Acne vulgaris treatment at home. Acne vulgaris

Skin problems, especially in adolescence, are a common problem of the modern generation. Acne vulgaris is a type of acne that affects both boys and girls. In the article we will understand why this occurs, how to get rid of it and methods of treatment.

The essence of the problem

When the sebaceous gland is blocked with a cork, a simple black dot (acne) is formed. This process occurs due to a strong, long-term accumulation of sebum and particles of keratinized skin. The next step is the entry of a secondary infection and the development of an inflammatory process, such an area becomes painful when pressed.

ICD 10 classification and pathogenesis

The 10th revision of the International Classification of Diseases consists of many classes and codes, thanks to which a doctor can distinguish between a particular disease. In this list of microbial infections, acne vulgaris is a common disease that has its own encoding L70.0.

Acne vulgaris mcb 10 revision includes the following acne development mechanism:

Sebum is produced in large quantities.

Violation of the integrity, elasticity of the epithelium.

The defeat and reproduction of a bacterial infection.

The growing inflammatory process around the hair follicle.

In the photo: this is how whiteheads, redheads and blackheads are formed

The pathogenesis of the disease, of course, also affects the general condition of the patient, but it is not so much the physiology that suffers, but the psycho-emotional state of the person. During adolescence, the relationship of the child with society is only being built, but because of the ugly, the harmonious development of the individual can be disturbed.

Medical treatment

In addition to the drug approach to the treatment of acne vulgaris, a dermatologist may prescribe cosmetic procedures, scrubs, masks, peeling.

Only a dermatologist can know how to get rid of acne vulgaris, so if you suspect a skin problem, quickly head to the hospital, because the initial stage is much easier to cure. The doctor may suggest both local treatment and the use of medications.

Topical therapy is used only in case of mild to moderate acne skin lesions. A specialist can prescribe an ointment for acne vulgaris, lotion, creams and others. It helps a lot with acne.

Such funds most often include the following components:
Retinoids or a derivative of vitamin A. Helps reduce swelling, flushing and reduces the formation of comedones and.
Azelaic acid - acts as an antibacterial agent and reduces inflammation. Azithromycin or Erythromycin is an antibiotic used for inflammatory acne.
Benzene peroxide - in addition to relieving inflammation, exfoliates keratinized skin well.
With local treatment, the doctor often prescribes combination therapy, which also includes medications.

General drug treatment occurs in severe advanced cases, and the following drugs are used:
Antibacterial agents. The course and duration of treatment is selected only by the attending physician. They contribute to the destruction of the pathogen, reduce inflammation. Uncontrolled reception should not be.
Contraceptives - before taking, you should visit a gynecologist, they are prescribed for hormonal disorders.
Isotretinoin - reduces the production of sebum, relieves inflammation and fights bacteria.

Acne vulgaris treatment, which is not easy, requires patience and effort. In addition to the drug approach, a dermatologist can prescribe cosmetic procedures (very popular and effective), sparing to.

Folk methods of treatment

With the help of masks and homemade face creams, you can get rid of acne

Herbal tinctures will also help:

With the initial appearance of acne, it is necessary to use medications that inhibit the growth of bacteria and the further development of acne.

Proper nutrition is important, especially at a young age. Sweet, starchy and spicy will only speed up the process of acne. You can apply that will help heal the skin.

Do not start the development of the disease, you need to treat the bottom immediately.

With the right approach to your health, you will not suffer a severe degree of damage to acne vulgaris. A mild degree can be treated much faster and more efficiently.

Formations on the human skin are most often harmless. But there are cases when the body is affected by serious pathologies, accompanied by rashes. Acne vulgaris is one such disease. This is a chronic inflammation of the hair follicle. Pathology causes seborrhea, the appearance of comedones, inflamed acne, scars on the skin and even abscesses. Treatment of acne vulgaris takes place under the close supervision of a doctor. Any wrong action can provoke the development of the disease.

How common is the disease in the modern world

Pathology may have a latent form. That is, it is present in the body, but does not show any special signs. Small pimples and comedones regularly appear on the skin, which many people simply do not pay attention to. This fact greatly affects the statistics. As a rule, only 20% of people who have this disease in their bodies turn to doctors for help. And there is it almost every fourth.

This is not critical, since in this state the disease is not capable of leading to major health problems or, even more so, to death. But you need to understand that any external or internal factor can provoke the activation of pathology. In this case, treating acne will be much more difficult. Therefore, it is recommended to go to the hospital for help as soon as you see any growths on the skin. Even small black dots can be a symptom of the onset of acne vulgaris in your body.

Who is most likely to get sick

Like other types of skin rashes, acne vulgaris is more common in young people during adolescence. Moreover, given that the female body develops faster, in girls this moment comes a little earlier. Usually, at about 13 years old for girls and at 14-15 years old for boys.

Pathology is in the body on average up to 21-24 years. That is, the main part of the rash disappears by the age of 18, but inflammation of the hair follicles and skin is still present. Thus, any external irritant can cause a profuse rash all over the skin.

Identifying acne vulgaris in a teenager is quite simple. It primarily manifests itself in a large number of comedones in the middle part of the face. The skin becomes oily, black dots appear on the nose and forehead.

Squeezing out such formations on your own is highly not recommended. First, it will not give any result. Part of the pollution will still remain in the sebaceous canal, since it is simply impossible to squeeze out all the contents. And secondly, you risk catching an infectious disease, as the skin is damaged. The protective part of the epidermis at the place of extrusion does not function, which contributes to the penetration of various microbes into the body, including harmful ones. Here we recommend paying attention to those that do a good job of cleaning the pores of the skin from dirt.

The appearance of acne vulgaris and common comedones in teenage girls indicates the approach of the menstrual period. Rashes can appear on the face a year before the first menstrual cycle.

Causes of acne vulgaris

In adolescents, such formations are explained by a violation of the hormonal background, due to the puberty of the body, as well as increased production of steroids. These are natural processes that cannot be avoided. Therefore, the main reasons are:

An increase in the amount of sebaceous secretion secreted by the glands. This is due primarily to androgens produced by the youthful body. Moreover, the process is equally common, both among boys and among girls.
Change in the consistency of the sebaceous secretion, due to hormonal imbalance. The amount of sebum is not the only factor influencing the formation of acne vulgaris and blackheads. Much depends on the structure and physical properties of the secret itself. For example, if the fat is much thicker than normal, it simply cannot go out through the sebaceous canal. And the amount of it here is absolutely irrelevant. The secret simply remains in the pore, where dust and dead skin cells are then added. This creates an excellent environment for the habitat and development of harmful bacteria.
Protracted process of natural regeneration of the skin. There are times when the amount and consistency of the sebaceous secret does not matter at all. The fact is that if the keratinized cells of the epidermis do not have time to peel off before the moment when new elements come in their place, they fall into the pores. Accordingly, the channel is clogged from the outside. Of course, in this case, the sebaceous secret cannot get out at all. This is how acne appears.

The worst option is when one person has the formation of acne vulgaris due to three of the above reasons at once. In this case, the process of their elimination can be very delayed, since each cause must be dealt with separately. That is why you should not wait until the process gets out of control, but immediately go to the hospital at the first opportunity for an examination. Already on the spot, the doctor will give you a complete picture of the pathology and recommendations on how to deal with it.

