Adult Acne

Source: http://www.acnecuresrevealed.net/adult-acne.php

Adult Acne

Adult acne is a more common occurence than you may think. So you really don't have to be all that embarrassed or feel unprofessional if you happen to suffer from it. For years, many of us have suffered from the misconception that once you hit 18 or may 21 for that matter, your acne will magically disappear, it will magically go away. And when we hit adulthood, we want it to go away, we don't want to look like an overgrown teenager, especially when we obtain more serious careers.

But the simple fact is that your hormones don't automatically die down, in fact they are likely to rise up again in times of stress and for that matter during certain life experiences such as menopause and pregnancy for women. And in some cases, adult acne is actually more severe than teenage acne, though in other cases while still present, it lessens in general severity.

The second most common misconception about adult acne is the idea that you need a specialized treatment. The treatments you used as a teenager are no longer good enough, and you need something that is possibly even harsher and more damaging to the skin, causing redness, peeling, and other symptoms that are just as embarrassing in some ways than the acne itself.

Adult acne in some ways is no different than teenage acne. Unless you have something such as acne rosacea or acne conglobata, the treatments are EXACTLY THE SAME. Believe it or not, your body may seem different, but your hormones for the most part are not if you happen to suffer from adult acne. So don't resort to harsher treatments, definitely don't resort to something like a chemical peel which can easily do irreparable damage to the skin and even disfigure you in some ways.

Instead, use natural and gentle treatments. They are actually some of the most effective treatments for any kind of acne vulgaris. A classic example of this would be tea tree oil. It is generally a little bit more expensive. But it has been shown to be just as effective as benzoyl peroxide. But it actually nourishes your skin, softens it, and it causes no side effects at all according to clinical studies, except in the cases of allergic reaction, which applies to any acne treatment or ingredient in general.

With this in mind, a less expensive and yet still effective alternative would be either salicylic acid or witch hazel. Both of these work in different ways, salicylic acid by peeling away dead skin cells increasing cell turnover and witch hazel as an astringent. But nonetheless, both are extremely effective, common, and extremely affordable. These are treatment options you can find just about anywhere.

Either way, if you suffer from adult acne, you don't have to panic. In fact, though scarring is more likely if you for example pop your zits, there are perfectly natural and appropriate ways to deal with it. You just have to take a realistic approach and most of all, be educated about the adult acne!

Psoriasis - Specific locations: scalp

Specific locations: scalp

At least half of all the people who have psoriasis have it on their scalp.

Scalp psoriasis can be very mild, with slight, fine scaling. It can also be very severe with thick, crusted plaques covering the entire scalp. Psoriasis can extend beyond the hairline onto the forehead, the back of the neck and around the ears.

Other skin disorders, such as seborrheic dermatitis, may look similar to psoriasis. However, scalp psoriasis appears powdery with a silvery sheen, while seborrheic dermatitis appears yellowish and greasy.

Treating scalp psoriasis

Treatments are often combined and rotated because a person’s psoriasis may become less responsive to medications after repeated use. Systemic treatments are not commonly used just for scalp psoriasis but may be used if psoriasis is present elsewhere on the body and/or the psoriasis is moderate to severe.

Mild scalp psoriasis

Tar products and salicylic acid are generally sufficient for treating very mild scalp psoriasis.

Many coal tar and non-coal tar medicated shampoos for treating scalp lesions are on the market. Remember, medicated shampoos are designed for the scalp, not the hair.

Sometimes doctors inject scalp lesions with steroid medications. This is done only when the scalp psoriasis is mild and involves a few areas. Steroid injections are given sparingly because the medication can be absorbed into the system.

Moderate to severe scalp psoriasis

If you have a more severe case of scalp psoriasis, you may need to try different treatment plans before you find the one that works for you. If crusting of the scalp along with scaling occurs and/or the lymph nodes in your neck are enlarged, indicating a yeast infection, your doctor may prescribe antimicrobial treatment.

