Acne: Causes and Treatment
- Causes of Acne
- How is acne manifested?
- Classification and characteristics of acne
- Diagnosis and treatment of acne
- Prevention of Acne
- Possible complications
Acne is one of the forms of acne. It is characterized by the manifestation of an open or closed form of comedones, chronic inflammatory processes on the skin, the result of which is the formation of lenticular or miliary papules, purulent pustules or inflammatory nodular formations.
Acne is a common disease. The peak of the development of the disease occurs in pubertal age, manifested earlier in girls as a result of hyperstimulation secretion of glands of external secretion with the formation of seborrhea and microcosmodes. Further development of the process leads to the formation of an open and closed type of comedones.
The prevalence of the disease among the male and female population is approximately equal. But, in men, the disease is more often lasting and more severe. By the age of 20, the development of spontaneous regression of the disease can be noted, turning into a chronic, recurrent process with changes on the skin - rash, pigment spots, keloid scars.
Causes of Acne
The basis of genesis of acne are:
- Pathology of the holocrin glands;
- Skin diseases associated with hyperkeratosis of the follicles;
- Skin diseases of inflammatory genesis;
- Multiple microbial colonization on the skin.
Pathologies that change the condition of the skin, caused by functional disorders in the holocrine glands and changing the cellular composition of the lipid secret, are a favorable background for the development of acne.
The provoking factor of the disease development is:
- Pathological increase in androgens, associated with genetic genesis.
- The effect of testosterone derivatives on the cellular secretion, leading to hypersecretion and the formation of hyperkeratosis.
- Stimulation of the growth of microorganisms as a result of increased lipid secretion.
- Changing the hormonal background.
- Admission of hormonal drugs.
- Changes in the hormonal background in different periods (the period of birth, puberty, the period of breastfeeding).
- Inflammatory diseases of the reproductive system.
- Termination of the use or replacement of contraceptive drugs.
- Androblastomas and adrenal tumors of androgen secretion genesis.
- Polycystic ovary .
- Skin irritation due to the action of soap, scrub, pilling procedures, which reduce the protective skin barrier.
- Injuries and stress.
From the level of sensitivity of sebaceous cells to the action of sex hormones, it depends on which part of the skin there is a process of lesions of acne-rich sebaceous ducts or lesion of a separate area of the skin.
How is acne manifested?
In different patients, the combination of etiological factors is of an individual nature. The clinic of the disease and the reaction to the medical process each person manifests itself in different ways. Hypertrophy and hyperactivity of the sebaceous ducts leads to hyperproduction of fatty lipids, causing:
- Bonding with excess lipid fats, dead flakes of the upper stratum corneum of the epidermis. This makes it difficult to remove them from the skin in time, causing a buildup of fat, microbes and dirt in the mouth of the hair follicle. Forms a crust of dark color, clogging the duct - the formation of an open form of comedones. With a liquid consistency of fat, the expansion of the ducts is insignificant, and comedones are small in size. A thick consistency is the cause of the appearance of large comedones. With the narrowed saline duct, the accumulation of lipids and horny flakes causes the ducts to expand with the formation of prosidic nodules - closed comedones.
- In the channels closed by the greasy congestion, all conditions are created for the favorable development of various kinds of microorganisms. The products of the microbial flora's activity cause disturbances in the acid-base balance, which leads to a decrease in protective functions and increased multiplication of microorganisms in fat deposits. Changes in the composition of free and bound fatty acids in sebum cause severe irritation and provoke the symptoms of seborrheic dermatitis.
- Disturbance of fatty outflow causes accumulation of fat. The plug closes the exit of the sala outside. The inner walls of the ducts are stretched, and microscopic cysts are formed. Under the action of multiple causes - as a result of independent removal of formations, using mechanical or hardware cleaning of the face - a rupture of the cysts occurs with the release of the sebaceous secretion into the surrounding tissues. As a result - inflammatory reactions with the formation of papules (nodules). Attachment of infection provokes manifestation of pustules (ulcers).
- Prolonged inflammatory process, for years, the existing acne disease leads to a disruption in the nutrition of tissues, promotes sclerotic skin changes, reduced tone and its reserve capabilities. On the skin, this is reflected by small atrophic scars, uneven pigmentation and deterioration of the texture.