Much depends on immunity. It is known that during adolescence, the immune system is underdeveloped. This is one of the main reasons for the onset of the inflammatory process. The body is not able to independently fight harmful bacteria in the pores. Therefore, it is recommended to regularly take vitamins and minerals to strengthen the immune system on their own. This will not help in the treatment of advanced vulgar rash, but is an excellent way of prevention.

Acne vulgaris can also appear in adulthood. There are a number of established reasons why this happens. Among them, the most common are:

Disruptions in hormonal rhythm. Again, it all comes down to the fact that the sebaceous glands are closely related to hormones. Any malfunction of the glands within the body can lead to excessive secretion and clogging of the channels. The rhythm is more likely to go astray in women, for example, during pregnancy or lactation.
Gynecological pathologies. Another purely feminine problem. It can be infectious or bacterial diseases. The treatment of acne vulgaris in this case is somewhat different. The fact is that it is necessary to influence not only the skin and sebaceous glands, but also the very cause of inflammation. That is, you first need to get rid of the gynecological disease itself.
Emotional disorders. Even such a seemingly trifle as frequent mood swings lead to a breakdown in the excretory system. This is especially true when you regularly find yourself in stressful situations. In general, it has been proven that negative emotions affect the body much more negatively. On the sebaceous glands and the skin as well.
Psychological disorders. Here again we are talking about the nervous system. As soon as it fails, immunity weakens. As a result, the skin gradually loses its protective abilities. The sebaceous glands are unstable, and harmful microorganisms quietly penetrate the pores and develop. Given that the efficiency of regeneration also falls, keratinized epithelial cells create an excellent habitat for microbes.
Disorders of the gastrointestinal tract. What you eat determines the condition of your skin. Any inflammatory process in the stomach or intestines can be the cause of a vulgar rash. Moreover, it is also the cause of the development of other, more dangerous pathologies. For example, a tumor of adipose tissue in the form of a lipoma can form due to malnutrition. Pay attention to this factor to keep the body safe.

It is likely that at least one of the factors listed above leads to the formation of acne vulgaris in your case. But such cases are quite rare. As a rule, the disease is explained by 4-5 reasons, 1-2 of which are fundamental. That is, special attention should be paid to the main reasons. Only a cosmetologist will help you determine the main factors affecting the appearance of the disease.

How does acne vulgaris appear?

First stage

Comedones are formations that appear almost immediately after the onset of pathology in the body. They are divided into two types:

Open. More commonly known as "black dots". These are formations that are immediately noticeable on the skin. A clogged sebaceous gland has a plug in the form of black pollution.
Closed. Comedones in this case are barely visible externally. The main inflammation is in the pore itself.

Second stage

Pustules. White inflammation. Appears when an infection penetrates the affected skin. Possible suppuration.
Red spots of small size, which are widely distributed over the skin with increased oil content.

You can learn more about this stage from.

extreme stage

Nodules. Hard formations on the skin. Appear due to mechanical damage to the above inflammations. And for this it is not necessary to crush eels. It is enough just to wash carelessly.
The worst outcome for this pathology. Inflammation is widespread throughout the skin and can cause severe pain.

How to treat acne vulgaris

It must be understood that this pathology is not the easiest. The skin is affected quite deeply, so you need to use all possible methods to influence the focus of the disease without harming the cover itself.

Treatment is individual for each patient and individual case. But there are a number of recommendations, adhering to which, you can definitely get rid of the problem relatively quickly and without difficulty.

The most effective tips:

Start treatment with an accurate diagnosis and a complete examination. In no case do not try to get rid of the disease yourself. If you are faced with acne vulgaris, first of all, seek the help of specialists in order to establish the exact causes and get a reliable diagnosis.

Choose who you need to contact, starting from the characteristics of the pathology and possible causes. Doctors who can definitely help you are a dermatologist (given that the skin is primarily affected), an endocrinologist (because the disease directly affects the endocrine system) and a gynecologist (since in women the problem is most often associated with hormonal disruptions).

Clearly adhere to the correct sequence of actions during treatment. First of all, you need to do everything possible to prevent the appearance of new rashes. To do this, it is necessary to restore the normal hormonal rhythm. Regardless of what was the specific cause for the onset of the disease, by putting the glands in order, you can definitely avoid many further problems.

The main thing here is to use the right individual methods. You need to understand that this process is very different, depending on your gender. Therefore, it makes no sense to try to restore the correct secretion of hormones on your own. Here you will 100% need the help of doctors.

Cleanse your skin regularly during treatment. Influence on the internal factors of pathology, of course, gives a result. But the cure is not the fastest. Therefore, you need to further clean the pores. In the early stages, when the disease manifests itself only in comedones, this can be done independently, using special cleaning products prescribed by a doctor. But if the pathology is running, the sebaceous canals are cleaned only in a clinical setting.

Doctors use mechanical cleaning methods. The positive fact is that the skin is not damaged. That is, we are not talking about banal extrusion. Here, special hardware methods are used that help to completely cleanse the pores of excess sebum, dust and dead cells.

Be sure to degrease the skin with suitable external application. In the process of treatment, the performance of the sebaceous canals gradually stabilizes. But it doesn't happen quickly. In the pores, for some time, an excessive amount of secretion continues to flow.

At this time, you need to use cosmetic preparations prescribed by a doctor for the treatment of acne vulgaris, which constantly maintain the skin in the desired condition. It is important to follow all instructions so as not to overdry the skin. The result of this will be even worse.

Watch your diet carefully and stick to your diet. No matter how strong drugs you take, they may not work if you continue to eat junk food. The course of treatment involves. She is pretty strict.

For example, you will likely have to cut out fatty, sugary, fried, and salty foods. But, believe me, it greatly speeds up the healing process. Any deviation from a given diet can lead to an exacerbation of the pathology. Even if you are clearly undergoing treatment, diet is a must.

This list includes treatment principles that are often used for patients with acne vulgaris. But this does not mean that it is in your case that the course will involve precisely these methods. You need to understand: during treatment, your immunity is strengthened and the work of all disturbed glands is stabilized. And the drugs for this are selected individually for the patient.

Do not try to use this guide to get rid of acne vulgaris on your own at home. These are just additional tips to follow. But the main treatment you can get only from professional doctors. Otherwise, all the methods listed above simply do not matter.

If you want to understand how the inflammation process goes, and what acne vulgaris is, be sure to watch the video below. This short video will help you understand what you are facing and how seriously the pathology has affected your body. Play video now:

Acne vulgaris is far from the most common pathology of the skin. Therefore, if you have this disease, contact the professionals to use the correct methods of treatment.

Acne vulgaris (acne vulgaris) is an inflammation of the sebaceous gland and surrounding tissues, provoked by Staphylococcus aureus. The disease is the most common complication of seborrhea (hypersecretion of the sebaceous glands).

Acne vulgaris appears during puberty and gradually disappears by the age of 30. Rashes bring aesthetic discomfort to a person, therefore it is important to know about methods of treatment and prevention.

Causes of a rash

During the transitional age, adolescents change their hormonal background, and the production of sex hormones increases significantly. Not always a young organism is able to cope with such a load. Against the background of the addition of provoking factors, acne vulgaris appears:

diseases of the gastrointestinal tract;
malnutrition (fatty, salty, smoked foods, fast food, soda, coffee, chocolate);
pathology of the nervous and endocrine systems;
weakening of the immune system;
avitaminosis;
stress, physical activity, sleep disturbance;
smoking and drinking alcohol.

