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Posts Tagged ‘accutane’

Sometimes, when you get to the basic chemistry of stuff, you will always find the same basic building blocks. So, for example, when you look at most of the basic food and drinks on the market, most of them rely on corn. This is heavily subsidized by the government and so allows us to eat high-calorie food for little money. By the way, the subsidy is why you can buy a mountainous burger for less than the cost of most fresh vegetables. Well, it’s the same with almost all the lotions, gels and creams sold over the counter in drugstores to treat acne. The standard ingredient is benzoyl peroxide. Why is this one ingredient so important?

The bacteria that causes acne lives on the surface of your skin. Under normal circumstances, being exposed to the air keeps their numbers down. But if the glands under your skin start to produce too much oil, the pores will slowly fill with dead skin cells. This creates a warm, dark place where there’s no oxygen. This is a perfect breeding ground for the bacteria. Benzoyl peroxide removes the layer of dead skin cells from the surface and opens up the pores. Once the air is able to get into the pores, the growth of the bacteria is reduced. Over time, if you only have a mild outbreak, the skin will return to normal. With moderate to severe outbreaks, benzoyl peroxide will usually prevent the problem from spreading.

The main advantage of this chemical is that you can buy it as a solution. This is really cheap. Most of the research shows there’s little to choose between the basic chemical and all the branded products over time, i.e. at the end of three months, there’s no real difference in the effectiveness. But some of the combinations work more quickly. So, if you decide to buy one of the products containing benzoyl peroxide, all the extra money does is buy you a few days of looking better. There’s some new research showing the combination with adapalene works faster over three months, no matter how bad the outbreak.
The importance of this research is that it involves almost 4,000 participants. This is an impressive effort. Unfortunately, the design does not give it full credibility, i.e. it’s not a double-blind trial and no placebo was used. The participants were divided into groups. Each group received adapalene, benzoyl peroxide, the combination as a lotion, or a gel as the delivery method. The researchers found the combination as a lotion produced the best results. Some 500 participants dropped out, most complaining about dry skin. This is a standard problem with benzoyl peroxide when starting out the treatment. Using a moisturizer is best.

Topical medications, i.e. that you rub on to the skin, are the best approach to skin problems. The active ingredients are delivered to and absorbed by, the areas immediately affected. But the strength of benzoyl peroxide is limited. It cannot “cure” the more serous outbreaks of acne. For those, you need to add an antibiotic or move up to Accutane. However, given the difficulties in using this drug, you should always give a fair trial to all the alternates before moving up to Accutane. Hopefully, you can avoid the need to rely on this powerful drug.

Let’s start off with a definition of a myth. Essentially, it’s a lie we tell ourselves to hide our fear. Suppose we’re frightened of lightning. No problem! We’ll invent a god who walks around the sky and, if he gets upset with anyone, he lets go a bolt or two. Why is this a good idea? As a priest in this new religion, all you have to do is keep the god happy by worshiping, giving me offerings and buying my comic books. So long as the god is happy, you will then be safe. No more fear! Thor rocks! Now let’s apply this to acne. As parents, we feel the need to prepare our children for all the bad stuff that’s likely to happen to them. So we tell them the story of acne. This is a disease so terrible that most affected end up looking like a toad with warts – obviously you want to keep the fear to Disney animation level so mention Princes turning into them and Princesse Fiona secretly being a green-skinned ogre at night. All this recognizes the new social reality. Only those with a perfect skin are acceptable. Everyone else is out of the magic circle in school and only allowed to mix with goths and nerds. To cushion the blow of having unattractive friends, we then tell them the really big lie – that they soon grow out of it and it will never affect them as adults.

The current estimate is that about 15% of the adult population suffers acne. That’s millions of people. Fortunately, the majority of sufferers are women and there’s a big market for selling concealer makeup, i.e. heavy foundation creams and a powder to put on top. Even metrosexual men are reluctant to wear obvious makeup. So why is acne affecting more adults? Here we get into yet more myths as self-appointed experts muscle their way on to television and radio stations to sell their miracle products or latest book detailing Obama’s acne and his loss of popularity. Their explanations range from too much stress in our lives to the diet we eat. This would be helpful if there was any scientific evidence to link either stress or diet to acne. Except there’s no such evidence. It’s all just more myths.

So what can or should we do as adults. For men, washing twice a day with an unmedicated soap is enough to clear the pores. If you want a cheap alternative to soap, use benzoyl peroxide in small amounts. Using too many products to clean your skin can dry it out and make acne harder to beat. For general health and the improvement of your skin, you should also drink less alcohol, quit smoking and avoid a smokey atmosphere. For women, using an oral contraceptive can reduce the hormone level. If this is not acceptable on moral grounds, then the usual self-help approaches to keeping the skin clean are the best. If all else fails and your appearance is so important, Accutane is available. As a woman, remember to take the strongest possible measures to prevent pregnancy. There’s very clear evidence Accutane does cause birth defects in the majority of cases. No one can pass this medical consequence off as a myth.

Thanks to Sarah Palin, we can now put verbs on either side of “baby” and still make perfect sense. In this case, we consumers all want there to be thousands of attorneys around to protect our interests when capitalist corporations sell us products that injure us. It can be a car that just will not stop no matter how hard we put our foot on the brake or a tomato that tries to kill us with salmonella. Just recently, even though we’re nowhere near Thanksgiving, 36 million pounds of turkey meat had to pulled from supermarket freezers around the country because it was dangerous. Cargill’s factory, where the meat was processed, has been closed down. Without attorneys to sue and get damages to cover the cost of our medical treatment, loss of earnings, and so on, we would pay for the product and then pay for our losses. Attorneys are wonderful human beings who deliver a great social service. Unless, that is, you listen to the GOP. To Republicans, attorneys are the spawn of the Devil who threaten to put good profit-earning companies out of business. The right wing believes attorneys are out of control and there must be limits placed on our right to sue those who injure us.

This is particularly hotly debated when it comes to the medical profession and the drugs they prescribe. The GOP wants limits on claims of professional negligence, and even suggests restricting the right to sue should people be injured by drugs or medical devices approved by the FDA. As to the latter, the argument goes that the FDA rigorously tests drugs and devices, and only licenses those that help more than harm patients. On the other side of the fence, we’ve recently had some interesting cases where attorneys have argued patients should be allowed to sue even though they ignored all the safety warnings in the leaflets sent out with the drugs. In one case, the patient acted as a complete idiot and not only took an outrageously high dose but did so for nearly a year. When he found the drug had damaged his stomach, he persuaded an attorney to sue. No one, he argued, can be expected to read and understand warnings put out by manufacturers. Everyone should be allowed to self-medicate and then sue if it goes wrong. Attorneys, you gotta love ‘em – always prepared to take on hopeless cases, gambling there will be prejudiced juries prepared to award damages against pharmaceutical companies.

All of which brings us to Accutane. There have been some cases involving celebrities who, fearing they would no longer be considered beautiful people, used the drug excessively and then tried to complain. At this point, we should note some of the research from outside the US which finds this drug effective and perfectly safe if taken at low dosage. The trials have lasted for up to a year without there being any adverse side effects. So the moral of all this should be clear. Follow the foreign research, take very low doses of Accutane and your acne will disappear. Abuse the drug by taking too much for too long and you will end up with serious problems. Fortunately, if you are injured, there will always be attorneys prepared to take on your case.