Self Care- Acne Treatment (keratolytics)
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What are (7) non-pharmacological treatments of acne?
- wash face twice daily (mild soap/cleanser)
- avoid oily skin products
- avoid squeezing/manipulating lesions
- stay well hydrated
- pore strips
- oil absorbing strips
What's the mechanism of action of Soap?
removal of excess sebum & oil---lipohilic center & hydrophilic heads
What are the side effects of soap?
What are the (5) Keratolytics?
- Benzoyl peroxide
- Salicylic acid
- Sulur compounds
- Azelaic acid
What is the MOA of benzoyl peroxide?
- Keratolytic- breaks up keratin
- Exfoliative- Desquamation
- Comedolytic- solubilizes proteins
- Bactericidal- oxygen radicals (dibenzoic acid)
What are the side effects of benzoyl peroxide?
- irritation, drying, peeling, erythema
- contact dermatitis- with 1st application
When to use benzoyl peroxide in therapy?
- mild acne- monotherapy
- moderate to severe- in combination
What are the benzoyl peroxides directions?
- Apply once to twice daily to clean, dry skin
- 30 min after washing face
- Titrate- test patch 15 min, then double time for each application until reach 4 hrs. Then try overnight then more than once a day.
What is the Preg Category for BPO?
What is the age for BPO?
greater than 12yrs
What is the MOA for salicylic acid?
- Solubilizes intracellular cement
- decreases corneocyte adhesion
What are the side effects of salicylic acid?
- salicylism---N/V/D, tinnitis, dizzieness (rare w/ topical)
When to use salicylic acid?
mild acne- less efficacious, fewer side effects, easier to use
What are the directions for salicylic acid?
Apply 1-3 times daily to clean dry skin (do not need to titrate but can for dryness)
What is the Preg Category for salicylic acid?
What age can salicylic acid be used?
greater than 12yrs
What is the MOA for sulfur compounds?
- Unproven Antibacterial effects
What are the side effects of sulfur compounds?
- comedogenic- triggers comedone formation
Where are sulfur compunds most commonly found?
When are sulfur compunds used?
- 2nd line in mild acne
- use limited to side effects
What are the directions of sulfur compounds?
Apply 1-3 times daily
What is the Preg Category of sulfur compounds?
What age can sulfur compounds be used?
greater than 12ys
When is Resorcinol used?
- in combo with sulfur
- enhances the keratolytic effects of sulfur
What are the side effects of Resorcinol?
reversible brown scaling of skin
What is the MOA of Azelaic acid?
- Inhibits anaerobic glycolysis (weak antibiotic)
- Scavenger of oxygen free radicals (weak anti-infalmmatory)
What are the side effects of Azelaic acid?
- Irritation, Itching
- Hypopigmentation- anti-tyrosinase and anti-mitochondrial enzymatic activities may interupt activity of normal melanocytes OR free radical scavengers cause hyperactivity of melanocytes
- Transient--resolve in 1-2 weeks
When to use azelaic acid?
- mild to moderate acne
- mono- for mild
- combo- for none responding mild OR in combo for moderate
What are the directions for azelaic acid?
- Apply twice daily
- see improvement in 1-2 months and continued over several months if needed
What is the Preg Category of azelaic acid?
When should azelaic acid be used?
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