The predisposition to acne vulgaris is often inherited. The process of formation of a rash is long. Main stages:

under the influence of hormones, the production of sebum increases;
pathological factors reduce the body's resistance to bacteria;
the protective skin barrier falls;
microbes (Staphylococcus aureus) begin to multiply actively;
the sebaceous gland is affected, and then the surrounding skin and subcutaneous fat.

The number of acne vulgaris can increase under the influence of hot food and emotional factors. Favorite localization - face, chest and back.

What types of rashes are found?

Acne vulgaris is a common name for skin manifestations during adolescence. There are several forms of acne. Each has a characteristic clinical picture:

Rosacea- the formation of pink-cyanotic nodules on the skin. The long course of the disease leads to a thickening of the integument and an increase in the size of the nose. It develops more often in adulthood. With this type of rash, iron mites can be detected.
Blackheads (comedones)- the most common type, occurs at any age. It is an accumulation of dead cells, sebum and dust in the ducts of the glands. Such a formation is easy to find on the wings of the nose, forehead and chin, as well as on the chest and back. When pressed, a "worm with a black head" appears.
1. Papular- inflamed comedones. An infiltrate and a nodule form at the base of the black dot.
2. Pustular- the reaction is more intense. The nodules turn red, a pustule forms in the center. After a while, the acne opens and heals with the formation of a crust.
3. Inductive acne vulgaris - 3 degree of severity. The infiltrate has the size of a cherry stone, the process deepens. Education becomes painful. After healing, scars sometimes remain.
spherical- inflammation of the follicle. Eruptions are multiple, deep, often suppurate. When opened, fistulas may form. Such acne vulgaris always leaves behind serious keloid scars.
Necrotic- damage to the follicular apparatus along with the sebaceous gland. Characteristic for men. Nodules with bloody-purulent contents, often covered with a crust, form on the forehead and temples.
Premenstrual- appear in women before or during menstruation on the cheeks and chin. After menstruation, they often go away on their own.

Important! Only a dermatologist can correctly determine the type of rash.

Which doctor should I contact?

Often, when acne vulgaris appears, girls try to mask them with foundation or powder. Such procedures only irritate the skin and aggravate the course of the disease.

If you notice a rash in yourself, consult a doctor. In this situation, a dermatologist or cosmetologist can help you. Such doctors conduct appointments in specialized skin care clinics and private clinics. If it is difficult to make an appointment with a narrow specialist, you can first go to a therapist. The doctor will prescribe temporary treatment so that the situation does not worsen.

How to get rid of acne?

Additionally, for the diagnosis of acne vulgaris, you will need to pass a general and biochemical blood test. This will allow you to assess the state of the body.

After making a diagnosis, the doctor will prescribe an adequate treatment. Depending on the severity of the process, local and general therapy can be used.

The local effect is on the rash, relieves irritation and pain, and dries the wound. This is the treatment of rashes with anti-inflammatory drugs, creams:

In the morning, the skin is washed with special lotions for problem skin (Clerasil, Cleaskin) or with a mixture of sea salt and soap. Wipe your face with disposable paper towels.
During the day, problem areas are wiped 2-3 times with salicylic or camphor alcohol.
Excellent for acne vulgaris are agents that improve tissue regeneration - Panthenol, Retinol-A.
Make face masks based on blue or green clay several times a week.
Antibiotic ointments for external use help fight microbes that provoke acne vulgaris - Levomekol, Tetracycline, Baneocin. The agent is applied to each element with a thin layer, if the cavity has already been opened, you can put it inside with a syringe.
Benzene peroxide (Baziron AS) dries the skin and exfoliates dead cells.

General therapy

To cure acne vulgaris, you often have to resort to more serious drugs that affect the essence of the disease:

Antibacterial agents are prescribed orally if external medicines have not had the desired effect:
- Amoxiclav 500 mg 2-3 times a day for 7-10 days;
- Azithromycin 500 mg once a day for 6 days;
- Ceftriaxone IV 1 g 1 time per day for 5 days.
Vitamin A, E, C, vitamins of group B restore the skin after acne vulgaris.
Hormonal contraceptives for girls (Dianne-35, Janine, Yarina). For men, hormones can only be used externally (sinestrol cream 0.15% for two weeks).

A good effect in getting rid of acne vulgaris is given by physiotherapy: UVR, darsonvalization, UHF, electrophoresis with zinc and ichthyol, cryomassage with liquid nitrogen, isokerite applications.

1-2 times every six months, you can carry out mechanical or ultrasonic cleaning of the face in a beauty parlor (but not in the acute stage).

Important! To make acne vulgaris a thing of the past, you need not only adequate treatment, but also personal hygiene.

If after acne healing there are cicatricial changes in the skin, they can be eliminated with the help of several sessions of laser therapy.

In order to prevent acne vulgaris, it is important to take good care of your skin:

Take a shower every day.
Wash your face with care products in the morning and evening, apply a moisturizer.
Once a week, use natural face and body scrubs.

Good in the treatment of acne vulgaris helps and marine rest. Salt water disinfects and dries the skin, and the sun's rays improve tissue repair. Don't forget to use sunscreen!

Therapy for acne vulgaris will not be complete without diet. If you do not limit yourself from harmful products, acne will return again:

Eat less flour, salty and sweet.
Forget fast food. High-quality food should undergo good heat treatment.
Eat more seasonal vegetables and fruits, cereals and lean meats.
Observe the drinking regime - 1.5-2 liters of water per day.

Any skin rash is best treated in a medical facility. Do not try to squeeze acne vulgaris yourself!

The effect of drugs will come faster if you start taking them at the first symptoms. Do not delay the visit to the doctor!

Acne vulgaris (acne vulgaris) is the result of an inflammatory process in the structures of the sebaceous glands and hair follicles. Common causes of pustules: staphylococcal infection and microtrauma on the surface of the skin.

The pathogenic agent enters the human body through the follicular orifice, after which it begins to replicate intensively, causing a rash.

Speaking about the clinical picture of acne, we should mention its diversity. Inflammation usually affects those areas of the skin on which a large number of sebaceous glands are located, for example, there are many acne on the face, chest and back.

At the initial stage, they look like comedones or black dots, the mouth of the hair follicle is blocked by a plug of sebum and horny masses. Later, a secondary infection joins and infiltration appears at the base of the plug.

Education becomes very painful.

Initially, acne vulgaris looks like a small red nodule. As the inflammatory process intensifies, the infiltrate will become larger, and pus will begin to accumulate at the top of the formation.

A few days later, the pustular capsule spontaneously opens, the pus comes out, forming a drying crust at the top. After the wound has healed, scars may remain.

If pinpoint inflammation is not treated, the process can spread deep into and involve nearby glands. Then a pustule with a compacted base is formed.

Causes of rosacea

acne vulgaris in the photo

This dermatological disease is considered quite common and occurs in a large number of inhabitants of the globe. Only 20% of all sick people seek medical help from a doctor.

As a rule, patients from this number have a complicated form of skin lesions. The rest carry out acne treatment at home, getting rid of acne with improvised means, or using pharmacy drugs without a doctor's prescription.

In newborns and children under the age of 12, acne vulgaris is extremely rare.

The likelihood of getting this dermatological disease increases when boys and girls begin puberty. At risk are children aged 14-16 years and young people who lead an active lifestyle, whose sebaceous glands are in intensive work every day with the release of large amounts of sebum.

