Archive for February, 2006
Most oral antibiotics for acne treatment are dosed at twice a day with a few extended release pills being only once a day. These medications can take 4-6 weeks at times to show their full benefts. But what should you do when you achieve great results?
The important thing with oral antibiotics and acne treatment is that you gradually taper the pills. There is a common phenomenon in acne treatment that if you simply stop the medications cold turkey, you may get a rebound effect with flaring of the acne.
So, if you’re on a pill twice a day, it’s best to first cut down to once a day, then go to every other day, and then stop. Each “step” down should occur after two to three weeks at the previous level. During this taper, if new breakouts occur, you should increase the dose back to the prior dose that allowed you to maintain good results.
Eventually, you will be able to stop the oral pills and just use the topical medications.
February 17th, 2006
While the winter weather is here the use of isotretinoin (Accutane, Sotret, Amnesteem, Claravis) for acne treatment can cause the lining of the nose to dry out. This can in turn lead to cracking and even bleeding.
The best way to prevent this is to keep the nasal mucosa nice and moist. Our favorite remedy is the use of Ocean Nasal Spray. This over the counter product can be used several times a day to help restore the nose’s natural moisture that may be decreased with the use of isotretinoin, especially in the winter months.
February 16th, 2006
Another new acne treatment product has been held up by the FDA for further study. Velac is a combination clindamycin/tretinoin combination that was to be used for acne treatment. This combination acne treatment would bring the power of a topical antibiotic and topical retinoid in one easy application.
Connetics, the company behind Velac remains focused on bringing this product to market.
February 15th, 2006
A recent study published in Cosmetic Dermatology took a look at using topical retinoids and benzoyl peroxide together (at the same time) in the treatment of acne.
In the past, the original topical reitnoid, tretinoin (Retin-a) was not stable and would lose its ability to work when combined with other acne products. More recently, newer topical retinoids such as adapalene (Differin) and the microsphere formulation of tretinoin (Retin-a Microgel) have shown better stability when used with other agents such as benzoyl peroxide.
The study made reference to tests that had been done that showed that Differin is 100% stable after 24 hours of being mixed with benzoyl peroxide and that Retin-a microgel was stable to 97% at 8 hours and 70% after 24 hours of being mixed with benzoyl peroxide.
The study’s main evaluation was on how this combination was tolerated and it proved that the combination of both agents was no more irritating than the topical retinoid alone.
The study conclusions showed that the use of either topical retinoid along with the benzoyl peroxide (which was the Triaz 3% pad) proved to be both stable and well tolerated. What this suggests is that this combination being used at the same time may make treatment easier to do and thus increase overall compliace and results. The study did not compare how well the combination worked in treating the acne, but we’re sure more data will be available on this in the future.
February 14th, 2006
Just as a reminder, if you are a woman being treated for acne, it is very important to let your dermatologist know if you are trying to conceive or if you have recently become pregnant. Many of the medications used to treat acne are contraindicated during pregnancy and may cause harm to a developing baby.
The most commonly used acne medications that should be stopped during pregnancy are isotretinoin (Accutane, Sotret, Amnesteem, Claravis), minocycline, doxycycline, tetracycline, Bactrim, the topical retinoids (Tazorac, Retin-a, Differn). The topical benzoyl peroxides and sulfa containing products (Klaron, Clenia, Rosula) and others should also be stopped.
It is important to speak with your dermatologist about treatment during pregnancy. Sometimes it can be difficult to find a regimen that is perfect becasue there is such limitation in what can be prescribed. Remember though, the reason you are sacrificing treatment is for your baby.
February 13th, 2006
Joining the topical benzoyl peroxide cleansing market is Zapzyt. Zapzyt 10% Benzoyl Peroxide bar is a soap-free cleanser that is marketed to help clear active blemishes as well as to help prevent new outbreaks. In the bar form, Zapzyt is easy to use on the face, back, and chest.
Zapzyt is priced to meet anyone’s budget and this may help increase its use and popularity in the topical acne over the counter market.
Learn more at here.
February 12th, 2006
Galderma was hoping to launch Differin XP in 2005, but delays from the FDA may move things back until late 2006.
This new formulation of Differin is a new offering to the topical retinoids. The 0.3% strength Differin XP has been proven in studies to be more effective at both reducing total lesion counts as well as reductions in both inflammatory (pimples and pustules) and non-inflammatory (blackheads and whiteheads) lesions than Differin 0.1% gel.
We will see where this fits in among other topical retinoids and look forward to possible head to head studies with Retin-a and Tazorac.
February 11th, 2006
Sometimes, the use of oral antibiotics can predispose women to yeast infections. This may present a problem in the treatment of acne, since many times, oral antibiotics are used to help with inflammatory acne. Fortunately, there are some treatments that can be used.
To begin, an oral antifungal pill in low doses (amphotericin) can be combined with tetracycline. By taking both of these together, this can almost eliminate the risk of yeast infections. Pharmacists need a special machine to combine these two agents into a capsule.
Another possiblity is sub-antimicrobial doses of doxycyline. This is a new trend in the treatment of acne and rosacea. By using a low dose, the levels of the medication actually never act like an antibiotic, they simply work by decreasing inflammation. In as such, there is no problem with yeast infections.
So, if you are a female who requires oral therapy for your acne and you are susceptible to yeast infetions, ask you dermatologist about these options.
February 10th, 2006
Some dermatologists like to start treatment off with a more simple, limited regimen. They may start with an oral antibiotic and a single topical gel, or maybe even start with just one topical medication. Then, at follow up visits, more medications are added as necessary.
The advantages of this approach are several. To begin, acne regimens can sometimes become difficult to keep up with. Starting with one or two medciations allows people to get used to a routine and to stick with it. Once established, it is easier to add new medications and the odds of keeping the routine are higher.
In addition, sometimes too many medications at the start of treatment can lead to irritation. Starting slowly allows the skin to adjust so that the addition of other medications is better tolerated.
So, it’s OK to start slowly and may in the end make treatment easier and more tolerable. As always, patience is necessary in achieving the end goal of clearer skin.
February 9th, 2006
Perhaps one of the quickest fixes for solitary or a few blemishes is with an intralesional injection. Typically, the injection consists of a combination of a steroid (usually Kenalog), an aqueous antibiotic (c0mmonly Lincocin), and bacteriostatic water that is used to dilute the first two agents to appropriate concentrations.
The benefits of the intralesional injection is that it helps to quickly resolve inflamed cyst-like lesions and blemishes. The risk however is that over doing the injection can actually lead to atrophy or “dimpling” of the skin.
So, it is important to realize that sometimes, simply waiting out a blemish may be safer than an intralesional injection. However, in the right hands, these injections can be extremely helpful in the treatment of isolated blemishes.
February 8th, 2006
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