Common topical treatments for scalp psoriasis include:

• Anthralin
• Dovonex 
• Taclonex 
• Tazorac 

 Common systemic medication treatments for psoriasis include:

• Methotrexate
• Oral retinoids
• Cyclosporine
• Biologics

Ultraviolet light

Hair blocks ultraviolet (UV) light treatments from reaching the scalp. However, better results can be achieved with conventional UV units if you part your hair in many rows, if you have very thin hair or if you shave your head. Hand-held devices called UV combs are available to deliver a higher intensity of UV light. Natural sunlight may also help if the hair is very thin or the head is shaved.

Scalp itch

Itching is often a problem for those with scalp psoriasis. Over-the-counter tar shampoos and shampoos containing menthol can help reduce itching. Topical steroids and oral antihistamines are also effective for reducing scalp itch.

Search the online treatment guide for more treatment information.

Psoriasis - Specific locations: genitals

Specific locations: genitals

The most common type of psoriasis in the genital region is inverse psoriasis. This type of psoriasis first shows up as smooth, dry, red lesions. It usually lacks the scale associated with plaque psoriasis.

There are various regions of the genital area that can be affected by psoriasis:

Pubis

The pubis is the region on males and females above the genitals. This area can be treated similarly to psoriasis on the scalp; however, use caution. Skin in the pubic region is more sensitive than the skin on the scalp.

Upper thighs

Psoriasis on the upper thighs often consists of many small, round patches that are red and scaly. Psoriasis in between the thighs is easily irritated, especially if the thighs rub together you walk or run.

Creases between thigh and groin

Psoriasis generally appears as non-scaly and reddish-white in the creases between the thigh and groin. The skin may have fissures (cracks). People who are overweight or athletic may have an infection called intertrigo, which looks similar yeast infection in the folds of the skin.

Genitals

Psoriasis of the vulva often appears as a smooth, non-scaly redness. Scratching this area may cause an infection, produce dryness, and result in thickening of the skin and further itching.

Genital psoriasis usually affects the outer skin of the vagina as psoriasis does not normally affect mucous membranes. In general, genital psoriasis does not affect the urethra.

Psoriasis of the penis may appear as many small, red patches on the glans, or shaft. The skin may be scaly or smooth and shiny. Genital psoriasis affects both circumcised and uncircumcised males.

Anus and surrounding skin

Psoriasis on or near the anus is red, non-scaly and prone to itchiness. Psoriasis in this area may be confused with yeast, infections, hemorrhoidal itching, and pinworm infestations. The presence of these conditions can complicate the treatment of psoriasis. Rectal examinations and skin cultures can confirm these conditions. Symptoms of anal psoriasis may include bleeding, pain during bowel movement, and excessive dryness and itching.

Buttocks crease

Psoriasis in the buttocks crease may be red and non-scaly or red with very heavy scales. The skin in this area is not as fragile as that of the groin.

Treatment

Genital psoriasis generally responds well to treatment. Due to the sensitivity of genital skin, treatment requires special attention. Topicals and ultraviolet (UV) light are most often used. Doctors generally don’t prescribe systemic medications for genital psoriasis alone. However, they may if psoriasis is severe or resistant to topical therapy, or also appears on other parts of the body.

Psoriasis - Specific locations: hands and feet

Specific locations: hands and feet

Treat acute flares of psoriasis on the hands and feet promptly and carefully. In some cases, cracking, blisters and swelling accompany flares.

Traditional topical treatment of palm and sole psoriasis includes tar, salicylic acid and corticosteroids. Combinations of these three agents may work better than using each individually. Moisturizers, mild soaps and soap substitutes also are often used.

Calcipotriene can also be effective to treat psoriasis on hands and feet. Wear cotton gloves so the medicine doesn’t get on sensitive skin sites, such as the face or skin folds. A regimen alternating calcipotriene and potent topical corticosteroids may be helpful.

If topical medications do not work, your doctor may recommend methotrexate, cyclosporine or Soriatane (acitretin). Methotrexate can clear many cases of palm and sole psoriasis within four to six weeks.

