Acne

Advantages of ONLINE MBA

2013-05-20T04:10:00.000-07:00

Is it possible for you to earn an MBA from your home? It is indeed, and it is far easier than you may imagine. All it takes is strong self-motivation and a sense of diligence as well as the dedication to keep going in the face of the many distractions of work and family. There are few experiences more rewarding than finishing your MBA degree, and with online programs now available, you do not have to postpone getting it any longer. An online MBA degree program can be fit into your schedule so that you can complete it at your own pace and convenience.Another advantage of a distance learning MBA program is the reduction of what you would otherwise spend on similar education. Let's face it, aside from the tuition you have to pay, higher education also includes a number of additional costs, such as travel to and from a university, and room and board.When you are on an online program, you do not have to go anywhere, and so you will not incur any expenses on fuel and parking lot fees. Nor will you have to experience the hassle of public transportation or deal with traffic congestion. The value of the time and convenience you save is incalculable. Furthermore, you will not have to uproot yourself and move to a distant state or city to attend the program of your choice. That will save you more travel costs, and the expenses of room and board, not the mention the bother of moving and the interruption of your lifestyle.It is also possible that you will save on tuition as well. Since an online MBA program does not require a classroom, the university will have that room for use in a different course, saving it money. This may be translated into a lower tuition fee, which you can take advantage of.But the primary advantage of an online MBA program is the flexibility that it offers. You can adapt its schedule to fit your lifestyle, instead of adapting your life to it. You will not be forced to take a leave of absence from your job or spend any time away from your family. You will be able to do your class work at the hours that are most convenient to you. And you are allowed ample time in which to finish, up to five years for some online programs. All these advantages make taking an online MBA program very attractive indeed.

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How Much Does A Top MBA Degree Cost?

2013-05-20T01:35:00.001-07:00

What’s the most expensive two-year MBA program you can take? You might be surprised to learn it isn’t Harvard or Stanford, or Wharton or Chicago, or Dartmouth or Yale. Instead, priciest MBA is being sold by Columbia Business School. Columbia estimates that the cost of its two-year, full-time MBA program in New York is a whopping $168,307.Harvard Business School Dean Nitin Nohria said earlier this week that the cost of a Harvard MBA is less than several other top rivals. “We are at the middle of the pack when it comes to the top ten schools,” he said in a wide-ranging interview with The Financial Times. By the estimates of the total cost of the degree posted on business school websites, he’s actually being somewhat conservative. Harvard comes in as the seventh most expensive MBA program among the top 20 U.S. business schools.Not only is Columbia number one, but the school Columbia also ends up on another extreme end of this list of premium-priced degrees. Columbia reports the lowest percentage of MBA students who are receiving financial aid from the school–just 55%, well below the 81% at Duke, the 80% at Dartmouth, or the 75% at Stanford.The total cost of the Columbia program includes two years worth of tuition, fees, books, and the estimated costs to live in New York City. But as often is the case, these numbers are often conservative. Yale’s School of Managment makes clear that its esimates assume a “modest lifestyle.” Cornell informs applicants on its website that its estimate of $11,250 a year for living expenses is “based on the cost of sharing a moderately priced apartment” at a cost of $700 a month rent and putting aside $425 a month for food.Most MBAs at elite schools will find it hard to live on that budget, especially in New York, Boston, Chicago, or San Francisco. Indeed, perhaps to make these estimates more believable to applicants, Cornell goes out of its way to note, “It is much easier to live like a student when you are a student than to live like a student when you are earning $90,000 annually. If you were to reduce your student loans from $50,000 to $40,000 you would save approximately $121 per month in student loan payments.”TOTAL COST ESTIMATES ARE VERY CONSERVATIVE.In almost all cases, these “total cost” numbers–taken from the school’s websites–are very conservative estimates. Wharton’s $168,000 pricetag, for example, fails to include the cost of its Global Immersion Program, which ranges from $5,800 to $7,800, or the inevitable cost to join clubs, attend conferences and “parties,” which Wharton estimates at $860 a year. Those two omissions alone add 6% to the total cost estimate of an MBA degree. Stanford’s estimate of the total cost of its MBA degree doesn’t include a required “global study tour” which costs about $4,000. In most cases, you can expect the “total cost estimate” to be 10% to 20% higher, given your lifestyle preferences and desire to take full advantage of the MBA experience.The costs of non-U.S. MBA programs can vary widely, especially because in Europe one-year programs are especially popular. London Business School’s 21-month MBA program looks like a bargain if you believe the estimate: $134,152, with $77,854 of that going to pay tuition. The accelerated 10-month MBA program at INSEAD in Fontainebleau, France, costs just $102,714 (with about $73,000 of that for tuition). Of course, that’s the estimate from INSEAD for living expenses, food, and travel. Could you live in France on $30,000 over those ten months? Perhaps if you lived in a trailer or a tent. What can you deduce from the costs of these top MBA programs and the amount of financial aid for students arranged by their schools? The least expensive program is at the University of Texas at Austin. At a total cost of $127,144–more than $40,000 less than a Columbia MBA–it looks like a true bargain for a top degree. Then, add in the fact that the school is helping 75% of its MBAs with financial aid–versus Columbia’s 55%–and it seems as if it is a very smart investment, indeed.The most expensive public university in the MBA game is surprisingly UCLA. Higher ranked B-schools at Berkeley, Michigan and Virginia are less expensive in total costs than the Anderson school in Los Angeles–largely because of the highest cost of living in L.A. than Berkeley, Ann Arbor, or Charlottesville.The most generous school in terms of financial aid? MIT Sloan. The school puts together the largest average financial aid packages of the top schools: $130,418. That’s more than $15,000 more than Columbia and more than twice the size of Berkeley’s $67,052 (the lowest amount reported by any of our top 20 schools). Be aware, however, that financial aid is a rather vague phrase to describe a package of financial help. You don’t know how much of this money is merely a loan or a scholarship or fellowship.HARVARD GIVING STUDENTS MORE THAN $20 MILLION A YEAR IN FELLOWSHIPS.Such fellowships–typically used to lure exceptional students or to help students on the basis of financial need–can significantly lower the price tag of an MBA. Harvard effectively discounts the sticker price of its MBA by paying out some $22 million a year in fellowship money. HBS says that nearly half of every MBA class receives an average of some $25,000 per year in “need-based” HBS Fellowships that are granted only on the basis of financial need and not academic merit. The school makes these awards based on an analysis of an applicant’s income for the prior three years as well as the applicant’s assets.

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What Do Celebrities Use for Acne?

