please tell me how to cure acne and got the best answer

Answer from Martha[guru]
For girls and women, there is a separate method of treating acne. Modern treatment is offered by the International Acne Alliance of Dermatologists.
Test:
If acne on the face is less than 10, then this is 1 degree of acne.
If acne is from 10 to 40 - 2nd degree
More than 40 pimples and they merge with each other - degree 3
Grade 1 acne is treated only by external means. Grade 2 acne is treated with both external agents and medicines that are taken orally. With grade 3 acne, external treatment is ineffective, and there is only one drug that treats grade 3.
Under the influence of androgens - male sex hormones - the sebaceous gland that surrounds the hair begins to secrete a huge amount of sebum. Microbes are happy to live, feed and multiply in sebum. As a result, inflammation of the sebaceous gland occurs and a pimple appears on the surface. It is also associated with increased keratinization of the skin - its scales close the exit of the contents from the sebaceous gland.
Causes of acne:
- an increase in the body's level of male sex hormones - androgens. During puberty, both boys and girls increase the level of male sex hormones. In girls, this is due to the fact that female sex hormones are formed from male sex hormones;
- increased production of sebum. The high sensitivity of the sebaceous glands to androgens causes them to produce a huge amount of sebum;
- microbial inflammation. Microbes receive high-quality nutrition - sebum, and successfully multiply, which causes inflammation on the skin;
- increased keratinization of the skin. Horny skin flakes block the exit for sebum, the gland becomes clogged and the inflamed secret cannot come out.
Pimples have nothing to do with eating disorders, dysbacteriosis or other causes.
When squeezing a pimple, all the pus flows into the inner layers of the skin, infects the neighboring sebaceous glands and the inflammation spreads. Therefore, it is better not to squeeze acne, but to properly care for your face. Squeezing acne, including the so-called "face cleansing" in the salon - an absolute violation of all modern standards for the treatment of acne.
Treatment of stage 2 acne for girls
You should wash your face with special cleansers: for oily and problem skin
Wipe the face with disposable wipes or disposable towels to avoid re-microbial contamination
In the evenings, you should use a drug that helps reduce keratinization of the skin, such as differin. It should be applied to the face in a very thin layer. The drug dissolves keratinized scales and releases sebum and acne.
In girls, one of the stages of treatment allows you to deal with the root cause - to reduce the level of male sex hormones. This consists in taking hormonal contraceptives that contain an antiandrogenic factor. These are not any contraceptives, the instructions should have a special inscription: "treatment of a moderate form of acne (acne)". A doctor should prescribe a course of hormonal treatment.
The minimum treatment period for acne is 3 months. The skin is renewed after 28 days, and for normalization it needs a minimum of 3 renewal cycles, that is, 3 months.

Answer from *** [newbie]
white clay masks need to be made - just mix with water until the consistency of sour cream, smear the face, rinse off when it dries.

Answer from Smith06[guru]
clearasil

Answer from Judo[guru]
go to the dermatologist!
and don't self-medicate.

Answer from Pauline[guru]
go to a good beautician.

Answer from Lyudmila Shevchenko (Yatsenko)[guru]

Answer from Yatiana Lagunova[guru]
1. I categorically DO NOT advise GIRLS to drink HORMONAL contraceptives! ! Not a single pimple in the world is worth the losses that a fragile girl's body will suffer as a result: from menstrual irregularities to incessant uterine bleeding and infertility! !
2. I absolutely disagree with the opinion that the appearance of acne (blackheads) is NOT related to nutrition in any way. Related! ! And you should eat right - healthy, healthy food: fresh juices in the morning, fruits and raw vegetables, cottage cheese, cereals, fish and many others. Not chips and Coke! !
3. Do NOT squeeze acne!
4. You should take care of your face in the most thorough way: DO NOT use creams, use Safeguard soap, boil face towels, do not touch your face with dirty hands. Acne must be cauterized with boric alcohol.
5. This is an age-related problem associated with the "game" of hormones - with age, everything should normalize. I recommend visiting an endocrinologist.
Pimples - the problem is not so much external as INTERNAL!

The peak of acne development falls on puberty (puberty). At this time, for many teenagers, it turns into a tragedy: youthful maximalism does not allow you to look "pimply". As the period ends, for most, it passes without a trace. With a mild form of the disease, there is no need for serious treatment. In some cases, the disease continues to develop over a long period. And then the treatment of acne should be carried out in conjunction with specialists.

Mechanisms of acne

During puberty, adolescents begin to produce male sex hormones - androgens. Natural hormonal changes occur in the body. They are the cause of the development of teenage acne.

An increase in androgen levels leads to excessive production of sebum. It accumulates in the ducts of the sebaceous glands and contributes to an increase in the number of bacteria. Bacteria feed on sebum, multiply, resulting in an inflammatory process.

Superficial skin cells clog the secretion of the sebaceous glands and a pimple occurs.

In any case, you need to consult a doctor to find out how to deal with acne.

Basic principles of treatment

There is no universal procedure or miracle cream for the treatment of acne. The problem requires a special approach - drawing up an individual treatment program. It should take into account age, gender, duration of the disease, the severity and nature of the lesion, the form of acne, and the results of laboratory tests.

To understand how to treat acne, you need to find out the causes of its occurrence. This skin disease cannot be considered separately only as a cosmetic defect of the skin. Its roots may lie very deep.

Medical examination of the body

Tests in the presence of acne are prescribed in the following cases:

1. 1. Development of the disease after 20 years.
2. 2. Clinical signs of hyperandrogenism in women.
3. 3. Violation of the menstrual cycle.
4. 4. Overweight.
5. 5. The presence of black acanthosis.

Any treatment for acne should be under the supervision of a dermatologist to avoid complications.

The dermatologist prescribes a general blood test and a hormone test. The following shows the culture crops to determine the presence or absence of microbes in the pores. Antibiotic susceptibility testing is also carried out in order to correctly select drugs.

According to all the results obtained, the general condition of the body is determined. If there are bad indicators in the blood tests, the patient is sent to the therapist.

Degrees of skin diseases and methods of their treatment

The International Alliance of Dermatologists identifies 3 degrees of skin lesions and recommendations on how to cure acne with medical methods.

1. 1. First degree. When on the face you can count up to 10 elements (acne). Treatment is prescribed only externally:

• a drug that reduces the production of sebum;
• medicine that fights bacteria on the face;
• a medicine that eliminates hyperkeratosis - an excessive thickening of the stratum corneum of the epidermis.

1. 2. Second degree. On the skin of the face, you can already count from 10 to 40 acne. In such a difficult case, there are two ways to cure acne: external and internal.

Outwardly, in the treatment of acne, all the same medicines as in the first degree help well.

