Acne is a common chronic skin inflammation with a high incidence, mostly seen in adolescent men and women. In recent years, with the development of the economy, people’s living standards have gradually improved and their dietary structure and living habits have changed significantly, making the incidence of the disease on the rise. This not only affects the patient’s appearance, but also has a negative impact on the patient’s psychology and social life.
Concept
It is a chronic inflammatory skin disease of the sebaceous gland unit of hair follicles, with onset in adolescence, and the prevalent sites are the face, back and forehead. Skin lesions include pustules, follicular papules, cysts, blackheads or whiteheads, accompanied by seborrhea and scarring, and have a chronic course.
Clinical manifestations
Skin papules, pustules, cysts, nodules, blackheads or whiteheads, with hyperpigmentation or scarring after healing, leading to orange peel face in severe cases. The disease is not easily cured because of its itchy and prolonged course. The disease usually occurs in adolescent men and women.
Etiology
The pathogenesis is still not fully understood. Genetics, androgen-induced sebum production, keratinization of follicular sebaceous ducts, Propionibacterium acnes colonization, inflammation and immune response may all be involved.
Classification of acne
Acne is classified into 3 and 4 grades according to the nature of the lesions: mild (grade I): acne only; moderate (grade II): inflammatory papules; moderate (grade III): pustules; severe (grade IV): nodules and cysts.
Treatment
1.Western medicine can use vitamin A acid drugs, hormones, antibiotics and other treatment, but the effect is general, and easy to recur.
2.Chinese medicine treatment
(1) Wind-heat evidence of the lung meridian: The lesions are mainly red or skin-colored papules and pimples, or itchy and painful, with yellow urine, constipated stools and dry mouth; the tongue is red, the fur is thin and yellow, and the pulse is floating. The formula is Loquat Qing Lung Drink or Diabai San with addition and subtraction, and the Chinese medicine can be Gardenia Jinhua Pill.
(2) Spleen and stomach damp-heat evidence: The skin lesions are mainly red papules and pustules with pain, oily skin on the face and back of the chest. The treatment should be to clear heat and dampness, ventilate and detoxify the internal organs. For constipation, the Chinese herbal medicines Lianxiao Defeat Toxin Pill and Fangfeng Tong Sheng Pill can be used; for loose stools, the Chinese herbal medicines Xiang Lian Pill and Ginseng and Baijiao San can be used.
(3) Phlegm and stagnation evidence: The lesions are mainly nodules and cysts, with dark red color and also pustules, which do not heal over time. The treatment should be to activate blood circulation and resolve blood stasis, resolve phlegm and disperse knots. The prescription is Hai Zha Yu Hu Tang or Tao Hong Si Wu Tang combined with Er Chen Tang with addition and reduction.
(4) Irregularity of the flush: The lesions are usually found on the forehead, between the eyebrows or on the cheeks, increasing before menstruation and decreasing after menstruation, accompanied by irregular menstruation, irritability before menstruation, breast swelling and pain, and impatience. The treatment should be to harmonize the flushes and the blood, regulate the qi and activate the blood, and the prescription should be Prosperity San or Erxian Tang combined with Zhi Bai Di Huang Wan plus or minus.
Health care
1.Health education
① Diet: Limit spicy and sweet foods that may trigger or aggravate acne, and eat more vegetables and fruits.
② Daily life: avoid staying up late, long-term exposure to computers, exposure to the sun, etc. Pay attention to facial skin cleansing, moisturizing and reducing sebum secretion, and keeping bowel movements smooth.
③Psychological counseling: Patients with acne, especially those with severe acne, are more prone to anxiety, depression and other psychological problems; therefore, it is also necessary to cooperate with the necessary psychological counseling for such patients.
2.Local cleansing
Choose water or suitable cleansing products to remove the mixture of excess oil, dander and bacteria from the skin surface, but do not over-wash. Avoid squeezing and scratching acne and inflammatory papules and other skin lesions with your hands.
3.Daily care
Some acne patients have a damaged skin barrier, and long-term oral or topical anti-acne medications such as vitamin A acid will often aggravate the destruction of the skin barrier and lead to skin sensitivity. Therefore, in addition to medication, physical therapy, and chemical peeling, it is sometimes necessary to use efficacious skin care products to maintain and repair the skin barrier function. If the skin is sensitive, topical soothing and oil-controlling moisturizing creams should be used, and skin care products with anti-acne effects can be used on local lesions; if the skin shows symptoms such as greasiness and enlarged pores, oil-controlling moisturizing gel should be mainly used.