2013-05-16T08:36:00.001-07:00

Celebrities on television and in movies are known for having clear, soft and pristine complexions. For people suffering from acne blemishes, how these celebrities keep their skin so clear can be a mystery. There are a few methods that celebrities use to clear their skin that you can benefit from.Many celebrities have benefited from accurately using a three-step system. Although there are different types of three-step acne-fighting systems on the market, one of the most effective systems uses a gentle cleanser, a low-concentration benzoyl peroxide cream and an oil-free moisturizer. The website acne.org addresses this method, and lays out an easy-to-follow regimen that includes video to help people understand how to treat their acne effectively. This involves carefully and gently lathering the face with a soap formulated for sensitive skin, spreading a 2.5%-concentration benzoyl peroxide cream onto the face, and following the cream with an oil-free moisturizer.Baking soda is a very alkaline substance, while lemon juice is highly acidic. When used in combination, these two products have effectively treated celebrity acne. All that is needed is a box of baking soda and a bottle of lemon juice. One tbsp. of baking soda is mixed with water, massaged onto wet skin for 30 seconds and rinsed with water, followed by a splash of lemon juice. This removes dead skin cells while killing off the bacteria that cause acne.Urine is a sterile substance that people have been using for thousands of years to treat skin conditions and medical ailments. Although foreign to most Americans, some celebrities are aware of how quickly urine can treat and eliminate acne blemishes. It is important to use the first urine of the day, as it is the most concentrated and can eliminate acne the quickest. Soak a cotton pad in the urine, then apply it to the skin by wiping the cotton pad across the face. Let the urine dry onto the skin.One costly method celebrities use to clear their skin is to have sessions of laser resurfacing from their dermatologist or plastic surgeon. Laser resurfacing is a minimally invasive procedure that gently sloughs off the top layer of the skin, revealing new, unblemished and unclogged skin underneath. Multiple treatments are often required.Many celebrities have cleared their skin effectively by using certain oils to unclog their pores and maintain clear, soft skin. The two oils used most often are extra-virgin olive oil and castor oil. These oils are both noncomedogenic, meaning that they do not clog the pores. These oils are massaged into the skin, and followed by draping a steaming washcloth over the face. The steam penetrates and opens the pores, effectively removing dirt and impurities. After the cloth cools, the excess oil is wiped away with the washcloth.

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Age groups affected by acne and pimples

2011-10-25T09:19:00.000-07:00

Nearly all of us suffer from a pimple, whitehead or blackhead, when we are aged between 12 - 18 years, regardless of our sex, ethnic background or race.

On this page

General

Age groups and acne

Acne - when is medical help required

Information on acne

General

Skin problems, or if we use the term "acne" loosely, is mostly found in teenagers and young adults in their 20s, but it is not unusual for people to experience problems in this area well into their 40s.

A large portion of skin problems can be handled by over-the-counter acne medication, or by using a specialized skincare range - like Dermaxime Problem Skin Range - but some people require systemic medication (taken orally) and / or prescription based topical treatments in the form of creams or lotions.

Age groups and acne

The occurrence of acne can be further noted as follows:

73-85% in people between 12 - 24 years of age

6-8% in people between 25 - 34 years of age

2 -4% in people over 35 years of age

Acne - when is medical help required

Although great results are obtained from non-medical and over-the-counter acne medication and specialized skincare products, like Dermaxime Problem Skin Range, you may be one of the unlucky few that do not react positively enough to such treatments, and then prescription medication, in the form of pills and/or creams and lotions may be called for.

Although some people would discuss acne problems with their normal medical practitioner, we would recommend that you consult a skin specialist - a dermatologist - to look at your problem.

What Do Celebrities Use for Acne?

2011-10-15T09:48:00.000-07:00

Three-Step Systems
- Many celebrities have benefited from accurately using a three-step system. Although there are different types of three-step acne-fighting systems on the market, one of the most effective systems uses a gentle cleanser, a low-concentration benzoyl peroxide cream and an oil-free moisturizer. The website acne.org addresses this method, and lays out an easy-to-follow regimen that includes video to help people understand how to treat their acne effectively. This involves carefully and gently lathering the face with a soap formulated for sensitive skin, spreading a 2.5%-concentration benzoyl peroxide cream onto the face, and following the cream with an oil-free moisturizer.
Baking Soda and Lemon Juice
- Baking soda is a very alkaline substance, while lemon juice is highly acidic. When used in combination, these two products have effectively treated celebrity acne. All that is needed is a box of baking soda and a bottle of lemon juice. One tbsp. of baking soda is mixed with water, massaged onto wet skin for 30 seconds and rinsed with water, followed by a splash of lemon juice. This removes dead skin cells while killing off the bacteria that cause acne.
Urine Therapy
- Urine is a sterile substance that people have been using for thousands of years to treat skin conditions and medical ailments. Although foreign to most Americans, some celebrities are aware of how quickly urine can treat and eliminate acne blemishes. It is important to use the first urine of the day, as it is the most concentrated and can eliminate acne the quickest. Soak a cotton pad in the urine, then apply it to the skin by wiping the cotton pad across the face. Let the urine dry onto the skin.
Laser Resurfacing
- One costly method celebrities use to clear their skin is to have sessions of laser resurfacing from their dermatologist or plastic surgeon. Laser resurfacing is a minimally invasive procedure that gently sloughs off the top layer of the skin, revealing new, unblemished and unclogged skin underneath. Multiple treatments are often required.
Oil Cleansing
- Many celebrities have cleared their skin effectively by using certain oils to unclog their pores and maintain clear, soft skin. The two oils used most often are extra-virgin olive oil and castor oil. These oils are both noncomedogenic, meaning that they do not clog the pores. These oils are massaged into the skin, and followed by draping a steaming washcloth over the face. The steam penetrates and opens the pores, effectively removing dirt and impurities. After the cloth cools, the excess oil is wiped away with the washcloth.

ANNA Hathaway with aCNE

2011-10-15T09:31:00.000-07:00

Anne Hathway

Beautiful women like Anne Hathway that are considered sexy and beautiful also get acne. She has also got some wrinkles so she will be joining the list of Celebrities with Wrinkle

Katy Perry Struggling With Acne

2011-10-08T03:54:00.000-07:00

Katy Perry is still struggling with acne! Perry does some shopping in Paris, France today during a break from her promotional blitz in support of her new album. Perry has always been candid about her struggle with acne, and as she made her way around the streets of Paris, it was no secret that she continues to struggle with it as acne bumps were apparent under her layers of make up.

more Katy & her skin problem after the jump…

Stress doesn’t help, with a new album to promote, wedding day around the corner and what not. Where is Romeo? Boyfriend Russell Brand needs to be around to give girlfriend ample of support!

Types

2011-10-08T03:50:00.000-07:00

Dermatologists classify types of acne into four grades. Determining acne grade is done by a simple visual inspection of the skin. Specific criteria are used to classify acne symptoms, including:

types of non-inflamed comedones present

types of inflamed comedones present

amount of breakout activity

amount of inflammation, if any

areas of the body affected by acne

Knowing the grade of your acne is an important step in treating acne. All acne grades require different treatment methods.

Understanding the grade of your acne can help you choose the course of treatment that will be most effective. It will help you in selecting products. It will help you decide if you can treat your acne at home or if you should see your dermatologist.

Grade I

Grade I acne is the mildest form of acne. There may be minor pimples but they will small, appear only very occasionally, and in small numbers (one or two). Blackheads and milia will be found, sometimes in great numbers, but there is no inflammation of Grade I acne.

Grade I acne is commonly seen in early adolescence, especially in the nose and/or forehead. Many adults also experience grade I acne, as blackheads on the nose and forehead. Milia are commonly found in the eye area and chin.

This type of acne can be successfully treated at home using an over-the-counter product containing salicylic acid. Results generally are seen quickly. Treating acne while it is still in its early stages helps prevent acne from progressing, especially in teens. Grade I acne may progress to Grade II if left untreated.

Grade II

Grade II is considered moderate acne. There will be blackheads and milia, generally in greater numbers. You will start seeing more papules and the formation of pustules in this stage. They will appear with greater frequency, and general breakout activity will be more obvious. Slight inflammation of the skin is now apparent.

