Archive | Skin Care

The Four Stages of Acne and Treatments – Why Does Adult Acne Still Occur?

When our teen years had passed, many people thought that we could also leave the pimple outbreaks which were very common during teen years. But, the bad news is: Adults are not immune to acne! We all know that acne can affect our self esteem and social life, especially in this age where image and appearance are so important. No one like to have acne.

Acne or pimple outbreaks are more widespread in teenagers; this is unsurprising because of teens’ hormonal surge and lifestyle during puberty. However, acne can persist even into adulthood. I am sure you have seen some adults who are in their 30s and 40s still plagued by acne.

Besides our lifestyle, the major causes of acne are overproduction of body’s oil called sebum; clogged pores and inflammation caused by bacteria and dead skin cells. When there is increased oil production below our skin surface; the oil will be trapped and accumulated in skin pores allowing bacteria to thrive there. The trapped oil becomes food for the bacteria, causing inflammation and eruptions of acne.

Acne can occur on the face, neck, shoulders, chest and back, where the most active oil glands are located. Males tend to get more severe cases during their teen years while females are more prone to adult acne due to hormonal cycles. For teenagers, it tends to occur on the T-zone; while for adults, it tends to occur near and around the mouth and jawline.

Acne condition can be classified into four stages, from mild to severe. For example, those blackheads and whiteheads are classified as stage 1; they are also known as comedonal or non-inflammatory acne. If blackheads and whiteheads are accompanied with papule (small red dots), it’s classified as stage 2; also known as mild or inflammatory acne.

Stage 3 acne is characterised by bigger pustules or pimples which can be painful. Stage 4 (severe acne) occurs when your skin is covered by many small and painful pustules.

Different stages have different treatments. Typical treatment for non-inflammatory acne (stage 1) is cream or facial washes with ingredients line benzoyl peroxide. Inflammatory acne (stage 2) can be treated with topical antibiotics such as clindamycin.

Stage 3 acne can also be treated by topical therapies but oral medication is common as well. People with severe cases (stage 4) are usually given Roacutane, which is an oral vitamin A derivative that is used to slow down the production of sebum. It’s normally taken for six months to a year. Roacutane, however, can cause side effects; pregnant women should avoid this drug.

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Skin Care- How Skin Changes With Age

With ageing, skin also changes. The changes in skin are both intrinsic and extrinsic. Intrinsic changes are those that appear with ageing of body. Extrinsic changes are those that occur because of external factors such as sun, smoking, gravity and bad skin care. We cannot stop any intrinsic change because that is programmed in our body, but we can surely change habits and reduce changes due to extrinsic factors.

Let us look at the changes in skin with ageing. As you know skin has three layers- Epidermis (Outermost layer), Dermis (Middle layer) and subcutaneous layer that is below the dermis. As we age, the epidermis or the outermost layer begins to thin. The melanocytes (Pigment containing cells) decrease. Though melanocytes decrease in number they increase in size. This gives a pale look to the skin. Ageing changes due to sun such as liver spots or lentigo appear. They are also called age spots. The blood vessels in the dermis begin to lose strength and easily lead to bruising and bleeding under the skin. The subcutaneous layer that gives fat padding to skin thins. This again increases the risk of skin injury. Both sweat glands and sebaceous glands become less active.

As we age, our skin loses its suppleness, texture and strength. With age spots and other pigmentation, the look is lost. With weakening of strength, it becomes easy for skin to suffer damage easily. Healing becomes very slow. The healing may be four times as slow in old age as compared to youth. Skin turns dry and our sense of touch heat etc. reduces considerably. Other growths such as skin tags, warts, mar the appearance further.

Wrinkles appear on skin at all the places. As the underlying fat in the subcutaneous layer is lost, hollowness appears on the cheeks and eye sockets. Jowls form because of gravity. The hair grays and turns white. Some people lose hair and some grow hair at unwanted places. The nails become thin and half moons on the nails disappear.

