There is a Fungus Among Us – Lets Kill It!

Topical fungal infections on various parts of the body are are considered to be a major health problem worldwide. These infections are often named after the body part they infect such as body ringworm (tinea corporis), athlete’s foot (tinea pedis) and jock itch (tinea cruris). Usually these infections do not pose serious problems but they are uncomfortable causing significant pain and itching. Effective treatment can be accomplished with over the counter medications but it is important to understand the available products.

There are two types of medications on the market. One type will inhibit the growth of the fungus (fungistatic) while the other will actually kill it (fungicidal). A fungistatic drug will prevent the fungus from reproducing and a fungicidal drug actually kills the fungus decreasing the number of fungal cells.

The medications available over the counter which are fungistatic are:

• clotrimazole (Cruex® cream, Lotrimin AF®)
• miconazole (Cruex® spray, Desenex® powder, Lotrimin AF® powder)
• *tolnaftate (Lamisil AF Defense® powder, Tinactin® cream and spray)

*it is not clear if tolnaftate is fungicidal or fungistatic

The above medications require twice daily treatment for 4 weeks to be effective.

The over the counter medications considered to be fungicidal are:

• butenafine (Lotrimin Ultra® cream)
• terbinafine (Lamisil AT® cream, spray pump, solution, gel)

The fungicidal medications generally require less frequent applications or for a shorter duration of time or both. The frequency and duration of treatment varies depending on the product and the location of the fungal infection. The shortest schedule is once daily for 7 days for Lamisil AT® gel when used for athlete’s foot between the toes.

As a general rule the fungistatic medications cost less to purchase than the fungicidal products, but in the long run you end up having to purchase multiple packages to complete the 4 weeks of therapy. As a result it may be cost effective to spend a little more up front to treat the problem with a single tube of medication.

You will notice there are multiple packages on the shelf with the same name but different claims. One package will say for jock itch while another will say athlete’s foot. This is due to the FDA labeling requirements and package information for each condition. For example, Lamisil AT® cream is available for both jock itch and athlete’s foot. The package for jock itch is labeled to be used once daily for 1 week but the one for athlete’s foot is labeled as twice daily for 1 week (between the toes) and twice daily for 2 weeks on the bottom or sides of the foot. Follow the instructions for the specific product and area you are treating.

Tips For Effective Treatment

• Wash the affected area carefully and pat dry with a towel.
• Do not use the above towel to dry other parts of the body and be sure to wash this towel after each use.
• Chose a product that is fungicidal whenever possible and follow all instructions on the package.
• Chose the product with shortest duration of therapy for the area you are treating (applying a product twice a day for 4 weeks can be difficult to complete).
• Wait 15 minutes after washing and drying before putting clothing over the affected area.
• Keep the affected area as dry as possible.
• Do not wear the same article of clothing over the area for 2 consecutive days.
• Wash all clothing and towels that contacts the affected area with hot water and dry them in the hot cycle of the dryer.
• Wear breathable cotton clothing over the affected areas.
• For athlete’s foot, wear non-occlusive shoes such as sandals whenever possible and do not wear the same pair of shoes 2 days in a row. You can also treat the shoes with one of the powdered antifungals available.
• When all symptoms have resolved, keep treating for 3 to 7 days to ensure the condition does not return.

Follow the above tips and you will have the best chance of a successful treatment.

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Acne, do this before you spend a lot of money for treatments.

What is acne?

Acne is when the skin’s pores get plugged causing blackheads, whiteheads, and pimples on the face, neck and other parts of the upper body. It is most common in the teenage years but can affect adults in their, 20s, 30s and 40s. Once the pore gets plugged bacteria can invade and cause inflammation and redness. This is an oversimplified explanation but the point is there is bacteria involved.

Treatment

There is only a handful of active ingredients to teat acne. They work by killing the bacteria involved or by correcting abnormal skin shedding. There are a lot of over the counter medications available but only a few active ingredients. My focus today is to highlight just a couple of of active ingredients to get you on the path to clearer skin. If you do not see improvements in your acne in 7 to 10 days or you have side effects or worsening conditions then I defer to a dermatologist. Do not waste a lot of money trying every product available on the shelf.

First

Wash the affected area twice daily with a product containing salicylic acid 2%. Read the ingredients. Some products with this ingredient are inexpensive and some very expensive. Purchase the least expensive one you can find. If you need a brand name to look for try Noxzema Triple Clean Blackhead Cleanser. This one can be found for under $5.00 at the local pharmacy or grocery store.

