Go Causes and treatment of acne in adults: a review of tools and procedures with proven effectiveness

Acne treatment: a review of tools and procedures with proven effectiveness

Acne is a polymorphic dermatosis caused by a malfunction of the apparatus of the sebaceous glands. This is the most common skin disease in adolescence, found in 90% of girls and 100% of boys. In the last decade, acne recurs more and more at an older age.

According to research data, the proportion of women with acne rashes between the ages of 25 and 40 is 40–55%. But with an increase in the incidence, methods of treatment are also developing. Over the past 5 years, dermatologists have developed a scheme for effective treatment of dermatosis. Also, medicine has advanced in explaining the specific causes of acne.

Causes of Acne

Acne develops on the background of oily seborrhea, which is associated with increased synthesis of sebum, a change in its formula. Normally, sebum is released to lubricate, moisturize and protect the epidermis. But because of the compacted stratum corneum, the sebum outflow is disturbed, it accumulates in the follicles, mixes with dead cells, forming clogged pores or comedones.

Important: Seborrheic zones are: the forehead, the nasolabial triangle, the chin, the chest, the shoulders, the hairy zones of the head, the armpits and the "bikini".

The secretion of sebum is influenced by sex steroid hormones: androgens, estrogens. The leading role in the formation of acne belongs to the active metabolite of testosterone - dihydrotestosterone. In women, such an imbalance of hormones is called - hyperadrogenia.

It has the following predisposing factors:

  1. Increased free testosterone in the blood.
  2. Increased sensitivity of hair follicles to androgens.

In the skin is the mass of hormonal receptors that respond to androgens, increase the synthesis of intercellular lipids. The sensitivity of epidermal cells to androgens is manifested by the following symptoms:

  • hyperhidrosis or increased sweating;
  • scalp seborrhea, hair get greasy soon ambassadors wash, fall out actively (androgen dependent alopecia)
  • hirsutism or male excess hairiness.

Common symptoms of hyperadutherans: menstrual disorders, marked PMS, amenorrhea, polycystic ovary, infertility.

Androgenic theory of the development of acne is confirmed by the features of the course of the disease:

  • acne appears in adolescence when the sex glands begin to function actively;
  • in women, acne aggravates in the last quarter of the menstrual cycle, during menopause, in response to a sharp decrease in estrogen;
  • acne is a common problem for bodybuilders on a steroid hormone course;
  • the intensity of the rash is reduced by taking combined oral contraceptives (COCs). They artificially correct hormones.

Oily seborrhea is a favorable environment for the development of bacteria. Human epidermal flora is different, it is formed by beneficial and pathogenic microorganisms. The inflammatory process in fatty follicles triggers reproduction of Propionibacterium acnes. They provoke the appearance of pustules, ulcers, boils.

Types of Acne

Acne is a polymorphic disease, rashes are classified depending on the nature of the formation into the following types:

Comedones or Wen appear in the pores or follicles when the mechanism of sebum outflow is disturbed due to horny layer consolidation.

Black dots are “born” in the same way as comedones only in open follicles. Then the fat becomes dark in color, oxidized upon contact with oxygen.

Pustules or pustules appear when pathogens multiply in comedones and neighboring tissues. These are red, inflamed elements with purulent contents.

Cysts are painful subcutaneous purulent infiltrates that are difficult to treat.

Papules (nodules) - impassable dense elements that heal for a long time, leaving purple or brown spots.

Stage of the disease

Depending on the severity of the inflammatory process, 4 stages of acne are distinguished:

  1. The skin of the face is oily or combined, there are enlarged pores, small comedones, several shallow inflammations (up to 10).
  2. On the skin of 10-20 papules, black spots, closed comedones, there are several inflammations on the body (chest, shoulders).
  3. The number of papules from 20-40 on the face, spots, scars from deep acne, dilated ports, comedones. Body skin is also a problem.
  4. More than 40 inflammatory elements on the face, cysts, subcutaneous pustules, scars. Sometimes inflamed areas provoke a local increase in body temperature.

The prevalence of severe forms, according to American researchers, is 6–14% of the total incidence statistics.

Acne Treatments

Acne with a chronic, recurrent course requires competent sequential treatment. Modern dermatology can provide effective therapy options for patients with acne.

The complex mechanism for the development of acne consists of the following stages:

  1. Sebum hypersynthesis is caused by androgens.
  2. Compaction of the stratum corneum prevents sebum outflow.
  3. The development of pathogenic bacteria in the sebaceous glands, which provoke inflammation.

Medicine has ways to move on to the course of the disease at any of the stages.

Contraceptives and antiadrogens for treating acne

Sebum overproduction occurs in response to excessive testosterone release. According to the standards of endocrinology, they start to treat hyperadrophy only when it affects the reproductive function and the functioning of the internal organs.

Ways guaranteed align hormones do not exist. For the correction of imbalance prescribed contraceptive or combined oral contraceptives (Diane, Janine, Three Merci). They inhibit the synthesis of androgens, but they give a temporary effect and have a pronounced withdrawal syndrome.

