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| Seborrheic dermatitis
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Definition:
Flaking is a symptom of seborrheic dermatitis. Joseph Bark notes that
"Redness and itching is actually seborrheic dermatitis, and it
frequently occurs around the folds of the nose and the eyebrow areas,
not just the scalp.
Symptoms:
Dry, thick, well-defined lesions consisting of large, silvery scales may
be traced to the less common psoriasis of the scalp.
Causes:
Seasonal changes, stress, and immuno-suppression seem to affect
seborrheic dermatitis.
Treatment:
Soaps and detergents such as Sodium Lauryl Sulfate may precipitate a
flare-up, as they strip moisture from the top layers of the skin, and
the drying property of these can cause flare-ups and may worsen the
condition. Accordingly a suitable alternative should be used instead.
Among dermatologist recommended treatments are:
►Shampoos containing coal tar, Ketoconazole e.g. Ketoderm cream,
selenium sulfide, or zinc pyrithione.
►For severe disease, keratolytics such as salicylic acid e.g.
Sorana
ointment or coal tar preparations may be used to remove dense scale.
►Topical terbinafine solution (1%) has also been shown to be effective
in the treatment of scalp seborrhea.
►Lotions containing alpha hydroxy acids or corticosteroids.
►Chronic treatment with topical corticosteroids may lead to permanent
skin changes, such as atrophy and telangiectasia.
►UV-A and UV-B light inhibit the growth of M. furfur, although caution
should be taken to avoid sun damage. |
| Acne vulgaris |
Definition:
Acne is an inflammatory disease of the skin, caused by changes in the pilosebaceous units . Acne lesions are commonly referred to
as pimples, spots or zits.
Causes:
It is considered an abnormal response to normal levels of the male
hormone testosterone. The condition is most common in puberty and the
response for most people diminishes over time and acne thus tends to
disappear, or at least decrease, after one reaches their early twenties.
The pilosebaceous unit (PSU) of the skin consists of the sebaceous gland
and the hair follicle.
The sebaceous gland secretes an oily substance called sebum which
protects the hair and skin and prevents them from drying and irritation.
Sebum may collect excessively as a result of:
►Poor hygiene
►Genetic predisposition
►Diet
►Use of anabolic steroids
►Hormonal activity, such as menstrual cycles and puberty.
►Hyperactive sebaceous glands, secondary to the three hormone sources
above.
►Accumulation of dead skin cells.
►Bacteria in the pores, to which the body becomes 'allergic'.
►Skin irritation or scratching of any sort will activate inflammation.
►Stress, through increased output of hormones from the adrenal (stress)
glands.
►Any medication containing halogens (iodides, chlorides, bromides),
lithium, barbiturates, or androgens.
►Exposure to high levels of chlorine compounds, particularly chlorinated
dioxins, can cause severe, long-lasting acne, known as
Chloracne.
Symptoms:
Overproduction of sebum is related to the disease called acne or
commonly pimples. Commonly involved areas are the face, neck, chest,
shoulders and upper back.
During an acne breakout, the pore of the hair follicle is plugged by a
mixture of sebum and cells that line the hair follicle. The trapped
sebum allows bacteria to grow in the plugged follicles. This forms the
primary acne lesion called a comedone. There are of 2 types of
comedones, whiteheads and blackheads. At times, these may develop into
an infection in the skin pore (pimple).
Whiteheads: When the sebum and bacteria stay below the skin surface, a
whitehead is formed.
Blackheads: Occurs when the trapped sebum and bacteria partially open to
the surface and turn black due to melanin, the skin's pigment.
Severe acne can produce hundreds of pimples that cover large areas of
skin. Cystic lesions are pimples that are large and deep. These lesions
are often painful and can leave scars on your skin.
It can last for a few months, many years, or come and go your entire
life.
These conditions need treatment along with the acne.
Aside from scarring, its main effects are psychological, such as reduced
self-esteem and depression or suicide.
Timeline of acne treatment:
The history of acne reaches back to the dawn of recorded history. In
Ancient Egypt, it is recorded that several pharaohs were acne sufferers.
From Ancient Greece comes the English word 'acne' (meaning 'point' or
'peak'). Acne treatments are also of considerable antiquity:
Ancient Rome : bathing in hot, and often sulfurous, mineral water was
one of the few available acne treatments. One of the earliest texts to
mention skin problems is De Medicina by the Roman writer Celsus.
1800s: Nineteenth century dermatologists used sulphur in the treatment
of acne. It was believed to dry the skin.
1920s: Benzyl Peroxide is used
1930s: Laxatives were used as a cure for what were known as 'chastity
pimples'
1950s: When antibiotics became available, it was discovered that they
had beneficial effects on acne. They were taken orally to begin with.
Much of the benefit was not from killing bacteria but from the
anti-inflammatory effects of tetracycline and its relatives. Topical
antibiotics became available later.
1960s: Tretinoin (original Trade Name Retin A) was found effective for
acne. This proceeded the development of oral Isoretinoin (sold as
Accutane and Roaccutane) since the early 1980s.
1990s: Laser treatment introduced
2000s: Blue/red light therapy
Some old treatments, like laxatives, have fallen into disuse but others,
like spas, are recovering their popularity.
Treatment includes:
►Keratolytics (e.g.
Sorana ointment)
►Antibiotics (Erythromycin tablets)
►Retinoids
►Isoretinoin in severe cases
►Hormone Therapy
►Spiromide
(spironolactone) for women
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