms listed above may be signs of serious problems, if you get these symptoms, stop taking Accutane and call your prescriber. If not treated, they could lead to serious health problems. Even if these problems are treated, they may not clear up after you stop taking Accutane.
Accutane has less serious possible side effects
The common less serious side effects of Accutane are dry skin, chapped lips, dry eyes, and dry nose that may lead to nosebleeds. People who wear contact lenses may have trouble wearing them while taking Accutane and after therapy. Sometimes, people's acne may get worse for a while. They should continue taking Accutane unless told to stop by their prescriber.
These are not all of Accutane's possible side effects. Your prescriber or pharmacist can give you more detailed information that is written for health care professionals.
This Medication Guide is only a summary of some important information about Accutane. Medicines are sometimes prescribed for purposes other than those listed in a Medication Guide. If you have any concerns or questions about Accutane, ask your prescriber. Do not use Accutane for a condition for which it was not prescribed.
Active Ingredient: Isotretinoin.
Inactive Ingredients: beeswax, butylated hydroxyanisole, edetate disodium, hydrogenated soybean oil flakes, hydrogenated vegetable oil, and soybean oil. Gelatin capsules contain glycerin and parabens (methyl and propyl), with the following dye systems: 10 mg - iron oxide (red) and titanium dioxide; 20 mg - FD&C Red No. 3, FD&C Blue No. 1, and titanium dioxide; 40 mg - FD&C Yellow No. 6, D&C Yellow No. 10, and titanium dioxide.
Tuesday, July 24, 2007
What to Expect from Laser Acne Scar Removal Procedures
by: Naweko Nicole Dial
Have you decided to invest in a laser procedure to remove acne scarring? What do you expect to get for your cash- a completely new look? You should because these services aren't cheap. No matter what your aims for laser skin corrections are, by using medical reviews of leading laser treatments for acne scarring, you can have a clearer idea of what to expect after your laser treatment.
Most appraisals of the effectiveness of laser skin enhancements are two-sided because both the patients and study-independent physicians typically access the level improvement in acne marks.
While these post-treatment assessments are not standardized, they still offer a glimpse into the potential cosmetic outcomes from using laser treatments. Besides cosmetic changes in the skin, another variable that you'll need to add to your review of laser treatments is the overall number of treatments required to see dramatic changes in the skin.
What follows is a rundown of what to anticipate from four different laser procedures for treating acne scarring along with estimates of how many treatment you will need.
Laser 1
1,064-nm Nd:YAG pulsed light system Marketed names include PhotoSilk Laser
Last year, a study in Dermatologic Surgery tested the efficacy of the 1,064-nm Nd:YAG laser at removing acne scars. Nine patients underwent eight treatments for moderate to severe acne scarring. Three independent physicians assessed the overall improvement level of acne scarring severity for the group at 29.36%.
Treatments: 8 Improvement rating: 29.36%
Laser 2
1,320-nm Nd:YAG Marketed names include CoolTouch Laser An investigation from the same journal featured eight patients with facial acne scars. The group received eight treatments with the 1,320-nm Nd:YAG laser. After five treatments, independent observes assessed the overall acne scarring improvement rate between 40-60 %.
Treatments: 5 Improvement rating: 40-60%
Laser 3
1,450-nm diode laser Marketed names include Smoothbeam Laser
In a split test comparison between the 1,450-nm laser and 1,320-nm laser at treating mild to moderate atrophic (indented, or lost skin tissue) acne scarring, the 1,450-nm laser demonstrated greater improvement in acne scarring.
Laser 4
1,550-nm erbium-doped fiber laser Marketed names include Fraxel Laser
Just this past March, a study in Dermatologic Surgery tested the 1,550-nm erbium-doped fiber laser on fifty-three patients with mild to moderate atrophic facial acne scars. After three treatments, two independent reviewers judged a 51-75% improvement in the scarring of 90% of the study participants.
Treatments: 3 Improvement rating: 51-75%
Remember, these ratings are based on the improvement levels patients coping with mild to severe acne scarring experienced after various laser treatments. As Dr. Rohrer pointed out that it is difficult to predict what your skin will look like after a laser treatment for acne scarring because many of the patient assessments during the studies were based on opinions of before and after photos.
