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Sometimes, when you get to the basic chemistry of stuff, you will always find the same basic building blocks. So, for example, when you look at most of the basic food and drinks on the market, most of them rely on corn. This is heavily subsidized by the government and so allows us to eat high-calorie food for little money. By the way, the subsidy is why you can buy a mountainous burger for less than the cost of most fresh vegetables. Well, it’s the same with almost all the lotions, gels and creams sold over the counter in drugstores to treat acne. The standard ingredient is benzoyl peroxide. Why is this one ingredient so important?

The bacteria that causes acne lives on the surface of your skin. Under normal circumstances, being exposed to the air keeps their numbers down. But if the glands under your skin start to produce too much oil, the pores will slowly fill with dead skin cells. This creates a warm, dark place where there’s no oxygen. This is a perfect breeding ground for the bacteria. Benzoyl peroxide removes the layer of dead skin cells from the surface and opens up the pores. Once the air is able to get into the pores, the growth of the bacteria is reduced. Over time, if you only have a mild outbreak, the skin will return to normal. With moderate to severe outbreaks, benzoyl peroxide will usually prevent the problem from spreading.

The main advantage of this chemical is that you can buy it as a solution. This is really cheap. Most of the research shows there’s little to choose between the basic chemical and all the branded products over time, i.e. at the end of three months, there’s no real difference in the effectiveness. But some of the combinations work more quickly. So, if you decide to buy one of the products containing benzoyl peroxide, all the extra money does is buy you a few days of looking better. There’s some new research showing the combination with adapalene works faster over three months, no matter how bad the outbreak.
The importance of this research is that it involves almost 4,000 participants. This is an impressive effort. Unfortunately, the design does not give it full credibility, i.e. it’s not a double-blind trial and no placebo was used. The participants were divided into groups. Each group received adapalene, benzoyl peroxide, the combination as a lotion, or a gel as the delivery method. The researchers found the combination as a lotion produced the best results. Some 500 participants dropped out, most complaining about dry skin. This is a standard problem with benzoyl peroxide when starting out the treatment. Using a moisturizer is best. (more…)

Over the centuries, we’ve been looking for a magic bullet to give instant pain relief. One of the earliest discoveries was based on the poppy. Depending on how the plant is processed, a range of different drugs can be produced. But there’s always been a problem – the extracts are addictive. Even short-term use can produce destructive consequences. When there were no alternatives, significant numbers of people were hooked, sometimes when only suffering minor symptoms. This led to increasing regulation and control as government grew concerned over the social consequences. The first steps were to make all the opiate drugs prescription only. This has never been a perfect system. Drugs always leak on to the streets when the rewards for illegal distribution are sufficiently high. But with the arrival of more effective alternates, it’s been slightly easier to control the level of addiction. Except control is never perfect. The death rates show more Americans die through the abuse of prescription medication than through the use of heroine and cocaine combined.

We’re the most heavily medicated group of people on the face of the planet. It’s a sad fact more teens experiment with painkillers than cigarettes. Yet every time a state or the federal government suggests tightening up on the prescription of painkillers, there’s an outcry. The libertarians among us believe we all have an absolute right to take whatever drugs we want. There should be no legal limits when the only victims are ourselves. So attempts to discipline doctors for overprescribing the narcotic painkillers often stall. It’s at this point the argument gets mixed up with the problems of end-of-life care.

There’s a strong view in many states that people should be allowed to die with dignity. This means, say, a cancer patient should be given high doses of painkillers even though this will accelerate death. The pro-lifers object saying this is murder, i.e. not death caused by the cancer, but death caused by the drugs. Yet, if lawmakers limit the use of these more powerful drugs without multiple exceptions, people who suffer chronic severe pain may be left without relief. Sometimes the pain from arthritis demands the use of the most powerful drugs. If the discretion of a doctor has been limited, many may be left in pain. (more…)