Dermatology - diseases of the skin

Acne


Acne

Acne is a chronic dermatosis of the face, back and chest. The skin lesions often can be found under names such as, pimples, seborrhea, acne, vulgaris (vulgar) acne.

Acne is a consequence of the interaction of multiple pathological factors, thereby resulting in increased production of sebum, stratum corneum thickening of the ducts of the sebaceous glands, irregular exfoliation of these dead cells and blockage of the Horny scales of the follicle duct. All this leads to the active reproduction in the follicle opportunistic microorganism, Propionbacterium acnes, and consequently, the occurrence of inflammation.

Each hair follicle is surrounded by sebaceous gland and connected to it by means of a suitable duct. Sebaceous secret, produced by a gland coats the skin and hair, thereby not only protects them from all environmental influences, respectively but moisturizes. Excess fat dead cells stick together, thus forming a tube at the mouth of the hair follicle. This tallow-hair tube is often caused by a bulging of the wall of the follicle.

Thus formed most of the elements of the rash acne. This so-called whiteheads or closed comedones – non-inflammatory hemispherical nodules, white in color, to the size of a pinhead. Open comedones are called black points formed as a result of this oxidation of the tallow-hair tube. With the active multiplication of bacteria in the follicle leads to the formation of inflammatory cells, which appear red papules, a conical shape, with a rim of hyperemia around and pustular element at the top.

Acne – photo, images and pictures

Especially dangerous is the formation of such elements in the nasolabial triangle, which is characterized by the presence of a very dense and superficial venous network located, which creates favorable conditions for the penetration of infection in the blood vessels and the development of purulent meningitis. The spread of the process promotes active movement of facial muscles. Therefore, in the area of the nasolabial triangle is strictly prohibited squeezing any inflammatory cells and in the formation of such is necessary to consult a dermatologist or surgeon.

Must be said of severe acne: acne conglobata, cysts, abscesses. Acne conglobata or nodular acne is large subcutaneous nodes, a dense consistence, formed deep in the hair follicle and cause pain when touched. This type of elements is also called a drain, which highlights the prevalence of the process. Nodular-cystic abscess and the items are rare, difficult to standard treatment and are resolved through the formation of scars.

Causes of acne

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

Causes of acneExcessive irritation of the skin various skin care: Soaps, peelings, scrubs reduce the barrier function of the skin and open access of pathogens to the follicles.

It is impossible to deny the presence of a genetic factor, since it is proved that the sensitivity of sebaceous glands to the action of androgens or thickening of the Horny layer of the sebaceous gland duct can be inherited.

The following options exist acne:

  • steroid that occurs when an inadequate hormonal methods;
  • infant acne occur on the face, in the first months of life. Self-limiting, but can be kept for several years;
  • necrotic acne, it is acne itchy scalp;
  • neurotic acne occurs as a result of compression or peeling of acne, remain as a result of erosion (defect of skin) and scars
  • fulminant (fulminant acne) acne, a rare form occurs in boys 13-17 years of age, accompanied by malaise, weakness, fatigue, increased temperture, pain, joints;
  • professional acne, under the influence of oils, tar, lubricants, DDT, herbicides or other chemical means.

Symptoms of acne

When acne on the face, back, chest inflammatory elements are formed, in the form of pustules, nodules (less than 5 mm in diameter) and nodes (more than 5 mm in diameter) and non-inflammatory elements – comedogenic, those “black dots” and white (called Whitehead). Skin appears Shine T-zone (this is the glabella, the transition from the nose to the cheeks, chin). With self-pressure on the eels remain scarring and erosion. Sometimes it may form keloid scars (the scars with increased formation of connective tissue) .

In patients with hyperandrogenism (increased levels of male sex hormones (androgens)) may be observed for signs of virilization (it’s thinning scalp hair, hirsutism (increased body hair)) and precocious puberty.Nodes may become suppurative cysts are called) or hemorrhagic (filled with blood). Very often these symptoms are accompanied by psychological problems, including depression, increased anxiety.

