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Why are particular laser-related skin products not recommended for darker skin tones?

Why are particular laser-related skin products not recommended for darker skin tones?



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This is about products such as:

  1. The "Theradome" laser helmet (this claims to stimulate hair growth through lasers)

Theradome™, a biomedical engineering company based in the Silicon Valley, is the proud designer, developer and manufacturer of the Theradome™ LH80 PRO, the first and most powerful FDA cleared OTC wearable laser hair helmet for laser hair growth treatment. At last, millions of people suffering hair loss can enjoy clinically effective laser hair restoration treatments at home, at an affordable price, with a simple push of a button.

  1. Silk'n Flash&Go Hair Removal Device (claims to remove hair using lasers)

Silk'n Flash&Go™ is a revolutionary light-based system for permanent results at home. Now you can remove unwanted hair forever on your body and face - all with gentle pulses of light that disable hair growth. It's the safe way to get smooth, beautiful skin.

From the information on the website, it would appear that the products are safe for all; however, both products seem to be not recommended for the two darkest skin colors on the Fitzpatrick Skin Tone Classification Scale on a variety of different product feedback websites. What is the reasoning behind this?


The reason for laser hair removal/growth products not being safe for darker skin tones is the ability for darker skin tones to absorb more light from the laser than lighter skin does BEFORE the light is able to reach the depth at which the hair follicle is located. Light from lasers must pass through the epidermis where melanocytes are located before they reach the hair follicle.

More melanin means increased ability to absorb wavelengths as seen in the curve below. Laser products such as Theradome (678nm) and Silk'N (475-1200 nm) have shorter wavelengths, which are highly absorbed by melanin, and therefore can damage skin in darker skin tone patients. Safer products like Nd:YAG are those that have higher wavelengths at 1064nm and can penetrate the skin without over-absorption by melanin.

Disclosures: I own no stock in any of these companies.

References:


Facial hyperpigmentation: causes and treatment

By midcentury, the U.S.A. will be more ethnically and racially diverse. Skin of colour will soon constitute nearly one-half of the U.S. population, and a full understanding of skin conditions that affect this group is of great importance. Structural and functional differences in the skin, as well as the influence of cultural practices, produce variances in skin disease and presentation based on skin type. In the skin of colour population, dyschromia is a growing concern, and a top chief complaint when patients present to the physician. A thorough understanding of the aetiology and management strategies of facial hyperpigmentation is of importance in caring for those afflicted and also in the development of new therapies.

Skin of colour, also known as ethnic skin, constitutes a wide range of racial and ethnic groups traditionally referring to persons of African, Asian, Native American, Middle Eastern and Hispanic backgrounds. By 2050, nearly one-half of the U.S. population will be nonwhite. 1 These skin types are generally categorized as Fitzpatrick types IV–VI, and are more richly pigmented. Structural and functional differences in the skin, as well as the influence of cultural practices, produce variances in skin disease, presentation and treatment based on skin type. Darker skin phenotypes are characterized by higher content of melanin, higher eumelanin to pheomelanin ratio, and more effective distribution of melanin for protection against ultraviolet (UV) radiation. 2

In skin of colour, the amount and epidermal distribution of melanin is an important biological feature. 3-5 Melanin is not a single compound rather, it is a mixture of biopolymers synthesized by melanocytes located in the basal layer of the epidermis. 2 Based on their chemical composition, melanins are broadly classified into two types: eumelanin and pheomelanin. 2 Multiple studies have reported that individuals with darker skin have higher total melanin content, and a higher amount of eumelanin than lighter-skinned individuals. 2 Furthermore, studies on cultured human melanocytes have demonstrated that melanocytes derived from darker skin have higher total melanin and eumelanin contents, and a higher ratio of eumelanin to pheomelanin, than those derived from lighter skin. 2, 6 Pheomelanin differs from eumelanin in its biological behaviour, importantly in the ability of pheomelanin to activate oxygen resulting in the formation of the superoxide radical anion. 2, 7, 8 These properties may be responsible for the high phototoxic potential of pheomelanin, which may contribute to the occurrence of photoinduced malignancies in lighter-skinned individuals.

Biosynthesis of melanin occurs within the melanosome, a lysosome-like organelle and metabolic unit of the melanocyte, where melanin granules are synthesized using the amino acid tyrosine as the major substrate. 3-5, 9 Variations in the number, size and aggregation of melanosomes within the melanocyte and keratinocyte contribute to racial and ethnic differences. 10 For example, darker skin types have nonaggregated and larger melanosomes. 3, 11 There are no racial differences in the overall number of melanocytes however, melanocyte number may differ by anatomical location. 10, 12, 13 For example, the head and forearm have the highest numbers of melanocytes. 8 Total melanin content is also greater in individuals with darker skin types. 3, 14

Melanin is the major determinant of colour in the skin. The concentration of epidermal melanin in melanosomes is double in darker skin types compared with lightly pigmented skin types. 5 In addition, melanosome degradation within the keratinocyte is slower in darkly pigmented skin when compared with lighter skin types. 15 The melanin content and melanosomal dispersion pattern is thought to confer protection from damage induced by UV radiation. 3, 16 Kaidbey et al. 16 demonstrated that black epidermis, on average, provides a sun-protection factor (SPF) of 13·4. Although the increased melanin provides protection from harmful effects of UV radiation, including photodamage and skin cancers, it also makes darkly pigmented skin more vulnerable to postinflammatory dyspigmentation.

Given these functional and structural differences, common conditions may require special considerations in ethnic skin. Additionally, there are many skin conditions relatively unique to persons with skin of colour. The aim of this review is to summarize what is currently known about facial hyperpigmentation as it relates to those with skin of colour. Table 1 summarizes causes of facial hyperpigmentation.

Typically preceded by mild erythema and pruritus, followed by a diffuse-to-reticulated hyperpigmentation

Favours sites of application of contactants, especially cosmetics

Complete avoidance of the suspected allergen and allergen-free soaps and cosmetics

Sun-protective measures, skin-lightening agents and chemical peels

Symmetric, centrofacial distribution of light to dark brown patches with irregular borders

History of exacerbation with pregnancy, hormonal therapy such as oral contraceptives, and intense sun exposure

History of hydroquinone application

Banana-shaped, yellow-brown deposits in the dermis

Symmetric, hyperpigmented, velvety plaques on the neck and axillae

History of diabetes and/or obesity

Blue-grey confluence of individual macules varying from pinhead-sized to several millimetres in diameter

Distribution of the first two branches of the trigeminal nerve

Onset in infancy or puberty

Asians, primarily Chinese and Japanese, women aged 20–70 years

Blue-grey to grey-brown macules primarily on the zygomatic area and less often on the forehead, temples, upper eyelids, and root and alae of the nose

Grey to blue-brown lesions

Inflammatory phase with rim of erythema

Distribution also includes nonsun-exposed areas

Oral corticosteroids, antibiotics (e.g. doxycycline), antimalarials, isoniazid, griseofulvin and UV light therapy have produced variable results

Successful treatment with dapsone and clofazimine has been reported in small series

Fine scale overlying violaceous lesions

Small macules of brown-black pigmentation or slate-like pigmentation of the centrofacial area

History of fever, morbilliform skin eruption and polyarthritis


Dermatology, Laser & Vein Specialists Answer Our Questions About Melasma: The Mask of Pregnancy

It’s no myth, pregnant women do have a radiant glow. That glow is caused by increased levels of hormones, extra blood circulating through their body and maybe a dash of pure joy. However, pregnancy can also wreak havoc on a woman’s complexion. One such bothersome condition is melasma (pronounced mu-LAZ-muh). A blotchy darkening of the skin on the face sometimes referred to as “the mask of pregnancy”. It isn’t painful or harmful but it IS annoying especially when instead of glowing skin you have blotchy skin. We reached out to client Dermatology, Laser & Vein Specialists of the Carolinas to find out more.

Greeted by a spa-like atmosphere and an upbeat staff, I took my seat in the waiting room and observed. Patients of all ages (men and women) were called back quickly–very little waiting involved. All procedures peels, lasers, surgeries are done “in house”. We spoke to Dr. Payman Kosari at Dermatology, Laser & Vein Specialists of the Carolinas and he filled us in on melasma.

Let’s start at the beginning—what is Melasma?

Melasma is a common acquired skin condition causing brown, tan or gray patches to appear on the cheeks, nose, forehead and chin. It can also appear on the forearms, neck and chest. It typically occurs in a symmetrical fashion and women with darker complexions are more prone to develop melasma than women with lighter skin tones. The increased pigment can be located in the epidermis (surface) or dermis (deeper in the skin). The location of pigment can be important when determining treatment options.

Melasma is called “the mask of pregnancy”. Why does it occur during pregnancy?

Why some are more predisposed to develop melasma than others is not entirely clear. The cause of melasma is likely multi-factorial. Causes include a genetic predisposition, being female, darker skin complexion, pregnancy, certain medications and excessive sun exposure. Melasma occurs when the color-making cells in the skin (melanocytes) produce too much color.These changes may be triggered by hormonal changes during pregnancy, which stimulate an increase in your body’s production of melanin, the natural substance that gives color to hair, skin, and eyes.

How am I diagnosed?

Melasma can be diagnosed through a simple exam. At Dermatology Laser &Vein Specialists of the Carolinas (DLVSC) the dermatologist will diagnose and suggest a course of treatment during an exam/consultation. The treatment will depend on how deep the melasma is in the skin (dermis or epidermis) and might require topical creams, lasers, or chemical peels. All can be done in our office.

What is the treatment? Is it painful? Most importantly…is it safe?

The first course of action is to avoid sun exposure and when you do venture into the sun, wear sunscreen or a wide brimmed hat. Always, look for a broad-spectrum sunscreen with an SPF of 30 or more to protect against both UVA and UVB rays. Make sure to reapply sunscreen every 1-2 hrs if you expect to be outdoors for an extended period of time.

Here are the treatment options for melasma at Dermatology, Laser & Vein Specialists of the Carolinas:

*Topical Creams include lightening agents, melanin blockers and vitamin A derivatives such as Tri-Luma cream. We sell Tri-Luma in our store and recommend it for nearly every patient that has melasma. The product is applied 1-2x daily and can produce dramatic lightening of the pigmented areas. Tri-Luma is not typically used during pregnancy and it is always recommended to consult with your Ob/Gyn before initiating therapy

*Lightening/anti-inflammatory creams containing azelaic acid can be prescribed during pregnancy. Products containing azeleic acid are thought to be effective because of their ability to interfere with the production of melanin. Results may be noticed in as little as 2-3 months with twice daily use.

*Laser or light-based treatments are also an option if topical creams do not work. Often, topical lightening agents are used in conjunction with laser therapy. The laser specifically and safely targets the melanin in skin. It is a short procedure requiring minimal to no downtime. Depending on the device used, multiple treatments may be required but the results are dramatic and always satisfying. Be sure to discuss the safety of laser treatments with your Dermatologist and Ob/Gyn.

*Chemical peels done by an esthetician will require multiple visits (probably every 4 weeks). The chemicals used during a peel are not recommended during pregnancy so this one will have to wait until your bundle of joy arrives.

What treatments are safe during pregnancy?

Every case is unique and requires a thorough clinical assessment. If you feel your melasma needs attention, make sure to consult with your dermatologist to create a treatment plan that caters to your personal needs. Some treatments may not be indicated during pregnancy but there are definitely options available.

Will it go away on its own or once the baby is born?

Melasma is quite unpredictable. Some cases of melasma will fade after delivery, while others will maintain the pigment. Remember, many factors are responsible for the development of the melasma. Although, it may appear during pregnancy, it may be that there is an underlying predisposition to hyperpigmenting and pregnancy merely brought it to surface. Early sun protection and treatment is the key to controlling melasma.

Most importantly, the staff at Dermatology, Laser & Vein Specialists make themselves available to consult, diagnose and treat melasma with the patient and their unborn child in mind. The atmosphere is comfortable and accessible and we encourage any patient with concerns regarding melasma, to make an appointment to discuss treatment options.

Dr. Kosari is a board-certified dermatologist. He received his Bachelor of Science degree in Biology from the University of California, Los Angeles before earning his Medical Degree from the Chicago Medical School. He completed his internship at Cedars-Sinai Medical Center and relocated to North Carolina for his Dermatology residency at Wake Forest Baptist Health. Dr. Kosari specializes in the treatment of pediatric and adult disorders of the skin, mucosal membranes, hair, and nails and has had extensive training in the diagnosis and treatment of skin cancers including malignant melanoma. He has a particular focus in venous disorders & associated treatments such as endovenous laser ablation and sclerotherapy.

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***HURST REVIEW NCLEX-RN Readiness Exam 1***

1. Incorrect: The rate of IV administration should not exceed 50 mg/min. for adults and 1-3 mg/kg/min (or 50 mg/min, whichever is slower) in pediatric clients because of the risk of severe hypotension and cardiac arrhythmias. So 100 mg can safely be delivered over a period of at least 2 minutes. Giving this dose over only one minute could lead to these or other potential harmful effects.

