Health related information and news from around the world.

SunscreensWith the increased awareness of the damaging effects of sunlight many teenagers are being encouraged to wear sunscreens. Unfortunately, most sunscreens have a moisturizing base and so tend to aggravate acne. People who suffer from acne should wear alcohol-based sunscreens, which are now available as either clear liquids or gels. Examples include Clinique Oil-Free Sun Block SPF 15, Ella Bache Great Sports Gel SPF 15+ and Koala Beach SPF 15 Gel. They may sting, however, and in this case an appropriate alternative would be a milky sunscreen such as Ego SunSense Toddler Milk, Ego Sunsensitive, Clinique City Block, Ella Bache Oil Free and Roche Aquababy.
VitaminsMany vitamin preparations contain kelp which is known to aggravate acne. Kelp is an iodine-containing substance, which in high concentrations stimulates pus. It is best for people with acne to avoid all vitamin preparations as they are of no benefit and can actually be counterproductive. There is no scientific evidence that vitamin therapy or zinc tablets are useful for acne.
StressStress is a common aggravating factor in acne, although the reason for this is poorly understood. It probably works through the stimulation of male hormones called androgens that are secreted from a gland called the adrenal gland during times of stress. It is, however, impossible to live without some stress and acne itself can produce more stress. Adequate treatment of acne will often relieve stress associated with lowered self-esteem. Lack of sleep may also be an aggravating factor here, and people with acne should always try to get enough sleep.
The oral contraceptive pillAs most people are aware, the oral contraceptive pill contains synthetic oestrogens and synthetic progestogens. The synthetic progestogens have a male hormone-like activity and so can aggravate acne. The pills that contain a higher ratio of progestogen to oestrogen will often make acne worse whereas those containing a higher concentration of oestrogen will tend to improve acne. Higher oestrogen-containing pills such as Biphasil and Sequilar are often useful in treating women with acne, particularly those with premenstrual flare ups. This can be discussed with your doctor.
DrugsCertain drugs can aggravate acne, particularly the anti-epileptic drugs and lithium. This issue should be discussed with your doctor.
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This is a common manifestation of excessive sun exposure in people of Celtic background and fair akin. It is extremely common in Australia, particularly on the backs of the hand and on the face; It is a precancerous, or premalignant, change in the epidermis. However progression to malignancy occurs in only a minority of these keratoses.

Features. Solar keratoses appears as small, rough patches on the skin surface. Usually they are skin coloured or red, and sting on exposure to sunlight. The scales may fall or be knocked off, but will invariably recur. Occasionally they spontaneously bleed. Some are very small, whereas others can be quite large and grow horny protuberances. Thickening of the base of the lesion, with increasing redness and tenderness, indicates activity and the possibility of malignant change.

Treatment.

1. Cryotherapy

This is the most popular treatment, using either solid carbon dioxide or liquid nitrogen.

2. Diathermy or curettage

When lesions are thick or if malignant change is suspected, this is the preferred treatment, the advantage being that microscopic examination can be performed on the suspect tissue.

3. Chemotherapy

More recently a cytotoxic chemical, 5 Fluououracil (5 F.U.) has been used in the destruction of solar keratoses. It is applied in the form of ointment or lotion twice dotty for 3-4 weeks. Where keratoses or other solar damage is present, acute inflammation followed by superficial erosion will occur. One or two weeks later, healing without scarring and without the return of the keratoses occurs. Frequently, patients observe that the cure is worse than the disease. As this form of treatment is not adequate for basal cell carcinomas, which could be mistaken for solar keratoses, careful diagnosis before treatment and follow-up afterwards is mandatory.

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