To reduce the uncertainty surrounding laser correction of acne scars, ask your laser surgeon for before and after images of laser cosmetic procedures she has performed in the past months. Then judge the overall acne scarring improvement level for yourself.
Sources: Alster, Tina; Elizabeth L Tanzi & Melissa Lazarus. The Use of Fractional Laser Photothermolysis for the Treatment of Atrophic Scars. Dermatologic Surgery; March 2007, vol 33, no 3, pp 295-299.
Lipper, Graeme M & Maritza Perez. Nonablative Acne Scar Reduction after a Series of Treatments with a Short-Pulsed 1,064-nm Neodymium:YAG Laser. Dermatologic Surgery; August 2006, vol 32, no 8, pp 998-1006.
Rohrer, Thomas E. Ethics in Cosmetic Laser Treatments. Skin and Allergy News; May 2007, vol 38, no 5, pp 14-15.
Sadick NS & AK Schecter. A Preliminary Study of Utilization of the 1320-nm Nd:YAG Laser for the Treatment of Acne Scarring. Dermatologic Surgery; July 2004, vol 30, no 7, pp 995-1000.
Tanzi, Elizabeth L & Tina S Alster. Comparison of a 1450-nm Diode Laser and a 1320-nm Nd:YAG Laser in the Treatment of Atrophic Facial Scars: A Prospective Clinical and Histologic Study. Dermatologic Surgery; February 2004, vol 30, no 2, pp 152-157.
Have you decided to invest in a laser procedure to remove acne scarring? What do you expect to get for your cash- a completely new look? You should because these services aren't cheap. No matter what your aims for laser skin corrections are, by using medical reviews of leading laser treatments for acne scarring, you can have a clearer idea of what to expect after your laser treatment.
Most appraisals of the effectiveness of laser skin enhancements are two-sided because both the patients and study-independent physicians typically access the level improvement in acne marks.
While these post-treatment assessments are not standardized, they still offer a glimpse into the potential cosmetic outcomes from using laser treatments. Besides cosmetic changes in the skin, another variable that you'll need to add to your review of laser treatments is the overall number of treatments required to see dramatic changes in the skin.
What follows is a rundown of what to anticipate from four different laser procedures for treating acne scarring along with estimates of how many treatment you will need.
Laser 1
1,064-nm Nd:YAG pulsed light system Marketed names include PhotoSilk Laser
Last year, a study in Dermatologic Surgery tested the efficacy of the 1,064-nm Nd:YAG laser at removing acne scars. Nine patients underwent eight treatments for moderate to severe acne scarring. Three independent physicians assessed the overall improvement level of acne scarring severity for the group at 29.36%.
Treatments: 8 Improvement rating: 29.36%
Laser 2
1,320-nm Nd:YAG Marketed names include CoolTouch Laser An investigation from the same journal featured eight patients with facial acne scars. The group received eight treatments with the 1,320-nm Nd:YAG laser. After five treatments, independent observes assessed the overall acne scarring improvement rate between 40-60 %.
Treatments: 5 Improvement rating: 40-60%
Laser 3
1,450-nm diode laser Marketed names include Smoothbeam Laser
In a split test comparison between the 1,450-nm laser and 1,320-nm laser at treating mild to moderate atrophic (indented, or lost skin tissue) acne scarring, the 1,450-nm laser demonstrated greater improvement in acne scarring.
Laser 4
1,550-nm erbium-doped fiber laser Marketed names include Fraxel Laser
Just this past March, a study in Dermatologic Surgery tested the 1,550-nm erbium-doped fiber laser on fifty-three patients with mild to moderate atrophic facial acne scars. After three treatments, two independent reviewers judged a 51-75% improvement in the scarring of 90% of the study participants.
Treatments: 3 Improvement rating: 51-75%
Remember, these ratings are based on the improvement levels patients coping with mild to severe acne scarring experienced after various laser treatments. As Dr. Rohrer pointed out that it is difficult to predict what your skin will look like after a laser treatment for acne scarring because many of the patient assessments during the studies were based on opinions of before and after photos.
To reduce the uncertainty surrounding laser correction of acne scars, ask your laser surgeon for before and after images of laser cosmetic procedures she has performed in the past months. Then judge the overall acne scarring improvement level for yourself.
