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We are requested from time to time by physicians for information regarding the use of various agents Most skin conditions that cause discoloration are on the skin. This is a very simplified survey of actually harmless, causing more cosmetic and emotional discomfort than medical problems. Skin hyperpigmentation and photoaging are however concentrations of Glycolic acid to achieve the
unacceptable, sometimes to such a level that they maximum benefits of treatments without painful Skin color can be altered by disease or exposure to miscellaneous agents or as a result of inflammatory disease, including acne or atopic Azelaic acid inhibits the growth of Propionibact- dermatitis. Skin cells contain melanocytes that erium spp. and reduces keratinisation. It is used in the topical treatment of mild to moderate skin-coloring pigment, melanin. Pituitary hormone atory acne and for the inflammatory papules and pustules of mild to moderate rosacea.
hormone], which stimulates melanin production. In the treatment of acne azelaic acid is applied The rate of production of the pigment varies. A number of conditions can cause the melanocytes [morning & evening] for up to 6 months as a 15 to 20% cream. Improvement usually occurs within distributed in the skin. These are listed in the table It has also been tried in hyperpigmentary skin dis- The goal of therapy in hyperpigmentation is to orders such as melasma, and in malignant lighten the skin so it blends into the normal skin in the area. Most products used to lighten the skin For the treatment of mild to moderate rosacea, a contain hydroquinone. Other drugs commonly used 15% gel should be applied to the affected area in the treatment of hyperpigmentation disorders twice daily for a period of up to 12 weeks. include azelaic acid, glycolic acid, kojic acid, tretinoin & hydrocortisone,and/or triamcinolone.
hypopigmentation after use of azelaic acid. Since azelaic acid has not been well studied in patients Skin Hyperpigmentation may be caused by the
with dark complexion, these patients should be following factors:-
monitored for early signs of hypopigmentation. It may produce a transient skin irritation that Congenital: Familial or Racial
Corticosteroids are used for their anti- inflammatory action. The most commonly used are Hydrocortisone 0.5 to 2% & Triamcinolone 0.1 to Bleomycin
0.2%. Dexamethasone is also used at 0.1%
Endocrine disorders
Glycolic Acid [Hydroxyacetic acid] is an organic Co-Trimoxasole(Resprim) acid that has been used in topical preparations for Cyclophosphamide hyperpigmentation and photodamaged skin. At low Estrogens concentrations will diminish the appearance of fine Fluorouracil lines and dark spots on the skin and produces a Heavy-metal poisoning smooth, even skin tone with improved skin texture. Hydroxychloroquine It is also used to brighten dull, ashy skin. Glycolic Systemic disease:
acid may be combined with Arginine and Lactic Nicotinic acid (Niacin)
Acid to achieve the maximum benefits of N S A I D 's
treatments without painful irritation. We can Phenolphthalein formulate to prolong & control delivery of the into Phenothiazines the skin over a period of eight to sixteen minutes. Ultraviolet irradiation
The normal range of concentration is 1% to 10% in a Beta Hydroxy acid. It is usaually effective at 1 to combination with other agents. 10% to 20% is sometimes prescribed as a solo Tretinoin [Retinoic acid] A number of studies
suggest that tretinoin can reverse some of the skin changes associated with chronic exposure to sunlight Alpha hydroxy acids are often combined with Hydroquinone to provide an exfoliant enhancing the also this has not been completely substantiated.
removal of the darkened cells. It bleaches or Used at concentrations of 0.01 to 0.1% Tretinoin is lightens the skin by slowing the production of usful in the topical treatment of acne vulgaris when melanin so the dark spots gradually fade to match comedones, papules, and pustules predominate. It appears to stimulate mitosis and turnover of follicular epithelial cells. Generally applied twice daily, hydroquinone is often It is also used alone or in combination with other used at a 2% to 5% or higher concentration (up to agents applied as a cream, gel, or alcoholic solution 15%), as a cream, gel or solution and is effective in [containing 0.025% or 0.05% tretinoin] for the decreasing cutaneous hyperpigmentation. Once the treatment of fine wrinkling of photo-damaged skin, desired results are achieved, a reduction to mottled hyperpigmentation and skin roughness, and . once-daily application is recommended. In more It is applied once daily at night. Effects may not be severe cases, Often prescribes in combination with seen until about 6 months after starting treatment. tretinoin and / or a corticosteroid. Note: preparations usually . darken upon exposure to light and air and therefore Tretinoin is also used in high concentration 2% or must be kept tightly closed in the fridge between more for peeling procedures.
Kojic acid is a natural antibiotic substance Commonly used in concentrations of betweenproduced of 0.1% and 0.25%. Appears to be more effective in microorganisms.It is also obtained from either aesthetic treatment creams than hydrocortisone.
Japanese mushrooms or asafetida .It is capable of blocking melanin production {tyrosinase blocker} and therefore us used to lighten the skin.Useful for A consistent treatment approach for problems related Hyperchromic stains, melasmae, and in high to the epidermis, papillary dermis, and immediate concentration Retinoic acid peels with Kojic, Azelaic upper reticular dermis. Often accompanied by the acids and ascorbate.
appearance of skin tightening and a reduction of skin Kojic acid is normally used in concentrations of 2% laxity. It is normally used as a simple solution.The to 4% but up to 10% have been used.
physician usually has available a range of strengths which include 20% 35% 50% 70% .
We normally supply these in 50 mL glass bottles.
is similar to Glycollic acid in that it is
also an Alpha Hydroxy acid [AHA].These acids are sometimes used in conjunction. In peeling 12% of Vitamin C is useful as an free radicle scavenger Lactic acid could form deposits of new collagen in the papillary derme, this did not happen with the use photoaging and wrinkles. A lotion containing 20% of with Phytic acid 4% is used to prepare the facial skin TCA 25% and Phenol 25% after 21 days.
for laser treatment and also to correct problems of residual hyperchromia after completion of treatment.
which prevents skin damage by oxidation. Cpodfqu!Bftuifujdt Quality that you can rely on.
It is used in concentration s of 0.1 to 0.4% Phenol is a classic peeling agent which should beused with care. We can provide strengths up to 90% Phone: 972-(0)9-766-7890 e-mail: Shimon@Concept-Rx.co.il

Source: http://www.concept-rx.co.il/mirkahat_%205.pdf

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