In teens, you may see the acne progress from the nose and forehead to other areas of the face. Acne may start to affect the chest and shoulders, with occasional breakouts on the back, especially in males. Adult women may find greater breakout activity in the cheeks, chin, and jaw line area, especially just before and during the menstrual cycle.

Grade II acne can still be treated at home, using over-the-counter products. In addition to a salicylic acid, a benzoyl peroxide lotion should be used daily to help kill the bacteria that cause inflamed breakouts. However, if after several weeks of home treatment your acne does not significantly improve, it is time to see a dermatologist. Grade II acne may progress to Grade III, especially if pimples are habitually picked at or squeezed.

Grade III

This type of acne is considered severe. The main difference between Grade II acne and Grade III is the amount of inflammation present. The skin is now obviously reddened and inflamed. Papules and pustules have developed in greater numbers, and nodules will be present.

Grade III usually involves other body areas, such as the neck, chest, shoulders, and/or upper back, as well as the face. The chance of scarring becomes higher as the infection spreads and becomes deeper.

A dermatologist should treat acne at this stage. Grade III acne is usually treated with both topical and systemic therapies available only by prescription. Left untreated, Grade III acne may progress to Grade IV.

Grade IV

The most serious form of acne, Grade IV is often referred to as nodulocystic or cystic acne. The skin will display numerous papules, pustules, and nodules, in addition to cysts. There is a pronounced amount of inflammation and breakouts are severe. Cystic acne is very painful.

Acne of this severity usually extends beyond the face, and may affect the entire back, chest, shoulders, and upper arms. The infection is deep and widespread. Nearly all cystic acne sufferers develop scarring.

Grade IV acne must be treated by a dermatologist. It tends to be hard to control, and almost always requires powerful systemic medications in addition to topical treatments.

Symptoms

2011-10-08T03:46:00.000-07:00

If you are suffering from acne, you probably do not need me to tell you about the symptoms, but for those who are reading this for other reasons, here is a summary of the physical symptoms:

Blackheads (open comedo) and Whiteheads (below the skin surface)

Nodules – large and firm lumps below the skin

Pustules – yellowish lumps on the skin surface, pus filled

Pimples – red spots with no pus – a symptom of non-inflammatory acne

Cysts – a sac, pus filled under the skin tissue of about 5mm in diameter – very painful

Dry, pink and itchy skin

Scarring

If the physical symptoms aren’t bad enough, the emotional side effects are just as painful to bear. I was ashamed of the way I looked. I felt as though somehow it was my fault that I looked like this, that I was doing something bad. I would hide my face behind my hands when I needed to talk to someone – shielding them from my scars and blemishes. I grew my hair long and styled it so that it fell across my face. The cruelty of this condition is that it usually attacks just when you are least likely to be able to cope with it emotionally.

From your early teens upwards, when your hormones are racing and your body is developing, you are having to grow up physically and are learning all about relationships – Bang! Your face and shoulders and back are covered in spots and scars and you just want to hide away from everyone. Not surprisingly, your confidence takes a huge knock - how can anyone take you seriously looking like this – let alone like you!

It affects your actions as well as you looks and emotions. My friends would go to the swimming pool or the beach and I would make up excuses as to why I couldn’t go – I just didn’t want to expose myself. You won’t find any photographs of me in my teens or early twenties – I didn’t like what the camera showed me. Even with family and close friends, I could not relax; the acne ruled my life – the clothes I wore; never going out without makeup on; the money I spent on cures!!

After trying all the conventional treatments for my acne with which I had little, if no success, I needed to find an alternative. After days of research on the internet, I discovered Mike Walden. Hurray! Mike details in his book ”Acne No More”, a system for dealing with the inner causes of acne so that you no longer have to treat the symptoms.

Mike was an acne sufferer himself and a medical researcher, so after years of suffering he has spent the last 7 years developing his holistic healing system. He has developed through a long process of trial, error and experimentation, a sure fire, 100% guaranteed, clinically proven system for eliminating acne for good.

Hospital Treatment for Acne

2011-10-02T23:43:00.000-07:00

When most people hear the word acne, they may think of all the pizza and chocolate they were told not to eat, followed by the endless tubes of Clearasil they bought to combat pimples. They don't generally think "hospitalization." But for some extreme cases of acne, a hospital stay is required to effectively treat the condition due to the medication prescribed.

Outpatient vs. Hospitalization

While the majority of acne can be treated with home or over-the-counter remedies, or even visits to the dermatologist, chronic acne that has resisted all other procedures may require an alternative therapy. Some of these therapies may include exposing a patient to a narrow-spectrum blue light, attacking pimple-causing bacteria with a laser or exfoliating the top layer of the patient's skin with a brush or a chemical peel. However, these therapies are mostly performed on an outpatient basis in a dermatologist's office. A patient may be hospitalized while undergoing acne therapy if he is taking a last-resort medication--one with severe side effects that needs to be closely monitored. The most commonly prescribed drug of this sort is Isotretinoin, more commonly known as Accutane.

Indications

Isotretinoin is used to treat severe, chronic, nodular acne. This is acne in which the infection grows inward and leads to painful nodules and scars. The medication, which is derived from vitamin A, shrinks the sebaceous glands in the skin. This forces them to produce less oil. The medication is available in liquid-filled capsules. It is typically prescribed only for a short duration.

Side Effects

Isotretinoin is typically not given to women of child-bearing years due to the chances of birth defects, unless all other medications have failed. The medicine has strong drug interactions with typical antibiotics that a physician may prescribe to treat acne, including tetracycline drugs such as Doxycycline. Isotrentinoin may also damage the liver or exacerbate issues with diabetes, eating disorders, depression, metabolism, asthma or heart disease.

5 Great Home Treatment For Acne

2011-09-30T20:20:00.000-07:00

Over the counter and prescription acne treatments often contain chemicals that many people do not wish to use. Instead, these people search for home treatments for acne. There are many home treatments for acne that actually do work. Here are some things you can try.

1. Apply essential oils, such as Tea Tree Oil, Bergamot Oil, Clove Oil, Lavender Oil, and Rosewood Oil. For sensitive skin, dilute the oil with grapeseed oil. Apply the oil before going to bed at night, then wash it away in the morning with a pure soap, such as Ivory, and clean water.

2. If you are not taking any medications that could cause you to be overly sensitive to the sun, try getting some sunshine everyday. The purpose is not to tan to hide the acne. Instead, the sun actually kills the bacteria, and dries up the sebum oil that produces acne. This is a common home treatment for acne that doesn't cost anything.

3. Acne begins on the inside of the body, not on the surface of the skin. Drink plenty of water - at least eight glasses per day - to help detoxify your body and cure acne. Also eat plenty of fresh fruits and vegetables.

4. For home treatment for acne, apply an oatmeal mask at least once or twice a week. Cook oatmeal, and while it is still warm (not scalding hot) apply it to your entire face. Allow the oatmeal to dry, then wash it away. You can also use dried oatmeal, dampened - but not cooked - with warm water as a facial scrub to exfolliate the skin and clean the pores.

5. Avoid eating processed foods, and stick to more natural fruits and vegetables. No food has ever been scientifically proven to cause acne, however, if you have a food allergy, the allergy often results in acne. Many people have food allergies, and go their entire lives without knowing it. Don't assume that a food allergy will leave you unconscious on the floor - the allergic reaction can appear in many forms, like acne breakouts. You can visit an allergist for a simple blood test to find out if you have any food allergies.

