What is acne?
Acne vulgaris is a chronic inflammatory disease of the hair follicles and sebaceous glands that occurs mainly on the face, chest and back. It causes acne, papules, pustular nodules, cysts and other damage. The pathogenesis is complex and is mainly related to hyperproduction of androgens and sebaceous glands, abnormal keratinization of follicular sebaceous ducts, the role of microorganisms in follicular sebaceous units, inflammation, and host immune response.
The excessive secretion of androgens during puberty increases the synthesis and secretion of sebaceous glands, keratinization and proliferation of the follicular funnel, blocking the pores and forming sebaceous plugs, or acne. In particular, the bacterium Acinetobacter breaks down stagnant sebum and produces free fatty acids, which stimulates inflammation of the hair follicle, causing damage to the follicle wall and rupture of the pimple contents into the dermis, causing inflammation of varying degrees around the hair follicle.
After getting acne, many people tend to make the following mistakes, which lead to more serious consequences.
1. Not considering it a skin disease, a normal reaction that all youths have, and letting it develop, mistakenly believing that it will heal itself.
2, inappropriate treatment. Self-treatment, aggravating the infection, going to an irregular hospital and using irregular drugs, leading to aggravation of the disease, such as highlighting the short-term effects, hormone abuse, starting well, getting worse, forming hormone dependence and heavy infection, as well as discoloration, vascular dilation, etc.
How can I tell if I have acne?
The main points of diagnosis are as follows.
1. Most often seen in youth, the damage occurs on the face, especially on the forehead, cheeks, followed by the back of the chest and back of the shoulder blades.
2, the initial stage of the lesion and the hair follicle consistent with the round normal skin color papule, containing yellowish sebum plugs, that is, acne, the tip of the yellow-white dots, the follicle opening is not obvious, not easy to squeeze out the fat plugs called white head acne, if the follicle open, sebum plugs the tip, dry, oxidation, pollution is black, called black head acne. The head is black and the body is translucent yellow when squeezed by hand. The lesions can appear as a series of symptoms such as inflammatory papules, pustular papules, pustules, nodules, cysts, etc. in the process of development.
3. Clinical typing: papular acne, pustular acne, cystic acne, nodular acne, atrophic acne, coalescent acne, necrotizing acne, and infantile acne.
4, often accompanied by facial seborrhea, oiliness, large pores, shiny and oily hair, increased scalp
5.Sugar-rich, lipid-rich and irritating foods can aggravate the lesions. Some female patients’ rashes can be aggravated during menstruation, also known as premenstrual acne.
6. Most patients have no conscious symptoms; those with strong inflammatory reactions feel pain or tenderness, and most of them reduce after puberty, but those with pustules, nodules, abscesses and cysts can leave depressed or hyperplastic scars after healing.
7, clinical grading: using Pillsbury classification, divided into Ⅰ-Ⅳ degrees
Ⅰ degree (light) blackhead acne, epidemic to multiple, inflammatory rash, epidemic
Ⅱ degree (moderate) Ⅰ degree plus shallow in pustules, inflammatory rash increased in number, limited to the face
Ⅲ degree (severe) Ⅱ degree deepening in inflammatory rash, occurring on the face, neck and chest and back
Ⅳ (severe – clustered) Ⅲ plus cysts, easy to form scarring, occurring in the upper half of the body
How is it treated?
Mild cases do not require treatment or only topical medications such as anti-inflammatory and antiseptic or mild exfoliation. More severe cases can be treated locally in addition to systemic medication as appropriate. Medication principles: Correct abnormal keratinization in the hair follicle, reduce sebaceous gland activity, reduce intrafollicular flora, especially Propionibacterium acnes, anti-inflammation and prevention of secondary infection.
1.Eat less animal fat, sugar and stimulating food, avoid drinking alcohol, drink more water and fruits, and avoid constipation.
2, remove facial sebum, avoid stimulating cosmetics, prohibit bromine, iodine and glucocorticoids and other irrational drugs, reduce triggering factors.
3, reduce the mental burden, reasonable work and diet, correct use of drugs, reasonable and effective treatment.
4.Local treatment.
(1) antibiotics to reduce the inflammatory response, reduce and inhibit propionic acid rods, commonly used in papules and pustules type. Such as: clindamycin, metronidazole gel.