Sources: Alster, Tina; Elizabeth L Tanzi & Melissa Lazarus. The Use of Fractional Laser Photothermolysis for the Treatment of Atrophic Scars. Dermatologic Surgery; March 2007, vol 33, no 3, pp 295-299.
Lipper, Graeme M & Maritza Perez. Nonablative Acne Scar Reduction after a Series of Treatments with a Short-Pulsed 1,064-nm Neodymium:YAG Laser. Dermatologic Surgery; August 2006, vol 32, no 8, pp 998-1006.
Rohrer, Thomas E. Ethics in Cosmetic Laser Treatments. Skin and Allergy News; May 2007, vol 38, no 5, pp 14-15.
Sadick NS & AK Schecter. A Preliminary Study of Utilization of the 1320-nm Nd:YAG Laser for the Treatment of Acne Scarring. Dermatologic Surgery; July 2004, vol 30, no 7, pp 995-1000.
Tanzi, Elizabeth L & Tina S Alster. Comparison of a 1450-nm Diode Laser and a 1320-nm Nd:YAG Laser in the Treatment of Atrophic Facial Scars: A Prospective Clinical and Histologic Study. Dermatologic Surgery; February 2004, vol 30, no 2, pp 152-157.
Wednesday, July 18, 2007
The Unspoken Horror Of Adult Acne
by: Frank Cordova
Did you know that more than 25% of the adult population worldwide suffers from acne? If we leave the pages of statistical data and look at people with plain eyes it will be hard to find a man or a woman who did not suffer the gnawing problem of zits. However, even though this problem is "skin deep", its effects germinate into bouts of despair and social angst, which jeopardizes quality of life.
Digging Into The Roots Of Adult Acne
Sebum secreted from the hair follicles moves to the skin pores and lubricates the skin. But sometimes the oil glands expand, producing an excess of sebum, which ultimately gets trapped in the hair follicle and clogs the pores. These clogged pores permit bacteria and growth of Propionibacterium acnes. This bacteria causes inflammation of the hair follicle and the surrounding skin and thus acne emerges.
Though till now the exact causes of adult acne are not known, most of the theories suggest hormonal imbalances as the root cause. Some other causes proposed are evolutionary biology, diet, stress, vitamin deficiency and the list goes on.
Some Effective Treatments To Get Rid Of Adult Acne
Studies reveal that Vitamin A plays an important role in the reduction of serum and keratin production and thus minimizes their growth in follicle comedos. So, nourish your system with Vitamin A and take at least five servings of vegetables and fresh fruits daily. However, always consult a doctor before starting up with any kind of regime. Zinc is an important element in treating acne too.
Zinc enhances the functions of Vitamin A and lends a helping hand in the healing and regeneration of tissues. Zinc also reduces the conversion of testosterone to dihydrotestosterone, which shrinks sebum production.
Most acne sufferers lack Selenium, which plays a crucial role in the action of the enzyme Gluthathione Peroxidase that prevents the inflammation of the hair follicle. Vitamin E minimizes this process and plays a vital part in the action of Vitamin A and Selenium.
Friendly bacteria, Acidophilus, can check injurious intestinal bacteria including yeasts such as Candida albicans. You can take in Acidophilus either in gel capsule form or as yogurt with live culture.
Benozyl peroxide reduces pimples and is effective for acne. You can have it in cream or lotion form.
Creams containing sulphur are also useful in treating acne.
Medications containing iodide and bromide can worsen your acne condition so stay away from such products.
All these things are medicines, all of which may have side effects and should not be taken without a prescription and the guidance of a doctor.
Good News For Foodies
You will be glad to know that chocolate or fried foods do not cause acne. These foods are often seen as unhealthy food habits and therefore "must be" related to skin breakouts, but this theory has no scientific backing. However, foods which are high in refined sugar, trans-fatty acid (milk products) oxidized fatty acids (fried oils) and synthetically hydrogenated vegetable oil contents may not cause acne but are definitely not very good for your health, and so an excess of these foods should be avoided. You can be infected with intestinal toxemia if your diet is low on fiber and essential vitamins and high on these contents. The result of glut of toxins may show on your skin.
Some Natural Remedies Of Adult Acne
The good news about the use of natural things is that they come without the risk of side effects.
Name And Fame Of Some Natural Ingredients
Azelaic acid
This acid makes the keratin production stable and you will get almost same results as using Benzoyl- Peroxide or oral antibiotics.
