Acne: symptoms, causes, treatment, types. Endogenous causes of acne Cure acne

Acne- inflammatory disease sebaceous glands. Common (or vulgar) acne is the most common. Their occurrence is associated with blockage of the duct of the sebaceous gland. Acne against the background of increased function of the sebaceous glands is most often observed during puberty. These are the so-called juvenile acne, which develops in boys and girls on the face, chest, and back.

Against the background of greasy, porous skin, grayish-black plugs (“black dots”) appear, from which, when pressed, a thick sebaceous secret is released in the form of “worms” with a black head.

Fat, stagnating in the outlet ducts of the sebaceous glands, decomposes, creating an excellent environment for the reproduction of pyogenic microbes. As a result, inflammation occurs around the plugs and acne is formed in the form of inflammatory nodules, pustules. Left untreated, they can grow into deeper, inflammatory, painful, local purplish red lumps that break open with pus and may be scarred. All processes that weaken the body's resistance to pyogenic microbes contribute to the appearance of acne.

not pronounced acne passes by the age of 20-25, more pronounced, as a rule, subsides by the age of 30-35. Acne should be periodically squeezed out, after steaming the skin and washing your hands cleanly. If the cork is already squeezed out, then the skin should be wiped well with alcohol; if after extrusion remains dark spot, especially after large acne, it is useful to apply compresses from a hydrogen peroxide solution twice a day for 10 minutes, so that the stain resolves faster.

Many women suffer from premenstrual acne, which is caused by the release of the hormone progesterone after ovulation. A form of the disease in which black dots (comedones) predominate occurs when sebaceous secretion combines with skin pigment and clogs pores. If the mass fills the pores inside the skin, then closed ("white") blackheads appear. In severe cases, whiteheads enlarge, spread under the skin, and rupture, leading to inflammation and suppuration.

The exact cause of acne has not been established.
If acne appears on the skin, you need to carefully protect it from dust and dirt, carefully use cosmetics, since rubbing some creams and ointments into the skin can contribute to the development of the disease. With a small number of "black dots" it is enough to wipe the face lemon juice(or a slice of lemon), toilet vinegar, 3% hydrogen peroxide solution. should be comprehensive and prescribed by a doctor. Usually used internally and externally. The diet is very important, the exclusion of fatty meats, smoked meats, the restriction of the use of eggs, sugar, jam, honey and the use of mainly fermented milk products, vegetables and fruits. With a tendency to constipation, food rich in fiber is recommended - black bread, sauerkraut, prunes, light laxatives - rhubarb, buckthorn. Vitamins are beneficial, especially vitamin A.

External acne treatments aim to degrease and disinfect the skin, soften the "black spots" and, if possible, eliminate the existing pigmentation. The places of the greatest accumulation of black plugs should be carefully wiped with a sponge or soft cloth moistened with soapy alcohol or soap suds mixed with finely ground salt and borax. Greasy skin, on which dust and dirt easily settles, must be wiped several times during the day with a cotton swab moistened with some kind of alcohol (2% salicylic, camphor, a mixture of alcohol with ether), diluted tincture of calendula, infusion of cucumbers in vodka and others; these compositions should be changed periodically.

In mild forms, when there is a small amount of comedones on the skin, and there are either no inflammatory elements at all, or there are very few of them, only proper skin care can be effective, and application medicines either not required at all, or has a purely preventive purpose.

Acne-prone skin needs mandatory cleansing 1-2 times a day. For washing use soft gels, foams, lotions. Today, the cosmetic market has a sufficient number various means for the care of oily and acne-prone skin, which not only cleanse, but also have a mattifying and anti-inflammatory effect.

To soften horny plugs, it is advisable to do steam baths 1-2 times a week, for which, after pouring boiling water into the basin, tilt your head over it, cover it with a terry towel and hold it over the basin for 10-15 minutes. Better than steam baths, poultices from infusions of medicinal herbs such as sage, chamomile, horsetail, etc. work. Moisten a napkin in a hot infusion, squeeze it quickly and apply on the face; change the towel as it cools. In order to avoid colds, after such procedures, you should not go outside. Complete removal of acne vulgaris is quite possible, but this requires long-term complex treatment and patience.

A large place in the treatment of acne is occupied by medicinal plants used for baths, compresses, poultices and ointments. Other remedies that have long been used by the people for an unclean face are also effective. Below are these remedies, which are recommended to be used only after consultation with a dermatologist.

Folk remedies for acne(for internal use)

1. When acne appears on the skin, it is recommended, as noted above, not to eat too much sweet and fatty foods. If due to any circumstances fatty foods you cannot exclude from the menu, you should consume as many lemons as possible or just drink lemon juice.
2. It is useful to drink parsley or carrot juice on an empty stomach.
3. Infusion of stinging nettle leaves
Two tablespoons of leaves pour 400 ml of boiling water, leave for 2 hours. Drink with acne half a cup 4 times a day before meals.
4. Dandelion Root Infusion
Pour one tablespoon of crushed roots with 1 cup of hot water, simmer for 15 minutes, cool for 45 minutes, strain. Drink warm 1/3-1/2 cup 3 times a day for 15 minutes. before meals. Apply with furunculosis, skin rashes, acne and other diseases associated with metabolic disorders.
5. Decoction of burdock roots
Boil one tablespoon of ground burdock roots in 0.5 liters of water for 10 minutes, strain. The cooled broth is taken in a medium glass 4 times a day.
6. Infusion of the herb of sage officinalis
Two spools (8.5 g) of herb to 3 oz (90 ml) of water. Take 2 oz (60 ml) every 3 hours. Apply against acne.
7. Brewer's yeast
The use of brewer's yeast 1-2 teaspoons before meals or with meals will relieve juvenile acne. Yeast can also be drunk on an empty stomach by diluting it in warm milk.
8. Infusion from a mixture of equal parts of licorice root, dandelion, burdock, buckthorn bark, dill seeds. Drink hot half a glass half an hour before meals.