There are many other home treatments for acne, some of which work, and some of which do not work. The important thing is to drink plenty of water, eat fresh fruits and vegetables, get plenty of sleep, wash your face at least twice a day, and take vitamins - especially vitamin A and vitamin E.

ACNE pill Roaccutane could increase the risk of suicide, an inquest heard.

2009-10-08T04:20:00.000-07:00

Tragic Angela Lee, 28, threw herself under a train after the drug allegedly triggered depression, a lawyer representing her family said.

Thousands of Brits use Roaccutane to combat their acne. The treatment has been linked to a series of UK suicides, although trials have declared it safe.

Unemployed Angela, from Ilford, East London, was prescribed Roaccutane last year and took the pills for three months.

Relatives yesterday told the inquest at Walthamstow that her acne improved but she felt "prematurely aged". Angela - who also suffered chronic fatigue syndrome - developed depression and killed herself last October.

Her family claim her depression deepened during and after the course of Roaccutane. Lawyer Ross Brain said: "There is clear evidence of some users of this drug experiencing acute depression and suicidal tendencies."

Angela's dermatologist Dr Sunil Chopra told the inquest it was unlikely the drug caused her suicide. Roaccutane maker Roche says acne itself can trigger depression by harming self-esteem.

After the hearing Mr Brain said: "In her suicide note Angela spoke about how Roaccutane had aged her body, how she would never get better, how there was no way out."

Michael Jackson : Acne problems during teenage years made MJ ‘paranoid’

2009-10-06T03:28:00.000-07:00

Michael Jackson’s new tapes that have surfaced have revealed that the singer’s acne problems in his teenage years had an effect on him mentally and left him paranoid.

The King of Pop is heard saying in the tapes that he was extremely worried about his skin problem.

“You can clear up physically but still mentally you’re scarred – so you really haven’t improved,” the News of the World quoted him as saying in the tape.

“My skin broke out real bad. It was tough – especially after everyone had been calling me cute for such a long time. And the more I worried about it the worse I got,” he added.

Apparently, the late singer only felt comfortable with his looks on stage when it was primarily hidden with his hat.

He said: “I wore hats, I kept my head down all the time, I wouldn’t look at people when I talked to them.

“I wouldn’t say nothin’ hardly. It was terrible. I felt I didn’t have anything to be proud of. My success meant nothing.

“On stage I didn’t think about it, it was gone. But when I came off stage, there it was again.”

The ‘Thriller’ hitmaker defended his decision to undergo surgery to make his looks better.

However, he did not want people to know about his skin problems.

He said: “I’m a perfectionist when it comes to skin. I would look in the mirror and I didn’t like they way I looked, so.. of course, never print this. Please don’t…

“But take Marilyn Monroe, and all those people. They got the works. Julie Andrews, Raquel Welch. Even Elvis. You look at his nose and the difference.. it’s true. But nobody ever mentions it.”

Jackson denied that by having his skin bleached white he was escaping the black community.

Perrigo buys KV Pharma filing for generic acne gel

2009-09-25T02:46:00.000-07:00

Generic drugmaker Perrigo Co (PRGO.O) bought the marketing application of KV Pharmaceuticals Inc (KVa.N) (KVb.N) to market a copycat version of GlaxoSmithKline's (GSK.L) (GSK.N) acne treatment Duac for an upfront payment of $14 million.

Perrigo's move to buy the additional new drug application (ANDA) for the generic version gives the embattled drugmaker KV Pharmaceuticals its second respite this month.

On Sept. 2, the U.S. Food and Drug Administration, which had restrained KV Pharma from manufacturing and shipping any of its drugs, accepted the company's work plan to address previously identified deficiencies in manufacturing practices.

KV Pharma, which has taken up a slew of restructuring activities since the beginning of the year, had earlier expressed significant doubt about its ability to continue as a going concern during the coming fiscal year.

However, selling its marketing application for a copycat version of Duac, in a deal that included $2 million in milestone payments, also lifted off expenses from a lawsuit filed by a GlaxoSmithKline unit.

Perrigo has assumed responsibility for the litigation and will immediately begin working on the transfer of production to a Perrigo site with the intention to amend the ANDA accordingly. Shares of KV Pharmaceuticals rose 4 percent to $3.09 in early trade on the New York Stock Exchange. Perrigo shares were up 1 percent at $32.25 on Nasdaq. (Reporting by Vidya L Nathan in Bangalore; Editing by Mike Miller)

Teen Acne and Depression: Can Mood Worsen Skin?

2009-09-22T04:04:00.000-07:00

Acne is a diabolically cruel thing: somehow it strikes your most visible feature just at the age when you become most vulnerable to a gaze. Not surprisingly, acne is often accompanied by serious depression among teenagers. In fact, a 1999 study found that kids with acne bad enough to prompt a trip to the dermatologist reported having emotional and social problems as severe as those reported by patients with disabling diabetes and epilepsy.

Other studies have shown similar, if less extreme, reactions to bad cases of acne. And so an international team of researchers — including scientists from Harvard Medical School in Boston and University Medical College in Tibet — decided the acne-depression question needed further investigation. The team's intriguing new paper, published this week in the open-access journal BMC Public Health, not only confirms that acne goes hand in hand with depression and anxiety but further suggests that teens' mental distress may in fact be worsening the condition of their skin.

Led by Jon Halvorsen, a dermatologist at the University of Oslo in Norway, the researchers launched their study in 2004, inviting every 18- and 19-year-old who was finishing high school in Oslo to answer some questions about zits and other things. Of the 3,659 students invited, 90% participated, along with 467 other 18- and 19-year-olds who were not graduating. The teenagers completed questionnaires about the severity of their acne as well as how much anxiety and depression they were experiencing, what they usually ate and whether they smoked and drank. Separately, the researchers collected socioeconomic data on the teens from the country's central information-gathering agency, Statistics Norway.

The results show that the level of mental distress kids reported was strongly associated with how much acne they said they had, independent of other factors like diet or lifestyle. Roughly 19% of all kids who reported symptoms of anxiety and depression said they had acne, compared to only 12% of those who reported no mental distress. Among boys, those with depression and anxiety were 68% more likely to report acne than their happier peers; among girls, those with mental distress were twice as likely as those without to report acne.

The study found, for the first time, a linear relationship between mood and pimples: the worse the mental-illness symptoms, the worse the acne. It's possible that the association simply means that kids who feel depressed are more likely to report they have bad acne, even if they don't — but previous studies have shown that dermatologists independently agree with teens' self-reports of acne severity about 75% of the time. Some of the depressed and anxious kids in the Norwegian study may have exaggerated their acne, but in a sample as large as this one, it's unlikely that most did.

So how could mental-health problems actually exacerbate acne? One theory is that people with mental distress eat more junk food. Dearly held teen lore says that overindulging in chocolate and potato chips — which can make greasy fingers and, consequently, greasy faces — spawns pimples. This is mostly myth, according to the study's findings, although they offered a bit of support for the notion that diet plays a role. Girls in the study who consumed few vegetables tended to have more zits than girls who ate lots of greens. But diet was entirely irrelevant for boys.

The authors also discount other lifestyle factors. The Norwegian adolescents who said they regularly use alcohol and cigarettes were no more likely to report acne than those who were abstemious. Only mental distress was strongly correlated with acne in both boys and girls.