Tea Tree Oil
Reduces acne with its antibacterial and antifungal qualities.
Green Tea
A renowned antioxidant, which trims down inflammation and infection Topical Vitamin C And E. Both are strong antioxidants, which improve skin condition by diminishing inflammation and infection.
Fruit Acids (AHAs And BHAs)
These acids gently exfoliate your skin, leaving it smooth.
Some Tips To Control Outbursts Of Adult Acne
Cleanse your face with a mild soap or sulphur soap but do not rub your face with a towel.
Never ever pick or squeeze the zits, it will only worsen your skin condition.
Some acne treatment products will hike up your skin's photosensitivity so when you are using these products, use a sunscreen and wear a hat when you are out. Avoid the tanning booths while using these products as well.
Try to avoid the use of oil-based products on your skin. To prevent the clogging of pores use only "noncomdomedogenic" skin products.
Try to avoid friction from sports equipment and airborne grease from fast food places; these can make your acne worse.
Along with a good diet include at least 8 to ten glasses of water in your daily regimen to keep your system clean and the skin glowing
Choosing the right path will help your skin get rid of adult acne scars. Make your skin dazzle with a smooth glow by following the tips in this article.
Did you know that more than 25% of the adult population worldwide suffers from acne? If we leave the pages of statistical data and look at people with plain eyes it will be hard to find a man or a woman who did not suffer the gnawing problem of zits. However, even though this problem is "skin deep", its effects germinate into bouts of despair and social angst, which jeopardizes quality of life.
Digging Into The Roots Of Adult Acne
Sebum secreted from the hair follicles moves to the skin pores and lubricates the skin. But sometimes the oil glands expand, producing an excess of sebum, which ultimately gets trapped in the hair follicle and clogs the pores. These clogged pores permit bacteria and growth of Propionibacterium acnes. This bacteria causes inflammation of the hair follicle and the surrounding skin and thus acne emerges.
Though till now the exact causes of adult acne are not known, most of the theories suggest hormonal imbalances as the root cause. Some other causes proposed are evolutionary biology, diet, stress, vitamin deficiency and the list goes on.
Some Effective Treatments To Get Rid Of Adult Acne
Studies reveal that Vitamin A plays an important role in the reduction of serum and keratin production and thus minimizes their growth in follicle comedos. So, nourish your system with Vitamin A and take at least five servings of vegetables and fresh fruits daily. However, always consult a doctor before starting up with any kind of regime. Zinc is an important element in treating acne too.
Zinc enhances the functions of Vitamin A and lends a helping hand in the healing and regeneration of tissues. Zinc also reduces the conversion of testosterone to dihydrotestosterone, which shrinks sebum production.
Most acne sufferers lack Selenium, which plays a crucial role in the action of the enzyme Gluthathione Peroxidase that prevents the inflammation of the hair follicle. Vitamin E minimizes this process and plays a vital part in the action of Vitamin A and Selenium.
Friendly bacteria, Acidophilus, can check injurious intestinal bacteria including yeasts such as Candida albicans. You can take in Acidophilus either in gel capsule form or as yogurt with live culture.
Benozyl peroxide reduces pimples and is effective for acne. You can have it in cream or lotion form.
Creams containing sulphur are also useful in treating acne.
Medications containing iodide and bromide can worsen your acne condition so stay away from such products.
All these things are medicines, all of which may have side effects and should not be taken without a prescription and the guidance of a doctor.
Good News For Foodies
You will be glad to know that chocolate or fried foods do not cause acne. These foods are often seen as unhealthy food habits and therefore "must be" related to skin breakouts, but this theory has no scientific backing. However, foods which are high in refined sugar, trans-fatty acid (milk products) oxidized fatty acids (fried oils) and synthetically hydrogenated vegetable oil contents may not cause acne but are definitely not very good for your health, and so an excess of these foods should be avoided. You can be infected with intestinal toxemia if your diet is low on fiber and essential vitamins and high on these contents. The result of glut of toxins may show on your skin.
Some Natural Remedies Of Adult Acne
The good news about the use of natural things is that they come without the risk of side effects.
Name And Fame Of Some Natural Ingredients
Azelaic acid
This acid makes the keratin production stable and you will get almost same results as using Benzoyl- Peroxide or oral antibiotics.