As with every part of our body skin ages and brings about changes that mar the look completely. Sun damage can accelerate the skin aging considerably and can also cause skin diseases such as skin cancers etc. regular care of skin is necessary along with protecting skin from the harm full rays of sun to maintain youthful look for a longer time.

This article is only for informative purposes. This article is not intended to be a medical advise and it is not a substitute for professional medical advice. Please consult your doctor for your medical concerns. Please follow any tip given in this article only after consulting your doctor. The author is not liable for any outcome or damage resulting from information obtained from this article.

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Tips to Make Bar Stool Cushions

It is far easier and cheaper to make bar stool cushions at home than to buy them. After all, the stools can be of various shapes and sizes, and finding the correct size can be quite a disturbing task. Therefore, you should be thinking about making your own cushions. This will make the sitting arrangement more comfortable and at the same time, it will add to the beauty of the room as well. I have been in the industry of interior design for quite many years now and I can say with certainty that nothing can be compared to the beauty of custom homemade bar stool cushions!

One thing that many people tend to forget is that, if you are out on the look for bar stool cushions, it is always wiser to try and make some yourself at home! You can surely come up with really delicate designs for your bar stool cushions. What’s more, these cushions don’t require a lot of money or effort. Therefore, you can make them easily, quickly and more importantly, quite cheap! Look for a set of instructions online and take the time to go out to the stores to get all the different materials that you may require, from fabrics and pieces of cloth, to tools and nails.

When you are trying to make your own bar stool cushions at home, the first thing that you should consider is that you need the right measurement in terms of shape and size. So, take a paper and cut a pattern that fits perfectly to the bar stool. Keep on trimming the edges until you get the right shape. Make sure you are taking the pattern of the outside edge of the seat. The bar stool cushions will have ruffles that would drape over the edges of the chair seat. Now, take the fabric and cut around the pattern while keeping the extra half inch you will need for seaming. When you are cutting fabric for ruffle, make sure they are cut 7 inches wide and the length should be two times the distance of three exposed sides of the cushion.

Now, take the ruffle fabric and fold the wrong sides together. This will halve the width while the length will remain the same. Now, run basting stitches along cut edges of the ruffle. You can also use the ruffling attachment. This will ensure the gathering cover all the three sides of the cushion and keep in mind that you can stitch a narrow hem at the end of each ruffle. You can cut four fabric pieces of 6 by 3 inches measurement and make ties with them. For that, you have to fold the long edges under half inch and press. Fold this end and press it further and then fold in half and stitch along the long edge.

A section of the seat fabric must be right side up and attach the ruffle to seat with pin. Keep the other side of seat on right side down. Now, stitch around the edges of the fabric while keeping the back of the cushion open for further stuffing. Turn right side out the cushion and press. To finish up your bar stool cushions, fill them up with polyester. However, if you feel the entire process to be too complicated, you can buy these cushions from $ 15 to $50 and more.

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5 Reasons Little White Bumps Are On Your Face and How to Get Rid Of Them

Are you making these mistakes each time you spot a little white little bump on your face? Fixing those little white bumps starts with a small dose of education and ends with a big dose of prevention. After understanding the five reasons below, your little bumps should give way to clearer skin.

Reason #1: You have no clue what those little white bumps are anyway.

Little white bumps, or milia, are keratin-filled cysts, or simply little globs of protein under the skin. There are generally two types of milia. Primary milia may result from oil glands that have not fully or properly developed. Secondary milia result from trauma to the skin.

Reason #2: You think all little white bumps are acne, and treat them that way.

Just because you have little white bumps on your face does not necessarily mean that you have acne. Milia, are little balls of protein beneath the skin that do not have a pore, or hole in the skin through which to escape.

Comedones or whiteheads are excess fats and wastes that are trapped in a hair follicle and so they clog up the pore. In short, milia are proteins trapped within the skin, while comedones are fats and skin debris trapped within the pore.

