【藥事知多D】暗瘡藥知多D：異維A酸

《史記》在〈刺客列傳〉中說：

女為悅己者容。

其實男生都會「為悅己者容」。

不過再怎麼悉心打扮，最後還是可能會敵不過一粒小小的暗瘡。

這時候，怎麼辦？

唔……藥罐子便在這裡跟大家分享一種暗瘡藥，稱為異維A酸(Isotretinoin)。

一般主要有以下四個作用原理：[1][2]

第一，誘發皮脂腺(Sebaceous Gland)萎縮，減少皮脂分泌，簡單說，便是「控油」。

第二，抑制毛囊(Follicle)裡面的痤瘡桿菌(Propionebacterium acnes)繁殖。

痤瘡桿菌是一種厭氧菌(Anaerobes)，較容易生存在一個低氧、無氧的環境。

要是毛囊堵塞，便可能會製造一個有利的環境刺激痤瘡桿菌大量繁殖並分解皮脂成為游離脂肪酸誘發暗瘡。

所以只要KO這些痤瘡桿菌，便可能會減少游離脂肪酸的產生，治療暗瘡。

第三，抑制炎症反應，紓緩暗瘡的炎症症狀。

第四，改善毛囊角化(Keratinization)，減少毛囊角栓(Follicular Plug)的產生，減少毛孔堵塞。

簡單說，異維A酸主要採用「全方位」的策略同時解決暗瘡的不同成因。

理論上，異維A酸一般會留作備胎做最後的殺著，適用於治療一些連其他暗瘡藥都宣告無效的暗瘡或者一些較嚴重的暗瘡，例如囊腫性痤瘡(Nodulocystic Acne)。[3]

在用法上，必須持之以恆，一般建議連續服用6個月做一個療程。

大家可能會問：

「咦？藥罐子！既然這種藥是一擊必殺，那為什麼還要左試右試，試到其他暗瘡藥都不行才用這種藥呢？」

其實能夠讓一種藥從首選淪為次選，要不是藥性，當然便是毒性，簡單說，便是「副作用」。

對，相較其他暗瘡藥而言，異維A酸的副作用一般較多、較廣、較深，而且一般跟劑量構成正比關係，簡單說，劑量愈大，副作用愈大[4]。

一般而言，一字記之曰：乾！

對，眼會乾、鼻會乾、嘴唇會乾、皮膚會乾，從而可能會出現眼乾、流鼻血、唇炎(Cheilitis)、皮膚脫屑(Skin Desquamation)。

還有服藥期間還可能會短暫升高體內的膽固醇、三酸甘油脂(Triglycerides)的水平[5]，一般建議在開始服藥前、服藥後第4、8個星期檢測肝功能，同時檢測體內的血脂水平，定期監測，以策安全。[6]
除此之外，還可能會出現頭痛、肝腫大(Hepatomegaly)、假性腦腫瘤(Pseudotumor Cerebri)、關節痛(Arthralgia)的副作用。[7]

最後Isotretinoin擁有致畸性(Teratogenicity)，從而可能會增加孕婦誕下畸胎的風險，所以必須做好風險管理，有人建議服藥前1個月、服藥期間、停藥後至少3個月，女性必須做足避孕措施。[4]

簡單說，服藥期間，暫時不要搞出人命，這就是說，要靚唔要命。

（如欲了解更多用藥資訊，歡迎看看「小小藥罐子」網誌。）

💊💊💊💊💊💊💊
BLOG➡️http://pegashadraymak.blogspot.com/
IG➡️https://www.instagram.com/pegashadraymak/
YT➡️https://www.youtube.com/channel/UCQOMojMd6q7XnESMWwldPhQ

📕📕📕📕📕📕📕
著作➡️藥事知多D、用藥知多D、藥房事件簿、家居用藥攻略（各大書店有售）

Reference:
1. Zaenglein AL, Thiboutot DM. Acne vulgaris. In: Horn TD, Mancini AJ, Mascaro JM, et al, eds. Dermatology. London, Mosby, 2003:531-544.
2. Ortonne JP. Oral isotretinoin treatment policy: Do we all agree? Dermatology. 1997;195(Suppl):34-37.
3. Goulden V. Guidelines for the management of acne vulgaris in adolescents. Paediatr Drugs. 2003;5:301-313.
4. Charakida A, Mouser PE, Chu AC. Safety and side effects of the acne drug, oral isotretinoin. Expert Opin Drug Saf. 2004;3:119-129.
5. Cooper AJ, Australian Roaccutane Advisory Board. Treatment of acne with isotretinoin: recommendations based on Australian experience. Australas J Dermatol. 2003;44:97-105.
6. Altman RS, Altman LJ, Altman JS. A proposed set of new guidelines for routine blood tests during isotretinoin therapy for acne vulgaris. Dermatology. 2002;204:232-235.
7. Kunynetz RA. A review of systemic retinoid therapy for acne and related conditions. Skin Therapy Lett. 2004;9:1-4.