The risks of side effects from phototherapy are reduced by combining low doses of oral retinoids with UVB or PUVA. The combination of low doses of oral retinoids with PUVA or UVB phototherapy is one of the most effective treatments available for palm and sole psoriasis. Special light therapy units for palms and soles are available.

Pustular psoriasis of the palms and soles

Topical treatments for pustular psoriasis such as corticosteroids and coal tar are usually prescribed first. Phototherapy, oral retinoids and/or methotrexate are also prescribed. Soriatane can be a helpful long-term solution for pustular psoriasis.

For difficult cases, doctors may prescribe a biologic drug.

Nails

Nail changes occur in up to 50 percent of people with psoriasis and at least 80 percent of people with psoriatic arthritis. The nail problems most commonly experienced by psoriasis patients are:

• Pitting—shallow or deep holes in the nail
• Deformation—alterations in the normal shape of the nail
• Thickening of the nail
• Onycholysis—separation of the nail from the nail bed
• Discoloration—unusual nail coloration, such as yellow-brown

Nail treatments

Because psoriasis affects the nail when the nail is being formed, it is challenging to treat. The nail bed is difficult to penetrate with topical medications. Injections of corticosteroids into the nail bed have been used with varying results.

In addition to topical treatments and phototherapy, other treatments for nail psoriasis are:

• Corticosteroid injections into each affected nail;
• Cosmetic repair including nail scraping and filing, nail polish, artificial nails and surgical removal.

Onychomycosis, a fungal infection that causes thickening of the nails, may be present with nail psoriasis. It can be treated with systemic anti-fungal agents. About one-third of people who have nail psoriasis also have a fungal infection.

Nail care

In most cases, keep the nails trimmed back with manicure scissors to the point of firm attachments. Keep nails as short as possible. Loose nails continue to be injured as they rub against surfaces. It is important to protect your nails from damage because trauma will often trigger or worsen nail psoriasis.

Psoriasis - Specific locations: face

Specific locations: face

On the face

Facial psoriasis most often affects the eyebrows, the skin between the nose and upper lip, the upper forehead and the hairline. You might need a biopsy to confirm that it is psoriasis.

Psoriasis on and around the face should be treated carefully as the skin here is very sensitive.  Occasional use of mild topical steroids, also called corticosteroids, may be effective.  Other treatments include Dovonex, Tazorac, keratolytic products (scale removers) and ultraviolet light. Dovonex and Tazorac can be irritating, so you should work with your doctor to find a way to address this concern.

The U.S. Food and Drug Administration (FDA) has approved two drugs, Protopic and Elidel, for the treatment of eczema which many dermatologists have found work well for treating psoriasis on the face or other sensitive areas.  Medication used to treat facial psoriasis should applied carefully and sparingly; creams and ointments can irritate eyes.  Because facial skin is delicate, prolonged use of steroids may cause it to become thin, shiny and/or prone to enlarged capillaries. Treatment with steroids may be safe if a careful treatment schedule is followed.

Around the eyes

When psoriasis affects the eyelids, scales may cover lashes. The edges of the eyelids may become red and crusty. If inflamed for long periods, the rims of the lids may turn up or down. If the rim turns down, lashes can rub against the eyeball and cause irritation.  Psoriasis of the eye is extremely rare.  When it does occur, it can cause inflammation, dryness and discomfort.  It may impair vision.  Topical antibiotics may be used to treat infection.

In some cases, a special steroid medication made for use around the eyes may be used to treat scaling. Your doctor must carefully supervise the treatment because eyelid skin can be easily damaged. If topical steroids are overused in and around your eyes, glaucoma and/or cataracts may develop, which is the reason doctors suggest having your intraocular pressure checked regularly by an ophthalmologist.

Protopic ointment or Elidel cream won't cause glaucoma and is effective on eyelids, but can sting the first few days of use. Using Protopic or Elidel for eyelid psoriasis may help you avoid the potential side effects of topical steroids.

