Acne(acne, acne) is a chronic disease of the sebaceous glands and hair follicles. This causes blockage of the glands, increased production of sebum (a special secretion that makes our skin elastic, protects us from infections and is involved in the thermoregulation of the whole body) and as a result, severe acne appears on the face. In this article, we will consider in detail what acne on the face is, its causes and treatment.
About 80% of teenagers and young adults live with this disease, but acne can appear at a later age, after 25 years.
Causes of acne
Causes of acne on the face most often are:
Acne tablets
Tablets for acne on the face are prescribed when the appearance of acne is associated with internal diseases, for example, disruption of the gastrointestinal tract. In this case, doctors prescribe Doxycycline, Isotretinoin or Aknekutan.
It is not recommended to carry out medicinal treatment of acne on the face on your own.
Nutrition for acne on the face
Proper nutrition plays an important role in treating the disease. Diet for acne on the face prescribes exclude from the diet sweets, fatty drinks, carbonated and alcoholic drinks, bread, chips, milk and replace them with green tea, yogurt, vegetable salads, fruits and steamed meat and fish.
Necessary replenish the body with vitamins A, B and E(carrots, cucumbers, apricots, sorrel, spinach, black currants, all kinds of nuts, cabbage, cheese, buckwheat, beans), as well as zinc(asparagus, herring, beef stew, oysters and veal liver).
There is a direct connection between healthy skin and healthy intestines, so first of all you need to pay attention to the health of the gastrointestinal tract.
Cleansing the intestines and following a diet will have a beneficial effect on the condition of the skin. Remember the need drink enough purified water. It removes toxins and actively helps cells recover.
How to get rid of acne on the face and how to cure acne on the face? To do this, you can carry out cleaning procedures acne faces, soft, special facial massages, superficial cryotherapy, peeling face with acne. If the acne is not inflamed, then laser therapy can be used.
Never try to squeeze out blackheads yourself.
This is dangerous in the future spread of infection and the appearance of new pustular lesions. In addition, after mechanical opening of the pustular cavities, rough and unaesthetic marks remain on the skin. scarring.
Washing with warm water using antiseptic soap or a weak solution of furatsilin. After washing, carefully wipe the face with a cotton swab dipped in a solution of salicylic, chloramphenicol or boric alcohol.
If there are no ulcers, then you can carry out "salt" procedures- using a steam bath, steam your facial skin, then apply a mixture of soap foam, a few teaspoons of soda and salt (only fine salt, otherwise you can injure the skin even more). Perform the peeling procedure with light circular movements, then rinse your face with warm and cold water. Gently dry your face with a towel without rubbing, then apply a light moisturizer and non-greasy cream.
In any case, because acne may hide more serious diseases.
According to statistics, almost every person on the planet has at least once observed acne on their face, chest or back. Acne is an inflammatory condition caused by blockage of the sebaceous glands due to increased sebum production. During adolescence, most boys and girls who face the problem of acne often feel psychological discomfort from their presence. Acne is common in young people under 25 years of age, however, people older than this age may also suffer from acne.
Acne - what is it?
Clogging of the sebaceous glands leads to acne. The glands are blocked by accumulations of sebum and dead skin cells. Suitable conditions are created for the active proliferation of bacteria, which then causes pustules to appear on the skin. For teenagers, such changes are normal due to hormonal changes in the body.
Remember! The causes of acne are divided into several main types: endogenous, i.e. internal causes, and exogenous (external).
What refers to internal reasons:
- hormonal changes in boys during the period of a surge of hormones, in girls before menstruation;
- immune status, chronic diseases (for example, acne around the mouth and on the chin in women can signal problems with the ovaries);
- gastrointestinal and liver diseases;
- infectious agents;
- in adults, seborrhea is a common cause;
- heredity: the sebaceous glands react painfully to an increase in testosterone levels in women and men. An important role is played by the size, quantity and secretory activity of the sebaceous glands, determined genetically.
External causes affecting the appearance of acne:
- Contact of the skin and substances with a comedogenic effect, leading to clogging of the sebaceous glands and roughening of the skin (hyperkeratosis). These are lubricants, oils, tar preparations, contact with which is possible in production.
- Abundant and constant application of fat-containing cosmetics: blush, powder, tanning oil.
- Excessive exposure to the sun, accompanied by the use of oily sunscreens, leads to the formation of acne.
- Friction and pressure of clothing on the skin, an aggravating factor is increased sweating of a person. Skin injury.
- Poor personal hygiene, untimely exfoliation of dead skin cells.
- Taking hormonal drugs, steroids.
- Stressful situations that activate the adrenal glands, promoting an increased release of hormones.
The development of acne goes through several stages: excess production of sebaceous glands, thickening of the skin layer, activation of bacteria, and inflammatory process.