By themselves, acne vulgaris resembles a large accumulation of inflamed pimples, inside of which there is a pustule with purulent contents. Due to weakened local immunity inside the affected areas of the skin, the presence of a bacterial infection is often diagnosed, which only aggravates the course of the inflammatory process.

The reasons for the appearance of acne vulgaris in a completely healthy person may be the presence of one or several negative factors at once. They may be as follows:

It is no coincidence that rashes appear at the age of 15–24 years. The period of puberty is characterized by "hormonal storms", intensive growth of the body, restructuring of all systems. It is not surprising that all failures are reflected in the skin.

The main causes of acne and the appearance of blackheads:

increased activity of the sebaceous glands, excess sebum;
blockage of the sebaceous ducts, inflammation of the hair follicles;
the activity of propionobacteria in case of imbalance in the body;
hereditary predisposition (type of secretion of sebaceous glands);
poor skin hygiene;
an excess of cosmetics (foundation, powder, fat cream) that clog the skin ducts;
frequent touching of the face with unwashed hands;
follicular hyperkeratosis.

Provoking factors in girls:

increased levels of male sex hormones;
violation of the menstrual cycle after taking anabolic hormones;
increased sensitivity of the sebaceous glands, hair follicles to androgens.

Find out all about hemangioma in newborns on our website. How to get rid of oily skin on the face? This article has the answer!

The initial stage of acne is comedones or so-called black dots. The mouth of the hair follicle is closed by a cork formed by secretions of the sebaceous glands and particles of the keratinized upper layer of the epidermis.

The next stage in the development of the disease is the addition of a secondary infection. At the base of the sebaceous plug, an infiltrative process begins.

The inflamed area becomes painful.

So, why do acne appear on the face, and why do acne form in the skin pores first, and then acne in their place? What do acne on the face mean for the body and what processes are they associated with? The appearance of acne with two main processes:

Strengthening the function of the sebaceous glands around the hair follicles –
as a result of this, the volume of sebum increases, which is formed by the sebaceous glands and is brought to the surface of the skin. Usually this happens during puberty against the background of hormonal changes - increased production of androgens (both in young people and girls).
Increase in the number of desquamated cells in the lumen of the follicle –
hair follicles are internally covered with a layer of epithelial cells. Gradually, the cells die and are replaced by new ones. However, with keratosis of the epithelium (i.e., with a violation of the process of keratinization of epithelial cells), there is a sharp increase in the number of desquamated epithelial cells in the lumen of the hair follicle.

An increase in the production of sebum and the number of desquamated cells leads to the formation of plugs (acne). At the same time, the sebaceous glands still secrete sebum, but which can no longer come to the surface of the skin (Scheme 10b).

Therefore, sebum accumulates in the lumen of the hair follicle, which stretches its walls. Sebum and confined spaces are great conditions for bacteria to thrive.

As a result, either a papule or a pustule develops in the space bounded by the walls of the hair follicle.

What factors exacerbate the appearance of acne -

Increased hormone production in adolescents and keratosis of the epithelium of the hair follicles are not the only factors that can affect the development of acne. The causes of acne on the face can be covered in details. Acne is promoted by:

Use of oily cosmetics –
Some cosmetics and skin care preparations, as well as sebum secreted by the sebaceous glands, can clog skin pores. This will be the case in cases where such products are made on a fat basis. Any cosmetics for you should be only water-based.

Contraceptive pills and hormonal changes –
Some birth control pills cause acne. This is typical for preparations containing pure progesterone. Also, during the premenstrual period, there is a change in the hormonal background, and therefore you can regularly observe the worsening of your acne once a month.

Medical preparations –
To stimulate the appearance of acne can drugs such as: prednisone, steroid hormones, drugs with lithium, anticonvulsants, iodides, bromides.

active sweating –
many people sweat a lot. This may be due to increased physical activity, stress, simply due to physiology or working conditions. Keep in mind that excessive sweating also contributes to acne. Therefore, such people need to take even more care of their skin.

Types of acne

There are the following types of acne:

There is also subcutaneous deep acne affecting the lower layers of the skin. It is more difficult to treat, and leaves scars or scars after it.

Forms of acne and stages of development

Therapy for acne vulgaris should be based on the principle of individual selection of a treatment course for each patient individually. In general, the treatment consists of the following steps, the observance of which is mandatory in order for the medical removal of acne to be successful:

Providing normal nutrition to the hair follicle. For this, the patient is prescribed premium vitamin-mineral complexes containing in their composition a sufficient amount of useful substances that can ensure the normal development of the hairline and hair roots.
Antibacterial therapy. During the diagnostic examination, the type of bacterial microflora that is present on the surface of the skin affected by acne vulgaris is determined. In case of detection of pathogenic microorganisms, antibiotics are prescribed, to which the infectious agent does not have stable natural immunity. Antibacterial drug is selected individually.
anti-inflammatory procedures. To achieve an anti-inflammatory effect, external agents are used in the form of ointments Zovirax, Salicylic-zinc, 3% hydrogen peroxide solution, Chlorhexidine. Ointments are applied morning and evening to the affected area of the skin. The drug is evenly distributed over the surface of acne vulgaris, so that all inflamed areas of the epidermal tissues are evenly covered. Hydrogen peroxide used to wipe the skin. Antiseptic treatment with this medicine is performed 1 time per day.
Face washing. In this case, we are talking about using antibacterial and anti-inflammatory tar soap during water procedures, making baths from chamomile decoctions and washing the skin.

If necessary, the attending dermatologist can prescribe the use of cosmetic masks with the addition of essential oils of medicinal plants and other components to their composition, which will help improve the health of the affected skin areas and speed up the patient's recovery.

Like any disease, acne comes in varying degrees of severity. Mild acne (blackheads or clogged pores) only needs to be treated with special products.

Symptoms depend on several factors.

Types of acne on the face:

inflammatory;
non-inflammatory.

According to the degree of location on the skin, acne is:

The majority of young people suffer from non-inflammatory forms of acne. Vulgar (youthful) acne is familiar to many. The weaker the body, the more provoking factors, the more extensive the rash.

Development of acne vulgaris:

increased activity of the sebaceous glands;
ducts are clogged;
comedones appear on the skin;
formations resemble tubercles;
color - rich red, size - up to 5 mm, often in the center there is an abscess;
after healing, pigmented areas remain on the skin, occasionally - shallow scars;
at the same time, hair becomes oily, thinning of the hair is occasionally observed.

Note! The main locations of superficial acne are the face, less often the upper chest, back.

Severe forms of acne

Unfortunately, for many young people, rashes do not go away as quickly as we would like.

What do acne symptoms look like?

The appearance of acne vulgaris is characterized by a whole list of symptoms, which are extremely difficult to confuse. The first signs of acne on the skin are as follows:

a small red spot appears, which has a swollen appearance with obvious signs of puffiness;
the inflamed neoplasm begins to itch, and becomes painful on palpation;
on the 2nd day from the moment of appearance, the affected area of the skin becomes elastic and more and more takes on the shape of an eel;
inside the pimple, biological fluid begins to accumulate in the form of lymph and blood;
as the inflammatory process develops, the pimple fills with purulent contents, swells, turns red and becomes very painful.

To prevent the transformation of acne at any stage of its development, it is necessary to use drug therapy. Properly selected medications will help not only eliminate unpleasant symptoms, but also speed up the process of complete cleansing of the skin from a dermatological disease.