Classification and characteristics of acne
A single classification of acne does not exist. The clinical classification is due to long-term studies of etiological features, the mechanism of development and individual features of the skin. By combining all these factors, a proper diagnosis is made and an adequate treatment program is drawn up.
Characterized by a rash:
- Papulopustular acne;
- Nodular-cystic acne;
- Lightning-fast acne eruptions, characterized by a severe form of flow. It occurs in boys puberty. Characterized by acute onset, rapid spread to the face and trunk of inflammatory foci and ulceration followed by coarse scarring. Symptomatic manifestations of worsening of the general condition, fever, anemia.
Acne in adults
- Acne disease, not stopped in the pubertal period, manifests late acne eruptions . Characterized by the manifestation of the weaker sex in the luteal phase of the menstrual cycle. Symptomatic manifestations of papules and the formation of deep cystic cavities on the chin.
- Inverse form of acne is a kind of chronic pyoderma. Symptomatology is caused by the appearance of painful nodular formations in the form of an abscess in the axillary basins and folds of the urogenital triangle. When they mature, they release pus and blood-purulent substrate. When healing, scars form in retracted form and fistula.
- Steroid acne . The manifestation is due to the intake of a different type of steroid-type hormones. It is characterized by the monomorphism of the rashes and the absence of comedones. The formation of nodular-cystic eruptions is noted on the chest, sometimes on the face. After hormone withdrawal there is a rapid deterioration.
- Acne globose or heaped up is a consequence of chromosomal abnormality in the male and Stein-Leventhal syndrome in women. It is caused by the fusion of nodular and cystic formations into characteristic seals with fistulous courses. This form of the disease affects the trunk and without the appropriate drug intervention last for years.
- Pink acne is characteristic of the female sex of all ages. In acute form manifests itself during pregnancy and in the postpartum period. There are large papules, nodular and cystic eruptions on brightly hyperemic skin.
Acne exogenous disease
The provoking factor of the appearance of acne is comedogenic substances that contribute to the blockage of sebaceous ducts. They can be contained in medical preparations, aerosols or cosmetics for skin care.
Acne as a consequence of mechanical stress
This form of acne is a response to a prolonged mechanical effect on the skin caused by pressure or friction. A similar form is the excoriated acne, when attempts are made to remove the small size of the rashes, or nonexistent (under the influence of neurosis).
This form of the disease is characterized by chronic inflammation of the skin, with the formation of acne eruptions, but there is no formation of comedones. To this disease is the manifestation of rosacea and perioral dermatitis.
Classification of the disease according to severity of clinical course
- The first degree of severity is acne vulgaris, affecting the face partially or completely. It is manifested by papular pustules and comedones, with the predominance of open forms of comedones. Perhaps a single manifestation of papulapustules.
- The second degree is characterized by a partial lesion of the skin on the face and body. It is manifested by single eruptions of papularpustules and comedones of both forms.
- In the third stage of the disease there is a strong inflammatory lesion of the skin with a large number of closed and open forms of comedones and deep seated papules and pustules. Characterized by cicatricial formation with stagnant spots on the skin.
- The fourth stage is caused by the formation of large blue-purple nodular-cystic conglobata acne with fistulous courses. At the resolution of education, gross atrophic nodes remain. Diagnosis is determined by the severity of the rashes, and not by their prevalence.
Diagnosis and treatment of acne
Diagnosis of acne in its various manifestations is based on the clinical course of the disease. Special difficulties do not cause. To confirm the diagnosis, indications of pathohistological examination and differential diagnosis are used, excluding:
- Pustular stage of rosacea;
- Oily seborrhea;
- Pustular stage of pustular syphilis;
- Demodecosis and folliculitis;
- Tuberous sclerosis and sarcoidosis.
The complex approach is applied in treatment:
- Antibacterial medication.
- Means that contribute to the regulation of the sebaceous secret are retinoid and antiandrogenic medications.
- Immunocorrective and antimicrobial agents.
- Wiping with solutions that have a disinfectant and degreasing action, which includes antibiotics.
- In an individual order, a selected vitamin complex.
- UV irradiation.
- Electrocoagulation of pustular eruptions.
Prevention of Acne
- Extensive suppuration;
- Keloid scars on the skin;
- Not passing redness and skin pigmentation;
- Exacerbation of the disease.
It should be noted that medication, preparations for internal use and drugs of external action should be selected individually only by a dermatologist.