The enlargement of the sebaceous gland occurs under the influence of increased secretion. Enlarged pores become visible on the face. Thickening of the layer of horny scales at the mouth of the duct due to an increase in the rate of their exfoliation. In a short time, dead cells completely clog the duct, sebum is not removed, but stretches the cavity of the sebaceous gland, gradually accumulating there. Inside, bacteria multiply, which are common inhabitants of the microflora of the sebaceous glands, but when actively multiplying, they lead to inflammation.
A clogged gland filled with sebum is called a comedon. A comedone that does not reach the surface remains under the skin and becomes a whitehead. The comedone that comes out undergoes partial oxidation with an admixture of melanin, giving a black color to its head - these are blackheads.
Important! There are so many reasons for the development of acne that its appearance is a reason to seek advice from a dermatologist. Hormonal disorders are eliminated by an endocrinologist, and external manifestations are eliminated by a cosmetologist.
Classification of acne by severity
There is a division of acne by type and severity of skin damage.
Acne grades:
- Mild degree. There are no inflammatory processes, the presence of comedones and acne (papules, pustules) in small quantities (no more than 10 pieces) is noted. There are usually no complications during treatment.
- Moderate degree of the disease. More open and closed comedones (10-25 pieces), more pimples. Treatment is long, up to 2 months, but the prognosis is favorable.
- Severe degree of development of the disease. The number of papules, pustules, comedones increases sharply (30, 50 pieces each). Specialized medical therapy is required.
- Extremely severe. Large numbers of rashes of varying severity on the skin: cysts, nodules, pustules, papules. There are a lot of comedonal rashes. Complex therapy is required.
Acne on the face, back, and chest in large quantities should not be ignored. Self-medication in this case is not the best option.
Remember! Pharmacy products used without a doctor's prescription are unable to properly cope with the problem. It is almost impossible to choose the right remedy on your own.
Types of acne
The inflammatory process in the sebaceous gland caused by its blockage can be of different types and have different origins.
Acne vulgaris
This is usually teenage acne, which is the norm for many teenagers, and disappears in most of them by the age of 20. Such acne can occur in a small percentage of adults; they are caused by disturbances in the gastrointestinal tract, liver, and endocrine disorders.
First, the skin becomes covered with small red pimples, which then open up, forming a purulent cavity. May leave behind scars and skin pigmentation disorders.
What is characteristic of them:
Pay attention! The physiological variety of such acne can be observed at both 40 and 60 years of age.
Milia are whiteheads that develop as a result of increased activity of the sebaceous glands. They can be primary or clinical. The first type occurs as a consequence of some kind of exposure, for example, sunlight. The clinical appearance is a consequence of inflammation or trauma to the skin.
Such acne is not very large, about the size of a pinhead (2-3 mm), dense white or yellowish formations, similar to grains. They like to be located on the cheeks, temples, around the eyes or on the nose. There are both single and group rashes.
To put it in simple language, milia is sebum that has no way of exiting and has accumulated in a closed pore. The white head is due to lack of contact with the surface.
Remember! Whiteheads form due to an unhealthy lifestyle, excessive exposure to the sun, consumption of large amounts of fried, salty, smoked foods, leading to the accumulation of toxins.
Gastrointestinal diseases, hormonal imbalance, climate change, lack of basic facial hygiene play a big role in the occurrence of skin imperfections. The white rash is not immediately noticeable and is usually not given due attention.
Dilatation of blood vessels, characteristic of people over 30 years of age, may be accompanied by the appearance of red nodules (papules) that pass into the purulent stage. More often affects women.
Distinctive features:
- persistent redness of the face (forehead, nose, chin, cheeks), which may spread to the back and chest;
- rash on the face, starting with ordinary redness, becoming acne;
- in the later stages, the skin in the area of redness thickens;
- the vessels dilate, the vascular network is reddened;
- pain, dryness, sensation of a foreign body or sand in the eyes, lacrimation, redness of the eyes.
Important! Prolonged exposure to cold or sun leads to a sharp deterioration in skin condition.
Blackheads (comedones)
A form of acne without inflammation, usually located on the face (cheeks, forehead, nose, chin), less often on the chest and back. Malfunctions of the sebaceous glands, problems with the thyroid gland, ovaries, and eating fatty and carbohydrate-rich foods are responsible for such rashes.
The most effective method of combating is facial cleansing, but the effect does not last too long and skin cleansing must be systematic. The older a person is, the less activity of the sebaceous glands, and the number of blackheads formed decreases.
The occurrence of such acne is explained by taking various hormonal drugs. Usually they do not cause significant harm to the body, but significantly spoil the appearance. Typically, drug withdrawal acne goes away, which can be a difficult task if a person is on certain medications.
Acne of this type is a small pustular rash, bright red in color. They can cover almost the entire surface of the body, especially if the medicine was taken orally or on a separate area treated with ointment.
Attention! Such rashes are characterized by severe itching and burning.
Located on the arms, legs, neck, back, and abdomen are piled-up spherical acne, formed in the deep layers of the skin and in the subcutaneous fatty tissue. A separate variety is painful, compacted acne of a blue-purple hue. Pustules may be located in the center of some lumps. More often this type is found on the cheeks, back, chest, and neck. They can appear at any age and most often affect the male population.
