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Ointment: how to choose?
Last reviewed: 23.04.2024
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In dermatology, local remedies are most commonly used to treat rashes that result from the hypersecretion of sebum and the development of inflammatory foci caused by the proliferation of the anaerobic bacterium Propionibacterium acnes.
Most of these agents are ointment ointments, as well as non-fatty gels and special creams with antiseptic and antimicrobial properties. And indications for the use of ointment acne are acne (youthful acne, acne), oily skin seborrhea, folliculitis and follicular hyperkeratosis.
[Pharmacodynamics
Salicylic acid in the form of ointment antiseptic acts as an antiseptic, and also reduces the secretion of sebum and removes dead keratsites.
The active substance of the drug Klindovit is a semisynthetic antibiotic clindamycin that bacteriostatically affects P. Acne, staphylo- and streptococci by binding to their RNA and inhibiting the synthesis of amino acids in microorganism cells.
The active substance means Aselex - azelaic acid (from the discharge of heptanedicarboxylic acids) - has a harmful effect on bacteria, reduces the level of fatty acids in sebum and simultaneously inhibits the accelerated process of keratinization of the skin.
Pharmacodynamics Adapalen (and its synonyms) is determined by the substance of adapalene, which is similar in structure to vitamin A and binds to retinol receptors in skin cells, preventing the formation of excess sebum and comedones. Under the influence of this ointment, the keratinization and exfoliation of the skin cells is also accelerated, and one hundredth prevents their accumulation in the mouths of the hair follicles.
And the drug Isotrexin (on a gel basis) besides the retinol derivative of isotretinoin contains the antibiotic erythromycin, which causes the bacteria to stop multiplying and perishing. In addition, retinoids promote the regeneration of epidermal cells.
Unlike a conventional zinc ointment containing zinc oxide (which reduces the production of sebum and drains the skin), the Zinc Gialuronate Gel (Kuriozin) is a mixture of zinc chloride and sodium hyaluronate. Thanks zinc, this ointment works as an antiseptic and drying agent, and sodium hyaluronate (synthetic hyaluronic acid) promotes the regeneration of damaged skin.
The mechanism of action of phyto-gel Ugrin is based on the total bacteriostatic and anti-inflammatory effects of its medicinal plants (celandine, chamomile, calendula, yarrow, mint, lavender and tansy), as well as antiseptic chlorhexidine.
Pharmacokinetics
Ointments are applied topically, and their active substances, as a rule, do not enter the systemic circulation. In addition, the pharmacokinetics of most of the drugs in this group have not been studied by manufacturers.
Antibiotic clindamycin - when using Clindovit ointment - can accumulate in comedones, which consist of lipids and keratsites, and from there get to the blood. However, the concentration of the drug is minimal, so there is no systemic effect. And the antibiotic residue, in case of its adsorption, after 8 hours is completely excreted by the kidneys.
Part of azelaic acid (Aselex and its synonyms) is absorbed into the deeper layers of the skin and enters the blood, but is also excreted by the kidneys, both in unchanged form and in the form of acid metabolites.
Names of ointments for acne
Previously, it should be clarified that the bacterium P.acnes - part of the synanthropic microflora of the skin of most healthy people, but it feeds on lipids and therefore, with increased production of sebum begins to multiply rapidly. Damage caused by this bacterium makes the skin more susceptible to colonization by pathogenic bacteria, such as Staphylococcus epidermidis. Acne occurs in the place of comedones - sebaceous horny plugs that clog the hair follicles of the skin, creating all the conditions for the multiplication of bacteria and the development of a local inflammatory process.
And now - the main names of ointments that help stop the inflammation and help to cleanse the skin of the rashes: salicylic ointment, Klindovit (other trade names Klindatop, Dalatsin T, Ugritsil), Azeleks (Skinoren, Skinomaks, AkneStop, Azix-derm, Azilin , Finevich, etc.), Adapaline gels (Adaklin, Adolen, Clenzite, Differin, Bezugrey), Isotrexin, Zinc hyaluronate (Kuriyozin) and Ugrin.
Ointments on a hydrophilic base (gels) and ointments based on polyethylene glycols are better absorbed into the skin, increase the bioavailability of the active substances and have a faster therapeutic effect.
The way of using ointments from acne
The ointment from acne has the only method of application - local: at least once or twice a day, it should be applied pointwise to the problem areas of the skin (skin should be clean and dry) 1-1.5 g (depending on the area of rashes). The duration of application depends on the skin condition, the extent of the rashes and the intensity of their inflammation. To determine the duration of treatment should consult a dermatologist.
It should be noted that ointments based on clindamycin, erythromycin and other antibiotics can cause an individual negative reaction, and their overdose can cause a prolonged disruption of bowel function and diarrhea.
According to the instructions to other described drugs, reports of cases of overdose were not spoiled, and such cases are hardly possible due to minimal systemic absorption of these local agents.
Contraindications for use
Salicylic ointment is contraindicated to use with severe renal failure and increased individual sensitivity to salicylates.
Contraindications: Clindovitis - intestinal dysbiosis and colitis, as well as age up to 12 years. Isotrexin and Adapalen are contraindicated in children under 12 years of age, with allergic reactions to retinoids, seborrheic dermatitis and eczema. In the instructions to the rest of the drugs, named earlier, there are reports of no contraindications, except for hypersensitivity to their components
The prohibition on the use of ointments during acne is related to the means in which antibiotics are present. Gel Adapalen and Isotrexin are categorically contraindicated to pregnant women due to the teratogenic effect on the fetus.
Since there is no reliable and valid data on how safe in pregnancy such drugs as Azeleks (Skinoren, etc.), Zinc hyaluronate and Ugrin, then it is not recommended to use them. The pregnant women should avoid the use of any local pharmacological agents as much as possible.
Side effects
Virtually all ointments, gels and acne creams have side effects in the form of
Local irritation and redness of the skin at the site of application, burning and itching, as well as a marked decrease in the moisture content of the epidermis and peeling.
Isotrexin and adapalene can cause severe skin flushing (erythema) and lead to a temporary increase in the sensitivity of the epidermis to UV irradiation.
A drug Aseleks (and all creams and gels based on azelaic acid), in addition to the above undesirable effects, can provoke an attack in patients with bronchial asthma in the anamnesis.
Interaction with other medicinal products
With topical application of drugs in the form of ointments, interaction with other drugs is extremely rare.
However, clindamycin (as part of the Clindovit gel, etc.) is completely incompatible with erythromycin, barbiturates and magnesia, and simultaneous use of ointments to relieve muscle spasms enhances the effect of the latter.
Gels Isotrexin and Adapalen should not be used concomitantly with keratolytic agents and facial scrubs, as well as with agents containing salicylic acid, zinc and sulfur compounds; You can not take vitamin A inside.
Optimum storage conditions of ointments - a temperature mode from +18 to 25 ° С.
Shelf life of most drugs is 2 years, ointments with azelaic acid - 3 years from the date of release.
Attention!
To simplify the perception of information, this instruction for use of the drug "Ointment: how to choose?" translated and presented in a special form on the basis of the official instructions for medical use of the drug. Before use read the annotation that came directly to medicines.
Description provided for informational purposes and is not a guide to self-healing. The need for this drug, the purpose of the treatment regimen, methods and dose of the drug is determined solely by the attending physician. Self-medication is dangerous for your health.