In the prevention of acne in persons predisposed to the disease three things especially are to be done: 1. Remove superfluous sebum and epithelial accu mulations in the ducts of the glands. 2. Stimulate the sebaeeous glands into healthy activity. 3. Keep the skin asep tic. so as to prevent the pus-cocci from gaining admission to the follicles. The soaps with an alkaline basis are the most efficient as they are the most powerful. The most useful soaps are the sulphur, campho-sulphur, Peruvian-balsam, and creolin cake soaps: while, of the pow dered soaps, the alkaline, brimstone, and creolin, and the neutral salicylic-acid sulphur, and salicylic-acid-resorein-sul phur soaps are the best.
When the disease is developed all comedones should be expressed and all pustules opened. Stimulating soaps or applications, or both, should then be used. Sulphur is the most important constituent of both. When there is very much inflammation around the aeneie lesions soothing treatment is necessary, especially at first, while zinc oxide and calamin lotion and belladonna, locally applied, are sometimes of much service. When the more active lesions are reme died the preventive treatment comes into play, and it must be impressed on the patients that, unless they are willing to take the trouble to carry it out in a thorough and continuous manner, they cannot expect to be free from acne. Stephen Mackenzie (British Journal of Derm., Oct., '94).
Treatment of acne of young girls should accomplish the following ends: 1. Overcoming of coldness of lower extremi ties by daily friction with cologne, spirit of camphor, or by flagellations with cold water. 2. Cure of any uterine difficulty. 3. Relief of habitual constipation. 4. Regulation of diet. Small meals with little fluid at a time, and plenty of out door walking. 5. Avoidance of stiff cor sets and stiff collars. Patients should never wash with sponges, but only with swabs of absorbent cotton, wet with a hot solution of borax and soda-2 tea spoonfuls of boric acid, and 1 each of borax and bicarbonate of soda to a quart of water. At night the face should be washed with a naphthol soap. After soap has been used the patient puts on each pustule a small amount of a pomade, prepared as follows:— Resorcin, 1 grain.
Betanaphthol, Camphor, of each, 12 grains. Cret. preparat., 15 grains.
Sapon. nigris, 30 grains.
Sulph. prmcip., 100 grains. Lanolin, Vaselin, of each, 1 ounce.—M.
Next morning patient should wash the face with spirit of camphor, and, if she has to go out, applies a little of follow ing:— Acidi salicyl., 15 grains. Zinci oxid., 3 drachms. Lanolin, 6 drachms.
Vaselin, 12 drachms.—M.
Face is then gently washed and dusted with starch-pow-der. Brocq (Rev. de Ther., May 15, '98).
Hot water and alcoholic lotions some times act promptly. In mild cases thes are applied at night with very hot water, either pure or combined with cologne water or camphorated alcohol. The water is gradually reduced until pure camphorated alcohol or cologne-water is used. Boric acid or borax may be added to the lotions: 1 part to 50.
Hot oil, used as a wash, easily dissolves solid fatty matter. The comedones are dissolved and the skin softened prepara tory to the application of sulphur. Lano lin should always be mixed with oil, vaselin, or benzoated lard. F. H. Barendt (Liverpool Medico-Chir. Jour., No. 38, 1900).
Instead of camphorated alcohol there have been used with success:— Alcohol, 96°, saturated with boric acid, and alcohol with salicylic acid, 1 to 30. The latter is strong and must be used with care.
Mercurial lotions are efficacious in some cases, employed as follows: 4 Corr. subl., 1 part.
Alcohol, 90°, 100 parts.
Dist. water or rose-water, 150 parts.
At first this solution is weakened with one-half its quantity of water; afterward, if no irritation has resulted, the water is gradually reduced until the solution is employed pure.
Other mercurial preparations, in oint ment form, such as the biniodide, the iodochloride, white precipitate, and mer curial plaster, viz.:— Ik iodochloride, 24 grains.
Axungim, ounce.
M. Rub in vigorously.
The local action is said to be very energetic. It should, therefore, be used at first with caution. Gailleton (Le Bull. Med., July, '89).
The ammoniated-mercury ointment, 5 grains or 30 grains to 1 ounce, of great value. Stopford Taylor (Brit. Jour. of Derm., Oct., '94).
Face to be washed with water as hot as can be borne and some bland unirri tating soap, and then, after carefully dry ing the skin, following lotion is applied once a day:— Ik Hydrargyrum bichloridi, 12 grains. Spiritus vini rectif., 0 ounees.—M.