Acne (acne , acne) - Causes, Symptoms and Treatment .MF .

Acne is a disease - a chronic dermatosis of the face, back and chest.This skin lesion more often be found under names such as acne, seborrhea, acne, ordinary (vulgar) acne.

Acne is a consequence of the interaction of several pathological factors, resulting in increased production of sebaceous secretion, thickening of the horny layer of the sebaceous glands, irregular flaking of dead skin cells and blockage of the follicle duct horny scales.All this leads to an active proliferation in the follicle opportunistic mikroorganizma- Propionbacterium acnes and therefore to the appearance of the inflammatory process.

Each hair follicle is surrounded by sebaceous glands and connected to it by an appropriate duct.Sebaceous secretion produced by gland covers the skin and hair, thus not only protects them from all environmental influences, but also moisturizes, respectively.Excessive amounts of fat glues the dead skin cells, thus forming a plug in the mouth of the hair follicle.This pilosebaceous plug often provok

es a bulging of the follicle wall.

thus formed most of the elements for acne scars.This so-called whitehead or closed comedones - not inflammatory hemispherical nodules, white, size up a pinhead.Open comedones are called black dots formed by the oxidation of the pilosebaceous plug.With the active multiplication of bacteria in the follicle the formation of inflammatory elements, which appear red papules, cone-shaped, with a rim around congestion and pustular element on top.

especially dangerous formation of such elements in the nasolabial triangle, which is characterized by a very thick and superficial venous network, which creates favorable conditions for the penetration of infection in the vessels and the development of purulent meningitis.The spread of the process promotes active movement of mimic muscles.Therefore, in the nasolabial triangle zone is strictly prohibited extrusion of any inflammatory cells and the formation of these should consult a dermatologist or a surgeon.

should be said about the severe forms of acne: conglobata acne, cysts, abscesses.Conglobata or acne spherical - a large subcutaneous nodules, dense consistency, formed deep in the hair follicle and cause pain when touched.This type of element is also called a drain, that emphasizes the prevalence of process.Knotty-cystic and phlegmonous elements are rare, poorly to standard treatment and resolved by the formation of scars.

Causes of acne

provoking factor is hormonal changes in the body.This explains the fact that acne is more common in adolescents, pregnant women, the girls and women in the last 7 days of the menstrual cycle (luteal phase), as well as in people taking hormones.

Excessive skin irritation various care products: soaps, peelings, scrubs reduce the skin barrier function and provide access of pathogens to the follicles.

can not deny the presence of a genetic factor, since it is proved that the sensitivity of the sebaceous glands to the action of androgens, or thickening of the horny layer of the sebaceous gland duct may be inherited.

the following options acne :

  • steroid that occurs when inadequate use of hormonal methods;
  • infant acne, appear on the face, in the first months of life.Independently tested, but can be kept for several years;
  • necrotic acne, acne is itchy scalp;
  • neurotic acne occurs as a result of compression or stripping of acne are the result of erosion (defect of the skin), and scarring;
  • lightning (fulminant acne) acne , a rare form occurs in young men 13-17 years old, accompanied by malaise, weakness, fatigue, increase in temperptury, pains of the joints;
  • professional acne , occur under the influence of oil, tar, lubricants, DDT and other herbicides. Chemicals.

symptoms of acne

When acne on the face, back, grudiobrazuyutsya inflammatory elements in the form of pustules, nodules (less than 5 mm in diameter) and units (more than 5 mm in diameter), as well as non-inflammatory elements- comedones, the same "black spots", and white (whitehead called ).On the skin of the face appears shine T-zone (this glabella, the transition from the nose to the cheeks, chin).With self-pressure to acne, scars remain and erosion.Sometimes it may form keloids (scar it with increased formation of connective tissue).

patients with hyperandrogenism (high male sex hormones (androgens)) can be observed signs of virilization (this thinning scalp hair, hirsutism (increased hair growth is a)) and precocious sozrevanie.Uzly may become purulent called cysts) or hemorrhagic (filledblood).Very often, these symptoms are accompanied by psychological problems, including depression, increased anxiety.