Second

Apply a benzoyl peroxide cream to the affected area twice daily after the above wash. There are several strengths of benzoyl peroxide on the market starting at 2.5% up to 10%. You should probably start with a 2.5% strength initially as this can be drying and sometimes irritating to the skin. If this strength is tolerated you could advance to the 5% or 10 % strengths. If you need a brand name to look for Clearasil Ultra Acne Treatment Cream is available as a 10% product.

Third

Apply a light moisturizer to the areas treated above. A good choice is Olay Complete Sensitive Skin.
Try this treatment plan for 7 to 10 days. You should see some improvements by this time. Continue this plan for several weeks and you should see a lot of improvement. If this basic plan does not produce visible results or you cannot tolerate the side effects, contact a dermatologist. Don’t spend a lot of time and money with all the different products available.

More info about acne.

Try this and leave a comment to let me know how it has worked for you.

Over The Counter Medications – Know The Ingredients

There is a dizzying array of over the counter medications. Walk into any pharmacy and you are confronted with an entire wall full of packages. In fact the FDA states there are over 80 categories of non prescription medications and over 100,000 products on the market. Despite the large number of products on the market there are only about 800 different active ingredients.

So where do all these products come from?

There are multiple answers to this question.

First, one manufacturer may market one product in several different strength and dosage forms. For example, regular strength, extra strength, maximum strength, tablet, capsule, gelcap, caplet, children’s suspension and much more.

Second, more than one manufacturer may market the same chemical. Motrin®, Nuprin® and Advil® are all ibuprofen (also available in multiple store brands).

Third, each medication could be combined with other medications to make a combination product. This is especial common in cough and cold formulas.

Reformulations

As if the large number of marketed products were not enough of a problem, the manufacturers sometimes reformulate a product. One example that comes to mind is Kaopectate®. The original product was a combination of Kaolin and Pectin. This formula was changed around 1990 to attapulgite until 2003 when it was changed again to bismuth subsalicylate (the same as Bepto Bismol®). A person who did not read the labels would not be aware the product had changed until the product was opened and they noticed the liquid was different. The new product is not appropriate for children with a fever, people with aspirin allergy or people taking warfarin.

As I was reviewing the shelf for examples I stumbled across a reformulation I had not seen before. Alka-Seltzer Plus® Cold Formula has just been reformulated but the name is the same.

Old Formula – acetaminophen, chlorpheniramine, and phenylephrine

New Formula – aspirin, chlorpheniramine, and phenylephrine

This reformulation could be a problem for some people. It may be a problem if you have an allergy to aspiring, kidney problems, are on daily aspiring therapy, are taking warfarin, or have ulcers or other stomach problems.

Marketing

Manufacturers are always trying to position their products for increased sales. As a result, they will expand their lines or rename a formula.

A line expansion happens when a manufacturer wants to capitalize on its brand name and introduce a different product and maintain brand recognition. One example of an expanded line is Advil PM®. The manufacture has a great reputation with Advil® because it is widely recognized as a high quality brand name product. The addition of diphenhydramine to the ibuprophen in the original product results in a product which treats pain and helps you sleep. The manufacturer wins by instant brand recognition, increased shelf space in the store and increased sales. The problem with this is the customer is now faced with more choices in an already confusing environment. Also, there is the potential for over treatment as the customer may only need a sleep aid and not a pain medicine. They believe the product to be only intended for sleep and end up taking ibuprofen when there is no need.

A renamed formula is the result of a manufacturer who will take an existing product and change the name without making any change to the ingredients. This can occur for a variety of reasons. A slow moving product may need to be marketed differently to stimulate sales or the item is renamed to decrease confusion with another similar package.

Here is just one example of a renamed formula. CoAdvil® is a product that contained ibuprofen and pseudoephedrine. This item has been renamed to Advil Cold and Sinus. Both products have the same ingredients at the same concentrations. Only the name has changed. The customer looking for the old formula would have a difficult time finding the new product.

