Угревая сыпь легкой и средней степени тяжести, в том числе при наличии папул и пустул. Гиперпигментация типа мелазмы, например хлоазма.
Противопоказания
Повышенная чувствительность к азелаиновой кислоте и другим компонентам препарата; детский возраст до 12 лет (угревая сыпь), до 18 лет (гиперпигментация типа мелазмы).
1 г крема содержит Действующее вещество: азелаиновая кислота 0,2 г. Вспомогательные вещества: бензойная кислота 0,002 г, макрогола глицерилстеарат 0,05 г, смесь глицерилстеарата, цетостеарилового спирта, цетилпальмитата и глицеридов жирных кислот кокосового масла 0,07 г, цетостеарил этилкапронат 0,03 г, пропиленгликоль 0,125 г, глицерол 85 % 0,015 г, вода очищенная 0,508 г.
Описание
Белый непрозрачный однородный крем.
Фармакологические свойства
Азелаиновая кислота при терапии угревой сыпи нормализует нарушенные процессы кератинизации в фолликулах сальных желез, уменьшает содержание свободных жирных кислот в липидах кожи. Проявляет противомикробную активность в отношении Propionobacterium acnes и Staphylococcus epidermidis. Противовоспалительный эффект также обусловлен уменьшением метаболизма нейтрофилов и снижением выработки ими свободно-радикальных форм кислорода. Азелаиновая кислота оказывает зависящее от дозы и от времени подавляющее воздействие на рост и жизнеспособность аномальных меланоцитов. Молекулярные механизмы этого воздействия до конца не установлены. Имеющиеся данные позволяют предположить, что основной эффект азелаиновой кислоты в лечении мелазмы связан с угнетением синтеза ДНК и/или клеточного дыхания в аномальных меланоцитах.
Показания к применению
Угревая сыпь легкой и средней степени тяжести, в том числе при наличии папул и пустул. Гиперпигментация типа мелазмы, например хлоазма.
Противопоказания
Повышенная чувствительность к азелаиновой кислоте и другим компонентам препарата; детский возраст до 12 лет (угревая сыпь), до 18 лет (гиперпигментация типа мелазмы).
Применение при беременности и в период грудного вскармливания
Применение препарата во время беременности и кормления грудью возможно только после согласования с врачом. Адекватные и строго контролируемые исследования при наружном применении азелаиновой кислоты у беременных женщин не проводились. Изучение на животных не выявило неблагоприятного действия азелаиновой кислоты в отношении беременности, внутриутробного развития плода, родов или постнатального развития. Потенциальный риск для человека неизвестен. При беременности препарат Скинорен® применяют только в случае, если предполагаемая польза для матери превышает потенциальный риск для плода. Точно неизвестно, проникает ли азелаиновая кислота в грудное молоко. Учитывая низкую системную абсорбцию азелаиновой кислоты при наружном применении, в период грудного вскармливания препарат Скинорен® применяют только в случае, если предполагаемая польза для матери превышает потенциальный риск для ребенка. При грудном вскармливании необходимо избегать нанесения препарата на область молочных желез перед кормлением, следует не допускать контакта детей с кожей, в том числе с кожей молочных желез, после нанесения препарата Скинорен®.
Способ применения и дозы
Наружно. Перед нанесением крема следует тщательно промыть кожу чистой водой и затем высушить, или использовать мягкое очищающее косметическое средство. Не использовать окклюзионные повязки. После каждого нанесения крема на кожу следует мыть руки. Крем наносят тонким слоем на пораженные участки кожи 2 раза в день (утром и вечером), слегка втирая в кожу (2,5 см крема достаточно для всей поверхности лица). У детей от 12 до 18 лет препарат Скинорен® применяется при лечении угревой сыпи, коррекция дозы не требуется. Эффективность и безопасность применения препарата у детей моложе 12 лет при лечении угревой сыпи не установлена. Эффективность и безопасность применения препарата у детей моложе 18 лет при лечении мелазмы не установлена. Важно, чтобы препарат Скинорен® использовался регулярно в течение всего периода лечения. Длительность лечения индивидуальна и зависит от тяжести заболевания. Улучшение наступает, как правило, через 4 недели лечения. При необходимости при лечении угревой сыпи возможно применение препарата Скинорен® в течение нескольких месяцев. При лечении мелазмы минимальный период применения препарата Скинорен® – 3 месяца. В период лечения мелазмы следует обязательно применять солнцезащитные средства с широким спектром защиты от ультрафиолетового (УФ) излучения: УФА и УФВ (UVA и UVB), чтобы предотвратить обострение заболевания и/или повторную пигментацию осветленных участков кожи под воздействием солнца. Если в течение 1 месяца при лечении угревой сыпи и 3 месяцев при лечении мелазмы улучшения не наступило или наступило обострение заболевания, то следует прекратить применение препарата Скинорен® и обратиться к врачу. В случае появления раздражения на коже следует уменьшить количество крема при каждом нанесении или сократить частоту применения крема до 1 раза в день. Возможна кратковременная отмена препарата с последующим возобновлением после исчезновения симптомов раздражения в рекомендованной дозе. Применяйте препарат только согласно тому способу применения и в тех дозах, которые указаны в инструкции. В случае необходимости, пожалуйста, проконсультируйтесь с врачом перед применением лекарственного препарата.