3. Incorrect: The rate of IV administration should not exceed 50 mg/min. for adults and 1-3 mg/kg/min (or 50 mg/min, whichever is slower) in pediatric clients because of the risk of severe hypotension and cardiac arrhythmias. So 100 mg can safely be delivered over a period of at least 2 minutes. Five minutes would be longer than required to be able to safely administer the medication.

1. Incorrect: The primary purpose of the NG tube to suction is to keep the stomach empty and dry to decrease pancreatic enzyme production, not to relieve nausea.

3. Incorrect: Because gastric contents are removed, the NG tube to suction may lead to fluid and electrolyte disturbances rather than helping to control them.

1. Incorrect: Sleep disturbances are common with depression. Selective serotonin reuptake inhibitors (SSRIs) may cause insomnia however, there is a more pertinent question needed for assessment of this client. You should be concerned with the more serious or life-threatening issue.

3. Incorrect: Sexual dysfunction may occur with the SSRIs however, the client is exhibiting significant symptoms of an adverse reaction which would take priority.

3. Incorrect: Increased body temperature is expected as is increased diaphoresis.

2. Incorrect: The client is not hypoventilating and would not be in metabolic acidosis because he ate 3 rolls of Tums which is a base. These ABGs are indicative of acidosis. The pH is low (acidosis), the pCO2 is high (acidosis) and the bicarb is low (acidosis).

3. Incorrect: The client is not a long-term COPD client as these ABGs might suggest. These ABGs are indicative of fully compensated respiratory acidosis. The pH is normal. The pCO2 is high (as with chronic retention) and the bicarb is high to help compensate.

4. Incorrect: A face shield is used when there is risk of splashing or spraying of blood or body fluids. This is not required for airborne precautions.

Place in the correct priority order.

Second, Bulb suction excessive mucus. It is important to assure that the throat and nose are kept clean of secretions to prevent respiratory distress.

Third, Assess newborn's heart rate. If there is no respiratory distress, the nurse continues the assessment by checking the heart rate and other vital signs.

Fourth, Place identification bands on newborn and mom. These are critical for ensuring babies and moms will be appropriately matched at all times but does not take priority over respiration and circulation.

4. Incorrect: When given by the buccal route, the medication does not go through the digestive system. This means that the medication is not metabolized through the liver, and thus a lower dose can be used.

1. Incorrect: Within one month after corticosteroid administration, weight gain is seen rather than weight loss.

1. Incorrect: This is considered a clean stick. The needle is sterile initially and has not been contaminated prior to removal of the needle from the syringe.

2. Incorrect: This is considered a clean stick since the suture needle has not been inserted into the client prior to the needle stick.

1. Incorrect: There is nothing in the stem about a problem with the medication dose or route.

3. Incorrect: There is nothing in the stem about a problem with the medication dose or route.

2. Incorrect: Supine position for 6 hours is contraindicated. The HOB should be elevated. In the event the client vomits, he/she is less likely to aspirate with the HOB elevated. Supine position for 6 hours is used after a heart catheterization.

4. Incorrect: A client who is going for a gastroscopy procedure cannot have a nasal gastric tube. An NG tube would interfere with the procedure.

1. Incorrect: Chlorpromazine does not potentiate the effects of benztropine, so dosage regulation is not appropriate.

3 Incorrect: Chlorpromazine can be used for severe hiccups, but the hiccups are not the result of using benztropine. Chlorpromazine is also used for psychosis in the schizophrenic client.

1. Incorrect. This is a normal creatinine level. Gradual accumulation of nitrogenous wastes from impaired renal function results in elevated BUN and serum creatinine.

2. Incorrect. This is a normal output level. This level alone would not necessarily be an indicator of acute renal failure and that value alone would not warrant reporting it to the primary healthcare provider.

1. Incorrect: Captopril should not be taken during pregnancy because serious harm (possibly fatal) to the unborn baby can result when taken during pregnancy.

2. Incorrect: Captopril should not be taken during pregnancy because serious harm (possibly fatal) to the unborn baby can result when taken during pregnancy.

2. Incorrect: Bedrest can keep the client from falling and injuring self however, that is not why it has been prescribed.

3. Incorrect: Promotion of rest is good, but this is not why the primary healthcare provider prescribed it. Simply promoting does not help improve the symptoms listed. The reason the client needs bedrest should focus on relieving the symptoms listed in the stem.

1. Incorrect: Many clients with schizophrenia are concrete thinkers. The nurse needs to be direct, clear and concise in communicating with the client. The client may not comprehend how the shower improves the overall sense of well-being and would remain reluctant to take the shower.

3. Incorrect: Clients diagnosed with schizophrenia often have trouble making decisions. The client needs to be guided with simple, direct instructions.

1. Incorrect: This client is unstable and should be cared for by the RN. Additionally, the RN is responsible for teaching.

2. Incorrect: This client is experiencing chest pain and is thus considered unstable and should be cared for by the RN.

5. Incorrect: Poor tolerance to larger meals may be due to abdominal distension and ascites. Clients should eat smaller, more frequent meals (6/day). The recommended diet is high calorie and low sodium with protein regulated based on liver function. Between meal snacks should be provided.

1. Incorrect: A headache is an expected common side effect of nitroglycerin administration. The headache is treated with medication.

2. Incorrect: A decrease in blood pressure when rising from a supine or sitting position is a common effect of the vasodilatation that occurs with the administration of nitroglycerin. The client should be advised to change positions slowly.

1. Incorrect: Cutaneous anthrax is also found in the United States, so asking about travel abroad would not be necessary.

3. Incorrect: Cutaneous anthrax can be contracted by spores entering cuts or abrasions in the skin. This is cutaneous anthrax that causes edema, itching and macule or papule formation, resulting in ulceration. Ingestion of anthrax can cause GI symptoms such as nausea and vomiting, abdominal pain, and bloody diarrhea. Inhalation of anthrax may result in flu-like symptoms that progress to severe respiratory distress.

1. Incorrect: The client's verbal understanding does not override the fact that he has received medication that can alter thought processes and decision-making.

2. Incorrect: Witnessing would not make this document legal. The consent would not be valid because the client has already received the pain medication that could alter the thought process.

1. Incorrect: The fever with rheumatic fever is usually low grade and is considered a minor manifestation of rheumatic fever.

3. Incorrect: Vomiting is not a commonly associated symptom with rheumatic fever and is not considered a major manifestation of rheumatic fever. Although the child may have a history of vomiting, this finding would not be specific to rheumatic fever.

First, cleanse the access port. Failure to cleanse the port first would increase the risk of infection from contamination when the port is accessed.

Second, connect 10 mL normal saline to access port. This 10 mL syringe will be connected to first check patency and then for flushing prior to medication administration. At least 10 mL of normal saline is used to flush central lines.

Third, gently aspirate for blood.

Fourth, flush saline using push-pause method. This method is utilized to help clear the catheter of blood or drugs that could potentially adhere to the internal surface of the central line catheter. This creation of turbulent flow from pausing then pushing causes swirling of the fluid and theoretically removes blood and medications from the walls of the catheter, which reduces the risk of occlusion in the catheter.

Fifth, administer phenytoin.

1. Incorrect: This question should be asked, but only after determining if suicidal thinking is present.

2. Incorrect: This question could be an introductory question to establish rapport, but it is not direct enough to use in suicide assessment.

1. Incorrect: Magnesium sulfate is given to stop preterm labor, however, if delivery is imminent, then Betamethasone should be given to stimulate maturation of the baby's lungs.

2. Incorrect: Terbutaline is contraindicated in preterm labor, however, if delivery is imminent, then Betamethasone should be given to stimulate maturation of the baby's lungs.

1. Incorrect: The child with DKA is in metabolic acidosis. The child is also at risk for other problems such as dehydration and electrolyte disturbances. Therefore, the child will need close observation and the RN's assessment skills.

2. Incorrect: IV fluid management is crucial for clients in a sickle cell crisis Assessment of the child's cardiovascular status, tissue perfusion and neuro status are priorities. Pain management is also very important in these clients. Therefore, the child with sickle cell will need close observation and the RN's assessment skills.

2. Incorrect. Pain is expected here. The incision is at the base of the neck, so movement of the head would increase the pain.

3. Incorrect. The sensation of pressure in the arm is considered normal when the BP is being measured. You worry if you see carpal spasm (+ Trousseau's) which is indicative of neuromuscular excitability caused by hypocalcemia secondary to the inadvertent removal of some of the parathyroids.

1. Incorrect: This is an appropriate action, but does not address the problem of lowering the client's blood pressure.

2. Incorrect: This is an appropriate action, but does not address the problem of lowering the client's blood pressure.

1. Incorrect: This blood has been hanging for 4 hours and must be discontinued.

2. Incorrect: The problem is that the blood has been hanging too long. It must be taken down. There is no indication that a transfusion reaction is occurring. Transfusion reaction symptoms include back pain, dark urine, chills, fainting or dizziness, fever, flank pain, skin flushing, shortness of breath.

1. Incorrect: Loss of pupillary reflexes is a late sign of increased ICP. Earlier pupil changes would include gradual dilation and pupils become sluggish in response to light.

2. Incorrect: This is a late sign of increased ICP. This pattern of respirations is characterized by an increase in depth and rate of respirations followed by a gradual reduction.

1. Incorrect: Although the nurse does need to check immunizations, the hints in the stem indicate several problems that should direct the focus to lead poisoning, which is the priority. Immunization should be administered if the child is not on schedule, but consequences of lead poisoning is much more serious.

2. Incorrect: There was nothing in the stem indicating school problems. This would not take priority over lead exposure assessment.

1. Incorrect: This comment shows adequate understanding. The client should only treat the eye with the increased pressure.

3. Incorrect: This comment demonstrates that the client does understand the treatment regimen. Overmedicating the affected eye could reduce the intraocular pressure too much.

1. Incorrect: Just because the victim leaves does not guarantee that the abuser will not follow or find her. The threat of injury or death increases at the time the abused person leaves. This response is giving false reassurance to the abused person.

3. Incorrect: The client should be praised however, there are risks with both leaving and staying. The client should be informed. The nurse should acknowledge the fear of staying in the relationship and guide the client to resources that can be used to help make informed decisions.

1. Incorrect: While beneficial for many clients, a high protein, low fat diet provides no benefit during the crisis phase of sickle cell disease. Hydration to improve circulation is a priority due to the impairment or obstruction of blood flow caused by the sickled cells clumping together.

2. Incorrect: Thrombolytics are indicated for the lysis of existing clots and do not have a primary role in the treatment or management of sickle cell disease. The issue in sickle cell crisis is not clot formation but rather a clumping together of sickled cells that impairs or blocks circulation.

1. Incorrect: Strict toilet training can result in retention of feces and constipation. In addition, strict toilet training practices before the child is ready can result in frustration and shame.

1. Incorrect: Everting the eyelid and examining for a foreign body are not measures that should be performed before placement of eye shield. You should never attempt to remove a foreign body, so examination would not be needed at this point.

2. Incorrect: Measuring visual acuity is not a priority and is not performed before placement of eye shield. The goal is to protect the eye from further injury and reduce movement of the eye. The shield will help accomplish this goal.

1. Incorrect: The client will breathe through a hole in his neck (tracheostomy) for the rest of their life. This is a true statement by the client. We are looking for the false statement.

3. Incorrect: Since the entrance to the trachea is closed, the client can no longer move air through the nasopharynx. Therefore, the capacity to smell may be diminished or lost. The ability to smell remains intact because the sensory nerves in the nose are not impacted by the surgery. However, in order to smell normally, air must pass over the sensory cells which is not occurring in this case. This is a true statement by the client. We are looking for the false statement.

1. Incorrect: The partial amputation would have associated bleeding could be seen next, but airway takes priority.

2. Incorrect: Most fevers in children do not last for long periods and do not have much consequence. Elevated temperature would not take priority over airway. Antipyretics can be given in triage.

1. Incorrect: This does not get rid of secretions. This monitors respiratory effectiveness.

1. Incorrect: The basis of reading the skin test is the presence or absence of induration, which is a hard, dense, raised formation. This is the area that is measured. Sometimes the site has erythema, a reddening of the skin that can also have swelling. The erythema should NOT be measured. Reactions to the skin test will vary. For example, this is a very large reaction with blistering, swelling, and redness. Make sure to record blistering, even if no induration is present. Palpate this induration gently, as it may be painful. Measure only the induration. The vesicle may have a different underlying cause.

2. Incorrect: The basis of reading the skin test is the presence or absence of induration, which is a hard, dense, raised formation. This is the area that is measured. Sometimes the site has erythema, a reddening of the skin that can also have swelling. The erythema should NOT be measured. Doing so would result in a false positive test for the client.

