Extended Reading: Acne Treatment and Side Effects

Ance is the most common skin problem between 15-25 years old, but in fact it is also very common in adults. Even if you haven't suffered from acne in your adolescence, you still have this problem in your 30s, 40s, and 50s. To make matters worse, due to pregnancy, menopause and hormonal imbalances, women are more susceptible to acne than men.

The severity of skin lesions determines the severity of acne, which can be divided into three degrees of grade IV acne:

Whitehead acne: The mouth of the hair follicle is accumulated and blocked by keratinocytes and filled with sebum to form white keratotic papules, covered with epidermis on the surface, which is not connected to the outside world. This is mild acne, that is, grade I acne.

Blackheads: The sebum that clogs the pores is directly oxidized when exposed to the air, forming blackheads. This is mild acne, grade I acne.

Papules: small, red bumps, this is moderate acne, that is, grade II acne.

Pustules: Pustules appear on the top of the papules. This is moderate acne, that is, grade III acne.

Nodules: Hard, painful lumps on the skin surface. This is severe acne, or grade IV acne.

Cyst: Pain under the surface of the skin and a lump with pus to the touch. This is severe acne, that is, grade IV acne.

Common acne treatments

Over-the-counter medication

Soap. Using soap can help remove bacteria and help treat Ance, but it does not remove acne. No more than twice a day. Excessive use can harm the skin or cause other skin problems.

sulfur. Sulfur is one of many over-the-counter acne treatments, but it smells bad and temporarily discolors the skin. And the benefits are minimal.

Detergent. Cleansers that contain glycolic acid, benzoyl peroxide, sulfur orsalicylic acid.

Benzoyl peroxide. Peroxide can slowly release new ecological oxygen and benzoic acid after topical application. It has the effects of killing Propionibacterium acnes, dissolving acne and astringent. This is why it has become one of the topical antibacterial drugs of choice for inflammatory acne. Continuous use will prevent acne from appearing, and will not affect the production of sebum or the shedding of skin hair follicle cells. Can not stop using. Face creams, lotions, cleansing pads, and gels all contain this. But benzoyl peroxide can bleach fabrics and cause dry skin.

Salicylic acid. Helps improve abnormal cell shedding.

Retinol gel or cream. It has a therapeutic effect on acne that begins to form under the skin, and the effect can be seen in 8-12 weeks. But it will lead to an increase in renewal cells, which will get worse before it gets better.

LED blue light treatment. Skin cells can absorb more light energy in a shorter time, thereby speeding up the elimination of acne and the skin healing process. The blue wavelength kills the bacteria that cause acne, while reducing inflammation, acne and redness associated with acne. The reduction of lesions and the overall improvement of skin appearance can usually be seen within only a few weeks. By eradicating bacteria under the skin, blue light therapy can also prevent future outbreaks. Generally speaking, LED light therapy is quite safe and does not cause burning or pain to the skin. LED therapy should not be used for individuals who have taken certain medications(such as Accutane), or who are allergic to sunlight. Patients with skin diseases should consult a dermatologist before using LED light therapy.

Commonly used topical medications

Tretinoin, topical tretinoin is the first choice for external use of mild to moderate acne. These drugs mainly regulate the differentiation of epidermal keratinocytes, improve hair follicle sebaceous duct keratinization, dissolve micro-acne and acne, and anti-inflammatory. They also have the effects of controlling post-inflammatory pigmentation of acne and improving acne scars. The combined use of tretinoin drugs and anti-inflammatory and antibacterial drugs can increase the skin permeability of related drugs. Topical retinoids often cause mild skin irritation such as flaking, tightness, burning and local erythema, but it fades with time of use.

Antibiotics, including erythromycin, clindamycin, fusidic acid cream, etc. Since topical antibiotics are likely to induce resistance to Propionibacterium acnes, it is not recommended for use alone. Recommended for use with benzoyl peroxide or topical retinoids

Azelaic acid can reduce the flora of the skin surface, hair follicles and sebaceous glands, and in particular has an inhibitory effect on Propionibacterium acnes and a pimple-dissolving effect.It is effective for all kinds of acne.Can be formulated as 15%-20% cream for external use. The adverse reactions are local mild erythema and tingling.

Commonly prescribed medications

Systemic treatment is generally used for patients with moderate to severe acne or ineffective external medications. Some systemic drugs can cause fetal malformations. Therefore, women during pregnancy should avoid systemic treatments. All systemic treatments require medication under the guidance of a doctor.

Antibiotics, the preferred systemic treatment for patients with moderate to severe acne. But antibiotics can easily cause resistance to P. acnes and non-P. acnes. Therefore, standardizing the selection and course of antimicrobial drugs, or combining with other therapies, is very important to improve the efficacy and prevent drug resistance.

Isotretinoin A, the most effective anti-acne drug at present, can be taken as soon as possible for acne patients without contraindications. It can reduce oil secretion, inhibit the formation of abnormal keratinization and blackheads, and inhibit Propionibacterium acnes. It has a good effect on nodular, cystic, and convergent acne. The side effects should be paid attention to when medication, including dry lips, desquamation, and elevated blood lipids. Such drugs also have a clear teratogenic effect. Female patients should be strictly contraceptive during the first month, during the treatment, and within 3 months after the treatment.

Oral contraceptives: Contraceptives are generally composed of estrogen and progesterone. Estrogen and progesterone can fight against androgens, and can also directly act on the sebaceous glands to reduce sebum secretion. Such drugs are only used for women with acne.

Spironolactone: It has a mild antiandrogenic effect and is not suitable for long-term use by male acne patients.

Glucocorticoids: suitable for severe nodular acne, acne conglobata, cystic acne inflammation and fulminant acne. For severe nodular or cystic acne, intralesional injection of glucocorticoids can be used. At the same time, it should be noted that long-term high-dose glucocorticoids should be avoided to avoid adverse reactions, including hormonal acne or folliculitis, which complicates the condition.

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