Tea Tree Oil
Reduces acne with its antibacterial and antifungal qualities.
Green Tea
A renowned antioxidant, which trims down inflammation and infection Topical Vitamin C And E. Both are strong antioxidants, which improve skin condition by diminishing inflammation and infection.
Fruit Acids (AHAs And BHAs)
These acids gently exfoliate your skin, leaving it smooth.
Some Tips To Control Outbursts Of Adult Acne
Cleanse your face with a mild soap or sulphur soap but do not rub your face with a towel.
Never ever pick or squeeze the zits, it will only worsen your skin condition.
Some acne treatment products will hike up your skin's photosensitivity so when you are using these products, use a sunscreen and wear a hat when you are out. Avoid the tanning booths while using these products as well.
Try to avoid the use of oil-based products on your skin. To prevent the clogging of pores use only "noncomdomedogenic" skin products.
Try to avoid friction from sports equipment and airborne grease from fast food places; these can make your acne worse.
Along with a good diet include at least 8 to ten glasses of water in your daily regimen to keep your system clean and the skin glowing
Choosing the right path will help your skin get rid of adult acne scars. Make your skin dazzle with a smooth glow by following the tips in this article.
Sunday, July 15, 2007
Dealing With Acne Can Be Embarassing At Any Age
by: Sarah Rhodes
When using acne solutions, make sure that you follow the directions. Overuse of the product can cause as many problems as under use of the product. Follow the directions to the letter, unless your doctor or dermatologist advises otherwise. The best acne solutions will contain both topical treatment, as well as oral treatment. Acne starts on the inside of the body, but it is prevented and healed on both the inside and outside of the body.
Other ingredients you may see in acne medications include resorcinol and sulphur. Resorcinol causes the top layer of skin to peel -- including the dead skin cells which clog the pores. It is often combined with sulphur. It is not known how sulphur affects acne conditions, but it has been used effectively for more than 50 years. Sulphur is often combined with other ingredients besides resorcinol like salicylate acid and benzoyl peroxide. It is not usually used by itself because of its strong, unpleasant odor.
Organic Apple Cider Vinegar swabs and other astringent cleansers work to remove the oil buildup that may become blocked in the skin's glands. These products may cause dryness, itching, and redness, so be sure to use them only on problem areas.
On the other hand, there are many popular myths and delusions about what causes acne. Acne does not occur as a result of stress, or of eating chocolate and greasy food. Also, acne is not an infectious disease, i.e. it cannot be transmitted by touch or through a sexual intercourse (like Chlamydia which is also a skin disease but is transmitted sexually).
Unlike the small whitehead pustules that most people with acne experience on the surface of their skin, cystic acne appears as large irritated bumps, often with the pustule hidden deep beneath the skin's surface. These cysts are caused when hormonal shifts result in your skin glands overproducing oil (sebum) at an unnatural rate. The gland becomes swollen and eventually bursts, but not before the sebum has swelled and hardened into a clump too large to escape through your pores. The irritation from your gland bursting results in inflammation, and buried pustule can remain in your skin for a very long time.
The skin is the largest organ in our body and it eliminates toxic body waste through the pores when we sweat. If the body has more toxins than the liver or kidneys can discharge the skin takes over. Many doctors actually refer to the skin as the third kidney. When toxins discharge through the skin they can cause a disruption in the healthy skin and you have pimples.
When using acne solutions, make sure that you follow the directions. Overuse of the product can cause as many problems as under use of the product. Follow the directions to the letter, unless your doctor or dermatologist advises otherwise. The best acne solutions will contain both topical treatment, as well as oral treatment. Acne starts on the inside of the body, but it is prevented and healed on both the inside and outside of the body.
Other ingredients you may see in acne medications include resorcinol and sulphur. Resorcinol causes the top layer of skin to peel -- including the dead skin cells which clog the pores. It is often combined with sulphur. It is not known how sulphur affects acne conditions, but it has been used effectively for more than 50 years. Sulphur is often combined with other ingredients besides resorcinol like salicylate acid and benzoyl peroxide. It is not usually used by itself because of its strong, unpleasant odor.
