Winter vacation fight "acne" strategy - from "acne" to "acne"

Adolescence is a period in life

A unique and wonderful journey

During this period

The body and mind are undergoing rapid changes

Acne may become

Small troubles during this period

Occasionally affects our self-confidence

But don't worry

This is almost every teenager

The "marks of growth" that everyone will experience

This holiday

Dr. Ke will take you to study

How to treat and manage acne

Let skin problems no longer become a stumbling block to self-confidence

What is acne?

Acne, also known as acne, often occurs on the forehead and face, and in some people, the chest and back are affected. Symptoms include acne, inflammatory papules, pustules, and even nodules and cysts. In severe cases, scars are left. Acne is a common skin disease among teenagers, and some people continue to have it into adulthood or even after the age of 40.

(1)

Endocrine factors: androgen and sebaceous glands

Speaking of "acne", it rarely occurs before puberty, and eunuchs do not get it, which shows that androgens play an important role. It is well known that strong oil secretion is prone to acne! Oil is sebum secreted by sebaceous glands. The sebaceous glands open at the top of the hair follicles and finally overflow from the same opening as the pores (picture). Its development and secretion are directly controlled by androgens . After the onset of puberty, androgen secretion increases, sebaceous glands enlarge and secretion increases, and sebum can stimulate the proliferation and hyperkeratosis of the sebaceous gland ducts of the hair follicles, resulting in the reduction of the hair follicle opening, and oil accumulation at the hair follicle opening, thus forming acne.

(2)

Microbes and inflammation

Normal parasites in hair follicles such as Propionibacterium acnes, Malassezia, and Staphylococcus epidermidis can easily proliferate and form bacterial inflammation when oil stagnates. Propionibacterium acnes can also decompose sebum to produce free fatty acids, which stimulate aseptic inflammation in the hair follicles and their surrounding areas, and papules (red pimples) and pustules will follow. In severe cases, nodules, cysts, and even abscesses will occur, and even if the wound heals, scars will be left.

(3)

Other factors

Heredity, immunity, improper use of makeup, dietary stimulation (such as tobacco, alcohol, spicy food, large amounts of dairy products, high sugar, high fat, etc.), certain medications, mental factors, endocrine disorders, etc. are all involved in the onset of acne.

(1)

Daily care and diet

Wash your face with warm water and avoid squeezing pimples; avoid ointment-based cosmetics and excessive makeup; avoid spicy, stimulating, high-sugar and high-fat foods, and eat more fresh fruits and vegetables.

(2)

Commonly used topical medications

① Antibiotics

Topical antibiotics (clindamycin preparations and erythromycin preparations, etc.) can both fight inflammation and reduce the colonization of Propionibacterium acnes.

②Benzoyl peroxide

It can kill acne bacteria, inhibit oil secretion, and dissolve acne.

③ Retinoic acid

Common ones include tretinoin cream, adapalene gel, etc., which can dissolve and discharge acne and inhibit sebum secretion.

④ Azelaic acid

Inhibit acne bacteria and relieve acne.

The above drugs need to be screened according to the skin lesions, skin characteristics, and drug side effects, and used under the guidance of a professional dermatologist.

(3)

Oral medication

① Antibiotics

Tetracyclines can reduce the concentration of free fatty acids, inhibit acne bacteria, and suppress inflammation. Clindamycin can be used for patients with severe inflammation or resistance to tetracycline, but gastrointestinal side effects should be noted.

②Isotretinoin

It can significantly reduce sebum secretion and acne formation, inhibit Propionibacterium acnes and fight inflammation. It is a standard method for treating moderate to severe acne. The course of treatment is 4-6 months or even longer. During treatment, strict contraception is required, and blood, liver and kidney function should be checked regularly, and attention should be paid to moisturizing and sun protection.

③ Hormones

Treatments include anti-androgen drugs such as spironolactone and female hormonal drugs such as birth control pills, which can suppress sebum production.

④Corticosteroids

It is used for short-term use in patients with obvious inflammation who are not responding to antibiotics.

(4)

Other treatments

① Red and blue light therapy

Antibacterial, anti-inflammatory, inhibiting sebaceous gland proliferation, secretion and abnormal keratinization. Red light can also induce the production of new collagen and promote the repair and improvement of scars.

②Chemical peel (acid peel)

It can remove the aged cuticle, correct abnormal hair keratinization, accelerate pigment shedding, promote metabolism and brighten skin tone.

③ Photodynamic therapy

For cases that are not suitable for antibiotic treatment , photodynamic therapy is undoubtedly an excellent choice. It can inhibit the growth and secretion of sebaceous glands, inhibit the differentiation and proliferation of acne bacteria and keratinocytes, etc. It can be used as a first-line treatment for moderate to severe or severe acne cases that are ineffective or uncontrollable with traditional treatments.

④Intense pulsed light

Pulsed light has the activity of killing acne bacteria, improving red marks and pigmentation after acne, brightening skin tone, shrinking pores and many other functions.

⑤Treatment of post-acne scars

Post-acne scars are the most difficult sequelae of moderate to severe acne. Once formed, they are difficult to recover on their own, and the effect of skin care products is extremely limited. Scar removal methods include ablative laser/ablative fractional laser, non-ablative fractional laser, gold microneedle, subcutaneous separation, trephine excision/trephine transplantation, dermabrasion, etc. The choice of which method should be based on different acne scar types, different skin types, and different skin sensitivities.

Although acne is annoying

But it won’t be with us forever

With the continuous advancement of medicine

Effectively control or even cure acne

It has become possible

May everyone

Young people fighting against acne

You can regain your confidence soon

Show your most natural and beautiful self

Author: Du Jianqun, chief physician of the Department of Cosmetic Dermatology, the Eighth Affiliated Hospital of Guangzhou Medical University

Reviewer: Lu Sihan, Chief Physician of the Department of Cosmetic Dermatology, the Eighth Affiliated Hospital of Guangzhou Medical University

Correspondent: Liu Qisha, Deputy Director of the Party Office of the Eighth Municipal Hospital Affiliated to Guangzhou Medical University