Побочное действие
Наблюдаемые в клинических исследованиях и во время пострегистрационного наблюдения наиболее частыми побочными эффектами были: жжение, зуд и эритема в месте нанесения. Нарушения со стороны иммунной системы: частота неизвестна – реакция повышенной чувствительности (в том числе ангионевротический отек, контактный дерматит, отек глаз, отек лица), обострение бронхиальной астмы. 4 Нарушения со стороны кожи и подкожных тканей: нечасто – себорея, акне (угревая сыпь), депигментация (обесцвечивание) кожи; редко – хейлит. Общие расстройства и нарушения в месте применения: очень часто – в месте нанесения: жжение, зуд, эритема (покраснение); часто – в месте нанесения: десквамация (отслойка эпидермиса), боль, сухость, изменение цвета кожи, раздражение на коже; нечасто – парестезия, дерматит, дискомфорт, отек; редко – в месте нанесения: сыпь, экзема, ощущение тепла, язвы; частота неизвестна – сыпь, крапивница. Если любые из указанных в инструкции побочных эффектов усугубляются, или Вы заметили любые другие побочные эффекты не указанные в инструкции, сообщите об этом врачу.
Передозировка
До настоящего времени сведений о передозировке не имеется.
Особые указания
Только для наружного применения. Следует избегать попадания крема в глаза, рот и другие слизистые оболочки. При случайном попадании крема на слизистые оболочки, в том числе глаза, рот, необходимо промыть их большим количеством воды. Если раздражение глаз не проходит, то следует обратиться к врачу. После каждого применения крема Скинорен® следует мыть руки. Мелазма, расположенная в эпидермисе или одновременно в эпидермисе и дерме, хорошо поддается лечению препаратом Скинорен®. Мелазма, расположенная только в дерме, нечувствительна к лечению. Для проведения дифференциальной диагностики используют лампу Вуда. Препарат Скинорен® содержит бензойную кислоту, которая может вызвать раздражение на коже, раздражение глаз и слизистых оболочек, и пропиленгликоль, который может вызвать раздражение на коже. Во время пострегистрационного наблюдения редко сообщалось об обострении у больных бронхиальной астмой при наружном применении азелаиновой кислоты. Внимательно прочтите инструкцию перед тем, как начать применение препарата. Сохраните инструкцию, она может понадобиться вновь. Если у Вас возникли вопросы, обратитесь к врачу. Лекарственное средство, которым Вы лечитесь, предназначено лично Вам, и его не следует передавать другим лицам, поскольку оно может причинить им вред даже при наличии тех же симптомов, что и у Вас. Влияние на способность управлять транспортными средствами, механизмами: Препарат Скинорен® не влияет на способность управлять транспортными средствами и работу с механизмами.
Условия хранения
Вскрытую алюминиевую тубу хранить в течение 6 месяцев. При температуре не выше 30 °С. Хранить в недоступном для детей месте.
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В период лечения мелазмы следует обязательно применять солнцезащитные средства с широким спектром защиты от ультрафиолетового (УФ) излучения: УФА и УФВ (UVA и UVB), чтобы предотвратить обострение заболевания и/или повторную пигментацию осветленных участков кожи под воздействием солнца. Если в течение 1 месяца при лечении угревой сыпи и 3 месяцев при лечении мелазмы улучшения не наступило или наступило обострение заболевания, то следует прекратить применение препарата Скинорен® и обратиться к врачу. В случае появления раздражения на коже следует уменьшить количество крема при каждом нанесении или сократить частоту применения крема до 1 раза в день. Возможна кратковременная отмена препарата с последующим возобновлением после исчезновения симптомов раздражения в рекомендованной дозе. Применяйте препарат только согласно тому способу применения и в тех дозах, которые указаны в инструкции. 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