1. Incorrect: Teaching is the responsibility of the RN and cannot be delegated to a LPN nor a non-licensed personnel.

2. Incorrect: Changing the colostomy bag on a client will need someone with the experience/skill of performing this task. Although some agencies allow UAP's to change colostomy bags, there may be further assessment needed associated with the ostomy, such as skin condition around the ostomy. This would not be the best option to assign to the UAP.

4. Incorrect: A lack of protein intake can interfere with the test. The screening test is most reliable when the blood sample is obtained after the baby has ingested a source of protein.

1. Incorrect: Breastfeeding decreases the incidence of otitis media. Ear infections are more common in children who drink from bottles or sippy cups, especially when lying on their back.

1. Incorrect: Arguing with the client who has delusions only upsets the client and may provoke violence. The client can not understand the logical argument, so the delusional ideas are not dispelled. Also, the argument can interfere with the development of trust.

2. Incorrect: Disagreement may anger the client. The client needs empathy and understanding from the nurse. This is dismissing the client's feelings. The focus should not be on what the nurse thinks. The focus should always be on the client's feelings.

1. Incorrect: This response dismisses the client's feelings and may only anger the client further. The response does not address the reason for the client's anger. The statement may be true however, the client does have the right to request and receive a copy of the medical record.

2. Incorrect: The primary healthcare provider does not have to be contacted, as there should be policies in place to grant the request for a copy of the medical record. Also, telling the client to speak to the healthcare provider would not address the reason for the client's anger. This would dismiss the client's feelings.

1. Incorrect: This is an appropriate measure Na restricted diet will help to lower the serum Na and decrease H2O retention. This does not need questioning.

2. Incorrect: Digoxin is a digitalis glycoside. It slows conduction and strengthens the force of contraction of the heart. Therefore, this medication that increases cardiac contractility and reduces the heart rate does not need questioning.

1. Incorrect: The following foods in the options listed above contain moderate to high levels of tyramine and should be avoided while taking MAOIs: smoked turkey, parmesan cheese, tea and liver.

2. Incorrect: The following foods in the options listed above contain moderate to high levels of tyramine and should be avoided while taking MAOIs: smoked turkey, parmesan cheese, tea and liver.

1. Incorrect. This is passive and would not benefit the new nurse to strengthen the skills. The best action would be to look up how to do the procedure, discuss with another nurse, and ask that nurse to observe the insertion of the feeding tube.

3. Incorrect. This is not the best option. The new nurse needs to insert the feeding tube in order to become more proficient with this skill. This option will not help the new nurse gain confidence in nursing skills.

1. Incorrect: Although 10 loose stools would result in fluid loss, the stool count of 10 episodes of diarrhea is an inaccurate measurement. The amount of fluid loss can vary depending on the amount of diarrhea, 10 "episodes" does not indicate how much fluid is lost.

2. Incorrect: Weight gains indicate fluid volume retention and excess. This question asks about fluid volume deficit. Also, it does not take into account the client's intake. Only the output is considered, so output has less meaning without being compared to the intake.

1. Incorrect: Application of a cooling blanket is appropriate, but the key in this question is to "fix the problem" ASAP. To treat the infection, the blood cultures must be drawn ASAP and be done before starting the antibiotics.

2. Incorrect: Antibiotics are not given until the cultures have been drawn. Administering the antibiotic first would cause the culture to be inaccurate.

Intake:
IV fluid-1025 mL
PRBC-250 mL

1. Incorrect: The nurse should be able to answer this question based upon the generally accepted regimen for electroconvulsive therapy (ECT).

3. Incorrect: Treatments are usually administered every other day (three times per week). Since the average number of treatments is 6-12, it only takes a couple of weeks to a month, on average for the regimen. Treatments are performed on an inpatient basis for those who require close observation and care, but can be done on an outpatient basis for some clients.

1. Incorrect: No intervention is needed because this is an appropriate action. Do not carry soiled linen down the hall to place in a receptacle.

2. Incorrect: No intervention is required because this is an appropriate action. Clients with tuberculosis (TB) need to be on airborne precautions in a negative pressure room with the door closed.

1. Incorrect: Although these are related to renal function, they do not impact the procedure itself. Therefore, they are not essential for the procedure.

2. Incorrect: Although both of these are carried out, they are not the priority over risk of bleeding. Always think what could be life threatening.

1. Incorrect: Although raw vegetables are full of fiber, vitamins and minerals, this is not the best option because they can contribute to foodborne illness, especially in a person who is immunosuppressed from receiving chemotherapy. Their immune system is weakened. To minimize the risk of infection, vegetables should be cooked for these clients. It is recommended that all fruits and vegetables be washed thoroughly in cold water and dried on a clean paper towel.

2. Incorrect: Oranges, grapefruits, and tangerines should be avoided in favor of softer, blander fruits such as bananas. Mouth sores are a common side effect of chemo treatment which can be extremely painful when even the blandest food rubs up against the sore. The citrus nature of oranges can cause discomfort if stomatitis is present.

1. Incorrect: Wernicke's Encephalopathy represents the most severe form of thiamine deficiency in alcoholics. Symptoms include paralysis of the ocular muscles, diplopia, ataxia, confusion, somnolence, and stupor. If thiamine replacement therapy is not given, death will ensue.

2. Incorrect: Korsakoff's Psychosis is identified by a syndrome of confusion, personality changes, loss of recent memory, and confabulation (filling in some memory gaps with different life events or created thoughts). It is frequently encountered in clients recovering from Wernicke's encephalopathy. Coordination may be affected, so the client may have difficulty maintaining balance. Treatment is parenteral or oral thiamine replacement.

1. Incorrect: If the client's BP drops below 90/60, this beta blocker should be held and the primary healthcare provider notified. The BP in this option is high enough to administer the medication, but the BP in clients on beta blockers should be monitored and the client should be taught about signs and symptoms of hypotension.

2. Incorrect: This is a normal glucose level. If the client is a diabetic, beta blockers can mask the signs of hypoglycemia. There diabetics on beta blockers should monitor their blood sugar carefully.

1. Incorrect: Taking sucralfate and lansoprazole at the same time will decrease the effects of lansoprazole because the sucralfate coats the stomach lining and reduces the absorption of the lansoprazole.

2. Incorrect: Taking sucralfate and lansoprazole at the same time will decrease the effects of lansoprazole because the sucralfate coats the stomach lining and reduces the absorption of the lansoprazole..

1. Incorrect. Respiratory syncytial virus (RSV) is a common and highly contagious virus that infects the respiratory tract of many children before their second birthday. This client requires contact and droplet precautions and should not be in the room with the client who has glomerulonephritis.

3. Incorrect. Febrile seizures are one of the most common neurologic childhood problems often caused by a fever with a viral infection. Although the underlying infection is not identified, this child with a probable infection should not be placed in the room with the client with glomerulonephritis.

1. Incorrect: Glucose tolerance test will show the immediate tolerance or response, to a glucose load. This test is often used to screen for gestational diabetes, and can be used to screen for type II diabetes. However it does not indicate what the blood glucose levels have been over time.

3. Incorrect: Glucose-6-phosphate is an enzyme that assists in maintaining the level of glutathione in erythrocytes to help protect against oxidative damage and breakdown of red blood cells (hemolytic anemia). Deficiency in glucose-6-phosphate dehydrogenase is linked to a genetic defect. This test does not measure blood glucose levels.

1. Incorrect: This is not the best action for the charge nurse to take.The charge nurse should remind the nurse of the responsibility for the agency to provide nondiscriminatory care to all clients. The re-assignment of the client to another nurse does not resolve the ethical dilemma by the nurse refusing to provide care.

3. Incorrect: The nurse can inform the employer of the reluctance to care for a certain population, but must provide strong rationale and documentation to support the necessity for refusal of the assignment. Recognition by the organization of an individual nurse's right to refuse to care for a specific client population sets a major personnel precedent and will not be made lightly. A health care agency has a responsibility to provide care for all clients accepted into the organization. Due to this responsibility the nurse cannot be guaranteed that he/she will never be asked to provide care for the client in question.

1. Incorrect: There is nothing in the question to suggest the client is embarrassed. In Asian cultures, making eye contact is considered disrespectful to the superior therefore, this client's demeanor is a respectful display of cultural influences.

3. Incorrect: The client's body language does not suggest disinterest. Although staring downward, this client does not display other signs of disinterest. A culturally aware nurse understands that the client's Asian background impacts this behavior and conveys the meaning of respect for the nurses' position.

1. Incorrect: Linen should be held away from the body to prevent contamination of the nurse's clothes. The linens should be handled as little as possible to avoid possible contamination of air, surfaces and persons.

2. Incorrect: Gloves should always be worn when handling soiled linen. A gown is not necessary. Soiled linen should be carried away from the body with minimal handling to prevent contamination.

2. Incorrect: No, that's left-sided heart failure. Hypertension increases afterload which can ultimately result in back flow to the left side of the heart and resulting left sided heart failure.

3. Incorrect: Not related to pulmonary hypertension. The mitral valve is located between the left atrium and left ventricle. If mild, there may be little or no obvious symptoms. However, if severe, left sided heart failure may occur.

3. Incorrect: This client is more acute and requires a higher skill level. Nursing care for this child would involve frequent neurologic assessments and monitoring for infection. The child should also be monitored for signs of possible complications including bowel perforation.

4. Incorrect: This client is more acute and requires a higher skill level. The nurse on the general pediatric unit would not be experienced in caring for a child on a ventilator.

3. Incorrect: This vaccine is recommended for people 60 years or older whether or not the person has ever had chicken pox and is at risk for developing shingles. Although the vaccine can be given to adults between the ages of 50-59, routine administration is not recommended.

1. Incorrect: This is arguing and defending which are non-therapeutic communication techniques. The nurse does not know how the others on the unit feel about the client, so this may not be a true statement. Arguing with a client's belief can further upset or anger the client and leads to mistrust of the nurse.

2. Incorrect: This is agreeing with the client that everyone hates the client. It also puts the client on the defense by implying that the client is at fault for doing something that made everyone hate the client. This response reinforces the client's false belief.

1. Incorrect: Clients should be turned at least every 2 hours, so this client is within the acceptable time frame for being turned.

3. Incorrect: The client with hip replacement needs the abduction pillow. This prevents dislocation of the hip prosthesis by helping to maintain the femoral head component in correct position.

4. Incorrect: There is nothing in this option to indicate that the child is unstable. This assignment is appropriate for LPN/VN

1. Incorrect: A nurse on an adult unit should understand classification of burns and associated care for the burn client. The pediatric burned client would be a similar to the condition adults might acquire, and the nurse's skill level could transfer to these clients.

2. Incorrect: The nurse who works on an adult unit should understand the concepts for caring for a client with a fracture. The pediatric client with the fracture would be a similar condition adults might acquire, and the nurse's skill level could transfer to these clients.

1. Incorrect: On NCLEX®, the nurse should know not to put work off on someone else. This answer avoids responsibility and does not provide the client with the information requested.

2. Incorrect: This answer assumes the client has financial concerns, but this is not the question the client asked. It also dismisses the client by being told not to worry.

1. Incorrect. A "2-gram sodium diet" would be appropriate for a client with hypertension.

2. Incorrect. Metoprolol is a beta-blocker used to decrease preload, which will also decrease pulse and blood pressure. The dose is appropriate for this client and does not need to be questioned.

1. Incorrect: 8:30 AM: Rapid acting insulin will begin peaking in 30 minutes.

3. Incorrect: 1:30 PM: Intermediate acting insulin begins peaking at 4 hours. So at 1:30 PM this would be a time of worry.

1. Incorrect: The size of the client's little finger does not determine the size of the oral airway that should be used. This would result in an inappropriate size oropharyngeal airway to be selected.

2. Incorrect: The epiglottis is an internal body part thus making it impossible to correctly measure it. In addition, the measurement would not determine the appropriate size oropharyngeal airway to use.

1. Incorrect: Although respiratory and heart rate may decrease with guided imagery and pain reduction, the most objective measure is to ask the client to rate the pain.

3. Incorrect: First, ask the client if pain is present. If present, the client should be asked to rate the pain. Once pain has been rated, the client should be asked to describe the pain.

1. Incorrect: A few small clots would be considered normal and occur due to pooling of the blood in the vagina. Passage of numerous or large blood clots (larger than a quarter) would indicate a problem.

1. Incorrect. The UAP can do this task as well as the LPN. In order to be most effective with the nurse's time, this task can be delegated to the UAP.

3. Incorrect. The RN with special training can insert a PICC line. The LPN cannot complete this task.

1. Incorrect: There would not be signs of infection so soon after the procedure.

2. Incorrect: The physiological needs have priority over psychological/self-esteem needs (Maslow's hierarchy). The fetal status should be the priority to be monitored. The client's feelings are important and would be assessed, but would not take priority over the fetal status.

