Acne is an inflammatory skin condition characterized by skin outbreaks around hair follicles. It is a common disease that mainly affects adolescents, but can also affect adults, especially those between 20 and 30 years of age. In these people acne may appear as different types of acne such as comedones (blackheads), papules (red, hard bumps), pustules (pus grains) and more rarely cysts and abscesses. The lesions are located on the face and less often in the back, chest, shoulders and neck. Acne requires treatment and there is no need to wait to for nature to resolve the problem as it is very difficult to predict how long it will take to disappear completely. The treatment can prevent the development of scars or marks, thus improving the complexion of the skin and physical appearance.
Acne is due to a series of hormonal changes that occur during adolescence. During puberty, sebaceous glands (located deep in the skin) produce an oily material called sebum caused by testosterone (male hormone). Sebum comes to the surface through small tubes (ducts) and their opening is a pore.
Obstruction of the sebaceous ducts cause it to retain sebum, forming pimples, which can be:
- White or closed
- Black or open (blackheads)
The black colour is due to the action of air on retained sebum in the pores. Sometimes an excess of retained sebum in the ducts and the duct walls swell and burst, dispensing the sebum into the skin, resulting in the formation of red, hard pimples, (internal) or abscesses. Along with this, the sebum is retained in an ideal breeding ground for skin bacteria, causing more irradiation and inflammation.
Other causes of acne, especially in adults are:
- Polycystic ovary syndrome
- Cushing´s syndrome
- The use of anabolic steroids
- Keratinization disorders
- Using medication containing halogens, lithium, barbiturates or androgens.
Seasons: Improvement in summer and worse in spring and fall.
Menstruation: In almost all women acne outbreaks occur with the period.
Menopause: the hormonal changes of menopause can lead to a type of menopausal acne.
Nerves: stress, exams, lack of sleep, etc. Aggravate acne.
Constipation: aggravates acne or makes it more rebellious to treatment. To avoid this:
- Food should be adequate and varied, based mostly on vegetables and legumes (beets, spinach, cabbage, cauliflower, carrots, tomatoes, lettuce, endive, artichokes, lentils, beans, peas, etc.).
- Restrict the intake of certain foods such as meat, white bread, flour and chocolate.
- Drink large amounts of fluids (1-2 liters of water a day), especially in the morning after waking up (water or orange juice).
- Avoid or reduce the consumption of red wine.
- Avoid sedentary lifestyle, try to exercise (walk or go to the gym before meals).
- Maintain the habit of taking stools at the same time, especially after breakfast.
Diet: Certain foods aggravate acne. The most notable are: chocolate, nuts and derivatives, milk, cheese, yogurt and other dairy products, foods made with a lot of oil or butter, pizza, beer, alcohol, coffee, tea, spices, too much iodized salt, pork, seafood (shrimp, oysters), citrus, and especially food that has been fried with butter or fat.
Fresh vegetables, fruits, juices and bread help improve acne.
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- Wash your skin daily to control the excess oil and bacteria that aggravate acne prone skin.
- Facial cleansing.
- Wash your hair frequently and comb it backwards to keep it away from the face. Oilier the hair should be washed more frequently. If you have dandruff you should use an antidandruff shampoo at least 3 times a week, and inform your dermatologist.
- Men with acne in the beard area should try electric and non-electric razors to see which irritates their skin less. Shaving should be gentile as to not cut into pimples, and the blade should be as sharp as possible.
- Do not apply pressure, scratch or rub lesions, because this can increase the damage to the skin.
- Watch diet.
- Avoid using greasy creams.
- Exfoliate once a week to stimulate cell renewal, unclog pores, and remove dead cells and withheld sebum. This produces a smooth skin without blemishes.
There are different options for the treatment of acne:
- Prevent the formation of new lesions and heal old ones.
- Topical medicines that dry grease and promote the shedding of skin:
- Glycolic, Salicylic, Azelaic and mandelic acids
- Benzoyl peroxide sulphur
- Oral contraceptives
- Topical antibiotics: clindamycin, erythromycin.
- Oral antibiotics: doxycycline, minocycline, limecycline.
- Derivatives of vitamin A (tretinoin, retinol)
Acne improves with sun exposure, therefore it is also recommended clinical treatment with UV lamps. Patients are advised to receive treatment 2-3 times a week. The treatment can be administered in conjunction with lasers in cases of a great deal of inflammation to prevent scarring.
Some patients with acne have unsightly scars (pits and red spots), particularly on the face and back. The scars can be improved by a chemical peel performed by qualified personnel.
The peeling is made by applying a lotion with concentrated fruit acids (glycolic, lactic, citric or salicylic) to the face with gauze to stimulate the natural repair mechanisms of the skin. Doing this will give smooth skin, and stimulate collagen synthesis to fill wrinkles and scars. The peelings also help to eliminate pimples and blackheads. The procedure involves applying fruit acid to the face every 1-2 weeks up to 6-8 times. Subsequently, a maintenance treatment should be applied every 2-3 months. There are other treatments for scars such as lasers and capacitive currents (INDIBA) which are completely painless and with no side effects. In these cases, the patient must go to the clinic 2 times a week, for a minimum of 2 months. There is also a procedure called laser – carbon laser abrasion, which is now the most recommended for acne.
- Wash your face 2 times daily with a suitable soap. After apply the indicated products.
- Avoid certain foods: chocolate or cocoa derivatives, nuts (sunflower seeds, almonds, etc.), Seafood, strong cheeses (Roquefort, Camembert, etc.).
- Avoid the contact of hair and facial skin (bangs, long hair, etc.).
- Avoid using cosmetics until the acne has improved. It is recommended that you use oil-free makeup.
- Avoid greasy sunscreens. Use formulas with alcohol content, as to not block pores.
- Regularly wash your hair 3 times a week.
- Avoid frequently supporting your head with your hands (passive study, etc.).
- Avoid conflicting emotional situations such as stress, nervousness and tiredness.
- Avoid skin exposure to greasy or oily environments (kitchens, etc.).
- Change pillowcases often.
- Develop the habit of caring for the skin, as beauty accentuates your image.