Treatment of acne
I. Etiology and pathogenesis.
It is mainly related to androgens, increased sebum secretion, abnormal keratinization of hair follicle sebaceous ducts, proliferation of Propionibacterium acnes and genetics.
Androgens → increased sebum secretion → proliferation of Propionibacterium acnes → production of free fatty acids and low molecular peptides → acne and other skin lesions.
II. Clinical manifestations.
1, adolescent onset.
2. The lesions tend to occur on the face, forehead, upper chest and back and other seborrheic areas.
3. Common rashes.
(1) Whiteheads (closed acne) can be picked and squeezed out of white bean curd-like material.
(2) Blackheads (open pimples) contain sebaceous plugs.
(3) Inflammatory papules and pustules.
4. More serious cases are accompanied by nodules, cysts, scarring, atrophy, etc.
III. Treatment.
Principles: Exfoliation, dissolution of keratin, sterilization, anti-inflammation and regulation of hormone levels.
1, general treatment.
Avoid squeezing and scratching the acne with hands, and use oily cosmetics with caution. Avoid spicy foods, control fat and sugar, and eat more fresh vegetables and fruits. Pay attention to moderate work and rest, correct constipation.
2. Topical medications.
① Retinoic acid: 0.05~0.1% cream or gel, mild irritation (local flushing, flaking or burning sensation, etc.) can occur after 5~12 days of medication, which can subside. It should be started from low concentration.
② benzoyl peroxide: 2.5, 5, 10% lotion, emulsion or gel, use from low concentration.
③Antibiotics: Jyothamycin, erythromycin tincture, etc.
④Other: compound sulfur lotion, 2.5% selenium sulfide lotion, etc.
3.Internal drugs.
①Antibiotics: doxycycline, erythromycin, etc.
② Vitamin A acid class: treatment of moderate to severe seat sores. Vitamin capsules.
③Vitamins: B vitamins.
④Antiandrogenic drugs: mainly used for severe patients.
⑤ Glucocorticoids: for severe nodular cystic thrush. Small doses of prednisone orally or trimethoprim topically.
⑥Zinc preparations: zinc gluconate oral solution, etc.
4.Physical treatment.
①Pimple squeezer to squeeze out the contents of open pimples, and massage or spray with medicine after cleaning;
②Mask or inversion mask;
③Phototherapy: combined with blue-red light irradiation to inhibit the seat bacillus and reduce the inflammatory response.