Acne (acne, acne) is a chronic inflammatory disease of the sebaceous glands, resulting from their blockage and increased production of sebum.
The sebaceous glands are only in the skin of mammals, to which we treat you. These glands produce a special secret (sebum) – a mixture of fats that prevent the skin from drying out, make it supple, protect the body from various bacteria and infections, and also participate in a complex system of skin thermoregulation.
The secretion of the sebaceous secretion may increase with an increase in the level of male sex hormones (androgens) and decrease under the influence of female genital (estrogens).
In one form or another, acne occurs in 60-80% of young people aged 12 to 24 years. However, acne can appear after 25 years, as a rule, against a background of metabolic disorders.
Specialists identify several major types of acne, depending on the causes of their occurrence. First of all, these are endogenous (arising from internal causes) and exogenous (arising from external causes) acne.
The cause of endogenous acne can be various hormonal changes, including a natural “hormonal splash” in adolescence and adolescence. A hereditary conditioned inadequate reaction of the sebaceous glands to the increasing level of male sex hormones in the blood, which can take place both in men and in women, also plays a role.
In adulthood, the most common cause of endogenous acne is seborrhea. In addition, acne can occur with various infections, as well as chronic diseases. Often the very clinical picture of acne may suggest the presence of a concomitant disease. So, for example, the location of acne in women around the mouth and on the chin often indicates a pathology of the ovaries.
Exogenous acne develops:
- When the skin gets various substances that have a comedogenic effect, it causes a blockage of the sebaceous glands and skin coarsening (hyperkeratosis) in the mouths of the hair pouches. These include various oils and lubricants, preparations containing tar. With these substances a person can contact, for example, in production.
- with excessive use of cosmetics containing fats (fatty cream-powder, blush, shadows, etc.). In some foreign classifications of acne, even a special form of acne is distinguished – acne mallorca. This clinical version was described in young people who were vacationing in Mallorca, who used tanning oil, which resulted in the appearance of blackheads.
- with prolonged pressure and friction of the skin with clothing or linen, which causes mechanical blockage of the holes of the follicles. An example is the long pressure of the headgear, sports helmet, plaster bandage, bed linen in immobilized patients, especially with excessive sweating. In these cases, people who are predisposed to the disease may experience mechanical acne.
- As a result of taking anabolic steroids by athletes and bodybuilders – this is the so-called bodybuilding acne.
In the development of acne, four main mechanisms can be distinguished:
- increased production of sebaceous secretion by sebaceous glands;
- hyperkeratosis – excessive thickening of the upper (horny) layer of the skin;
- activity of skin microflora, i.e. those bacteria that normally live on human skin;
Due to increased production of secretion, sebaceous gland increases in size, which leads to the appearance of ugly enlarged pores on the face. At the mouth of its duct thickens a layer of horny skin scales, which slough off faster than usual. Soon the scales clog the duct and clog it. Not finding an outlet, sebum dilates the cavity of the sebaceous gland, in which it gradually accumulates more and more. In the blocked sebaceous glands, the Propionobacterium acne bacterium begins to multiply. This bacterium is a normal representative of the microflora of the sebaceous glands, but when it multiplies too much, inflammation occurs.
The sealed sebaceous gland, filled with sebum, is called a comedo. If the comedon does not have an outlet on the surface of the skin, the sebum remains white and whiteheads appear. If the comedon comes to the surface, the sebum is partially oxidized, melanin is mixed with it, resulting in the head of the comedon acquiring a black color – black acne occurs.
Acne can occur for a variety of reasons. That is why when it appears, you should contact a dermatologist – the doctor will find out what exactly led to the appearance of acne and will prescribe the appropriate treatment. If it turns out that acne is caused by hormonal disorders, you will also need an endocrinologist’s advice. The cosmetician, in turn, will help get rid of the external manifestations of the disease.
Treatment of acne is prescribed depending on the severity of the course of the disease. There are three degrees of severity of acne:
- Light – in the presence of closed or open acne with little or no inflammation. On the face skin there are less than 10 similar elements;
Medium – from 10 to 40 acne on the skin of the face;
- Heavy – more than 40 acne on the face skin – usually inflamed, purulent.
For mild acne, preparations for external (local) therapy are used: creams, gels, ointments, lotions, etc. containing various active substances that interfere with the formation of comedones or destroy them, reducing the formation of sebum and inflammation. Such means, in particular, include benzoyl peroxide (OXY5, OXY10), tretinoin (Airol Roche, Retin-A) and azelaic acid (Skinoren).
With moderate and severe form of treatment is carried out by external means, and the intake of drugs inside. In some cases, the appointment of antibiotics (for example, tetracyclines) is necessary. With hormonal disorders can be used sex hormones.
To clean the skin from acne, peeling is done – removing the surface layers of the skin with the help of weak acid solutions (chemical peeling) or mechanical grinding (dermabrasion). Also, to combat acne, face cleansing, special facial massage, surface cryotherapy, and even laser therapy for individual non-inflamed acne are used.
Surgical manipulations have very limited application in acne. Opening of cystic cavities is contraindicated, as it leads to the formation of persistent scars. Sometimes with severe suppuration of acne scaling of the foci with special preparations is used.
Acne is quite easy to treat. In most cases, it is possible to achieve complete disappearance of inflammatory elements and prevent the formation of new acne for a period of one to several years (and sometimes, and forever).
To prevent acne, regular skin care is required. People prone to this disease, it is not recommended to use fatty creams, oils and ointments containing lanolin and petroleum jelly. From cosmetics, you should choose those that are labeled “non-comedogenic” (that is, do not contain ingredients that contribute to the formation of acne).