What causes them to appear:
- stressful conditions, psycho-emotional overload, depressive states;
- hormonal disorders, diabetes mellitus, dysfunction of the endocrine glands;
- chronic form of infectious diseases;
- increased amount of bromine and iodine in the diet;
- taking certain medications;
- negative impact of the external environment, smoking.
The surface of such eels is uneven, they are often grouped. They may leave scars behind.
Such acne occurs in adults and adolescents. Occur as a result of the accumulation of a large amount of pus due to inflammation of the ducts of the sebaceous glands. The back, shoulders, neck, chest, and face are most often affected.
White pimples are subcutaneous pustules filled with pus. The red pimple located inside is an area of inflamed skin that enlarges as a result of swelling.
Appear due to:
- hormonal disorders, problems with the functioning of immune cells;
- skin diseases, subcutaneous mite activity;
- diseases of the gastrointestinal tract, liver;
- mechanical impact on the gland;
- poor nutrition;
- increased sweating;
- genetic predisposition, chronic diseases.
A pimple located under the skin is difficult to eliminate; the skin of the face and body looks repulsive. If you squeeze pimples yourself, you can end up with severe skin damage, blood poisoning, and scarring.
Acne treatment should begin with an examination to identify the causes of the problem. You may need to visit an endocrinologist, gastroenterologist; women and girls should consult a gynecologist. They may take blood and urine for a general analysis, blood for biochemistry, hormone tests, stool analysis for dysbacteriosis, and ultrasound diagnostics may be required.
If the rash is mild, then an acne remedy suitable for a specific skin type may be recommended: acne creams, gels, ointments and lotions containing the necessary components to combat comedones, reduce sebum secretion, and eliminate inflammation. These are products containing tretinoin, azelaic acid, benzoyl peroxide.
Moderate and severe degrees are treated with antibiotics; hormones may be prescribed if a hormonal imbalance is detected.
What means to use for treatment:
- Antibiotics. Minolexin is considered the most effective. Available for use in children over 8 years old. It dissolves well in fats, which allows it to act more effectively on the clogged sebaceous gland.
- Sebostatic drugs: Isotretinoin. For severe forms of skin lesions.
- Hormonal therapy. The drug is prescribed by a doctor.
Review
Acne (acne) appears in most people at a certain age. Acne is accompanied by the appearance of inflamed pimples - rosacea and blackheads - comedones on the skin of the face, back and chest.
Doctors call the appearance of pimples on the face and other parts of the body acne. This is a chronic lesion of the sebaceous glands and hair follicles of the skin, which affects about 93% of people of both sexes aged 12 to 30 years. Most often, acne occurs in girls aged 14 to 17 years, and in boys - from 16 to 19. With age, symptoms begin to gradually subside. In some cases, acne persists in adults. Approximately 5% of women and 1% of men suffer from acne after age 25.
Acne on the face and body is most often associated with hormonal changes during puberty. Under the influence of certain hormones, the sebaceous glands produce more sebum than required. Because of this, bacteria living on the skin become more aggressive, causing inflammation and the formation of pus. Hormones can also cause the inner lining of the hair follicle to thicken, causing the pore (opening in the follicle) to become clogged. Regular washing does not remove this blockage.
Keeping your skin clean is important, but it won't help prevent acne. Wash acne-prone areas twice daily with soap or cleanser, but do not scrub or scrub the skin too hard to avoid irritation. If your skin is dry, apply a moisturizer to it. Pharmacies sell a variety of creams, lotions and gels for treating acne. A dermatologist can give you advice on choosing a remedy for acne.
The choice of treatment tactics for acne depends on the severity of acne:
- I degree (mild)- the skin contains white (milia) and black (comedone) acne, papules and pustules - single;
- II degree (medium)- there are papules and pustules, most of all on the face;
- III degree (moderately severe)- there are many papules and pustules, single deep-lying nodes - subcutaneous pimples, acne spreads to the chest and back;
- IV degree (severe)- There are many large painful pustules, subcutaneous nodules and cysts.
Acne is one of the most common diseases and yet people know very little about it. Listed below are some of the most common myths and misconceptions about acne:
- Acne on the face appears from poor nutrition. To date, scientists have not discovered a single product that causes acne. Proper balanced nutrition is recommended because it is beneficial for the health of the skin and the body as a whole.
- Acne appears due to poor hygiene. Most of the biological reactions that can cause acne occur under the skin, not on it, so clean skin has little effect on your likelihood of developing acne. Washing your face more than twice a day can only harm your skin.
- The best way to get rid of acne is to squeeze the pimples.. This can only worsen the symptoms, and later leave scars on the skin.
- Acne may be affected by sexual activity. Having sex or masturbating has no effect on acne.
