Teens and Adults alike suffer from this common but frustrating skin condition. It can be painful at times and embarrassing when severe permanent scars can result both physically and psychologically. Your dermatologist treats this seriously and offers many treatment approaches to suit your personal needs. Approaches To Treatment: Multimodality & Accutane Multimodality- Acne starts with a whitehead or blackhead. These are the result of abnormal skin cell development making them too “sticky” clogging the pores. Vigorous cleansing doesn’t help here. Instead a Vitamin A cream is necessary to prevent these “clogged pores”. Examples your dermatologist might use include: Retin A & Retin A micro, Stieva & Stievamycin, or Differin. Side effects include dry skin and pink skin. -A plugged pore has bacteria which can overgrow producing free fatty acids. These thing the wall of the whiteheads and cause them to rupture. ie “THE ZIT”. Benzyl peroxide and antibiotics can inhibit their growth preventing these painful bumps. Examples your dermatologist might use include: Clindoxyl gel or BenzaClin, even Pro Active (expensive and weaker). Side effects include dry skin and pink skin. -The inflamed pimple results from the ruptured whitehead. Your dermatologist can use an oral medication to dampen down this reaction. The antibiotics Minocycline, Doxycycline & Tetracycline are used most often for their anti-inflammatory effects in Acne. Side effects include dizziness, pigmentation, sun sensitivity and upset tummy. Not for pre-teens. -The hormonal component of Acne induces larger and over-productive sweat glands feeding the bacteria involved in pimple formation. The oral contraceptive pill can be used to help with this aspect. There are a couple of prescriptions that have hormone blocking components and your dermatologist can use these medications to help with Acne if necessary. Examples your dermatologist might recommend include: Diane 35 or Jasmine, but a Family Doctor prescribed pill can help too. Side effects include 5lbs weight gain, changes in mood and changes in cycles. -Finally to help open pores cloged in Acne your dermatologist may recommend a “Peel” for patients with predominantly whitehead/blackhead acne. This is a fruit acid applied to the skin for 2-3 minutes and then washed off as often as once per month. Side effects include dry skin and pink skin. ACCUTANE -This is a Vitamin A medication taken orally once a day. -This is the one approach that can cure Acne (85% successful). Multimodality therapy is a control measure until the Acne “burns out”. -This treatment lasts 4-6 months and only rarely needs to be repeated (<1 in 10). -This is the treatment of choice for severe or scarring acne. -Many people are concerned about side effects. Understanding is often reassuring. Side Effects The patient’s concerns -You will become dry….lips, nose and eyes. -You may be a bit sore. -Blood work needs to be drawn monthly (at least 2-3 months) -You must abstain from drinking alcohol. -Females must not become pregnant (ie oral contraceptive pill if active). The teen’s parent’s concerns -Not a “strong” pill- only well known side effects -Teratogen- can cause birth defects but effects are only while on the medication. You can get pregnant one month after pills stopped. No long term effects on reproduction -Liver effects- Your doctor must watch the triglyceride and cholesterol levels. Safe if the patient is not drinking alcohol during the treatment -Depression- the studies show just the opposite. Acne is typically a teenage disease. Teens often suffer from depression, anecdotal association and media over-reaction. -Close follow up with your dermatologist is the best approach What is Blue U therapy? Photodynamic Therapy -This is a new and popular method of treating skin disease including Acne. -A medical liquid (ALA) is applied to the skin and left on for about 1 hour. -Blue light is then shined onto the skin for 15 minutes activating the liquid and effectively shrinking the sweat glands to aid in the control of acne. -Side effects include some stinging during treatment and a mild sunburn like effect for a couple of days after. Treatment cost $300.00 to the patient. Blue U Light Alone -Some dermatologist expose the skin to 15 minutes of blue light alone and have found some improvement in some patient’s acne. -This is repeated twice a week for 2 or more weeks and was popularized in La Joya California. Each treatment costs $50.00 to the patient.


EMPLOYMENT APPEALS TRIBUNAL UNFAIR DISMISSALS ACTS, 1977 TO 2001 MINIMUM NOTICE AND TERMS OF EMPLOYMENT ACTS, 1973 TO 2001 I certify that the Tribunal(Division of Tribunal)Chairman: heard these claims at Tralee on 4 March, 16&17June, 13-15 September 2005 and 17-19 January 2006 Representation: Claimant: Mr. Donal Tobin, SIPTU, Park Road, Killarney, Co. KerryMr. Henry Downing

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