Exfoliating the skin, or removing the dead skin cells from your skin with an abrasive product or chemical, is beneficial. But brutally scrubbing your face with soaps and chemicals too frequently may actually create milia. To avoid this, remember that gentle exfoliation helps prevent excess dead skin cell build-up that could clog your pores and cause whiteheads, not milia.

This gentle exfoliation helps make eventual removal of the milia easier because the skin layer around the milia becomes thinner, with frequent, yet gentle exfoliation. In short, Exfoliate your skin to prevent milia, not to cure them.

Reason # 3 You have no idea what causes those little white bumps anyway.

When you were a baby, you were probably covered with milia that disappear after a few days. Or, you may have inherited milia from your parents.

On the other hand, you may develop milia after excessive exposure to the sun. The reasons for developing milia after sun exposure are debatable. According to some studies, the active ingredients sunscreens like Parsol 1789 may cause sun allergies and later lead to a milia breakout. Other studies blame the sun itself for “damaging” the skin can thus causing little white bumps.

Some people experience milia around the mouth. This could be the result of fluoride irritation from toothpaste.

Reason # 4: No one ever told you how to prevent milia.

The best way to prevent milia is to avoid treating your skin with excessively harsh chemicals and to limit sun exposure.

To reduce creating milia around the eyes, use eye creams with the least amount of ingredients possible to avoid irritating the delicately thin eye area. Also, gently touch the eyes and avoid rubbing the eyes vigorously so as not to damage the skin.

When brushing you teeth, try to keep the pasty foam from staying around your mouth too long. This limits possible fluoride irritation to the skin.

Use a sunscreen with the least amount of ingredients. Extraneous ingredients like fragrances may irritate your skin. Additionally, purchase sunscreens that offer physical sun blockage that contain active ingredients like titanium oxide or zinc oxide.

Reason #5: You still want to know what you can do right now to get rid of milia.

The key to getting rid of milia is realizing that they have no escape route, those little bumps are trapped under the skin. So, to get them out, you’ll need to have a professional like a dermatologist or aesthetician extract them. You can extract the milia yourself, but this involves risks.

Precautions

You need to ensure that you milia are not symptoms of some underlying disease or illness. Also, if you extract the milia yourself, you may have trouble completely pulling out the cysts, as the removable process may prove too painful.

Otherwise, if you are confident with your health and courage, you can cleanse your hands and face. Then wet a cloth with warm water and apply it to your face for a few minutes. Gently apply a sterile needle to the center of the little white bump to create a tiny opening in the skin.

Wrap your thumbs in a clean tissue and, using your thumbs, proceed to gently squeeze the contents of the little white bump out. Finally, cleanse the area of the extracted little white bump with an astringent.

Now, you have no reason to walk around with little white bumps on your face. If you still think you do, please consider the possibility that you’re just telling yourself little white bumpy lies.

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Best Skin Whitening Cream – What Works Best to Whiten Your Skin Effectively

So you are looking for the best skin whitening cream. But why are you looking for such a product? Obviously you want to lighten your skin tone. Skin whitening or skin bleaching is very popular in some part of the world where a fair skin is considered an important and integral part of beauty. Skin whitening also becomes imperative in certain skin conditions where skin becomes pigmented due to excessive production of melanin.

Different Ways To Lighten Skin

There are many ways to lighten your skin tone or remove pigmentation effectively. There are pills, injections, chemical peels and also creams that can effectively lighten your skin tone.

Efficiency of Skin Whitening Cream

Cream for lightening the skin is the most popular method as it requires topical application and the most non-invasive way to lighten the skin. But the effectiveness of the product depends on the extent of damage caused to your skin.

How They Works

A good whitening cream should work in three ways.

1. It should protect your skin from the UV rays of sun.

2. It should remove the damaged outer layer of the skin to reveal and regenerate healthy light skin.

3. It should inhibit the production of excessive melanin that causes skin darkening in the first place.

Ingredients Of Skin Whitening Cream

The common ingredients of any lightening cream are usually the following.