Folk remedies for the treatment of acne (for external use)

1. Infusion of aloe vera leaves
Cut the leaves from the plant, wash and hold for 10 days in a dark, cold place, then grind them to a mushy state, pour cold boiled water (5 parts of water into 1 part of the slurry). Infuse the mixture for an hour, then boil for no more than 2-3 minutes, strain. Apply to wipe the face with oily skin, skin irritation, acne.

2. Cucumber treatment
a) cucumber juice
Four tablespoons of chopped cucumber pour 300 ml of boiling water, leave for 4 hours. Apply for lotions for acne.
b) Cucumber mask
Grate unpeeled fresh cucumber; Pour 3 tablespoons of the mass with 2 cups of boiling water, insist and apply a mask on the face.
Apply for acne.
c) Cucumber-honey gruel
Pour three tablespoons of grated cucumber with 1 cup of boiling water, insist for 2-3 hours, strain, squeeze out the sediment. Add 1 tablespoon of bee honey to the infusion, stir well until completely dissolved. Moisten a cotton swab with this mixture, wipe your face after washing and wait until it dries. After 30 - 40 min. wash face with cool water. Use as one of the complex means in the treatment of acne.

3. Eels are removed from onion gruel.

4. Fresh parsley juice
Lubricate the acne-prone skin of the face with juice 2 times a day for 20-25 days.
5. Radish Seed Oil
Lubricate purulent acne on the face. From this, the skin of the face becomes clean and soft.
6. Common raspberry
a) Infusion and decoction of raspberry flowers are used to treat acne on the face with oily skin.
b) Fresh raspberry leaves are useful for treating acne.
c) Ointment from leaf juice
Mix one part fresh raspberry leaf juice with 4 parts vaseline or butter. Use to treat acne.
d) Infusion of berries or raspberry leaves
Pour two or three tablespoons of berries or leaves with 2 cups of boiling water, insist. Use to wash your face with acne and rashes.
7. Calendula officinalis
a) Infusion of flowers
Pour one tablespoon of dried flowers with 2 cups of boiling water, leave for 20-30 minutes, strain, cool. Apply for lotions and ointments for oily porous acne.
b) Calendula tincture with honey
Pour 1 teaspoon of calendula tincture into a glass of warm water ( pharmacy drug) and 1 teaspoon honey, mix well. Use for lotions for acne and oily skin.
c) Take 2 tablespoons of flowers and juice of fresh calendula herb, pour 50 ml of pure alcohol, add 40 ml of water, 30 ml of cologne. Insist 3 days in a warm place; then add 5 g of boric acid and 3 g of glycerin. To stir thoroughly. This emulsion lubricates acne-affected areas of the skin 2 times a day.
8. Infusion of marshmallow roots
Pour 6 g of marshmallow roots 200 ml cold water, insist 5-7 hours, strain. Apply to lotions for inflamed acne.
9. Infusion of rose hips
Pour 10 g of chopped fruits with 100 ml of boiling water, boil for 5 minutes. over low heat, leave for 1 hour, strain. Apply for acne.
10. Viburnum fruit juice
Lubricate the face with acne. You can brew viburnum fruits as tea, and then wash them, make lotions and compresses, and also take them inside. The face will become clean.
11. Chamomile, calendula, camphor alcohol
For wiping oily, acne-prone skin, a mixture of chamomile infusion, calendula and camphor alcohol works well.
12. Infusion of chamomile
A compress of chamomile infusion works well on oily, acne-prone skin: pour a tablespoon of dry inflorescences with 2 cups of boiling water, leave for 10-15 minutes, strain. In a moderately hot infusion, moisten the wipes, wring them out slightly and apply to the face 6 times in a row every 5 minutes. The course of treatment is 20 - 25 procedures, of which the first 10 - 15 are done daily, the rest - every other day.
13. Pumpkin
For acne, it is recommended to wipe the face with a piece of pumpkin.
14. Mud mask
Stir 50 g of therapeutic mud in powder with a few tablespoons of fresh milk until a slurry is formed and add 0.5 g of sulfur in powder. Apply the resulting mixture on the face. After 30 min. wash off the mask with cool water. Use for acne vulgaris.
15. Mask of sauerkraut. Sauerkraut is applied to the face in a thick layer for 15 minutes, then the skin is rinsed with sage infusion and smeared with a nourishing cream for oily skin.

16. Watermelon. For the mask, watermelon juice is used. Napkins (or the pulp of watermelon itself), moistened with juice, are applied to the face for 20 minutes daily for 15-20 days. The mask is washed off with water at room temperature.

For acne, it is recommended to cut out a mask from several layers of gauze, soak it with aloe juice and apply on the face for 30-40 minutes. It is advisable to put a layer of absorbent cotton over the gauze, covering it with a bandage of gauze, also cut out in the form of a mask. Procedures are done first daily, then every other day, and then twice a week. The course of treatment is about 30 procedures.

Tea tree oil is a natural antiseptic and antibiotic. The concentrated oil should be applied strictly to the inflamed areas 3 times a day. Soaps containing tea tree oil may also be helpful.
To perfectly cleanse your face, take oatmeal porridge and into a mixer, beat everything down to a powder and you can still add bodyagi there, only for those who have inflammation, add a teaspoon of lemon and peroxide and mix. Apply to steamed skin for 20-30 minutes. When it hardens it will be difficult to wash off, rinse with hot water

Whiteheads (prosyanki)

Millets are small, round, convex, white spots. They usually appear on the bridge of the nose, cheekbones and around the eyes. The reason for their appearance is a seal in the ducts of the sebaceous and sweat glands with a reduced separation of sebum. The gland does not burst, as is the case with acne, the sebum thickens and turns white.
None preventive actions have no meaning. If you want to remove them, then pierce the skin with a sterile needle and gently squeeze out. Then lubricate this place with alcohol or cologne, and if blood appears, tincture of iodine. If the prosyanki do not bother you, then it is better not to touch them.

You can not treat acne for everyone according to one template scheme. After all, everyone has their own reason for the appearance of a rash. Treatment should be prescribed by a doctor after a detailed examination of the patient. When prescribing a treatment regimen, the age of the patient, gender, duration and severity of the disease are also taken into account. Often, for the treatment of acne, local treatment with antibiotics, acids is necessary. The duration of treatment also depends on the above factors.
On average, it is more than two months. After treatment, it is necessary to obtain advice from the attending physician on the issue proper care behind the skin.

