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It can be said that there is no person in the world who has not suffered the stresses of acne. Especially when this problem occurs at the most colorful and exciting period of life.
What do we know about acne from the point of view of medicine?
Common acne (Latin acne vulgaris) is a very common dermatological disease that affects the sebaceous glands and develops in adolescence. It most often affects people aged 12–20 years and is present in both female and male sex.
Acne is a disease with a complex mechanism of formation, which consists of several elements:
- disorders in the secretion of sebum – its excessive secretion
- disturbances in the sebaceous glands themselves – there is hyperkeratosis of the gland mouth and discharge ducts
- participation of bacteria – as a result of clogged sebaceous glands, excessive development of anaerobic bacterial flora, especially bacteria of the Propionibacterium genus, occurs inside them; under natural and physiological conditions, these bacteria are part of our skin flora
- inflammatory reaction – the effect of the first three components is the formation of an inflammatory process within the sebaceous gland and the formation of visible skin changes
Acne – a picture of the disease
Recognizing whether someone has acne is usually not difficult, especially when changes appear at a typical time of life and in characteristic places, the so-called seborrhoeic areas: on the face, shoulders, chest and back.
A classic skin lesion in the course of acne is a blackhead (I eat) – it is a non-inflammatory initial eruption, from which inflammatory skin lesions such as pustules, papules, cysts or nodules may develop at a later stage of the disease. Depending on the predominance of individual skin lesions, several forms of acne vulgaris are distinguished:
- blackhead acne
- maculopapular acne
- nodular cystic acne
- pyoderma – characterized by a large number of inflammatory skin lesions, both superficial and deep
- concentrated acne – this type is characterized by the predominance of deep skin lesions (cysts, nodules), often located close to each other and sometimes merging
- scarring acne – characterized by the formation of adherent scars at the site of inflammatory lesions
- fulminant acne – a severe form characterized by, in addition to local changes, the bone and joint system (pain in muscles and joints, fever, weakness, features of the general inflammatory reaction of the body: high ESR, increased value of white blood cells (leukocytes) in morphology); a complication may be bone deformity; this form affects only men and treatment requires hospitalization
Fortunately, most acne vulgaris is mild, leaving no permanent disfiguring lesions. The disease lasts for several years, with an initial period of exacerbation, and then with a gradual extinction of the disease process.
The cause of severe acne may be additional skin diseases or bacterial superinfections (e.g. during unhygienic removal of comedones, an infection with staphylococcus aureus may occur and the disease may exacerbate significantly). Very often the cause of acne exacerbation, especially in men, is the use of anabolic steroids.
Are all acne lesions common acne?
Acne changes occurring especially in the post-pubertal period, but also not only, may have a different cause, for example:
- rosacea – can occur after the age of 30, and the characteristic features of this disease are: no blackheads, location of changes on the face and the presence of numerous telangiectasias (dilatation of small vessels)
- spring acne – formed under the influence of UV rays; It is characterized by homogeneous maculopapular lesions without comedones and the disappearance of changes after cessation of UV exposure
- inflammation of the hair follicles – there are no blackheads, and the characteristic lesion is an inflammatory papule and pimple
How to deal with acne?
Common acne is a gold vein for the pharmaceutical and cosmetic industries. Companies compete in advertising preparations, especially those that act locally, against acne.
Depending on the form of acne and its course, local treatments and general treatments are available. General treatment is used in the case of acne with the presence of deep inflammatory lesions or purulent lesions with a tendency to disfigure scars. However, in the case of blackhead acne or mild maculopapular form, you can limit yourself to local treatment only.
In local treatment, the following are used:
- benzoyl peroxide – has an antibacterial effect
- azelaic acid – has antibacterial and keratolytic properties
- salicylic acid – has a keratolytic effect (removes excess sebum, clears the sebaceous glands)
- antibiotics – used in the form of a solution or gel, e.g. clindamycin, erythromycin
- Vitamin A acid – reduces keratinization of the sebaceous glands and causes the renewal of connective tissue
- steroids
We also recommend Acnerose cosmetics for rosacea – available on Medonet Market at an attractive price.
General treatment comes down to:
- the use of antibiotics – this is the first-line treatment in exacerbations; oral doxycycline or clindamycin is most commonly used
- the use of isotretinoin – a derivative of vitamin A, which inhibits the excessive secretion of sebum, keratosis of the sebaceous glands, the formation of blackheads and reduces the inflammatory infiltrate; it is used in the case of failure of the treatment of severe acne cases; the main disadvantage of this drug are numerous side effects, and above all high teratogenic effect (pregnancy should be ruled out before starting treatment and not used during and two months after the end of contraception).
The use of an autovaccine may be an alternative therapy. The therapy involves growing bacteria from acne lesions Propionibacterium acnesand then producing an individual vaccine from the killed bacteria. The purpose of the autovaccine is to stimulate the immune system to produce antibodies that will inhibit the excessive growth of pathogenic flora in the sebaceous glands. The effectiveness of an autovaccine varies and depends on the individual’s response to vaccination.