1. Kojic Acid: It is very popular as skin lightening in Japan. It is a by product of rice fermentation. That is why rice sake is widely used as a natural ingredient to remove all kinds of skin pigmentation like age spots and freckles.

2. Licorice Extract: This is a natural ingredient to treat pigmentation. Some good quality whitening creams have this as one of the base ingredient. A very important melanin suppressing agent is glabridin which is found in licorice.

3. Aloe Vera: This is another natural ingredient to remove sun tan and skin darkening to over exposure to the sun. Most popular brands of skin brightening cream have aloe vera as an active ingredient.

4. Octyl-p-methoxycinnamate: This component acts basically as a sun block.

5. Octyl salicylate: This also protects you from the UV ray of the sun and hence lessens skin darkening.

6. Oxybenzone: This is also a very active chemical in sunscreen lotions as well as skin lighteing creams.

7. Mercury: Some skin lightening creams do contain mercury. But if you are looking for a good quality cream you are better off with one that does not contain mercury.

8. Hydroquinone: It is also most common in some skin lightening cream as it is strong inhibitor of melanin production. But it has lot of long term negative effects on your skin. So look for a cream that does not contain hydroquinone.

9. Arbutin: This is extracted from leaves of bearberry, cranberry, mulberry or blueberry shrubs. Arbutin is a known melanin inhibiting agent.

10. Tretinoin: This ingredient is very effective all kinds pigmentation from the skin.

11. Alpha hydroxy acids: It is a kind of chemical peel. This ingredient in the creams removes the outer damaged layer of the skin and help to generate healthy skin.

12. Azelaic acid: Even though it is not such a strong melanin inhibitor, it is an active ingredient in many skin bleaching creams. 13. Vitamin C: It is a great antioxidant and helps in generating new skin.

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Waxing Exam Questions – Examples for Your Revision Plan

Waxing is a popular treatment in a beauty salon, so as a beauty therapist you need to be 100% confident with your technique and make sure your knowledge of waxing is second to none. Having a large selection of waxing exam questions is therefore essential to any beauty student’s study plan.

There are 4 different types of wax including;

Hot

Warm

Cold

Sugar

You need to know the difference between each one, the ingredients, what temperature they should be, what areas of the body they are used on and how to apply the wax etc.

Another vital area that needs to be covered when you are studying waxing is the anatomy and physiology part of it, namely anatomy of the skin and hair.

Take a look at the following waxing questions and see how many you can answer, try not to look at the answers;

1. What temperature should warm wax be used at? (Around 43 degrees C)

2. What 3 things make up the hair shaft? (Medulla, Cortex, Cuticle)

3. What are the 3 stages of the hair growth cycle? (Catagen, Telogen, Anagen)

4. What type of wax is ideally used on stronger, short hairs? (Hot)

5. Where is sebum produced? (Sebaceous Glands)

How did you do? These are the most basic questions that you need to know so if you were not able to answer even 1 of them, then you need to alter your revision plan.

A lot of terminology that you need to learn can be very difficult to remember so using your waxing revision questions over and over again will greatly improve your chances of retaining the information.

A lot of examining bodies such as ITEC, VTCT, NVQ and CIDESCO offer multiple choice questions as the format for the exam. Some examples of these type of waxing exam questions include the following;

01. Which endocrine gland is known as the master gland?

a) Pineal

b) Thyrod

c) Adrenal

d) Pituitary – Answer

02. Warm waxes are frequently made of mixtures of;

a) Resin and oil

b) Glucose syrup and honey

c) Glucose syrup and zinc oxide – Answer

d) Honey and witch hazel

03. Which one of the following is a cause of ingrowing hairs?

a) Too much exfoliation

b) Oily skin

c) Hot wax

d) Poor waxing technique – Answer

04. What is the composition of the cortex?

a) Thin, unpigmented flat cells

b) Thick, pigmented cells

c) Several layers of closely packed elongated cells – Answer

d) Several layer of closely packed endothelial cells

The secret to passing your waxing exam is having a structured revision plan which includes various exam questions and quizzes that you can revise.

