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Alcoholism is a disease that needs immediate and effective treatment because the longer a person is addicted, the more severe the disease will become and the use of inappropriate treatment increases the chances of relapse and failure. Given this, there is a need for rehabilitation centers to employ proven and effective methods at rehabilitation. However, given that the ultimate objective of these treatment centers is long-term sobriety, there is a need to examine and assess the effectiveness of their programs in the long term. The information from these assessments can be very helpful to the personnel of rehabilitation centers because they would be able to address the gaps that they might find in their programs.

Alcohol treatment are quite varied because there are multiple perspectives for the condition itself. Those who approach alcohol abuse as a medical condition or disease recommend different treatments than for instance those who approach the condition as one of social or personal choice.

Alcohol rehabilitation has to be a commitment for a turn around and change in one’s lifestyle. Very often alcohol abusers do stop drinking and remain sober after receiving psychological and emotional help or treatment. Others have long periods of sobriety followed by bouts of withdrawals. This occurs due to the consistent presence of tension at work or at home.

Alcohol treatment is a multi-faceted, long-term process. It is a systematic approach to recovery from alcoholism. Alcoholism is dealt with in many stages. Often alcoholics find it difficult to admit to the fact that they are suffering from a drinking problem. It is important to break the problem of self-denial, prior to treatment. Admittance to the problem is major step towards recovery.

Most treatments are focused on helping alcoholics discontinue their alcohol intake, followed by life training and/or social support in order to help them resist a return to alcohol use. Since alcoholism involves multiple factors which encourage a person to continue drinking, they must all be addressed in order to successfully prevent a relapse. An example of this kind of treatment is detoxification. Alcohol detoxification or ‘detox’ for alcoholics is an abrupt stop of alcohol drinking coupled with the substitution of drugs that have similar effects to prevent alcohol withdrawal and is often quite a sucessful method at this stage alcohol treatment. It will then be followed by a combination of supportive therapy, attendance at self-help groups, and ongoing development of coping mechanisms. The treatment community for alcoholism typically supports an abstinence-based zero tolerance approach.

Acne develops from of blockages in follicles. Hyperkeratinization and formation of a blocked keratin and sebum (a microcomedo) is the first change. Enlargement of sebaceous glands and an increase in sebum production occur with increased androgen (DHEA-S) production at adrenarche. The microcomedo may enlarge to form an open comedo (blackhead) or closed comedo (whitehead). Whiteheads are the direct result of skin pores becoming clogged with sebum, a naturally occurring oil, and dead skin cells. In these conditions the naturally occurring largely commensal bacteria Propionibacterium acnes can cause inflammation, leading to inflammatory lesions (papules, infected pustules, or nodules) in the dermis around the microcomedo or comedo, which results in redness and may result in scarring or hyperpigmentation.

Common Causes of Acne :-

• Hormonal activity, such as menstrual cycles and puberty. During puberty, an increased in male sex hormones called androgens cause the glands to get larger and make more sebum.
• Family/Genetic history. The tendency to develop acne is hereditary.
• Stress, through increased output of hormones from the adrenal (stress) glands.
• Inflammation, skin irritation or scratching of any sort will activate inflammation.
• Use of any medication containing lithium, barbiturates or androgens.
• Hyperactive sebaceous glands.
• Accumulation of dead skin cells that block or cover pores.
• Use of anabolic steroids.
• Exposure to certain chemical compounds.
• Exposure to halogens. Halogen acne is linked to exposure to halogens (e.g. iodides, chlorides, bromides, fluorides)
• Chronic use of amphetamines.

Treatments

There are many products available for the treatment of acne, many of which are without any scientifically-proven effects. Usually treatments show little improvement within the first two weeks. In general treatments they usually work in at least four different ways, normalizing shedding into the pore to prevent blockage, killing P. acnes, anti-inflammatory effects, hormonal manipulation. A combination of treatments can greatly reduce the amount and severity of acne in many cases. Those treatments that are most effective tend to have greater potential for side effects. Many people consult with doctors when deciding which treatments to use, especially when considering using any treatments in combination.

Common Treatments for Acne:-

Topical

Topical bactericidals such as OTC bactericidal products containing benzoyl peroxide may be used in mild to moderate acne. The gel or cream containing benzoyl peroxide is rubbed, twice daily, into the pores over the affected region. Bar soaps or washes are also commonly used and vary from 2% to 10% in strength. In addition to its therapeutic effect as a keratolytic (a chemical that dissolves the keratin plugging the pores) benzoyl peroxide also prevents new lesions by killing P. acnes. Topical antibiotics that are externally applied such as erythromycin, clindamycin, stievamycin, or tetracycline kills the bacteria that are around the blocked follicles are also usually used.

Oral Antibiotics

Oral antibiotics are also usually used to treat acne. They include erythromycin or one of the tetracycline antibiotics (tetracycline, the better absorbed oxytetracycline, or one of the once daily doxycycline, minocycline, or lymecycline).

Hormonal treatments

Treatment for female acne can be improved with hormonal treatments. The common combined oestrogen/progestogen methods of hormonal contraception have some effect, but the antiandrogen, Cyproterone, in combination with an oestrogen (Diane 35) is particularly effective at reducing androgenic hormone levels.

Oral retinoids

A daily oral intake of vitamin A derivative isotretinoin (marketed as Accutane, Amnesteem, Sotret, Claravis, Clarus) over a period of 4-6 months can cause long-term resolution and reduction of acne. Isotretinoin works primarily by reducing the secretion of oils from the glandsand has been shown to be very effective in treating severe acne and can either improve or clear well over 80% of patients.

Topical retinoids

A group of medications for normalizing the follicle cell lifecycle are topical retinoids such as tretinoin, adapalene and tazarotene. Like isotretinoin, they are related to vitamin A, but they are administered as topicals and generally have much milder side effects. They can, however, cause significant irritation of the skin. The retinoids appear to influence the cell creation and death lifecycle of cells in the follicle lining.