Anti-Acne Products Flashcards
Common dermatological disorder of the pilosebaceous unit
Acne
T/F: Acne is not a disease condition
False
T/F: Before it becomes a full blown acne it can be managed in part by using cosmetic products
True
What are the major contributing factors to acne development?
Sebum, androgens, hyperkeratinization, Propionibacterium acnes, Inflammation (immune responses)
T/F: Usually acne is in part triggered by excess sebum production
True
T/F: When our sebaceous glands hyporeact, there is increase sebum production
False. Hyper react
This is a contributing factor, a hormone that commonly starts with puberty
Androgens
T/F: Hyperkeratinization is a normal process
False. Keratinization is a normal process
Process where forming of the skin cells. They are gradually going up into the epidermis eventually being sloughed off
Keratinization
T/F: With hyperkeratinization formation of skin cells becomes faster and yet they are not being sloughed off. There is a tendency for the skin cells to clog the skin pores
True
Main causative agent associated with acne development
Propionibacterium acnes (P. acnes)
T/F: Common immune response manifest itself in the form of inflammation
True
Identify the Pathogenesis Stage of Acne:
Hyperkeratosis and increased corneocyte cohesiveness in the upper sebaceous follicle, which lead to microcomedo formation
Early comedo
Identify the Pathogenesis Stage of Acne:
Androgen stimulation of sebum production
Early comedo
Identify the Pathogenesis Stage of Acne:
Accumulation of shed keratin and sebum
Later comedo
Identify the Pathogenesis Stage of Acne:
Formation of whorled lamellar concretions
Later comedo
Identify the Pathogenesis Stage of Acne:
Comedo may be closed (no obvious follicular opening) or open (dilated follicular opening; keratin plug darkens due to oxidized lipids & melanin)
Later comedo
Identify the Pathogenesis Stage of Acne:
Propionibacterium acnes proliferation, which upregulates innate immune responses (e.g. via TLRs)
Inflammatory papule/pustule
Identify the Pathogenesis Stage of Acne:
Mild inflammation (primarily neutrophils), which increases upon rupture of the comedo wall
Inflammatory papule/pustule
Identify the Pathogenesis Stage of Acne:
Sebaceous lobule regression
Inflammatory papule/pustule
Identify the Pathogenesis Stage of Acne:
Marked inflammation (primarily T cells)
Nodule/cyst
Identify the Pathogenesis Stage of Acne:
May lead to scarring
Nodule/cyst
○ Not visible by the naked eye because of its small size
○ Occurs under the skin
○ Caused by androgen stimulation of sebum production
Microcomedo
Consists of open and closed comedones, which are not inflamed and red because follicle walls are intact
Non-inflammatory Lesions
● Known as open comedones
● Follicles that have wider opening filled with sebum and dead cells
Blackheads
T/F: the dark color of the blackhead is caused by exposure of the top of the comedo to oxidization
True
● Known as closed comedones
● Follicles opening is closed and have normal skin color
● More likely to progress into inflammatory lesion
Whiteheads
Closed comedo becomes larger and packed due to debris and inflammation from P. acnes. When follicle ruptures, white blood cells and red blood cells migrate to contain rupture, and lesions turn red.
Inflammatory Lesions
Primary inflammatory lesions; small, raised, usually red, and tender bumps under the skin
Papules
Also called pimple; red tender bumps with white pus at the tip
Pustules
Deep lesions that are hard to touch, more painful, and deep red or purple of in color
Nodule
Large pus-filled lesions resulting from severe inflammatory reaction. Can result to scarring of acne
Cyst
T/F: The grading of acne is based on severity, including number of comedones, inflammatory lesions, total lesion count, and cysts
True
Grade of acne: limited to face, and characterized by presence of non-inflammatory closed and open comedones with few inflammatory lesions
Mild acne
Grade of acne: increased number of inflammatory papules and pustules on the face and affects other body parts (Common examples such as: back, chest, shoulders)
Moderate acne
Grade of acne: presence of nodules and cysts; facial lesions accompanied by widespread disease on the neck, chest, and back
Severe acne
Identify the topical treatment
Non-antibiotic antimicrobial agent that kill bacteria by producing reactive oxygen species within clogged pores
benzoyl peroxide
Identify the topical treatment
Increases cell turnover, cleans pores, desquamates skin, and has anti-inflammatory properties
benzoyl peroxide
Identify the topical treatment
Mainstay treatment of mild to moderate acne, in combination with antibiotics and/or retinoids
benzoyl peroxide
Identify the topical treatment
Topical OTC products at 2.5-10% concentration as creams, gels, lotions, and facial wash
benzoyl peroxide
Identify the topical treatment
Side effects include peeling, dryness, burning, and redness of the skin
benzoyl peroxide
Identify the topical treatment
Irritation resolves with continued use during 1st month of treatment
benzoyl peroxide
Identify the topical treatment
Desquamating and comedolytic properties. Less potent and better tolerated than topical retinoids
salicylic acid
Identify the topical treatment
OTC products at concentrations of 0.5-2% as lotions, creams, foams, facial wash gels, toners, and cleansing pads