1. Incorrect. Although this condition may be uncomfortable and could lead to renal problems if not resolved, it does not take priority over a client who is bleeding.

2. Incorrect. This person is likely experiencing pain, but this client does not take priority over a client who has peritonitis and may be going into shock from bleeding or third spacing into the peritoneum. Remember, pain never killed anyone.

1. Incorrect: This does not provide safety for the nurse and might increase the client's anger.

2. Incorrect: This is not a true statement and does not provide immediate safety for the nurse. Clients seeking treatment are not refused care in the ED.

1. Incorrect: Eating alone may actually lead to reduce food intake. Eating is also a social activity.

3. Incorrect: A high protein supplement may increase caloric intake however, to give that to the client 30 minutes before a meal will interfere with food intake at mealtime.

2. Incorrect: When an infection occurs, blood sugar increases. The normal response to infection is to increase available glucose to assist in combating the infection. This will increase the requirement for insulin, not decrease it.

3. Incorrect: Obesity increases not decreases insulin resistance, so the cells do not respond normally (are resistant) to insulin. Maintaining a healthy weight with exercise and diet can result in less need for insulin (less resistance to insulin) and less problems in individuals with type 2 diabetes.

1. Incorrect: This is an appropriate assignment. There are no identified contraindications for the nurse or clients to prevent the nurse from caring for a client with shingles.

2. Incorrect: This is an appropriate assignment. There are no identified contraindications for the nurse or clients to prevent the nurse from caring for a client with shingles.

2. Incorrect: The goal should be client centered. This option is a nursing intervention, not a client goal.

3. Incorrect: We are focusing on client response, not limiting pain meds. The goal of a pain crisis should be aimed at reducing the client's pain.

3. Incorrect: The priority is safety of the client and others on the unit. This question does not get the most essential information related to command hallucinations that may cause the client to engage in behavior that is harmful to self or others.

1. Incorrect: This is a sterile procedure. The catheter needs to be replaced because it is no longer sterile. The client would be at high risk of developing a urinary tract infection. The catheter cannot be made sterile by the use of alcohol.

3. Incorrect: This is a sterile procedure. The catheter needs to be replaced because it is no longer sterile. Inserting the now non-sterile catheter puts the client at risk for infection. There is no reason at this time to start antibiotics.

1. Incorrect: This problem is respiratory, but there is excessive CO2 loss. CO2 combines with water to form an acid. If too much of the CO2 is lost, the result of the acid forming substance loss would be alkalosis-Not acidosis.

3. Incorrect: The problem in this situation is respiratory in origin and has acid loss. Therefore, it is not metabolic nor acidotic in nature.

1. Incorrect: The family's wishes for treatment of the client do not take the place of or negate the client's advance directive.

2. Incorrect: This delays care and does not resolve an occluded NG tube.

3. Incorrect: Increasing the suction level is very dangerous for the client. This could cause hemorrhage in this client. Don't be a killer nurse! Call the primary healthcare provider.

1. Incorrect: The CVP is high and correlates with fluid volume excess. Dry oral mucous membranes indicate fluid volume deficit.

4. Incorrect: This client has adrenal insufficiency. Primary adrenal insufficiency occurs when at least 90 percent of the adrenal cortex has been destroyed generally from autoimmune disorders. Secondary adrenal insufficiency can be caused by such things as abrupt stoppage of corticosteroid medications and surgical removal of pituitary tumors. As a result, often both glucocorticoid (cortisol) and mineralocorticoid (aldosterone) hormones may be lacking. This puts the client at risk for fluid volume deficit (FVD) and shock. This requires the higher level assessment skills of the RN.

3. Incorrect: A structured schedule is needed for this client. If the client is allowed to perform the maladaptive behavior whenever desired, the client will not begin to problem solve ways to limit the ritual nor lessen the anxiety associated with the ritualistic behavior. The set schedule helps the client to develop trust with the nurse, knowing that time will be allowed for the behavior until better coping skills are developed.

2. Incorrect: Heparin is not part of the protocol within the guidelines and is not recommended at this time.

1. Incorrect: This will not prevent shearing forces on the skin and may result in scratches to the skin if the staff are wearing rings or other jewelry. The shearing force is created by gravity pushing down on the client's body, creating a resistance to movement. It creates a downward and forward pressure on tissues beneath the skin.

2. Incorrect: Using powder may actually irritate the skin as it may be abrasive when client's weight pushes against it and the bed.

1. Incorrect: Errors are more likely to be made if documentation is not made at the time the prescription is received.

2. Incorrect: Nurses can take telephone prescriptions however, safety measures include writing down the prescriptions immediately and repeating the prescriptions to the primary healthcare provider.

1. Incorrect: Striae on the abdomen may be a sign of past weight changes such as those seen with weight gain from pregnancy. These do not create abdominal discomfort nor constipation.

2. Incorrect: Borborygmi are normal, loud, rumbling sounds from gas movement through the intestines or from hunger. These are easily audible bowel sounds. These are not typically associated with constipation but may be present with diarrhea.

1. Incorrect: This is appropriate however, client safety is priority at this time. Suicide risk is higher when a plan is expressed and lethal means are available.

3. Incorrect: Charting the thinking pattern is an appropriate action however, the priority at this time is the client's safety. Suicide risk is higher when a plan is expressed and lethal means are available. Making a follow up appointment would be delaying care for the immediate action that is needed to protect the client.

2. Incorrect: This is seen in tension headaches. Headaches last 30 minutes to 7 days. Pain is mild or moderate in intensity. It is not aggravated by routine physical activity. Nausea/vomiting, photophobia and phonophobia are not common manifestations with tension headaches. These usually start gradually, often in the middle of the day.

3. Incorrect: This is associated with cluster headaches, which are severe or very severe unilateral orbital, supraorbital and/or temporal pain lasting 15-180 minutes. Symptoms include stabbing pain in one eye with associated rhinorrhea (runny nose) and possible drooping eyelid on the affected side. The headaches tend to occur in "clusters": typically one to three headaches per day (but may be as many as eight) during a cluster period.

2. Incorrect: This is not the best option. Some pre-surgical procedure may be difficult to draw or difficult for the client to understand what was drawn. There is no way to know if the client is understanding what the nurse is trying to communicate through the pictures. Client safety could be compromised if decisions are made based on inaccurate perceptions.

3. Incorrect: This is called "Getting by" and may have to be used when the nurse cannot speak the client's language, and there are no interpreters, audiotapes, or written materials available to inform the client in their language. This is not the best option and should be used only if other more reliable means for interpreting are not available.

2. Incorrect: Generativity versus Stagnation is the major task for 40-64 year olds. To achieve the life goals established for oneself while also considering the welfare of future generations. The primary developmental task during this middle age period is one in which the individual contributes to society as well as helping to guide future generations. A sense of generativity (sense of productivity and accomplishment) often results from such things as raising a family and helping to better the society. In contrast, those individuals not willing to work to better society and those who are egocentric and self-centered often develop a sense of stagnation (dissatisfaction and the lack of productivity).

3. Incorrect: Intimacy versus Isolation is the objective from 20-39 year olds to form an intense, lasting relationship or a commitment to another person. If the individual cannot form the intimate relationships (possibly due to personal needs) a sense of isolation may develop which can lead to feelings of depression.

2. Incorrect: Pain medication is traditional, not alternative pain control. Also, pain medication should be provided prior to a rate of 5/10.


CHAPTER 9 - CHELONIANS

This chapter covers the basic anatomy, physiology, husbandry, and health issues of chelonians. Chelonians represent one of the most unique and recognizable groups of animals in the world. For husbandry of chelonians, the shape and size of the enclosure should be selected based on the chelonian's habitat preference. Aquatic species should be provided deep, leak-proof enclosures, whereas tortoises can be provided shallow containers. All chelonians should be provided the largest enclosure possible. Maximizing the surface area of the enclosure is important for ensuring ample area for exercise and an appropriate thermal gradient. Chelonians are ectotherms and depend on the environmental temperature to regulate their core body temperature. If these animals are not provided an appropriate temperature range, their metabolic rate slows. Chelonians with reduced metabolic rates often present with a history of being anorectic, lethargic, and depressed. An inability to maintain an appropriate body temperature can also result in a reduced immune response. Substrate selection for chelonians is also an important consideration, as many of these animals are geophagic and can develop foreign bodies if provided an inappropriate substrate. Aquatic species must be provided access to a clean water source. A chelonian vivarium should mimic an animal's natural habitat. Accessories or “cage furniture” can be used to create an environment that reduces the stress an animal may otherwise encounter in captivity.


You’re Not a Dried Up Old Prune, Why Should Your Skin Look Like One?

Let’s face facts: As we age, our skin goes from baby smooth to drip and droop. If you are like most women, trying to prevent your “true” age from showing may be a continuous battle that you may or may not feel like you are losing. Every day new lines and wrinkles show up where they never were before and although this can be disheartening, we encourage all women to take a stand against aging!

Here is another fact to chew over: You do NOT need to be twenty to have fabulous skin. Beautiful skin is the reflection of proper skin care, a good diet and a conscious effort to look your best at any age. If you have fabulous skin when you’re twenty, that’s the result of genetics but having fabulous skin at fifty? That’s something to brag about!
Wrinkles begin to show as early as your mid-twenties. These begin as fine lines around the eyes, lips, chin and nose. These initial signs of aging should be the first red alarm that your skin care routine needs to be updated. A daily moisturizer is a simple way to combat these early signs but can be ineffective during the greater battle. Remember you are not just fighting time – genetics, the environment and natural biology will all play a role.

Start with a basic understanding of what to expect by studying your family. A mother being a “preview” of what you can expect to look like in twenty years is a phrase that holds some truth. Genetics play a HUGE role in how we develop and that doesn’t stop during the advanced aging process. If your mother (or father) has deep wrinkles, pronounced sagging skin or develops uneven skin texture and color, these are all problems you may need to eventually face but should certainly act upon to prevent. Yes, prevent. Skin care is not just about dealing with the problems as they arise it’s about stopping them before they start!
Design a system that will target your specific skin types and needs. We recommend a six step system that will cleanse, exfoliate, tone, correct, moisturize and protect.
Begin with a basic cleanser: depending on your particular skin type and whether you are seeking botanical, natural organic or Cosmeceuticals (anti-aging) this may vary. A good cleanse will remove excess debris and oils from the skin, preparing it for step two.
Exfoliation: The build up of dead skin cells and debris is a prime source of wrinkles and fine lines in the face. A gentle exfoliant will remove this build up without causing damage to your skin.
Toner: After cleansing and exfoliation, you may wonder why you should bother adding in a toner. Water contains harsh minerals that will build up on your skin, even when you are rinsing off the cleanser and toner. A quick rub of toner will remove these impurities and leave your skin primed for more aggressive care.
Correct: Should your skin have any special issues such as uneven skin tone, discolorations, redness, loss of elastic, dark eye circles – now is the step to apply targeted products. Your skin is clean and ready to receive these treatments without applying it to unnecessary dead skin cells.
Moisturize: Hydration will play a key factor in keeping your skin looking beautiful. Your skin relies on water and natural oils to stay smooth and feel beautiful. By removing these oils to remove the grime and debris, we are actually depriving our skin of its most basic essentials. Now it is time to replenish the skin with carefully designed moisturizers that will penetrate the outer layers of skin and reach the deepest layer. Healthy new skin cells will develop and give you that smooth skin you want and deserve!
Protect: If you’re outside, protect your skin by covering up with a SPF 30 moisturizer. This will prevent sun damage and keep your skin safe. Remember that any exposure is really too much so even in the winter when the sun may not be so obvious, add this to your daily routine!
Occasional Masques: Applying a masque one a week or every other week is a great way to penetrate the skin even further. These will often exfoliate and hydrate the skin simultaneously and leave your face and body feeling smooth and glowing.

Take control of your skin today and take steps towards keeping your skin healthy, beautiful and youthful for an entire lifetime!


Ingredients of Resurge

  1. 10mg Melatonin
  2. 150mg Ashwagandha plant
  3. 100mg Hydroxytryptophan
  4. 200mg L-Theanine
  5. 50mg Magnesium
  6. 15mg zinc
  7. 1200mg Arginine
  8. 1200mg Lysine

According to the ‘specialist’, each of these ingredients are good for sleep when taken alone, but work even better when taken together at the same time.

Barban also claims that the last two ingredients (Arginine and Lysine) have been proven to increase growth hormone levels by ‘up to 695%’ during sleep. We’ll see about that.


50 Facts About Nature's Wonders That Will Take Your Breath Away

Even the most methodical scientists and jaded skeptics can't help but be impressed by the awesomeness of nature. Whether it's the majesty of the Grand Canyon, the intensity of a hurricane, or the intricate beauty of a colorful butterfly, the world around us really is incredible. But the craziest thing about nature is perhaps that there is always new information to learn and new sights to see. So, we've rounded up some shocking, funny, and just plain weird facts about nature's wonders that will give you even more appreciation for the planet's riches.