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How Long Does It Take Pimples To Form?

What causes pimples and how long does it take for them to form are good questions. The answers are a bit confusing as till date science has not been able to pinpoint at the clear reasons for the formation of acne. Still, the conclusion that has been reached in this regard is that the oil glands in the skin that secrete oil cause these pustules. These glands become larger at the time of puberty making it obvious why teenagers struggle against acne the most.

Are you also troubled by pimples or have just got a teenie-weenie one yourself. A single zit or many zits are all acne. Either way, whether young or old- who in the whole wide world would ever want a pimple? It is an embarrassment and makes your self-esteem take a nose dive. You might have already asked around to know how long it takes pimples to form. If you have, it is good, for the more information you have at hand about acne, the better prepared you would be to effectively treat them and prevent new ones from forming.

Their Root Cause

Pimples start out in the hair follicles more than 2 weeks before you can even see them. So once you know you are getting one or more, you should immediately start off a preventive treatment regime.

To understand how long it takes these annoying blemishes to form, you have to first understand how pimples relate to hair follicles. Hair follicles contain oil glands that contain a substance called as sebum. This sebum after being formed in the hair follicle slowly travels its way upwards towards the surface of the skin. Hormones that are released in the body all along play a vital role in deciding how much sebum will be produced by your sebaceous glands.

The hormone Androgen and Progesterone trigger excessive production of sebum in both men and women and those who have high levels of these hormones have acne prone skin. Sebum en-route to its way to the skin surface picks up dirt and debris as it gets nearer to the surface. Then it goes and blocks the skin pores, clogging the hair follicles. Bacteria attack the skin when it is clogged by sebum or perspiration. This bacteria scientifically known as P. acnes live on your skin and turns into a malicious harmful agent of acne, thriving and growing in the clogged hair follicles.

All this takes anything from 2-4 weeks, ample time for you to take action rather than grieve over your wrecked skin condition.

Types And Causes

Acne comes in various forms and the most common ones are blackheads and whiteheads. These are harmless non-inflammatory acne but make the face quite unsightly.

Now if bacterium infects a whitehead, a papule or pustule- a pimple forms. Such acne is inflammatory by nature and can be from mild to severe in nature.

In very severe cases of acne, cysts and nodules develop, rupture and spread infection thereby causing permanent scars.

Everyone secretes oil from their glands but unfortunately some secrete it more than others. Genetics plays havoc here and so does pregnancy and other hormonal fluctuations in the body. All cause acne. Other modern day factors like stress, pollution and changing diet are also causes of pimples. The dead cells on the skin that seem harmless enough can also clog the hair follicles and because a cause for distress- pimples.

Basically, there is no single reason for acne and no fixed time for acne to form. Pimples are formed by a number of reasons and the time that they take to form also varies from person to person. You can fight the problem of acne right at its initial stage with proper care.

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What Are the Characteristics of Healthy Skin

Each of us has their own definition of what healthy skin is. What are the characteristics of healthy skin? Basically healthy skin should be smooth, blemish-free, glowing and radiant. This is the ideal characteristics of the skin. Is it possible to attain? Yes it is but it may require some efforts from you such as:

1. Being healthy – maintaining a balanced healthy diet is one of the necessities of a healthy skin. As the saying goes “You are what you eat” is true. Some nutrients in the food that we eat are not only to nourish the body but also needed to have a healthy skin. Eating healthy makes your skin glow and healthy.

2. Good skincare regimen – to have a good looking, healthy skin is to have a good skin care routine. Cleanse, tone and moisturize should be the basic on your beauty regimen. Also, choosing the products to use for cleansing, toning and moisturizing is also equally important. Know your skin type. Products for dry skin have different desirable components than those that are for oily skin. There is also a different component to look for in a product that is desirable for sensitive skin. Finally, use products that contain only natural ingredients to avoid harmful side effects.

