【Health Lecture】Fighting Acne to the End

Acne, the name sounds like a prank, always reminds people of the photo of a face full of red spots. But acne is not fun. It is a common skin problem that turns your face into a battlefield, where you fight a ruthless battle every day. Acne, commonly known as "acne", is a chronic inflammatory skin disease of the pilosebaceous gland unit. It mainly occurs in adolescents and has a great impact on their psychology and social life, but it often alleviates or heals naturally after puberty. If it is not handled properly, or if it is not actively prevented and treated, it is easy to leave pigmentation, scars and other damages, leaving lifelong regrets. If it can be scientifically and reasonably prevented and treated early, disfiguring scars and other damages can be completely avoided, or the harm can be reduced to the minimum. So, how to correctly prevent and treat acne? Let's briefly introduce it below, hoping to help you avoid detours and doubts on the road to fighting acne, and give you more caring guidance.

1. First of all, we should learn to recognize this enemy---acne. However, in clinical work, it is often found that patients only regard some red pimples or pus heads as acne, and think that blackheads, whiteheads, cysts, etc. are not acne. In fact, the clinical manifestations of acne are characterized by polymorphic skin lesions such as acne, papules, pustules, nodules, etc. that are prone to occur on the face. Its main feature is the appearance of red, swollen papules on the skin, usually accompanied by pain and itching. There may be pus in these papules. In clinical practice, patients often ask, "Doctor, is my condition serious?" Let's solve these doubts below. Knowing yourself and the enemy, you will never be defeated in a hundred battles. The grading of acne helps doctors formulate appropriate treatment plans. It is also an important basis for acne treatment and efficacy evaluation.

Acne can be divided into three degrees and four levels according to the nature and severity of acne lesions: Level 1 (mild): only comedones; Level 2 (moderate): in addition to comedones, there are also inflammatory papules; Level 3 (moderate): in addition to comedones and inflammatory papules, there are also pustules; Level 4 (severe): in addition to comedones, inflammatory papules and pustules, there are also nodules, cysts or scars.

2. Let's learn about the causes of acne. Patient's question: Doctor, what causes my acne? The occurrence of acne is closely related to factors such as excessive sebum secretion, blockage of the sebaceous gland ducts, bacterial infection and inflammatory response. After entering puberty, the level of androgens in the human body, especially testosterone, rises rapidly, which promotes the development of sebaceous glands and produces a large amount of sebum. At the same time, abnormal keratinization of the sebaceous gland ducts of the hair follicles causes blockage of the ducts, obstruction of sebum excretion, and formation of keratin plugs, i.e. micro-acnes. Various microorganisms, especially Propionibacterium acnes, multiply in the hair follicles. The lipase produced by Propionibacterium acnes decomposes sebum to produce free fatty acids, while chemotacticizing inflammatory cells and mediators, ultimately inducing and aggravating the inflammatory response. Generally speaking, it is believed that the onset of acne is mainly related to the following factors: 1. Excessive secretion of lipids by sebaceous glands induced by hormones; 2. Excessive keratinization of the sebaceous gland ducts of the hair follicles; 3. Proliferation of hair follicle microorganisms such as Propionibacterium acnes; 4. Inflammation and immune response; 5. Neuroendocrine regulation mechanism; 6. Bad eating habits (often staying up late, excessive stress, eating spicy, greasy and other foods) and genetic factors; 7. Drug factors, such as glucocorticoids, anti-tuberculosis drugs, anti-epileptic drugs, halogen compounds, etc. 3. How to treat acne 1. Daily care Maintain good living and eating habits and be in a good mood. Wash your face with warm water once or twice a day, or use some oil-removing and acne-removing facial cleansers to clean your skin. Avoid squeezing or scratching skin lesions with your hands. Avoid using oily and powdery cosmetics and ointments and creams containing glucocorticoids.

