Salicylic acid acts well in from 1 to 2 per cent. in various ointments.
Combination of the iodides and bro mides of potassium with soap, the latter possessing keratolytic qualities. Two varieties: strong soaps containing from 2 to 6 per cent. of sodium iodide and from 1 to 3 per cent. of potassium iodide; weak soaps, containing but from 1 to 3 per cent. of potassium iodide and bro mide. Useful to allow suds to dry upon site of application. Bardach (Lyon Med., June 23, '95).
[New treatments should be used with much prudence and with due thought to the susceptibility of the patient; there is a tendency to reject preparations of the iodides and bromides in acne, because these substances cause acne in many per sons; yet in some rare cases I have per sonally noted improvement in acne to follow the use of minute doses of sodium or potassium iodide and of applications of tincture of iodine: it must never be forgotten, however, that idiosyncrasy may play a most important part in any medication. L. BROCQ, Assoc. Ed., An nual, '96.] Electrolysis has been recommended for the removal of the indurated masses left on the skin.
In acne of the back the strongest ap plications, as a rule, are demanded. Of especial value in some cases is the liquor calcis sulphuridis (Vleminckx's solution). This should be used at first diluted.
Massage of the face has recently been recommended.
Massering-ball for use in the local treatment of acne. A ball set in a steel socket, the small sphere rotating within the cup of the latter, as in the ordinary ball-and-socket joint. The skin is first operated upon with disinfected needle and comedo-extractor, until all pustules and subepidermic foci are emptied. The surface is then rendered aseptic with a solution of formalin (40 per cent. of for mic aldehyde), 'I, per cent. to 2 per cent., according to the sensitiveness of the rotated freely over the surface, and deep pressure made upon the affected region. James Nevins Hyde (Jour. Cut. and Cenito-Urin. Dis., Mar., '96).
Before undertaking the local treat ment of acne it is well to open the pust ules, empty the comedones and sebaceous cysts, etc. Other direct surgical meas ures consist in cauterizations with the hot needle or electrolytic needle or in scarifications. These are often satisfac tory in indurated and rebellious acne.
The galvanocautery recommended in acne. Infiltration anaesthesia is pro duced, and a cautery needle, similar to that employed in epilation, is introduced to a depth of about two millimetres. Bloebaum (Dent. med. Zeit., No. 52, '93).
Ichthyol is particularly beneficial both in acne vulgaris and acne rosacea. In the former strong external applications can be borne, but in the latter much weaker strengths must be used. The best results are obtained when external and internal treatment are combined, and in some eases of acne rosacea in which the skin is too thin and irritable to bear even weak solutions the inter nal administration of iehthyol alone with steaming will suffice to effect a cure. The general plan of treatment is to begin with 5 grains of ichthyol thrice daily after food, increasing to 10 grains. Every night and morning the face is steamed for fifteen minutes and then washed with ichthyol soap made into a lather and allowed to dry on, which is then gently washed off with water. After each washing, if it can be borne, ichthyol salve (often combined with am moniated mercury) is applied. In acne vulgaris, after steaming, strong sulphur and ichthyol soap is used, with brisk rubbing by means of a flesh glove. The diet is regulated. lchthyol itself relieves mild cases of constipation, but, if it does not, a compound pill of iridin and euonymin or podopbyllin may be given. Alexander Brownlie (N. Y. Lancet, May, 1901).
Exposure to Roentgen rays causes atrophy of the cutaneous follicles and cheeks pus-formation. Series of per sonal cases with interesting results. Case I, aged 22, treated for hypertri chosis, but had moderately severe acne simplex. The lesions were usually in dolent, inflammatory papules without much induration and rarely with the formation of well-marked pustules. She was exposed to the x-rays for three months, with a production of some der matitis, and she has been under similar treatment at intervals during the year. After the development of the first erythema her acne disappeared. and she had no lesions within the last year. Case II was practically identical with Case I. Case III, aged 26, treated for hypertriehosis, slight acne, comedones, and constantly recurring outbreaks of a few indolent, inflammatory papules. After the first erythema she has had no acne lesions. In all of the above cases the skin is smooth and soft, and the result is satisfactory from a cos metic point of view. William A. Pusey (Jour. of Cutaneous and Genito-urin. Dis., May, 1902).
Treatment of acne by exposure to the x-rays tried in fifteen cases. With one exception, satisfactory results were ob tained. The cases were not selected. R. R. Campbell (Jour. Amer. Med. As soc., Aug. 9, 1902).