topicals

Acne is a common skin disease that causes pimples. Pimples form when hair follicles under your skin clog up. Most pimples form on the face, neck, back, chest, and shoulders. Anyone can get acne, but it is common in teenagers and young adults. It is not serious, but it can cause scars.

No one knows exactly what causes acne. Hormone changes, such as those during the teenage years and pregnancy, probably play a role. There are many myths about what causes acne. Chocolate and greasy foods are often blamed, but there is little evidence that foods have much effect on acne in most people. Another common myth is that dirty skin causes acne; however, blackheads and pimples are not caused by dirt. Stress doesn't cause acne, but stress can make it worse.

If you have acne:

• Clean your skin gently
• Try not to touch your skin
• Avoid the sun

Treatments for acne include medicines and creams.

NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases

Your anus is the opening at the end of your large intestine. It is where stool (poop) leaves your body. The anus is formed partly from your outer layers of skin and partly from your intestine. Anal cancer is a type of cancer that forms in the tissues of your anus.

Anyone can get anal cancer, but you are more likely to develop it if you:

• You have an infection with high-risk HPV, especially if you have certain types. Most anal cancers are related to HPV infection.
• Have a weakened immune system, from conditions such as HIV or because of medicines you need to take after an organ transplant.
• Have had vulvar, vaginal, or cervical cancer.
• Have many sexual partners.
• Have anal sex.
• Smoke cigarettes.

The signs and symptoms of anal cancer may include:

• Bleeding from the anus or rectum
• A lump near the anus
• Pain or pressure in the area around the anus
• Itching or discharge from the anus
• A change in bowel habits, such as narrower stools, having to go more often, or bowel incontinence

To find out if you have anal cancer, your provider:

• Will take your medical history, which includes asking about your symptoms.
• Will ask about your family health history.
• May do a digital rectal examination (DRE). A DRE is an exam of the anus and rectum. For the exam, your provider will insert a lubricated, gloved finger into the lower part of your rectum to feel for lumps or anything else that seems unusual.
• May order tests that examine the anus and rectum, such as:
  • An anoscopy, an exam of the anus and lower rectum using a short, lighted tube called an anoscope. There is also a type of anoscopy called a high-resolution anoscopy. It uses a special magnifying device called a colposcope along with the anoscope to view these areas.
  • A proctoscopy, a procedure to look inside the rectum and anus using a thin, tube-like instrument with a light and a lens.
  • An endo-anal or endorectal ultrasound, a procedure in which an ultrasound probe is inserted into the rectum.
• May do a biopsy during an anoscopy or proctoscopy.

The treatments for anal cancer include radiation therapy, chemotherapy, and surgery. Which treatment you get will depend on how advanced the cancer is, your overall health, and your preferences.

You may be able to lower your risk of getting anal cancer by getting an HPV vaccine and not smoking. Contact your provider if you need help quitting smoking.

It is currently not known if using condoms can prevent anal HPV infections. But using latex condoms every time you have sex can help prevent HIV, a risk factor for anal cancer. And they also help prevent other sexually transmitted infections (STIs). If your or your partner is allergic to latex, you can use polyurethane condoms.

If you are an adult with HIV, it's important to get an anal cancer screening every year. The screening checks for anything that seems unusual, such as lumps, burning, and precancer cells (cells that could turn into cancer). The screening will include a digital rectal exam. If anything unusual is found, you will have an anoscopy or high resolution anoscopy.

Anesthesia is the use of medicines to prevent pain during surgery and other procedures. These medicines are called anesthetics. They may be given by injection, inhalation, topical lotion, spray, eye drops, or skin patch. They cause you to have a loss of feeling or awareness.

Anesthesia may be used in minor procedures, such as filling a tooth. It could be used during childbirth or procedures such as colonoscopies. And it is used during minor and major surgeries.

In some cases, a dentist, nurse, or doctor may give you an anesthetic. In other cases, you may need an anesthesiologist. This is a doctor who specializes in giving anesthesia.

There are several different types of anesthesia:

• Local anesthesia numbs a small part of the body. It might be used on a tooth that needs to be pulled or on a small area around a wound that needs stitches. You are awake and alert during local anesthesia.
• Regional anesthesia is used for larger areas of the body such as an arm, a leg, or everything below the waist. You may be awake during the procedure, or you may be given sedation. Regional anesthesia may be used during childbirth, a Cesarean delivery (C-section), or minor surgeries.
• General anesthesia affects the whole body. It makes you unconscious and unable to move. It is used during major surgeries, such as heart surgery, brain surgery, back surgery, and organ transplants.

