For Women and some Men

Skin Whitening Creams - 
to -for women and some Men 

Lightening skin tone is an ancient and well‐documented practice, and remains common practice among many cultures specially in Asian and African region. Specially women since the early days have been very considerate about the skin care and skin color had become a parameter of beauty!!! 

Skin color is due to the melanin pigments present in our skin and more melanin less fairer you look. So most of the women try to look fair by trying out different cosmetic and pharmaceutical products. 

Owing to the very high demand, Currently in the market there are numerous skin whitening products with different purposes for different body parts in diverse dosage form such as creams, gels, ointments, capsules, tablets lotions and many more. 

Whitening agents such as corticosteroids, tretinoin and hydroquinone are medically applied to effectively lighten the skin tone of hyperpigmented lesions. 
However, when these agents are used cosmetically, they are associated with a variety of side‐effect.

These products may or may not be pharmaceutical products and in Sri Lanka most of the cosmetics are not registered as borderline products. Given the loop-hall in the laws and the acts there are numerous skin care products claiming skin fairness. 

Most of these products are synthetic chemicals in proportions harmful to the skin and lack of proper regulation has created a huge market for the skin whitening products which are sold under different names and prices with no any quality standards and assurance. These are promoted as the only solution for suffering women through various media including TV channels, social media and even newspapers. 

Not all products that purport to lighten the skin are illegal and unsuitable for use,in fact there are several quality herbal preparations with proven effect,  but many creams and other dosage forms contain chemicals banned under safety regulations. These include mercury and hydroquinone. over the last 50 years hydroquinone had been the key component in skin whitening products and it acts by reducing the production of melonocytes - melanin producing cells. The prolonged use of synthetic hydroquinone is linked with 

• poisoning, 
• skin damage 
• liver and kidney malfunction 
• skin rashes 
• skin irritation
•  Death  

Also  misuse of corticosteroid creams is associated with thinning of the skin, an increased chance of skin cancer and, even with darkening of the skin. 

What you should know? 

- For all the skin problems including hyper pigmentation there are skin clinics in hospitals and specialized doctors to help you out 
- Pharmaceutical products should always be taken under a prescription 
- you should strictly follow the directions of the physicians or the pharmacists when using skin care products.  
- when buying any other fairness cream 

• check whether the product is registered in Sri Lanka 
• look for the composition of ingredients
• get the help of your pharmacists if it is sold in the pharmacy   
• check whether the directions been given properly and clearly 
• always check for the authenticity of the product.    
• avoid over night solutions !! 

Most of the products in the market could be very much misleading and they may not even mention about the composition of the products in such cases its best to avoid such preparations or seek help.  

Simply because your salon, favourite actress, or your friend recomend dont use whitening products. 

what can you do? 

Well becoming fair is a real struggle unless you are not born with it. Specially we being Asian women we do know that skin color is a parameter of beauty which is very unfair in certain circumstances. This will always make you want to apply more creams and skin care products with low quality and more side effects after all we all love to look beautiful and radiant. Rather than trying out all bleaching products and thousands of creams recommended by your salons and actresses we can simply follow these too .. 

Dearest Women and Some men, 

• Drink more water 
• Eat fresh fruits and vegetables 
• Eat balanced healthy diet 
• Avoid artificial food flavors,colors and fast food 
• Keep your skin clean  
• Avoid sunlight as much as possible 

these will give you a better glowing healthier skin. 

Its always good to have a healthier glowing skin even if you are dark!!!!!!!!!! 

Well have a look 

Miss Universe 2019

reference - 

Overview of skin whitening agents with an insight into the illegal cosmetic market in Europe B. Desmedt P. Courselle

Piumishh - (B. Pharm)

So many Pills - Yet so Ill

So many Pills - Yet so Ill 

This is quite a complain we all have heard all our lives and even we might have thought the same when we are ill or when one of our dearest people has fallen ill. 

Not being well despite been under medication is a common scenario most patients face and this could be due to many reasons and the top most out of all is the lack of "Compliance" and Non - Adherence

Compliance and adherence have very subtle difference and in very simple terms it is the extent to which the patients behavior matches the recommendation of the prescriber, which means patients should take 

• right medicine, 
• in right dose, 
• at right time, 
• for the right duration and 
• in the right route. 

Non-adherence refers to unfilled prescriptions, incorrect dosing intervals, skipped dosages or premature cessation of medication. 

Why not adhere? 

There could be several reasons as to why patients do not adhere to the medication and this could be both intentional and unintentional 

 Intentional 

• bad side effects 
• lack of knowledge in proper administration technique - inhalers 
• high cost of medicines 
• not feeling well   

Unintentional  

• forgetful 
• careless 

How to improve compliance 

•  talk to the doctor or your pharmacist about side effects and they will help you  with the side effects. 

•  talk to your pharmacist regarding administration techniques  he may always help with demonstrations, leaflets, diagrams or even videos  

• there are so many brands and generics  available for the same drug and switching as instructed by the pharmacist can help you with the cost  

• drugs are no Magic beans!!!! please continue medicine as you have been instructed for the right duration ....  stopping medication as and when you want will do no good !!!  

• use your smart phone to make reminders about your medication it will always be helpful. you may also use drug charts , pill boxes  

reference - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2203247/

Piumish - B.pharm - (USJ)

HPV Vaccine

HPV Vaccine - Vaccine for the girl child  

HPV vaccine is for the prevention of Cervical cancers and the genital warts caused by the Human Papiloma Virus and currently this is been given for the girls of age 12 - 14 years old under the recommendation of the Ministry of Health, Sri Lanka.        