Arcadia trees, which grow all over the African savannah, have a unique defense system. When animals like antelopes start to gobble up its leaves, the tree increases tannin production to levels that are toxic to animals.

But that's not all. The tree then emits a cloud of ethylene gas that travels through the air, reaching other trees so they too can begin producing more tannins.

What they have instead are better described as eye tubes. Since they can't move these tubes back and forth, owls have developed incredible neck flexibility to be able to see the world around them. They can turn their heads a whopping 270 degrees , whereas humans can only manage about 180.

As a result, owls have a special blood vessel system in their heads to keep fresh blood circulating to the brain when a quick head turn cuts off circulation.

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On Earth, you need heat to fuse metal, but in space, two pieces of the same kind of metal will fuse together with only a little pressure. The process is called cold welding , and it happens because of the lack of atmosphere.

You might not know about the plant genus Rafflesia, but you may have heard about the "corpse flower," a rare type of jungle plant that attracts pollinating insects to its huge flowers by smelling like death and rot.

In fact, there are 28 distinct species of this rootless, leafless plant, with flowers varying in size from about 5 inches to 40 inches. Most of these flowers take six to nine months to grow and will begin to decay within a few days.

Fun fact: The Pokémon characters Vileplume and Gloom were inspired by this unusual flower.

While adult giraffes usually sleep standing up, b aby giraffes will get a bit more comfortable. They hunker down on the ground and take advantage of their extra-flexible necks, twisting around to plop their noggins on their own behinds. It doesn't look especially comfortable, but it sure does look cute!

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Tornadoes, hurricanes, and flooding can devastate entire towns at once, but the weather condition that proves deadliest to humans is actually heat.

Looking at the numbers from the past 30 years, tornadoes caused an average of 70 deaths a year and flooding an average of 81, but heat caused an average of 130 deaths a year. If you don't have access to air conditioning or sufficient water, excessive heat can be deadly.

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Turns out, Jaws really blew things out of proportion for sharks. According to the Center for Disease Control, sharks kill an average of four people per year, while cows kill an average of 22 annually. Though some are due to road accidents, 75 percent were premeditated attacks.

"What's really chilling is that, in five cases, people were killed by multiple cows in group attacks," one Gizmodo reporter wrote. "Group attacks can be surprisingly well-coordinated. When they're feeling defensive, cows will gather in a circle, all facing outwards, lowering their heads and stamping the ground. When they're feeling offensive, certain cows lead the charge."

The biggest penguins around nowadays are emperor penguins, measuring a respectable 4 feet in height.

However, 37 million years ago, a species known as Palaeeudyptes klekowskii , or colossus penguins , roamed Antarctica. They weighed about 250 pounds and stood about 6 feet, 6 inches tall, which is the height of the average NBA player. Unfortunately, like modern penguins, these colossus penguins could neither fly nor, presumably, dunk. But it's still fun to imagine a penguin going one-on-one with LeBron James.

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Researchers at Queen Mary University of London found that though goats don't have their own language, they do seem able to pick up accents from one another. You can listen to some of them here.

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Found all across the United States, particularly in the Pacific Northwest, the mushroom Hydnellum peckii has a pretty unmistakable appearance, particularly when it's young.

This fungus exudes a thick, dark red sap across a white cap, earning it numerous nicknames, from "strawberries and cream," to "devil's tooth," to "bleeding tooth fungus." Fortunately, neither the fungus nor the sap are poisonous, but they're both said to be inedibly bitter. So we suggest staying away.

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Apparently, democracy isn't limited to humanity. For example, African buffalo herds are known to select the direction they'll travel by voting.

One by one, the adult females of the herd will stand up, look in a particular direction, and then lay back down. Whichever direction gets the most looks is almost always where the herd travels. If voting is strongly divided, the herd will often split up temporarily.

Red deer and numerous kinds of monkeys display similar democratic behavior.

You've probably heard of carnivorous plants like the Venus flytrap, but the Nepenthes lowii (or the Low's pitcher-plant) has moved away from eating animals, to instead feasting on what they leave behind.

The plant secretes a white, sugary nectar that both birds and shrews love. But in order to access it, they must perch their rear ends over the mouth of the Low's pitcher-plant. "Basically it's a toilet complete with a feeding station," said one researcher at Royal Roads University in British Columbia.

Bats tend to get a bad rap. The truth is, they gobble up lots of troublesome insects. In fact, they're so good at keeping pests away from our food crops that they save U.S. farmers alone at least $3.7 billion on pesticides every year. So bats are actually a significant factor in our agricultural economy.

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Fossil evidence shows us that, over the past 10,000 years, the average human brain has shrunk about the size of a tennis ball. But that doesn't mean we're any less intelligent. Our smaller brains are probably more efficient, particularly since most of us live in settled societies and don't need to constantly be on the lookout for predators. So don't worry too much your own brain is probably just fine.

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Dark Truth about Dark Eyes

They say that beauty is in the eye of the beholder and believe us when we say there is no more critical judge of your face than your set of eyes. Lines, wrinkles and puffiness can all contribute to signs of aging but perhaps the most frustrating problem to face is dark under eye circles. Sometimes referred to as “bags” because they can be accompanied by puffiness, this is something that affects men and women equally. Luckily there are steps you can take to banish the darkness and greet the day with eyes that look as great as you feel.

Before you can treat a problem you have to know the source. Late nights are often blamed for this occurrence but if that were the case a good night’s sleep should provide a simple cure. Anyone who has developed dark eyes knows that sometimes no matter how great your sleep was those bags still taunt you in the morning.

So what could be causing those dark shadows to develop?

Common sources of under eye circles include:

• Allergies
• Heredity
• Pigmentation Irregularities
• Nasal Congestion (there is a reason you don’t look so great when your sick)
• Thinning Skin (result of intrinsic or natural aging)
• Loss of Collagen and Elasticity (result of intrinsic or natural aging)
• Sun Exposure (result of extrinsic aging or aging influenced by the environment)
• Lifestyle Factors like smoking, drinking alcohol or caffeine

Self Treatment versus Professional Care

Seeing a specialist such as a dermatologist can be an expensive choice when dealing with a problem like under eye circles. If you are worried there might be other factors contributing to your dark eyes consult with a physician but there are several at home treatments that you can try as well.

• Cold Compress – try placing a cold or cool compress against your eyes. This can reduce dilation and puffiness temporarily.
• Pillows – an extra pillow under your head at night can prevent fluid from pooling in the lower lids.
• Get More Rest – while it is true that a lack of sleep is not a direct cause of your dark eyes, less sleep can make your eyes appear more hallow and impact the overall look and feel of your skin. Catch some extra “z’s” to keep your skin looking fresh.
• Protect Your Skin – the environment and especially the sun can wreak havoc on your skin in the long run. Overexposure can lead to a myriad of health problems to cover up when possible (sunglasses are an inexpensive way to protect the fragile skin around your eyes) and use sun block, even in the Winter.
• Make Up – Although not all make up will cover those dark circles, try an oil free concealer to help minimize the appearance. This should be paired with a cold compress to reduce puffiness at the same time.
• Serums – There are several great serums available that utilize natural ingredients to minimize the appearance of dark circles. Try using one twice daily to see incredible results!

Don’t let dark circles ruin your day! Fight back against this premature sign of aging by taking control. Home remedies may take time to show full results (allow up to 12 weeks) but are worth the investment on the road to healthier, happier skin care.


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Here you will find our acne frequently asked questions. If your question is not answered here, please feel free to contact us.

1. What causes acne?

All acne is a disorder of the pilosebaceous unit, which is made up of a hair follicle, sebaceous gland, and a hair. These units are found everywhere on the body except on the palms, soles, top of the feet, and the lower lip. The number of pilosebaceous units is greatest on the face, upper neck, and chest. Sebaceous glands produce a substance called sebum, which is responsible for keeping the skin and hair moisturized. During adolescence sebaceous glands enlarge and produce more sebum under the influence of hormones, also called androgens. After about age 20, sebum production begins to decrease.

A bacteria, known as Propionibacterium acnes, is a normal inhabitant of the skin. It uses sebum as a nutrient for growth, therefore increases in follicles during puberty.

People with acne have more Propionibacterium acnes in their follicles than people without acne. The presence of bacteria attracts white blood cells to the follicle. These white blood cells produce an enzyme that damages the wall of the follicle, allowing the contents of the follicle to enter the dermis. This process causes an inflammatory response seen as papules (red bumps), pustules, and nodules. The bacteria also cause the formation of free fatty acids, which are irritants, increasing the inflammatory process in the follicle.

Sebum produced by the sebaceous gland combines with cells being sloughed off within the hair follicle and "fills up" the hair follicle. When the follicle is "full", the sebum spreads over the skin surface giving the skin an oily appearance. When this process works correctly, the skin is moisturized and remains healthy.

Problems arise when the sebum is trapped in the hair follicle. For reasons that are still unclear, some hair follicles become obstructed. The sebum is produced but gets trapped on the way out, and the cells that are normally sloughed off become "sticky", plugging up the follicle. The process of obstructing follicles is called comedogenesis. It causes some follicles to form a type of acne called comedones, also known as blackheads and whiteheads. [top of page]

2. Acne in teens

Acne commonly starts in the early teen years, when the oil glands in the body start making more sebum (oil). Some people also have too many "sticky" skin cells. In people who have acne, these cells mix with the oil and plug up the hair follicles in the skin.

A "whitehead" results when the hair follicle is plugged with oil and skin cells. If this plug reaches the surface of the skin and the air touches it, it turns black and is called a "blackhead." A blackhead isn't caused by dirt.

If the wall of a plugged follicle breaks, the area swells and turns into a red bump. If the follicle wall breaks near the skin surface, the bump usually becomes a pimple. If the wall breaks deep in the skin, acne nodules or cysts can form. This is called "cystic acne."

Things that often make acne worse

  • Oil-based makeup, suntan oil, hair gels and sprays
  • Stress
  • In girls: menstruation
  • Squeezing or picking at blemishes
  • Hard scrubbing of the skin
  • Too much exposure to the sun
  • Things that don't cause acne
  • Dirt
  • Foods such as chocolate or French fries
  • Sexual activity
  • Masturbation

Both boys and girls get acne. But it may be worse in boys because they have more skin oils.

Heredity also plays a role. If your mother and father had bad acne, you may too.

Your immune system plays a role too. Some people are extra sensitive to the bacteria that get trapped in their hair follicles.

How can acne be treated?

Acne can be treated in different ways. Talk with your doctor about the options.

Can an over-the-counter acne product help?

Yes. Benzoyl peroxide, resorcinol, salicylic acid and sulphur are the most common over-the-counter medications used to treat acne. Each works a little differently. These medications are available in many forms, such as gels, lotions, creams, soaps or pads. (Many have side effects!)

In some people, over-the-counter acne medications may cause side effects such as skin irritation, burning or redness. Tell your doctor if you have side effects that are severe or that don't go away over time.

Keep in mind that it can take between 4 and 8 weeks before you notice an improvement in your skin. If an over-the-counter acne product doesn't seem to help after 2 months, get advice from your doctor.

What can my doctor prescribe?

Your doctor may recommend antibiotics, which can be very effective for treating acne. They can be taken by mouth, or used on the skin in a lotion, cream or gel.

Retinoid, such as tretinoin (brand names: Retin-A, Avita, Altinac cream) and adapalene (brand name: Differin), are other medicines for treating acne. They are usually rubbed onto the skin once a day. Be sure not to get them near your eyes, mouth and the area under your nose.

If you use a retinoid, you must avoid the sun or use a strong sunscreen because this medicine increases your risk of getting a very bad sunburn. Girls who are pregnant or may become pregnant should not use a retinoid called tazarotene (brand name: Tazorac) because it can cause birth defects.

How is severe cystic acne treated?

Isotretinoin (brand name: Accutane) may be used to treat severe cystic acne that doesn't get better with other treatments. It's a pill that is taken once a day by mouth for 15 to 20 weeks.

In girls, isotretinoin can cause very serious side effects such as birth defects and miscarriages. It should never be taken during pregnancy or even 1 month before pregnancy. Girls must use 2 types of birth control or not have sex while they take isotretinoin, as well as 1 month before they start and 1 month after they stop taking it.

There is a possibility that other side effects may occur, so people taking isotretinoin should be closely monitored by their doctor.