For internal use, two features must be considered:

• girls (women) should use an approved hormonal contraceptive for the treatment of second-degree acne. It contains an anti-androgenic factor, reduces the level of male sex hormones and helps well in the treatment of acne;
• antibiotics are used to treat acne in both sexes. This is doxycycline, which is used by mouth for 3 months. The skin renewal cycle lasts 28 days: it takes three skin renewals for the skin to become acne-free.

1. 3. Third degree. It is characterized by localization on the skin of 40 or more acne; in fact, the whole face is dotted with them.

External treatment for the third degree is not provided. The only way is the internal use of the drug roaccutane (isotretinoin). This medicine prevents the secretion of fat from the sebaceous glands, deprives the bacteria of food, and causes drying of the skin. It should only be prescribed by a doctor, because although it gives the most effective result, it also has a serious side effect.

Skin care tips for acne patients

There are rules for dealing with acne, adhering to which you can achieve the desired results. Squeezing pimples is strictly prohibited. Indeed, with pressure on them, purulent contents move into the deeper layers of the skin. Thus, acne spreads even more.

For washing it is necessary to use products for oily and problem skin. To avoid further spread of the infection on the skin, it is better to wipe your face only with disposable towels. After washing, apply any acne remedy to the skin.

Acne treatment also includes following a special diet. A competent nutritionist should choose an individual diet, in which the use of sweet, salty, fatty foods is usually prohibited. The main emphasis in food should be on plant foods.

None of the currently existing methods and procedures can guarantee a complete cure for acne. Only a persistent desire, expressed in complex actions and taking preventive measures, will help get rid of the disease forever.

What is acne?

Most often, by this word, people mean acne or acne. You may also see the terms "acne" and "acne" referring to the skin manifestations of acne. Therefore, pimples, blackheads, acne are synonymous. Acne is a skin disease associated with damage to the sebaceous-hair apparatus of the skin. It occurs on areas of the skin, especially rich in sebaceous glands - this is the face, back, chest. Acne or acne is a very common condition. It occurs in 85% of young people between the ages of 12 and 24; almost every teenager. But the manifestations can be quite different: from single acne in the field of vision - to extensive rashes.

Pimples appear in life at the most inopportune moment. Acne makes the face unrecognizable and life unbearable. Hated acne teenagers declare war. And they use all kinds of means. They try to squeeze them out, make lotions, but there is no result. The happiness is that modern medicine knows how to deal with this. But many parents do not know how to treat acne. The international alliance of dermatologists and cosmetologists has established a protocol (rules) for the treatment of acne. Treatment begins with determining the stage of the disease.

There are three stages of acne.

Finding out what stage you have is easy - you need to count the number of acne on the skin.

• The first stage is less than 10 pimples.
• The second stage - from 10 to 40 acne.
• The third stage - more than 40 acne.

Acne is an inflammation of the sebaceous gland.

Normally, the sebaceous gland surrounds the hair follicle and secretes an oily fluid, sebum. Salo lubricates the surface of the skin and is our own natural cream, which is the best. But everything changes when adolescence begins. During adolescence, testosterone rises in both boys and girls. During puberty, it is from testosterone that the female hormones, estrogens, are formed. Testosterone promotes overactive sebum production.
Both boys and girls at this time have an excess of male sex hormones, androgens. They cause the sebaceous glands to produce a lot of sebum. But, and fat is a favorite food not only of people, but also of microbes. Bacteria literally pounce on the sebum and begin to multiply in it as in a nutrient medium ... this is how bacterial inflammation occurs. And most importantly, during this period, the number of keratinized skin flakes increases dramatically. It is they who close the duct of the sebaceous gland and do not allow the secret to stand out. As a result, a swollen sebaceous gland with a closed duct comes out on your face in the form of a nasty pimple.
Treatment lasts, as a rule, at least 3 months and up to six months. Acne treatment is a long process. Because the surface of our skin is completely renewed once a month. During this time, the keratinized layer of cells is exfoliated from it and young cells appear on the surface.
For acne to disappear without a trace, it takes 4-6 months to be treated.

Why do pimples appear?

4 causes of acne:

1. Increased testosterone levels.
   Testosterone promotes overactive sebum production.
2. Increased production of sebum.
   Sebum is a breeding ground for bacteria.
3. Reproduction of microbes on the surface of the skin.
4. Increased keratinization of the skin.
   Blockage of the sebaceous gland by keratinocytes - cells that clog the sebaceous gland. Those. there is an increased keratinization of the skin, and sebum can no longer be removed from the sebaceous gland.

Treatment of the 1st stage of the disease.

1. Wash your face 2-3 times a day with alcohol-free products!
2. 
   The retinoid cream dissolves the crust and makes the fat thinner. For it to come out freely. In fact, at the first stage, we are struggling with one cause - hyperkeratosis. We release the sebaceous glands and let them come out.

The first results will appear in 28 days. Why is the result not fast? Because the skin needs to be renewed. The rate of skin renewal is on average 28 days. Therefore, the first result will be in 1 month. But you can’t stop, because the update must go through several times. Acne in the first stage is treated within 4-6 months. The next step is to learn how to care for this type of skin, as it will remain sensitive to the possible activity of bacteria on it.

The 2nd stage of the disease of acne is distinguished by the number of acne from 10 to 40 pieces.

Treatment of the 2nd stage of the disease.

1. External washing with alcohol-free products!
2. Lubricate acne with a cream with retinoid.
3. Taking antibiotics.

During the second stage of acne, a large number of microbes occur, so taking antibiotics is important for treatment. Treatment with antibiotics is carried out under the supervision of a doctor, for 4-6 months. For the treatment of the second stage of acne in girls, hormonal contraceptives can be used. They reduce testosterone levels and new acne does not appear on the skin, and the old ones disappear. Hormonal preparations should be prescribed only by a doctor!

3rd stage of the disease.

This stage is when a person has more than 40 pimples on his face. A distinctive feature of the third stage of the disease is a large amount of keratinized skin. The keratinized skin does not allow the sebaceous gland to stand out. Because of this, a swollen sebaceous gland with a closed duct comes out in the form of a pimple. In the third stage, external cleaning of the face is prohibited!
At this stage, additional diagnostics is necessary: ​​a biochemical blood test.

Treatment of the 3rd stage.

The third stage is the most serious. Therefore, for its treatment, in addition to washing and cream, it is necessary to use the drug isotretinoin in the form of tablets. THIS MEDICINE IS APPOINTED ONLY BY A DOCTOR! Isotretinone reduces the production of sebum, the treatment lasts at least 6 months. And it is carried out only under the supervision of a doctor. Be sure to take a blood test once a month. To determine your stage of the disease, you need to consult a dermatologist or cosmetologist. At this stage of acne, antibiotics and other systemic therapy are not used.