The disease develops gradually - first, under the influence of various environmental factors (stay in hot shops, in the sun), an expansion of skin vessels appears, which disappears after the cessation of the adverse factor.

Then the vessels of the skin of the face lose their elasticity, expand and red streaks, spider veins and rashes appear. Patients with rosacea complain of periodic flushes of heat to the face.

So the main symptoms are:

redness of the face, in rare cases, redness may spread to the back and chest;

dilation of skin vessels and the appearance of a pronounced vascular network;
the appearance of rashes against the background of reddening of the skin of the face: pink tubercles (papules), when infected, pustules are formed (with purulent contents). Gradually, the papulo-pustular rash spreads, the skin becomes edematous, porous, bumpy. Rosacea is characterized by a purple-bluish hue. With rosacea, there may be sensations of burning, tightening and itching of the skin.
at a late stage of the disease - thickening of the skin of the face;
thickening of the skin of the nose, the appearance of a knobby formation due to hyperplasia of the sebaceous glands - rhinophyma;
thickening of the skin of the forehead, ears and chin, deformity of the eyelids;
eye damage - redness, dryness, sensation of a foreign body, pain, inflammation of the conjunctiva and cornea.

In most cases, the doctor can make a diagnosis according to the characteristic appearance of the patient, however, it may be necessary to study the state of the vessels of the face and the microflora of the skin.

Acne vulgaris treatment: starting with diagnosis

"Acne vulgaris" is a diagnosis, and the disease requires professional treatment with antibiotics, hormonal drugs, ointments, talkers and other substances.

To make a diagnosis, a dermatologist will send you for tests (you may need to consult a urologist, gynecologist, endocrinologist).

To make a diagnosis, you will need to be examined and set the level:

After that, the dermatologist sends for flushing from the mucous membranes of the oral cavity, as well as for flushing (“scraping”) of the affected skin. This is necessary in order to confirm or disprove gram-negative folliculitis.

Medical treatment

In addition to the drug approach to the treatment of acne vulgaris, a dermatologist may prescribe cosmetic procedures, scrubs, masks, peeling.

Topical therapy is used only in case of mild to moderate acne skin lesions. A specialist can prescribe an ointment for acne vulgaris, lotion, creams and other remedies for acne on the face. Well helps to cope with acne milk Vidal.

Such remedies most often include the following components: Retinoids or a derivative of vitamin A. Helps reduce swelling, flushing and reduces the formation of comedones and rosacea.

Azelaic acid - acts as an antibacterial agent and reduces inflammation. Azithromycin or Erythromycin is an antibiotic used for inflammatory acne.

Benzene peroxide - in addition to relieving inflammation, exfoliates keratinized skin well. With local treatment, the doctor often prescribes combination therapy, which also includes medications.

General drug treatment occurs in severe advanced cases, and the following drugs are used: Antibacterial agents. The course and duration of treatment is selected only by the attending physician.

They contribute to the destruction of the pathogen, reduce inflammation. Uncontrolled reception should not be.

Contraceptives - before taking, you should visit a gynecologist, they are prescribed for hormonal disorders. Isotretinoin - reduces the production of sebum, relieves inflammation and fights bacteria.

Acne vulgaris treatment, which is not easy, requires patience and effort. In addition to the drug approach, a dermatologist can prescribe cosmetic procedures, acne masks (a black acne mask is very popular and effective), gentle peeling to remove acne from the face.

With the help of masks and homemade face creams, you can get rid of acne

To permanently get rid of acne, treatment at home is one of the most effective ways.

The main methods used at home: Compress with viburnum juice. Using a blender, grind a small amount of berries, squeeze the juice out of them.

Soak a small towel or piece of gauze in the resulting liquid and apply to the inflamed areas for 15 minutes. A good remedy for acne is a compress of aloe.

Thanks to its properties, pus from acne can be completely removed, even from the deepest comedones. To have the effect, carry out the procedure daily for a month.

Propolis infusion is suitable for daily use by teenagers. Wash your face at night and wash your face during the day.

This method will reduce the secretion of fat and remove inflammation. A very oily face can be wiped twice a day with a slice of lemon.

It dries out the skin and relieves inflammation.

How to get rid of acne with salicylic acid, read the article. The main methods of dealing with acne on the forehead are described in the article.

Herbal tinctures will also help: Chamomile, an infusion from which is easy to prepare at home. For this you need 1 hour.

l flowers and a glass of hot water, let it brew for half an hour. Next, strain and moisten with gauze, wipe the affected areas, if acne is on the body, you can take chamomile baths.

Dandelion infusion. Prepare similarly to the previous recipe.

After cooking, strain and take inside a third of a glass three times a day before meals.

In the photo: a map of the formation of acne and its causes

In combination, treatment will be more effective and faster. Listen to the doctor's recommendations and do not neglect your health.

The diet prescribes taking care of the cells and tissues of your body, avoiding dairy, fatty, store-bought smoked meats, sweets, confectionery (especially those created on an industrial scale in factories and factories).

We'll have to give up alcoholic beverages, "artificial" shop juices.

It has been proven that fatty foods create a favorable environment for the development of acne vulgaris: sausage, ham, meat, store smoked meats (therefore, they will also have to be abandoned).

In the diet should be fresh vegetables and fruits, low-fat foods, cereals (semolina, oatmeal, buckwheat), cereals. The duration is the same as that of the treatment.

Be careful with oatmeal: excessive consumption of it can cause a large number of red pimples on the forehead, cheeks, neck and other areas of the skin.

The choice of therapy and treatment for acne depends on:

the depth of the location of the pustules;
nature of acne;
the presence or absence of an inflammatory process.

The choice of treatment methods is influenced by:

causes, provoking factors that caused acne;
the severity of damage to various layers of the skin;
activity of the sebaceous glands.

Important! The formation of sebum cannot be regulated by external means alone. Ointments, creams, masks only temporarily reduce the fat content of the epidermis.

Combination therapy is effective. Treatment result:

Cosmetologists call this form "problem skin". The nature of the skin lesion is superficial, the course of the disease is mild. It is observed mainly in adolescents. The main focus is on local funds.

How to get rid of acne? Effective drugs:

Azelaic acid;
Tretinoin;
Adapalene;
Boric acid ;
products containing sulfur;
salicylic acid preparations;
Isotretinoin;
Retinol palmitate.

Note. Tretinoin and azelaic acid deserved the greatest number of positive reviews.

If intolerance to the first drug, use azelaic acid. It does not cause side effects in most patients.

The course of treatment is at least three to four months to achieve a stable remission.

Treatment of acne vulgaris should be built depending on the cause that provoked the problem and the severity of the disease. For mild acne, your doctor may prescribe medications containing ichthyol, sulfur, or lemon juice.

With oily facial skin, teenagers can use Oxy-5, Klerasil, Kleaskin lotions. These products have a bacteriostatic effect, clean the pores from comedones and dry.

Skinoren cream also showed effectiveness. It contains azelaic acid.

It inhibits bacterial growth and reduces free fatty acids in hair follicles, helping to reduce inflammation. Some dermatologists recommend additionally treating mild acne with topical antibiotics such as erythromycin or tetracycline.

Remedies for acne on the face

Treatment of acne with medicinal herbs, home methods will complement the use of medications. Most folk remedies have no contraindications. Choose a few recipes, consult your doctor if they are right for you.