Organic Apple Cider Vinegar swabs and other astringent cleansers work to remove the oil buildup that may become blocked in the skin's glands. These products may cause dryness, itching, and redness, so be sure to use them only on problem areas.
On the other hand, there are many popular myths and delusions about what causes acne. Acne does not occur as a result of stress, or of eating chocolate and greasy food. Also, acne is not an infectious disease, i.e. it cannot be transmitted by touch or through a sexual intercourse (like Chlamydia which is also a skin disease but is transmitted sexually).
Unlike the small whitehead pustules that most people with acne experience on the surface of their skin, cystic acne appears as large irritated bumps, often with the pustule hidden deep beneath the skin's surface. These cysts are caused when hormonal shifts result in your skin glands overproducing oil (sebum) at an unnatural rate. The gland becomes swollen and eventually bursts, but not before the sebum has swelled and hardened into a clump too large to escape through your pores. The irritation from your gland bursting results in inflammation, and buried pustule can remain in your skin for a very long time.
The skin is the largest organ in our body and it eliminates toxic body waste through the pores when we sweat. If the body has more toxins than the liver or kidneys can discharge the skin takes over. Many doctors actually refer to the skin as the third kidney. When toxins discharge through the skin they can cause a disruption in the healthy skin and you have pimples.
6 Effective Ingredients Of Quality Acne Treatments
by: Sonny Dhinjan
If you ask an acne patient who for many years, has used a vast range of topical acne treatments in the hope of finding one that successfully got rid of all the acne spots on her face fully and consistently, whether or not she managed to find one... you can bet that her answer will be, "No I didn't".
Millions of people all over the world break out with acne spots. Unfortunately, only a very small proportion of them "luckily" get to meet somebody who points them in the direction of finding a good quality acne treatment. A topical cream that contains powerful natural and synthetic ingredients that are put together in the right mix to make a formulation that has the ability to effectiely free up some space in the follicular openings in the epidermal layer of their skin. A cream that then allows trapped oily sebum to flow out easily, which in turn, dramatically leaves their skin looking clearer, smoother, tougher, younger, and enviable. A product that does this well... in fact, very well.
It's important to note that your skin is made up of several layers, and we are concerned with the stratum corneum (which is in actual fact the upper layer of the epidermal layer), the remainder of the epidermal layer itself, and the dermis which lies beneath the epidermis. Why note this? Because hyperstimulation of the sebaceous glands in response to a surge in androgenic hormones is what starts everything off, and this happens in the dermis. Also, many of the pronounced comedones form here. As far as the epidermis and stratum corneum are concerned, these layers are full of Propionibacterium Acnes, dirt, debris, and dead skin cells. You need to get rid of these to make it easy to unblock the plugged follicles in the dermis. The most efficient way to achieve this is by the process of "abrasion", "sloughing", or exfoliation, which all mean the same thing really.
My intention here is to talk about specific ingredients that go inside ance treatments that are topically applied, and why such ingredients set the treatments that they are found in, apart from the money wasters. The below average treatments that are merely adequate for people who break out with the mildest form of acne. The type where they break out with one little tiny red spot once in a blue moon. And this is certainly not the case with somebody with large prominent pimples.
If you fit in this latter category of people and would like to know what pioneering skincare experts include in their cosmetic products to bring them to a standard where the formulation is able to effectively get rid of such spots, then here are some pointers for you to follow before you purchase your next acne treatment. This is a list of the most effective, and widely used ingredients in good cosmetic products that will bring about a marginal improvement in your complexion:
1. Glycolic Acid - This is number one on the list for a good reason, and that reason is, that it is one of the most powerful and effective exfoliants in the industry. Glycolic acid penetrates your skin, frees plugged pores and follicles, and does this job well. I would suggest that you end your frustrations with benzoyl peroxide and move onto this ingredient soon. Glycolic acid is classified as an "alpha hydroxy acid" (AHA). It is a naturally occuring chemical found in sugar cane. There are others - namely lactic acid, citric acid, malic acid, and tartaric acid. These are all less potent than glycolic acid, but they are now all found together in home chemical peel kits. Start using a glycolic acid face wash or moisturizer as soon as possible - a 5% concentration would be good to begin with.