(previous article - https://maesterofdrugs.blogspot.com/2019/ )

Why Girls? 

HPV vaccine is currently given for girls to prevent the cervical cancers but it also has the potential to prevent penile cancers and oral cancers of males too. But in Sri Lanka priority is given to the girls and many western countries including US has recommended vaccinating the boys too.

Why  Age specificity? 

Human Papiloma Virus spreads through sexual contact and HPV vaccine is only a preventive medication for the HPV associated cervical cancers and this doesn't mean that it has a therapeutic benefit if you are already infected. Therefore it is important to select an age group who are not sexually active thus the age of 12 - 14 years.

But in  a country like Sri Lanka with much social boundaries for  girls this age group could be extended to early 20 s as in the case of most of the girls.  

Who else can get HPV vaccine? 

HPV vaccination is also recommended for everyone through age 26 years, if not vaccinated already.

Vaccination is not recommended for everyone older than age 26 years. However, some adults age 27 through 45 years who are not already vaccinated may decide to get HPV vaccine after speaking with their doctor about their risk for new HPV infections and the possible benefits of vaccination. HPV vaccination in this age range provides less benefit, as more people have already been exposed to HPV. 

Concerns prior to vaccination  

before getting the vaccine to yourself or your teen daughter , 

• inform if you have any allergies to your doctor 
• inform the doctor if you are on any long term medication for any disease
• inform about any alternative or herbal medication that you are using  
• inform if you have a weakened immune system, for example due to a genetic defect, HIV infection or medicines that affect the immune system.

Side effects of the vaccine 

According to the CDC report  July 2014 

 most common events reported (for both male and female patients) 

1. fainting-common after needle injections, especially in pre-teens and teens
2.  pain and redness in the site of injection
3. dizziness;
4. nausea;
5. headache.  

serious adverse events ( Adverse events are considered serious if it is life threatening, or results in death, permanent disability, abnormal conditions at birth, hospitalization or prolonged administration.)

1. Death 
2. Immobility  

according to the manufacturers of the HPV vaccine the side effects could be - 

• Very commonly (more than 1 in 10 patients), side effects found at the injection site include: pain, swelling and redness. Headache was also seen. 
• Commonly (more than 1 in 100 patients), side effects found at the injection site include: bruising, itching, pain in extremity. 
• Rarely (less than 1 in 1000 patients): hives (urticaria).
• Very rarely (less than 1 in 10,000 patients), difficulty breathing (bronchospasm) has been reported.  

As of any medication the HPV vaccine has its own pros and cons and what is really important is to make sure that the parents as well as the children are properly made aware of why it is given and what measures to be taken if any side effect is experienced. 

Also once the parents are properly educated they must be allowed to make the decision whether or not their daughter needs the vaccination, thus the parental consent must be obtained before the girls are being vaccinated.  

Reference - 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4708146/ 

https://www.cdc.gov/hpv/parents/vaccine.html

Piumish (B.pharm - USJ)

HPV vaccine - for your Girl Child

HPV vaccine - For the GIRL CHILD  

What is HPV? 

Human Papiloma Virus (HPV) is a common virus which transfers from person to person from skin to skin contact during sexual activities. HPV infections are common in late teens and early 20s and most go unnoticed with no symptoms. among the 40 different types of HPV about 20 may cause cervical cancers in women and also cancers associated with vulva, anus, penis and oropharynx in both genders. 

Every year, about 12,000 women are diagnosed with cervical cancer and 4,000 women die from this disease in the U.S. 

Cervical cancer is the second common cause of cancer deaths causing nearly 80% of deaths in developing countries. It has been globally estimated that almost 12% of all female cancers are cervical cancers. 

In Sri Lanka, it is estimated that 7.52 million are at risk of developing cervical cancer, 1395 cases with 11.8 age specific standardized rates and 814 deaths (International Agency for Research on Cancer). 

How to prevent HPV related cancer? 

there are basically two ways to prevent the HPV related cervical cancer 

1. Screeneing for HPV cancer 

 this is also called the pap smear test and is recomended for the women of age 21 - 65 and in Sri Lanka test has been conducted in women for the past two decades. All women at the age of 35 years (or above) are offered one time screening at the well women clinics conducted by Medical Officers of Health and the tests should be done once in 3-5 years. 


2. Getting the HPV vaccination  

 The primary target population is likely to be girls within the age range of 10 to 13 years who are not sexually active by the time of the vaccination.  

 Vaccination of secondary target populations of older adolescent females or young women is recommended only if this is feasible, affordable, cost effective, and does not divert resources from vaccinating the primary target population or effective cervical cancer screening programmes, and if a significant proportion of the secondary target population is likely to be naive to vaccine-related HPV types.

The most important point to be remembered is the vaccine doesnot provide any therapeutic benefit if you are already infected or diagnosed with cervical cancer. 

HPV vaccination in Sri Lanka. 

Who - 

            Girls of grade  7 and 8 island wide no boys at current status. 

how many -

              2 doses 6 months apart 

before - 

               girls become 14 years old. 

vacccination handled by -  

                Medical Officers of Health (MOOH) and Public Health Inspectors (PHII) 

reference -
http://www.epid.gov.lk/web/index.php?option=com_content&view=article&id=208&Itemid=517&lang=en
https://www.cdc.gov


piumish - (Bpharm - USJ)