Lecture 5

Topical medications are usually packaged in tubes of 30g, 45g, 60g, or 80g. Some generic topical steroids come in 454g (one pound) jars. It's important to prescribe the correct amount to avoid running out before the treatment is complete.

Terms like "hypoallergenic", "unscented", and "for sensitive skin" are marketing terms, not medical guarantees. A product labeled as hypoallergenic can still cause allergies, an unscented product might contain fragrance, and a sensitive skin product can irritate.

Ointments are the most moisturizing and greasiest. Creams are less moisturizing and less greasy. Lotions are minimally moisturizing and minimally greasy. Gels and solutions are drying and not greasy.

Applying a ceramide-based cream or plain petroleum jelly immediately after bathing and before drying off is the most effective way to moisturize.

Soaps and shampoos contain long chain molecules with a hydrophilic (water-loving) end and a hydrophobic (water-fearing) end. This allows them to bind to oily substances and dissolve them in water, but also removes the skin's natural oils, which can be drying.

Shampoos are specifically formulated to prevent residue build-up on hair shafts.

Soap and shampoo can be inherently drying and slightly irritating to the skin because they strip away natural oils.

A common misconception is that "hypoallergenic" dermatological products can't cause allergic reactions, but this is false. Many dermatological products can still cause allergies despite being labeled as hypoallergenic.

A measure of how well a sunscreen protects skin from sunburn caused by UVB radiation.

The amount of time it takes to get a sunburn while wearing sunscreen compared to the time it takes to get a sunburn without sunscreen.

UV light that is absorbed by the ozone layer and does not reach the Earth in significant amounts.

UV light that is the main cause of sunburn.

UV light that contributes to skin aging and wrinkles.

Sunscreen ingredients that absorb UV light and convert it to infrared energy (heat).

The build-up of soap residue on hair shafts, similar to 'soap scum' on surfaces.

Sunscreen ingredients that reflect and scatter UV light.

Conditioners are designed to replace natural oils (sebum) removed by shampoos, making hair shiny and manageable.

Zinc oxide and titanium dioxide are the two main types of physical blockers, known for their stability and effectiveness in blocking both UVA and UVB radiation.

Products that contain ingredients like zinc pyrithione, selenium sulfide, or salicylic acid to combat dandruff. They can also help with seborrheic dermatitis.

Using soap only on areas with higher sweat and oil production (face, groin, armpits) for routine cleaning, while relying on water for the rest of the body.

Antibacterial soaps are not proven to be more effective than regular soap and may contribute to bacterial resistance.

Deodorant soaps can be irritating and drying, especially for people with dry skin.

Facial cleansers are non-lathering and gentler than regular soaps, making them suitable for dry or irritated skin.

Sunscreens, measured by SPF, protect skin from harmful ultraviolet radiation.

Applying topical steroids for longer than two weeks may increase the risk of side effects. To minimize risks, consider using it for two weeks, then taking one week off, or using it Monday to Friday and taking weekends off.

Chronic topical steroid use on the face can lead to skin becoming dependent on the steroid. Stopping steroid use abruptly can cause severe skin reactions.

Steroids come in different strengths. Choosing the right strength for the area being treated is important for effectiveness and safety.

Protopic and Elidel are non-steroid treatments for skin conditions with similar effectiveness to medium-strength steroids. They have a lower risk of typical steroid side effects.

Protopic and Elidel may increase the risk of developing lymphoma, but more research is needed to confirm this.

Protopic and Elidel are generally reserved for patients with long-term skin conditions, especially on the face or groin.

Topical steroids are generally more effective, safer, and cheaper than Protopic and Elidel for most skin conditions. They should be the first choice unless a specific condition requires alternatives.

Topical steroids can cause thinning of the skin, stretch marks, broken blood vessels, easy bruising, decreased production of cortisol (a hormone), and eye problems (glaucoma and cataracts) when applied to the eyelids.

Aldara (imiquimod) is a topical medication that stimulates the immune system to fight skin infections. It works by increasing the production of interferon-alpha and other cytokines that help the body fight off viruses and bacteria.

Aldara does not penetrate thick skin well, so it may need to be combined with other treatments for conditions like thick warts.

Aldara's primary use is for genital warts, but it's also used for actinic keratosis, common warts, and some skin cancers.

Mild acne can be treated with topical medications like tretinoin or benzoyl peroxide.

Moderate acne requires a combination of treatments like topical medications, oral antibiotics, and sometimes hormonal therapy.

Severe acne often requires oral medications like Accutane, which can have serious side effects.

Rosacea, a skin condition causing redness and bumps, can be treated with topical medications like metronidazole and avoiding triggers like sun exposure.

Seborrheic dermatitis, a condition causing flaky scalp and skin, can be treated with shampoos like Head & Shoulders and topical medications like ketoconazole.

A common skin condition characterized by a rash in skin folds, such as under the breasts, the groin, or armpits. This is caused by moisture trapped in these areas, leading to irritation and fungal growth.

A fungal infection of the mouth, often causing white patches on the tongue and inner cheeks. It's common in individuals with weakened immune systems, like those with diabetes or taking certain medications.

A fungal infection of the skin, hair, or nails. It can appear as itchy, scaly patches on the body, ringworm-like patterns on the skin, or nail discoloration and thickening.

A fungal infection of the nails, causing discoloration, thickening, and sometimes even separation of the nail from the nail bed. It's more common in individuals with diabetes or weakened immune systems.

A viral infection that causes a painful rash with blisters, typically on one side of the body. It's caused by the varicella-zoster virus, the same virus that causes chickenpox.

A viral infection that causes sores on the lips or genitals. It's caused by the herpes simplex virus (HSV).

A very common skin condition caused by a virus, producing small, flesh-colored, dome-shaped bumps. It's often spread through close contact or sharing towels.

A common skin condition caused by a virus, which leads to the formation of warts. Warts are rough, raised growths on the skin, usually caused by the human papillomavirus (HPV).