Acne, especially cystic acne, can cause scars in some people. You can help reduce scarring by not squeezing or picking at blemishes. Also, avoid scrubbing your skin. If you do get scars, treatments are available. [top of page]

3. Information for parents on acne

Acne. Pimples. and Zits

Think back, way back for some of us, to your teen years when you were standing in front of a mirror staring at the huge zit on your face. Thoughts were racing through your mind. 'How did it get there?' and more importantly, 'How were you going to get it off before someone actually sees it?' Now keep this thought in the back of your mind. You're going to need to draw some sympathy from it when your teen is asking for yet another five bucks to try yet another acne medication, face wash, cream, etc.

The truth is no one is sure what causes acne. Scientists think a hormone called androgen plays a role. Androgen stimulates the sebum-producing glands. After puberty, boys produce 10 times as much androgen as girls. Therefore, more boys tend to develop severe cases of acne than girls, but that does not mean that some girls won't develop a severe case.

  • Acne most often starts at around age 11 for girls and 13 for boys
  • There's no scientific evidence to back up the claims that junk food and greasy foods cause acne. But, if your see an increase in acne after your teen eats these foods, have them cut back on eating them.
  • A whopping 85 percent of the U.S. population between ages 12 and 25 develops some form acne.
  • There's no scientific evidence to back up the claims that oily skin or hair causes acne. But if your teen is experiencing more pimples under their bangs for instance, it might be a good idea to change their hair style.
    Some studies have shown that up to 70 percent of women notice their acne worsening the week before their periods.
  • If you or your spouse had problem acne as a teenager, there is more of a likelihood that your teen will experience this.
  • There's no scientific evidence to back up the claims that stress brings on acne. But many teens experience a break out right before big events in their lives. A little sympathy, and reassurance can help here.

What can you do about acne?

Mild acne can often be cleared up simply by washing your face once or twice daily. If this doesn't work, try some of the over the counter products that clear skin. These drugs are "peeling agents," which cause irritation and drying that help the body loosen plugs and shed dead cells. The drugs also can keep bacteria from forming, which reduces the fatty acids that contribute to acne.

Don't let them pick at or "pop" zits. This can injure skin and underlying tissues. If they have acne that won't clear up with home treatment, take them to a dermatologist, a doctor who specializes in treating skin problems. [top of page]

4. Before you buy an acne treatment

Everybody gets zits. True, some of us get more than others, but nobody escapes puberty (or life for that matter) without dealing with the odd flare up. Things like stress, hormones, environment and life style can cause break outs, but more often than not how badly you get acne depends on one thing -- genetics. Yes, it is sad but true, if zits are in your genes there is nothing you can do to stop them from coming. But don't despair, you can successfully control most break outs and flare ups with over-the-counter acne products and we've assembled a list of the most teen friendly products on the market. Whether you prefer medicated products or natural therapies, we can help you find the ones that work and avoid the ones that don't.

Before you buy any acne treatment product you should take the following into consideration:

Know your skin type. People with oily skin should choose a gel based product, those with dry skin should choose a cream. If you are like most people and have combination skin, choose the product that best works with the afflicted area. If your acne flares up in the oily spots, choose a gel, if it is the dry skin that gets the zits, choose a cream.

The more sensitive your skin, the lower concentration of active ingredient you will need. Choosing a product that is too strong could actually make the situation worse by over drying the area and causing the skin to react by increasing oil production. This can end up causing more acne. If you have sensitive skin, stick with the milder formulations.

Some mild creams can be used as a preventative measure, but most acne creams are too harsh to be used before you see or feel a zit. Read the labels carefully and only apply the medication to places that are acne prone or actually have acne present.

If the acne is excessively painful, or if it becomes painful after trying an OTC product, try taking an anti-inflammatory medication like ibuprofen and get to a doctor ASAP.
If your skin has large pustules that appear in clusters, if they are painful, if your acne causes scars, or if you can't seem to get rid of a blemish (it starts to go away only to reappear just when you thought it was gone), your acne may require treatment by a doctor.

Regardless of category or active ingredients, these products are quite simply the best.

Medicated Products

Medicated products contain a chemical that dries up the pimple while acting as an exfoliant. The most common ingredients used for this purpose are Benzoyl peroxide and solicit acid. People with sensitive skin should choose a product that contains solicit acid over one containing Benzoyl peroxide. The amount of drying chemical added to a product is measured in terms of percentage, with the stronger creams having a higher percentage (or concentration) of the active ingredient. Contrary to the "more is better" instinct, the highest concentration is not always the most effective, it all depends on your skin type and the sort of acne you are dealing with. Some acne will not respond well to OTC products and must be treated by a doctor or dermatologist (skin specialist).

Natural products contain various naturally occurring ingredients, usually plant extracts, that work to dry up the pimple and sooth the effected area. Most of these products are blends of natural ingredients like Vitamin E, grape seed oil, calendula, aloe vera or witch hazel and essential oils, but there are a few essential oils that work well in treating acne when used alone or with a single carrier oil. Natural treatments contain ingredients to dry the blemish, sooth the redness and add moisture to the irritated area. It is important to note that just because a product is natural doesn't mean that it is mild. People with sensitive skin should be every bit as careful when using a natural treatment as they are when using one that is medicated. Natural products can be very irritating to sensitive skin and can even cause reactions in people with allergies like hay fever. As with medicated treatments, if a natural treatment makes the acne worse or causes a painful reaction you should stop using the product and see a doctor right away. [top of page]

5. Types of acne

Acne Basics

Acne is the most common skin disorder seen by doctors. In fact, it will affect almost every one of us at some time in our lives. It can happen at any time, but teenagers are the ones who get it most often.

Acne can cause a great deal of embarrassment and anxiety. If it s really bad it can cause people to become depressed. They may withdraw from their friends, and perform poorly at school or work.

Visible Signs Of Acne:

The following are visible signs of acne:

An early acne blemish is caused by blocked pores, and at first the skin does not look red and inflamed. These early blemishes are called open comedones (black specks/blackheads) and closed comedones (white heads).

As these early spots get larger and inflamed, they become papules and pustules (pimples or zits).

Nodules:

Very large and deep lumps can also develop in some people, these are called nodules and cysts (like boils), and can be painful.

Oily skin:

The sebum production increases so that your skin looks and feels oily.

After the inflammation subsides, the skin can be discoloured by brown acne stains, (called Hyperpigmentation), and damaged by scars. Acne scars are common and may occur even in mild acne.

Acne is the most common of all skin disorders. Almost everyone will have acne - most get mild cases, some moderate, and a few are severe. Teens aren't the only ones who get it. Acne has been diagnosed in young infants as well as in the elderly, but it is most often seen in teens and young adults with 85-100% of adolescents and up to 10% of young adults getting it.

Acne seems to affect the sexes somewhat differently. Before children reach puberty, acne is more commonly seen in girls. During puberty, acne affects boys and girls almost equally, but boys generally have more severe cases, and in adulthood, it tends to be seen more often in women.

Where Does Acne Develop?

You can have acne on any part of your skin where sebaceous glands are found. These are the glands that produce oil for the skin. Most, but not all people get acne on their face, but the skin on the chest and back can also be affected. Acne can also be seen on the arms and thighs, but it s much less common.

When Do People Get Acne?

Acne usually starts around the time you reach puberty, and usually will be mild. Often it will last for about 5 years, but can persist for as long as 10-20 years. About 25% of teens who have acne will still have it when they turn 25. The cause is not understood, but it s becoming more common for women who are in their 20s, 30s, and 40s to develop acne, often for the first time. Temporary acne is often seen on the faces of newborns.

How Does Acne Affect You?

Acne not only causes physical discomfort and damage, but it can also have a big emotional and social impact on your life. Acne pimples, or zits can be tender and painful, and in extreme cases, the pimples can drain pus and blood, soiling pillowcases and clothing.

But, if you re feeling embarrassed and anxious about your appearance, that can be even more painful. Emotional effects can lead to mood changes, depression, social withdrawal and poor performance in school or at work. If acne is bad enough to leave scars, you may have to endure these emotional issues for years, because scarring is not readily correctable. While laser therapy and skin fillers certainly improve scars, it is best if you can prevent their formation in the first place. [top of page]

6. Acne education

What is Acne?

Acne is the term for plugged pores (blackheads and whiteheads), pimples, and even deeper lumps (cysts or nodules) that occur on the face, neck, chest, back, shoulders and even the upper arms. Acne affects most teenagers to some extent. However, the disease is not restricted to any age group adults in their 20s - even into their 40s - can get acne. While not a life threatening condition, acne can be upsetting and disfiguring. When severe, acne can lead to serious and permanent scarring. Even less severe cases can lead to scarring.

When you read about acne or other skin diseases, you encounter words or phrases that may be confusing. For example, the words used to describe the lesions of acnecomedo, papule, pustule, nodule and cystare understandable only if you know each word s definition. It also is helpful to have a photo that is characteristic for each type of lesion.

Here is a brief summary of definitions of words used to describe acne, with accompanying photos. Let s begin, though, with the definition of lesion, an all-purpose word:

Lesions are a physical change in body tissue caused by disease or injury. A lesion may be external (e.g., acne, skin cancer, psoriatic plaque, knife cut), or internal (e.g., lung cancer, atherosclerosis in a blood vessel, cirrhosis of the liver).

Thus, when you read about acne lesions you understand what is meant by a physical change in the skin caused by a disease process in the sebaceous follicle.

Acne lesions range in severity from comedones (blackheads and whiteheads) to nodules and cysts. Here is a brief definition of acne lesions:

Comedo (plural comedones) A comedo is a sebaceous follicle plugged with sebum, dead cells from inside the sebaceous follicle, tiny hairs, and sometimes bacteria. When a comedo is open, it is commonly called a blackhead because the surface of the plug in the follicle has a blackish appearance. A closed comedo is commonly called a whitehead its appearance is that of a skin-colored or slightly inflamed "bump" in the skin. The whitehead differs in colour from the blackhead because the opening of the plugged sebaceous follicle to the skin s surface is closed or very narrow, in contrast to the distended follicular opening of the blackhead. Neither blackheads nor whiteheads should be squeezed or picked open, unless extracted by a dermatologist under sterile conditions. Tissue injured by squeezing or picking can become infected by staphylococci, streptococci and other skin bacteria.

PapuleA papule is defined as a small (5 millimetres or less), solid lesion slightly elevated above the surface of the skin. A group of very small papules and microcomedone may be almost invisible but have a "sandpaper" feel to the touch. A papule is caused by localized cellular reaction to the process of acne.

PustuleA dome-shaped, fragile lesion containing pus that typically consists of a mixture of white blood cells, dead skin cells, and bacteria. A pustule that forms over a sebaceous follicle usually has a hair in the centre. Acne pustules that heal without progressing to cystic form usually leave no scars.

MaculeA macule is the temporary red spot left by a healed acne lesion. It is flat, usually red or red-pink, with a well defined border. A macule may persist for days to weeks before disappearing. When a number of macules are present at one time they can contribute to the "inflamed face" appearance of acne.

Nodule Like a papule, a nodule is a solid, dome-shaped or irregularly-shaped lesion. Unlike a papule, a nodule is characterized by inflammation, extends into deeper layers of the skin and may cause tissue destruction that results in scarring. A nodule may be very painful. Nodular acne is a severe form of acne that may not respond to therapies other than isotretinoin

CystA cyst is a sac-like lesion containing liquid or semi-liquid material consisting of white blood cells, dead cells, and bacteria. It is larger than a pustule, may be severely inflamed, extends into deeper layers of the skin, may be very painful, and can result in scarring. Cysts and nodules often occur together in a severe form of acne called nodulocystic. Systemic therapy with isotretinoin is sometimes the only effective treatment for nodulocystic acne. Some acne investigators believe that true cysts rarely occur in acne, and that (1) the lesions called cysts are usually severely inflamed nodules, and (2) the term nodulocystic should be abandoned. Regardless of terminology, this is a severe form of acne that is often resistant to treatment and likely to leave scars after healing.

Close to 100% of people between the ages of twelve and seventeen have at least an occasional whitehead, blackhead or pimple, regardless of race or ethnicity. Many of these young people are able to manage their acne with over-the-counter (non-prescription) treatments. For some, however, acne is more serious. In fact, by their mid-teens, more than 40% of adolescents have acne severe enough to require some treatment by a physician.

In most cases, acne starts between the ages of ten and thirteen and usually lasts for five to ten years. It normally goes away on its own sometime in the early twenties. However, acne can persist into the late twenties or thirties or even beyond. Some people get acne for the first time as adults.

Acne affects young men and young women about equally, but there are differences. Young men are more likely than young women to have more severe, longer lasting forms of acne. Despite this fact, young men are less likely than young women to visit a dermatologist for their acne. In contrast, young women are more likely to have intermittent acne due to hormonal changes associated with their menstrual cycle and acne caused by cosmetics. These kinds of acne may afflict young women well into adulthood.

Acne lesions are most common on the face, but they can also occur on the neck, chest, back, shoulders, scalp, and upper arms and legs.