Olesya suffered from the first stage of acne. There were not so many “pimples” on her face, but black dots (comedones) really interfered with her life and made her skin ugly. One day she looked at herself in the mirror and saw that her face looked untidy with all these "pimples" and redness on her face. Because of this, she always had a bad mood, self-doubt appeared. When she walked with her friends, she didn’t even want to be photographed because of the rashes. At first, everyone told Olesya that this was a transitional age and that everything would pass, but there were more and more acne on her face. And then she realized that if she did not urgently seek help, acne would remain with her for life.

Errors in the treatment of acne.

The most common mistakes that are made in the treatment of acne are:

1. Intense tan. Acne exacerbation occurs 2-3 months after tanning. If you have acne, don't sunbathe. You can sunbathe, but moderately. In the sun, the face dries up, the fat becomes less. But after drying in the period July-August, in September-October there will be an aggravation.
2. Wipe pimples with alcohol. Alcohol only exacerbates acne. It is STRICTLY FORBIDDEN to wipe acne with ALCOHOL! Alcohol is very drying to the skin. The skin is protected from alcohol aggression by producing even more sebum.
3. Popping pimples leads to scarring of the skin and increases inflammation. STEAMING and CLEANING of the skin is strictly FORBIDDEN! After squeezing out acne, scars, bluish spots, etc. remain.

Why Treat Acne?

Acne disease entails severe cosmetic consequences. Some manifestations of acne may remain forever. If it proceeded safely (for example, there was a mild form of juvenile acne that passed after the end of puberty), then there may not be any traces.
But it is not always so lucky: severe inflammation, nodes and cysts leave traces - post-acne.

March 14-16, 2018 in Moscow at the International Exhibition Center "Crocus Expo" was held XIInternational forum of dermatovenereologists and cosmetologists - XIInternational Forum of Dermatovenerologists and Cosmetologists (XI IFDC) is a significant scientific event, which was attended by 1935 people from Russia, France, Switzerland, Poland, Germany, Canada, Israel, Jordan, Belarus, Azerbaijan, Kyrgyzstan, Kazakhstan, Uzbekistan, Ukraine, Armenia, Georgia, Latvia, Moldova.

The Forum is organized by the National Alliance of Dermatologists and Cosmetologists (NADC), the Euro-Asian Association of Dermatovenerologists (EAAD) and the Guild of Specialists in Sexually Transmitted Infections (IUSTI) with the active participation of the National Academy of Mycology, the Professional Society of Trichologists and the Russian Perfume and Cosmetic Association, in cooperation with other large professional communities, including foreign ones.

A distinctive feature of this Forum was its representativeness; in 2018, the international participation of world-famous scientists was unprecedentedly extensive, which certainly underlines the authority of the event.

The XI International Forum of Dermatovenerologists and Cosmetologists was solemnly opened by the Chief Specialist in Dermatovenereology and Cosmetology of the Moscow City Health Department, Head of the Department of Skin Diseases and Cosmetology of the Russian National Research Medical University. N.I. Pirogova, President of the National Alliance of Dermatologists and Cosmetologists, President of the Euro-Asian Association of Dermatovenereologists, Professor Nikolai Nikolaevich Potekaev.

Every year IFDC gathers leading scientists, doctors, heads of legislative and executive authorities, representatives of public organizations to discuss a wide range of problems in the development of dermatovenereology and cosmetology.

Within the framework of the Forum, participants get the opportunity to formulate and discuss the problems of interdisciplinary interaction between dermatovenereology and related specialties and develop an algorithm for their solution, determine the main directions of development in solving urgent problems and training qualified specialists.

In a solemn atmosphere, the awards of the National Alliance of Dermatologists and Cosmetologists "For an outstanding contribution to dermatovenereology and cosmetology" were presented to Professor, MD. Gomberg M.A., professor, MD Raznatovsky K.I., MD Gadzhigoroeva A.G., professor, MD Korolkova T.N., professor, MD Orlova O.R.

The Forum was attended by representatives of 12 delegations from countries near and far abroad. Within the framework of the Forum, the summit "Dermatovenereology of the CIS" was held with the participation of leading experts from the countries of the post-Soviet space. Leading specialists from the Commonwealth countries were invited to discuss a joint plan for long-term cooperation. The meeting of leaders, doctors, scientists in Moscow made it possible to discuss topical problems at a new level and strengthen international cooperation.

The Forum hosted a broad discussion of clinical approaches to the diagnosis and treatment of diseases of the skin and subcutaneous tissue, sexually transmitted infections. The discussion of complex clinical cases aroused great interest of the participants. A rich program was provided for doctors specializing in cosmetology: discussion of advanced methods for correcting cosmetic defects, aesthetic dermatology, skin care programs, removal of cosmetic skin defects.

Within the framework of the Forum, the 1st Moscow Conference "Non-invasive research methods and laser technologies: new opportunities in diagnostics, dermatological research and treatment of dermatosis" was held for the first time (organized jointly with the Volga Research Medical University, Nizhny Novgorod). Other interesting events include the extended section of IUSTI, the Herpes Forum, the VI Congress on Dermatoscopy, meetings on dermato-oncology and pediatric dermatology, organizational and methodological meetings, extended cosmetology, trichology and podology sections, sections of apparatus and laser dermatology and cosmetology.

The most important condition for the success of major scientific events is an interdisciplinary approach; therefore, the event was attended not only by dermatovenereologists and cosmetologists, but also by allergologists-immunologists, rheumatologists, endocrinologists, specialists in the field of internal diseases, pediatrics, psychosomatic medicine, gynecology, ophthalmology, infectious diseases, and other specialists.

The interdisciplinary format of IFDC 2018 presented an expanded scientific program structured into the main thematic scientific areas: "Organization of specialized medical care for the population in the profile" Dermatovenereology "and" Cosmetology "," Allergology and Dermatology "," Trichology "," Laser therapy in dermatology and cosmetology ", "Pediatric dermatology", "Dermato-oncology", "Clinical mycology", "Modern methods and approaches to laboratory diagnostics in dermatovenereology", "Modern issues of syphilidology", "HPV-associated diseases", "HIV-associated diseases", "Ophthalmology and dermatology" ”, “Psychodermatology”, “Undesirable phenomena in cosmetology”, “Botulinum therapy”, “Injection techniques”, “Topical methods in dermatology and cosmetology”, “Acne and Rosacea”, “Dermatoscopy”, “Systemic approach to psoriasis therapy”.

Organizationally, the scientific program included a plenary session, 65 symposiums, 254 oral and 17 poster presentations, 4 sections of the VI All-Russian Congress on Dermatoscopy and Optical Diagnostics of the Skin, 4 blocks of clinical analyzes, 3 video demonstrations, the 1st Moscow Conference "Non-invasive research methods", master class on practical trichology, competition of young scientists, which were held in parallel in 5 conference halls.