Photo acne Photo acne on his back

Photo conglobata acne

Photo cysts

What diseases can be mistaken for acne

Despite the fact that nowadays acne- fairly common skin problem, you need to know from some pathological conditions of the person to be distinguished.Rosacea and rozatseapodobny dermatitis disease looks quite similar, both among themselves and with the manifestations of seborrhea.

Rosacea (acne rosacea, rosacea) - chronic dermatosis face formed on the background angioneurosis (trigeminal nerve), dysfunctional disorders of the gastrointestinal tract and is irritating to the skin of the face of various environmental factors (sunshine, wind, rain and snow)and when used with hot food and alcoholic beverages.Most often, this disease affects the nose, forehead, cheeks and chin, where the background of the strong reddening observed abundant papules, pustules, and spider veins.This problem is most actively affects people after age 40.With long-term existence of the process of developing thickening of the subcutaneous tissue and sebaceous glands of the nose and the tip of the wing, which is manifested by thickening and the formation of bumpy surface of the nose.

Photo Rosacea (acne rosacea, rosacea)

Rozatseapodobny dermatitis (perioral dermatitis, steroid dermatitis, dermatitis stewardess) - problem skin girls and young women, provoked active irritating cosmetic products and irrational use of hormonal external fundsfacial skin.This problem manifests itself red-pink papules and pustules on a background of reddened skin, grouped around the mouth and eyes.

Photo Rozatseapodobny dermatitis

Diagnostics acne

For diagnosis quite a visual inspection, and help to identify the causes of the following tests:

  • blood test for hormones (free testosterone, FSH, LH, estradiol, 5-testosterone (dihydrotestosterone, DHT) and 5-androstenediol).Analyses have to take on an empty stomach for women at 5-7 day from the beginning of the menstrual cycle, for men it does not matter, preferably before 10 am;
  • biochemical analysis of blood (especially liver counts), fasting for US women, and 5-7 days of the menstrual cycle (to exclude polycystic ovaries);
  • analysis on intestinal dysbiosis;when any change analysis - medical consultation for the correction state (gynecologist, gynecologist, endocrinologist, physician, andrologist, a gastroenterologist);
  • blood count (if there is inflammation. Because it will exacerbate acne) the presence gnoynikov- analysis on pathogenic flora and sensitivity to antibiotics

Acne treatment

In severe acne should be allocated and identification of microbialflora by culture content pustules with definition of sensitivity to antibiotics sown flora.It is also necessary to determine the levels of androgens, followed by consultation at the gynecologist and endocrinologist.Determined blood count indices, where the presence of abnormalities control study carried out every 10 days.Monitoring of blood on liver function (biochemical study: blood cholesterol, total bilirubin and fractions, triglycerides, ALT, AST) is necessary in the treatment of systemic retinoids, but this will be discussed later.

The basic approach in the treatment of acne should be directed to the correct and careful care for problem skin.The use of alcohol-containing and other corrosive agents on the skin can further disrupt the barrier function of the skin and lead to an exacerbation of the process.Therefore, cleansing or her gentle washing detergent can only contribute to a positive outcome during treatment.You can use the following dermatological cosmetics line: "Uriage" - "Iseak", "Bioderma" - "Sebium", "Avenue" - "Klinans".

the presence of inflammatory cells in the facial skin treatment should begin with the appointment of the external antibacterial agents, "Zener" gel "Dalatsin T" ointment "Imex", as well as various prescription tools manufactured in the pharmacy network on prescription dermatology.Often a good effect has Metrogil gel, but it has a phototoxic effect, what you must know and remember.

When remission acute inflammatory process in the treatment of added drugs affecting the process of keratinization of the epidermis cells, thereby reducing the formation of comedones.This property has azelaic acid, produced as officinal means "Skinoren", with cream-colored form of the drug has an additional depigmenting property.

positive effect has the combination of these drugs (antibacterial skinoren and external agents) to conduct 15-20 sessions selective phototherapy or appointment procedures with a helium-neon laser.

