Acne - a disease of the hair follicles and sebaceous glands, which occurs in 80% of adolescents and young adults. Among the various clinical varieties are most common acne vulgaris.
Causes of acne
Are 4 main reasons leading to the development of acne:
- Lipid imbalance: patients with marked excess sebum.
- Participation of microorganisms in patients often reveals a combination of yeast-like (P.ovale) and bacterial flora (P.acne). These pathogens lead to blockage of the mouth of the gland.
- Hormonal disorders: given that acne vulgaris usually appear in puberty, when the active start functioning gonads, a significant role in the development of acne given to sexually hormones. The disease affects women with menstrual irregularities, with a syndrome of hyperandrogenism, chronic administration of androgens or anabolic hormones.
A significant role played by genetic predisposition (genetically determined type of secretion of the sebaceous glands and congenital endocrine pathology).
Symptoms of acne
Acne has an effect which manifests itself in the clearly marked symptoms.
The most common or vulgar acne vulgaris on the face, which occur in 80% of people aged 15-24 years. They are characterized by the appearance of the face (at least - on the chest and back) comedones, fine up to 5 mm in diameter pimples bright red color. Rashes, allowing leave pigmentation, less often - superficial scars. Increased sebum secretion, the skin has a characteristic shine, hair and fat, maybe a slight thinning.
After a few weeks nodes are opened to form a cavity from which allocated stringy pus - phlegmonous acne. After the healing of acne scars are deep.
Photo: site of the Department of dermatology Tomsk Military Medical Institute
Acne treatment
For the treatment of various forms of acne apply a variety of techniques, the choice depending upon the particular patient.
Nutritional factors, different types of food, the diet does not have implications for the development of acne and selection of therapy.
Outdoor therapy does not affect the formation of sebum. Various cosmetic products may only temporarily reduce the amount of sebum. However, when using cleaning agents should not resort to peeling off the drugs, which can cause irritation of the skin, injury.
early treatment
Treatment in early stage, usually is prophylactic, and includes external agents, reduce the formation of acne and inhibiting the development of pathogenic flora.
selection means - Salicylic acid drugs, agents containing sulfur, azelaic acid, retinol palmitate, tretinoin, adapalene, isotretinoin, benzoyl peroxide.
As tretinoin and azelaic acid is used within a few months to achieve clinical remission.
Treatment of inflammatory forms of acne
mild form
In the treatment of mild forms of acne with few pustules on the face should be used topically alcoholic solutions containing salicylic acid, resorcinol, antibiotics, benzoyl peroxide, ointment antibiotics.
Formulations sulfur, salicylic acid, resorcinol have exfoliating and antimicrobial action. Means comprising niacinamide and a-hydroxy acids, are also quite effective in topical therapy.
Outdoor antibiotic therapy include erythromycin, tetracycline, linkomitsinovuyu ointment, clindamycin. Antibiotics as ointments applied 2 times a day. They inhibit the multiplication of P.acne and other bacteria.
Retinoic ointment applied as long to areas affected by acne. It should be remembered that various derivatives of tretinoin and retinol can not be used with peeling means and at high insolation, in combination with UV-irradiation. For oily seborrhea conducting preventive therapy comprising cryomassage, cleansing and exfoliating agents, extracting comedones.
severe form
For treatment of severe forms of acne with tissue destruction, cystic and severe suppurative processes use a combination of systemic and topical therapy.
Systemic means affecting sebum include estrogens, androgens, spironolactone isotretinoin.
Women with long flowing acne, after failure of antibiotic therapy and topical use of tretinoin, administered estrogens and androgens. In this case, the determining factors are the disruption of the menstrual cycle, hirsutism, Hypertrichosis, adrenal or ovarian hyperandrogenism. Androgens and estrogens exert a therapeutic effect by influencing the production of sebum and condition of the sebaceous glands.
Spironolactone use as an antiandrogen, 100-200 mg per day. It can have an effect in small doses - 25-50 mg. The course of the treatment of acne in this way is carried out for several months and is also used in women only. This dramatically reduces the amount of sebum and pathological elements. In pregnancy, spironolactone therapy is contraindicated.
Acne treatment with antiandrogens and estrogen lasts from several months to several years.
Antibiotic therapy is of considerable importance in the treatment of acne. However, not all antibiotics are able to penetrate the follicular unit, a sebaceous gland, which determines their effectiveness.
Systemic antibiotic therapy of acne involves the use of doxycycline, clindamycin, cotrimoxazole, erythromycin, tetracycline. Doxycycline, minocycline, trimethoprim-sulfamethoxazole are more soluble in fats; It proved that they are most effective in comparison with other antibacterial agents.
To achieve resistant, prolonged remission is necessary to use discontinuous courses of antibiotics over a long time.
Algorithm therapy for acne
For treatment using various immunomodulators, biologically active substances angioprotectors, B vitamins, ascorbic acid and its derivatives, lipotropics. Apply the following active ingredients: Leuzea tinctures, Eleutherococcus, aralia, ginseng, Saparal, Pantocrinum, glycyram et al.
Of the drugs that affect peripheral circulation using pentoxifylline, xantinol nicotinate, dipyridamole etc.
Lipotropics (fenofibrate, lipoic acid) is assigned as supporting, and is used in combination with other drugs.