In the ears

Psoriasis in the ears can cause scale buildup that blocks the ear canal. This buildup may lead to temporary hearing loss. A doctor should remove this scale. Psoriasis generally occurs in the external ear canal, not inside the ear or behind the eardrum.

Prescription steroid solutions can be dripped into the ear canal or applied to the outside portion of the ear canal. Dovonex or Tazorac may cause irritation when used alone and may be best used in combination with a topical steroid. The eardrum is easily damaged. Care should be taken when inserting anything rigid into the ear. Also, impaction of scale already present from psoriasis can occur if medication prescribed for the skin on the ear is not appropriately applied inside the ear canal.

Around the mouth and nose

For a very small number of people, psoriasis lesions appear on the gums, the tongue, inside the cheek, inside the nose or on the lips. The lesions are usually white or gray. Psoriasis in these areas can be relatively uncomfortable. It can cause difficulty in chewing and swallowing food.

For the most part, psoriasis treatments for the mouth and nose involve the use of topical steroids that have been designed to treat moist areas. Improving hygiene and rinsing frequently with a saline solution can help relieve oral discomfort. Low-potency steroids, such as hydrocortisone 1% ointment, may be useful in treating psoriasis on the lips. Protopic and Elidel may also be effective treatment options for psoriasis in and around the mouth.

Dr. Crowley : Board-Certified Dermatologist - Management of Psoriasis

Meet Dr Crowley

I’m Jeffrey Crowley. I’m a board-certified dermatologist in private practice in Bakersfield, California. I’ve been involved in the treatment of psoriasis patients for many, many years.

Diagnosing psoriasis

To establish a diagnosis of psoriasis, we examine the entire patient’s skin. That includes the scalp and the entire body. Psoriasis can sometimes hide in certain places, like, people can have it just on the scalp or just on the hands or just on the feet. Sometimes psoriasis can even involve areas that aren’t seen... in the underarm or in the groin area.

So we generally examine the entire skin, but before we examine the skin, we talk to the patient, and it’s important to understand what they’re concerned about. Are there rashes that they’re concerned about? What has been going on with their skin? Do they have itching? Do they have a family history of psoriasis? Do they have any symptoms of arthritis? And that’s very important. Are they having some morning stiffness in their hands? Are they having back problems? Problems in their joints? And so, really, it’s a very comprehensive exam in terms of, determining whether a patient has psoriasis, and then what type of psoriasis and how severe the psoriasis is. And then, of course, how much the psoriasis is affecting the patient’s daily activities and life.

Importance of seeing a dermatologist

So in our healthcare system now, you often have to see a primary care provider, whether that’s a physician, a physician’s assistant, or a nurse practitioner. And that may be the first place that you seek care for your skin. And that may be all you need, you know, if you just need a topical treatment. But it really is important to get an expert opinion, and an expert opinion comes from a dermatologist, and especially a dermatologist that’s interested and treats a lot of patients with psoriasis.

Preparing for your dermatologist appointment

When you go and see your dermatologist—when you set your appointment—that is your time, and you need to really set the agenda for what you want to get out of that visit with your doctor. And I would recommend really making a list. What are your concerns for your psoriasis? What are the issues that you’re concerned about? What do you want to achieve with your psoriasis? Are there certain areas that you’re more concerned with? Do you have joint involvement? Do you have arthritis? Those are all things that you want to address with the dermatologist because the dermatology practice is very busy, just like all doctors are—just like we all are—and so they may not address all your issues without you specifically asking the questions. So I recommend being prepared for your visit, especially your initial visit with your dermatologist.

Doing some research on your own, I think, is an outstanding idea. The National Psoriasis Foundation has an excellent Web site, which can provide you with background information. There are other Web sites that are available as well, which can give you information on psoriasis. They can tell you not only the types of psoriasis, but the different types of treatments available, too, and if you are armed with that knowledge going into the appointment, you’re going to get a lot more out of that visit.