2. Topical drugs for acne: 1) Whiteheads and blackheads: topical retinoic acid drugs, such as retinoic acid, retinoic acid, adapalene, etc. 2) Inflammatory skin lesions (red papules, pustules): benzoyl peroxide, antibiotics

3) Severe skin lesions (cysts, nodules): retinoic acid, benzoyl peroxide, antibiotics, etc.

4) Other drugs: topical salicylic acid, azelaic acid, etc.

5) Acne marks and scars: Centella asiatica ointment, silicone gel, Hi-Liaoto ointment, etc.

There are many other ways to treat acne, such as:

1) Chinese medicine cold spray, Chinese medicine wet compress, Chinese medicine inverted film

2) Fire needle therapy, bloodletting therapy, acupuncture therapy...

3) Red and blue light irradiation

4) Fruit acid treatment

5) Photon therapy

6) Photodynamic therapy

7) Fractional laser...

With so many drug names and treatment methods, I guess you may be overwhelmed. I would like to remind you that whether it is oral or topical, it is recommended that you go to the dermatology department of a hospital for a consultation, and the doctor will determine whether it is suitable for you based on your specific condition.

3. Maintenance treatment of acne

In fact, no matter what treatment method is used, maintenance treatment should be continued after the skin lesions have obviously subsided. Topical retinoic acid drugs (similar to Differin, etc.) are the first choice, and maintenance treatment should be continued for 6 to 12 months. If necessary, benzoyl peroxide (Bansert) can be used in combination.

4. Self-management for people prone to acne

The prevention and treatment of acne actually requires more education for high-risk groups and patients. Because the increase in the incidence of acne is closely related to the current bad living habits of the public. It is recommended that patients and high-risk groups do the following:

1) Stay up less late, have a regular work and rest schedule, and relax appropriately;

2) Pay attention to diet conditioning, eat light food, reduce spicy and irritating food, and reduce fat and sugar intake. Based on a variety of plant foods, choose local, seasonal fresh fruits and vegetables as ingredients. When cooking, use vegetable oil (containing unsaturated fatty acids) instead of animal oil (containing saturated fatty acids) and various margarines. Olive oil and linseed oil are recommended. Dairy products should be consumed in moderation. When acne is severe, it is recommended to stop eating dairy products and replace desserts and milk tea with fresh fruits;

3) Pay attention to cleanliness and hygiene, and clean and moisturize the skin properly and appropriately.

4) Proper sun protection and moderate exercise.

After understanding the above basic knowledge about acne, everyone's equipment on the road to fighting acne will definitely be upgraded. Maintain a good attitude at ordinary times, respond to the call "young people should not sleep too late", control their mouths that love snacks and spicy foods, use medicines scientifically and rationally, and I believe that annoying acne will stay away from us.

About the Author

Wang Congcong, attending physician, master's degree student, Department of Dermatology and Venereology, Zibo Central Hospital, graduated from Tianjin Medical University in 2015, majoring in dermatology and venereology. He is mainly good at the diagnosis and treatment of common diseases in skin diseases and venereal diseases. He published two papers in core journals in 2017 and 2021, and one SCI paper in 2023. He won the second prize of Science and Technology Progress in Zibo City. In September 2020, he went to the Department of Dermatology and Venereology, Peking University First Hospital for half a year of advanced study in dermatology surgery, followed Professor Li Hang to learn mosh surgery and conventional surgical operations, and then studied in dermatology for half a year. He is proficient in the diagnosis and treatment of common dermatological diseases and has a certain understanding of rare diseases. He is currently a member of the Science Popularization Committee of the Chinese Medical Education Association, a member of the Dermatology and Venereology Branch of the Shandong Research Hospital Association, a member of the Hemangioma and Vascular Malformation Branch of the Shandong Health Management Association, and a member of the Skin Tumor and Skin Surgery Professional Committee of the Shandong Geriatrics Society. Main research directions: skin diseases and venereal diseases.