2. Glycolic Compound - There are skin care products in the "chemical peeling" market that consist of high strength glycolic acid, typically 20-70%. These contain something called "glycolic compound" - a pH-balanced complex of glycolic acid and ammonium glycolate. You will find this compound has helped several people achieve excellent results with their skin problems, particularly acne. MD Formulations and MD Forte are top brands that have released lotions, creams, and gels containing this ingredient.
3. Salicylic Acid - Also known as "beta hydroxy acid" and the only one. This is usually found as a 2% concentration in most skincare products. Its mode of action is similar to glycolic acid in that it causes skin cells to slough off. Salicylic acid is a good choice if you get mild to moderate breakouts.
4. Ferulic Acid - This is commonly found in anti-aging products because of it antioxidant properties. Your skin is undergoing constant oxidation. It is being oxidized by free radicals, other environmental pollutants, and the UV rays from the sun. You may think this to be inappropriate for your acne condition, but antioxidants stop oxidation, and this helps to prevent pre-existing scars and lines from advancing further. Antioxidants also help post-inflammatory hyperpigmentation which is a problem that many acne patients get. There are many antioxidants out there, but this one is good and it's widely used in brands like Skinceuticals, Murad, and Dr. Michelle Copeland.
The point to note here is that acne treatments "treat" through different modes of action - exfoliation, dermabrasion, and anti-bacterial action for example. But then there are others which work to "protect" and this is what antioxidants do, so these can prove to be very effective, especially in adult acne. Overall, anti-oxidants are great at improving the integrity of your skin. They give it the radiacne and the glowing effect that you're looking for.
5. Idebenone - Take the time to visit http://prevageskin.co.uk/ and here you can read about idebenone. I have chosen this product to demonstrate the importance of stopping your skin from oxidizing. Idebenone is an analogue of another anti-oxidant called Co-enzyme Q10. This will make an expensive, but a potent free radical quencher. 6. Ascorbyl palmitate - You will find this in the famous Jan Marini C-ESTA products. It is the fat-soluble form of vitamin C, another antioxidant. This synthetic compound was made fat-soluble to improve its absorption through the skin. Water-soluble products don't penetrate the skin as well as lipid-soluble ones. Again, this one is great for tightening up contours around scarred regions in the T-Zone area, particularly around the nose.
So what I've tried to do here is to give you a good range of products like glycolic acid and other alpha hydroxy acids that unplug your hair follicles and allow oil and debris to flow out from under your skin, as well as powerful antioxidants n the current market that improve the overall integrity of your skin by giving it shine, glow, and make it less bumpy and more smooth.
It's very easy to get wrapped up in the habit of sticking to prescribed antibiotics, or OTC treatments for mild acne and end up frustrated having realized that they don't work, and sometimes even make your acne worse. If this is happening to you, start branching out by discovering more advanced treatments that contain the ingredients discussed herein, and you never know... a breakthrough in finding a treatment that works wonders for you may be just weeks away.
If you ask an acne patient who for many years, has used a vast range of topical acne treatments in the hope of finding one that successfully got rid of all the acne spots on her face fully and consistently, whether or not she managed to find one... you can bet that her answer will be, "No I didn't".
Millions of people all over the world break out with acne spots. Unfortunately, only a very small proportion of them "luckily" get to meet somebody who points them in the direction of finding a good quality acne treatment. A topical cream that contains powerful natural and synthetic ingredients that are put together in the right mix to make a formulation that has the ability to effectiely free up some space in the follicular openings in the epidermal layer of their skin. A cream that then allows trapped oily sebum to flow out easily, which in turn, dramatically leaves their skin looking clearer, smoother, tougher, younger, and enviable. A product that does this well... in fact, very well.
It's important to note that your skin is made up of several layers, and we are concerned with the stratum corneum (which is in actual fact the upper layer of the epidermal layer), the remainder of the epidermal layer itself, and the dermis which lies beneath the epidermis. Why note this? Because hyperstimulation of the sebaceous glands in response to a surge in androgenic hormones is what starts everything off, and this happens in the dermis. Also, many of the pronounced comedones form here. As far as the epidermis and stratum corneum are concerned, these layers are full of Propionibacterium Acnes, dirt, debris, and dead skin cells. You need to get rid of these to make it easy to unblock the plugged follicles in the dermis. The most efficient way to achieve this is by the process of "abrasion", "sloughing", or exfoliation, which all mean the same thing really.
