Comedonal acne

Comedonal acne Salicylic acid 25% Pyruvic acid 40-70% JessnePs solution Unna Paste Glycolic acid 70%... 

In patients with acne (Fig. 2.4), the chemical peels were performed with a 70% glycolic acid solution, for 2 to8 min. The number and frequency of the applications depended on the intensity of the clinical response. The most rapid improvement was observed in comedonic acne, in the papulo-pustular forms. An average of six applications were necessary (Fig. 2.5a, b). 

Comedonal acne and acne rosacea respond well to tretinoin. In fact, the anti-aging effect of tretinoin was first observed in patients being treated with tretinoin for comedonal acne their skin texture and skin tone were gradually seen to improve. 

Comedonal acne (Figure 5.5) can be treated with an intraepidermal peel or a peel to the basal layer. A trichloroacetic acid (TCA) peel to the papillary or reticular dermis could be considered, but such a deep treatment would be pointless for this type of disorder, which can be treated with a lighter peel and, in any case, requires longterm maintenance treatment. 

Topical retinoids—tretinoin, adapalene, tazarotene, and in some countries topical isotretinoin, motretinide, retinaldehyde, and retinoyl-/S-glucuronide —should be used as first-line therapy for mild to moderate inflammatory acne and comedonal acne. They are also preferred agents for maintenance therapy to minimize antibiotic use in acne therapy. To optimize efficacy in moderate inflammatory acne, topical retinoids should be combined with topical antibiotics or BP0.2T33... 

TABLE 95—5. Typical Pharmaceutical Care Plan for Mild Comedonal Acne... 

Diagnosis is usually easy, but acne may be confused with folliculitis, rosacea, or perioral dermatitis. However, in these skin conditions, there are no comedones. Comedonal acne has to be differentiated from milia and sebaceous hyperplasia. Inflammatory acne could mimic rosacea or perioral dermatitis. Rosacea is... 

Petroleum distillates obtained at temperatures above 315 °C are mainly oils (lubricating, spindle, transformer, machine and cutting oils) and have less defatting but more keratogenic action. They can cause comedones, acne, photosensitivity, melanosis, keratoses and epitheliomas. 

In pitch workers, pure comedonal acne develops on areas such as the face and neck, which are exposed to fumes but not to friction whereas, folliculitis, characterized by papules and pustules, most often occurs on the thighs, forearms, and back, where there is friction and occlusion from clothing in addition to pitch exposure (Crow 1970 T.F. Downham, unpublished observations). Other authors observed that even pilo-sebaceous follicles on the proximal phalanges and thumb webs can be covered by black comedo-like plugs (Ross 1948 Combes 1954). Pitch acne usually clears quickly and results in minimal scarring however, it is not uncommon for pitch workers to have a few persistent comedones which, despite regular extraction, still reappear even 10 years later (Crow 1970). 

Azelaic acid or 1,7-heptanedicarboxylic acid is a saturated dicarboxyhc acid naturally found in wheat, barley, and rye. It is active in a concentration of 20% in topical products used in a number of skin conditions, mainly acne. Azelaic acid is used to treat mild to moderate acne, i.e., both comedonal acne and inflammatory acne. It works in... 

Salicylic acid is hpid soluble therefore, it is a good peeling agent for comedonal acne. The salicylic acid is able to penetrate the comedones better than other acids. The anti-inflammatory and anesthetic effects of the salicylate result in a decrease in the amount of erythema and discomfort that generally is associated with chemical peels. 

To control comedonal acne and seborrhea, several sessions of weekly light chemical peels are performed over the course of a month. For photo rejuvenation, periodic light chemical peels can exfoliate the hyperkeratotic stratum corneum and improve skin brightness and texture. Concentrations of the peeling agent are titrated upwards as the patient tolerates. Today s patients desire cost-effective procedures which produce reliable results and have minimal associated side effects and downtime. For many indications, chemical peels are just that. 

While salicylic acid peels are our first choice in comedonal acne, we consider pymvic acid peels as an alternative. 

All compounds that we have studied for effects on keratinization have been initially evaluated on a series of over twenty patients with ichthyosis of several types. Many of the compounds have been evaluated for therapeutic effects on larger series of patients with dry skin several have been used therapeutically for comedonous acne and a few have been used in therapy of a diverse group of disorders including palmar and plantar hyperkeratosis, Darier s disease, lichen simplex chronicus and others. Reduction in stratum corneum accumulation has been readily demonstrable in all disorders in response to two-four times daily topical application of the compounds formulated as 5-20% oil-in-water creams, as solutions and as gels. 

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