Increasingly in recent years in the treatment of acne use benzoyl peroxide 2.5%;5%;10% - "Baziron AU" has not only antimicrobial, but also keratolytic action, ie,It helps soften and tearing away the outer layer of the skin.It must be remembered that it is unacceptable to use Baziron during the active sun.

well proven Differin 0.1% -analog vitamin A - a retinoid for the topical, anti-inflammatory effect and komedonoliticheskuyu activity.He also contributes to the stabilization process of rejection dead skin cells.Known phototoxic effect of the drug, as well as contraindications for its use in pregnant women, and nursing.Lokatsid and Retin-A similar preparations.

the treatment of pulmonary forms of acne often enough combinations of these drugs.It is possible to use an independent external funds.Often have a positive effect and folk remedies.
Lotions infusion of herb St. John's wort to help relieve acute inflammation and reduce redness.To do this, 1-2 tablespoons of herbs for 1 hour, insist in a glass of boiling water.Then infusion of cooled and moistened it in gauze, folded into 6-8 layers and 15 minutes cover the most damaged part of the skin.The procedure is repeated for one and a half hours, followed by 3-yoh hours of rest.On the chest and back skin can be used 10% of inflorescences calendula tincture ordinary 40 ° cent alcohol in the form of rubdowns 2 times a day.

In severe seborrhea and moderately severe forms in addition to topical therapy prescribers inside.Broad-spectrum antibiotics are aimed not only to combat Propionbacterium acnes, but also a reduction in fat products.There are considered to be the drug of choice tetracycline (500 mg 2 times a day) and doxycycline (100-200 mg daily) primenyamye within 2-4 weeks.These drugs are prohibited for use in the active period of the sun, because they have phototoxic effect, as well as pregnant women, breast-feeding and children under 13 years.Despite the fact that the erythromycin Propionbacterium acnes most stable, the preparation may used in pregnant, lactating and children (500 mg, 2 times a day, 2-4 weeks).

often shows the assignment of staphylococcal vaccines.

To mitigate the effects of androgens on women and girls are appointed by the sebaceous glands combined oral contraceptives.The most commonly used "Jess", "Diane-35" designated long, 6 months or more.

most effective is the appointment of systemic retinoids.This so-called "Roaccutane", which is assigned to the ineffectiveness of the above treatment, with obligatory monthly monitoring of liver function.There is a certain approach to the appointment of the daily dose, selected entirely individually.In connection with the presence of teratogenic and embryotoxic action contraindication is installed and planned pregnancy and lactation.To support the work of the liver in treatment of hepatic shows an application (Essentiale forte (2 capsules) and Kars (1 tablet) 3 times a day for 1 month).It can be assigned prednisolone, alone or in combination with Roaccutane.

For large and deep nodes assigned intralesional corticosteroids every 2-3 weeks.This procedure can lead to discoloration of the skin and thinning.Also shown are the paraffin baths and ultraviolet irradiation in erythema doses.
Acne vulgaris (acne) - one of the most common diseases.The main complaint - is the appearance of pimples, blackheads, greasy kozhi.Zabolevanie life is not in danger, but how much mental suffering brings, especially among young people.Many parents believe that the disease is not necessary to pay attention to, say, a child is older, hormonal changes, and everything will go by itself, so perhaps someone and resolved on their own, but this is rare;so it is best to start treatment at an early stage.

disease affects 70 to 80% of the teenage population (including women appear at the age of 10-17 years and in men aged 14-19 years), and about 10-12% of the adult population over 25 years, the course of the diseaseheavier.Often the disease is accompanied by psychological problems, including anxiety, depression.Do not turn in on themselves, and remember, the earlier start treatment, the better.

Preventing acne

These tips will help you reduce the appearance of acne.

  • not applied to the skin cosmetics based on lanolin and Vaseline, which clog pores.
  • Do not use products that contain oil.
  • not abused products such as chocolate, carbonated beverages, nuts, coffee.
  • Choose cosmetics for skin cleansing, according to your skin type.This will help you a beautician.
  • begin treatment at an early stage.

Complications of acne

Complications include abscess, scarring after resolution of lesions may remain red spots and pigmentation, which may persist for several months;frequent relapses (exacerbations).

Dermatologist Kuklin ETC.