RU2275907C2 - Method for acne treatment - Google Patents

Abstract

FIELD: medicine, in particular cosmetology, acne treatment.

SUBSTANCE: method includes multiple administration of isotretinoin in single dose of 0.1-0.3 mg/kg per day followed by dose increasing wherein total dose is 10-40 mg/kg with simultaneous chemical piling and cosmetic clearing.

EFFECT: effective treatment using decreased preparation doses and reduced side effects.

3 ex, 1 tbl, 2 cl

Description

The invention relates to medicines for the treatment of dermatological diseases, in particular to anti-acne agents.

It is already known that acne is a widespread disease, leading to the formation of irreversible skin defects (scars, pigmentation disorders, enlargement of pores and capillaries) and to a violation of psychosocial adaptation up to suicidal attempts, and existing treatment methods often give serious adverse reactions and have little effect on the consequences of the disease, which subsequently requires a long and expensive correction.

A known method of treating acne by prolonged use of antibiotics (Parsad D, Pandhi R, Nagpal R, Negi KS. Azithromycin monthly pulse vs daily doxycycline in the treatment of acne vulgaris. // J Dermatol. - 2001. - Jan. - Vol. 28 . - P.1-4).

Another known treatment for acne is the use of antiandrogens (Carmina E, Lobo RA. A comparison of the relative efficacy of antiandrogens for the treatment of acne in hyperandrogenic women. // Clin Endocrinol (Oxf). - 2002. - Aug. - Vol. 57. - P.231-234).

The closest analogue of the claimed method is a known method for the treatment of acne, including therapy through repeated oral administration of doses of a drug containing retinoids (Nazhmutdinova D.K. Treatment of patients with acne vulgaris dermoretin containing 13-cis-retinoic acid, taking into account the state of lipid peroxidation and sex hormones. Abstract of the dissertation. Russian State Medical University, code of specialty 14.00.11, M. 1995).

However, when implementing the known method, there are pronounced side effects in the form of a reaction of exacerbation, dryness and peeling of the skin, cheilitis, dermatitis, nosebleeds, joint pain, depression, changes in clinical and biochemical blood tests, and irreversible changes in the skin persist after treatment.

The technical result that can be obtained by carrying out the invention is to prevent the formation of scars, spots, reduce pores and capillaries, to smooth out existing scars, to accelerate the achievement of a stable clinical result and to reduce side effects.

This result is achieved by a method of treating acne, including therapy by repeatedly ingesting doses of a drug containing retinoids, due to the fact that during the period of oral administration of doses of a drug containing retinoids, chemical peeling and cosmetic cleansing are performed repeatedly, while using retinoid isotretinoin, and single doses of isotretinoin are prescribed in an amount of 0.1-0.3 mg / kg per day, followed by a dose reduction at a course dose of 10-40 mg / kg.

And also due to the fact that the ingestion of doses of a drug containing retinoids is carried out in a daily and course dose that is 3-10 times lower than the recommended one.

And also due to the fact that chemical peeling and cosmetic cleansing are carried out in an amount from 4 to 15 procedures using an alpha-beta-retinol skin foliator and the contents of the ducts of the sebaceous glands, pustules and cysts are evacuated during oral administration of doses of a drug containing retinoids .

The implementation of the claimed method is illustrated by the following examples of its application.

Example 1

Patient L., 18 years old, complained of common rashes on the face and trunk. Sick for 6 years, received treatment with antibiotics and drying agents without effect. No complaints from the internal organs, indicators of clinical tests of blood and urine, biochemical analysis of blood without pathological changes. Heredity: the mother has oily seborrhea and acne, enlarged pores, and small atrophic scars. Allergic reactions denied. Infectious diseases are sick 2-3 times a year.

Objectively at the time of the initial examination: on the skin of the face, neck, chest, shoulders, multiple comedones, papules and pustules with a diameter of up to 7 mm, merging with each other with the formation of fistulous passages, when you click on the elements an abundant purulent-hemorrhagic content is released. On the entire affected surface of the skin, the spots are bluish-purple in color, atrophic scars, enlarged pores.

Treatment

Inside: isotretinoin at a dose of 0.3 mg / kg per day for 8 weeks, then with a gradual decrease in dose to 0.1 mg / kg over 12 weeks. The course dose was 30 mg / kg;

externally: during the period of oral administration of doses of isotretinoin, the procedures included chemical peeling and cosmetic cleaning of the affected areas of the skin with ichthyol soap, heated by wiping with A-Knox lotion (Holy Land Laboratory Cosmetics, Israel, hygiene certificate No. 77.01.12.915.P .12585.06.4), peeling with alpha-beta-retinol with a skin foliator (Holy Land cosmetics laboratories, Israel, hygiene certificate No. 77.01.12.915.P.12585.06.4) for 20 minutes, softening the elements with A-Knox solution ( the same), the evacuation of the contents of the sebaceous ducts glands, pustules and cysts, applying an anti-inflammatory mask for 20 minutes, applying an alpha-beta-retinol restoring cream (Holy Land Cosmetics Lab, Israel, hygiene certificate No. 77.01.12.915.P.12585.06.4) and antiseptic powder " Double action "(Holy Land Cosmetics Laboratory, Israel, hygiene certificate No. 77.01.12.915.P.12585.06.4).