My intention here is to talk about specific ingredients that go inside ance treatments that are topically applied, and why such ingredients set the treatments that they are found in, apart from the money wasters. The below average treatments that are merely adequate for people who break out with the mildest form of acne. The type where they break out with one little tiny red spot once in a blue moon. And this is certainly not the case with somebody with large prominent pimples.
If you fit in this latter category of people and would like to know what pioneering skincare experts include in their cosmetic products to bring them to a standard where the formulation is able to effectively get rid of such spots, then here are some pointers for you to follow before you purchase your next acne treatment. This is a list of the most effective, and widely used ingredients in good cosmetic products that will bring about a marginal improvement in your complexion:
1. Glycolic Acid - This is number one on the list for a good reason, and that reason is, that it is one of the most powerful and effective exfoliants in the industry. Glycolic acid penetrates your skin, frees plugged pores and follicles, and does this job well. I would suggest that you end your frustrations with benzoyl peroxide and move onto this ingredient soon. Glycolic acid is classified as an "alpha hydroxy acid" (AHA). It is a naturally occuring chemical found in sugar cane. There are others - namely lactic acid, citric acid, malic acid, and tartaric acid. These are all less potent than glycolic acid, but they are now all found together in home chemical peel kits. Start using a glycolic acid face wash or moisturizer as soon as possible - a 5% concentration would be good to begin with.
2. Glycolic Compound - There are skin care products in the "chemical peeling" market that consist of high strength glycolic acid, typically 20-70%. These contain something called "glycolic compound" - a pH-balanced complex of glycolic acid and ammonium glycolate. You will find this compound has helped several people achieve excellent results with their skin problems, particularly acne. MD Formulations and MD Forte are top brands that have released lotions, creams, and gels containing this ingredient.
3. Salicylic Acid - Also known as "beta hydroxy acid" and the only one. This is usually found as a 2% concentration in most skincare products. Its mode of action is similar to glycolic acid in that it causes skin cells to slough off. Salicylic acid is a good choice if you get mild to moderate breakouts.
4. Ferulic Acid - This is commonly found in anti-aging products because of it antioxidant properties. Your skin is undergoing constant oxidation. It is being oxidized by free radicals, other environmental pollutants, and the UV rays from the sun. You may think this to be inappropriate for your acne condition, but antioxidants stop oxidation, and this helps to prevent pre-existing scars and lines from advancing further. Antioxidants also help post-inflammatory hyperpigmentation which is a problem that many acne patients get. There are many antioxidants out there, but this one is good and it's widely used in brands like Skinceuticals, Murad, and Dr. Michelle Copeland.
The point to note here is that acne treatments "treat" through different modes of action - exfoliation, dermabrasion, and anti-bacterial action for example. But then there are others which work to "protect" and this is what antioxidants do, so these can prove to be very effective, especially in adult acne. Overall, anti-oxidants are great at improving the integrity of your skin. They give it the radiacne and the glowing effect that you're looking for.
5. Idebenone - Take the time to visit http://prevageskin.co.uk/ and here you can read about idebenone. I have chosen this product to demonstrate the importance of stopping your skin from oxidizing. Idebenone is an analogue of another anti-oxidant called Co-enzyme Q10. This will make an expensive, but a potent free radical quencher. 6. Ascorbyl palmitate - You will find this in the famous Jan Marini C-ESTA products. It is the fat-soluble form of vitamin C, another antioxidant. This synthetic compound was made fat-soluble to improve its absorption through the skin. Water-soluble products don't penetrate the skin as well as lipid-soluble ones. Again, this one is great for tightening up contours around scarred regions in the T-Zone area, particularly around the nose.
So what I've tried to do here is to give you a good range of products like glycolic acid and other alpha hydroxy acids that unplug your hair follicles and allow oil and debris to flow out from under your skin, as well as powerful antioxidants n the current market that improve the overall integrity of your skin by giving it shine, glow, and make it less bumpy and more smooth.
It's very easy to get wrapped up in the habit of sticking to prescribed antibiotics, or OTC treatments for mild acne and end up frustrated having realized that they don't work, and sometimes even make your acne worse. If this is happening to you, start branching out by discovering more advanced treatments that contain the ingredients discussed herein, and you never know... a breakthrough in finding a treatment that works wonders for you may be just weeks away.
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