Acne is a particular manifestation of acne - skin eruptive elements, and does not reflect the fullness clinical picture diseases. The term "acne" includes different kinds acne rashes in adolescence, adult acne, as well as a group of dermatoses with acneiform rashes (rosacea, rosacea, small-nodular facial sarcoidosis, perioral dermatitis, skin tuberculosis). Depending on the type of acne and the course of acne, the method of its treatment is determined.

General information

In medical literature acne often referred to simply as "acne" or "acne vulgaris". However, these terms are not equivalent. Acne is a particular manifestation of acne - skin eruptions, and does not reflect the fullness of the clinical picture of the disease. Acne, characterized by inflammation of the sebaceous glands, develops due to various reasons and has its own characteristics depending on the age of the patient and the pathogenetic mechanisms of its occurrence. The concept of "acne disease" includes various types of acne in adolescence, adult acne, as well as a group of dermatoses with acneiform rashes (rosacea, rosacea, small nodular facial sarcoidosis, perioral dermatitis, skin tuberculosis). Depending on the type of acne and the course of acne, the method of its treatment is determined.

acne

Both acne vulgaris and acne are a manifestation of a chronic inflammatory process of the sebaceous glands of the face, chest and back, which results in the formation of comedones. The disease is caused by gram-positive rods Propionibacterium acnes. The appearance of acne is a fairly common phenomenon: between the ages of 12 and 24, it occurs in 60-80% of people. One third of patients require therapeutic treatment acne disease.

The relevance of acne treatment is determined by their influence on the psycho-emotional state of the patient. Acne causes psychological discomfort and worries about aesthetic problems of appearance. Patients with manifestations of acne suffer from loss of attractiveness, their self-esteem decreases, they do not adapt well in society, they experience anxiety and depression. The decision to treat acne is dictated by the elimination of psychological problems, in particular dysmorphophobia (fear, the idea of ​​a far-fetched ugliness of appearance) and the desire for free socialization in society.

The development of acne

In the occurrence of acne, genetic predisposition is of no small importance. The development of acne occurs under the influence of certain factors that allow us to trace the mechanism of acne, the development and course of acne.

Excessive secretion of sebum

Excessive secretion of sebum is one of the manifestations of seborrhea. With seborrhea, the secret secreted by the sebaceous glands is characterized by a decrease in bactericidal properties, which causes active reproduction of bacteria and the creation of prerequisites for skin inflammation and acne.

Follicular hyperkeratosis

The appearance of blackheads presents a serious aesthetic problem for patients with acne. The appearance of acne is accompanied increased keratinization epithelial cells in the funnels of the hair follicles, into which the excretory ducts of the sebaceous gland open (follicular hyperkeratosis). Usually this process proceeds at a moderate pace, so that the horny scales have time to exfoliate at the mouth of the follicle and, together with the sebum, are released to the outside. Hyperkeratosis prevents the normal outflow of sebum and leads to its accumulation in the follicle. The accumulation of dead cells and sebum leads to blockage of the pores and causes the appearance of black dots - microcomedones, which do not manifest themselves clinically.

With further accumulation of sebum and pressure on the clogged follicle, its cystic expansion occurs, which is clinically manifested in the form of closed comedones (non-inflamed dense nodules). Further development of the process causes atrophic changes in the sebaceous gland and expansion of the pore. This is how blackheads or open comedones appear. At the same time, sebum has a dense structure, it is poorly excreted due to the large accumulation of horny scales. The black staining of the secret, visible from the enlarged pore, is due to the content of melanin pigment in it.

Reproduction of microorganisms

Human skin and hair follicles are inhabited by many saprophytic and opportunistic microorganisms (epidermal staphylococcus aureus, mycobacteria, clostridia, demodex mites, etc.). With clogged pores and accumulation of sebum, favorable conditions for their reproduction inside the hair follicles.

Inflammatory process

Propionibacterium acnes (Propionibacterium acnes) plays a special role in the development of the inflammatory process in acne. Its reproduction in the follicle and the release of waste products have an irritating effect on tissues and cause a local inflammatory reaction. The inflammatory process can occur at any stage of acne, affect the superficial or deep layers of the skin, which explains the variety of forms and clinical manifestations diseases.

Classification of acne

Existing classifications of acne are based, as a rule, on the clinical manifestations of acne or on the degree of their severity. The most complete classification of acne was proposed in 1994 by scientists G. Plewig and A. Kligman (Plewig, Kligman).

1. Acne childhood(childhood acne):

• Newborn acne (acne neonatorum).
• Acne of children (acne infantum).

2. Acne juveniles (acne juveniles):

• Lightning acne (acne fulminans).

3. Adult acne (acne adultorum):

• Late acne (acne tarda).
• Spherical or heaped acne (acne conglobata).
• Inverse acne (acne inversa, hidradenitis suppurativa).
• Pyoderma faciale.
• Bodybuilding acne.

4. Acne caused by mechanical factors(acne mechanica).

5. Acne exogenous(acne venenata, cosmetic acne, contact acne).

Childhood acne

Newborn acne (acne neonatorum)

The appearance of acne in newborns is a borderline physiological state of this period and occurs as a result of a sexual (hormonal) crisis. Its manifestations also include engorgement mammary glands, hydrocele , physiological vulvovaginitis . These conditions are due to the action of maternal hormones obtained by the fetus in the prenatal period. Newborn acne is closed comedones located on the nose, cheeks, chin and forehead in the form of dotted white or yellowish papules. As a rule, they disappear on their own without a trace within 1.5-2 weeks.

Acne children (acne infantum)

In children, acne can appear at the age of 3-6 months and cause prolonged, severe forms of acne. Their development may be associated with dangerous congenital pathology(hyperplasia or tumor of the adrenal glands) and requires a thorough examination of the child.