Regulations

Because the FDA requires specific labeling depending on various uses for a medication, it is difficult for a manufacturer to market a product for more than one indication. For example, diphenhydramine is useful to treat allergies, runny nose, motion sickness, insomnia and hives. Due to labeling regulations and other restrictions it cannot be marketed in a single package for all theses uses. Each use is marketed in a different package and often under a different brand name. (Bendryl®, Sominex®)

Conclusion

If you are looking for a safe and effective over the counter treatment, you have a lot of different options available. Unfortunately, selection of the right product is getting more difficult. It is important to read the package label and know the names of the medications in the package. If you are unsure which product to select check with your pharmacist. They are your best resource for information about over the counter medications and can help you select the best medication.

Take Control of Cholesterol for a Healthy Heart

What is Cholesterol?

Cholesterol is a waxy substance found in all cells of the body. It is essential for normal function. Cholesterol is also used by the body to make some hormones and other chemicals. Cholesterol is carried through the blood steam by lipoproteins. The three major categories of lipoproteins most commonly measured by doctors are:

• HDL – High Denity Lipoprotein – These are considered “good cholesterol” because they carry cholesterol from the body to the liver. This is good because the liver is responsible for removing cholesterol from the body. A high HDL will reduce your chances of heart disease.
• LDL – Low Density Lipoprotein – These are considered “bad cholesterol” because they carry cholesterol from the liver out to the body. This is not a good thing because a high LDL is associated with an increased chance of premature heart disease and death.
• VLDL – Very Low Density Lipoprotein – Also considered to be bad because they carry triglycerides from the liver to the body. A high triglyceride level is also associated with heart disease.

If you know your cholesterol numbers and your blood pressure you can go to the National Heart Lung and Blood Institute Web Site to calculate the risk of your having a heart attack within the next 10 years.

What happens when cholesterol is high?

An LDL cholesterol over 100 mg/dl appears to be atherogenic. What this means is, because the level is high, cholesterol can build up on the walls of the arteries. A buildup of cholesterol on the arteries is called a plaque. Over time the plaque causes a narrowing of the arteries which can decrease or even stop the blood flow through the artery. When this happens to an artery of the heart it is known as coronary heart disease. Sometimes a clot can form over the plaque which can block the flow of blood. The result of this block can be angina (chest pain) or a heart attack.

What causes high cholesterol?

High cholesterol can run in families and in this case it is inherited. Also, as we age cholesterol levels go up. And women have lower cholesterol than men up to age 55 when this reverses and men have lower cholesterol than women. These are factors which cannot be controlled.

There are several factors which can be controlled. These are diet, weight control and exercise. Many foods can contribute to high cholesterol. These are foods that contain saturated fats, trans fats and cholesterol. Lack of regular exercise and being overweight can also contribute to high cholesterol.

Drug therapy lower cholesterol?

There are many drugs used to lower cholesterol. Often times a person will need more than one medication to achieve an adequate reduction of cholesterol. Work with your doctor to discuss your cholesterol levels and goals of therapy. Take your medications consistently. Let your doctor know if you are having problems with the medications.

Only 38% of those who are on cholesterol medications are achieving their goals. This is alarming because it has been shown that a reduction in cholesterol levels can decrease heart disease. Tell your doctor you want to achieve your goals.

Lifestyle modifications to lower cholesterol.

There are many things which can be done without or in addition to medication therapy to lower cholesterol. Also, medications cannot fix a poor diet and unhealthy lifestyle. You must do everything you can to improve your diet and get enough exercise. Your life depends on it. Here is a great free resource for lifestyle modifications for lowering cholesterol.

Diet

• Limit the amount of saturated fat, trans fat and cholesterol in your diet. Read food labels.
• Do not over eat. Eat enough to maintain a healthy weight.
• Oatmeal, apples, kidney beans and other sources of soluble fiber should be added to the diet.
• Eat whole grains over refined ones. (brown rice, whole wheat bread etc)
• Add more fruits and vegetables to your diet.

Weight management

• If you are overweight, losing weight can help lower cholesterol. This is especially important if your waist is greater than 40 inches for a man or 35 inches for a woman.

Physical activity

• Regular physical activity raises HDL (the good cholesterol) and can lower LDL levels. Aim for 30 minutes of moderate intensity activity most days of the week.

There is no doubt lifestyle modifications can be difficult. Take it slow. Make one change at a time and just keep working on it. Any change you accomplish and maintain long term will payoff with better health and a sense of accomplishment. Then you can build from there and keep making small changes that when added together result in huge benefits. Just remember, the medications will work better and you have a better chance of achieving your goals if you live a healthy lifestyle.