What is acne?
Acne is commonly known as “acne”, also known as “acne”, “acne”, “acne”, etc. It usually occurs on It usually occurs on the face, neck, chest and back, shoulders and upper arms. It is a chronic inflammatory skin disease of the sebaceous units of the hair follicles and is characterized by whiteheads, blackheads, inflammatory papules, pustules, nodules, and cysts. This disease is prevalent in adolescence, but is not entirely limited by age stage, and can develop in almost all age groups, from children to adults. The results of a joint survey by the Chinese Dermatology Association and the China Youth Federation show that the prevalence of acne among adolescents aged 11 to 25 is over 80%, and among youth aged 26 to 35, the prevalence is over 15%.
How is acne formed?
Acne is a multifactorial disease. The pathogenesis is mainly due to
1. Hyperandrogenism, increased sebum synthesis and secretion
2. Blockage of pores due to keratinization of the sebaceous ducts of hair follicles
3, Propionibacterium acnes infection
4, the body’s immune response
When the human body is in puberty, the level of androgens in the body is high, promoting the secretion of a large number of sebaceous glands. At this time, if the pores are blocked due to hyperkeratosis of the hair follicles, a large amount of secreted sebum is not effectively excreted, and then it accumulates locally to form acne. The sebum in acne is a good nutrient for the growth of bacteria. Propionibacterium acnes grows and multiplies in large numbers and decomposes sebum to form free fatty acids, which stimulates the inflammatory reaction of the hair follicle wall, resulting in a series of clinical manifestations such as acne, inflammatory papules, pustules and nodules.
In addition, genetic factors and some external environmental and psychological factors also have a certain influence.
Acne typing clinically classifies acne into the following types according to the main manifestations of lesions: acne vulgaris, acne papularis, acne pustularis, acne sclerosis, acne cysticum, acne atrophicum, acne aggregatum, acne necrophorum, acne neonatorum, and grading of acne.
Grade I (mild) has predominantly acne with a few papules and pustules and less than 30 total lesions.
Grade II (moderate) with acne, moderate number of papules and pustules, and a total number of lesions of 31-50.
Grade III (moderate) with a large number of papules and pustules, occasional large inflammatory lesions, total number of lesions 51-100, and less than 3 nodules.
Grade IV (severe) nodular/cystic acne or coalescent acne with a total number of lesions over 100 and more than 3 nodules/cysts.
How can acne be effectively treated?
I. Topical drug treatment
1. Retinoic acid: It can promote the conversion of ductal epithelial cells, regulate the keratinization process, reduce the formation of micro acne and help mature acne subside, and also has anti-inflammatory effects.
2.Peroxyphenoyl: an organic peroxide with bactericidal, exfoliating, dissolving acne and inhibiting sebum secretion effects.
3, antibiotics: commonly used are clindamycin and erythromycin, which can effectively kill Propionibacterium acnes and control inflammation, but have no effect on acne formation.
Second, systemic treatment
1, oral isotretinoin: Isotretinoin is the most effective sebaceous gland inhibitor and the only drug that can target all aspects of acne. It can shrink sebaceous glands and reduce sebum secretion, promote normal keratinization, inhibit the proliferation of Propionibacterium acnes and anti-inflammatory effects, which can fundamentally block the formation of acne. It is mainly used for moderate to severe acne and recurrent acne.
2, antibiotics: commonly used antibiotics are tetracyclines, macrolides, etc., which generally take 4-8 weeks to take effect. In recent years, the rapid increase in resistant strains of Propionibacterium acnes has been found, resulting in the inability to improve the condition.
3, contraceptive pills: have a strong anti-androgen effect, blocking the effect of dihydrotestosterone on the sebaceous glands, so that sebaceous secretion is reduced, but this method is not applicable to male patients.
4. Mask inversion therapy: For mild to moderate acne, acne draining, mask and inversion therapy can be used.
5. Photodynamic therapy: For acne patients who do not tolerate medication or do not want to receive medication, photodynamic is the best choice.
What are the reasons for acne treatment failure?
1. Patients choose their own medications, resulting in improper medication and failure to achieve typological treatment.
2. Inadequate treatment dosage or insufficient treatment time due to fear of drug side effects.
3, the use of drugs at the beginning, sometimes there will be aggravation of symptoms, mistaken for adverse reactions and stop treatment
4.Resistant to antibiotics.
5, the simultaneous use of other drugs, drug interactions have occurred.
Prevention and proper treatment of acne
Develop good habits: pay attention to personal cleanliness and hygiene, keep your face and hands clean, and do not use your hands to squeeze, pinch or pinch acne. The dangers: one will lead to inflammation and the development of bacteria to the depths; the second is the evil of disfiguring scars.
1, after the occurrence of acne should go to the hospital to see a dermatologist as soon as possible, follow the doctor’s instructions, take the medication and apply the medication carefully, it is important to adhere to
2, do not apply topical drugs containing hormones, because although hormones can reduce the inflammatory reaction of skin lesions in the short term, long-term use will induce acne and aggravate the condition.
3, pay attention to a light diet and regular life, and strengthen exercise
4. Avoid using oily cosmetics, which cannot treat acne and contain acne-derived substances that can aggravate acne.
5, pay attention to some drugs will aggravate the condition: such as glucocorticoids, androgens, iodine, bromine and lithium, etc.