In general, during the Forum, leading domestic and foreign scientists and specialists made 254 reports. The topics of the reports included current trends in dermatovenereology, cosmetology, healthcare organization, pediatric dermatology, trichology, anti-age medicine, laser and phototherapy, dermato-oncology, as well as issues of an interdisciplinary approach in the diagnosis, prevention and treatment of skin and venereal diseases and related specialties.

The plenary session was opened by the report of the Chief Specialist in Dermatovenereology and Cosmetology of the Moscow Department of Health, Head of the Department of Skin Diseases and Cosmetology of the Russian National Research Medical University named after N.I. "Modern dermatovenereology - directions of development", which presented world priority achievements in science and practice in the field of fundamental and applied research in dermatovenereology and cosmetology, which were reflected in the forum program.

A plenary presentation on contact dermatitis and PATCH tests was made by Israeli professor Arie Ingber, in which he highlighted the difficulties in everyday practice, interesting clinical observations and considerable perseverance and deductive method.

The first scientific symposium was opened by Roman Nowicki from Poland with the report "Innovative developments in the field of basic therapy", which reflected the importance of basic treatment with emollients as a prevention of the development of atopic march. The topic "The role and place of emollients in the treatment of atopic dermatitis in the daily practice of a dermatologist" was continued by Didier Cousteau from France and Alain Delarue made the final report of this symposium on the topic: "Emolients: the simpler the formula, the better for any patient with xerosis", where in detail consecrated the features of the composition of cosmetic products aimed at moisturizing the skin.

The pearls of the Forum program were lectures by world-famous experts:

• Bridget Dreno from France "Acne pathophysiology: new data and their application in clinical practice"
• Alain Delarue from France "Treatment of infantile hemangiomas: a dream come true"
• Lallas Amilios from Greece "Dermatoscopy in the daily practice of a dermatologist"

An innovative approach in the treatment of psoriasis with a phosphodiesterase 4 inhibitor was presented by Professor Arie Ingber (Israel) on the example of an analysis of clinical cases from his own practice; D.N. Serov, the choice of patients for whom apremilast would be the right therapeutic solution was outlined by the head of the Department of Clinical Dermatovenereology and Cosmetology Professor A.N. Lvov.

Reports of the scientific direction: "Organization of specialized medical care for the population in the profile" Dermatovenereology ": problems and solutions" (co-chairs: Ivanova M.A., Novozhilova O.L.) included a discussion of topical issues about modern ways to optimize the organization of medical care, financing medical organizations in modern conditions of improving methodological approaches in the regulation of labor, the organization of dermatovenereological care in non-state medical institutions.

Sections under VIII were highly appreciated Moscow Conference of the Guild of Specialists in Sexually Transmitted Infections "YUSTI RU" professors: M.A.Gomberg, V.I.Kisina, Ph.D. A.E. Gushchin and others) and the X Russian Herpes Forum (Professor: A.A. Khaldin and others).

The relevant sections were:

- "Dermatooncology" and "Oncodermatosurgery and diagnostics", during which reports of recognized world scientists in the field of dermatooncology were heard: prof. N.N. Potekaev, prof. M.Yu. Byakhov, Academician of the Russian Academy of Sciences L.A. Ashrafyan, Corresponding Member of the RAS V.I. Kiselev, MD K.S. Titov, prof. A.V. Molochkov and others Prof. N.N. Potekaev, in his speech, emphasized the relevance and urgent need for interdisciplinary cooperation within both the Moscow and the national community of doctors.

- "Laboratory technologies in dermatovenereology" (Professors N.V. Frigo, S.V. Rotanov, Candidate of Medical Sciences N.A. Sapozhnikova and others), within which specialists received recommendations on new approaches in the diagnosis of skin and venereal diseases diseases.

Traditionally, within the framework of IFDC 2018, sections were held:

- "Children's Dermatology" (professors: N.G. Korotkiy, V.N. Grebenyuk, A.N. Lvov, O.B. Tamrazova, Ph.D. O.V. Porshina, Ph.D. N .F. Zatorskaya and others);

- « Apparatus methods in dermatology and cosmetology” (professors: V.A. Volnukhin, E.V. Vladimirova, etc.);

- "Trichology" (doctor of medical sciences A.G. Gadzhigoroeva and others).

The VI All-Russian Congress on Dermatoscopy and Optical Diagnostics of the Skin was held (Professors: V.Yu. Sergeev, Ustinov M.V., I.G. Sergeeva, Oganesyan M.V., Shlivko I.L., Dreval D.A. and others .)

Within the " I Moscow Conference Non-Invasive Research Methods and Laser Technologies: New Opportunities in Diagnostics, Dermatological Research and Treatment of Dermatoses” (withchairmen: prof. N.N. Potekaev, prof. G.A. Petrova, Ph.D. M.A. Kochetkov, Ph.D.: A.P. Bezugly) specialists discussed the algorithms of methods for non-invasive diagnosis of dermatosis and monitoring of correction methods in aesthetic medicine.

The section “HIV infection” aroused great interest among the Forum participants (chairman: chief specialist on the problems of diagnosing and treating HIV infection, DZM, MD A.I. Mazus, Professor Loseva O.K.) modern principles of providing medical care to patients with HIV infection.

Of great professional interest with an active fruitful discussion were the sections on cosmetology, where 2 symposiums were held on botulinum therapy in the daily practice of dermatologists and cosmetologists chaired by the President of the Interregional Public Organization of Botulinum Therapy Specialists Orlova O.R., demonstration of the use of a special complex for the practical development of injection skills botulinum toxin, a video master class on injection correction of excess volumes of the face and neck, the section "Injection techniques - the avant-garde of modern cosmetology" was held. The moderator of the specialized section on injection techniques was Alisa Alexandrovna Sharova, a well-known professional in the industry. A separate symposium was devoted to complications in cosmetic patients - a three-pronged approach was consecrated from the standpoint of a cosmetologist, dermatologist and surgeon, an analysis of the most common complications in cosmetology practice was conducted by G.A. Aganesov, E.A. Shuginina spoke with a clinical analysis of examples of complications after mesotherapy, infectious complications of injection contour plastic surgery was clearly demonstrated by Stenko A.G., the treatment of compression-ischemic syndrome after injection plastic surgery, depending on the clinical manifestations, was discussed in the report of O.I. Danischuk, E.I. Karpova. As part of the cosmetology program, a professional competition "Cosmetologist-2018" was held. The participants presented an essay on the topic “Cosmetologist-2018. Secrets of the profession”, where they talked about professional subtleties, personal know-how used in everyday practice and giving a real effect.