Juvenile acne (acne juveniles)

Juvenile or vulgar acne (acne juveniles) - occurs in a third of adolescents aged 12 to 16 years. According to statistics, girls suffer from acne more often than boys. In 75% of cases, juvenile acne is localized on the face, in 16% - on the face and back. In the vast majority of adolescents, acne disappears by the age of 18-20. However, sometimes acne occurs for a long time and occurs in 3% of men and 5% of women aged 40-50 and even 60 years (“physiological acne”). This variety refers to the manifestations of adult acne (acne adultorum).

Comedones (acne comedonica) are formed as a result of blockage of hair follicles by an accumulation of horny scales and sebum. Mild comedones in the absence of an inflammatory component are considered a variant of the physiological norm. The initial manifestation of acne is microcomedones, which do not manifest themselves clinically. At the next stage, closed comedones are formed, that is, white, dense, non-inflamed nodules with a diameter of about 2 mm, covered with skin and not having an open exit to the surface. Inflammation is not expressed in them, but there are favorable conditions for its further development. Further accumulation of sebum in them leads to an increase in nodules and the transformation of closed comedones into open ones (black comedones or black dot acne).

The nodular cystic form of acne (acne nodulocystica) is characterized by the formation of purulent cystic cavities and infiltrates deep in the dermis, their tendency to merge and form inflammatory conglomerates. With the reverse development, such elements always heal with the formation of scars. This form of acne usually takes a long time (several years), even with a moderate degree of the process.

Acne fulminans (acne fulminans)

Acne fulminans is the rarest and most severe form of acne. It usually develops in adolescents aged 13-18 who have papulopustular or nodular-cystic acne. The fulminant form is characterized by a sudden, abrupt onset, the appearance of ulcerative necrotic areas on the body, and an increase in symptoms of intoxication. The fulminant form of acne is close in its course to gangrenous form pyoderma.

The reasons for the development of the fulminant form are not fully understood. Probably, toxic-allergic and infectious-allergic mechanisms play a certain role here. Usually, acne fulminans develops in patients suffering from severe lesions of the digestive system (ulcerative colitis, Crohn's disease, etc.), or after taking certain medications: tetracyclines, androgens, synthetic retinoids.

The development of the disease is rapid. Come to the fore general symptoms and intoxication phenomena: a rise in body temperature above 38 ° C, pain in the joints and muscles, in the abdomen, anorexia, a sharp deterioration in well-being. Sometimes changes in organs and tissues develop: softening of the bones, enlargement of the liver and spleen. In the blood - an increased content of leukocytes, a decrease in the level of hemoglobin and an acceleration of ESR, blood cultures - negative. on the skin of the body and upper limbs areas of erythema are formed with pustules, and then ulcers. There are no rashes on the face. Subsequently, numerous scars, including keloids, form at the site of the rash.

Papulopustular acne (acne papulopustulosa) is characterized by attachment to closed or open comedones of the inflammatory process. This form of acne is characterized by the formation of inflammatory elements - papules (nodules) and pustules (pustules). The outcome of papulopustular acne depends on the depth of damage to the layers of the skin. Light form usually heals without a trace, when involved in inflammatory process deep layers of the dermis and damage to its structure, inflammatory elements heal with the formation of a scar defect.

Comedones and papulopustular acne are the most common forms of acne. Other types of acne in clinical practice are quite rare, are characterized by a more severe course and require a different treatment strategy.

Adult acne (acne adultorum)

If acne persists until the patient reaches adulthood or appears for the first time in adults, then they are classified as manifestations of acne adultorum or adult acne. They occur in 3-5% of men and women aged 40 to 50 and older. In some cases, their late resumption is noted years after the resolution of juvenile acne.

Late acne (acne tarda)

This form of acne is more often observed in women and requires additional consultation with a gynecologist. In 20% of cases, adult women complain about the occurrence of rashes a few days before the onset of menstruation and the disappearance of acne on their own with the start of a new cycle. Often, late acne is present all the time. Usually it is papular, papulopustular or nodular cystic acne. The cause of late acne is often polycystic ovaries, complicated by hirsutism and anovulatory menstrual cycle. It is also necessary to exclude tumor lesions of the ovaries and adrenal glands.

Globular or piled acne (acne conglobata)

One of the most severe manifestations of acne - spherical (heaped) acne - occurs in men against the background of thick seborrhea. Spherical acne is manifested by multiple nodular-cystic elements and large comedones located not only in areas of seborrhea, but also on the skin of the extremities, abdomen and back. Their healing occurs with the formation of keloid, hypertrophic and atrophic scars. Globular acne occurs in adolescence and persists, as a rule, up to 40 years or more.

Inverse acne (acne inversa, hidradenitis suppurativa)

The clinic of inverse acne is associated with secondary involvement in the inflammatory process of the apocrine or large sweat glands of the armpits, the perineum, pubis, navel, etc. Increased body weight, injury to the corresponding areas with combing or tight clothing predispose to their development. The disease is characterized by the formation of bumpy painful infiltrates with purulent or bloody-purulent discharge. Separate elements, merging, lead to an increase in the area of ​​the lesion. Heal for a long time with the formation of fistulas and scars. Inverse acne has chronic course With frequent relapses.

Pyoderma of the face (Pyoderma faciale)

Many researchers attribute pyodermatitis to a manifestation of rosacea, and not acne. Pyodermatitis of the skin of the face often affects young women 20-40 years old. The disease begins with the appearance of persistent erythema on the face, against which papulopustular rashes and nodes rapidly develop, which then merge into purulent conglomerates. Inflammatory elements are localized exclusively on the face, while there are no comedones and general symptoms. Healing of the elements occurs slowly, over a year or more.

Bodybuilding acne

The occurrence of bodybuilding acne is associated with the intake of androgens or anabolic steroids. The resulting hyperandrogenism causes increased secretion of sebum. A similar effect occurs as a result of long-term use of glucocorticoids. Anabolic steroids are often combined with vitamin cocktails that include B vitamins and causing the appearance nodular cystic acne. With this form of acne in patients, it is necessary to exclude endocrine disorders.

Acne caused by mechanical factors (acne mechanica)

The appearance of this type of acne is associated with mechanical blockage of the ducts of the follicles as a result of pressure or friction (wearing a tight headgear, plaster, with severe sweating, etc.).