3. Avoid the sun – although the sun is also needed for Vitamin D to be absorbed, too much sun causes the skin damage by burning it. Therefore, getting a tan is a misconception of being healthy. Using products with a sun protection factor, avoiding the time of the day when the sun’s heat is very intense and using protection gears like sunglasses are the best action to protect the skin from the sun.

4. Vitamin and mineral supplement – aside from having a healthy diet, as you go older you may need to support good food with vitamin and mineral supplements. There are vitamins and mineral that acts on the skin cells rendering its function effectively. Free radicals increase in numbers causing damage to the skin as you age, but most vitamins and mineral supplements today are anti-oxidants that are effective in fighting free radicals leaving the skin healthy and glowing.

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How to Prepare for Miss India

Beauty pageants are held to appreciate the unparalleled beauty. Miss India contest is an effort to recognize the young elegant and graceful ladies. Femina Miss India is the most popular and oldest of all the pageants for Indian women. If you have always dreamt of becoming a Beauty Pageant start preparing as early as possible. This article helps you prepare for this heritage beauty pageant for women.

Join the Beauty Contest training programme in a reputed institute. Select from an array of Training Institutes based on their past record and the quality of trainers. Improve your chances of winning among so many contestants vying for the same title by getting trained by ex-miss India. These training schools will guide with their expert advice. They will primarily work out on your Public Speaking, Voice Modulation, accent, Diction, articulation, Body Language

They also prepare you for the important question-answer round, Evening Gown Presentation round, Modeling Technique, analysis, customize and stylize wardrobe. This contest is high pressure time, so work on to cope up with it.

Healthy and well balanced diet, yoga and meditation increases confidence in you. You should be well prepared for the 60 second interview on which a lot more your selection depends. An experienced trainer knows what panels look for in contestants so they groom accordingly.

Your way to present yourself and beauty is the first thing that makes the first impression on everyone’s mind. So try to create positive first impression which will somewhat smoothen the path.

The beauty contest has created way for many contestants into modeling and film industry. Miss India 1994 Aishwarya Rai is a well known name in film industry. Yukta Mookhey, Neha Dhupia, Gul Panag, Sangeeta Bijlani, Nafisa Joseph and many more vent in the industry only after participating in Miss India, Miss world, Miss Universe contests.

Quick tips for Miss India

Physical Appearance is important. A good dressing sense will definitely work for you but there is lot of other points on which you should work hard. They are-

Instill self-confidence. Confidence is the quality which helps you achieve big targets and gives a starry shine to your personality.

Prepare well for question-answer round and quick short interview. The panel of judges expects a short, crisp and sensible answer from contestant.

Leadership skills are also sought for in contestants.

Interview skills, on-stage questions, bio sheets and total imaging are very important to learn for an aspirant.

Go to a good training institute or trainer who will assist the aspiring Miss India in paperwork, photos and wardrobe, public speaking skills, self-confidence and on-stage presence.

Keep stress away from yourself. Practicing yoga, pranayam, calisthenics and agility drills will help keeping you in good shape.

A well balanced diet should necessarily be combined with exercise. This all will not only enhance your beauty but also make you energetic.

Many Institutes in India has dedicated programme for preparing the young ladies coming in for beauty contests. Get groomed and be confident! This is the key to success!

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How to Treat Adult Acne

Acne vulgaris (commonly called acne) is a common skin condition, caused by changes in the pilosebaceous units. These units are skin structures consisting of a hair follicle and a sebaceous gland. The changes occur as a result of increased sebum production via testosterone stimulation. Both men and women have varying amounts of testosterone. Acne is most common during adolescence, affecting more than 85% of teenagers, and frequently continues into adulthood. This type of acne affects the areas of skin with the largest amount of sebaceous follicles. These areas include the face, the upper part of the chest, and the back. Whenever acne becomes inflammatory it can damage the skin by destroying the collagen. For most people, acne diminishes over time and tends to disappear-or at the very least decrease-after one reaches one’s early twenties. There is, however, no way to predict how long it will take to disappear entirely, and some individuals may continue to suffer well into their thirties, forties and beyond.

