MANAGING ACNE IN PHARMACY

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1 MANAGING ACNE IN PHARMACY

2 ACNE PREVALENCE Acne is the most common of skin diseases, affecting 85 per cent of Australians aged years old. Very few people manage to escape their teenage and young adult years without some pimples and blackheads. Acne usually clears spontaneously for many people by their mid 20s. However, for some young people acne is a far more serious problem with the possibility of permanent physical, mental and emotional effects (Depression). Adolescent boys and young men (13 25 yrs old) have higher levels of androgens than females so they are more likely to have acne and unfortunately, are also more likely to have severe acne. Acne in guys usually settles during their early 20s. Females are more likely to suffer with ongoing acne. In some cases, this means acne can be hanging around even in their 30s and 40s. Females can also develop acne for the first time after puberty.

3 Causes and Symptoms of Acne Acne happens when the oil glands pores in the skin become blocked. Hormones make the oil glands produce more oil (sebum) and if the pores are blocked, a build-up occurs and pimples will appear. The face, neck, chest, shoulders and upper back are the areas mainly affected by acne because they have the highest number of oil glands. Acne usually starts at puberty when increased levels of sex hormones ( androgens) cause an increase in oil production of glands. If you have a family history of acne, it may also increase your chances of developing acne.

4 Causes and Symptoms of Acne cont d If the pore becomes blocked, oil builds up and causes irritation. Bacteria (P. acnes) rapidly multiply within these blocked follicles contributing to the redness, swelling and tenderness of pimples. The blockage is sometimes visible and when it takes on a dark (melanin) pigmentation it is called a blackhead. Sometimes the blockage is invisible and the collection of sebum under the skin appears as a small white lump or whitehead. Damage to the surface and underlying layers of the skin can be extensive, following moderate to severe acne. This can result in flat or thick raised scars, discolouration and pitted, indented skin. Picking or squeezing of pimples can also be a cause of scarring.

5 ACNE SEVERITY Acne can be classified as Mild, Moderate or Severe. Mild Acne If one s acne condition is limited mainly to whiteheads and blackheads, he/she probably has mild acne, especially if the lesions do not cover large areas of the face or body. Moderate Acne If one has papules (raised reddish bumps) or pustules (raised reddish bumps but with white centres). He/she may have moderate acne, especially if the lesions are widespread across the face or body. Breakouts last longer than in mild acne and often do not go away.

6 ACNE SEVERITY cont d Severe Acne If one has large, deep, solid and painful lumps or cysts under your skin, he/she may have severe acne. The breakouts cover large areas of the face or body and last longer than in moderate acne, often not going away for months or years. It can have a huge impact on selfconfidence and self-esteem, leading to anxiety and depression. Untreated, severe acne can cause permanent and disfiguring scars. Referral to a GP and then a Dermatologist is recommended.

7 MILD-MODERATE ACNE MANAGEMENT AT PHARMACY Topical Over The Counter Treatments: Benzoyl Peroxide Salicylic Acid (BHA) Alpha Hydroxy Acids (AHA) New Generation: a combination to combat acne causes and gentle on the skin BENZOYL PEROXIDE Antibacterial action probably due to oxidizing effect; mild keratolytic effect. Adverse effects: skin dryness or peeling. stinging. bleaching or discolouration with hair and coloured fabric. 2.5% or 5% is less irritant than 10% but as effective SALICYLIC ACID (BHA) Keratolytic: Unsatisfactory results in clearing acne Pregnancy: data lacking. Avoid using large amounts as it is readily absorbed. Side Effect: irritation and photosensitivity. (3) ALPHA HYDROXY ACIDS (AHA) Keratolytic. Unsatisfactory results in clearing acne. Side effects: irritation and photosensitivity

8 NEW GENERATION FOR ACNE MANAGEMENT Combination of Niacinamide; Oleanolic Acid AND Nordihydroguairetic Acid (NDGA) in an osmotic gel; Zinc Gluconate NIACINAMIDE Nicotinamide (Vit. B3, not Nicotinic Acid) Topical Niacinamide is equivalent to topical Clindamycin in reducing the number of papulo-pustule (pimples)count. Non Antibiotic : No risk of bacterial resistance and OTC. No Photosensitivity Hydrates without greasiness (4) ZINC GLUCONATE Antibacterial Calming OLEANOLIC ACID & NDGA IN AN OSMOTIC GEL 44% reduction in sebum production in 6 weeks 31% reduction in the number of active glands 35% reduction in comedonal lesions 100% inactivation of Bacteria: P.Acnes 54% inhibition of keratinocyte proliferation (5)

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