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The sight of a young man with acne is not surprising. Without underestimating the emotions of a teenager, as adults we recognize that “it must be so”. Because of puberty, because of hormones. But when acne lesions appear in our forties, it causes panic. Because there is a problem with them: they are not easy to hide and difficult to cure.
Juvenile acne and acne in adults – how is it different?
Until some time, the term “acne” was supplemented by dermatologists with the term “youthful” because it included the skin of adolescents. We used to consider pustules as an integral part of the next 3-5 consecutive years of young people’s lives.
It was assumed that – leaving traces of its presence or not – this ailment passed with the end of the hormonal storm. In recent years, however, it has turned out that – especially in the case of women – acne does not end at the age of puberty, and can continue through the years of sexual maturity, be muted during pregnancy, and become the bane of 40- or even 50-year-old women again. .
Worse still, bad luck so bad that some people experience acne from adolescence throughout adulthood.
Myths about acne
Let’s overthrow the first stereotype. Adult acne is not the result of an endocrine disruption. Dr. Ewa Chlebus from the NovaDerm clinic in Warsaw explains that in only 7% of women over 30 years of age, the specialist in the treatment of this ailment. hormones play any role in the formation of inflammatory skin eruptions. Yes, just a few years ago, attempts were made to treat acne with birth control pills, and temporarily positive results were achieved. It turned out, however, that after discontinuing the pills, the problem returned. It just goes to show that girls who take birth control pills early are likely to postpone the time when acne develops anyway.
So if not hormones – then what? First: stress, dermatologists said. It increases the over-reactivity of androgen – the hormone responsible for the overproduction of sebum, the substance with which everything begins in acne. Second: our diet. If we can talk about constant changes for the worse in some area of life, it will be nutrition. Research results indicate that we may blame high-glycemic products. Why? Because the sudden increase in the level of insulin in the blood stimulates the production of androgens, which in turn intensifies seborrhea, and he – the formation of comedones. And here we debunk the second myth. The chocolate associated with acne is not the main culprit. Highly processed food, led by fast food, is sitting in the dock. Third: the sun. Because although the sun’s rays minimize the visibility of the pimples, it actually increases them later. This is why we experience the greatest acne nightmare in October (after holidays) and in April (after a winter trip to the mountains).
And the third myth: today’s cosmetics are unlikely to cause the acne we are talking about (there is a separate condition called “cosmetic acne”). In the past, when the formulas of most preparations had comedogenic features (i.e. clogging the pores) – this could have happened. Today, both care and color cosmetics usually have light, absorbable formulas. The skin beneath them “breathes”. If we should definitely avoid something in the case of acne-prone skin, it is perfumed, colored and multi-ingredient preparations.
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Acne therapy – what can it look like?
For reasons incomprehensible to dermatologists, the distribution of acne lesions on the faces of adolescents differs from those observed in adults. – Adult skin lesions are located on the lower part of the face, on the jaw, chin, and around the mouth. Adult acne is not disseminated, nor is it very severe (in terms of its extent), but it takes the form of persistent, not very advanced inflammatory changes, often on the basis of dry skin – says Dr. Barbara Pytrus, a specialist dermatologist and cosmetologist from the Platinum Therapeutic and Aesthetic Dermatology Clinic in Wrocław.
When asked how to treat acne, we get the answer: a therapy selected individually by a doctor. Since one form of treatment usually does not bring satisfactory results, combination therapy is most often used. As drugs, the so-called In the first-line treatment, in the most severe cases of acne (not responding to oral antibiotic therapy, with severe seborrhea and a tendency to scarring), oral retinoids (vitamin A derivative) – e.g. isotretinoin – are used.
A few words about her. It normalizes the differentiation of epidermal cells, reduces the accumulation of sebum in the hair follicles. It is very effective, it has made a huge progress in the treatment of the most severe forms of acne, but its therapy is not without problems. It must be systematic, lasting several months and carried out under constant medical supervision. Its administration is preceded by tests for cholesterol levels (its high level is a contraindication), for the duration of the therapy you cannot sunbathe (sun protection), undergo invasive cosmetic procedures, get pregnant or (in the case of men) try to have children for another 4 months after the end of therapy.
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The action of the drug is teratogenic (it can damage the fetus). A side effect of the therapy is also (temporary) severe drying of the skin and mucous membranes. So we must remember about preparations that restore proper hydration. As for antibiotics, they have found use in the treatment of acne due to their obvious antibacterial effects. For years, tetracycline, doxycycline, azithromycin and limecycline have been used mainly.