But that still doesn't answer the question of what mechanism might be at work. The authors offer a few hypotheses. For instance, stress may somehow stimulate the growth of nerve fibers near sebaceous glands, which in turn contributes to the increased production of sebum — the fatty substance that combines with cell debris and dead skin cells to form those familiar blackheads and pustules. (All together now: Eww.) That theory is unproved, but previous research on the effects of depression and acne drugs suggests the authors may be onto something: we know, for example, that antidepressants can improve acne. We also know that a widely used drug that treats acne, Accutane (isotretinoin), has been associated with an increase in depression, although no causal link has been established.

The new study has some obvious shortcomings, particularly that it relies entirely on self-reports from a self-selected group of respondents. Much more rigorous research needs to be conducted to understand the relationship between mental illness and pimples — as well as the root cause of bad cases of acne. But in the meantime, drug companies might want to start working on a Clearasil-Prozac miracle cream.

Acne, Pregnancy Among Disqualifying Conditions

2009-09-20T21:10:00.000-07:00

A proposal to make preexisting health conditions irrelevant in the sale of insurance policies could help not just the seriously ill but also people who might consider themselves healthy, documents released Friday by a California-based advocacy group illustrate.

Health insurers have issued guidelines saying they could deny coverage to people suffering from such conditions as acne, hemorrhoids and bunions.

One big insurer refused to issue individual policies to police officers and firefighters, along with people in other hazardous occupations.

Some treated pregnancy or the intention to adopt as a reason for rejection.

As Congress and President Obama work on legislation to overhaul the nation's health-care system, one of their main objectives is to stop insurers from denying coverage on the basis of health status. Proposed legislation would prohibit insurers from denying coverage to individuals with preexisting conditions or charging them higher premiums because of their medical history -- practices known as medical underwriting.

Even the insurance lobby has endorsed that goal as part of a larger reform package in which the government would extend coverage to the uninsured, greatly expanding the market for insurance.

Guidelines that insurance companies have written for professionals involved in selling policies offer a glimpse inside the underwriting process.

"What these documents show is the lengths to which insurance companies are willing to go to make a profit," said Jerry Flanagan, health-care policy director of the advocacy group Consumer Watchdog, which distributed the documents Friday. "What it shows is that insurance companies want premiums without any risk."

Consumer Watchdog argues that consumers should be given the option of enrolling in a government-run health plan. It obtained the documents from a California insurance broker, Flanagan said.

A PacifiCare "Medical Underwriting Guidelines" document from 2003 lists under "Ineligible Occupations" such risk-takers as stunt people, test pilots and circus workers -- along with police officers, firefighters and migrant workers.

Uninsurable conditions included pregnancy, and being an "expectant father" was grounds for "automatic rejection." So was having received "therapy/counseling" within six months of the application. There was also this more general disqualifier: "currently experiencing/experienced within the last 12 months symptoms for which a physician has not been consulted."

The PacifiCare document "is completely outdated and predates the acquisition of PacifiCare by United Healthcare," Cheryl J. Randolph, a spokeswoman for the parent company, said by e-mail. She declined to provide current underwriting documents.

"Underwriting enables insurers to adequately assess risks, keeping premium costs lower for more consumers," she added.

Health Net guidelines for 2006 say that people could be denied coverage or charged higher premiums if they were taking certain medications, including Zyrtec, an allergy remedy, and Lamisil, which is widely advertised as a treatment for toenail fungus.

Pregnant women could be rejected, as could expectant fathers, the document said.

A Health Net spokeswoman did not respond to requests to comment.

Blue Cross of California guidelines for 2004 said potential disqualifiers included chronic tonsillitis and, under certain circumstances, varicose veins.

Kristin E. Binns, a spokeswoman for parent company WellPoint, said by e-mail that she could not comment on the guidelines because they are from years ago.

Roche discontinues sales of acne drug Accutane

2009-07-01T04:54:00.000-07:00

Roche said Friday it will stop selling the acne drug Accutane as sales of the treatment continue falling amid competition from less expensive generic versions.

Generic versions of the acne treatment have been on the market since 2002 and Roche's branded product's market share has since slipped to less than 5 percent.

The decision was made for economic reasons, not safety reasons, the company said. The drug has a rocky safety history, having been linked to birth defects if taken during pregnancy, along with depression and suicidal thoughts. The company said costs for personal-injury lawsuits are high, but it continues to "rigorously" defend the drug.

DO I REALLY NEED SUNSCREEN WITH SPF 100?

2009-06-01T04:36:00.000-07:00

NEUTROGENA recently launched a sunscreen with an SPF of 100 and a lot of people are sure to be asking whether they should switch to this new sunscreen.

Are those old sunscreens deficient? Can they still cut the mustard? Can it be that the higher the SPF the better the sunscreen?

Summertime is coming up and more people go on holidays at this time and end up at the beach, upping the sun exposure.

Neutrogena has an SPF of 100, Coppertone has an SPF of 85 and Banana Boat has an SPF of 80.

The SPF or sun protecting factor refers to the ability of the sunscreen to prevent burning of the skin.

Let us say that when you go into the sun it takes one hour for the skin to turn red, ie to start to burn.

If you applied a sunscreen with a SPF of four, it would then take four hours for you to start to burn. Therefore, the sunscreen with the SPF of 100 would seem to offer better protection.

The part of the sunlight which causes the problem is the ultra violet light and this is divided into two parts - UVA called the ageing rays and UVB called the burning rays of the sun.

Now we have had good protection from the UVA for many years but the UVB has always been a problem, However, with the introduction of two new chemicals, Meroxyl and Avobenzone, we now have sunscreens which helps us with UVA.

Many people believe that the higher the SPF the better. But is this necessarily so. An SPF of 100 gives 99 per cent protection; an SPF of 50 gives 98 per cent protection an SPF of 30 gives 96 per cent protection. An SPF of 15 gives 95 per cent protection. So my advice at this time is that we should continue to use our usual sunblocks but use them more frequently and in greater quantities.

We should note that the majority of the population of Jamaica is of African descent and we do not show the signs of ageing - that is the lines and the wrinkles - as early in life as the Caucasians. Also, cancer of the skin is rare in our population. Nevertheless we should respect the sun and use sunscreen every day as it can only do us good.

I find that as an outdoorsman or woman the best way to put on the sunscreen is to bathe and then dry off and apply the sunscreen to the entire body. With the right sort of clothes you are then ready to go out and to face the sun.

We must realise that sunlight also has an effect on the immune cells in the skin and this may be more important than we realise at present. We should also get our kids into the habit of using sunscreens early in life

Acne scars can be more than skin deep

2009-05-26T03:52:00.000-07:00

t's the fear many teens face -- an acne outbreak, especially at prom time.

Britany Hutton is taking steps to make sure it doesn’t happen to her. Under the care of nationally-known dermatologist Dr. David McDaniel, the Salem High School senior is undergoing a combination of treatments to clear up her skin.

McDaniel says teens want a more aggressive treatment to get rid of acne faster. Injecting a mild steroid called kenalog into the pimple can make it disappear nearly overnight by reducing the inflammation.

Kathryn Zapatka began the injection treatment last year as she prepared for prom, but the outbreaks continued. She was referred to Dr. McDaniel.

Acne scars can be more than skin deep; they can damage your self image.

“I tried it and it was like a Godsend. I was so lucky to be referred to him,” she said.

Five months later, Zapatka's skin – and outlook on life -- has improved.