Traditionally, a symposium on trichology (Diseases of the hair and scalp) aroused great attention, where a professional portrait of a specialist trichologist was discussed (report by Gadzhigoroeva A.G.), chronic fatigue syndrome in the context of pathology of the scalp (report by Vavilov V.V.), elimination of deficient conditions (report by Tkachev V.P.), new achievements and technologies in cosmetology (report by Tsymbalenko T.V.). The section "Oncological patient at the appointment of a cosmetologist" was held

Special attention should be paid to the specialized section "Beautician's Business", which discussed the entire arsenal of business tools that a modern cosmetologist must have in order to work successfully and profitably: new methods of active sales, the expediency and rules for organizing an individual entrepreneur, legislative subtleties and much more. The moderator of this section was a recognized expert and analyst of the beauty industry E.V. Moskvicheva. As part of the discussion organizational and legal issues of providing medical care in the field of "cosmetology" in the section Business cosmetologist presented a report Moskvicheva E.V., where she consecrated the credit system of continuous medical education, new terms of accreditation. In addition, for the first time an interdisciplinary seminar “Woman 40+. The Body as Evidence”, which discussed the role of sex hormones and their deficiency in the main manifestations of aging, nutrition issues, the psychological characteristics of the perception of body changes and the use of cosmetic products in anti- age therapy. Special attention was paid to the section of technologies for managing patients with acne and complications in cosmetic patients.

Important and informative was the section "Allergology and Immunology (with chairmen: A.N. Pampura, E.I. Kasikhin) where reports on food allergy and atopic dermatitis were discussed, about modern aspects of treatment and topical dermatitis, chronic urticaria, pruritus pathogenesis.

Clinical analyzes were topical (co-chairs: Professor N.N. Potekaev, Professor A.N. Lvov): psoriasis in children (analysis presented by Associate Professor E.I. Kasikhina), errors in dermatology (analysis presented by Professor V.G. Akimov), skin manifestations of rheumatological pathology. Many-sided scleroderma (analysis presented by Professor I.V. Khamaganova), errors in cosmetology (analysis presented by T.B. Kostsova, E.A. Khlystova, A.V. Igoshina).

Within the framework of the Forum, the Young Scientists Competition for the best poster scientific report of the X International Forum of Dermatovenereologists and Cosmetologists was traditionally held. Young specialists dermatovenereologists competed in the nomination: "Innovation and practice". In total, according to the results of the preliminary review of the submitted scientific papers, 17 applicants in one nomination were admitted to the Competition. The poster section of the Competition took place on March 16.

The performances of the participants were evaluated by a competent jury consisting of leading domestic scientists chaired by the head of the Department of Skin Diseases and Cosmetology of the Russian National Research Medical University. N.I. Pirogova N.N. Potekayeva, Deputy Chairman, Head of the Department of Clinical Dermatovenereology and Cosmetology, Professor A.N. Lvov, Leading Associate Professor V.V. Petunina, members of the Jury: Chief Physician of the MNPCDC O.V. Zhukova, Professor of the Department of Skin Diseases and Cosmetology, FGBOU VPO Russian National Research Medical University. N.I. Pirogova I.V. Khamaganova, head of the educational department Ph.D. E.I.Kasikhina, Associate Professor of the Institute of DPO "Institute of Plastic Surgery and Fundamental Cosmetology" of the Russian Academy of Natural Sciences E.A.Shuginina, d Assessor of the Department of Skin Diseases and Cosmetology of the Russian National Research Medical University. N.I. Pirogov A.A. Tsykin.

The winners of the Competition are:

in the nomination "Innovation and practice" (dermatovenereology)

two first places

Yu. A. Krakhaleva "Possibilities of ultrasound examination of the skin in the assessment of structural and inflammatory processes and their dynamics during treatment in children with atopic dermatitis" (Center for Postgraduate Medical Education "Novosibirsk NIGU")

O.V. Kadakova "Clinical evaluation of the effectiveness of the treatment of hand-foot syndrome - an undesirable phenomenon of antitumor therapy" (TSGMA UDP)

four second places

YES. Belyanina "Assessment of atopic status in patients with psoriasis" (Center for Postgraduate Medical Education "Novosibirsk National Research University")

A.A. Karpenko, L.V. Kulagin "Determination of the optical characteristics of the skin in the presence of artificial pigment" "Privolzhsky Research Medical University", Nizhny Novgorod

IN AND. Dudak "Yarish-Herxheimer-Lukashevich reaction in patients with syphilis" (MNPTSDK DZM)

A.V. Titenko "Virtual school on dermatovenereology "trip with skin": a new step in teaching methodology" (Center for Postgraduate Medical Education "Novosibirsk NIGU")

Four third places

E.A. Parfenov "Dermatozoic delusions: neuropsychological aspects of the functioning of the tactile sphere" (Moscow State University named after M.V. Lomonosov)

I.S. Petrov "Mixed infections of the urogenital tract and oncopathology of the mucous membrane of the oral cavity, cervix and rectum" "Moscow State University of Medicine and Dentistry. A.I. Evdokimov"

M.A. Koroleva "Experience with the use of ustekinumab in patients with psoriasis and psoriatic arthritis" (TsGMA UDP RF)

A.A. Bolsheva "Linear scleroderma with extensor contracture of the left elbow joint" (Russian National Research Medical University named after N.I. Pirogov)

Special Jury Prizes awarded to:

K. F. Karvatskaya "Experience in determining the boundaries of excision of dysplastic nevi in ​​order to prevent recurrent nevi and their malignancy" RUDN University for relevant and interesting research in the field of determining the boundaries of neoplasms in adults and children

M.N. Markova "Analysis of the current clinical course of staphylococcal scalded skin syndrome in children" (MNPTSDC DZM) for the fact that in her work she raised a very relevant topic for pediatric dermatology: "Staphylococcal scalded skin syndrome

T.D. Masiyanskaya "Innovative method of treatment of recurrent herpetic infection" "Russian State Medical University named after Academician I.P. Pavlova" for the bold use of botulinum toxin in the treatment of herpes infection

Yu.Yu. Romanova "Trichotillomania: clinical diversity of the disorder (results of a comprehensive psychodermatological study" (MNPTSDK DZM) for work at the intersection of two specialties.

M.S. Kornyat "Perspectives in acne therapy: an analytical review" (ISPCDC DZM) for a deep and relevant study of new approaches in the treatment of one of the most common diseases in the world

O.V. Kalashnikova "Allergic contact dermatitis in children" for raising the topic of punch tests in patients with allergic contact dermatitis in her work, since one of the first reports of the forum of our colleague from Israel was devoted to this topic.

The solemn awarding of the contestants took place at the official closing of IFDC 2018. The competition once again confirmed the relevance of the presented research and the high scientific and practical level of young scientists, and became a bright result of IFDC 2018.

It should be noted the clear organization of the Forum: this is, first of all, the observance of the schedule of presentations of the speakers.

The activities of the scientific program were rich: at least 100 specialists participated in each section or symposium. The speakers shared their experience and knowledge, gave detailed answers about the methods of diagnosis, therapy and prevention of the most common dermatoses and STIs.

