As the saying goes, "one white covers three uglies", it can be seen that good skin can help create a better external image and make people more confident. However, modern people suffer more skin problems due to diet and living habits, such as acne, blackheads, acne, etc., and acne itself and improper treatment may also lead to pigmentation, acne pits and acne scars and other skin problems that are more difficult to remove.
Acne, blackheads, acne and pimples are actually the same type of skin problems, the official clinical name is acne, which is a chronic inflammatory manifestation that occurs on the sebaceous glands of hair follicles and belongs to common skin diseases. However, many people do not know enough about acne, thinking that acne is just a skin problem and do not receive formal treatment in time, resulting in repeated acne.
Understand the factors that cause acne
The pathogenesis of acne is not fully understood, but it is generally thought to be related to excessive secretion of sebum by the sebaceous glands, abnormal keratinization of hair follicle duct epithelial cells, microbial hyperplasia and inflammation. There are many factors related to the onset of acne in life, such as cream, fried foods, sweets, spicy heavy mouth, and alcohol and other diets can stimulate the sebaceous glands, resulting in abnormal secretion of sebum. Excessive secretion of sebum by the sebaceous glands is considered a prerequisite for acne. Excessive sebum will not only accumulate at the mouth of the hair follicle, but also stimulate abnormal keratinization of the hair follicle epithelial cells, shrinking the mouth of the hair follicle, and the fallen keratinocytes are mixed with oil, eventually causing the mouth of the hair follicle to be completely blocked. When the mouth of the hair follicle is completely blocked, an oxygen-free and fatty environment is formed in the hair follicle, in which common microorganisms on the skin, such as Propionibacterium acnes and mites, can multiply in the hair follicle, stimulating and causing inflammation of the hair follicle.
In addition to diet, high work pressure, frequent constipation, lack of attention to hair and collar hygiene, habitual cheek buttoning, incomplete makeup removal or excessive cleaning, as well as genetics, excessive sun exposure, environmental pollution, etc. may induce acne.
Recognize acne grading
According to the manifestations of acne, it is clinically divided into 3 degrees and 4 grades.
Mild grade 1: with acne as the predominant lesion, individual papules and pustules are allowed.
Moderate grade 2: coexisting acne and moderate number of papules and pustules;
Moderate grade 3: skin lesions are mainly papules and pustules, occasionally relatively large inflammatory skin lesions, and acne can occur in sebaceous areas such as the chest and back, not limited to the face.
Severe grade 4: skin lesions often present as nodules, cystic acne, or polymeric acne, may be painful, and the number of nodules or cystic acne is more than 3.
Generally speaking, mild grade 1 and moderate grade 2 acne have less inflammatory reactions, and often do not cause pigmentation after acne subsides; Moderate grade 3 and moderate grade 4 acne can have different degrees of inflammatory response, and the inflammatory response can lead to the destruction of hair follicle structure, sebum and bacteria entering the dermal tissue, inducing local immune damage and fibrosis, and eventually leading to pigmentation and acne scarring. Therefore, acne should be treated in time, especially moderate to severe acne that may cause appearance damage, and should be actively treated properly.
Whether to use topical or oral medication first depends on the grade of acne
Whether acne treatment is treated first with topical or oral medication is mainly determined by the grade of acne. Clinically, mild to moderate acne is mainly treated with external drugs, while moderate and severe acne is mostly treated with oral drugs combined with external drugs.
Topical drugs for acne mainly include external isotretinoin such as adapalene and isotretinoin, benzoyl peroxide and topical antibiotics. Topical isovitamin A has the effect of inhibiting the secretion of sebaceous glands, and can be used as a single first-line treatment for mild acne; It also increases skin permeability and therefore efficacy when combined with topical antibiotics. Benzoyl peroxide indirectly inhibits Propionibacterium acnes by releasing reactive oxygen species to improve the anaerobic environment of the skin, while benzoic acid can directly kill Propionibacterium acnes and play an antibacterial and anti-inflammatory role. Topical antibiotics commonly use erythromycin, lincomycin, etc., usually used for the treatment of superficial inflammatory acne such as papules and pustules, but because antibiotics are easy to cause drug resistance, isotretinoin drugs are often used sequentially to maintain treatment after inflammation is controlled.
Isotretinoin softgels and oral antibiotics are the main oral drugs for acne treatment. Oral antibiotics are mainly tetracyclines, such as doxycycline, minocycline, etc., mainly used in moderate to severe acne, severe acne with severe inflammatory reaction, explosive acne and early polymeric acne, and then sequentially use isotretinoin softgels after inflammation is controlled. Isotretinoin softgels are currently drugs that can act on the four links of acne occurrence and development, and have the effects of inhibiting sebum secretion by sebaceous gland tissue, improving keratinization abnormalities of hair follicle epithelial cells, reducing the anaerobic environment in hair follicles, indirectly inhibiting the reproduction of Propionibacterium acnes, anti-inflammatory and preventing the formation of acne scars.
Isotretinoin softgels are not only a first-line treatment for nodular cystic acne, but can also be used for a variety of acne types:
Other moderate, moderate, to severe acne that does not respond well
Acne that recurs and other methods do not work well
Acne with severe seborrhea
Explosive and polymeric acne
Acne with a tendency to scarring
There is a need for rapid treatment for mild to moderate acne
The treatment of acne should choose the right plan, not simply treat acne as an ordinary skin problem, and try to improve it through acne functional skin care products. There are many causes of acne, and not only can not be eliminated by relying on skin care products alone, but may even aggravate acne due to the quality of skin care products.
In the selection of topical drugs and oral drugs, doctors often need to make appropriate treatment plans according to the comprehensive assessment of acne severity, the patient's treatment needs, etc., such as mild acne selection of topical drugs, moderate and severe acne need oral drugs combined with external drugs, but if it is occupational factors that need to quickly resolve acne, then you can also choose oral drugs such as isotretinoin soft capsules under the guidance of doctors. Once the treatment plan is formulated, it is necessary to be patient and adhere to the treatment, and the treatment course can be fully treated to reduce acne recurrence.
Resources:
1, Guidelines for the Treatment of Acne in China (2019 Revised Edition)
2,Continue Fengfeng, Lang Xiaoqing, Guo Shuping. Advances in the treatment of acne[J]. Chinese Journal of Clinical Research, 2020, 33(5):3.