- If you sunbathe in the sun or in a solarium, the symptoms of acne will go away. There is no convincing evidence that prolonged sun exposure or tanning beds can improve acne symptoms. Many medications taken to treat acne make your skin more sensitive to light, so sun exposure can be harmful and painful, not to mention an increased risk of skin cancer.
- Acne is a contagious disease. You cannot infect other people with acne.
Symptoms of acne (acne)
Acne is accompanied by the appearance of pimples and excess oily skin. In rare cases, skin temperature may increase and pain when touched. Most often, acne develops on the face, in 50% of cases - on the back and in 15% of cases - on the chest. Skin rashes due to acne are varied. Conventionally, several elements of the rash can be distinguished, which are usually combined with each other:
- Blackheads (comedones)- small black or brown raised dots that appear on the skin. These are clogged hair follicles (bulbs). The black color of the “plug” is not caused by dirt, but by a pigment (melanin) that is secreted by the inner lining of the follicle.
- Whiteheads (milia, millet)- white small grains under the skin that cannot be squeezed out without damaging the skin.
- Papules- small red bumps, sometimes painful to touch.
- Pustules (pustules)- the next stage of development of the papule, when its contents suppurate. Pustules have a yellow-white “head”.
- Nodules- large dense and painful formations located deeper under the skin. After healing, scars may remain.
- Cysts- the most severe type of acne rash. They are large boil-like ulcers, the skin over which may acquire a bluish-purple color. They most often leave scars behind.
Causes of acne
Sebaceous glands are located shallow under the skin. They attach to hair follicles, small openings in the skin from which individual hairs grow. The sebaceous glands produce sebum, which lubricates the hair and protects the skin from drying out.
With acne, the glands produce too much sebum, which is a good nutrient medium and contributes to the rapid proliferation of various bacteria that are normally present on the surface of the skin.
In parallel with the increase in skin greasiness, its renewal accelerates; the upper layers of the skin age faster, becoming dense and exfoliating. Sebum mixes with dead skin cells, and a plug is formed that closes the duct of the sebaceous gland and follicle, comedones and milia are formed. Bacteria can enter clogged follicles, causing the skin to become inflamed and cause pimples.
Testosterone as a cause of facial acne
It is believed that increased levels of the hormone testosterone contribute to the development of acne - this usually occurs during puberty. Testosterone plays an important role: in boys it stimulates the growth and development of the penis and testicles, and in girls it is responsible for strong muscles and bones.
The sebaceous glands are especially sensitive to hormones. It is believed that due to increased testosterone levels, they produce more sebum than normal.
Hereditary predisposition to acne
Acne (acne) can be inherited. If both parents suffered from acne, then the likelihood of acne in the child exceeds 50%. In addition, according to the results of one study, in such families, the severity and severity of acne in children is usually greater than in parents. It was also found that if one or both parents had acne as an adult, the child was also more likely to develop acne after age 20.
Acne in women
Women account for over 80% of all cases of adult acne. It is believed that acne is often caused by hormonal changes that occur in the body, in particular:
- In some women, acne worsens before menstruation;
- acne symptoms may worsen during pregnancy, especially in the first trimester (first three months);
- acne is often observed against the background of polycystic ovary syndrome, a common disease that is accompanied by weight gain and the formation of small cysts in the ovaries.
Acne in adult women is often accompanied by symptoms such as excessive body hair growth (hypertrichosis) or menstrual irregularities.
Other risk factors for acne
The following can cause acne to worsen:
- some cosmetic products - this is rare, since most modern products are dermatologically tested and do not cause acne;
- certain medications such as steroids, lithium (used to treat depression and bipolar disorder), and certain antiepileptic drugs (used to treat epilepsy);
- regularly wearing items that put pressure on areas of the body with acne, such as a headband or a backpack on the back;
- Smoking can contribute to acne in older people.
How to get rid of acne?
There are many remedies for acne. The choice of a specific method and duration of treatment depends on the severity of the acne. Sometimes it takes several months for your skin to improve. If you only have a few acne, you can cure them yourself by following skin care rules and using medicinal cosmetics.
Acne treatment should begin with the following measures:
- Try not to touch your face with your hands or other objects during the day, this will pollute your skin.
- Do not cleanse your face too often using cosmetics, including soap. Overuse of hygiene procedures can cause irritation and worsen symptoms.
- Wash with warm water and special cleansers such as lotions or soaps with a neutral or acidic pH. Water that is too hot or cold can make acne worse.
- Do not squeeze inflamed pimples yourself. This can lead to the spread of infection and worsening of acne. The most dangerous pimples are those located on the face in the area of the nasolabial triangle. Squeezing out purulent pimples in this area can result in complications dangerous to life and health: thrombosis of the cavernous sinus of the brain with loss of vision, meningitis - inflammation of the meninges and abscess (abscess) of the brain.
- Do not overuse makeup and cosmetics. Use water-based products (they are less likely to clog skin pores).
- Remove makeup completely before bed.
- If you have dry skin, opt for water-based moisturizers without fragrance.
- Exercise. This will not make acne go away, but it will improve your mood and self-esteem. Take a shower immediately after training, as sweat worsens the condition of the skin.
