A.

Drugs for Skin Disorders

1. Introduction
● The integumentary system consists of the skin, hair, nails, sweat
glands, and oil glands.
● The largest of all organs is the skin.
● Because of its large surface area, it normally provides an effective
barrier between extreme conditions in the outside environment and
the body’s internal organs.
● The purpose of this chapter is to examine the broad scope of skin
disorders and the medications used for skin therapy.
● Particular attention to: lice and mite infestation, sunburn, acne,
inflammation, and dry, scaly skin.
2. Three Layers of Skin
a. Epidermis—most superficial skin layer
● Thick skin—5 layers
● Soles of feet, palms of hands
● Melanocytes—provide protection against the sun.
b. Dermis—under epidermis
● Provides foundation for epidermis, hair and nails
● Location of receptor nerve endings, sweat glands, oil glands,
blood vessels.
c. Subcutaneous layer or hypodermis—deepest layer
● Mainly composed of adipose tissue
● Cushions, insulates, provides a source of energy.
● Involved with the maintenance of homeostasis, temperature
regulation, metabolism
3. Major Causes of Skin Disorders
● Major causes of skin disorders are injury, aging, inherited factors and
other medical conditions.
● Symptoms associated with stress or injury to the skin.
● Classification of Skin Disorders: infectious disorders, inflammatory
disorders, and skin cancers.
4. Scabicides & Peducilicides
a. Scabicides and peducilicides treat parasitic mite and lice infestation.
b. Common skin parasites are mites and lice
● Mites cause scabies
● Female burrows into the skin and lays eggs
● Causes intense itching
● Fingers, extremities, around the trunk, pubic area
5. Scabicides & Peducilicides
a. Lice (Pediculus)
 ● Passed by infected clothing or personal contact
● Infest pubic area, hair
● Lay eggs and leave debris called nits that attach to body hairs.
6. Scabicides & Peducilicides
Three drugs kill lice and mites
1. Lindane (Kwell, Scabene)—gamma benzene hexachloride
2. Crotamiton (Eurax)
3. Permethrin (Nix)—insecticide
Drug profile—lindane (Kwell) pg. 628
7. Drugs for Sunburn & Minor Irritation
● The goal of drug therapy for sunburn is to eliminate discomfort until
healing occurs.
● Drugs include mild lotions and topical anesthetics
1. Benzocaine (Solarcaine)
2. Dibucaine (Nupercainal)
3. Tetracaine (Pontocaine)
8. Drugs for Acne
● Problems of acne and rosacea are treated by a combination of OTC
and prescription drugs—
● Effects of acne drugs—slow down turnover of skin cells and inhibit
bacterial growth.
9. Drugs for Acne
a. Benzoyl peroxide (Benzaclin, Benzamycin) main OTC medication
● Inhibits bacteria growth
● Suppresses skin turnover at the opening of pores
● Sometimes combined with antibiotics
● Several preparations—lotion, cream, gel
● Several concentrations available.
10. Drugs for Acne
a. Retinoids—vitamin A-like compounds
● Reduce oil produciton and clogged pores
● Resistance to bacteria
● Do not use if pregnant—may harm fetus
● Common reaction—sensitivity to sunlight
11. Drugs for Acne
a. Prescription medications for acne
● Adapalene (Differin)
● Azelaic acid (Alzelax)
 ● Sulfacetamide (Klaren)
● Tretinoin (Retin-A)—someimes used for wrinkle removal
12. Drugs for Acne
a. Keratolytic agents—severe conditions; promote shedding of old skin
● Resorcinol
● Salicylic acid
● sulfur
13. Drugs for Acne
a. Other drugs taken in combination or instead of acne medication
● Vibramycin
● Tetracycline
● Ortho Tri-Cyclen
14. Drugs for Acne
a. Most severe cases of acne
● Accutane—reduces oil production; may cause nosebleeds and
inflammation of areas of the face
15. Topical Corticosteroids
a. Topical corticosteroids are used mainly to treat dermatitis and
related symptoms—
● Eczema—aka atopic dermatitis --resembles an allergic reaction
● Contact dermatitis—delayed type allergic reaction
● Seborrheic dermatitis—caused by overactive oil glands
● Stasis dermatitis—seen more in older women
16. Topical Corticosteroids
a. Topical steroids best way to treat symptoms of dermatitis
● Available in different levels of potency
● Different preparations available—creams, lotions, solutions, gels,
pads
● Relieves local inflammation and itching
● Topical Corticosteroids
17. Topical Corticosteroids
● Adverse effects with long-term use—irritation, redness, thinning of
skin membranes.
● Undesirable systemic effects if skin is broken.
18. Drugs for Psoriasis
● A variety of topical and systemic medications are used to treat
psoriatic symptoms—
 ● Psoriasis is a chronic skin disorder with red patches of skin covered
with flaky, silver colored scales (called plaques)—may be genetic
19. Drugs for Psoriasis
a. Treatments include:
● Emollients
● Topical corticosteroids
● Immunosuppressants
● Systemic medications
● Skin therapy techniques—tar treatment (coal tar)
● UVB and UVA phototherapy used in severe psorasis.