Proven Recipes:

a decoction with a rhizome of a hemophilus. A tablespoon of raw materials, half a liter of water, cook for 10 minutes. Use daily for wet-dry dressings;
infusion of celandine leaves. Take 2 tbsp. l. vegetable raw materials, 3 cups of purified water, boil for 3-5 minutes. After 8 hours, the lotion is ready;
rowan fruit juice. Mash fresh berries, extract juice. Moisten gauze, a napkin, apply to your face for a quarter of an hour. Do compresses every other day. Course - 20 procedures;
chamomile decoction. A versatile anti-inflammatory agent. A tablespoon of flowers, half a liter of boiling water. Boil, insist 30 minutes. Wipe the affected areas with a cotton swab;
infusion of raspberries. Pour boiling water over dried berries. Proportions 1:10. Wait half an hour, kiss. Do 15-minute compresses daily, after 10 days - three times a week;
cabbage juice. Great for reducing inflammation. Grind the cabbage, squeeze out the juice. Keep lotions on your face for a quarter of an hour. Number of procedures - 20, interval - every other day;
wet-drying dressings with tincture of calendula. Dilute the pharmaceutical composition - a teaspoon in a glass of water. The duration of the procedure is half an hour;
yeast mask. Pound fresh yeast with water or chamomile decoction. Keep the mass on your face for no more than twenty minutes. Make a mask twice a week. (You can also find out about other acne remedies on our website. For example, laundry soap for acne is written here, and about zinc ointment in this article).

Advice! Carry out procedures regularly. The effect will definitely show up.

How to remove acne from the face quickly and without complications? The most difficult thing here is to choose the right drug or combination of drugs, to choose treatment regimens.

Only a dermatologist (sometimes a cosmetologist) can professionally treat acne on the face. Unfortunately, in most cases, people turn to a specialist late for advice, and this leads to complications - the appearance of superficial scars and age spots that form during the healing of deep acne and cysts.

Acne treatment will vary in the following situations −

when you have acne and pimples at the same time,
when there are only pimples,
with a cystic form of acne (i.e. when there are large purulent cavities).

How to quickly get rid of acne: a scheme compiled by a dermatologist

Below we will consider all types of drugs that are indicated in this scheme.

1. Benzoyl peroxide -

This is the best remedy for acne. We can say - the gold standard of therapy.

Benzoyl peroxide is a bactericidal component that kills bacteria that lead to the formation of pus inside the hair follicles. In addition, benzoyl peroxide has a slight exfoliating effect, which will also help unclog pores.

Benzoyl peroxide can be in the composition of gels, lotions or creams, with a concentration of 2.5%, 5%, 10%. It is optimal to use a concentration of 2.5% for the first month, and then use 5% funds thereafter.

For dry skin, cream forms are more suitable, for oily skin - in the form of gels. Lotions are suitable for all skin types.

Monocomponent preparations of benzoyl peroxide are very high-quality products made in the USA: Persa-gel 10, Proactive, Desquam, Proderm-cream, in addition, there are cool products under the brands Neutrogena and Mary Kay.

French production - Eclaran-cream, Baziron-gel. As well as Benzakne-gel (Poland), Benzoyl Peroxide Gel (India), Oxygel (India).

Combination benzoyl peroxide preparations - there are preparations where benzoyl peroxide is combined with an antibiotic or retinoid. Examples of combination drugs:

They are used in the following situations -1) If you have only acne (no acne) and you have been treated with pure benzoyl peroxide, but the effect was not sufficient.

In this case, you need the drug "benzoyl peroxide + antibiotic". 2) If you have a mixed form of the disease (acne + acne) or a cystic form of acne - you need the drug "benzoyl peroxide + retinoid".

Scheme of application - the drug is applied 1-2 times a day only to areas of the skin prone to inflammation. Before each treatment, clean the skin of the face with only mild detergents (for example, Dove or Neutrogena).

The effect of the drug will be noticeable after 5-6 days. But for that.

to achieve permanent improvement - you will need to complete a full 6-week course of treatment.

Possible Side Effects - Be aware that itching, burning sensation, dryness, tension, redness or flaking of the skin may occur after application. But usually these effects are not pronounced.

And at the end of the application - immediately pass. If you use the drug during an active sunny period, be sure to use sunscreen, because. benzoyl peroxide makes the skin of the face more sensitive to sunlight.

2. Retinoids -

Preparations of the Retinoid group are prescribed when there is only acne, with a mixed form of "acne + acne", as well as with a cystic form of acne. Retinoids are derivatives of vitamin A.

They help to remove blackheads and pores, and also prevent their appearance. Retinoids also have an exfoliating effect, removing dead surface skin cells.

Examples of monocomponent retinoids -

Retin-A (Fig. 15), Lokatsid, Airol - contain Tretinoin,
Differin (Fig. 16), Klenzit, Deriva - contain Adapalene,
Tazret-gel, Zorak - contain Tazarotene.

Examples of combined retinoids - are prescribed for "acne + acne" and cystic acne. In these forms of the disease, such drugs will be much more effective than monocomponent drugs. Examples of drugs:

"Epiduo" (Fig. 17) - contains adapalene + benzoyl peroxide,
"Deriva-S", "Klenzit-S" - contain adapalene together with the antibiotic clindamycin,
"Isotrexin" - contains the retinoid Isotretinoin + the antibiotic erythromycin.

How to treat acne on the face with retinoids - a drug with a retinoid should be used 1 time per day before bedtime. The full course of treatment will be at least 3 months, but a noticeable result will be visible after 6-7 weeks.

In order for the skin to get used to and not be strongly irritated, start using the drug 3 times a week. After 1-2 weeks, switch to daily use.

Wash your face with a mild cleanser before applying the retinoid. Forms of release of retinoids in the form of lotions - will be the most effective, in the form of creams - the least.

3. Antibacterial drugs -

How to cure acne on the face with antibiotics? In most cases, antibiotics for acne are prescribed only locally (as part of gels and creams). The use of antibiotics in the form of ointments is strictly prohibited, because the fatty components of ointments will clog pores and aggravate acne.

Tableted oral antibiotics –
antibiotics in tablets are prescribed immediately (as basic therapy) only for cystic acne. For acne + pimples, and only for acne, oral antibiotics are prescribed only when the use of basic drugs has not been successful.

4. Azelaic acid -

Azelaic acid is commonly used as an alternative to benzoyl peroxide because has less irritating effect. This acid has both an antibacterial effect and the effect of exfoliating superficial dead skin cells.

Examples of preparations: Skinoren (Germany), Azogel (Russia), Akne-derma (Poland).

Application features - gels with azelaic acid are applied 2 times a day. The minimum course of treatment will be 1 month (this is the time during which you will see the desired effect), the standard course of application is 3 months.

Unlike benzoyl peroxide, this drug can be used in active sun and without the use of sunscreen, because. Azelaic acid does not increase skin sensitivity to the sun.

In cystic forms of acne, azelaic acid has the effect of preventing the appearance of post-inflammatory skin pigmentation.

4. Isotretinoin -

Acne on the face how to get rid of the most severe forms of this disease? For this, there are systemic retinoids, for example, Isotretinoin. It is taken orally in the form of capsules.

Analogues of Isotretinoin are drugs Aknekutan (Fig. 20), Aknetin and Roaccutane.