- Wash your hair regularly and tie your long hair into a bun and don't let your hair fall on your face.
An effective remedy for acne at home are gels and creams containing benzoyl peroxide, which are sold in pharmacies without a prescription. Treatment sometimes lasts up to three months, so don't expect results the next day. If available acne treatments do not help, consult a dermatologist. The doctor will be able to prescribe more effective medications.
There are a number of methods for treating acne without the help of drugs. These include the following:
- mechanical squeezing of acne using various cosmetic instruments - extractors for removing acne, Uno spoon, Vidal needle, etc.;
- chemical skin peeling- a special chemical solution is applied to the face, after which the upper stratum corneum of the skin is removed, and a new one is formed under it;
- photodynamic therapy with aminolevulenic acid - acne is treated with light; a course of 6 sessions is prescribed at an interval of two weeks.
These treatments are not effective in all cases of acne.
People often write on the Internet that individual pimples can be dried with toothpaste. It does contain antibacterial substances, but it also contains other compounds that irritate and damage the skin. The doctor can offer much more effective and safe treatment methods. It is better to use toothpaste for its intended purpose.
The following medications can be used to treat acne:
- topical (local) retinoids;
- local antibiotics;
- azelaic acid;
- antibiotics in tablets;
- for women - combined oral contraceptive;
- isotretinoin tablets.
If you have severe acne, such as with a large number of papules and pustules on the chest, back and face, or if you have painful subcutaneous pimples (nodules), you need help from a dermatologist. As a rule, for severe acne, a combination treatment consisting of antibiotic tablets and local treatment is first prescribed. If this doesn't help, your doctor may prescribe a medicine called isotretinoin.
Hormone therapy or combined oral contraceptives may be the treatment of choice for women, but acne can sometimes be worsened by taking progestogen pills or using a contraceptive implant.
Benzoyl peroxide in the treatment of acne
Benzoyl peroxide has two functions:
- prevents dead skin from clogging hair follicles;
- kills bacteria on the skin, preventing inflammation.
Benzoyl peroxide usually comes in cream or gel form. 5% benzoyl peroxide should be applied to clean and dry skin 1-2 times a day for 1-3 months. When using the drug, dry skin is possible, as well as an increase in its photosensitivity, so you need to protect exposed parts of the body from exposure to the sun in the summer or use sunscreen. Avoid getting benzoyl peroxide on fabrics or hair, as it may discolor them.
Typical side effects when taking benzoyl peroxide:
- dryness and tightness of the skin;
- burning, itching or tingling sensation;
- redness and peeling of the skin.
Side effects are usually mild and should subside after treatment is completed. Most often, a six-week course of treatment is prescribed, after which the acne goes away completely or almost completely. Your doctor may also recommend that you continue treatment as a preventive measure and reduce the frequency of treatment.
Topical retinoids for acne
Topical retinoids suppress sebum production by preventing dead skin cells from clogging hair follicles. Topical retinoids tretinoin and adapalene are used to treat acne. They come in the form of a gel or cream and are usually applied once a day before bed to areas of the face with acne, 20 minutes after washing. A six-week course of treatment is usually prescribed, but after it is completed, your doctor may recommend that you continue it at less frequent intervals.
Topical retinoids should be applied gradually and contact with sunlight and ultraviolet radiation should be avoided. The most common local side effect is mild irritation and tingling of the skin. Topical retinoids should not be used during pregnancy as they can cause birth defects.
Topical antibiotics for acne treatment
Topical antibiotics kill bacteria on the skin that can cause inflammation in clogged hair follicles. These products are available in the form of a lotion or gel, which is applied to the skin 1-2 times a day.
A six or eight week course of treatment is usually prescribed. Longer use of topical antibacterial agents for acne is not recommended, as microbes can become resistant to antibiotics. This can cause acne to worsen, and new foci of inflammation will appear.
Side effects of topical antibiotics are uncommon. These include:
- mild skin irritation;
- redness and burning of the skin;
- peeling of the skin.
Treatment of acne with azelaic acid
Azelaic acid is often used as an alternative acne treatment when benzoyl peroxide or topical retinoids cause side effects or are not effective. Azelaic acid removes dead skin particles and kills bacteria. It comes in the form of a cream or gel and is usually applied 2 times a day (or 1 time for particularly sensitive skin).
Azelaic acid does not increase skin sensitivity to sunlight, which distinguishes it from other anti-acne agents. Acne usually starts to go away after a month of treatment.
Azelaic acid generally has mild side effects, which include:
- burning and tingling sensation in the skin;
- dry skin;
- redness of the skin.
Antibiotic tablets for acne
Oral antibiotic tablets are usually used in combination with topical treatments for severe cases of acne. The most commonly prescribed antibiotics are the tetracycline class; for pregnant or breastfeeding women, erythromycin. Typically, acne symptoms begin to subside within six weeks.