Also, the synthesis of testosterone is affected by antiandrogens: spiroloactone in high doses, androkur, vegetable estrogens (boron womb, red brush, Serenoa palm extract, primroses, fenugreek).

Studies are underway about the relationship between insulin secretion and the conversion of testosterone to active acne-forming form. Intermediate results prove a correlation between sugar consumption and aggravation of acne. Therefore, for the correction of androgen-dependent acne, a low-carb diet is prescribed.

Tretinoin and adapalen

The common names for this class of drugs are retinoids. These are forms of vitamin A. For the treatment of hyperkeratosis, as acne factor, retinol esters, acetate and palmitate, as well as pure retinol, do not have high activity.

Tretinoin or retinoic acid is the active form of vitamin A, it has a pronounced exfoliating action, it thinns the stratum corneum, but compacts the dermis. This is the “gold standard” of acne treatment; it is used not only in the care of problem skin, but also in age.

A lasting effect from the use of tetinoin appears for 2-3 months of therapy. In the first days after the start of use, side effects are possible in the form of increased sensitivity, peeling. It is necessary to strictly follow the instructions for use of the drug: do not apply to wet skin, apply a nourishing, containing panthenol care, use SPF.

Tretinoin-based preparations: Retin-A, Ayrol, Retino-A, Vesanoid, Lokatsid, Tretin 0.05%, Stieva-A, Vitacid.

In case of cystic acne of the 4th degree, internal tertionoins (Roaccutane, Aknekutan) are prescribed, they help even if all the “before” means were ineffective.

Pregnancy - the first contraindication to tretinoin. It is proved that it causes fetal malformations in 40% of subjects. Also for the entire period of retinol therapy you need to use contraceptives with a 100% guarantee.

Adapalen, a synthetic derivative of naphthoic acid with a retin-like effect, provides a pronounced effect on the renewal of the epidermis.

Drugs based on adapalene: Differin, Bezugrei gel.

Acne Acne

For the treatment of acne, BHA and AHA are used.

BHA - salicylic acid inhibits the reproduction of Propionibacterium acnes, tightens pores, boosts the skin renewal process.

AHA, so-called fruit acids: azelaic, citrus, lactic glycolic, almond glycolic, lactic. They provide a powerful exfoliation leveling relief.

Also, acids are able to change the formula of sebum, they liquefy it and promote free discharge from the pores. Therefore, AHA is prescribed to moisturize the skin, even though they themselves do not deliver moisture to the cell, but they resume the natural hydrobalance of the epithelium.

Azelaic acid is highly active against Propionibacterium. On its basis, the drug is produced - Skinoren and its generic drugs: Azogel, Skinoklir, Azik-derm.

Acids are used in the form of peels, serums, as a part of tonics and means for washing. The product of the new generation - pads with a combination of exfoliants, for example from CosRx, Dr. Jart, A'PIEU, DR Dennis Gross.

Acne with benzoyl peroxide

Benziol peroxide has been used in cosmetologists since the 90s. It is a powerful oxidizing agent. When it is destroyed, benzoic acid is formed on the skin, which inhibits the activity of bacteria and renews the skin.

Preparations with benzoyl peroxide: Baziron, Duac (benzoyl peroxide + clindomycin), Eclaran, Ugresol.

They are used in stage 1-2 acne, as their activity is lower than that of tretinoin. But peroxides are cheaper, distributed in pharmacy chains and begin to act faster.

Antibiotics for Acne

With a strong inflammatory process, it is impossible to cure acne without antibiotics. If the papules are located on the body, it is advisable to prescribe a course of internal antibacterial drugs. Tetracyclines, linkosamides, clindomycin have activity against Propionibacterium acnes.

External preparations: synthomycin mal, chloramphenicol solution, clindomycin mash. External preparations can also be used only in courses, but on large areas of the skin.

The sensational drug Zenerit, based on erythromycin, is considered a failure in the West, but due to the marketing campaign, it still enjoys undue popularity in the domestic market. Erythromycin is not recommended for use against acne because of the high threshold of resistance of bacteria to it.

A significant lack of antibiotics: they act only on papules or pustules, relieve inflammation, but do not affect the general condition of the skin (and acids and retinoids affect), are not effective against comedones, cysts and black dots.

Also, antibiotics disturb the balance of the flora in the area of ​​application. When suppressing bacteria, fungi, viruses are activated. Passion for antibacterial drugs may in rare cases (2-8%) of pityriasis versicolor or cutaneous herpes.

Acne treatment at the beautician (laser, cleansing, peels)

The beauty industry offers a wealth of options for correcting acne. The most common procedures are microderma and mechanical cleaning .

With active inflammation, all these options are contraindicated, plus mechanical cleansing injures the skin. Although it frees pores from pollution, the effect is short. Microdermabrasion - in fact, a hardware scrub, but peeling occurs with aluminum microcrystals, which does not injure the skin.

Both procedures are very painful and unnecessarily expensive due to low efficiency.

