Since acne is a common disease and there have been many inquiries recently, we would like to summarize your concerns as follows for your reference.
Acne is the most common skin disease among young men and women, commonly known as acne, pimples, and acne.
I. Causes.
The occurrence of acne is related to a variety of factors, such as endocrine factors, abnormal keratinization of the hair follicle opening, bacterial overgrowth in the hair follicle, and genetic factors.
1, endocrine factors: mainly androgens, androgens can promote sebaceous gland development and sebum secretion. The interstitial testes and adrenal glands of men can secrete androgens, and the adrenal glands and ovaries of women also secrete androgens.
2, Propionibacterium acnes: The triglycerides in sebum are decomposed by the lipase secreted by bacteria (Propionibacterium acnes), and the free fatty acids produced can penetrate the hair follicle wall, causing dermal inflammation and producing the red raised rash generally seen.
3. Keratinization at the hair funnel: Free fatty acids also enhance the keratinization process at the hair funnel in the upper part of the hair follicle, blocking the discharge of sebum and forming acne. All these factors interact with each other.
4. Heredity: It is also an important factor. In some families, acne is more frequent and severe.
Note: Although acne is closely related to endocrine, except for some special cases, in most cases it is not necessary to routinely check the endocrine (hormone) level, as many patients request the examination, especially here to remind. If a woman has low menstrual flow, long intervals, or more body hair, polycystic ovary syndrome needs to be ruled out.
II. Clinical features.
1. Main manifestations: It mainly occurs on the forehead, cheeks and upper chest and back, which are areas with more sebum secretion. It starts as a pimple and can be squeezed out with a little force as a black top and yellow-white bottom pimple. In addition to acne, there may be red papules, small pustules, and in severe cases, dark red nodules or cysts. Some patients are left with small depressed scars after healing, and some have dark red raised scars on the jawline or chest and back. The rash tends to be heavier in hotter climates.
2.Typing: According to the amount of rash, it is divided into mild, moderate, severe or one to seven degrees; according to the main type of rash, it is divided into papular acne, pustular acne, cystic acne, etc.
3. Age of onset: Generally, after puberty (around 25 years old), most patients’ symptoms gradually reduce or heal on their own, while severe cases gradually improve until around 30 years old. However, there are a few patients, especially female patients, who continue to have acne until they are about 40 years old, or until they are about 40 years old, which is called “adult acne” or “late-onset acne”.
C. How to treat: 1.
1. Internal medication.
① Retinoids (such as isotretinoin or retinoids);
② Antibiotics such as tetracycline, minocycline hydrochloride, etc;
③Sex hormones such as oestradiol or oral contraceptives, such as Daing-35;
④Anti-androgens such as spironolactone;
⑤ Chinese patent medicines, such as Danshinone capsules, Menopin granules.
Note: Female patients taking retinoids, such as isotretinoin and vincristine, have to stop taking them for more than three months (preferably six months) before they can get pregnant if they want to have children.
2.Topical medication.
① such as our hospital’s development of the static skin flat, face thorn cream;
② benzoyl peroxide, if there is redness and soreness after application, can be suspended for 1 to 2 days before use;
③Vitaminic acid, such as Daphne gel, etc;
④Antibiotics such as fusidic acid, compound polymyxin B, erythromycin, chloramphenicol, jasmin, chlortetracycline, etc.
Note: Acne topical medications are generally more irritating compared to medications used to treat other diseases.
3. Some new treatments: such as red and blue light, are effective for inflammatory acne treatment and have no side effects, and are a good choice when economic conditions allow. Fruit acid revitalization treatment is good for papules and acne, and has better efficacy.
4.How to choose the treatment method: There are many types of acne treatment drugs, and the treatment method needs to be chosen according to the severity of the condition.
Mild acne: Topical medications can be used mainly, together with Chinese medicines (such as Menopin granules and Tanshinone capsules) if necessary;
Moderate acne: If there are more red papules or a few pustules, you can take retinoids or antibiotics internally; apply retinoids, benzoyl peroxide or nonanedioic acid topically to the rash;
Severe acne: If there are more papules, pustules and hard nodules or cysts, then several types of drugs are used for simultaneous treatment, such as internal retinoids and antibiotics. Female patients can take internal Henestrol or oral contraceptive tablets, and apply topical benzoyl peroxide, antibiotics or retinoids. Photodynamic therapy is also a good treatment for severe acne.
Photodynamic therapy
IV. How to prevent.
Daily life precautions.
① Acne patients’ skin is mostly oily, so you should wash your face with warm water frequently, and general facial cleansers are available.
②Eat less greasy and spicy food, eat more vegetables and fruits, and pay attention to keeping the bowels open.
③ This disease and mental factors also have a certain relationship, so pay attention to adequate sleep, emotional relaxation, happy, etc.
V. How to remove acne marks.
Post-acne pigmentation and scarring (acne marks): can be treated with laser, grinding and fruit acid revitalization.