Patients may be surprised to learn that development of acne vulgaris in later years is actually quite uncommon. True acne vulgaris in an adult woman may be a feature of an underlying condition such as pregnancy and disorders such as polycystic ovary syndrome or the rare Cushing’s syndrome. It is also known that menopause-associated acne occurs as production of the natural anti-acne ovarian hormone oestradiol fails at menopause. The lack of oestradiol also causes thinning hair, hot flashes, thin skin, wrinkles, vaginal dryness, and predisposes to osteopenia and osteoporosis as well as triggering acne (known as acne climacterica). So what is adult acne and why does it occur in later life? Why does it also seem to affect mostly women and occur around the mouth area where there are fewer pilosebaceous units? In fact why does it last for years and not respond to the normal treatments such as Benzoyl peroxide or Salicylic acid 2% (Acnesal) products. I would also ask why is it so common and bothersome for so many people?.

Is adult acne really acne?

I think these effects happen because what we call adult acne is probably a totally different disease. Several factors are known to be linked to acne, including the tendency for the condition to run in families and exposure to certain chemical compounds such as dioxins. Remember the thirties are the decades of rosacea and what we see is often a different disease called perioral dermatitis masquerading as adult acne. Many GPs also call this acne and treat it the wrong way. Stress, through increased output of hormones from the adrenal (stress) glands causes outbreak of the condition. While the connection between acne and stress has long been debated, scientific research indicates that “increased perioral dermatitis” is “significantly associated with increased stress levels.

So what exactly is perioral dermatitis?

Perioral dermatitis is a condition closely related to acne vulgaris that affect young women between the ages of twenty and forty five. Occasionally men or children are affected. Perioral refers to the area around the mouth, and dermatitis indicates redness of the skin. In addition to redness, there are usually small red bumps or pus bumps, and mild peeling. Sometimes the bumps are the most obvious feature, and the disease can look a lot like acne. The areas most affected are within the borders of the lines from the nose, to the sides of the lips, and the chin. There is frequent sparing of a small band of skin that borders the lips. The skin lesions can affect the area around the eyes. It is not uncommon, and has a tendency to recurrence in individuals who have had it once. This condition is often related to stress and become common in summer time as it acts like rosacea, becoming worse with sunlight exposure. Sometimes there is mild itching or burning.

How long does it last?

If not treated, perioral dermatitis may last for months to years. Even if treated, the condition may recur several times, but usually the disorder does not return after successful treatment.

What causes perioral dermatitis?

The cause of perioral dermatitis is unknown. We know it is a neurodermatis and hence related to stress. Some dermatologists believe it is actually a form of rosacea or sunlight-worsened seborrheic dermatitis. We know that strong corticosteroid creams applied to the face can cause perioral dermatitis. Once perioral dermatitis develops, corticosteroid creams seem to help, but the disorder reappears when treatment is stopped. In fact, perioral dermatitis usually comes back even worse than it was before use of steroid creams. Some types of makeup, moisturizers, and dental products may be partially responsible. There is also a suspicion that fluorinated toothpastes are related to an outbreak of this condition.

Can it be prevented?

There is no guaranteed way to prevent perioral dermatitis. Do not use strong prescription strength corticosteroid creams on the face. Your dermatologist may have suggestions about the use of moisturizers, cosmetics, and sunscreens, and may advise against using toothpaste with fluoride, tartar control ingredients, or cinnamon flavouring.

Are laboratory tests needed to diagnose the problem?

Most of the time, no tests are necessary. A dermatologist can usually make an accurate diagnosis by just examining the skin. Sometimes, scraping or a biopsy of the skin is done. Occasionally, blood tests are ordered to eliminate other conditions that can look similar.

How is this condition treated?

Dermatologists tend to use oral antibiotics, similar to the ones we use in Rosacea to treat the condition. This means a patient would require taking doxycycline or tetracycline for minimum of 3 months to prevent recurrence. For milder cases or pregnant women, topical antibiotic creams may be used. Occasionally, your dermatologist may recommend a specific corticosteroid cream, just for a short time to help your appearance while the antibiotics are working.