During the first 12 weeks of treatment, the procedures were performed once every 2 weeks, then once every 4 weeks. A total of 10 procedures were required.

Of the side effects during the first two months, dryness and peeling of the skin were noted, which were easily corrected by applying moisturizers and decreased after a dose reduction.

An improvement in the skin condition appeared 4 weeks after the start of treatment, after 2 months. the number of rashes decreased by more than 50%, clinical recovery was achieved after 6 months. As a result of external therapy, the spots brightened, pores were reduced, and the depth of scars was significantly reduced. Subsequent observation for 3 years of relapse did not reveal.

Example 2

Patient K., 16 years old, complained of rashes on the skin of the face, chest, and back. Sick for 4 years. Received isotretinoin in a standard dosage of 1 mg / kg body weight for 3 months. He noted a slight improvement in the form of a flattening of inflammatory elements, while severe dryness, thinning, bleeding of the skin and mucous membranes, and inflammation of the red border of the lips bothered. On examination: on the skin of the face are multiple nodular-cystic elements with abundant purulent-hemorrhagic contents, merging with each other, atrophic scars of a bluish-purple color. The skin is thinned, easily damaged and bleeds on palpation. The red border of the lips is hyperemic, edematous, with peeling on the surface, in the corners of the mouth of a crack. On the skin of the chest and back are multiple bright red papules with a diameter of up to 0.7 mm, bluish spots, scars. The patient is psychologically depressed, communication is difficult.

Treatment

Inside: the dose of isotretinoin - 0.3 mg / kg per day for 4 weeks, then 0.1 mg / kg per day for 3 months. The course dose was 17 mg / kg;

externally: the procedures were carried out according to the sequence of actions described in example 1 with a frequency of 2 times a week for 2 weeks, then 1 time per week for a month, then 1 time in 3-4 weeks for 3 months.

To achieve a state of clinical remission, 12 procedures were required.

Treatment results: a significant improvement in the form of resorption of inflammatory elements, a decrease in the number of fresh papules was achieved 2 weeks after the start of combination therapy. In addition, postinflammatory spots lightened significantly, the skin texture was leveled. The patient is contactable, notes an improvement in mood. Side effects of isotretinoin were not disturbed after a daily dose reduction.

Example 3

Patient B., 28 years old, complained of constantly occurring rashes in the face and neck, enlarged pores and the formation of gross scars. Suffers from acne for 15 years. Received treatment with antibiotics, antiandrogens with little effect. No complaints from internal organs. Objectively: face and neck skin is oily, hyperkeratosis is expressed, pores are enlarged, skin tone, severity of skin folds do not correspond to age. In the area of nasolabial folds, cheeks, neck, multiple papules and nodes with a diameter of up to 1 cm, cyanotic-crimson color, atrophic scars with a diameter of up to 5 mm and a depth of 2 mm.

Treatment: oral dose of isotretinoin at a dose of 0.1 mg / kg body weight for 4 months. in combination with external procedures according to the sequence of actions described in example 1 with a frequency of 1 time in 2 weeks. The course dose of isotretinoin was 10 mg / kg. To achieve clinical recovery, 8 procedures were required.

Results of treatment: Significant improvement in the skin condition was observed already 4 weeks after the start of complex treatment. In addition to clinical recovery, it was possible to achieve equalization of the skin relief, increase its tone, reduce pores, lighten spots. The patient notes a significant improvement in the psycho-emotional state. Subsequent observation for 2 years of relapse did not reveal.

Thus, as a result of the application of the proposed method of treatment, it is possible to quickly achieve clinical improvement and cure without significant side effects, while preventing the formation of scars and correcting existing skin defects, while significantly reducing the total cost of treating the disease and correcting its consequences.

The method was tested at the Department of Skin and Sexually Transmitted Diseases of the Federal University of Moscow State Medical University, in the Department of Internal Affairs No. 19 of Moscow, LLC Center for Aesthetic Medicine, on a significant number of patients, the treatment results of which are presented in the table.

Table
Treatment results The severity of acne Moderate Heavy Very heavy Treatment result Remission 49 41 9 Significant improvement 8 7 6 Total 120

As can be seen from the table, the proposed method was applied in 120 patients with acne of moderate to severe, severe and very severe course. Clinical cure and significant improvement were achieved in 83% and 17% of patients, respectively, alignment of the relief, color and texture of the skin was noted in all patients, which indicates a high clinical effectiveness of the method.

The proposed method is the method of choice in the treatment of acne of severe and moderate course, accompanied by the formation of skin defects.

The method is practically tested, based on safe drugs and can be applied directly according to this description.

Claims (2)

1. A method of treating acne, including therapy through repeated oral administration of doses of a drug containing retinoids, characterized in that during the period of oral administration of doses of a drug containing retinoids, chemical peeling and cosmetic cleaning are repeatedly performed, while isotretinoin is used as a retinoid, and single doses of isotretinoin are prescribed in an amount of 0.1-0.3 mg / kg per day, followed by a dose reduction at a course dose of 10-40 mg / kg. 2. The method according to claim 1, characterized in that chemical peeling and cosmetic cleaning in an amount of from 4 to 15 procedures using an alpha-beta-retinol skin foliator and evacuation of the contents of the ducts of the sebaceous glands, pustules and cysts are carried out during oral administration of doses a drug containing isotretinoin.