Acne caused by exogenous causes

• Toxic acne, professional acne (Acne venenata). Occurs when a person comes in contact with chemicals and compounds that clog pores and cause acne (tar, lubricating oils, chlorine, etc.).
• Cosmetic acne (Acne cosmetica). Occurs as a result of excessive or misuse cosmetics (usually face creams).
• Acne from detergents (Acne detergicans). Develop from frequent use detergents leading to the formation of comedones.
• Solar acne (Acne aestivalis, acne Majorca). Acne that appears or worsens in hot and humid climates.

Acneiform rashes

Rashes in which there are no comedones are called acneiform. These include a large group of dermatoses: rosacea, rosacea, perioral dermatitis, skin tuberculosis, facial sarcoidosis, drug rash. For acneiform rashes, inflammation of the sebaceous hair follicle is primary. When diagnosing, they should be distinguished from acne.

Acne Treatment

Treating acne with diet

To date, there is no evidence-based evidence of a direct relationship between the occurrence of acne and the nature of the patient's diet. However, many of them note the aggravation of acne when eating citrus fruits, chocolate, coffee, pork, red wine, cheeses.

Studies have shown that the qualitative composition of the secretion of the sebaceous glands does not depend on the nature of the patient's diet. Also, the dependence of the severity of acne on the total calorie content of food, the amount of fat, carbohydrates, proteins, mineral compounds and vitamins in it has not been established. Therefore, it is impossible to speak unambiguously about the treatment of acne with the help of diet therapy. This question decided by doctors in each case individually. General recommendations according to the nature of the diet of patients with acne, they are aimed at reducing body weight and limiting drinks and foods that stimulate the secretion of the sebaceous glands.

Acne Treatment UVI

Some patients with acne associate a decrease in the manifestation of acne with insolation. Indeed, ultraviolet radiation stimulates the exfoliation of keratinized epithelium and immune processes in the skin.

But, on the other hand, ultraviolet light promotes the oxidation of sebum components, thereby enhancing their comedogenic properties. In high doses, ultraviolet leads to a decrease in local immunity of the skin and aggravation of acne. Therefore, when prescribing UVI procedures, one should take into account the nature of clinical manifestations, the severity of acne, and the individual course of the disease.

External acne therapy

The use of external agents is almost always used in complex treatment acne. Them pharmachologic effect aimed at suppressing the mechanisms of acne development: excessive secretion of sebum, hyperkeratosis, reproduction of microorganisms, development of the inflammatory process.

External remedies for acne lubricate the entire area of ​​\u200b\u200bthe affected skin (face, chest, back), and not individual elements of acne. A combination of drugs is acceptable, but not their simultaneous application. Treatment is carried out for several months until the disappearance of acne. In the future, a maintenance course with less frequent use of external preparations is required. For external use in acne, the following drugs are used: synthetic retinoids, azelaic acid derivatives, benzoyl peroxide and antibiotics. However, all of them have a weakly pronounced effect on hypersecretion of sebum.

Acne treatment with retinoids

Retinoids are synthetic analogues of retinol (vitamin A). Release forms - solutions, creams and gels. Indications for the use of retinoids are a mild degree of acne, accompanied by increased secretion of sebum, as well as intolerance to benzoyl peroxide. Preparations with retinol dissolve comedones, normalize the processes of keratinization of hair follicles, have an antibacterial effect and somewhat reduce the secretion of sebum.

Treatment of acne with azelaic acid

Azelaic acid is found in gels and creams for external use. Therapeutic effect azelaic acid is associated with the normalization of the processes of keratinization of the walls of the hair follicles, the suppression of increased reproduction of microbes and the development of inflammation in the sebaceous gland. Suitable for use in patients with comedones or moderate papulopustular acne, as well as in cases of ineffectiveness or poor tolerance of benzoyl peroxide and retinoids. A noticeable improvement usually occurs within a month, and the most pronounced effect is achieved after 2-3 months.

Treatment of acne with benzoyl peroxide

Benzoyl peroxide - active ingredient, which is part of many external preparations, has been used in dermatological practice for over 20 years. Possessing a powerful keratolytic ("dissolving" keratinized tissue) and whitening effect, benzoyl peroxide preparations are used in the treatment of ichthyosis, pigmented formations. Benzoyl peroxide is also effective against acne. The drug is available in various dosage forms(lotions, liniments, creams, gels) and concentrations (10%, 5%, 2.5%). It can be used alone or as part of complex preparations in combination with erythromycin, sulfur, hydroxyquinolone or imidazoles. The indication for the use of benzoyl peroxide is a mild degree of acne, characterized by the formation of comedones and inflammatory elements.

It is possible to use a combination remedy for acne, including benzoyl peroxide and erythromycin. This gel is prepared immediately before use. The keratolytic, antibacterial and anti-inflammatory effects of benzoyl peroxide combined with the bacteriostatic action of the antibiotic erythromycin on propionic acne bacteria give good results in the treatment of acne.

Treatment of acne with antibiotics

In the treatment of acne, topical antibiotics are usually used in cases of failure or intolerance to retinoids, benzoyl peroxide, and azelaic acid. Sometimes antibiotics are used as an additional drug to the first three main ones. medicines. 1% liniment or lotion containing the antibiotic clindamycin is used to treat moderate acne in the absence of the effect of the use of other drugs. Penetrating into sebaceous glands, clindamycin stops the reproduction of propionibacteria and staphylococci.

A preparation containing a powder complex of erythromycin and zinc acetate is successfully used to prepare a lotion. Erythromycin is effective against propionic acne bacteria and epidermal staphylococcus aureus, and zinc suppresses excessive sebum secretion. Indications for the use of this drug are mild and average degree course of acne. Of the tetracycline antibiotics, doxycycline and minocycline are more commonly used in the treatment of acne. These antibiotics tend to accumulate in the sebaceous glands, have high antimicrobial activity and are better tolerated by patients.

In its action, erythromycin is close to tetracycline antibiotics, but microflora resistance is rapidly developing to it. As the drug of choice in the treatment of acne, it can be used during pregnancy and breastfeeding, in pediatric practice, as well as in case of ineffectiveness of tetracyclines or their intolerance.