Is this similar to the treatment of acne?

Yes and no. I suppose systemic antibiotics are a mainstay in the treatment of ordinary acne vulgaris. Some of these antibiotics, such as Doxycycline (ByMycin) and Minocycline (Minocin) have anti-inflammatory properties and generally more effective than tetracycline. However, resistance is becoming more common and other antibiotics, including Trimethoprim (Septrim) are reportedly more helpful in acne than perioral dermatitis. Roaccutane (Isotretinoin) is a systemic retinoid that is highly effective in the treatment of severe acne vulgaris. It does this as it depresses sebum excretion by 70%, is anti-inflammatory, and even reduces the presence of acne bacteria. I do not tend to use it with perioral dermatitis as the basis of the condition is not sebum related. Roaccutane is a teratogenic and pregnancy must be avoided. A negative pregnancy test result is required prior to the initiation of therapy. A doctor will also check your cholesterol and liver tests monthly.

Are lasers of any value?

Lasers that use Photopneumatic™ technology such as the PPx and Isolaz has little use treating this condition as the underlying problem is not related to an increase in sebum However IPL (as used in Rosacea) appears to be of some benefit in controlling the condition.

What can be expected with treatment?

Most patients improve within two months of oral antibiotics. If corticosteroid creams were used for treatment, there may be a flare-up when the creams are stopped. If antibiotic treatment is stopped too early, however, the problem can come back.

Are there any other treatments?

There are many OTC products available for the treatment of acne, many of which are without any scientifically-proven effects. Generally speaking, successful treatments show little improvement within the first two weeks, instead taking a period of approximately three months to improve and start flattening out. Many treatments that promise big improvements within two weeks are likely to be largely disappointing. However, short bursts of cortisone can give very quick results to ordinary acne but are not recommended for this condition. .

Topical bactericidals

Topical bactericidal products containing benzoyl peroxide may be used in mild to moderate acne. The gel or cream containing benzoyl peroxide is rubbed, twice daily, into the pores over the affected region. Bar soaps or washes may also be used and vary from 2 to 10% in strength.

I normally do not recommend benzoyl peroxide to be used in this condition as it is a keratolytic (a chemical that dissolves the keratin plugging the pores) and the primary problem is not due to blocked pores. Other antibacterials with less keratolytic effects include triclosan, or chlorhexidine gluconate.

Topical antibiotics

These include ointments such as erythromycin, clindamycin or tetracycline. They act by killing the bacteria that are harboured in the follicles. While topical use of antibiotics is equally as effective in ordinary acne as oral use, I do not find them as effective in this condition. However, sometime I use Rozex and Metrogel (metronidazole) in much the same way I would treat a Rosacea patient.

Hormonal treatments

In females, ordinary acne can be improved with hormonal treatments. The common combined oestrogen/progestogen pill has some effect, but the antiandrogen, cyproterone in combination with an oestrogen (Dianette) is particularly effective at reducing androgenic hormone levels. Most patients with adult acne are too old to use this drug so it is not generally used

Topical retinoids

This group of medications are used to normalise the follicle cell lifecycle. They include brands such as tretinoin (brand name Retin-A), adapalene (brand name Differin), and tazarotene (brand name Tazorac). Like isotretinoin, they are related to vitamin A, but they are administered as topicals and generally have much milder side effects. They can, however, cause significant irritation of the skin and I never use them in this condition.

Phototherapy

It has long been known that short term improvement can be achieved with blue and red light. Recently, visible light has been successfully employed to treat acne (phototherapy) – in particular intense violet light (405-420 nm) generated by purpose-built fluorescent lighting, LEDs or lasers used twice weekly has been shown to reduce the number of acne lesions by two thirds. It is even more effective when applied daily. The mechanism appears to be that a porphyrin produced within P. acnes generates free radicals when irradiated by 420 nm and shorter wavelengths of light. These free radicals ultimately kill the bacteria.

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