Pimples, blackheads, and whiteheads oh my

What is acne?

Acne (acne vulgaris, common acne) is a disease of the hair follicles of the face, chest, and back that affects almost all teenagers during puberty.  Acne is primarily a hormonal condition driven by male or ‘androgenic’ hormones, which typically become active during the teenage years. Sensitivity to such hormones, combined with bacteria on the skin, and fatty acids within oil glands, cause acne.

Acne appears on the skin as

  • blackheads or whiteheads as a result of occluded pores known as comedones

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  • tender red bumps also known as pimples or zits
  • pustules
 <b>Pustules</b>

 

  • Cysts which are deep pimples or boils.

How Is Acne Treated?

Three types of drugs have proven to be effective for the treatment of acne — benzoyl peroxide, retinoids, and antibiotics. Most people require at least one or two agents, depending on the severity of their acne.

  1. Benzoyl peroxide, available as an over-the-counter product (for example, Clearasil, Stridex) and by prescription (for example, Benoxyl, PanOxyl, Persagel), targets surface bacteria, which often aggravate acne. Irritation (dryness) is a common side effect.
  2. Retinoids (vitamin A derivatives), for example, Retin-A, Differin, Tazorac, treat blackheads and whiteheads, the first lesions of acne. The most common side effect is irritation.
  3. Antibiotics, either topically applied to the skin (clindamycin, erythromycin), or taken orally (tetracycline and its derivatives) control surface bacteria and reduce inflammation in the skin. Antibiotics are more effective when combined with benzoyl peroxide or retinoids. The oral retinoid isotretinoin, Accutane, is reserved for people with severe (nodular or cystic) disease. Isotretinoin shrinks the size of oil glands, the anatomic origin of acne. Without active, plump oil glands, acne actively diminishes. Side effects can include dry skin, elevated cholesterol and triglycerides, and birth defects. Women of childbearing age must practice birth control before, during, and after treatment (often a year) with isotretinoin. The use of isotretinoin requires rigorous testing (cholesterol, pregnancy) and follow-up for the prescribed period (5 months). It is reserved for the most severe types of acne that do not respond to other treatments.
  4. Hormone therapy may be helpful for some women with acne, especially for those with signs and symptoms (irregular periods, thinning hair) of androgen (male hormone) excess. The hormone therapy consists of low-dose estrogen and progesterone (birth control pills).

How Can Acne Be Prevented?

To prevent acne and reduce its damage to your skin, follow these tips.

  • Choose a cleanser specially formulated for acne. These products often contain salicylic acid or benzoyl peroxide, which help to clear acne sores.
  • Clean your face gently, as trauma to the acne breakouts may worsen the acne or cause scarring. When washing your face, use your hands, as any terrycloth or other scrubbing material may cause acne sores to rupture.
  • If you need to use a moisturizer, use only light, noncomedogenic moisturizers, which do not aggravate acne. This type of product may be your best option.
  • If you are a woman, use an oil-free foundation. Heavy makeup or other cosmetic products that block pores may cause a flare-up of acne.

 

Generic vs Brand name medication: The choice is clear.

Generic medications are copies of brand-name medications that  have exactly the same dosage, intended use, effects, side effects, route of administration, risks, safety, and strength as the original medication. In other words, their pharmacological effects are exactly the same as those of their brand-name counterparts. The Federal Drug Administration, FDA, requires that generic medications work as fast and as effectively as the original brand-name products. Generic versions of a medication have different colors, flavors, or combinations of inactive ingredients than the original medications. Trademark laws in the United States do not allow the generic medications to look exactly like the brand-name preparation, but the active ingredients must be the same in both preparations, ensuring that both have the same medicinal effects.

An example of a generic medication that is often used to treat diabetes is metformin. A brand name for metformin is Glucophage. Brand names are usually capitalized while generic names are not. Another generic drug used for hypertension is metoprolol. A brand name for the same drug is Lopressor.

The concern I here most from patients is whether the generic medications are as effective as the brand name. The Federal Drug Administration requires that generic medications be as safe and as effective as brand-name medication. The cost of generic medication can be substantially less than there branded counterparts. This saving can help many of our seniors from having to choose their medication or other essentials in their daily lives. Rest assured that the quality and effectiveness of your generic medication has not been compromised.
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Generic medications are only cheaper because the manufacturers have not had the expenses of developing and marketing a new drug. It is very expensive to bring a new drug onto the market. The generic companies do not have to spend substantial money on research, development, marketing and promotion of the medication. Thus the saving is passed to the consumer.

So there is no truth in the myths that generic medications are manufactured in poorer-quality facilities or are inferior in quality to brand-name medications. The FDA applies the same standards for all drug manufacturing facilities, and many companies manufacture both brand-name and generic medication. In fact, the FDA estimates that 50% of generic drug production is by brand-name companies.

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