What disease can be mistaken for acne

Despite the fact that to date acne is quite common skin problem, you must know what pathological conditions of the person they should be distinguished. Rosariopatsy rosacea and dermatitis, diseases superficially they are quite similar, both among themselves and with the manifestations of seborrhea.

Rosacea (acne rosacea, rosacea) is a chronic dermatosis of the face, formed on the background of angioneurosis (trigeminal nerve), dysfunctional disorders of the gastrointestinal tract and irritating action on the skin of various environmental factors(such as direct sunlight, wind, rain and snow), as well as when consuming hot foods and alcoholic beverages. Most often, this pathology affects the nose, forehead, cheeks, and chin, where the background of severe redness are observed abundant papules, pustules and spider veins. This problem is most actively affects people after the age of 40. Prolonged existence of the process of developing thickening of subcutaneous tissue and sebaceous glands of the tip and wings of the nose, which is manifested by thickening and by forming the rough surfaces of the nose.

Rosacea-like dermatitis (perioral dermatitis, steroid dermatitis, dermatitis stewardesses) – the problem of the skin of girls and young women, provoked an active irritant effect of cosmetic products and hormonal irrational use of external means for the skin. This issue is a red-pink papules and pustules on a background of reddened skin, grouped around the mouth and eyes.

Diagnosis of acne

For diagnosis enough visual inspection, and for identifying the causes will help the following tests:

  • Analysis of blood on hormones (free testosterone, FSH, LH, estradiol, 5-testosterone (dihydrotestosterone, DHT) and 5-androstendiol). Tests should pass on an empty stomach for women at 5-7 day menstrual cycle, for men it does not matter, preferably before 10 o’clock in the morning;
  • Biochemical analysis of blood (especially liver enzymes), fasting for women ultrasound , also at 5-7 day menstrual cycle (to exclude cystic ovaries);
  • The analysis on a dysbacteriosis of intestines; any changes to the tests – consult a doctor to correct the condition( gynecologist, gynecologist-endocrinologist, therapist, andrologist, gastroenterologist);
  • Clinical analysis of blood (whether there is inflammation. because it will aggravate acne) in the presence of ulcers – analysis of pathogenic flora and sensitivity to antibiotics

Acne Treatment

In severe acne should the isolation and identification of microbial flora by culture content pustules with sensitivity sown flora to antibiotics. You must also determine the level of androgens with subsequent consultation with a gynecologist and endocrinologist. Defined indicators of the General analysis of blood, where the presence of deviations control study carried out every 10 days. Blood monitoring the condition of the liver ( biochemical study: blood cholesterol, total bilirubin and fractions, triglycerides, Alt, AST) are required in the treatment of systemic retinoids, but of this we shall speak below.

Acne TreatmentThe basic approach in the treatment of acne should be directed to the proper and gentle care for problem skin. The use of alcohol-containing and other aggressive agents on the skin can further disrupt skin barrier function and lead to exacerbation of the process. Therefore, a cleansing or washing with gentle detergent can only promote a positive result during the treatment. Perhaps the use of cosmetics following dermatological lines: “Uriage”- “Isaac”, “Bioderm”- “Sebium”, “Aven”- “Cleans”.

In the presence of inflammatory cells on the skin treatment should start with the appointment of the external antibacterial agents: “Zinerita” gel “Dalatsin T” ointment “IMEX”, and various copybook funds manufactured in drugstores prescribed by dermatologists. Often has a good effect, Metrogyl gel, but it has a phototoxic effect, what you need to know and remember.

With remission of acute inflammation in the treatment means are added, influencing the process of keratinization of epidermal cells, thereby reducing the formation of comedones. This property has azelaic acid, as produced by officinal remedies “Skinoren”, and the cream form of this drug has depigmenting properties.

The positive effect provided by the combination of these drugs (antibacterial skinoren and external means) with conducting 15-20 sessions of selective phototherapy, or treatment with a helium-neon laser.

Increasingly, in recent times in the treatment of acne use benzoyl peroxide 2.5% ; 5%; 10%- “Baziron as” having not only an antimicrobial, but also a keratolytic effect, ie promotes softening and rejection of the outer layer of the skin. It must be remembered that it is unacceptable to use basiron during the period of active sun.