If there are no medical contraindications, we can try a cream treatment that can give quite good results. The condition is a wise selection of the cosmetic and regular use. For example, one of our partners recommends an acne cream based only on natural ingredients – Sevolium.
Anti-acne antibiotics – how do they work?
Oral drug therapy is supplemented, and over time – after achieving results – replaced with local treatment. Creams, gels, ointments containing antibiotics – erythromycin or clindamycin, topically applied retinoids or ordinary benzoyl peroxide are used here. When used as maintenance therapy, they reduce the amount of bacteria that cause acne, while reducing the ability of these organisms to become resistant to acne antibiotics. In modern acne treatment, prescription drugs (according to a doctor’s prescription) are no longer used.
At this point, there is no longer any question of unpleasant side effects. People with acne-prone skin are lucky that many substances used in the external treatment of these lesions are simultaneously used to eliminate the effects of skin aging. Therefore, ladies affected by acne can achieve the effect of “two in one”. The best example is retinol used in creams. It prevents disorders of the epidermis keratinization (the accumulation of dead cells on its surface), but also promotes the renewal of the epidermis, improves the connective tissue stroma, lightens discoloration, visibly reduces wrinkles.
The same applies to peels. For example, glycol peels, available in Poland for more or less 6 years, are on the one hand a form of acne therapy and its consequences, and on the other hand, they are used in all anti-aging treatments. Vitamin C also has a simultaneous rejuvenating and anti-inflammatory effect, its presence in creams both counteract free radicals and inhibit the production of pro-inflammatory cytokines.
Cosmetics for cleansing the skin and acne
What should we watch out for in everyday care? Creams with rich anti-aging formulas (the simpler the composition of the cosmetic, the better for problem skin), highly moisturizing preparations with mineral oils (we choose those with silicones in the composition), perfumed. Incredible as it sounds, dermatologists even warn against certain shampoos and hair conditioners. Quickly washing your hair over the bathtub or inadequate rinsing causes irritating substances to run down your forehead and cheeks, exacerbating acne lesions.
We must also avoid washing our face with ordinary soaps (they destroy the skin’s lipid coat) and the use of alcohol-based cleansing preparations. We use micellar liquids, gels and tonics for sensitive skin. It is good if they are based on salicylic or glycolic acid – they “stick” the epidermis and allow easier evacuation from the sebaceous glands. Washing gels for acne-prone skin are often enriched with particles that act as peels – both mechanical and chemical. And that’s a good thing: it helps to remove dead epidermis cells, stimulating its renewal and unblocking the pores.
However, do not use lotions to wash your face, and if you do, wash your face with water after removing make-up. The idea is to wash the sebum and dirt thoroughly, not to pat it into the skin. In general: cosmetics intended for people with acne should improve the appearance of the skin, mattifying it, reducing the severity of seborrhea, narrowing the pores, anti-inflammatory, and providing camouflage of changes.
Corrective makeup for acne
Why camouflage? Because the obvious need of a woman with acne-affected skin will be to cover up pimples. Therefore, it is best to use cosmetics available in pharmacies for the make-up of acne-prone skin. Some of them have additional healing properties, such as antibacterial and matting.
An emulsion foundation can be successfully used for oily and acne-prone skin with a small amount of efflorescence, while the compact one, containing much more pigment and volatile substances, which, after evaporation, leave the skin feeling dull – it works well for oily skin with enlarged pores and lots of skin lesions.
Loose powder – used to finish makeup – absorbs excess sebum, has a smoothing effect, can be used even in the case of irritated skin, as it protects it to some extent from harmful external factors.
Mechanism of acne formation
It all starts with the increased production of sebaceous gland secretions. Overproduced tallow becomes much thicker than usual and, unable to reach the surface of the skin, obstructs the openings of the sebaceous glands. This process is also accompanied by hyperkeratosis (keratinization) of the epidermis. In this way, sebaceous secretion becomes “trapped” in the skin. Micro-blackheads are formed, then closed blackheads (blackheads).
Such clogged sebaceous glands are an ideal place for the development of anaerobic bacteria. Anaerobes, under the influence of enzymes, break down the components of sebum into fatty acids, which in turn irritate the surrounding tissues, provoking inflammation.
Simultaneously with anaerobes, other microorganisms may enter the action: cutaneous staphylococcus, yeast, which additionally intensify secondary inflammatory reactions. Pimples, papules (pustular-papular acne) begin to form on the skin, then nodules, infiltrates, and finally purulent cysts and fistulas (pyoderma). This last stage of acne leaves scars on the face even after it has healed.