The Use of Local Therapy

Initial treatment of early or minor lesions is usually local. Provided the local therapy is part of a therapeutic strategy for each patient, this is a rational approach, in terms of both traditional clinical assessments such as effect and cost-efficiency and also cost-benefit to the patient. Efficient forms of local treatment exist, although none is universally effective. They have a low potential for side-effects and many can be used for both prophylactic therapy and self-treatment of early lesions. Self-treatment of early lesions is further indicated because this group of patients is very well acquainted with the natural evolution of lesions, and can therefore start therapy at a very early point in any flare of the disease.

Local treatment can be carried out as mono-therapy, but most often a better result is achieved by combining several treatment modalities, such as topical antibiotics and intralesional steroids. By combining local therapies with different mechanisms of action it may be possible to contain disease progression without having to use systemic therapies or surgery. Just as for other therapies the long cycles of HS require that a therapy is used for at least 3 months before its efficacy can be adequately assessed. It is therefore of benefit to the patient and the treating physician if a plan for the containment of the disease is drawn up for each patient. If the disease is progressive treatment should be intensified every third month until adequate relief is achieved. This could involve progressively more aggressive therapy, starting with topical therapy and moving on in a predetermined manner to combinations of topical therapies, to intralesional steroids, to systemic therapy and then to surgery.

How To Reduce Acne Scarring

How To Reduce Acne Scarring

Acne is a name that is famous in its own right, but for all of the wrong reasons. Most teenagers know, and dread, the very word, as it so prevalently wrecks havoc on their faces throughout their adolescent years.

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