Treatment of acne when antibiotics are ineffective

The lack of effect from the treatment of acne with antibiotics may be due to the habituation of the flora to antibacterial drug in case of prolonged use or the development of gram-negative folliculitis (inflammation of the hair follicle caused by gram-negative bacteria). To establish the sensitivity of the microflora to the antibiotic, a bacteriological culture of the separated acne elements is carried out. Next, the question is whether to replace the antibiotic or prescribe retinoids.

Treatment of acne in men and women is different. In men, signs of seborrhea and multiple acne on the trunk have increased sebum secretion, therefore, antibiotics in high doses in combination with isotretinoin are required for their treatment. Isotretinoin is a synthetic retinoid drug that suppresses sebum secretion. Already 2 weeks after the start of treatment, sebum production is reduced by 90% and remains at this level for up to several months. After stopping the use of isotretinoin, sebum secretion returns to normal. In addition, against the background of treatment with isotretinoin, the processes of keratinization in the hair follicles are normalized, the number of comedones and propionibacteria and the inflammatory manifestations associated with them are reduced.

May be effective in treating acne in women hormone therapy. The gynecologist-endocrinologist should decide on the advisability of hormone therapy after analyzing the hormonal background of a woman. It is acceptable to combine topical acne treatment with hormonal combined oral contraceptives containing antiandrogens or an estrogenic profile. Usually, with such treatment, the effect appears after 3-6 months and is observed for a long time.

Treatment of acne with antiandrogens

Among the combined estrogen-progestin contraceptives, the most effective are cyproterone and ethinyl estradiol, which can be prescribed in the treatment of acne, either alone or in combination with each other. Corticosteroid antiandrogens are used to suppress adrenal hyperandrogenism. The duration of acne treatment with antiandrogens and estrogens can last for several months and even years.

Combination therapy for acne

Severe cases of acne require combination therapy combining standard topical and general treatment. In such cases, women may be prescribed contraceptives with estrogens or antiandrogens after a preliminary consultation with a gynecologist-endocrinologist.

Physical treatments for acne

General warming procedures (massage, heating, hot baths) are strictly contraindicated for acne, as they can aggravate inflammation. However, the use of local hot medicinal compresses contributes to the removal of comedones and the resorption of infiltration. For this purpose, Alibur's solution containing copper and zinc sulfates is used.

In the treatment of acne, phototherapy and ozone therapy can be used. To correct cicatricial changes remaining after the resolution of acne elements, mesotherapy is prescribed.

In the acute period of acne usually do not resort to surgical procedures. When cystic cavities are formed, they are exposed to liquid nitrogen (cryotherapy) or a triamcinolone solution is injected with a thin needle. Surgical opening of cystic cavities leads to scarring. Multiple subcutaneous keratin cysts (

In the vast majority of cases, acne vulgaris is benign. Severe forms, resistant to treatment, prone to complications and relapses, disfiguring the appearance, are less common. Some doctors “blame” hormones on them, others blame them on “clogged pores” or skin infections that have once been transferred, an imbalance in the skin microflora. But treatment, taking into account any and these opinions, gives a result infrequently and looks more like a palliative measure. This means that none of them is 100% correct.

Complex of reasons

Single "imperfections", as cosmetologists delicately call them, can occur throughout life in all people. Acne is called only systemic, regularly recurring or continuous rashes. They "choose" the most oily and intensively renewing areas of the skin - the face, shoulders, chest, sometimes they can appear on the stomach, back, buttocks. All the reasons for their occurrence have not yet been established, but most often the following are mentioned in their list.

• Hormonal fluctuations. Balance disorders, excess testosterone (it increases the activity of the sebaceous glands in both sexes), special periods and conditions (critical days, menopause, pregnancy, hormone therapy), in which the background changes dramatically in the natural framework.
• Infections. Usually lowering the local immunity of the skin or associated with a violation of its microflora (pores infect opportunistic bacteria that are part of the normal composition). Among them is the activity of the demodex mite, the causative agent of demodicosis.
• Heredity. The special structure of the sebaceous ducts, which makes it difficult for the outflow of fat produced by them to the surface of the skin. There is also an increased secretory activity of the sebaceous glands laid down at the gene level.
• Digestive pathologies. Intestinal diseases are most often manifested by rashes on the skin. Also indicate a connection with gastritis associated with Helicobacter pylori infection.
• Horniness. The layering of dead cells of the epidermis with insufficient hygiene or its renewal too fast, which leads to clogging of the pores.
• Chemical influences. Frequent contact with chlorine, bromine, lithium, barbiturates, iodine or their use for therapeutic purposes. This also includes makeup problems in women - excess foundation, powder coating and blush.

Even non-comedogenic cosmetics are more of a threat to women's skin than a means of improving appearance. There are many reasons for this - from dense silicone, which replaces comedogenic fats in it, to fragrances, metal salts and additives (flavors, preservatives, texturers). But acne is rarely associated with its use, only when allergies appear.

Forms and stages

Acne rashes are divided into the following forms.

• Comedonal. It is characterized by the formation in the pores of the skin of many "plugs" of white (yellowish) or black color. Dirt or its absence has nothing to do with it - we are talking about different types of rashes. The main advantage of a comedonal rash over other options is the low percentage of inflammation under the "plugs", especially with regular cleaning of the skin surface from the stratum corneum. And its main drawback is the ability to gradually stretch the skin pores, making them visible.
• Papulo-pustular. It is more pronounced, gives patients more discomfort, since the papule is an inflammation of the pore, a pimple without a purulent head or rod. The pustule is the next and final stage of the process. It is an abscess under the very surface of the skin that occurs after the “ripening” of the papule. After the breakthrough of the pustule, the healing of the focus begins. A papulo-pustular rash is especially bad because it leaves behind purple-bluish spots (a temporary phenomenon, but it lasts from several months to six months) and cicatricial indentations that make the skin uneven, although they do not violate its functionality.
• Cystic. belongs to the most severe forms acne. With it, the foci of suppuration in separate pores merge, spreading not only to the sides, but also deep into the skin. It ends in inflammation subcutaneous tissue with the formation of large nodes resembling a boil or carbuncle. The difference is that in their center the place of the purulent rod is occupied by a black comedone. A cystic rash is painful, greatly disfigures the appearance, leaves behind deep “craters” on the skin.

