How Do I Choose the Best Topical Acne Treatment?

Acne is a chronic inflammatory skin disease of the sebaceous glands of the hair follicle. It occurs mainly in adolescents and has a great psychological and social impact on adolescents. However, it can often be reduced or cured naturally after adolescence. The clinical manifestations are characterized by acne, pimples, pustules, nodules and other polymorphous skin lesions that are common in the face.

Acne and sepsis

Acne, commonly known as acne, is an infectious inflammation of the sebaceous glands of the hair follicles. The sebaceous glands mostly open at the mouth of the hair follicle. Once the mouth of the hair follicle is blocked, the stimulation of excessive fatty acids produced by excessive sebum metabolism and the role of P. acnes in the closed environment will cause an inflammatory reaction in the skin. Light to severe manifestations are whiteheads and blackheads, inflammatory pimples and pustules, cysts and nodules, while red and purulent acne is a bacterial infection.

Can acne squeeze out? More

If improperly squeezed, in addition to damaging the surrounding tissues of acne, causing more inflammation, causing delayed healing, obvious acne marks and other adverse consequences, it may also cause bacteria to spread with the bloodstream, causing more serious life-threatening s consequence.

What is the facial danger triangle? More

The "dangerous triangle area" is an isosceles triangle area with the root of the nose of the human as the apex and the line connecting the two corners as the bottom. There are many blood vessels in this part that can pass directly to the brain. Once the bacteria are infected, the bacteria will flow into the intracranial blood vessels due to the pressure reaction after squeezing, causing sepsis.

Related entries:

Pimples and rosacea

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Basic Information

nickname

acne

English name

acne

Visiting department

dermatology

Multiple groups

teens

Common locations

Facial

Common causes

Related to excessive sebum secretion, blockage of sebaceous glands in hair follicles, endocrine hormones and other factors

Common symptoms

Facial acne, pimples, pustules, nodules and other polymorphous skin lesions

Contagious

no

Causes of acne

The occurrence of acne is mainly related to excessive secretion of sebum, clogging of sebaceous glands in hair follicles, bacterial infection and inflammatory response. After entering puberty, the level of androgen, especially testosterone, in the human body rises rapidly, promoting the development of sebaceous glands and producing a large amount of sebum. At the same time, abnormal keratinization of the sebaceous gland ducts in the hair follicles causes clogging of the ducts, obstruction of sebum excretion, and formation of keratinous plugs, or micro-acne. A variety of microorganisms in the hair follicles, especially Propionibacterium acnes, multiply. The lipase produced by Propionibacterium acnes breaks down sebum to produce free fatty acids, chemoattracts inflammatory cells and mediators, and finally induces and aggravates inflammation.

Clinical manifestations of acne

Skin lesions occur on the face and upper chest and back. Non-inflammatory skin lesions of acne appear as open and closed acne. The typical skin lesion of closed acne (also known as whitehead) is a skin papules of about 1 mm in size, without obvious openings in the hair follicles. Open acne (also known as blackheads) appears as a dome-shaped pimples with significantly dilated hair follicle openings. Further development of acne can develop into various inflammatory skin lesions, manifested as inflammatory pimples, pustules, nodules, and cysts. Inflammatory papules are red, ranging from 1 to 5 mm in diameter; pustules are of the same size, filled with white pus; nodules are larger than 5 mm in diameter, causing induration and pain; cysts are deeper and filled with pus And blood mixture. These lesions can also fuse to form large inflammatory plaques and sinus tracts. After the inflammatory skin lesions have subsided, pigmentation, persistent erythema, pitting or hypertrophic scars often remain. According to the nature and severity of acne skin lesions, acne is divided into 3 degrees and 4 degrees: 1 (mild): acne only; 2 (moderate): in addition to acne, there are some inflammatory pimples; 3 Grade (moderate): In addition to acne, there are more inflammatory pimples or pustules; Grade 4 (severe): In addition to acne, inflammatory pimples and pustules, there are nodules, cysts or scars.

Acne diagnosis

According to the characteristics of adolescents, skin lesions distributed on the face and chest and back, mainly manifested as polymorphous skin lesions such as whiteheads, blackheads, inflammatory pimples, pustules, etc., the clinical diagnosis is easy, and usually no other examination is required. Sometimes it needs to be distinguished from rosacea, facial disseminated miliary lupus, and sebaceous adenoma.

Acne treatment

Daily care

Wash your face with warm water once or twice a day to clean your skin. Avoid squeezing or scratching your skin with your hands. Avoid oils, powder cosmetics and ointments and creams containing glucocorticoids.

2.Common methods of acne treatment

(1) Topical topical retinoids (retinoic acid cream, adapalene gel, tazarotene gel), benzoyl peroxide, antibiotics (clindamycin, erythromycin, chlorine (Mycin, etc.), azelaic acid, sulfur lotion, etc.

(2) Oral antibiotics The first choice is tetracyclines (minocycline, doxycycline, etc.), followed by macrolides (erythromycin). Avoid antibiotics commonly used to treat systemic infections, such as levofloxacin. The course of antibiotics is usually 6 to 12 weeks.

(3) Oral isotretinoin For severe acne, oral isotretinoin is the standard treatment and is currently the most effective method for treating acne. The course of treatment is to achieve the minimum cumulative dose of 60mg / kg.

(4) Anti-androgen treatments such as oral contraceptive compound cycloprogesterone acetate tablets, suitable for women with moderate and severe acne, accompanied by excessive androgen levels (such as hairy, seborrhea, etc.) or polycystic ovary syndrome . Oral contraceptives can also be considered for women with late-onset acne and significantly worsened acne before menstruation.

(5) Oral glucocorticoids are mainly used for fulminant or polymeric acne, following the principle of short-term, low-dose, combined with other methods.

(6) Others For patients who cannot tolerate or are unwilling to receive medication, physical therapy, such as photodynamic therapy (PDT), fruit acid therapy, and laser therapy, can also be considered.

3. Graded treatment of acne

(1) Grade 1 Local treatment is generally used, and topical vitamin A preparations are preferred.

(2) Grade 2 Combine topical retinoids with benzoyl peroxide or antibiotics, and oral antibiotics if necessary.

(3) Grade 3 Combination therapy is often required. Oral antibiotics combined with topical benzoyl peroxide and / or retinoic acid are preferred. Indicated female patients can also consider antiandrogen therapy.

(4) Grade 4 Oral isotretinoin is the most effective treatment and can be used as first-line treatment. For those with more inflammatory pimples and pustules, antibiotics can be used in combination with topical benzoyl peroxide. After the skin lesions are significantly improved, oral isotretinoin is used for sequential treatment.

4. Maintenance treatment for acne

Regardless of the treatment method, maintenance treatment should be continued after the skin lesions have subsided significantly. Topical retinoids are preferred. Maintenance treatment is performed for 6 to 12 months, and benzoyl peroxide can be combined if necessary. ^[1]