MD Dermatology

It is of great concern that in the recent announcement from GSK Malaysia that Acne-Aid Soap and Liquid Cleanser contain porcine derived sulfonated olive oil. This is a major setback in this country where the majority of the population are Muslims. Not only that, as more people are moving away from using cosmetics containing animal by-products, this revelation set an added disadvantage. It is one of the top-selling cleansers and we hope that GSK would consider removing any animal derived ingredients from their products.

Acne vulgaris, or more commonly termed ‘pimples’, is probably the most common skin disorder occurring in mankind. It is a chronic self-limited condition but the sequelae can be lifelong, causing scar formation with profound psychological and emotional impact. The prevalence of acne among various countries differs. A recent large study in China showed the prevalence of between 10.5% to 36% among children more than 10 years old to those above 25 years old. There is no population based study done in Malaysia, but there was a study done among adolescent (13-18 years old) in two small district secondary schools showed the prevalence of 67.5%. The causes of acne are multi-factorial. Four mechanisms causing acne are identified, mainly increased sebum production, the formation of comedones (white and black heads), proliferation of the bacteria Propionibacterium acnes and inflammation of the hair follicles. Most patients with acne had gradual onset of lesions around puberty...

Acne Medication Unconnected to Inflammatory Bowel Disease A new study of isotretinoin (originally marketed as Accutane [Roche]), used in the treatment of severe, recalcitrant acne, found no increased risk for inflammatory bowel disease (IBD) associated with the use of the vitamin A derivative, according to a study published in the February 20 issue of JAMA Dermatology . The drug, which is the only US Food and Drug Administration–approved medication for severe acne, is the target of thousands of lawsuits, including one in which a jury awarded $25 million to a patient who claimed isotretinoin caused his IBD, according to a 2011 article in Lawyers USA . Mahyar Etminan, PharmD, assistant professor of medicine at the University of British Columbia, Vancouver, Canada, and colleagues compared 2159 women taking combined oral contraceptives who were diagnosed with IBD with 43,180 women matched by age and index date. Information about the women (age, 18 - 46 years) ...

Severe acne scarring Last week, a couple brought their teenage son for consultation for acne. He has moderate to severe acne over the face with numerous comedones, papules, pustules and some nodules (inflammatory acne). He obviously needed systemic treatment. I counseled them regarding various options and their possible side-effects. The parents asked one very good question. Can acne resolve by itself? Well, the answer is, YES. So, why do we need treatment then? Well, the answer is pretty obvious from the picture shown above. We want to prevent acne scars!! Inflammatory acne always lead to scarring. It is of cosmetic concern and treating the scars that had formed is very challenging. Despite a lengthy explanation, however, they parents decided not to have any treatment. Various reasons were expressed especially concerning side-effects of the treatments. I have re-assured them that the side-effects are uncommon and tolerable. Anyway, the choice is with ...

  Unilateral Dermatoheliosis (Source: New England Journal of Medicine 2012) Photoaging is defined as a process of premature aging of the skin caused by continuous and long-term exposure to ultraviolet (UV) radiation from the sun or from a synthetic source such as tanning device. It affects primarily the area of exposed skin especially over the face, ear, neck and hands. Clinically, it is characterized by early appearance of irregular pigmentation, prominent capillary blood vessels, lentigenes (age spots), wrinkles, thickening and laxity of the skin. Chronic exposure further predispose to formation of pre-cancerous lesions such as actinic keratoses which can lead to skin cancer. Severity of photoaging is dependent on the duration of exposure to UV light as well as the patient’s skin type. Fair-skinned individuals with blonde or red hair usually burn easily upon exposure to direct sunlight and are at increased risk. Darker-skinned people show fewer signs of...