The severity of the condition can vary from a dozen scattered papules on the forehead and cheeks to a few pustules on different stages"maturation" to merging knots that turn the skin of the face into a "Martian landscape". On the chin and beard line in men, a profuse rash is less common. The activity of the sebaceous glands there is low, and the thickness of the subcutaneous fat layer is minimal.

It is the same with the neck area: acne almost never passes from the face to the chest and shoulders in a single “carpet” - only bypassing it. But this rule is not strict. In the strong and fair sex, the distribution of rashes may differ - not only due to the difference in hormonal levels, but also the presence of areas of constant irritation on the face of men (during shaving), methods and means of skin care, the frequency of using special procedures (peeling, whitening) .

Blackheads on the face are more worrying because they form a more visible defect. And white ones are the least distinguishable visually, they are easiest to hide with makeup for both women and men. In the vast majority of cases, several types of acne in different combinations are present on problem skin at the same time. If papules "prefer" the cheekbones and forehead, then black and white comedones - the nose, chin, the area around the mouth.

Medical means of struggle

Because of the difficulty in understanding the nature of acne, treating it is a long, self-disciplined exercise with no guarantees. Improvement occurs in 98% of cases. But even with strict observance of all measures, only 20-30% of those suffering from it over 30 years old can completely cure acne.

Dermatology considers acne to be more of a hormonal problem, just with a layer of other "aggravating circumstances". But acne is not treated with hormones for several reasons.

• Unpredictability of the result. Intervention in the natural background of the body often leads to unpredictable and irreparable consequences in the future.
• The need to act recklessly. If the doctor does not guess with the direction of the correction, the situation can worsen dramatically.
• Low performance. The direct effect of steroid therapy for acne is about the same as that of safer ones. endocrine system funds.
• Unjustified force impact . Acne spoils the appearance, but it is not dangerous for health and life. The consequences of even severe acne are reduced to more or less noticeable scarring, which does not change the basic properties of the skin.

A blood test for hormones for acne is really handed over. It is possible to carry out treatment together with a gynecologist, especially if there are other signs of hyperandrogenism. Then women are recommended to take combined oral contraceptives with an antiandrogenic effect:

• "Jess";
• "Jess Plus";
• "Yarina";
• "Diana-35"
• "Dimia".

But the main medical remedies for acne include the following drugs and measures.

Light antiseptics and anti-inflammatory

Among them are acetylsalicylic, hyaluronic, citric acids. Organic acids are present in the vast majority of products for problem skin, as they have a whitening effect. But they give good effect only in mild cases - in adolescents and young adults. For persons over 20 years of age, it is more appropriate to prescribe combined preparations(the rate of skin regeneration is already slowing down, and a rash that persists at this age worsens the prognosis for its treatment in the future). Among them are "Regecin" (hyaluronic acid plus bleaching zinc that has a slight anti-inflammatory effect) and "Delex Acne" (boric and citric acids in combination with anti-inflammatory herbs - and nettle).

The products of this type also include masks based on clay and sulfur. Sulfur disinfects and dries inflamed skin, and clay “pulls out” the comedones themselves from the pores, tightens the “holes” formed by them.

For acne, only yellow, red and black varieties of clay are used.

Antibiotics

They are "heavy artillery", but they help even in the most difficult cases of extensive purulent lesions of the subcutaneous tissue. At topical application the effect of antibiotics on the body as a whole is small. They are not suitable for the prevention of acne, unlike other means. Before prescribing them, the doctor must make sure that the rash is not provoked by a specific infection - even a long-standing or latent one (syphilis, herpes virus). In this case, general treatment and with the help of specialized drugs will be required.

Locally against acne, a broad-spectrum semi-synthetic doxycycline (tetracycline series latest generation, resistance to it in the bacterial microflora of the skin is still rare). It contains, for example, Unidox.

Mesotherapy

Its purely medical "specialization" is explained by high manufacturability. The essence of the method is the introduction deep into the subcutaneous layers of various means. It is more commonly known as "beauty shots" and can be used for more than just acne. With the help of mesotherapy, cosmetologists fight aging, age spots, irregularities of the fatty layer of the skin, its excessive dryness.

With acne, all the same acids are injected into the skin - organic (to whiten and fight inflammation) or amino acids (to accelerate regeneration). Sometimes whole molecules of proteins - collagen and elastin - are included in the injections. This option is relevant after the age of 40, when cosmetic defects due to past and present foci of inflammation become more noticeable, and the skin's own regenerative resource is greatly reduced. It is possible to administer an antibiotic solution in this way, but this will complicate the control of the total dose received by the patient.

Other means

As a method of applying the above drugs or even extracts medicinal plants the patch fits. Acne patches contain the same components as gels, masks. Due to the imaginary "ease of use" their cost exceeds the severity therapeutic effect several times, because their purchase is usually impractical.

As an aid in inflammation, patients must be prescribed a diet with a restriction on fats (both animal and vegetable). It reduces the activity of the sebaceous glands slightly and indirectly, therefore it serves only as an addition to treatment or a way to prevent exacerbations.

In the arsenal of medicine, there are several procedures with unproven effectiveness. For example, plasmolifting. Now this procedure with a catchy foreign name is served by cosmetology clinics as an absolute novelty. In fact, something similar was practiced by Soviet dermatologists. Plasmolifting consists of three stages.

1. Seizures in a patient of small volume arterial blood.
2. Hardware extraction of plasma from it.
3. Injection of plasma into the skin of the face.

In smoothing out wrinkles and scars, tightening the skin and eliminating other effects of acne, it helps more than in the fight against acne. The "prototype" of the technique was developed back in the USSR, and it consisted of injecting the patient's own arterial blood into the upper lobes of his buttocks. How both manipulations “work”, science cannot say, but they help to get rid of rashes on the face for the next few years in 60-70% of cases, including severe ones.