Summing up, it should be noted that the results of IFDC 2018 showed the latest achievements in dermatovenereology and cosmetology, which will certainly find practical application and will contribute to the introduction of innovative scientific developments into medical practice.

The exposition rich in novelties - among the exhibitors of 41 well-known Russian and foreign companies - demonstrated the latest achievements and technologies for diagnostics and therapy of the future

In general, both speakers and numerous participants noted the very successful nature of the work of the Forum.

The drug of first choice for the treatment of inflammatory and non-inflammatory forms of acne

Gel

Contains adapalene and benzoyl peroxide

Unique base

Combined drugs in the external treatment of acne: current data

E.R. Arabian, E.V. Sokolovsky
E.R. Arabian - Doctor of Medical Sciences, Professor of the Department of Dermatovenereology with the Clinic of St. Petersburg State Medical University. acad. I.P. Pavlova
E.V. Sokolovsky - Doctor of Medical Sciences, Professor of the Department of Dermatovenereology with the Clinic of St. Petersburg State Medical University. acad. I.P. Pavlova

The article provides information on the effectiveness of ready-made combination drugs for the treatment of acne, discusses the synergistic effect of the finished combination of adapalene/benzoyl peroxide.
Key words: adapalene, benzoyl peroxide, antibiotic resistance, synergistic effect.

Combined pharmaceuticals in the external treatment of acne: modern data

E.R. Aravyiskaya, E.V. Sokolovsky

The article contains data on the efficiency of ready combined pharmaceuticals in acne treatment and discusses the synergic effect of the new adapalene / benzoyl peroxide combination.
Key words: adapalene, benzoyl peroxide, antibiotic resistance, synergic effect.

Acne treatment cannot be imagined without external therapy using drugs that act on the main pathogenetic links of the disease. At the same time, the multifactorial pathogenesis of this dermatosis and certain limitations in the therapeutic arsenal dictate the need to use a combination of drugs with a complementary mechanism of action. Modern studies show that the mechanisms of acne development are disturbances in the processes of keratinization in the area of ​​the sebaceous and hairy apparatus and excessive ability of keratinocytes to adhere, increased production of sebum, hypercolonization of P. acnes and inflammation.

Until recently, topical acne treatments have been used alone or in combination. Based on the recommendations of the International Committee "Global Alliance Acne Treatment" (GA), topical retinoids are indicated for mild acne with a predominance of comedones (the so-called comedonal form), and topical retinoids in combination with topical antibiotics and / or benzoyl peroxide (BPO). In moderate cases, topical retinoids in combination with BPO are considered first-choice topical preparations. The GA recommendations were formulated on the basis of a large number of evidence-based studies. In particular, in the publication of J. Leyden (1988) it was shown that the combination of BPO or tretinoin with topical antibiotics is significantly more effective than BPO, tretinoin or antibiotics alone: ​​a significantly faster onset of the effect, a decrease in the number of rashes, and the number of P. acnes were registered. , as well as free fatty acids in sebum. The combination of tretinoin (0.1%) with BPO (6% in detergent) resulted in a rapid reduction in P. acnes without increasing the irritant effect. Similar results were obtained when using a combination of retinoic acid and antibiotics, while the authors noted the absence of an exacerbation characteristic of retinoids. Combination of tazarotene or tretinoin with clindamycin or BPO vs tazarotene or tretinoin alone was more effective. J. Wolf et al. (2003) in a randomized study in 249 patients with mild to moderate acne demonstrated high efficacy of the combination of adapalene with clindamycin. D. Thiboutot et al. (2005) also showed that the combination of adapalene with topical clindomycin was highly effective: by the 12th week of treatment, the total number, the number of inflammatory and non-inflammatory acne were significantly reduced, a rapid onset of effect without side effects was characteristic. Thus, most authors concluded that that the combination of topical retinoids with topical antibiotics covers at least three pathogenic factors: comedogenesis, microbial growth, and inflammation. At the same time, all monopreparations were recommended for patients to be applied to the skin sequentially.

In recent years, in the world of dermatology, ready-made combined external preparations, including two active agents introduced into one base, have become widespread. This is what contributes, according to many researchers, to an effective impact on the maximum number of links in the pathogenesis of acne.

It should be emphasized that the idea of ​​using such means has existed for a long time. Back in the 1980s, it was shown that the combination of erythromycin with zinc (a solution of 4% erythromycin + 1.2% zinc acetate - Zinerit) was significantly more effective in terms of the amount of acne and reducing the severity of the disease than a single preparation containing only a topical antibiotic ( 2% erythromycin - Eryderm). At the same time, it was shown that ready-made combination products (4% erythromycin + 1.2% zinc acetate solution or 4% erythromycin + 1.2% zinc octoate gel) were more effective against the clinical manifestations of acne than placebo, and their effect is comparable with systemic tetracycline. The activity of such a combination against P. acnes, including erythromycin-resistant ones, was emphasized. A complex effect on other links of pathogenesis was also noted. The inclusion of zinc compounds, according to the researchers, contributed not only to anti-inflammatory and disinfectant effects, but also to a decrease in sebum production. There are indications of a significant decrease in free fatty acids in skin lipids and an increase in sebum triglycerides. At the same time, there was no effect on the processes of keratinization in the sebaceous-hairy apparatus.

It was further shown that antibiotic monotherapy leads to the risk of developing widespread resistance in P. acnes, as well as Staph. aureus. This led to the recommendation to stop topical antibiotic monotherapy for acne. The researchers emphasized that this potential resistance may be limited by combination drugs that act on various links in the pathogenesis of acne. Then various external combinations of topical retinoids (tretinoin, tazarotene, retinoic acid, adapalene) or BPO with topical antibiotics (erythromycin, clindamycin, etc.) began to appear. Such combinations have been shown to be highly effective against both inflammatory and non-inflammatory acne and resistant bacteria. For example, a finished combination product including BPO (5%) and clindomycin (1%) (Duac) showed a significant reduction in the number of rashes, the number of P. acnes without the irritant effect characteristic of BPO. It was emphasized that application once a day significantly increases the adherence of patients to treatment.

To date, Russian dermatologists have at their disposal the following ready-made combinations of retinoids and antibiotics: Isotrexin (GSK), which includes isotretinoin and erythromycin, and Klenzit C (Glenmark), which includes adapalene and clindomycin. More recently, a new finished combination drug Effezel (Galderma) has appeared, which includes adapalene (0.1%) and BPO (2.5%). This new drug has been well studied by our foreign colleagues on a large number of patients and is currently the most popular topical acne treatment. It is noteworthy that the agent should be applied once a day, which, of course, contributes to adherence to treatment.

The idea that the combination of adapalene and BPO is the most optimal for the treatment of acne vulgaris is confirmed, first of all, by the accumulated knowledge about the mechanisms of action of these drugs.

