Acne is a chronic inflammatory skin disease of the hair follicles and sebaceous glands, known as acne in Chinese medicine. It has a significant impact on the facial beauty and mental health of patients. In our long-term clinical practice, we have achieved excellent clinical results in the treatment of acne based on Chinese medicine, combining Chinese and Western medicine, systematic treatment, topical creams, and herbal masks. At the same time, Chinese medicine combined with physical treatments such as ion introduction and microdermabrasion have also achieved good results in the treatment of post-acne marks (discoloration and small scars).
Causes of acne 1. Endocrine factors. Androgens, especially testosterone, play an important role. Some patients have higher blood testosterone levels than those without acne.
2, excessive sebum secretion. The stimulation of free fatty acids causes inflammatory reactions.
3, Abnormal keratinization and obstruction of follicular sebaceous gland ducts.
4, Bacterial infection. Mainly Propionibacterium acnes. Bacterial infection itself, and free fatty acids, peptides and enzymes caused by Propionibacterium acnes infection, cause and aggravate inflammation.
5, Some patients are also related to the immune function of the body, especially in severe acne and fulminant acne.
6, Others such as acne caused by certain drugs.
Chinese medicine etiology and pathogenesis: Heat is contained in the lung meridian, and the face is fumigated by wind evil; damp heat is caused by poor diet, or damp heat is caused by spleen deficiency, and the face is steamed. Damp-heat and stagnant phlegm can stagnate in the skin. Classified as: wind-heat evidence of the lung meridian, damp-heat evidence of the intestines and stomach, and phlegm-damp stagnation.
Grading of acne: three degrees and four grades Grade 1 (mild): acne only; Grade 2 (moderate): inflammatory papules in addition to acne; Grade 3 (moderate): pustules in addition to acne and inflammatory papules; Grade 4 (severe): nodules, cysts or scarring in addition to acne, inflammatory papules and pustules.
Laboratory tests Sex hormone levels (gonadotropic) and humoral immune function, gynecologic ultrasound, if necessary.
Treatment ① Topical medications: Retinoids, such as Ansonia (isotretinoin gel), Daphne (adapalene gel); Bansai (benzoyl peroxide gel); turmeric acne cream. Retinoids and Bansai may cause mild skin irritation such as local flushing, flaking, tightness or burning sensation in the first 3 days after starting the medication, but most of the skin will gradually adapt and the symptoms will disappear. Acne cream (homemade in our hospital) The greasy areas are given the compound bitter ginseng lotion or Hilsen (selenium disulfide) lotion made by our hospital for external washing.
② Oral antibiotics: Applicable to moderate and severe acne. Tetracyclines (methomycin, doxycycline) should be preferred, followed by macrolides (erythromycin), and other drugs such as metronidazole can be used as appropriate. Pay attention to the adverse reactions of tetracyclines, such as gastrointestinal reactions, liver damage, photosensitivity reactions, dizziness and headache, etc.
③ Oral Tylenol (isotretinoin): its application indications should be mastered. Pay attention to side effects: teratogenic effects (contraception should be used 3 months-1 year after the end of treatment), dryness of skin mucosa, abnormal liver function and lipids, bone abnormalities and, rarely, depressive symptoms, photosensitivity, etc. Isotretinoin should not be used simultaneously with tetracyclines and systemic glucocorticoids.
④Hormone therapy: compound cyclopentone acetate tablets (Daine-35), start taking 1 tablet on the 1st day of menstrual cycle for 21d, stop for 7d, and repeat for 21d after another period, for a course of 3-4 months. Anti-androgen drugs: Adequantoin (spironolactone) and metformin (cimetidine). The duration of treatment with Ativan is 3-6 months. Adverse effects are menstrual disorders, etc. It is not recommended for male patients.
⑤ Our own acne combination and defeat (sore) combination: Clears heat and detoxifies toxins and is used for patients with lung heat and gastrointestinal damp heat. They are suitable for patients with mild to moderate acne. A few have stomach discomfort and diarrhea after taking them.
(6) Chinese medicine evidence-based treatment.
(7) Chinese medicine: Tanshinone (papules, pustules), Baixian Xia Ta Zhe tablets (heat clearing, laxative), Xi Huang capsule (nodules, cysts).
⑧Adjunctive medicine: vitamin B6, zinc gluconate, zinc licorice, etc.
Treatment of hyperpigmentation spots 1.Topical application of tretinoin cream, Bi-oil liquid, Daphne.
2.Oral use of vitamin C, vitamin E, Chinese herbal medicine such as ginseng and maidenhair pills, and safflower prolotherapy pills if you have menstrual disorders.
3.Oral administration of our homemade mother-of-pearl spot removal soup and spot removal formula.
4.Facial massage and homemade herbal mask (containing yam, angelica, chuanxiong, etc.).
5.L-vitamin C ultrasonic audio ion introduction.
6.Photonic skin rejuvenation.