Acne
General Information
Acne is the disorders of oil glands (sebaceous glands) of skin that results in plugged pores and out breaks of lesions commonly called as pimples or zits. It is also characterized by comedones, papules, pustules, inflamed nodules and superficial pus filled cysts.
It usually occurs on the face, neck, and center of chest, upper back and shoulders in the patients of 14 to 19 year age group, although people in their 20’s and 30’s may also experience acne.
The underlying cause may be due to increased production of androgen and increased sensitivity of androgen receptors.
It is characterized by blocked pores due to increase in keratin and sebaceous gland secretions.
Also acne like eruptions may occur due to the side effects to some medications.
Signs and Symptoms
Blackheads (black spots, the size of a pinhead)
Whiteheads (white spots similar to blackheads)
Pustules (small pus-filled lesions)
Redness and inflammation around eruptions
Cysts (larger, firm swellings in the skin)
Abscesses (swollen, inflamed, tender area of infection containing pus)
Advice
Washing the face twice daily with a mild soap and water or an antiseptic wash is enough and there is no need to wash your face frequently.
Acne products should be applied to all areas affected by acne, rather than just put on individual spots. Preferably use water base acne products.
Only a thin smear should be applied to dry clean skin at nighttime.
Acne products may work better if applied in the morning as well.
Keep your hair off your face. Hair, especially greasy, can worsen the blocked pores.
Acne products often cause dryness particularly in the first 2-4 weeks of use. This is partly how they work and the skin usually adjusts to this.
Apply an oil-free moisturizer only if the affected skin is obviously peeling.
Treatment of existing acne (pimples) will not make it disappear any faster but will help prevent further pimples, that is why it may take 12 weeks before the skin improves.
Avoid squeezing or pricking the pimples, doing so may cause infection and scarring.
Discontinue using product if severe irritation results. See your doctor for advice.
Eating a healthy balanced diet contributes to a healthy skin.
Prescription Advice
Instruct the patient on the medication and how to use it properly, i.e. name of the medication, frequency of dosage etc.
In case of exacerbation despite treatment, or in cases where acne does not improve, instruct the patient to consult a dermatologist immediately.
Advise the patient on the possible adverse effects of some anti-acne preparations, i.e. photosensitivity, reddening of the skin etc.
Discuss Advice to the customers thoroughly for more information on the prevention and management of acne.

Allergy
General Information
Allergies are hypersensitive reactions of the body against usually harmless substances, e.g. dust, pollen, food, etc Manifestations -
Respiratory allergies: rhinitis, asthma or hay fever.
Intestinal allergies: vomiting, abdominal pain and diarrhea
Skin allergies: mild skin reddeni to urticaria, hives or dermatitis, commonly observed in various areas of the skin including the e (allergic conjunctivitis).
Serious allergy could result in anaph tic shock characterized by agitg breathing difficulty and wheezing, heart rate, cold sweat, clammy skin, \ abdominal cramps, dizziness, na and vomiting, collapse, convuls and if untreated, death
Signs and Symptoms
Symptoms of allergy are limitless, can affect any part of the body. They can cause a wide variety of distressing physical and psychological symptoms and in many cases, both. They can mimic symptoms of other illnesses. It is impossible to list all the symptoms, which can be caused by allergic reactions or intolerances. Amongst those of which people complain are:
Abdominal pain, catarrh, rhinitis, wheezing, exhaustion, swelling, visual disturbances, weeping or itching eyes, running nose, sneezing, sinusitis, ringing in the ears, sore throat, coughs, hoarseness, asthma, bronchitis and other breathing difficulties, palpitations, chest pains, nausea, faintness, diarrhoea, constipation, bloating, indigestion, irritable bowel syndrome, urticaria, cramps, convulsions, pins and needles, numbness, abnormal menstruation, eczema, other skin complaints, mouth ulcers, arthritis, psoriasis, backache, pruritus, water retention, dark puffy circles under the eyes, debility, drowsiness, a feeling of being drugged, sweating unrelated to exercise, frequent urination or bedwetting, lack of libido, mental confusion, irritability or aggressiveness, depression, nightmares, hyperactivity, learning difficulties, inability to concentrate, nervousness, anxiety, clumsiness, food addictions, raised blood pressure, obesity, migraine, headaches, epilepsy, agoraphobia.
Advice
If the cause of allergy is known, avoid it as much as possible.
If the allergy is caused by a drug, stop the use of the drug immediately and resume only after a physician has been consulted. The physician should be informed of any known drug allergy at each consultation.
If the allergy-induced itch is severe, use calamine or other anti-itch preparations. Further scratching may exacerbate the symptom.
Keep the home clean and allergen- free at all time.
Prescription Advice
Instruct the patient on the medica¬tion and how to use it properly, i.e. name of the medication, frequency of dosage etc.
In cases where the allergic symptoms are intense, instruct the patient to consult a dermatologist immediately
In case of exacerbation despite treatment, instruct the patient to consult the dermatologist immediately.
This exacerbation may lead to anaphylactic shock.
Discuss Advice to the Customers thoroughly for more information on the prevention and management of allergy. 
Stethoscope Information
Source: MIMS/2011