Laser resurfacing is the exfoliation of the upper layer of dead horny cells by a laser. The procedure starts skin renewal, helps to even out its texture, to narrow pores. But the price of laser cleansing is exorbitant, the healing period is long and requires the supervision of a specialist.

Without proper home care (with the participation of acids or retinoids), this procedure does not provide the desired effect, since acne “successfully” recurs after the horny epithelium is restored.

Peeling is probably the most effective of cosmetic procedures, especially if a specialist after a session prescribes a home care regimen with acids to the patient. Peeling is performed by AHA and BHA, most often dairy, glycolic, salicylic.

Three acetic acid is a median peeling. It requires a long period of adaptation, but helps with very serious problems: scars, scars, severe pigmentation after acne.

Important: Acids, retinol and other procedures provoke the thinning of the stratum corneum, thereby increasing the risk of the appearance of age spots. It is necessary to carry out treatment in a period of low solar activity or to use agents with an SPF filter.

In addition, today, the beauty community is promoting important information about the need to apply UV protection creams on a daily basis. It has been proven that strong insolation provokes photoaging, dry skin and even the formation of malignant melanoma.

Home care for problem skin

If there are foci of bacterial inflammation on the face (white papules, cysts, subcutaneous acne), cleanliness should be observed during contact with the skin:

  • Do not touch your face with dirty hands.
  • Collect dirty hair in a ponytail or braid.
  • Wipe the screen of the smartphone, which regularly comes into contact with the cheek, alcohol or disinfector.
  • Change the pillow 1-2 times a week.
  • Use clean or, ideally, disposable, face towels.
  • Regularly wash brushes and sponges for makeup.
  • It is forbidden to use tools with large abrasives - scrubs. They injure the skin and spread bacteria. It is better to carry out exfoliation with acidic pads, peels, and rolls.

To find care products for problem skin is difficult and easy at the same time. In the US market, products without risky ingredients are labeled non-comedogenic - not comedogenic, which means that they do not cause clogged pores. But not all European and domestic brands follow the labeling nuances.

The most common comedogenic components that should be avoided in the care of problem skin: castor, soybean, coconut, cocoa butter, talc, alginate, isopropyl, vaseline.

The point is that many anti-acne lines from iconic brands contain a “lethal dose” of comedogenic components, for example, La roche posay, Mary Kay, Garnier, Pure Line.

Important: Do not put suspicious substances on problematic skin on the advice of members of the forum, neighbors and dubious girlfriends.

Anti Acne Rating

  • Baby powder. It contains talc, which clogs the pores. Instead of “dry pimple”, it provokes black dots.
  • Economic, tar soap dramatically dry the skin, without providing any anti-inflammatory effect.
  • Garlic, onions have a weak antibacterial effect, weaker than the usual pharmaceutical antiseptic chlorhexidine or Miramistin.
  • Soda is one of the crimes against the skin. Ph epidermis is more acidic than other membranes. Soaps and cleaners violate it, so tonics often contain acids to restore balance. Alkaline soda is the best way to "kill" the immune system of the skin and provoke more acne.
  • Zinc paste. Zinc gives a drying effect, but the paste format is contraindicated in acne. It is produced on the basis of paraffin or animal fats that clog pores. It is better to use a talker with zinc (for example Zindol) pointwise on the rash.

Folk remedies that do not eliminate the problem completely, but positively affect the problematic skin: blue, green clay, calendula, chamomile, turn, aloe, iodine (dot!), Lemon.

Acne Treatment Myths

Opportunities to cure acne forever exist, but the lack of visual therapeutic aids with reliable information pushes women to look for questionable ways to get rid of acne. Hence the mass of myths about the treatment of acne.

Myth 1. Face sprinkles from cosmetics. It is necessary to stop smearing the decorative elements on yourself and the skin will become clean.

Makeup that spoils the skin is long gone. Today, beauty companies produce decorative products with care components that can be applied daily. But you should avoid products with comedogenic ingredients. And, even more so, with a real acne disease, the simple abandonment of makeup does not affect the problem.

Myth 2. Skin is a mirror of health. You need to “heal yourself from the inside,” eat right, get enough sleep, and problems will recede.

A healthy lifestyle is great. But, with severe acne, it is not enough. Need targeted therapy. The theory that acne is indicative of an organism’s “pollution” does not hold water. You do not need to suspect a dysbacteriosis, cancer, diabetes or other sores because of acne. This dermatosis has specific causes. There is no need to develop a health phobia at home because the next genius of pharmaceutical marketing wants to sell an unnecessary pill that supposedly “cures the intestines and skin at the same time”.

Myth 3. Only natural remedies, better than the people, they definitely will not harm, and chemistry is evil.

Natural ingredients may not hurt, but are unlikely to help. If acne is higher than 1 degree, then all popular wisdom is impotent. It is better to go and buy a drug with proven effectiveness than to choke the juice from the plantain.

The key to successful acne treatment is the belief in success. Adjust yourself to the fact that modern dermatology offers a lot of really effective ways to treat acne dermatosis. Having rejected belief in myths and stereotypes, and having resorted to the help of the correct preparations, one can permanently normalize the skin.

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