Anesthesia is generally safe. But there can be risks, especially with general anesthesia, including:

• Heart rhythm or breathing problems
• An allergic reaction to the anesthesia
• Delirium after general anesthesia. Delirium makes people confused. They may be unclear about what is happening to them. Some people over the age of 60 have delirium for several days after surgery. It can also happen to children when they first wake up from anesthesia.
• Awareness when someone is under general anesthesia. This usually means that the person hears sounds. But sometimes they can feel pain. This is rare.

Cancer chemotherapy is a type of cancer treatment. It uses medicines to destroy cancer cells.

Normally, the cells in your body grow and die in a controlled way. Cancer cells keep growing without control. Chemotherapy works by killing the cancer cells, stopping them from spreading, or slowing their growth.

Chemotherapy is used to:

• Treat cancer by curing the cancer, lessening the chance it will return, or stopping or slowing its growth.
• Ease cancer symptoms by shrinking tumors that are causing pain and other problems.

Chemotherapy does not just destroy cancer cells. It can also harm some healthy cells, which causes side effects.

You may have a lot of side effects, some side effects, or none at all. It depends on the type and amount of chemotherapy you get and how your body reacts.

Some common side effects are:

• Mouth sores
• Fatigue
• Nausea and vomiting
• Pain
• Hair loss

There are ways to prevent or control some side effects. Talk with your health care provider about how to manage them. Healthy cells usually recover after chemotherapy is over, so most side effects gradually go away.

You may get chemotherapy in a hospital or at home, a doctor's office, or a medical clinic. You might be given the medicines by mouth, in a shot, as a cream, through a catheter, or intravenously (by IV).

Your treatment plan will depend on the type of cancer you have, which chemotherapy medicines are used, the treatment goals, and how your body responds to the medicines.

Chemotherapy may be given alone or with other treatments. You may get treatment every day, every week, or every month. You may have breaks between treatments so that your body has a chance to build new healthy cells.

NIH: National Cancer Institute

Eosinophilic esophagitis (EoE) is a chronic disease of the esophagus. Your esophagus is the muscular tube that carries food and liquids from your mouth to the stomach. If you have EoE, white blood cells called eosinophils build up in your esophagus. This causes damage and inflammation, which can cause pain, trouble swallowing, and food getting stuck in your throat.

EoE is rare. But because it is a newly recognized disease, it is being diagnosed more often. Some people who think that they have reflux (GERD) may actually have EoE.

Researchers are not certain about the exact cause of EoE. They think that it is an immune system/allergic reaction to foods or to substances in your environment, such as dust mites, animal dander, pollen, and molds. Certain genes may also play a role in EoE.

EoE can affect anyone, but it is more common in people who:

• Are male
• Have other allergic diseases, such as hay fever, eczema, asthma and food allergies
• Have family members with EoE

The most common symptoms of EoE can depend on your age.

In infants and toddlers::

• Feeding problems
• Vomiting
• Poor weight gain and growth
• Reflux that does not get better with medicines

In older children::

• Vomiting
• Abdominal pain
• Trouble swallowing, especially with solid foods
• Reflux that does not get better with medicines
• Poor appetite

In adults::

• Trouble swallowing, especially with solid foods
• Food getting stuck in the esophagus
• Reflux that does not get better with medicines
• Heartburn
• Chest pain

To find out if you have EoE, your doctor will likely:

• Ask about your symptoms and medical history. Since other conditions can have the same symptoms of EoE, it is important for your doctor to take a thorough history.
• Do an upper gastrointestinal (GI) endoscopy. An endoscope is a long, flexible tube with a light and camera at the end of it. Your doctor will run the endoscope down your esophagus and look at it. Some signs that you might have EoE include white spots, rings, narrowing, and inflammation in the esophagus. However, not everyone with EoE has those signs, and sometimes they can be signs of a different esophagus disorder.
• Do a biopsy. During the endoscopy, the doctor will take small tissue samples from your esophagus. The samples will be checked for a high number of eosinophils. This is the only way to make a diagnosis of EoE.
• Do other tests as needed. You may have blood tests to check for other conditions. If you do have EoE, you may have blood or other types of tests to check for specific allergies.

There is no cure for EoE. Treatments can manage your symptoms and prevent further damage. The two main types of treatments are medicines and diet.

Medicines used to treat EoE are:

• Steroids, which can help control inflammation. These are usually topical steroids, which you swallow either from an inhaler or as a liquid. Sometimes doctors prescribe oral steroids (pills) to treat people who have serious swallowing problems or weight loss.
• Acid suppressors such as proton pump inhibitors (PPIs), which may help with reflux symptoms and decrease inflammation.
• Monoclonal antibodies, which can reduce inflammation and may help with swallowing. They can be used in adults and children over age 12.

