Topical Anti Inflammatory Therapy

No formal studies have been published on the use of topical anti-inflammatory treatment of HS. Experience nevertheless suggests that some preparations may prove useful to selected patients. The preparations tried are azelaic and fusidic acid, the latter both alone and in combination with topical corticosteroids (personal observation, G.B.E. Jemec).

Azelaic acid occurs naturally on the skin. It is a straight-chained nine-carbon-atom dicarbox-ylic acid, which is non-toxic, non-teratogenic, and non-mutagenic [30]. It has numerous biological effects. These include inhibition of mito-chondrial oxidoreductases of the respiratory chain and of enzymes concerned with DNA synthesis. Reportedly it has antiproliferative and cytotoxic effects on a variety of tumor cell lines in culture [31, 32]. In vitro it can influence the growth of keratinocytes and has antifungal and bacteriostatic effects [33, 34]. Clinically az-elaic acid is registered for the treatment of mild acne and is used in hyperpigmentary disorders [35, 36].

In HS there are no formal studies of the effects of azelaic acid, but occasionally patients achieve control of their disease by using it as a preventive therapy. Typically the drug is used in combination with other treatments of acute lesions, e.g., topical clindamycin or intralesional steroids.

Azelaic acid is a very safe drug and its side-effects are correspondingly restricted to mild local irritation of the skin. The exact role of this drug in the treatment awaits formal studies.

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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