This group of drugs is used exclusively for the treatment of cystic acne. The drug has impressive efficacy, but has a lot of side effects.

The course of the disease and complications of rosacea

The course of the disease is undulating: manifestations may disappear for a while, and then rosacea (rosacea) reappears. Exacerbation can cause hypothermia and overheating of the skin, prolonged exposure to the wind, the sun, the use of hot dishes, as well as emotional outbursts.

Gradually, the duration of remissions decreases, and exacerbations become more frequent.

Rosacea (rosacea) progresses and passes into severe stages that are difficult to treat, complications appear. Rosacea causes eye diseases - keratitis, chalazion, blepharitis, which lead to visual impairment.

Rhinophyma, which is also a complication, disfigures the appearance, and sometimes surgery is required to get rid of this deficiency.

In this regard, when an ailment appears, it is necessary to contact a dermatologist in order to prevent the progression of the disease in a timely manner. Rosacea, the symptoms of which are varied, do not go away on their own.

Treatment should be complex, it depends on the stage of the disease and is selected individually.

Prevention of rosacea

To prevent the disease, dermatologists recommend protecting the skin of the face from excess insolation in the summer, from frost in winter, since exposure, overheating and hypothermia contribute to the appearance of rosacea (rosacea).

The exclusion of occupational harmful factors (work in construction, in hot shops and at the stove) is of great importance in the prevention of this disease.

The use of modern techniques, drug treatment, traditional medicine recipes allows you to gradually get rid of pustular rashes of any severity. The process is long, the success of treatment depends on many factors.

No two cases are alike, each patient requires an individual approach. Sometimes rashes stay on the skin for several years.

With a mild form, it is possible to get rid of acne vulgaris in 2-3 months. Many suffer from acne before the end of the puberty process.

The therapy is designed to:

reduce the manifestations of the disease;
reduce the number of rashes;
return (as far as possible) a pleasant appearance to the skin.

Stick to the rules:

strengthen immunity;
eat right;
carefully monitor the hygiene of the face and body;
avoid stressful situations;
touch your face less with your hands;
follow the daily routine.

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Acne vulgaris (acne) is a chronic inflammatory disease of the sebaceous hair follicle, characterized by seborrhea, the formation of comedones and inflammatory acne, less often nodes, abscesses, pseudocysts, and sometimes scars.

Epidemiology. The disease occurs very often, however, only 20% of patients consult a doctor; in the rest, acne vulgaris occurs in a mild form and is often considered as a physiological condition. It is extremely rare in newborns, mild forms are sometimes observed in the neonatal period. The peak of the disease falls on the period of puberty (14-16 years, in girls somewhat earlier than in boys, which is explained by the earlier onset of puberty in women); rashes continue, as a rule, up to 20-25 years. Acne vulgaris is an early symptom of puberty, especially when inflammatory acne appears in the middle part of the face; in very young adolescents, comedones are the most common manifestation of the disease; inflammatory acne is rare. In girls, the onset of acne precedes the onset of the menstrual period by more than a year. The largest number of patients is observed in the middle and late adolescence.

Between the ages of 20 and 25 years, acne vulgaris begins to gradually resolve, in 7-17% of patients acne occurs after 25 years, and in these cases women with physiological acne predominate. Recently, the number of women suffering from acne has decreased, which is associated with the use of oral contraceptives. At the same time, there has been an increase in the number of patients in whom acne first appears at a later age (over 25 years old, and in some patients it exists up to 30-40 years old.) In some cases, acne is a family disease.

Etiology and pathogenesis of acne vulgaris (acne). The following factors play a major role in the development of acne vulgaris:

hereditary predisposition;
seborrhea;
The formation of comedones (comedogenesis);
Change in the qualitative and quantitative composition of the microbial flora of the follicle;
androgenic hormones;
development of an inflammatory response.

1. Hereditary predisposition is of undoubted importance in the occurrence of acne vulgaris, the severity of their course, localization, prevalence and sensitivity to therapy. According to German dermatologists, in 45% of schoolchildren with acne vulgaris, one or both parents also noted acne, while acne vulgaris was observed only in 8% of schoolchildren whose parents did not have acne. Hereditary predisposition to the appearance of acne vulgaris is also confirmed by genetic studies on twins.

2. Seborrhea is a violation of the secretory function of the sebaceous glands, characterized by a change in the quantitative and qualitative composition of sebum, especially in the sebaceous hair follicles. There is a lot of evidence that sebum plays an important role in the development of comedones: it has a comedonogenic effect, causing an inflammatory reaction when injected into the skin. Acne mainly occurs during puberty, when the maximum development of the sebaceous glands occurs. Drugs that reduce the function of the sebaceous glands (antiandrogenic, estrogens, systemic retinoids) have a therapeutic effect in acne.

3. Formation of acne (comedogenesis). Violation of the keratinization of the hair follicle plays a major role in the formation of the primary morphological element of the skin rash in acne vulgaris - microcomedone. There is hyperkeratosis of the mouth of the hair follicle, which leads to the formation of a corneal plug that clogs the mouth of the follicle. Under this plug, horny masses, sebum and bacteria accumulate in the hair follicle, which leads to thinning of the follicle and atrophy of the sebaceous gland. Microcomedone may initially appear histologically as folliculitis, and clinically as microacne.

4. Microflora of the hair follicle. Three types of bacteria were isolated from the surface of the skin and mouths of sebaceous hair follicles: anaerobic pleomorphic diphtheroids Propionbacterium: P. acnes, P. granulosum and P. avidum; Staphylococcus epidermidis and Malassezia furfur. Of primary importance in the development of acne vulgaris are P. acnes, the number of which in these patients increases dramatically; to a lesser extent, the formation of acne is affected by P. granulosum.

5. Androgenic hormones are of some importance in the development of acne vulgaris, especially in middle-aged women with treatment-resistant acne. The activity of the sebaceous glands is mainly regulated by androgenic hormones of gonadal or adrenal origin. Dihydrotestosterone is a potent androgen that may play an important role in the development of acne. Dehydroepiandrosterone and androstenedione, weakly potent androgens produced in the adrenal glands, are converted into the more potent testosterone and dihydrotestosterone by the action of enzymes.

Since the importance of hormones in the development of acne has been proven, the sudden appearance of acne in an adult should be the reason for examining the patient for hidden diseases of the pituitary-genital or pituitary-adrenal system.

Indications for endocrinological examination of women, suffering from acne vulgaris may be:

sudden onset of severe acne in adult women;
acne resistance to conventional therapy, especially if women have hirsutism; menstrual irregularities; signs of hyperandrogenism;
a very sharp exacerbation of the process a short time after the start of isotretinoin therapy.

6. Inflammatory reaction. The mechanisms underlying the development of inflammation in acne have not been fully elucidated. In the initial stage of inflammation, pro-inflammatory agents, especially T-helpers, penetrate the follicle wall into the dermis. Bacteria are not a direct cause of inflammation in the dermis, but they produce biologically active inflammatory mediators.

Various agents can enhance the development of acne: anabolic drugs, gonadotropins; corticosteroids and ACTH, as well as emotional stress.

Clinical picture of acne vulgaris.

Anamnesis. In most patients, acne vulgaris begins gradually at the age of puberty. Neonatal acne (around 2 weeks of age) and childhood acne (3-6 months of age) are rare. With the sudden appearance of acne, the patient should be examined to rule out another etiology.