To date, the retinoid adapalene is known to have anti-comedogenic, comedolytic, and anti-inflammatory effects. Importantly, this agent affects the state of the adaptive immune response involved in the pathogenesis of acne. Thus, a dose-dependent suppression of toll-like receptors (toll-like receptors 2, TLR2) on keratinocytes, a decrease in the production of various pro-inflammatory cytokines, and the activity of matrix metalloproteinases were revealed. Adapalene proved to be more clinically effective than other retinoids (tretinoin, tazarotene), and also stable with respect to visible light and ultraviolet exposure than tretinoin, which is important in the production of topical preparations.

BPO is known to be the most potent antimicrobial agent and more effective than topical antibiotics. It should be emphasized that BPO, a tool well known to specialists, has already been used in dermatology for more than half a century. Due to its powerful disinfecting effect, it was used in dermatology for the treatment of trophic ulcers, the possible keratolytic effect of this drug was widely used in the external therapy of ichthyosis, and its bleaching properties were used for various skin pigmentations. According to W. Cunliffe (1988), this was the first topical acne treatment that produced real clinical results. BPO has a pronounced antibacterial effect on P. acnes and Staph. epidermidis due to its powerful oxidative effect. This is what it could be

explained the pronounced positive effect on inflammatory acne, especially pustular acne, found in numerous studies. Comparative studies of the antibacterial activity of benzoyl peroxide and erythromycin, as well as benzoyl peroxide and clindamycin phosphate, showed significant benefits of benzoyl peroxide. It has been shown that this agent actively affects strains resistant to antibiotics, in particular to erythromycin. It is believed that this drug does not cause the emergence of antibiotic-resistant strains of microorganisms.

As for the opinion of specialists about the new finished combination drug containing adapalene and BPO, D. Thiboutot et al. (2007) in a double-blind, placebo-controlled study studied the efficacy and safety profile of a ready-made adapalene/BPO gel in 517 patients. 12 weeks of use of this drug resulted in a significantly faster reduction in acne compared to adapalene or benzoyl peroxide alone. The safety and tolerability profile was comparable to that of adapalene treatment.

In world dermatology, information has been accumulated on the long-term use of the drug. D. Pariser et al. (2007) demonstrated that 12 months of adapalene/BPO gel was safe and effective in patients with acne vulgaris. The authors emphasize that the irritating effect of the drug was mild and occurred only in the early stages of treatment. It is noteworthy that a significant decrease in the number of inflammatory and non-inflammatory acne was observed after 1 week. after the start of therapy and persisted until the end of the study (70 and 76%, respectively).

In 2009, H. Golnick et al. published the results of a comparative randomized, double-blind, controlled trial of the efficacy and safety of a combination adapalene 0.1%/2.5% BPO gel versus adapalene 0.1% gel, BPO 2.5% gel, and placebo. This transatlantic study included 1670 patients from Europe and North America. The authors found that the combined agent was significantly more effective than monotherapy and placebo in terms of the total number of rashes, inflammatory and non-inflammatory acne. The greatest satisfaction of patients with the results of treatment was noted in the treatment with a gel containing adapalene/BPO. The synergistic effect of the combined preparation is emphasized. It is noteworthy that a significant clinical improvement was registered after 1 week. only in patients who used adapalene/BPO gel, which is consistent with the data of other researchers. The highest frequency of side effects in the form of dry skin of mild / moderate severity was observed more often in patients who received the combination drug and at the initial stages of treatment. Subsequently, tolerability was comparable to that of adapalene therapy. The authors document that the reported side effect was transient.

Adapalene/BPO gel was also found to be effective in treating patients with moderate to severe acne when combined with systemic doxycycline. The importance of this drug in maintenance therapy after achieving clinical improvement is emphasized.

It is also important to emphasize once again that many years of research have shown that neither topical retinoids nor BPO cause the emergence of resistant strains of P. acnes. This fact confirms the importance of prescribing this combination in case of potential and real resistance to antibacterial drugs. J. Leyden et al. (2011) studied the effect of adapalene/BPO gel on antibiotic-sensitive and antibiotic-resistant strains of propionobacteria in 30 volunteers. It was shown that 4-week use of the drug led to a significant decrease in the population density of P. acnes on the skin as a whole, as well as a significant decrease in the number of strains resistant to erythromycin, tetracycline, clindamycin, doxycycline and minocycline. And in a number of patients, as the authors emphasize, it was possible to achieve complete eradication of antibiotic-resistant bacteria.

In publications devoted to the drug under discussion, the phenomenon of "synergistic effect" is increasingly mentioned. Indeed, the success rate for the adapalene/BPO combination was higher than that for either ingredient alone or placebo. The synergistic effect is also shown in the work of J. Tan et al. (2010), who had 3855 patients under observation. Moreover, a unique fact was noted: the greater the number of inflammatory acne before the start of treatment, the higher the effectiveness of the adapalene/BPO combination. In another study, biopsy specimens of inflammatory acne revealed a more significant decrease in the expression of a number of proliferation/differentiation markers and innate immunity factors upon exposure of the combined drug adapalene/BPO compared to adapalene and BPO alone: ​​Ki67, α2 and α6-integrins, TLR-2, β -defensin and IL-8. Most likely, synergism in relation to the anti-inflammatory effect is due to the elimination of P. acnes by benzoyl peroxide, on the one hand, and a decrease in the production of pro-inflammatory cytokines due to the suppression of the activity of toll-like receptors (TLR-2) on keratinocytes by adapalene, on the other hand. As a result, these two ingredients reduce the contribution of propionibacteria to the development of acne. In addition, the penetration of BPO into the skin is enhanced in the presence of a retinoid. All this leads to a change in the "microclimate" in the area of ​​the sebaceous-hairy apparatus. Most authors associate a synergistic effect with the complementary mechanisms of adapalene and BPO in acne.

In conclusion, it should be emphasized that the new combination drug Effezel (Galderma), containing 0.1% adapalene and 2.5% BPO, is highly effective and safe. The positive qualities of this tool have been demonstrated in a large number of studies. The potential irritant effect can be minimized by adequate basic care.