Good results Differin 0.1% analogue of vitamin A – a retinoid for topical use, which are anti-inflammatory and comedolytic activity. He also contributes to the stabilization of processes of exclusion of dead cells. The known phototoxic effects of this drug,as well as contraindications for use in pregnant women, and lactating. Located and retin-A similar drugs.

When treating mild forms of acne quite often combinations of these agents. It is possible for a separate external means. Often have a positive effect and folk remedies.
Lotions with infusion of the herb St. John’s wort can help relieve acute inflammation and reduce redness. For this 1-2 tablespoons of herbs for 1 hour, soaked in a Cup of boiling water. Then the infusion is cooled and moistened it in the gauze, folded in 6-8 layers and 15 minutes to cover the most damaged part of the skin. The procedure is repeated within one and a half hours, with a subsequent 3 hour rest. On the skin chest and back you can use 10% tincture of calendula blossoms ordinary 40°alcohol in the form of brushing 2 times a day.

In severe seborrhea and manifestations of moderate severity in addition to external therapy prescribers inside. The broad-spectrum antibiotics are aimed not only against Propionbacterium acnes, and reducing the production of fat. Here the drug of choice are tetracycline (500mg 2 times a day) and doxycycline (100-200 mg daily) used within 2-4 weeks. These drugs are banned for use in the active period of the sun, because they have a phototoxic effect, pregnant, lactating and children under 13 years of age. Despite the fact that Propionbacterium acnes to erythromycin is most often stable, the product can be used in pregnant, lactating and children (500 mg 2 times daily-2 to 4 weeks).

Often shows the assignment of a staphylococcal vaccine.

To reduce the effect of androgens on the sebaceous glands to women and girls are assigned to combined oral contraceptives. Most often used “GES”, “Diane-35” assigned to for a long time, 6 months or more.

Prevention of acneThe most effective is the purpose of systemic retinoids. This so-called “Roaccutane”, which is assigned to the ineffectiveness of the above treatment, with required monthly monitoring of liver function. There is a certain approach to the administration of a daily dose of the drug, we select exclusively individually. Due to the presence of teratogenic and embryotoxic action contraindication is established and planned pregnancy, and lactation. To support the work of the liver, in treatment illustrates the application of hepatoprotectors(Essentiale Forte(2 capsules) or Kars(1 tablet) 3 times daily for 1 month). Can be assigned to prednisolone,alone or in combination with Roaccutane.

For large and deep sites vnutridiskovoe is assigned to corticosteroids every 2-3 weeks. This procedure can cause discoloration and thinning of the skin. Also shown are paraffin and ultraviolet irradiation in erythema doses.
Acne vulgaris (acne) is one of the most common diseases. The main complaint is the appearance of pimples, blackheads, greasy skin.The disease is life threatening, but how much mental suffering brings, especially in young people. Many parents believe that this disease is not necessary to pay attention to, say, a child gets older, the hormones will change and all will pass by itself, Yes, maybe someone will resolve on their own, but this is rare; so it is better to start treatment at an early stage. The disease affects 70 to 80% of the teenage population( of which appears in women at the age of 10-17 years and men aged 14-19 years), and approximately 10-12% of the adult population over 25 years old, and techenie more severe disease. Often the disease is accompanied by psychological problems, including anxiety, depression. Do not withdraw into yourself, and remember, the sooner you start treatment, the better.

Video: Acne Treatment

Prevention of acne

These tips will help You reduce the appearance of acne.

  • Do Not apply on the skin cosmetics containing lanolin and petrolatum, which clog the pores.
  • Do Not use products containing oil.
  • Not to abuse such products as chocolate, soda, nuts, coffee.
  • Select cosmetics for cleansing the skin according to Your skin type. This will help You a beautician.
  • To Begin treatment at an early stage.

Complications of acne

Complications include infection, scarring after resolution of the rash may remain redness or pigmentation, which may persist for several months; often relapses (exacerbations).