(2) Vitamin A acid class targets a variety of pathogenic links, anti-keratinization, inhibition of sebaceous gland secretion, removal of mature acne, maintenance of acne remission, and moderate anti-inflammation. Suitable for papular, pustular, nodular and cystic. For example: the first generation of all-trans retinoic acid, the third generation of retinoic acid (adapalene), better action, less side effects, and better results for mild to moderate severity, including maintenance of the treatment state. Foreign reports,0.05-0.1% tazarotene on inflammatory and non-inflammatory damage and adapalene equivalent.
(3) Benzoyl peroxide keratolytic + broad-spectrum antiseptic, dissolves blackheads, inhibits sebaceous gland secretion, and reduces free fatty acid formation. Indicated for papulopustular and pustular acne. The effect is better.
(4) Azelaic acid is antibacterial, anti-acne, anti-inflammatory, and can also improve post-acne pigmentation, which is not yet officially applied in China.
5. Systemic treatment.
(1) Antibiotics: The principle is a reasonable dose and a sufficiently long course of treatment. (Minocycline), also known as Mymanomycin, is a semi-synthetic tetracycline with good lipid solubility, penetrates into the sebaceous glands of hair follicles, and inhibits Propionibacterium acnes. Indicated for papules, pustules, nodules, cystic, 50-100mg 1-2 times daily, 2-3 weeks reduction, adverse reactions: gastrointestinal reactions, headache, etc., also rarely skin, sclera and bone, pigmentation, serum sickness-like reactions, prohibited for pregnant women. (Azithromycin), effective inhibition of intracellular pathogens, 250 mg once daily for three weeks, few adverse effects. Good patient compliance. Others such as: clarithromycin, doxycycline, metronidazole, etc.
(2) Retinoic acid: Inhibit hyperkeratosis of sebaceous glands, reduce sebum production and acne formation, inhibit Acinetobacter, reduce chemotaxis, and change lymphocyte function. It is suitable for nodular, cystic, coalescent, severe acne that fails conventional treatment and those with high sebum secretion overflow. Isotretinoin, 0.5-1.0mg/kg, divided into 2 oral doses for 4-6 weeks. Side effects: dry skin, gastrointestinal symptoms and teratogenicity. Contraception within six months of stopping the drug.
(3) Sex hormones: limited to severe cases and other poor treatments, capable of causing endocrine disorders, such as feminization of male patients, menstrual disorders, etc. Not used as routine therapy. Estrogen, for women only, can be tried with hexestrol 1mg, applied on the 5th day after menstruation, once a night for 22 days. Progesterone, for premenstrual acne, 10mg of progesterone can be injected 10 days before menstruation and another 5mg 5 days before; compound norethindrone, 0.625mg starting 5 days before menstruation for 22 days. Chorionic gonadotropin, 500-1000 U, 1-2 intramuscular injections per week, 10 times a course. Daing-35, for the treatment of acne caused by excessive female hormones, start taking one tablet daily on the first day before menstruation for 3 weeks, stop for one week, and then start another cycle for several months of application.
(4) Anti-androgen drugs: spironolactone, cimetidine.
(5) Tanshinone: Chinese patent medicine, weak estrogen and mild anti-androgen effect, mild, good effect, often used as an auxiliary medicine
(6) Glucocorticoids: conventional medication is not effective, severe nodules, cystic, can be tried for a short period of time, must be used under the guidance of a doctor, because the side effects are more, and the drug brings a lot of problems, is not recommended.
(7) zinc preparations: more reported in recent years, can inhibit hyperkeratosis and anti-inflammatory effects.
(8) vitamin class: A B2 B6 complex B, etc.
6, medical beauty: inversion mask technology, closed therapy
The current advanced technology: phototherapy, is the current acne treatment advantage of choice, a short period of time can make acne inflammation subside, eliminate hyperpigmentation spots, capillary dilation and other problems. The post-operative recovery is fast and the results are remarkable.
Laser Mask Technology (Black Face Doll): Through nano-level toner + photorejuvenation + Nd:YAG laser, it can minimize enlarged pores, inhibit sebaceous gland secretion, reduce inflammation, even out skin tone, and reshape the subcutaneous collagen system to receive the most desirable treatment effect in the shortest possible time.
The last point is that acne is not terrible and is completely curable, but it must be treated formally, without delay or indiscriminate use of drugs!