#口服A酸 要吃多久為什麼醫生講的都不一樣呢？總劑量越高是不是越不容易復發？
Ａ酸每天吃跟間歇吃有差嗎？
如果我只想 #控油 的話要吃多久？#皮脂腺 會永久萎縮嗎？
今天就一起幫大家解答吧！

The last time i did laser treatment was in 2011 masa shooting film KL Zombie..
I gave up,they keep asking me to continue the session over and over again,and my duit oso flying up high 💸💸
Result mmg ade,klu ckp tkde mmg menipu sgt.. mmg ade beza cume perbezaan tu tk berbaloi dgn duit yg dh pon leboq.. klu kira2 balik boleh down payment kereta..
.
I was on roaccutane quite long..not only lips but my whole body jd dry..
Till 2013 after i gave birth,jumpa la member lama and apparently she’s a dermatologist.. tk tau mcm mana dia jd doctor kulit,sbb dulu tk lah pandai sgt..cut the story short,sekali dia kata,ni pijah parut mana boleh hilang?? Luka dihati pon berparut walau tk nampak,ni kan pulak kulit muka.. chia chia chai!! 🤣😂
Dia kata parut boleh lighten tp nk hilang mmg tk boleh.
Dia suruh try buat microneedling kt umah.. jimat duit hg!
Tp bukan semua kulit sesuai pakai dermaroller,mcm eczema,keloids tk boleh pakai..
And tk semua serum boleh pakai after dermaroller..
Its been 7 years now And sampai skrg masih roll,ni gambaq baru habih workout and semlm roll,dia punya rasa gatai tu lain maciam..
Ni tkdak filter,tkda makeup,tkdak lighting on point yg ada peluh bercucuran..
.
@officialpurestbyfaezahelai
@officialpurestbyfaezahelai
@officialpurestbyfaezahelai
.
And owh sblom ampa buat pitnah,i dont use any contact lenses..satgi ampa suruh buat review contact lenses pulak cheq tk review lens.. tk tau pakai..
.
P/S : Posting ini tidak dpt membantu menurunkan harga minyak atau emas.. jugak tk dpt membantu ekonomi negara..
Sekian Terima Kasih
.
#nononeisperfect #myskin #nakedface #purestbyfaezahelai #skincare #skincaretips #acnescarsremoval #acnescars #asianskin #asianskincare #homemicroneedling #faezahelai #feelingblessed #alhamdulillah

Hey guys, here's another highly requested video, it's a Skincare Routine video together with some tips for clearer skin. I have oily skin and I used to have acne growing up and was on Roaccutane & antibiotics medication which in hindsight wasn't the best for my gut health. My skin these days has been good and I owe a lot of it to health eating and proper skin care. I'm aware that i spend a lot on my skincare but I want to take care of my skin. We've only got one!

Let me know in the comments in you have specific questions. Moving forward, these lifestyle videos would eventually migrate over to my 2nd channel so do subscribe on there as well!

SPONSOR THIS CHANNEL: https://www.youtube.com/chloeting/join
SUB TO MY 2ND CHANNEL: https://www.youtube.com/channel/UCBrcDabYtwbR1VIhwH5efZA?sub_confirmation=1

Products shown:
-- Day --
Thursday Plantation Tea Tree Face Wash: https://amzn.to/2SNaQKz
SKII Facial Treatment Essence: https://amzn.to/2CZIGX0
SKII Genoptics Aura Essence: https://amzn.to/2QgMpmP
SKII R.N.A Power Eye Cream: https://amzn.to/2PGEBxy
SKII Airy Light UV Cream: https://amzn.to/2yPoww8

-- Night --
SKII Facial Treatment Clear Lotion: https://amzn.to/2SGKABv
SKII R.N.A Airy Milky Lotion: https://sk-ii.co/2CXyBdk

-- Makeup Removal --
Cle De Peau Eye and Lip Makeup Remover https://amzn.to/2PGlzYh
Shu Uemura Cleansing Oil: https://amzn.to/2yPGLlc

☆Fitness Outfits☆
My Gymshark Affiliate Link - https://gym.sh/Shop-Chloe-Ting

☆My Instagram links☆
https://www.instagram.com/chloe_t/
https://www.instagram.com/itschloeting/

☆Filmed With☆
Panasonic GH5
Lumix G 8-18mm
Lumix G 12-35mm
Lumix G 42.5mm
https://www.amazon.com/shop/chloeting

☆Music by☆
Blue Wednesday
https://soundcloud.com/bluewednesday

#skincare #skincareroutine #acnefree #oilyskin

How To GET RID of ACNE | 20 TIPS to get CLEAR SKIN | Get rid of pimples | Acne free skin | How to get clear skin

SOoooooo.. I had pretty bad acne in the past so I have seen many dermatologists and went on roaccutane 4 times, antibiotics twice, on the pills, on loads of different type of topical creams, you name it. It is only after I started changing my lifestyle and applying some of these tips then my skin started clearing. The oral medication did work but it was temporary. It was my lifestyle which helps to maintain it. Hope this video helps you out. I know the pain of having acne and not being able to wash your face without being in pain, or looked in the mirror and felt upset about the red spots and scars. It will get better. :)

Thursday Plantation Tea Tree Face Wash:
http://bit.ly/28QXipa

Aspect Fruit Enzyme Mask:
http://bit.ly/2whAx9R

Shu Uemura Cleansing Oil (pink bottle):
http://bit.ly/2vehdxo

SKII Facial Treatment Clear Lotion:
http://bit.ly/2uRIBQP

Innisfree Clay Mask:
http://bit.ly/2uRzXld

Kiehl's clay mask:
http://bit.ly/2vp0Tdy

Thursday Plantation Tea Tree Oil (This is really strong so you'll need to dilute it with water)
http://bit.ly/2hkkXYD

☆ MY LINKS ☆
Instagram: http://instagram.com/chloe_t
Fitness Instagram: http://instagram.com/itschloeting
Blog: http://www.chloeting.com
Twitter: http://twitter.com/chloe_ting
Facebook: http://www.facebook.com/itschloeting
Snapchat: chloe_ting


Music by: DJ Quads
https://soundcloud.com/aka-dj-quads

I've been taking Roaccutane for 6 months and this is my story.
Like.Comment.Subscribe.

Follow me :
Instagram https://www.instagram.com/jrmdzn/?hl=en
Snapchat @jrmdzn

Much love,
xoxo,
JR.