The course of treatment may take from 1 to 6 months, depending on your tolerance to antibiotics. In the first weeks of treatment, tetracyclines may increase the skin's sensitivity to sunlight and ultraviolet radiation and may reduce the effectiveness of birth control pills. Therefore, during treatment you need to use another method of contraception.
Hormonal therapy for acne
Hormonal therapy methods are most effective in women with acne, especially if acne worsens during menstruation or is associated with polycystic ovary syndrome and other dyshormonal diseases. Your doctor may prescribe you a combined oral contraceptive (COC) even if you are not sexually active. This often helps relieve acne symptoms. However, treatment periods sometimes extend up to a year.
Hormonal treatment of acne in girls who are not sexually active is prescribed only if the acne does not respond to treatment with antibiotics and other available remedies. This is due to the presence of side effects from long-term use of oral contraceptives. Thus, combined oral contraceptives slightly increase the risk of blood clots in blood vessels, and can also provoke the development of breast cancer. Although the likelihood of these complications is low. Other side effects of COCs:
- spotting between periods - usually goes away after a few months of use;
- headache;
- pain in the mammary glands;
- mood swings;
- loss of interest in sex;
- weight gain or loss.
Isotretinoin as a treatment for acne
Isotretinoin has a number of beneficial effects on acne:
- helps normalize and reduce sebum secretion;
- prevents blockage of hair follicles;
- reduces the number of bacteria on the skin;
- relieves redness and inflammation.
However, due to the large number of side effects present, this drug is recommended to be taken only in severe cases of acne, when the skin does not respond to other treatments. The drug is available in tablet form. As a rule, a course of treatment is prescribed for 4 to 6 months. In the first 7-10 days of treatment, acne may worsen, but this is normal and will soon go away.
Typical side effects when taking isotretinoin:
- inflammation, dry skin in the area of the lips and nostrils and the formation of cracks in them;
- changes in blood sugar levels;
- inflammation of the edges of the eyelids (blepharitis);
- inflammation and irritation of the eyes (conjunctivitis);
Rare side effects when taking isotretinoin:
- liver inflammation (hepatitis);
- inflammation of the pancreas (pancreatitis);
- renal failure.
Because of the risk of these rarer side effects, blood tests will be required before starting and during treatment.
Isotretinoin has a teratogenic effect on the fetus, so before starting treatment you need to test for pregnancy and exclude it. During the course of therapy, you need to protect yourself from conception using reliable methods. If there is a need for treatment with isotretinoin after childbirth, breastfeeding will have to be stopped.
There are reports of people experiencing mood swings while taking isotretinoin, and although there is no evidence that they were caused by this drug, as a precaution, tell your doctor if you experience any depression, anxiety, aggression, or suicidal thoughts.
Post-acne: acne marks and spots
A complication of moderate and severe forms of acne is often the formation of spots and scars on the skin. This is called post-acne. Most often, marks remain after large subcutaneous pimples and cysts. The likelihood of scarring on the skin also increases after attempting to squeeze out pimples on your own.
Acne marks can look like small holes in the skin that resemble punctures with a sharp object, areas of bumpy skin as a result of the formation of keloid scars in its thickness, as well as rounded crater-like impressions. Acne marks may also remain.
Currently, many clinics offer post-acne treatment services (scar removal). However, it is worth considering that thanks to the successes of modern aesthetic medicine, you can significantly improve the appearance of your skin, but you will not be able to completely get rid of scars. After post-acne treatment, most people notice an improvement in their appearance by 50–75%. Below are some scar treatment methods.
Facial resurfacing (dermabrasion)
Facial resurfacing involves removing the top layer of skin using a laser or a special tool in the form of a metal brush. The skin will be red and sore for a few months after the procedure, but once it has healed, you should notice that the scarring is less noticeable.
Laser treatment
Laser treatment is used to treat small to medium sized scars. There are two types of laser treatment:
laser ablation - using a laser, a small area of skin around the scar is removed, after which new, smoother skin grows;
Non-ablative laser treatment - laser stimulates the production of collagen (a protein found in the skin), which smoothes the surface of the skin.
Surgical operations for post-acne
Removal of atrophic and stamped scars is also carried out surgically. There are four types of such operations:
- Punch excision- used to treat pinpoint deep scars that look like holes in the skin. The scar is cut out and the edges of the incision are sutured. After healing, the skin looks smoother.
- Punch elevation- used to treat scars that resemble a funnel on the skin. The base of the scar is surgically cut away, leaving the edges behind. The base is then attached to the edges, leveling the surface of the skin. The scar becomes much less noticeable.
- Punch grafting- used to treat very deep atrophic scars. As with punch excision, the scar is removed, but then a “patch” of skin taken from another location (usually from behind the ear) is inserted into the incision.
- Subcision is a surgical procedure that can be performed to treat keloid scars. The top layer of skin separates from the underlying scar tissue, causing blood to pool there. It helps form connective tissue that pushes the keloid scar to the surface of the skin. After subcision, laser treatment or skin resurfacing may be used to improve the appearance of the scar.