In women with acne, it is necessary to think about hyperandrogenism in severe, sudden onset or combination of acne with hirsutism or menstrual irregularities. Hyperandrogenism is also the cause of coarsening of the voice, decreased libido and hirsutism.

In patients with an acute onset and a monomorphic clinical picture, the drug-induced nature of the acneiform rash should be carefully excluded. The most common acne-causing medications are anabolic steroids, corticosteroids, corticotropin, phenytoin, lithium, isoniazid, vitamin B complex, halogens, and some chemotherapy drugs.

Clinical manifestations. The face is the most common site for the development of acne vulgaris (99% of patients), less often they are observed on the back (60%), chest (15%) and shoulders. In young people, the face is most often affected; in older people - the back. The disease is characterized by a polymorphic rash, the elements of which can be inflammatory and non-inflammatory.

Non-inflammatory acne represented by comedones, which can be open(blackheads, blackheads) or closed(whiteheads, whitheads,). Comedones are localized on the skin of the face, chest, back, and later in the auricles, on the back of the neck.
open comedones have the appearance of black dots that clog the mouths of hair follicles; when they are squeezed out, a white or brownish cork in the form of a worm is released, consisting of thick sebum and horny scales. The black color of a comedone is due to melanin (not pollution or oxidized sebum).
Closed comedones are small, slightly raised hemispherical papules, white in color and have a very small follicular opening. Closed comedones are a major potential source of inflammatory acne.

There are also several subspecies of non-inflammatory comedones that may not be noticed by the physician but are of great clinical importance. These acne are a manifestation of the underlying disease, or are caused by external influences.
To these special forms of closed comedones relate:

so-called comedones like "sandpaper" ("sandpaper comedones"). They are multiple (up to 500 pieces), small white comedones, localized mainly on the forehead;
macrocomedones, which are large, more than 1 mm in diameter, closed or open (usually closed) comedones. Sandpaper comedones and macrocomedones do not respond well to conventional therapy;
the so-called "underwater comedones" ("submarine comedones") - large comedo-like structures, up to 0.5 cm in diameter, located in the deep parts of the dermis. They can be a source of recurrent inflammatory nodes.

Inflammatory acne vulgaris. The development of a purulent inflammatory reaction in the altered follicles is clinically manifested by various inflammatory acne vulgaris. There are the following varieties of acne vulgaris: papular (a.papulosa) - hemispherical or conical papules, pink, up to 0.5 cm in diameter, rash on oily skin. Often in the center of papular acne there is a black dot of the comedone (a. punctata). Pustular acne (a.pustulosa) is characterized by the appearance of pustules on the surface of papular acne. Papular and pustular acne vulgaris usually breaks out sharply and in significant amounts. Having existed for several days, the nodules resolve, leaving in their place small pigment spots or a small, barely noticeable scar. Indurative acne (A. indurata) is characteristic of patients with thick seborrhea. These acne are deep, dense, painful infiltrates, the size of a large pea or more; the skin over which is painted in a bluish color. Consistently, the infiltrates either dissolve, or soften and open, releasing a viscous oily-purulent liquid. After their healing, deep disfiguring scars remain, often hypertrophic. Drain acne (a.confluens) are the result of the growth and merging of indurative acne, which can be connected to each other by deep passages, forming a roller-shaped or worm-shaped infiltrate that opens with several holes. Sometimes this process takes an acute course, the skin over the infiltrates turns bright red, after opening a large amount of pus is released - phlegmonous acne (a.phlegmonosa).

Scarring. Scarring is an important clinical symptom of acne. Scars usually occur after resolution of deep inflammatory lesions, however, they may occur with resolution of superficial inflammatory lesions in patients prone to scarring.

Persistent pigmentation may remain after acne vulgaris has resolved and sometimes causes cosmetic complaints more than the underlying disease.

Factors affecting the course of acne vulgaris.

stress can increase the severity of the course and lead to the emergence of new acne. In turn, blackheads themselves cause stress, and their extrusion worsens the appearance of a person. This is especially pronounced in young women suffering from excoriated acne (acne excoree). Surveys of a large number of patients suffering from acne showed that many of them experience a sense of shame (70%); embarrassment and anxiety (63%); uncertainty (67%); deterioration of social contacts (57%) and have significant problems with finding a job. Severe acne can be a cause of anger and anxiety.
Diet(food calories, carbohydrates, proteins, minerals, vitamins, amino acids) does not significantly affect the development and severity of acne.
Premenstrual exacerbations. About 70% of women note an exacerbation of inflammation 2-7 days before menstruation. It is possible that this is due to a change in the hydration of the epithelium of the follicles in the premenstrual period. Progesterone and estrogens have a pro-inflammatory effect on acne vulgaris.
Sweating. 15% of patients noted the negative impact of humidity on the course of the disease, especially in cases where a person lives in a humid, warm environment.
Ultraviolet irradiation. Many patients and doctors are convinced of the positive effect of sunlight on acne. There is no scientific evidence for this. It is possible that the improvement is due to the psychological effect of tanning. Artificial ultraviolet radiation (UVB-B; PUVA) often increases the comedogenicity of sebum and the development of acne.
Professions. Cooking and steam cleaning can increase hydration of the stratum corneum of the follicles and cause acne. Working with halogenated hydrocarbons can cause chloracne.
Smoking negatively affects the course of acne.

Principles of examination of patients with acne.

Recommended methods of examination for patients suffering from seborrhea and acne vulgaris, with suspected hormonal disorders (including: resistance to therapy, irregular menstruation, severe hirsutism, signs of female alopecia):
1. testosterone;
2. dehydroepiandrosterone; dehydroepiandrosterone sulfate (precursors of testosterone and dihydrotestosterone);
3. globulin that binds sex hormones (sex hormone - binding globuline; SHBG);
4. prolactin;
5. follicular/lutein-stimulating hormone ratio;
6. exclusion of polycystic ovaries (if necessary);
7. in men and women with resistance to acne vulgaris therapy, the determination at 9 am of the level of cortisol and 17alpha-hydroxyprogesterone to exclude late-onset congenital adrenal hyperplasia
8. swabs from the oral mucosa and skin to exclude gram-negative folliculitis.

Treatment of seborrhea and acne vulgaris.

Principles of acne therapy.

Elimination of violation of keratinization of the follicle;
Decreased secretory activity of the sebaceous glands;
Suppression of the microflora of the follicles, especially the population of Propionbacterium acnes;
Anti-inflammatory measures;
External treatment and cleansing of the skin Cleansing of the skin in patients with acne vulgaris should be gentle. It is preferable to wash your face with mild cleansers twice a day, followed by topical acne treatments.
Light and laser therapy. The use of ultraviolet radiation for the treatment of acne vulgaris is currently considered ineffective. Blue light (wavelength 440 nm) has a detrimental effect on P. acnes protoporphyrins, leading to the release of oxygen and the death of anaerobic bacteria. There are also reports on the effectiveness of laser therapy for acne vulgaris, for example NLite pulsed laser with a wavelength of 585nm with a very short pulse has been shown to be effective. Other physical methods of treatment are also used, which include cautery of comedones, cryotherapy and the introduction of triamcinolone into the lesions with keloid scars, laser therapy, chemical peeling, paraffin applications. In some cases, especially women, cosmetic camouflage should be recommended.

Rodionov A.N., Doctor of Medical Sciences, Professor

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