Since it does not threaten the overall health, Acne vulgaris is seen as a cosmetic problem but in fact it represents a serious chronic disease of the skin. Do not wait for acne to disappear by itself but visit a dermatologist who will set a diagnosis and implement treatment.
Acne usually occurs during puberty and adolescence, in the period between 12 and 16 years, but may occur earlier or later in life. If left untreated, it may be present for years and leave the scars on the skin. Acne usually occurs on the face but is not uncommon on the skin of the back, chest and neck. In addition to the visible consequence (scars), since they occur during a very vulnerable period of life, acne can have an impact on the mental health of the patient too. The problems that arise as a result of the disease are: low self-esteem, anxiety, depression.
Why does acne occur?
Acne is usually caused by increased secretion of sebum (oil), which is associated with increased cornification of the cells in the hair follicle.
These processes are accompanied by the infection Propionbacterium acnes. Sebum is normally secreted to the skin surface through the secretory tubules which are located along the follicle. When the process of cornification is increased, cornified cells make a plug on the surface of the hair follicles and prevent the normal secretion of sebum. Instead excretion of fat from the sebaceous glands to the skin surface, it remains trapped in the follicle. This builds up until the follicle can naturally expand, and then it causes the splashing of follicles and the spread of infection in the tissue around the hair follicles. All this creates favorable conditions for multiplication of bacteria Propionbacterium acnes. The result of these interrelated processes is visible in form of changes on the skin. Initial changes are in the form of comedones (blackheads) and can be observed on the nose, forehead and chin.
At a later stage, changes are spreading on the cheeks, behind the ears, on the side of the neck, décolleté and back. These changes are eventually joined by the red, smaller or larger "bumps" which then fester and can be quite painful. In severe forms of the disease such changes are grouped together.
Does stress affect acne condition?
Acne is exacerbated in various stressful situations, such as: end of the school year, the period of assessment, exams, the transition from middle to high school and other situations. It is not precisely determined the mechanism by which emotional stress leads to worsening of acne. It is believed that stress hormones are responsible for that, especially glucocorticoids and the androgen hormones that normally stimulate the secretion of sebum. According to some, deterioration occurs when stress suppresses the immune system and makes multiplication of bacteria Propionbacterium acnes easier. Studies have shown that it usually takes two days from stressful situation until the deterioration of the skin to become noticeable.
How is acne treated?
Treatment depends on the clinical picture.
For the treatment of mild forms the local therapy is sufficient. Retinoids (vitamin A derivatives) that dandruff skin surface and enable undisturbed secretion of sebum, without retaining in the follicle are applied for local therapy. These drugs for local application can be used for several months even after healing, in order to prevent recurrence. Various mixtures with or without antibiotics (usually erythromycin or clindamycin) are also used for the treatment.
The use of antibiotics is mandatory if the acne is inflamed. Length of the therapy depends on the severity. Sometimes the use of antibiotics is necessary during the whole month.
If acne is the result of polycystic ovaries, which is relatively often in girls, then the tablets that are normally used for birth control are prescribed. Do not be afraid of these tablets. This is a new generation of drugs that do not have those harmful effects that drugs from this group have had 20 or more years ago.
For the treatment of severe form of acne, called acne conglobata- which besides the usual clinical picture has keloid scars, the doctor may prescribe Roaccutane (isotretinoin). This medicine is taken under the supervision of a dermatologist because it is eliminated through the liver and can be hepatotoxic. It is retained in fatty tissue for a longer period of time and because of its teratogenic effect (it causes fetal damage) one should not give birth two years after the cessation of therapy with this medicine.
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How to care for the skin that has acne?
In the care of acne-prone skin, the product which is used to wash the skin is very important. The best gels for washing are those with antiseptic effect and which will not dry out the skin's surface. The use of soaps and alcoholic lotions derives the moisture from the skin and then you have a double problem-oily and dehydrated skin. It is also necessary to use a day cream that will hydrate the skin and have at least some effect on the reduction of sebum secretion in the sebaceous glands. Modern cosmetology offers a large selection of products for care and cleaning of acne-prone skin.
Treatment of acne scars
A dermatologist can use a variety of methods to heal the scars caused by acne. Leveling of the skin using a laser, dermabrasion, chemical peel or electrosurgical treatment will align the irregularities caused by scars. Regeneration of the soft tissue by collagen or fat transfer can help with the scars. Scar revision using micro excision and "punch" grafts can correct deep scars and combination of these dermatologic- surgical methods can significantly alter the appearance.
No matter what special treatment your dermatologist chooses remember that you must continue to properly care for the skin.
Acne is not curable but can be controlled, and the proper treatment can help you feel better, look better and prevent scarring.