Normal distribution of acne

Acne also has significant economic impact. Americans spend well over a hundred million dollars a year for non-prescription acne treatments, not even taking into account special soaps and cleansers. But there are also the costs of prescription therapies, visits to physicians and time lost from school or work. [top of page]

7. A complete acne guide

What Is Acne?

Acne is a disorder resulting from the action of hormones on the skin's oil glands (sebaceous glands), which leads to plugged pores and outbreaks of lesions commonly called pimples or zits. Acne lesions usually occur on the face, neck, back, chest, and shoulders. Nearly 17 million people in the United States have acne, making it the most common skin disease. Although acne is not a serious health threat, severe acne can lead to disfiguring, permanent scarring, which can be upsetting to people who are affected by the disorder.

How Does Acne Develop?

Doctors describe acne as a disease of the pilosebaceous units (PSUs). Found over most of the body, PSUs consist of a sebaceous gland connected to a canal, called a follicle, that contains a fine hair (see "Normal Pilosebaceous Unit" diagram, below). These units are most numerous on the face, upper back, and chest. The sebaceous glands make an oily substance called sebum that normally empties onto the skin surface through the opening of the follicle, commonly called a pore. Cells called keratinocytes line the follicle.

Normal Pilosebaceous Unit

The hair, sebum, and keratinocytes that fill the narrow follicle may produce a plug, which is an early sign of acne. The plug prevents sebum from reaching the surface of the skin through a pore. The mixture of oil and cells allows bacteria Propionibacterium acnes (P. acnes) that normally live on the skin to grow in the plugged follicles. These bacteria produce chemicals and enzymes and attract white blood cells that cause inflammation. (Inflammation is a characteristic reaction of tissues to disease or injury and is marked by four signs: swelling, redness, heat, and pain.) When the wall of the plugged follicle breaks down, it spills everything into the nearby skin--sebum, shed skin cells, and bacteria--leading to lesions or pimples.

People with acne frequently have a variety of lesions, some of which are shown in the diagrams below. The basic acne lesion, called the comedo (KOM-e-do), is simply an enlarged and plugged hair follicle. If the plugged follicle, or comedo, stays beneath the skin, it is called a closed comedo and produces a white bump called a whitehead. A comedo that reaches the surface of the skin and opens up is called a blackhead because it looks black on the skin's surface. This black discoloration is not due to dirt. Both whiteheads and blackheads may stay in the skin for a long time.

Other troublesome acne lesions can develop, including the following:

Papules--inflamed lesions that usually appear as small, pink bumps on the skin and can be tender to the touch
Pustules (pimples)--papules topped by pus-filled lesions that may be red at the base
Nodules--large, painful, solid lesions that are lodged deep within the skin
Cysts--deep, painful, pus-filled lesions that can cause scarring.
What Causes Acne?

The exact cause of acne is unknown, but doctors believe it results from several related factors. One important factor is an increase in hormones called androgens (male sex hormones). These increase in both boys and girls during puberty and cause the sebaceous glands to enlarge and make more sebum. Hormonal changes related to pregnancy or starting or stopping birth control pills can also cause acne.

Another factor is heredity or genetics. Researchers believe that the tendency to develop acne can be inherited from parents. For example, studies have shown that many school-age boys with acne have a family history of the disorder. Certain drugs, including androgens and lithium, are known to cause acne. Greasy cosmetics may alter the cells of the follicles and make them stick together, producing a plug.

Factors That Can Make Acne Worse

Factors that can cause an acne flare include:

Changing hormone levels in adolescent girls and adult women 2 to 7 days before their menstrual period starts
Friction caused by leaning on or rubbing the skin
Pressure from bike helmets, backpacks, or tight collars
Environmental irritants, such as pollution and high humidity
Squeezing or picking at blemishes
Hard scrubbing of the skin.
Myths About the Causes of Acne

There are many myths about what causes acne. Chocolate and greasy foods are often blamed, but foods seem to have little effect on the development and course of acne in most people. Another common myth is that dirty skin causes acne however, blackheads and other acne lesions are not caused by dirt. Finally, stress does not cause acne.

People of all races and ages get acne. It is most common in adolescents and young adults. Nearly 85 percent of people between the ages of 12 and 24 develop the disorder. For most people, acne tends to go away by the time they reach their thirties however, some people in their forties and fifties continue to have this skin problem.

Acne is often treated by dermatologists (doctors who specialize in skin problems). These doctors treat all kinds of acne, particularly severe cases. Doctors who are general or family practitioners, paediatricians, or internists may treat patients with milder cases of acne.

The goals of treatment are to heal existing lesions, stop new lesions from forming, prevent scarring, and minimize the psychological stress and embarrassment caused by this disease. Drug treatment is aimed at reducing several problems that play a part in causing acne: abnormal clumping of cells in the follicles, increased oil production, bacteria, and inflammation. Depending on the extent of the person's acne, the doctor will recommend one of several over-the-counter (OTC) medicines or prescription medicines that are topical (applied to the skin) or systemic (taken by mouth). The doctor may suggest using more than one topical medicine or combining oral and topical medicines.

Treatment for Blackheads, Whiteheads, and Mild Inflammatory Acne

Doctors usually recommend an OTC or prescription topical medication for people with mild signs of acne. Topical medicine is applied directly to the acne lesions or to the entire area of affected skin.

Benzoyl peroxide, resorcinol, salicylic acid, and sulphur are the most common topical OTC medicines used to treat acne. Each works a little differently. Benzoyl peroxide is best at killing P. acnes and may reduce oil production. Resorcinol, salicylic acid, and sulphur help break down blackheads and whiteheads. Salicylic acid also helps cut down the shedding of cells lining the follicles of the oil glands. Topical OTC medications are available in many forms, such as gel, lotion, cream, soap, or pad.

In some patients, OTC acne medicines may cause side effects such as skin irritation, burning, or redness. Some people find that the side effects lessen or go away with continued use of the medicine. Severe or prolonged side effects should be reported to the doctor.

OTC topical medicines are somewhat effective in treating acne when used regularly. Patients must keep in mind that it can take 8 weeks or more before they notice their skin looks and feels better.

Treatment for Moderate to Severe Inflammatory Acne

Patients with moderate to severe inflammatory acne may be treated with prescription topical or oral medicines, alone or in combination.

Prescription Topical Medicines

Several types of prescription topical medicines are used to treat acne, including antibiotics, Benzoyl peroxide, tretinoin, adapalene, and azelaic acid. Antibiotics and azelaic acid help stop or slow the growth of bacteria and reduce inflammation. Tretinoin, a type of drug called a retinoid that contains an altered form of vitamin A, is an effective topical medicine for stopping the development of new comedones. It works by unplugging existing comedones, thereby allowing other topical medicines, such as antibiotics, to enter the follicles. The doctor may also prescribe newer retinoids or retinoid-like drugs, such as tazarotene or adapalene, that help decrease comedo formation.

Like OTC topical medicines, prescription topical medicines come as creams, lotions, solutions, or gels. The doctor will consider the patient's skin type when prescribing a product. Creams and lotions provide moisture and tend to be good for people with sensitive skin. Gels and solutions are generally alcohol based and tend to dry the skin. Therefore, patients with very oily skin or those who live in hot, humid climates may prefer them. The doctor will tell the patient how to apply the medicine and how often to use it.

Some people develop side effects from using prescription topical medicines. Initially, the skin may look worse before improving. Common side effects include stinging, burning, redness, peeling, scaling, or discoloration of the skin. With some medicines, like retinoids, these side effects usually decrease or go away after the medicine is used for a period of time. Patients should report prolonged or severe side effects to their doctor. Between 4 and 8 weeks will most likely pass before patients see their skin improve.

Prescription Oral Medicines

For patients with moderate to severe acne, the doctor often prescribes oral antibiotics (taken by mouth). Oral antibiotics are thought to help control acne by curbing the growth of bacteria and reducing inflammation. Prescription oral and topical medicines may be combined. For example, Benzoyl peroxide may be combined with clindamycin, erythromycin, or sulphur. Other common antibiotics used to treat acne are tetracycline, minocycline, and doxycycline. Some people have side effects when taking these antibiotics, such as an increased tendency to sunburn, upset stomach, dizziness or lightheadedness, and changes in skin colour. Tetracycline is not given to pregnant women, nor is it given to children under 8 years of age because it might discolour developing teeth. Tetracycline and minocycline may also decrease the effectiveness of birth control pills. Therefore, a backup or another form of birth control may be needed. Prolonged treatment with oral antibiotics may be necessary to achieve the desired results.

Treatment for Severe Nodular or Cystic Acne

People with nodules or cysts should be treated by a dermatologist. For patients with severe inflammatory acne that does not improve with medicines such as those described above, a doctor may prescribe isotretinoin (Accutane*), a retinoid. Isotretinoin is an oral drug that is usually taken once or twice a day with food for 15 to 20 weeks. It markedly reduces the size of the oil glands so that much less oil is produced. As a result, the growth of bacteria is decreased.

* Brand names included in this booklet are provided as examples only, and their inclusion does not mean that these products are endorsed by the National Institutes of Health or any other Government agency. Also, if a particular brand name is not mentioned, this does not mean or imply that the product is unsatisfactory.

Advantages of Isotretinoin (Accutane)

Isotretinoin is a very effective medicine that can help prevent scarring. After 15 to 20 weeks of treatment with isotretinoin, acne completely or almost completely goes away in up to 90 percent of patients. In those patients where acne recurs after a course of isotretinoin, the doctor may institute another course of the same treatment or prescribe other medicines.

Disadvantages of Isotretinoin (Accutane)

Isotretinoin can cause birth defects in the developing foetus of a pregnant woman. It is important that women of childbearing age are not pregnant and do not get pregnant while taking this medicine. Women must use two separate effective forms of birth control at the same time for 1 month before treatment begins, during the entire course of treatment, and for 1 full month after stopping the drug. They should ask their doctor when it is safe to get pregnant after they have stopped taking Accutane.

Some people with acne become depressed by the changes in the appearance of their skin. Changes in mental health may be intensified during treatment or soon after completing a course of medicines like Accutane. A doctor should be consulted if a person feels unusually sad or has other symptoms of depression, such as loss of appetite or trouble concentrating.

Other possible side effects include dry eyes, mouth, lips, nose, or skin itching nosebleeds muscle aches sensitivity to the sun and, sometimes, poor night vision. More serious side effects include changes in the blood, such as an increase in triglycerides and cholesterol, or a change in liver function. To make sure Accutane is stopped if side effects occur, the doctor monitors blood studies that are done before treatment is started and periodically during treatment. Side effects usually go away after the medicine is stopped.

Treatments for Hormonally Influenced Acne in Women

Clues that help the doctor determine whether acne in an adult woman is due to an excess of androgen hormones are hirsutism (excessive growth of hair in unusual places), premenstrual acne flares, irregular menstrual cycles, and elevated blood levels of certain androgens. The doctor may prescribe one of several drugs to treat women with this type of acne. Low-dose estrogen birth control pills help suppress the androgen produced by the ovaries. Low-dose corticosteroid drugs, such as prednisone or dexamethasone, may suppress the androgen produced by the adrenal glands. Finally, the doctor may prescribe an antiandrogen drug, such as spironolactone (Aldactone). This medicine reduces excessive oil production. Side effects of antiandrogen drugs may include irregular menstruation, tender breasts, headache, and fatigue.

Other Treatments for Acne

Doctors may use other types of procedures in addition to drug therapy to treat patients with acne. For example, the doctor may remove the patient's comedones during office visits. Sometimes the doctor will inject Hydrocortisone directly into lesions to help reduce the size and pain of inflamed cysts and nodules.

Early treatment is the best way to prevent acne scars. Once scarring has occurred, the doctor may suggest a medical or surgical procedure to help reduce the scars. A superficial laser may be used to treat irregular scars. Another kind of laser allows energy to go deeper into the skin and tighten the underlying tissue and plump out depressed scars. Dermabrasion (or microdermabrasion), which is a form of "sanding down" scars, is sometimes combined with the subsurface laser treatment. Another treatment option for deep scars caused by cystic acne is the transfer of fat from one part of the body to the face.

How Should People With Acne Care for Their Skin?

Most doctors recommend that people with acne gently wash their skin with a mild cleanser, once in the morning and once in the evening and after heavy exercise. Some people with acne may try to stop outbreaks and oil production by scrubbing their skin and using strong detergent soaps and rough scrub pads. However, scrubbing will not improve acne in fact, it can make the problem worse. Patients should ask their doctor or another health professional for advice on the best type of cleanser to use. Patients should wash their face from under the jaw to the hairline. It is important that patients thoroughly rinse their skin after washing it. Astringents are not recommended unless the skin is very oily, and then they should be used only on oily spots. Doctors also recommend that patients regularly shampoo their hair. Those with oily hair may want to shampoo it every day.

Avoid Frequent Handling of the Skin

People who squeeze, pinch, or pick their blemishes risk developing scars or dark blotches. People should avoid rubbing and touching their skin lesions.