Can acne be cured?
Acne is a skin disease that can be cured, and most people can be cured without recurrence, but it requires a regular treatment and a long enough treatment course. Otherwise, acne will recur, giving you the illusion that it cannot be cured. Some people have acne that is self-limiting and develops during adolescence. Later, as they age, acne will gradually improve and subside, but some people do not heal on their own, and there is a tendency for acne to worsen and even leave scars.
Can acne fade on its own without treatment?
Acne does have a certain degree of self-limitation, as demonstrated by the fact that the disease has a certain age of onset and natural course. Most people are at high risk of developing acne during adolescence, after which it gradually resolves and subsides on its own. However, treatment is still needed due to.
1. Acne often leads to the formation of scars and marks on the face, some of which are difficult to treat and will exist for life, greatly affecting beauty and aesthetics. Early, timely and regular treatment can not only significantly shorten the course of the disease but also prevent the formation of scars.
On the contrary, some people develop acne after the age of 30, and the course of the disease lasts for a very long time, such as after the age of 40, and a few people cannot even remit on their own even at the age of 50.
What is the proper treatment if an adverse reaction occurs?
The use of acne medications can cause adverse reactions of varying degrees. For example, topical retinoids and peroxynivalenes may sometimes cause reactions including erythema, dryness, itching, irritation and burning sensation. If the above-mentioned adverse reactions occur and cannot be tolerated, you should consult your doctor promptly and discontinue the drug if necessary.
Antibiotics can cause different degrees of gastrointestinal reactions, serious drug-related hepatitis, intracranial hypertension, etc.; women using hormones can have edema, thrombosis, weight gain, breast pain, chloasma, etc. Some adverse reactions are reversible and will disappear after stopping the drug. For example, if the ingredients of retinoids are acids, they are metabolized quickly and have good long-term safety, while if the ingredients are esters, they are metabolized slowly and have poor long-term safety.
Can cosmetics cure acne?
Cosmetics themselves are used for the health and care of the skin. The biggest requirement for cosmetics is that they must be safe for the skin, non-irritating, moist and protective. Recently, however, there have been a number of so-called special healing cosmetics that do add low concentrations of pharmaceutical ingredients that have a very limited therapeutic effect on acne, but of course these added pharmaceutical ingredients are not new. The problem is that the concentrations of these drug ingredients are usually very low, below the therapeutic concentration of the drug, and therefore often insufficient to treat acne, and only have some suppressive effect on very mild acne. In addition, state verification of such cosmetics is mainly to verify their safety and not to critically examine their efficacy, so usually the state also does not allow any cosmetics to make any trade claims about their efficacy. Unfortunately, almost all cosmetic products advertise their miraculous “efficacy” and no one asks questions about this violation.
Can acne treatment work in a few days?
This is the most common advertising phrase used in all types of trade promotion. With the development of dermatological science, acne treatment is now easier and more reliable, but it should be clear that even short-term results are usually maintained for weeks or even months to prevent recurrence. We do not rule out the possibility that the medication will work within a few days, but a short treatment period of a few days is of little practical importance in the treatment of acne. In fact, almost all effective medications are more or less effective within a few days, but once they have been cleverly designed and packaged with a certain amount of trade promotion, they can become a miracle drug overnight and create a social sensation.
Is acne caused by unclean skin?
This is a viewpoint that has been strongly exaggerated, amplified and promoted by all kinds of skin cleanser sellers, as it facilitates the marketing of their products. Although clogged pores are an important part of acne development, it does not mean in any way that clogged pores are caused by unclean skin. In fact, acne sufferers take skin cleansing more seriously than anyone else, and they spend a lot of effort cleaning their facial skin almost daily. Clogged pores in acne patients are mainly caused by intrinsic causes in the skin itself, starting with abnormal keratinization of the pores, which ultimately leads to clogging. The cleansing of the skin is not the main problem. On the contrary, excessive cleansing sometimes aggravates the keratinization of the skin pores, which may further aggravate the clogging of the pores and worsen the condition. Many people buy a lot of various skin cleansing products (such as facial cleansers) in the hope of replacing medication to treat acne, which is not effective or necessary, and is a treatment that puts the cart before the horse.
Is acne caused by mites?
In fact, acne is caused by hyperkeratosis in the funnel of the hair follicle, sex hormone imbalance and hyperfunction of the sebaceous glands, the action of microorganisms in the sebaceous units of the hair follicle, inflammation and the immune response of the host. It is normal for something called follicles (commonly known as mites) to live in our hair follicles, just like bacteria exist on our skin nothing special, but sometimes follicles can indeed cause a disease called follicular dermatitis, but there is a big difference between this disease and acne, so don’t get confused.
What should I pay attention to with acne skin?
1, daily life should be careful to eat less spicy food and stimulating food.
2.Keep your skin clean. Be sure to wash your face with cleanser every night. Then apply moisturizing water.
3, keep a happy mood, learn to self-regulation, happy life.
4.Quit bad habits, such as smoking, drinking, staying up late, etc.
5, drink more water, eat more vegetables and fruits, and develop a daily bowel habit.