Reactions to ingredients (Was Re: Giving Gold Bond a try..)

[Guest guest]

I wasn't aware that Austin Powers was putting out a new film. I

liked the previous two, but have no plans to change in my moniker

Perhaps the most efficient thing would be to develop a profile of

rosaceans who are acne prone, which would include things such as

history of severe acne during puberty, history of breakouts in

relation to applying topicals, high sebum production, younger in age,

male rather than female, and apply this profile as a relative

indication for choosing minocycline over doxycyline as a first line

therapy. Also, we could add living in a photo-intensive climate as a

consideration.

> > cea induces cytokine production, anything which

> > causes a flare does, in fact, and cytokines significantly

influence

> > comedone formation. Cunliff goes over cytokine induced comedones

> > in his book. This has been deomonstrated via cultured ducts in

> > vitro experimentally. It appears that rosacea and acne are more

> > closely linked that realized.

>

> I wouldn't think the relationship is closer than we think, 007.

> Cytokines play a role in all inflammation. As I understand it, in

> rosacea the inflammation causes acne, perhaps as Cunliff describes,

> but in vulgaris the abnormal keratinization lining the pores sets

the

> stage for comedone formation and inflammation, through a number of

> mechanisms.

>

True there are other causes of acne through other mechanisms besides

purely cytokines. However, it is interesting to note that

inflammation begets more inflammation and worsening of the

condition. A pure rosacean can likely be converted into a rosacean

plus an acne sufferer by not keeping his or her inflammation under

control (as this inflammation leads to acne and comedone formation

via the cytokine route) and also by apply comedogenic rosacea

oriented topicals. A complication arises in the treatment of rosacea

by the notion of first doing nothing which can cause acne.

Parallelly, the treatment of acne in a flusher is complicated by

first doing nothing which can cause rosacea. All roads leads to low

dose accutane in these two situations. The etiologies of the two

different diseases are different, however they can and do co-exist,

and the ideal treatment for both is 5mg Accutane/d plus a good

antibiotic for faster response.

> > In the case of one type of pustule, a rosacea mediated pustule

> > caused by immune system reaction, and an acne related pustule

(like

> > a rosacea mediated pustule with the addition of p. acne

> > involvement), it would make sense to use either full dose

zithromax

> > or minocyline because they work for either type of pustular

> > etiology. Whereas,

> > tetracyline, doxycycline, clindamycin, and erythromycin,

generally

> > are ineffective for acne pustules due to high p. acne resistance.

>

> But why start off treating for two conditions when the patient only

> has one condition? It's one thing if someone doesn't respond as

> expected, but most rosaceans do fine with first-line antibiotics.

And

> why be overconcerned about P. acne in rosacea, when at best it's a

> concern in only a minority of rosaceans? I think the goal is to

> isolate that subset of rosaceans where bacteria contributes to a

> pathogenic process, if that's true -- not to assume that even if

it's

> relevant for a group of rosaceans then it's relevant for everyone.

>

> > Additionally, isn't it ironic that retin a cream vehicle is

> > comedogenic?

>

> I don't know. Not really. Sorry 007, it may be my ignorance but I'm

> not convinced.

>

In order to convince you, try getting the vehicle w/o the retin a and

apply it to your facial skin and see what happens.

> When the new Austin Powers film comes out, are you going to change

> your moniker from 007 to Goldmember?

>

> Marjorie

>

> Marjorie Lazoff, MD