“Before, I really did not have that type of ambition. I was kinda like fine where I was, wasn't trying to venture out, but now I have the confidence to just pursue everything I've wanted to,” she relates.

With a few weeks to go before the prom, Hutton is ready to face the prom and the future with a bright smile.

“It’s working very well and I've only been seeing him for about a month. Lots of people have noticed the breakouts have stopped, so I'm very happy,” Hutton says.

Some medications and injections are often covered by insurance, but other treatments are not. The parents of these teens are paying $200-$300 every two weeks for surface treatments and they say it’s worth it.

New Chocolate Product Said to Clear Acne

2009-05-22T02:52:00.000-07:00

A new chocolate claiming to reduce acne will soon hit the shelves of Australia.

Manufacturers of Acne Care say pimple-plagued sufferers will experience dramatic results within just two weeks of eating the chocolate — if they eat between two and five chocolates per day.

Developed by U.S.-based Frutels, the chocolate-coated treatment is believed to be the first of its kind. Packed with antioxidants and micro-nutrients, the chocolate is supposed to clarify the skin from within.

The company says it costs about $40 for a month's supply.

Acne in a Patient With Pancreatic Cancer

2009-05-19T19:10:00.000-07:00

Our patient was a 62-year-old white man diagnosed recently with a form of pancreatic carcinoma. Per his report, the cancer was judged inoperable, and he was instead placed on a multiagent chemotherapeutic regimen. He could not recall the names of the specific agents when he came to our clinic.

Two weeks after initiation of this regimen, he noticed acne upon his face, neck, and upper chest (Figure 1). Even his scalp was involved, and he also reported some "thinning of [his] hair" that was difficult to quantify (Figure 2). The lesions began as small erythematous papules, but many became frank pustules over time. There was some associated pruritus. He had a history of limited acne as a teenager, but he did not have a strong personal or family history of nodulocystic acne or rosacea. There was no involvement of his nails.

Laxative may ease severe acne problem

2009-05-14T19:56:00.000-07:00

Q. My son has suffered from horrible acne for two years, even after seeing two dermatologists. We’ve tried everything, from prescriptions and Proactiv to laser treatments. There’s nothing left to try except Accutane, but we worry about side effects.

After using milk of magnesia on his face for only two weeks, his skin has improved. It is so much better that instead of hiding behind shoulder-length hair, he got his hair cut so his face can actually be seen now.

Milk of magnesia definitely works on severe acne. Be sure to get the original MoM, because the mint one contains mineral oil. It's wonderful to have my son smiling again.

A. Dermatologists are skeptical that milk of magnesia would be helpful against acne even though a letter in the Archives of Dermatology (January 1975) stated that topical application of MoM might reduce redness and inflammation.

We have received a number of testimonials like yours. Certainly there is little harm in trying MoM on blemishes.

Under appropriate medical supervision, Accutane can be effective against severe acne, but it is expensive and has some potentially serious side effects.

Q. I have taken simvastatin for many years, and during the past year or so I have developed extreme intolerance to heat. My face gets flushed beet red, to the dismay of my companions who wonder if they should treat me for heatstroke. Can simvastatin cause this reaction? Or is something else going on?

P.S. The only other medication I take is Detrol.

A . We could find no link between the cholesterol-lowering drug simvastatin (Zocor) and heat intolerance. Detrol, on the other hand, could be the culprit behind your problem.

Detrol and other bladder medicines are considered anticholinergic drugs. Medications such as Detrol, Ditropan, Enablex and VESIcare can cause symptoms such as dry mouth and constipation. They also reduce the body's ability to sweat. That makes people vulnerable to overheating because the evaporation of perspiration is a crucial means of cooling off.

Be very careful to avoid situations where you might become overheated. Heatstroke is a dangerous complication!

Q. I took Fosamax for osteoporosis and started waking up every night with hip and leg pain. One friend mentioned that she also developed bone pain while taking Fosamax, while another complained of terrible backaches.

I told my doctor, and he said he had never heard of such problems. After stopping the drug, the pain gradually subsided. My doctor is still dubious. What other options for osteoporosis won't cause such terrible pain?

A . Medications like Fosamax, Actonel and Boniva can sometimes cause severe and occasionally incapacitating bone, joint or muscle pain. We’re surprised your doctor was unaware of this complication, as the Food and Drug Administration has issued warnings about it.

There are other drugs for osteoporosis, such as Evista (raloxifene), Forteo (teriparatide) and Miacalcin (calcitonin). We discuss the pros and cons of drugs and nondrug approaches in our Guide to Osteoporosis.

e Remedies for Acne – Get Clear and Beautiful Skin Back

2009-05-14T05:20:00.000-07:00

Some people might think that why to use home remedies to treat acne when there are so many medication methods are available and you will find that the answer will vary from person to person but the main reason you can heard is that the naturalness of the treatment and amore advantages over the medications. Probably, all results are not the same but people who have tried it and found it successful truly believe in it. These natural medicines are from long time, even before the modern methods had been found. There are numerous natural and healthy methods for the treatment that can be very easily found online and ingredients for these methods are available either in your garden or your kitchen or both of them.

Many people are now turning towards the natural home therapies to cure acne, instead of going for medications to get rid of acne. This is understandable as it is convenient as well as economical to have a natural therapy at the home. Before going for the home therapy for acne, let’s look at some of the things to do to complement acne home the rapies.

Lots of water intake, proper vitamins and regular exercise will assist to detoxify the bodies and improves the skin condition. This can work handy with the following very cheap and effective home remedies for acne.

Do you know that just toothpaste can help to reduce the swelling of the pimples? If not, just try applying some over the pimples before you go to sleep and you will be able to see the effects on the next morning itself.

Mix the rose water and lemon juice, and take the proportion of one lemon with same amount of rose water. Apply it on the face and clean it after half an hour. If you will keep doing this, it will not just get rid of the pimples but it will also give a shine to your skin. You can use the fresh mint juice to apply on the face and even the strawberry leaves can help to reduce the swelling of pimple.

Even the peel of orange can be used. Actually, you have to blend it or mash it or have to mix it with some water to form the paste before applying on the problem area. You can mix the mint juice with the turmeric powder and apply it onto the acne. Just wash it off after half an hour with the lukewarm, clean water.

You don’t believe but even the cooking condiments like salt and vinegar have their effects as home remedies for pimples. Mix these two ingredients together before rubbing the mix on the acne. Leave this on your face for at least 20-25 minutes and remove it with the lukewarm water. Make the paste of cucumber before taking it into the use as a facial mask. Leave this mask for 30 minutes everyday and probably you will be able to prevent the pimples from breaking out.

If it is possible for you to tolerate the smell of garlic on the face, then apply some fresh garlic on the pimples. Pimples will be disappeared after numerous applications of garlic.

Even though these methods have worked wonder for lot many people but it is not guaranteed that it can work for you as well.