Depression due to acne
Acne often causes feelings of extreme anxiety and stress, which can sometimes cause people to become socially withdrawn. This can lead to depression. Symptoms of depression include persistent feelings of sadness, depression, or hopelessness. A person is not interested in anything and does not make him happy.
If you think you or your child is depressed, see a therapist. Treatment for depression usually takes the form of talk therapy (such as cognitive behavioral therapy) and antidepressants called selective serotonin reuptake inhibitors (SSRIs).
You can hide scars on your face using cosmetics. There are special products for camouflage makeup. You can also ask a cosmetologist for a recommendation.
When to see a doctor for acne
Even in mild form, acne can cause cosmetic defects. If this bothers you or if you can't deal with acne on your face on your own, consult a dermatologist. Be sure to visit a doctor if acne is severe: deep nodules, cysts and pustules form on the skin in large numbers. Proper treatment will help minimize the risk of scarring on the skin.
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All site materials have been checked by doctors. However, even the most reliable article does not allow us to take into account all the features of the disease in a particular person. Therefore, the information posted on our website cannot replace a visit to the doctor, but only complements it. The articles have been prepared for informational purposes and are advisory in nature.
A disease of the sebaceous glands, characterized by blockage and inflammation of the hair follicles, is called acne ( acne), or acne. The variety of causes and clinical manifestations of acne, its frequent occurrence at different ages, and the cosmetic problems it causes make this disease relevant to many medical specialists. The main elements of acne are pustular and papular acne, comedones, nodules and cystic cavities. An individual and comprehensive approach plays an important role in the effective treatment of acne.
General information
A disease of the sebaceous glands, characterized by blockage and inflammation of the hair follicles, is called acne(acne), or acne. The variety of causes and clinical manifestations of acne, its frequent occurrence at different ages, and the cosmetic problems it causes make this disease relevant to many medical specialists.
The concept of “acne” reflects the cause-and-effect dependence of skin manifestations on the general condition of the body. Infections, disorders of the genetic, endocrine and immune systems, digestive and neuropsychic disorders play a large role in the occurrence of acne.
Acne occurs at almost any age: from the neonatal period to old age. Previously, acne was considered a purely teenage problem, but over the past decades, cases of acne in patients 25-35 years old have become more frequent. The most common form of acne is juvenile acne, observed in patients 12-24 years old in almost 90% of cases. Acne brings a lot of worries about their appearance to people of any gender and age.
Signs of acne
Eruptive elements in acne are represented by closed and open comedones, papular and pustular acne, nodular and cystic formations. Closed comedones are non-inflammatory white nodular formations that do not reach the surface of the skin. Further accumulation of sebaceous gland secretions, epithelial cells, pigment, and dust in the pores leads to the formation of open comedones with a black tip protruding above the surface of the skin. Typical locations for comedones are the skin of the forehead and chin.
Further addition to the existing blockage of the hair follicle of the inflammatory process leads to the development of papulopustular acne, and in severe forms - cystic cavities, phlegmonous and necrotic acne elements. Papular acne (Latin “papula” - nodule, pimple) is a raised, dense lump above the skin up to the size of a pea, reddish-bluish in color. Multiple papules give the skin an uneven appearance. Papules may undergo reverse development or further development into pustules. Pustular acne (Latin “pustula” - pustule) is a painful vesicle with purulent contents of a softer consistency than a papule. Small pustules, up to 5 mm in diameter, usually heal without a trace; large pustules often leave scar defects.
Further development of inflammatory elements of acne can lead to the appearance of nodes and cystic cavities. The nodes are large infiltrates (more than 5 mm in diameter) located in the dermis and subcutaneous fat. With reverse development, the nodes disintegrate, ulcerate and heal with a scar. Cysts are cavity formations filled with pus, purple-bluish in color. Healing of cysts also occurs with the formation of a scar.
Mechanism of acne development
The mechanism of acne is due to the mutual action of 4 factors:
- Excessive increase in the secretion of the sebaceous glands. Hypersecretion of sebum leads to a decrease in its bactericidal properties and a change in consistency. The secretion of the sebaceous glands becomes dense, forming plugs in the ducts and blocking them. Often observed during rapid puberty in adolescents and in the last week of the menstrual cycle in women.
- Follicular hyperkeratosis. The development of follicular hyperkeratosis is based on a disruption of the normal process of constant renewal of hair follicle cells. Thickening of the superficial stratum corneum of the hair follicles, along with sebaceous plugs, creates an additional obstacle to the outflow of sebaceous gland secretions.
- Reproduction of propionic acne bacteria(Propionibacterium acnes). Microorganisms that live in large numbers on the skin of healthy people, under certain conditions, can cause the development of acute inflammatory reactions. The sebaceous-horny plugs of hair follicles are a favorable environment for their increased reproduction and active life. The leading role in the appearance of acne belongs to propionic acne bacteria.