LITERATURE
1. Arabian E.R., Krasnoselskikh T.V., Sokolovsky E.V. Acne. B: Skin itching. Acne. Urogenital chlamydial infection / Ed. E.V.Sokolovsky. St. Petersburg: "Sotis" 1998; 68-100.
2. Samtsov A.V. Acne and acneiform dermatoses. Monograph. M.: YUTKOM 2009.
3. Cunliffe W.J. acne. London: Martin Dunitz; 1988.
4. Gollnick H.P., Draelos Z., Glenn M.J. et al. Adapalene-benzoyl peroxide, a unique fixeddose combination topical gel for the treatment of acne vulgaris: a transatlantic, randomized, double-blind, controlled study in 1670 patients. BJD 2009; 161(5): 1180-1189.
5. Nast A., Dreno B., Bettoli V., Degitz K. et al. European evidence-based (S3) guidelines for the treatment of acne. JEADV 2012; 26(suppl. 1): 1-29.
6. Thiboutot D., Gollnick H.P., Bettoli V. et al. New insights into the management of acne: An update from the Global Alliacne to improve outcomes in acne group. JAAD 2009; 60(5): suppl. 1:1-50.
7. Leyden J., Kaidbey K., Levy S.F. The combination formulation of clindamycin 1% plus benzoyl peroxide 5% versus 3 different formulations of topical clindamycin alone in the reduction of Propionibacterium acnes. An in vivo comparative study. Am J Clin Dermatol 2001; 2:263-266.
8. Brown S.K., Shalita A.R. acne vulgaris. Lancet 1998; 351: 1871-1876.
9. Shalita A.R., Rafal E.S., Anderson D.N. et al. Compared efficacy and tolerability of tretinoin 0.1% microsphere gel alone and in combination with benzoyl peroxide 6% cleanser for the treatment of acne vulgaris. Cutis 2003; 72:167-172.
10 Verschoore M. et al. topical retinoids. Their uses in dermatology. Dermatol Clinic 1993; 11:107-115.
11. Weiss J.S., Ellis C.N., Goldfarb M.T. et al. Tretinoin therapy: practical aspects of evaluation and treatment. J Int Med Res 1990;18(Suppl. 3): 41-48.
12. Wolf J.E., Kaplan D., Kraus S.I. et al. Efficacy and tolerability of combined topical treatment of acne vulgaris with adapalene and clindomycine: a multi-center randomized, investigator-blind study. JAAD 2003; 49(suppl.): 211-217.
13. Thiboutot D., Shalita A., Yamauchi P.S. et al. Combination therapy with adapalene gel 0.1% and doxycycline for severe acne vulgaris: a multicenter, investigator-blind, randomized, controlled study. Skinmed 2005; 4:138-146.
14. Bikowsky J.B. Mechanisms of the comedolytic and anti-inflammatory properties of topical reti-noids. J Drug Dermatol 2005; 4:41-47.
15. Zaenglein A.L., Thiboutot D.M. Expert committee recommendations for acne management. Pediatrics 2006; 118:1188-1199.
16. Habbema L., Koopmans B., Menke H.E. et al. A 4% erythromycin and zinc combination (Zineryt) versus 2% erythromycin (Eryderm) in acne vulgaris: a randomized, double-blind comparative study. BJD 1989; 121(4): 497-502.
17. Feucht C.L., Allen B.S., Chalker D.K. et al. Topical erythromycin with zinc in acne. A double-blind controlled study. JAAD 1980; 3(5): 483-491.
18. Eady E.A., Farmery M.R., Ross J.I. et al. Effects of benzoyl peroxide and erythromycin alone and in combination against antibiotic-sensitive and –resistant skin bacteria from acne patients. BJD 1994; 131:331-336.
19. Piérard G.E., Piérard-Franchimont C. Effect of a topical erythromycin-zinc formulation on sebum delivery. Evaluation by combined photometric-multi-step sampling with Sebutape. Clin Exp Dermatol 1993; 18(5): 410-413.
20. Strauss J.S., Stranieri A.M. Acne treatment with topical erythromycin and zinc: effect of Propioni-bacterium acnes and free fatty acid composition. JAAD 1984; 11(1): 86-89.
21. Taylor G.A., Shalita A.R. Benzoyl peroxide-based combination therapies for acne vulgaris: a comparative review. Am J Ciln Dermatol 2004; 5:261-265.
22. Michel S., Jomard A., Demarchez M. Pharmacology of adapalene. BJD 1998; 139(suppl. 52): 3-7.
23. Tenaud I, Khammari A, Dreno B. In vitro modulation of TLR-2, CD1d and IL-10 by adapalene on normal human skin and acne inflammatory lesions. Exp Dermatol 2007; 16(6): 500-506.
24. Burke B., Eady E.A., Cunliffe W.J. Benzoyl peroxide versus topical erythromycin in the treatment of acne vulgaris. BJD 1983; 108:199-204.
25. Swinyer L.J., Baker M.D., Swinyer T.A., Mills O.H. A comparative study of benzoyl peroxide and clindamycin phosphate for treating acne vulgaris. BJD 1988; 199:615-622.
26. Thiboutot D.M., Weiss J., Bucko A. et al. Ada-palene–benzoyl peroxide, a fixed-dose combination for the treatment of acne vulgaris: results of a multicenter, randomized double-blind, controlled study. JAAD 2007; 57:791-799.
27. Pariser D.M., Westmoreland P., Morris A. et al. Long-term safety and efficacy of a unique fixed-dose combination gel of adapalene 0.1% and benzoyl peroxide 2.5% for the treatment of acne vulgaris. J Drugs Dermatol 2007; 6: 899-905.
28. Stein Gold L Cruz A., Eichenfield L., Tan J. et al. Effective and safe combination therapy for severe acne vulgaris: a randomized, vehicle-controlled, double-blind study of adapalene 0.1%–benzoyl peroxide 2.5% fixed-dose combination gel with doxy-cycline hyclate 100 mg. Cutis 2010; 85:94-104.
29. Poulin Y., Sanchez N.P., Bucko A., Fower J. et al. A 6-month maintenance therapy with adapalene-benzoyl peroxide gel prevents relapse and continuously improves efficacy among patients with severe acne vulgaris: results of a randomized controlled trial. BJD 2011; 164(6): 1376-1382.
30. Leyden J., Preston N., Osborn C., Gottschalk R.W. In-vivo effectiveness of adapalene 0.1%/ benzoyl peroxide 2.5% gel on antibiotic-sensitive and resistant propionibacterium acnes. Clin Aesthet Dermatol 2011; 4(5): 22-26.
31. Tan J., Gollnick H.P.M., Loesche C. et al. Synergistic efficacy of adapalene 0.1%-benzoyl peroxide 2.5% in the treatment of 3855 acne vulgaris patients. J Dermatol Treatment 2010; Early Online: 1-9.
32. Feldman S.R., Tan J., Poulin Y. et al. The efficacy of adapalene-benzoyl peroxide combination increases with a number of acne lesions. JAAD, article in press: 10.1016/j.jaad.2010.03.036 (published online March 23, 2011).
33. Zuliani T., Khammari A., Chaussy H. et al. Ex vivo demonstration of a synergistic effect of adapalene and benzoyl peroxide on inflammatory acne lesions. Exp Dermatol 2011; 20(10): 850-853.
34. Tan J., Stein Gold L., Schlessinger J. et al. Short-term combination therapy and long-term relapse prevention in the treatment of severe acne vulgaris. J Drugs Dermatol 2012; 11(2): 174-180.