Dietary changes for EoE include:

• Elimination diet. If you are on an elimination diet, you stop eating and drinking certain foods and beverages for several weeks. If you are feeling better, you add the foods back to your diet one at a time. You have repeat endoscopies to see whether or not you are tolerating those foods. There are different types of elimination diets:
• With one type, you first have an allergy test. Then you stop eating and drinking the foods you are allergic to.
• For another type, you eliminate foods and drinks that commonly cause allergies, such as dairy products, egg, wheat, soy, peanuts, tree nuts and fish/shellfish.
• Elemental diet. With this diet, you stop eating and drinking all proteins. Instead, you drink an amino acid formula. Some people who do not like the taste of the formula use a feeding tube instead. If your symptoms and inflammation go away completely, you may be able to try adding foods back one at a time, to see whether you can tolerate them.

Which treatment your doctor suggests depends on different factors, including your age. Some people may use more than one kind of treatment. Researchers are still trying to understand EoE and how best to treat it.

If your treatment is not working well enough and you have narrowing of the esophagus, you may need dilation. This is a procedure to stretch the esophagus. This makes it easier for you to swallow.

Hidradenitis suppurativa (HS) is a chronic skin disease. Another name for it is acne inversa. It causes painful, boil-like lumps that form under the skin. It often affects areas where the skin rubs together, such as your armpits and groin. The lumps become inflamed and painful. They often break open, causing abscesses that drain fluid and pus. As the abscesses heal, they can cause scarring of the skin.

The lumps in HS form because of blockages of the hair follicles. The blocked hair follicles trap bacteria, which leads to inflammation and rupture. In most cases, the cause of the blockages is unknown. Genetics, environment, and hormonal factors may play a role. Some cases of HS are caused by changes in certain genes.

HS is not caused by bad hygiene, and it cannot be spread to others.

HS usually starts after puberty, usually in the teens or twenties. It is more common in:

• Women
• People who are Black
• People with a family history of HS
• People who are overweight or have obesity
• People who smoke

The symptoms of HS include:

• Small pitted areas of skin containing blackheads
• Painful, red, lumps that get bigger and break open. This causes abscesses that drain fluid and pus. They may itch and have an unpleasant odor.
• The abscesses heal very slowly, recur over time, and can lead to scarring and tunnels under the skin.

HS can be mild, moderate, or severe:

• In mild HS, there are only one or a few lumps in one area of the skin. A mild case will often get worse, becoming a moderate disease.
• Moderate HS includes recurrences of the lumps that get bigger and break open. The lumps form in more than one area of the body.
• With severe HS, there are widespread lumps, scarring, and chronic pain that may make it hard to move.

Because of the difficulty of dealing with the disease, people with HS are at risk for depression and anxiety.

There is no specific test for HS. It can be hard to diagnose in the early stages because it can look like pimples or acne. To make a diagnosis, your health care provider:

• Will ask about your medical history and your symptoms
• Will look at the lumps on your skin
• May take a sample of the skin or pus (if there is any) and send it to a lab to be tested

Your provider may refer you to a dermatologist (skin doctor) to get a diagnosis or treatment.

There is no cure for HS. Treatments focus on the symptoms, but they are not always effective for everyone. The treatments depend on how severe the disease is and may include:

• Medicines, including steroids, antibiotics, pain relievers, and medicines that flight inflammation. In mild cases, the medicines may be topical (applied to your skin). Otherwise, the medicines may be injected or taken orally (by mouth).
• Procedures or surgery to remove the lumps and scars or make the sores go away.

It may also help if you can avoid things that can irritate your skin, by:

• Wearing loose-fitting clothing
• Staying at a healthy weight
• Quitting smoking
• Avoiding heat and humidity
• Being careful not to injure your skin

Not all medicines are safe to take when you are pregnant. Some medicines can harm your baby. That includes over-the-counter or prescription drugs, herbs, and supplements.

Always speak with your health care provider before you start or stop any medicine. Not using medicine that you need may be more harmful to you and your baby than using the medicine. For example, many pregnant women take prescription medicines for health problems like diabetes, asthma, seizures, and heartburn. The decision about whether or not to take a medicine depends on the risks and benefits. You and your health care provider should make this choice together.

Pregnant women should not take regular vitamins. They may have too much or too little of the vitamins that you need. There are special vitamins for pregnant women. It is important to take 0.4 mg of folic acid every day before you become pregnant through the first part of your pregnancy. Folic acid helps to prevent birth defects of the baby's brain or spine.

Food and Drug Administration