- Inflammation. The active proliferation of propionic acne bacteria leads to a tissue response and the development of inflammation in them.
Endogenous causes of acne
The basis for the appearance of acne is a dysfunction of the sebaceous glands - hypersecretion of sebum. This occurs under the influence of a number of internal and external reasons that create favorable conditions for the development of acne.
Testosterone and acne
One of the most common causes of acne in adolescence is hormonal changes in the body. The active release of steroid hormones, especially androgens - male sex hormones, in both girls and boys causes increased secretion of the sebaceous glands. Sebum changes its properties, turning from liquid to dense and viscous.
Features of hormonal levels and skin reactions can be inherited. Therefore, the likelihood of teenage acne in young people whose parents suffered from acne is much higher than in their peers with no family history.
Premenstrual acne
The level of steroid hormones in women fluctuates during the menstrual cycle and increases in its final phase. This circumstance is associated with the appearance of acne approximately a week before menstruation in 70% of women. Even those who do not suffer from acne often notice the appearance of single pimples on their chin on the eve of their period.
"Hormonal" acne
The appearance of pimples and acne during adolescence is physiologically determined. However, if acne persists into adulthood, then this is a serious signal to think about your health. Typically, the presence of such acne indicates disturbances in the production of sex hormones.
In women, so-called hormonal acne can be caused by polycystic ovary syndrome, pregnancy or abortion, i.e. conditions associated with sudden changes in hormonal levels.
Surgical procedures are not widely used in the treatment of acne, because they lead to the formation of rough scars. In the treatment of abscess forms of acne, it is possible to inject purulent foci with corticosteroid drugs.
From the experience of complex acne treatment
As practice shows, the best results are achieved by an integrated approach to treating acne. Since it was previously noted that doctors of many specialties are called upon to solve the problem of acne in the community, the observed patients with acne had to undergo a comprehensive examination by a dermatologist, gastroenterologist, endocrinologist, and gynecologist. The choice of methods and duration of treatment was determined by the severity and severity of acne, taking into account individual characteristics.
On average, the course of acne treatment was 7-8 months. At the first stage, it included external treatment with azelaic acid and metronidazole gel, as well as doxycycline. Additionally, cryomassage and darsonvalization were prescribed. A month later, the course included chemical peeling with fruit acids in gradually increasing doses. At the same time, correction of identified disorders in the endocrine, reproductive, and digestive systems was carried out. A month later, an interim assessment of the effectiveness of acne treatment showed a stable trend towards improvement: the disappearance of pustular rashes was noted in 89%, a reduction in the number of comedones - in 71.2% of patients, and the process of sebum secretion decreased. Subsequently, stable remission was observed.
Acne treatment prognosis
When predicting the long-term results of acne, the following points should be considered:
- Acne is a chronic, intractable disease, since hereditary predisposition or provoking factors can cause a new exacerbation, even if the disease has not recurred for several years. However, knowing the reasons that provoke a new wave of acne, you can clearly control and quickly relieve exacerbations of acne, prevent the development of gross cicatricial changes in the skin (post-acne) and the formation of persistent cosmetic defects.
- If the disease has already occurred, then the changes in the skin are irreversible, and it will not be possible to achieve its previous ideal state.
- A full course of acne treatment is a long process, taking 4 months or more.
- Treatment of acne can occur with exacerbations of the process, especially in the first months, when the mechanisms of disease development are suppressed.
- It is necessary to carry out a full course of acne treatment, without interruptions, even if there is a noticeable improvement. Untreated acne can manifest itself with a new exacerbation at any time.
Despite the fact that adult acne is a disease that will accompany you throughout your life, you should not despair. A modern selection of methods and preparations for external and systemic use can significantly alleviate the course of acne, carry out timely prevention of its exacerbations, and avoid serious complications and destructive changes in the skin. Today, acne treatment is carried out at all stages of the disease, allowing one to achieve good cosmetic results and long-term remission.
Acne, or acne, usually appears during adolescence and goes away after a few years. But in some cases, painful symptoms in the form of red bumps, pimples, white and blackheads on the face remain longer, and young people suffer from complexes because of their appearance. However, do not despair, everything is in your hands. If you watch your diet, maintain hygiene, avoid bad habits and, of course, regularly use various anti-acne medications, your facial skin will become clean and soft, like a child’s.
The main rule: you cannot squeeze out pimples and blackheads yourself. You will only worsen your situation and ignite the inflammatory process - so you are not far from the severe stage of acne. When starting facial treatments, be sure to thoroughly cleanse the skin of dirt, sweat and excess oil. Instead of washing your face with water in the morning, wipe your face with ice cubes made from brewed St. John's wort or chamomile. Ice will tighten your pores, herbs will soothe your skin and reduce inflammation.
Curing acne at home is not so difficult if you regularly and properly care for your facial skin. Believe in yourself, imagine your skin clean and silky, smile at the whole world and tune in to a complete recovery - and you will be convinced of your beauty and uniqueness. Thoughts are material, the main thing is to believe in yourself!