You may be interested in reading Neem Supplements and Natural Acne Treatment. Also visit Natural Remedy for Acne

ACNE: Facing up the scourge of adolesence

2009-04-29T01:16:00.000-07:00

Acne vulgaris is an extraordinarily common disease throughout the world. Some people see the disorder as merely cosmetic, but few skin diseases cause as much physical and psychological misery as this scourge of adolescence.1
Between 17 million and 28 million Americans have acne, about 7 million of whom have moderately intense activity and 750,000 of whom have more severe inflammation.2 Acne is one of the most common complaints in clinical practice, whether it is the chief complaint, a secondary complaint or simply
noticed by clinicians during routine inspection. Acne is not difficult to recognize, but strangely, it is sometimes difficult to understand. With an increase in the percentage of acne patients being treated by their primary care providers,3 we must realize the importance of our thorough understanding of the skin so that we can chose appropriate and effective treatments.
Patients with acne have a disfigurement at an age when its effects are felt most acutely. Depression and anxiety are clearly linked to severe acne.4 It's sometimes helpful to create a systematic approach that's flexible enough to allow for the great variety of presentations of acne and acne-like disorders. For the recalcitrant and scarred patients, we must know about the resources available to help improve the appearance of their skin.
Acne: Where It All Begins
All acne lesions begin as microcomedones. Prevent microcomedones and you'll prevent acne. The plugging of follicles, whether in the form of an open or closed comedo, is necessary to some extent in the formation of acne lesions. This superficial obstruction is the hallmark of acne and separates it from the similar folliculitis, perioral dermatitis and rosacea.
The acne cyst is an infection within the sebaceous hair follicle. It originates above the point where the sebaceous gland empties into the hair follicle. This is why acne is referred to as a pilosebaceous disease--and incorrectly referred to as a sebaceous disease. Acne has no true etiology and is not caused by any single factor. Lesions typically occur on the face, chest and back, where there are plenty of sebaceous glands. The face has about 800 sebaceous glands per square inch, and the back has an average of 50 sebaceous glands per square inch.1
Within the sebaceous hair follicle, sebum mixes with the sloughing epidermal lining (squamous epithelium from the shaft of the sebaceous follicle) to "clog" the follicle. When the follicle becomes engorged, it is visible as the common closed comedo, commonly referred to as a whitehead. If the comedo is exposed to oxygen, the material in the plug oxidizes and darkens and becomes an open comedo, or blackhead. The material in the comedo becomes a medium for Propionibacterium acnes. These factors act together to produce irritating free fatty acids, which are thought to attract inflammatory elements.5
Understanding Skin
Normal skin is simultaneously growing and sloughing at a constant rate. I compare the skin to a brick wall that grows from the bottom. The bricks at the top are dried and have already done their job to protect the body. The "glue" (desmosomes) that holds the dried skin cells together is still healthy, which allows the skin to become thicker on the surface. This is how I describe the purpose of keratolytic products to patients--this outer layer needs help in sloughing off, but without physical scrubbing.
Sometimes, we're too late because the patient has delayed medical care during many attempts to rid himself or herself of this nuisance. Often, we see a patient with acne who has tried every over-the-counter product available to no avail. It's crucial to review good skin care with patients and reinforce healthy skin habits.
Patients should cleanse their skin once or twice a day with a gentle or soapless cleanser such as Aquanil, Cetaphil, Neutrogena Oil-Free Acne Wash, Lever 2000, Dove, Basis, Purpose or Oilatum. Cleansing should be a gentle process and not scrubbing or "buff-puffing" the skin aggressively. I tell patients that every time they squeeze or rub the skin hard, the contents spill out onto surrounding healthy skin, adding further trauma to the already infected skin.
I often add that when I was diagnosed personally with acne in high school, like many young men, I didn't use my medicine as often as I should have. If I could go back to those days, I'd work hard to avoid the problems I created by picking and scratching my acne. I believe this would have been more beneficial than never missing a dose or application of medication. I use this example to show patients the importance of letting the skin heal itself and not causing further damage and possibly scarring the skin.
Why Now, Why Me?
Puberty is acne's typical age of onset, but it is not confined to adolescence.6 One of the effects of hormones on the body during puberty is the maturation of the sebaceous gland, which can include a 15-fold increase in the size of the gland. Sebum production is increased to a lifetime high, and acne may begin to occur. This hormonal effect also occurs when some women begin taking oral contraceptives. Yet at the same time, Ortho Tri-Cyclen (ethinyl estradiol and norgestimate), which has recently been cleared by the U.S. Food and Drug Administration acne treatment, is a fantastic therapeutic adjunct for acne. Adult women with no acne history sometimes have their first occurrence along with other significant hormonal changes such as pregnancy or menopause.
Clearly, acne has a hormonal component, but with these wildly varying effects from the same or similar factors, acne cannot be thought of in a neatly linear pattern. Some women get the best skin of their life during pregnancy, while other pregnant women suffer from horrible acne.
Numerous studies have documented specifically the trauma that disfiguring diseases have on patients. These psychological studies include patients who either had a body-image disorder or acne. Facial scarring may be a risk factor for suicide, especially for men.7 This makes a clear case that we should always try to know our patients a little bit better and take acne seriously as a treatable disease.
Severe and Common Forms
It's sometimes difficult to narrow the many treatment options considering the varieties of acne. The best approach to acne is to divide it into two major types: more severe, scarring and recalcitrant acne, and common acne (acne vulgaris). Common acne typically presents itself as comedonal or noncomedonal.
Comedonal acne must be approached differently than the more severe pustular or nodular acne. When choosing acne treatments, I use some commonsense guidelines and adjust them according to the reaction with the patient. If they have tried every OTC product under the sun, they might have made their acne worse with too many irritants.
With mild nonerythematous acne, I recommend the following: Discontinue all other "acne" products. Emphasize a mild cleanser. Initiate Retin-A Micro, beginning two to three times per week and increasing in frequency based on the dryness and irritation. I find this topical tretinoin less irritating and very beneficial for the primarily comedonal variety of acne.
For many patients, Retin-A Micro is too irritating, even when applied every other night. For these patients, I recommend adapalene gel (Differin) with the same instructions regarding increase in frequency as the Retin-A Micro. When even these therapies are too irritating, Retin-A 0.025% cream or moisturizers containing alphahydroxy acids are very mild options (NeoStrata has some excellent sensitive moisturizers and other skin products available for this purpose). Patients who cannot tolerate topical products can use an occasional chemical peel to help rid and prevent comedones. This can be repeated every 2 to 6 weeks, depending on the sensitivity of the patient and strength of the peel.
Erythematous papules (with or without comedones) lead me to prescribe topical antibiotic creams. I still like the effect of the benzoyl peroxide gels, so I usually begin with Benzamycin (benzoyl peroxide and erythromycin). I use this in the morning, alternating with Retin-A at night, or else Benzamycin b.i.d. with Differin at night. (Retin-A and benzoyl peroxide are thought to cancel each other chemically, but many dermatologists use them together very successfully).
With two effective active ingredients, Benzamycin gel has an excellent history in many nonbiased studies for quickly reducing overall comedones and inflammatory papules.8 With increasing resistance to topical and oral antibiotic therapy in acne patients, quickly reducing the total use of all forms of antibiotics is an exceptionally desirable goal. When transitioning off antibiotics, do it gradually, from b.i.d. to q.d. to q.o.d., with 1- to 4-week intervals. I also like to continue benzoyl peroxides or superficial acids. These products (azelaic acids such as Azelex; benzoyl peroxides such as Benzac and Triaz) provide a hostile environment for acne but little or no discomfort for the patient.
Recalcitrant Acne
Any significant pustules with nodular acne result in the prescription of an oral antibiotic. I usually begin with doxycycline in the winter and switch to cephalexin or enteric-coated erythromycin for the summer months. Tetracycline is still the drug of choice, but I find the food restrictions too much for the already hard-to-make-compliant patient.
When patients have acne that is recalcitrant to multiple treatment attempts, I will consider prescribing isotretinoin (Accutane). In addition, patients with severe scarring nodular or cystic acne, acne conglobata or acne fulminans are likely candidates for Accutane. Isotretinoin (13-cis retinoic acid) is a vitamin A analog that inhibits sebaceous glands and reduces sebum production. It also normalizes intrafollicular keratinization. When I begin a patient on Accutane, it typically means that they have failed oral antibiotic therapy. I expect they have attempted no fewer than two or three different families of antibiotics over a 4- to 6-month period. When Accutane is used for acne, the standard therapeutic regimen is 0.5 to 1 mg/kg/day for 20 weeks.
If my patients are on oral antibiotics, I see them every 4 to 12 weeks, depending on the control. Once the acne is under control, I follow up one to four times every year and encourage patients to taper off of oral antibiotics and transition to topical medications. For patients who do not have severe enough acne to warrant (Accutane), but have not been helped with the typical oral antibiotics, here are other drugs I use successfully: Septra DS (b.i.d.); ampicillin (250 or 500 mg b.i.d.); azithromycin (z-pack after 10th day begin t.i.d. or b.i.d.).9
Scar Revision
When acne has progressed treated or untreated for years, the emotional scars are unseen and often are ignored. The visible scars are often seen, noted and described--and then ignored. We can achieve tremendous scar revision outcomes with new laser technology.10 The scars that were once notoriously difficult to treat are now significantly improved with the latest laser therapies.11 It wasn't long ago when the only alternative to having acne scars for life was freezing the skin of the face hard enough to sand down the prominent peaks. Now we can cosmetically remove deep pits and replace them with miniature skin grafts of the same size. Combined with state-of-the-art lasers, we can resurface the skin, leaving it smoother, healthier and younger looking. Chemical peels and moisturizers can improve skin tone and texture. We now have a topical vitamin C that reverses sun damage to the skin, diminishes wrinkles and stimulates collagen regrowth. These and a vast array of other possible skin-enhancing tools are relatively recent improvements that we must pass along to our patients with acne disfigurement.
Other Forms of Acne
When considering the possible scarring effects of acne, we should also consider the possibility of preventing the disease. Some forms of acne are caused, at least in part, by exogenous factors and can be prevented.
Acne mechanica is a form of acne produced by repeated physical trauma to the sebaceous skin, such as football and baseball players' foreheads--both have constant mild trauma, and sometimes acne forms that's localized to only these locations. This also occurs in students who rest their head in one hand on one side of the face, or teenagers who talk on the telephone with the mouthpiece pressed firmly to the side of the face. Treat these by reducing or removing the friction (with softer material, lubricants, etc.)
Acne cosmetica comes from products that contain chemicals that occlude the follicle and help form acne lesions. Steroid acne is a diffuse papulopustular eruption that can take place while on systemic steroids. Usually treatable topically, steroid acne dissipates when steroids are discontinued. Neonatal acne is a common acneiform presentation for infants because the mother's androgens stimulate the baby's sebaceous glands. This is self-limiting and usually requires no treatment.
Occupational acne, pomade acne and pitch acne are forms of acne in which environmental chemicals help occlude the pores and lead to acne. Acne excori_e des filles (excoriated acne or picker's acne) is a form with no active lesions. It is usually a condition of girls and young women who compulsively pick and squeeze minute ore even nonexistent facial lesions, leading to larger lesions. Healed crusted ulcers, large erythematous adherent crusts and postinflammatory hyperpigmentation are the hallmarks of this disease.
Gram-negative acne sometimes forms after long antibiotic use and a shift in acne flora. This is easily treated with a cephalosporin such as cephalexin 500 mg b.i.d. for 21 days.
Milia are small, white, dome-shaped papules that are very shallow cysts with no follicular opening. These require fine-needle drainage and sometimes expression. Keratolytics sometimes can help cases of chronic milia.12
Some diseases that frequently occur on the face are confused for acne, but are best not treated as acne. With any perioral distribution, I ensure first that the patient discontinue any steroid use at the face. I plan a 3-month course of antibiotics (0.1% metronidazole cream q.d.), and sometimes add a class V or VI steroid, sodium sulfacetamide (Klaron) or both to help in the first few weeks until the erythema subsides.
For rosacea, I use the same formula as for perioral dermatitis, expecting to use topical and possibly oral antibiotics for years. I especially prefer the newer 0.1% metronidazole cream. This seems more effective at reducing erythema quicker and is only applied once a day, but Metrogel and Metrocream are still excellent options. It is crucial to explain to rosacea patients that there are triggers that dilate (flush) the face, and if the triggers can be controlled, then the rosacea should lessen.
A Simple Approach
Many acne and acne-like disorders can be devastating to our patients. With early recognition, we can greatly reduce the risk of permanent scars. "If acne were so simple," I tell my patients, "your doctor would have already noticed your acne and prescribed for you 'the' acne pill or 'the' acne cream, and the acne would be gone by now!"
Unfortunately, acne treatment is a little more complex than that, but it is still very manageable. Ask your patients with noticeable comedones or acne lesions how they feel about their acne and whether they would want a prescription that you could quickly write for them (while asking about their basic skin care). If they simply are asked during a medical office visit, they more likely will tell you exactly what they think, and if they want help. Do not rely on their spontaneity. With some patients, we can do a great deal of good with little effort. Acne is the perfect condition to apply a simple approach and have a tremendous outcome.
I have mentioned many products by name in this article. I hope you use this as a starting point only and expand your treatment of dermatologic disorders based on your personal experiences. I have received no payments for any part of this article and use the products mentioned as a personal choice because of excellent results. *