Men who shave and who have acne can test both electric and safety razors to see which is more comfortable. Men who use a safety razor should use a sharp blade and soften their beard thoroughly with soap and water before applying shaving cream. Nicking blemishes can be avoided by shaving lightly and only when necessary.

Avoid a Sunburn or Suntan

Many of the medicines used to treat acne can make a person more prone to sunburn. A sunburn that reddens the skin or suntan that darkens the skin may make blemishes less visible and make the skin feel drier. However, these benefits are only temporary, and there are known risks of excessive sun exposure, such as more rapid skin aging and a risk of developing skin cancer.

Choose Cosmetics Carefully

People being treated for acne often need to change some of the cosmetics they use. All cosmetics, such as foundation, blush, eye shadow, and moisturizers, should be oil free. Patients may find it difficult to apply foundation evenly during the first few weeks of treatment because the skin may be red or scaly, particularly with the use of topical tretinoin or Benzoyl peroxide. Oily hair products may eventually spread over the forehead, causing closed comedones. Products that are labelled as noncomedogenic (do not promote the formation of closed pores) should be used in some people, however, even these products may cause acne.

What Research Is Being Done on Acne?

Medical researchers are working on new drugs to treat acne, particularly topical antibiotics to replace some of those in current use. As with many other types of bacterial infections, doctors are finding that, over time, the bacteria that are associated with acne are becoming resistant to treatment with certain antibiotics. Research is also being conducted by industry on the potential side effects of isotretinoin and the long-term use of medicines used for treating acne.

Scientists are working on other means of treating acne. For example, researchers are studying the biology of sebaceous cells and testing a laser in laboratory animals to treat acne by disrupting sebaceous glands. Scientists are also studying the treatment of androgenic disorders, including acne, in men by inhibiting an enzyme that changes testosterone to a more potent androgen. [top of page]

8. Acne: Dermatologic disease database extract

Acne is a common skin condition that afflicts most people, to a varying degree, during the teen years. However, the disease is by no means restricted to this age group adults in their 20's or 30's may have acne. Don't think that because acne is common, treatment is unnecessary. Waiting to "outgrow" acne can be a serious mistake. Medical treatment can improve your appearance and self esteem, and prevent the development of lifelong scars.

Acne is actually caused by a combination of several factors:

Rising hormone levels during adolescence cause enlargement and over activity of the oil glands in the skin.

The canals that bring this oil to the surface become blocked with keratin (a protein that is part o f the skin).

When these oil glands are overactive and the canals are blocked, the bacteria that normally l have on the skin and in the oil multiply, and inflame the skin.

Cleansing and Cosmetics

Even though you may be told to wash frequently, acne is not a disease caused by dirt. For example, the blackness of a blackhead is not dirt, but is due to the accumulation of the normal skin pigment in the oil gland ducts.

Wash your face with a mild antibacterial soap recommended by your dermatologist twice a day. If one's skin is very oily, it may be washed more often. Over washing or scrubbing tends to irritate the skin and will make acne worse. Therefore, do not use any abrasive cleaners or cleansing pads.

Shampooing is also important in acne therapy. The oilier your hair is, the more often you should shampoo it. Also, it is best to keep hair off the face as much as possible to avoid hair oils.

For covering blemishes, many preparations have been formulated to match skin colour. These cosmetics should be water based (i.e. the first ingredient on the label should be water). Greasy applications such as Vaseline, cocoa butter, cold cream, and vitamin E oil should be avoided. If the face is dry, your dermatologist can recommend a moisturizer for your type skin.

A generation ago, it was widely believed that greasy type foods aggravated acne. Since then, well-controlled studies have shown that in the great majority of people there is no relationship between diet and acne. So in addition to a well balanced diet, pizza, fried foods, chocolate, potato chips, and soft drinks may be eaten. If you are allergic to any of these, or they do not agree with you, don't eat them.

Acne need not be feared as something untreatable. In recent years many effective forms of therapy have been developed. Dermatologists want to prevent scars that acne can leave. Years of untreated acne can leave a lifelong imprint on a person's face and can have an effect on his or her self-image. While acne may not be curable, it is usually controllable.

Since acne has many forms, your dermatologist designs an individual approach to care for successful control. Thus, the course of therapy will vary according to such factors as type of acne, it's severity and extent, and the patient's day-to-day activities.

Mild acne is treated with one or a combination of creams and solutions. The purpose of these topical medicines is to prevent new blemishes from forming. Therefore, apply these all over your affected areas, not just directly on the present pimples. In addition, in some people these creams may cause the face to become a little dry, pink or feel taught. This is normal. If your face becomes too irritated or 'raw' feeling, don't stop the creams, just decrease the frequency of application (i.e. apply every second or third day).

Moderate and severe acne is usually treated by topical medicines with the addition of antibiotic pills. Since different combinations work better for some patients than others, you are usually evaluated every four to six weeks until the acne is well controlled.

In addition to this conventional therapy, your dermatologist may recommend one or more of these treatments to speed healing and clearing of your acne:

Acne Surgery: This procedure greatly speeds acne clearing and appearance by manually removing blackheads and whiteheads. A round loop extractor is used to apply uniform smooth pressure to dislodge the material. Inserting a pointed instrument to carefully expose the contents loosens lesions that offer resistance.

Intralesional Corticosteroid Therapy: If one or several painful acne cysts develop, fast relief is available with this relatively painless procedure. Each cyst is given a single injection of a dilute Hydrocortisone solution, using a very tiny needle.

Accutane Therapy: In 1982 a new oral medication, isotretinoin (Accutane), became available for the treatment of patients with severe acne not responsive to conventional treatments. The duration of treatment is usually 5 months, and one such course is often curative of acne forever. Use of this medication does require a thorough understanding of its side effects and precautions (e.g. the prevention of pregnancy).

Treatment of Acne Scarring

Prior to correcting acne scarring, it is generally advisable to wait until acne activity has been low or absent for several months. Scars improve with time as the body softens their appearance. The colour contrast is often the most troublesome aspect of resolving large acne blemishes. These lesions may leave a flat or depressed red scar that is so obvious, patients mistake the mark for an active lesion. The colour will fade and approach skin tones in 4 to 12 months. Many patients are self-conscious about the pitted and crater like scars that do not fade. These remain as a permanent record of previous severe acne. Your dermatologist may a variety of procedures to you to remove or revise these marks:

Chemical Peel: Superficial acne scarring, and irregular pigmentation of the skin are easily treated with this technique. Chemical agents are applied to the skin, which cause the outer layer to be removed. Different chemicals and concentrations are used, depending on ones skin type and degree of scarring.

Laser Resurfacing: More prominent scarring from acne is best treated by this technique. The top several layers of skin are removed with this high energy light. This action evens out the skin to give it a smoother, more pleasing contour.

Punch Excision and/or Grafting: Some narrow pitted scars are too deep to be removed by dermabrasion. These can be removed with a surgical instrument called a punch. The resulting defect is closed, either primarily or with a tiny skin graft, with gratifying results. Sometimes this procedure is followed by chemical peel or laser resurfacing for patients with a mixed type of scarring.

Collagen Implantation: Patients with a few soft depressed scars with smooth edges respond well to collagen. This natural protein is injected under the lesion to elevate it to the level of the skin.

Treatment of acne is a continuing process if the disorder is to be controlled successfully. You must follow your dermatologist's instructions, since you are the only one who can accomplish the necessary daily care. If you are willing to spend the time and extend the effort, you can expect a pleasing result. [top of page]

9. A guide to acne treatment

Acne Treatment

Today, virtually every case of acne can be resolved. The key to getting rid of acne lesions and preventing new ones from forming lies in knowing that:

What works for one person may not work for another.

A dermatologist s help may be required.

Resolution takes time. Treatments that promise fast, miraculous or overnight results often capture the attention of acne sufferers hoping for quick resolution. However, the fact remains that acne does not clear overnight. On average, 6 to 8 weeks are needed to see initial results. Once acne significantly improves or clears, continued treatment is needed to keep acne from re-appearing. If acne does not improve in 6 to 8 weeks, treatment may need to be adjusted as not every acne treatment clears every case of acne.

What works for one person may not work for another. What is an appropriate treatment for one person may not clear another s acne because many factors affect resolution, including the cause(s) of the acne, a person s skin type and the kind of acne lesions present.

A dermatologist s help may be required. With so many factors affecting clearance and a multitude of treatment options available (some only by prescription), a dermatologist s help can make a difference. Before prescribing treatment, dermatologists consider several factors, including the severity of the acne, types of lesions present, co-existing conditions, as well as the patient s age, skin type, lifestyle and motivation.

The knowledge gained from considering these factors allows dermatologists to create effective individualized therapy that will resolve the patient s acne over time and prevent new lesions from forming.

Sometimes a dermatologist may combine two or more treatment options. A patient may be instructed to use one medication in the morning and the other at night. Or, two medications may be combined in one prescription medication. Due to possible side effects, over-the-counter medications should not be combined unless directed by a dermatologist or other medical practitioner.

Acne responds especially well to early treatment. Dermatologists recommend that acne be treated early to maximize effectiveness as well as help prevent scarring. [top of page]

10. Acne causes and what causes acne?

Almost all teenagers get acne at one time or another. You haven't done anything to cause your acne. It's not your fault if you have it. Pimples are caused when oil ducts in the skin get plugged up and then burst, causing redness and swelling. Although there are many myths about acne, the following are the three main factors that cause it.

When you begin puberty, certain hormones, called androgens, increase in both males and females. These hormones trigger oil ducts on the face, back and upper chest to begin producing oil. This can cause acne in some people.

If other members of your family had acne as teenagers, there may be a chance that you've inherited a tendency toward getting acne as well.

If you are prone to acne, the cells that line the oil ducts in your skin tend to get larger and produce more oil, and the ducts get plugged. This traps the oil and leads to the formation of blackheads or whiteheads. The plugged ducts allow germs in the skin to multiply and produce chemicals that cause redness and swelling. This is why simple blackheads and whiteheads may turn red and bumpy and turn into the pimples of acne.

There is not much you can do about heredity, so your best control efforts are those that keep the oil ducts unplugged.

What doesn't cause acne?

Acne is not caused by foods you eat. Despite what you may have heard, there is no proof that soft drinks, chocolate and greasy foods cause acne.

It's not caused by dirt. The black plug in a blackhead is caused by a chemical reaction. It's not dirt. No matter how carefully you wash your face, you can still have acne.

It's not something you can "catch" or "give" to another person.
It's not caused by sexual thoughts or masturbation.
If you have acne, there are some things that can make it worse. To keep acne under control, try to avoid the following:

  • Pinching (or "popping") pimples, which forces oil from the oil ducts into the surrounding normal skin, causing redness and swelling
  • Harsh scrubbing, which irritates the skin
  • Things that rub on the skin, such as headbands, hats, hair and chin straps, which also cause irritation
  • Certain cosmetics (makeup), such as creams and oily hair products, which can block oil ducts and aggravate acne
  • Some medications
  • For young women, changes in hormone levels brought on by menstrual periods
  • Emotional stress and nervous tension

11. Acne myths

Acne is caused by poor hygiene. This is not true. As mentioned before, acne is caused by extra skin and oil, but if you wash your skin hard and too often, you can make your acne worse. Remember: acne is not caused by dirt or surface skin oils, therefore, 'over washing' your epidermis will not help.

Acne is caused by certain foods. This is not true. All too many studies have found no connection between diet and acne. Not chocolate, nor French fries, nor pizza. If you happen to be one of the few who actually are affected by a certain food, then don't eat it! As a general rule, however, your body will always respond better to a good diet and lots of water.

Acne is caused by stress. This is not true, especially in young people. If anything, stress may worsen acne. The worsening of acne from stress is because more sebum, or oil, is released when you are stressed out.

You have to grow out of acne. This is not true a lot of the time. There are many products and methods for treating acne. If nothing is working for you, always see a dermatologist.

Acne is just a cosmetic disease. It is obvious that acne can worsen your looks and can result in permanent physical scars, however, it is usually never life-threatening. This does not mean acne is a simple cosmetic disease though. Acne and its negatives can affect the way people feel about themselves to the point of affecting their lives. If someone doesn't handle their life properly, acne can become a type of mental disease as well. [top of page]

12. Acne light / UV treatment for acne

The use of light, specifically ultra violet light frequency, has been shown to provide excellent results for acne sufferers. UV light penetrates the skin subcutaneously to help kill bacteria build up which clogs pores and causes acne. In theory it makes a lot of sense to use higher frequency UV light to affect and alter problematic skin which is vibrating at the lower hertzian frequency level. [top of page]

Products for the treatment of acne

We offer a variety of products for treatment of acne. Please click here to see all products or here for the Dermalight80 for spot treatment of acne (requires UVA.)