Acne is also known as “pimples and acne”. I often hear people say to people who have acne, “Acne means you are still young”. So is acne a young person’s problem? The reason it is called acne is because teenagers have a high prevalence of acne, which has led to the term “acne”. In fact, some people’s acne lasts for a long time, even when they reach the age of 40, they start to grow acne.
So why are teenagers the most likely to have acne? This depends on the pathogenesis of acne. The pathogenesis of acne has the following aspects.
1, endocrine factors: mainly androgens, androgens can promote the development of sebaceous glands and the secretion of sebum. Male testicular interstitium and adrenal glands can secrete androgens, and female adrenal glands and ovaries also secrete androgens. After puberty, the level of androgens, especially testosterone, increases rapidly, which promotes the development of sebaceous glands and the production of large amounts of sebum. (This explains why adolescents are the most prevalent group).
2, abnormal keratinization of follicular sebaceous ducts: Free fatty acids also enhance the keratinization process at the hair funnel in the upper part of the follicle, causing duct obstruction, sebum discharge obstruction, forming keratin plugs, i.e. acne; and increasing the pressure in the follicular sebaceous glands, causing the follicle wall to rupture and dermal inflammation to intensify, forming acne.
3, bacterial factors: mainly Propionibacterium acnes. A variety of microorganisms in the hair follicle, especially Propionibacterium acnes, multiply, and the lipase produced by Propionibacterium acnes breaks down sebum to generate free fatty acids, while chemotactic inflammatory cells and mediators, eventually inducing and aggravating the inflammatory response and producing red rashes (acne). There are other factors such as genetic factors, i.e. multiple people in the family suffer from acne and have more pronounced symptoms than the average patient.
Is acne just pimples on the face?
Not really. Acne can manifest itself in a variety of ways, and acne is only one of them. Acne tends to occur on the forehead, cheeks, and upper chest and back (these areas produce more sebum). It is specifically classified as.
Pimples (squeezing hard can squeeze out the black lower yellow-white fat plugs at the top, which are the non-inflammatory lesion manifestation of acne).
It is also divided into open and closed. Closed acne (also known as whiteheads) is typically a skin-colored papule about 1 mm in size with no visible follicular opening. Open pimples (also known as blackheads) appear as dome-shaped papules with significantly dilated follicular openings. Acne further progresses to various inflammatory lesions that manifest as inflammatory papules, pustules, nodules, and cysts (pimples). Inflammatory papules are red in color and range from 1 to 5 mm in diameter; pustules are uniform in size and filled with white pus; nodules are larger than 5 mm in diameter and are hard and painful to touch; and cysts are deeper in location and filled with a mixture of pus and blood. These lesions may also fuse to form large inflammatory plaques and sinus tracts, etc. The inflammatory lesions often resolve with hyperpigmentation, persistent erythema, and depressed or hypertrophic scarring. The rash becomes more pronounced in hot climates.
Acne is clinically classified into 3 or 4 grades according to the nature and severity of acne lesions.
Grade 1 (mild): acne only.
Grade 2 (moderate): some inflammatory papules in addition to acne.
Grade 3 (moderate): more inflammatory papules or pustules in addition to acne.
Grade 4 (severe): In addition to acne, inflammatory papules and pustules, there are also nodules, cysts or scarring.
Do I have to have sex hormones if I have acne?
The examination of sex hormones, especially knowing the level of androgens, helps to determine the proportion of the role of androgens in the formation of acne. However, some patients do not have high androgen levels, which may be related to the increased responsiveness of the sebaceous glands to androgens.
Does acne really have to wait until puberty is over before it gets better on its own?
After puberty (around the age of 25), most patients’ symptoms gradually diminish or heal on their own, while severe cases gradually improve until around the age of 30. However, there are a few patients, especially women, who continue to have acne until they are about 40 years old, or until they are in their 40s, which is called “adult acne” or “late-onset acne”. Although we say that androgens play an important role in the development of acne, they are also one of the many causative factors. Therefore, patients with significant acne do not have to “sit back and wait”. You can intervene in other aspects of acne development and, if necessary, use medications to counteract androgens in order to relieve or cure K-acne.
Chinese medicine understanding of acne.
Chinese medicine recognizes acne mainly in terms of lung heat, liver heat and intestinal damp heat. Chinese medicine believes that the lung is the master of the skin. Liver fire is strong, wood and fire penalize gold or there is heat in the lung meridian that smolders the skin. The lung and the large intestine are in close proximity to each other. The damp heat in the intestine is very strong and dries up the lung through the meridians, which then depresses the skin.
How to cure acne quickly?
1. Daily care
As we mentioned earlier, the formation of acne is related to blocked ducts and sebum discharge. Therefore, wash your face with warm water once or twice a day to cleanse your skin. Avoid using oily and powder cosmetics (foundations, BB creams) and ointments and creams containing glucocorticoids. Avoid squeezing or scratching the lesions with your hands (once formed, they are difficult to remove later).
Live a regular life and ensure sufficient sleep. The human body has an obvious circadian rhythm of hormone release. If the rhythm of life is disturbed, lack of sleep or sleeping too late, which in turn interferes with the hormone level in the body and leads to inappropriate overproduction of androgens, it will certainly aggravate acne performance. Avoid spicy and greasy diets and keep your bowels clear. Chinese medicine believes that acne is related to heat and damp heat. Spicy products are warm in nature, so eating more of them helps heat; greasy products are easy to produce damp heat, so eating more of them helps damp heat. Therefore, it should be avoided.
2.Common methods of acne treatment
(1) Topical topical drugs: Vitamin A, benzoyl peroxide, antibiotics (clindamycin, erythromycin, chloramphenicol, etc.), azelaic acid, sulfur lotion, etc.
(2) Oral antibiotics: tetracyclines are preferred, followed by macrolides, avoiding antibiotics commonly used to treat systemic infections such as levofloxacin. The course of antibiotics is usually 6 to 12 weeks.
(3) Oral isotretinoin: Used for severe acne, contraindicated in pregnant and lactating women. Pregnancy should be considered only after at least 3 months of discontinuation of this product (preferably 6 months).
(4) Anti-androgen therapy: such as the oral contraceptive compound cyproterone acetate tablets, for women with moderate or severe acne with manifestations of excessive androgen levels (such as hirsutism, seborrhea, etc.) or polycystic ovary syndrome. Late onset acne and female patients with significantly worse acne before menstruation may also consider applying oral contraceptives.
(5) Others: For patients who cannot tolerate or do not want to accept medication, physical therapy, such as photodynamic therapy (PDT), fruit acid therapy, laser therapy, etc., can also be considered.
(6) Chinese medicine treatment: Chinese medicine mainly treats from the perspective of clearing lung heat, clearing liver and draining fire, and clearing damp heat.