Dr Reddy launches anti-acne drug Nexret in India

2009-04-28T05:17:00.000-07:00

Hyderabad-based pharmaceutical major Dr Reddy’s Laboratories Limited (DRL) has launched Nexret, a drug for treatment of acne, in India.

Nexret is a next generation anti-acne formulation made from a proprietary non-porous microsphere technology. "This unique technology minimises irritation associated with drugs like Tretinoin and provides controlled delivery of drug to the skin," the company stated in a press release.
The anti-acne market in India is estimated to be about Rs 130 crore and is growing at the rate of about 14 per cent per annum.
Topical Tretinoin is considered as one of the most efficacious drug to treat acne, a commonly diagnosed condition by dermatologists. However, its use is restricted because of irritation, erythema, burning and dryness.
According to DRL, Nexret contains Tretinoin entrapped in microspheres enabling more amount of drug loading and also reducing unwanted adverse effects. This microsphere technology has been developed internally and patent application has been filed in seven countries.
Nexret is available in gel formulation and in pack size of 15 gm.

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ACNE pill Roaccutane could increase the risk of suicide, an inquest heard.

Michael Jackson : Acne problems during teenage years made MJ ‘paranoid’

Perrigo buys KV Pharma filing for generic acne gel

Teen Acne and Depression: Can Mood Worsen Skin?

Acne, Pregnancy Among Disqualifying Conditions

Roche discontinues sales of acne drug Accutane

DO I REALLY NEED SUNSCREEN WITH SPF 100?

Acne scars can be more than skin deep

New Chocolate Product Said to Clear Acne

Acne in a Patient With Pancreatic Cancer

Laxative may ease severe acne problem

e Remedies for Acne – Get Clear and Beautiful Skin Back

ACNE: Facing up the scourge of adolesence

Dr Reddy launches anti-acne drug Nexret in India