The consequences of acne, especially for aging and severely damaged skin, are eliminated with the help of peeling and laser resurfacing (controlled burn of the epidermis accelerates its regeneration). Peeling is also indicated as a means of treating comedones. But in reality, their appearance due to blockage of pores by keratinization of the skin or fat is rarely observed. This is possible with an extremely low level of personal hygiene of the patient or a passion for fat-based care products.

Folk methods

Threats from folk remedies, two:

• increased risk of allergies;
• untested efficacy.

basis folk treatment acne, approved even by doctors, are local applications of anti-inflammatory herbs - celandine, St. John's wort, calendula officinalis, mint, oak bark. Almost all of these plants are moderately toxic. Contain high concentrations of alkaloids and tannins. These compounds are poisonous not only for bacteria with fungi, but also for animals and humans. Their effect is especially noticeable on the work nervous system- central and peripheral. Their presence also explains the frequent acute reactions of the immune defense to the use of these plants. But natural antibiotics in the form of herbal decoctions, they really help to overcome acne or reduce the brightness of the manifestations of the disease. To use them, any of the recommended herbs need only be brewed in high concentration (two tablespoons per glass of water) and wiped with the resulting product. clean skin face three times a day.

Usually plants with antiseptic properties are enough to combat rashes. But sometimes ethnoscience she can also recommend sulphurous clay masks (a remedy adopted from her by official cosmetology), as well as even more exotic recipes.

• Pure fresh citrus. There are a lot of citric and ascorbic acids, which manifests itself in the form of an antiseptic effect.
• Mummy mask. But the effectiveness has not been proven, the risk of developing allergies is high.
• Propolis, apitoxin and other bee products. Used topically or orally. The degree of their influence on immunity has not been objectively verified by anyone, but subjectively (according to reviews), it is equal to zero or close to it. But the high ability of honey and bee products to provoke allergies is well known.
• Yeast. Also used internally or externally in the form of masks. Yeast improves the condition of the skin, hair and nails, accelerates their growth and regeneration simply because they are a multivitamin supplement. They contain half, which are fundamentally important for horny cells (they form the nail plates, hair and epidermis), and E. Taking these same components with any other food or supplements gives the same effect. And the local application of yeast to the foci of inflammation is impractical and dangerous by worsening the situation. Yeasts are an ideal breeding ground for pathogens of the most different types. Yeast, "enriched" with the same vitamins as in their natural composition, is sold in the form of Nagipol tablets. But the drug does not contain recommendations for taking with acne - only for improvement appearance hair, nails and skin.

According to experts, the effectiveness of folk remedies in the treatment of acne is not higher than that of methods official medicine. They have their own side effects, often on the same scale as pharmaceuticals. And there are no ways to eliminate skin defects that have arisen due to “former” inflammations at the disposal of healers. But they are more convenient for home use, and they are cheaper. True, the cost-effectiveness, taking into account “lifelong treatment”, is often higher.

Acne(acne, acne) is chronic illness sebaceous glands and hair follicles. At the same time, there is a blockage of the glands, increased production of sebum (a special secret due to which our skin is elastic, protects us from infections and participates in the thermoregulation of the whole organism), and as a result, a severe acne appears on the face. In this article, we will consider in detail what is acne on the face, causes and treatment.

About 80% of adolescents and young people live with this disease, but acne can also appear at a later age, after 25 years.

Causes of acne

Causes of acne on the face most often are:

acne pills

Acne pills on the face are prescribed when the appearance of acne is associated with internal diseases, for example, with disruption of the gastrointestinal tract. In this case, doctors prescribe Doxycycline, Isotretinoin or Aknekutan.

Medical treatment of acne on the face alone is not recommended.

Nutrition for acne on the face

plays an important role in the treatment of disease proper nutrition. Diet for acne on the face prescribes exclude from the diet of sweets, fatty, carbonated and alcoholic drinks, bread, chips, milk and replace them with green tea, yogurt, vegetable salads, fruits and steamed meat and fish.

Necessary replenish the body with vitamins A, B and E(carrots, cucumbers, apricots, sorrel, spinach, black currants, all kinds of nuts, cabbage, cheese, buckwheat, beans), as well as zinc(asparagus, herring, beef stew, oysters and veal liver).

There is a direct link between healthy skin and a healthy gut, so the first thing you need to pay attention to is the health of your gastrointestinal tract.

Cleansing the intestines and following a diet will favorably affect the condition of the skin. Remember the need drink enough purified water. It removes toxins, actively helps cells recover.

How to get rid of acne on the face and how to cure acne on the face? For this, it is possible to cleaning procedures acne faces, soft, special facial massages, surface cryotherapy, peeling faces with acne. If acne is not inflamed, then laser therapy may be used.

In no case do not try to squeeze blackheads on your own.

This is dangerous in the future. spread of infection and the appearance of new pustular foci. In addition, after mechanical opening of the pustular cavities, rough and unaesthetic scarring.

Useful washing with warm water using antiseptic soap or a weak solution of furacilin. After washing, the face is gently wiped with a cotton swab dipped in a solution of salicylic, chloramphenicol or boric alcohol.

If there are no abscesses, then you can carry out "salt" procedures- using a steam bath, steam the skin of the face, then apply a mixture of soap suds, a few teaspoons of soda and salt (only fine, otherwise you can injure the skin even more). Lungs in a circular motion perform a peeling procedure, then rinse your face with warm and cold water. Dry your face gently with a towel without rubbing, then apply a light moisturizer and non-greasy cream.

In any case, since acne can hide more serious diseases.

Acne or acne usually appears in adolescence and goes away after a few years. But in some cases, painful symptoms in the form of red bumps, pimples, white and black spots on the face stay longer, and young people suffer from complexes because of their appearance. However, do not despair, everything is in your hands. If you watch your diet, observe hygiene, avoid bad habits and, of course, regularly use various anti-acne drugs - your skin on your face will become clean and soft, like a child's.

Curing acne at home is not so difficult if you regularly and properly care for your skin. Believe in yourself, imagine your skin clean and silky, smile to the whole world and tune in to a complete recovery - and you will be convinced of your beauty and originality. Thoughts are material, the main thing is to believe in yourself!