Sharing all the ways psoriasis affects you

So psoriasis can affect you both in terms of how you look and how your skin feels—itch, things like that—discomfort, trouble sitting… all sorts of different physical symptoms can occur with psoriasis. And then, of course, there’s the emotional aspects of psoriasis, and this really varies dramatically by patients, and some patients with even fairly small amounts of disease may be very troubled emotionally by their psoriasis. I have patients who basically are recluses in their home. Now we have treatments that can help these people, and we’d like to see more of those patients in our practices and be able to help them.

Don’t be afraid to tell the doctor what is bothering you. Don’t hold back, you know, if the psoriasis is keeping you from having the social life that you want, keeping you from doing the things that you want to do, the fact that you can’t wear shorts because you have these ugly plaques on your legs—those are the kind of things you need to communicate with your doctor. You need to tell him the emotional toll that it’s taking on you. Is it affecting other people in the family as well? Is this affecting relationships? Those are all important things to convey.

Psoriasis treatment options

There are a wide range of treatments for psoriasis, and more than one treatment may be appropriate for you. There’s phototherapy, which is usually done in-office, but sometimes can be done at home with a home phototherapy unit. This can be very effective, even for fairly widespread psoriasis. There are topical therapies. These usually work better for patients with smaller amounts of disease because it’s very difficult to put topical medications on large areas of your skin.

And then there are more systemic-type therapies; there are therapies that have pills that you can take, such as methotrexate and cyclosporine, which have been used for psoriasis for many years. And then we have the biologic therapies, and there’s a whole host of different agents available.

Finding the treatment that’s right for you

One of the most important things that I look at every time a patient comes in the office—are they happy with their current treatment, and that is the most important question. Are you happy with how things are going? And this is, of course, on a follow-up visit. You know, sit down, how is it going? How is the current treatment going? And if it’s not going well, if there’s not a good degree of satisfaction, then something else should be done, and at that point, we discuss the options. That may include changing to another medication.

If you have a question about how to use your medication, if you didn’t understand what the dermatologist was telling you or they didn’t even communicate it to you effectively, you need to ask. You need to call, you need to ask.

Taking control

You may be very frustrated with the attempts you’ve made to improve your psoriasis, with the treatments that you’ve tried, with the healthcare professionals that you’ve seen. You need to know that there are other options, and that you haven’t had every treatment available. And you need to find someone—a healthcare provider, preferably a dermatologist—who you can work with to make your psoriasis better.

So if you’re sitting there at home and you have psoriasis, you’re frustrated, you’ve been checking on the Internet trying to see what’s out there, but you haven’t been happy with the experience that you’ve had with physicians in the past or with the healthcare system in the past, you really need to give it another chance. And I would do some research. I would ask friends, check on the Web sites for the National Psoriasis Foundation—find doctors who are treating psoriasis, find dermatologists who are interested in treating psoriasis, and give them a chance.

Living well

One of the most important things in managing your psoriasis is taking care of your overall health—eating healthy, being healthy, exercising. There are a lot of things that contribute to making psoriasis much more difficult to treat. These include being overweight, they include not eating well, drinking alcohol to excess… all of these can be factors that can make your psoriasis more difficult to control.

One of the wonderful things is having a patient back who’s used a therapy and is pleased. And, it’s changed their lives, you know, and it really can change your life. Now you may not even realize how much improving your psoriasis may change the way you feel, the way you see yourself, the way others see you.

http://www.therealyou.com/ManagingYourPsoriasis/Default.aspx

National Psoriasis Foundation - FDA approves new psoriasis drug

National Psoriasis Foundation - FDA approves new psoriasis drug

FDA approves new psoriasis drug Stelara

Stelara offers patients a new treatment option

September 25, 2009

Stelara, a new drug for treating moderate to severe psoriasis in adults, was approved today by the U.S. Food and Drug Administration. Known by the generic name ustekinumab, the drug is injected in the skin, and works by blocking part of the body's immune system.

Stelara is a "very significant medication," said Dr. Craig Leonardi, a dermatologist in St. Louis, Mo. who served as a lead investigator in clinical trials for the drug. Leonardi believes Stelara is particularly effective for patients who've seen little or no response to treatments with other medications.

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