salicylic acid
identify the topical treatment
May cause skin dryness, redness, scaling, itching, and burning. Couple the use of these agents with sunblock/sunscreen
salicylic acid
Identify the topical treatment
Available as creams, masks, ointments, and soap bars
Resorcinol and sulfur
identify the topical treatment
Vitamin A derivatives that normalize abnormal desquamation in sebaceous follicles, decrease coherence of follicular keratinocytes, and prevent formation of new microcomedones
topical retinoids
identify the topical treatment
Maybe used as monotherapy for the management of mild noninflammatory comedonal acne with maximum benefit after 3-4 mos., and as maintenance therapy
topical retinoids
identify the topical treatment
tretinoin, adapalene, tazarotene
topical retinoids
identify the topical treatment
Prescription drug available as cream, gel, liquid, and microsphere formulations
topical retinoids
identify the topical treatment
May cause transient skin irritation, burning sensation, redness, itching, and peeling. Negative effects can be prevented by using lower concentration of active ingredients or modifying the vehicle. Used according to its directions
topical retinoids
T/F: In topical retinoids, liquid vehicle would be more irritating (especially if alcohol based)
True
identify the topical treatment
Used for mild or moderate acne with inflammatory lesions. Include clindamycin and erythromycin
topical antibiotics
identify the topical treatment
With bacteriostatic and anti-inflammatory properties
topical antibiotics
identify the topical treatment
Available as gels, creams, lotions, foams, toners, and pads
topical antibiotics
identify the topical treatment
Combined with benzoyl peroxide (minimize bacterial resistance) and retinoids (synergistic comedolytic and anti inflammatory properties)
topical antibiotics
identify the topical treatment
Alternative to retinoids; with comedolytic, antimicrobial, and anti-inflammatory properties
azelaic acid
identify the topical treatment
Part of the annex that list the ingredients that are not allowed for use in cosmetics. They are categorized as OTC drugs usually
azelaic acid
identify the systemic treatment
With antimicrobial and anti-inflammatory effects. Include doxycycline, minocycline, tetracycline, and erythromycin
oral antibiotics
identify the systemic treatment
May cause upset stomach, dizziness, or skin discoloration
oral antibiotics
it is an oral antibiotic that can cause sun sensitivity
doxycycline
it is an oral antibiotic that can cause teeth discoloration
tetracycline
it is an oral antibiotic that can cause hyperpigmentation
minocycline
identify the systemic treatment
Adjunct therapy in women with moderate to severe acne. Reduces and/or prevents outbreaks, but not effective for existing lesions
hormonal therapy
this form of hormonal therapy suppress ovarian androgen production
combination oral contraceptives
this form of horomonal therapy block effect of androgens on the sebaceous gland
androgen receptor blockers
examples of androgen receptor blockers
spironolactone, cyproterone, and flutamide
identify the systemic treatment
Used as adjunct therapy in combination with topical retinoids
hormonal therapy
identify the systemic treatment
May cause headache, breast tenderness, nausea and depression; increased risk of heart disease, high blood pressure, and blood clots
hormonal treatment
identify the systemic treatment
Oral retinoid for the treatment of moderate to severe acne that does not respond to other treatments
isotretinoin
T/F: isotretinoin is used as a first-line oral retinoid
False. It is used as a last resort
identify the systemic treatment
Targets all major components in acne development, and may be used as monotherapy
isotretinoin
identify the systemic treatment
May cause dryness of the skin, eyes, mouth, lips, and nose; itching; nosebleeds; muscle aches; sun sensitivity; and poor night vision
isotretinoin
identify the systemic treatment
May increase levels of triglycerides and cholesterol in the blood, and increase liver enzyme levels
isotretinoin
identify the systemic treatment
May cause malformation of developing fetus (teratogenic). When using this, make sure the patient is not pregnant or no plans in being pregnant
isotretinoin
identify the treatment, other than topical or systemic
AHAs desquamate the SC and give a smoother appearance
chemical peels
this is a chemical peel that has moderate growth inhibitory and bactericidal effect on Propionibacterium acnes
glycolic acid
identify the treatment, other than topical or systemic
By squeezing with fingertips and using a comedone extractor
comedo extraction
identify the treatment, other than topical or systemic
Include broad-spectrum continuous-wave visible light, intense pulsed light, pulsed dye lasers, photodynamic therapy (PDT), and pulsed diode laser
optical therapies
T/F: optical therapies should be used intermittently
True
identify the treatment, other than topical or systemic
Include herbal ingredients like aloe vera, fruit-derived acids, and tea tree oil
herbal and alternative therapies
identify the treatment, other than topical or systemic
avoiding oily foods, reducing chocolates, reducing dairy consumption, and not eating nuts
dietary restriction
Bonus question: Who has a perfect, glass skin and has a very glowing skin everyday?
Andre Martin E. Marapao
