Acne is defined as inflammation of the pilosebaceous glands and hair follicles. This condition leads to the formation of so-called “pimples.”
In medical terms, acne is responsible for various types of lesions depending on the severity of the condition:
- Comedones: whiteheads and blackheads;
- Papules: solid, raised lesions of the skin surface;
- Pustules: severe, disfiguring lesions resulting from infection of papules;
- Cysts: small superficial or deep hard nodules more or less suppurated;
- Fistulas: cysts that deep down join together.
Types of acne
The presence and/or concurrence of these lesions then allows us to distinguish different types of acne by identifying their different degrees of aggravation:
- Comedonic: mild or severe based on the presence of only blackheads;
- Papulo-comedonic: blackheads are associated with painful or itchy red swellings;
- Papulo-pustular: widespread inflammation and infection of papules;
- Cystic: related to the presence along with the previous lesions, also of more or less deep hard nodules;
- Conglobate: aggregation of deep lesions that will leave scars.
The condition takes its start from the obstruction of sebaceous follicles by cell fragments resulting from the desquamation of epithelial cells (keratinocytes).
The pore from which the hair escapes becomes clogged, and the sebum secreted by the sebaceous glands is unable to escape and accumulates together with fragments of dead cells. Subsequent to follicle obstruction, microbial contamination by bacteria (Propionibacterium Acnes) occurs.
The anatomical sites most affected are different depending on the onset of the disease: adolescent acne or juvenile acne mainly affects the forehead and nose. Acne of adulthood occurs on the lower part of the face, the neck but also the chest and back area.
Causes
There can be many different causes of acne breakouts:
- Hormonal imbalances. The occurrence is very common at pubertal age. This period is, in fact, characterized by an overproduction of androgen hormones, leading to sebum secretion with comedones formation.
- Bacterial causes. Acne is promoted by a bacterium called Propionibacterium Acnes that lives on the skin under physiological conditions. When skin pores become clogged it multiplies causing inflammation.
- Genetic predisposition. Acne often appears in people from families that have suffered from the same problem.
- Stress and psychological disorders. Often with-cause especially in the adolescent period.
- Eating disorders.
Therapy
The treatments that can be undertaken to defeat acne are different depending on the severity and causes. From natural or homeopathic remedies to actual drug treatments.
To remedy its consequences, such as scars and various blemishes, on the other hand, various types of aesthetic medicine techniques can be used.
Before resorting to any treatment, it is of paramount importance, in order not to thwart the result, to identify and analyze the causes that triggered the acne. The dermatology specialist will need to analyze not only the predisposing “psychological terrain” (stress, behavioral disorders), but also identify hormonal (puberty, menstruation, pregnancy) and hepato-intestinal (eating disorders) disorders.
Behavioral norms
The first therapy to be put in place, common to all forms, is through observance of certain hygienic-behavioral rules:
- Always clean the skin with mild, mild detergents;
- Avoid over-cleansing the skin so as not to alter the thin natural lipid layer. In fact, skin that is too dry is more sensitive;
- Always remove makeup from the skin and avoid keeping hair in contact with the face;
- Do not apply oily creams;
- Do not rub or scratch pimples: permanent scarring may be avoided;
- Follow a proper and balanced dietary pattern, low in sweet and fatty foods, preferring fruits and vegetables;
- Hydrate with at least two liters of water daily.
Natural remedies
These are remedies of natural origin of various kinds (plant, animal and mineral) used to counteract the onset of injury. They are mainly used in cream form but also in the form of compresses and tinctures.
- Phytotherapy. The most commonly used medicinal plants are:
- Burdock root: has an antiseptic and diaphoretic action on the skin promoting purifying and decongestant activity. It also promotes liver and kidney purification and contains substances that counteract the action of bacteria.
- Stimulates microcirculation by improving capillary function.
- Aloe vera: excellent natural remedy with anti-inflammatory re-epithelializing and astringent activity. Acts as a healing agent.
- The violet of thought. Used in mother tincture or infusion it has good diuretic and depurative properties.
- Dandelion. It is an excellent natural product designed for internal use. Promotes intense depurative and diuretic activity.
- Clay mask. Effective in cleansing the skin of toxins and bacteria, clay works by incorporating impurities but also by enriching the skin with mineral trace elements (iron, silicon, and magnesium).
- Essential oils. Of thyme, oregano, bitter orange geranium, camphor bergamot, melaleuca, are an excellent remedy by giving tone to the skin by disinfecting it from impurities.
- Probiotics. Live milk enzymes are an indispensable remedy in rebalancing intestinal flora. In fact, gut dysmicrobials can often be responsible at the skin level for acne formation.
Homeopathy
Homeopathic medicine intervenes in the two aspects of acne disease-symptomatic remedies and underlying remedies-as well as in the formulation of vaccines. In the present case:
- Vaccine. It can be obtained from the material coming out of the pustules (microbial immunity) but also from the patient’s blood (hormonal desensitization).
- Symptomatic remedies. They are prescribed on the basis of injury and skin constitution. Recall:
- Hepar sulphur, when the bacterial component prevails;
- Arnica montana, when there is an important inflammatory component.
- Background remedies. They act on the individual’s personality, which may be the underlying ground for the occurrence of acne disease:
- Sulphur iodine: for thin and nervous subjects;
- Calcium bromatum: for the depressed;
- Natrum Muriaticum. For those who tend toward isolation.
Drugs
Drug therapies mainly address:
- Antibiotics. Normally antibiotic therapies are reserved for severe cases that are resistant to topical therapies and remedies. They can be used systemically as well as topically. The most commonly used antibiotics are clindamycin (zindaclin, cleocin) erythrocin (eriacne gel, zineryt), metronidazole (rozex, zidoval).
- Antimicrobials. Prolonged administration of antibiotics often creates resistance of the bacteria responsible for acne manifestations. The most commonly used are benzoyl peroxide-based (acnidazil, benzac, panoxyl) and azelaic acid-based (skinoren, finacea).
- Hormones. Hormone therapies are reserved for women and girls. However, these are oral contraceptive drugs used for the purpose of treating acne but also related dermatological conditions such as hirsutism, alopecia, and seborrhea. The most commonly used are ethinylestradiol and cyproterone acetate (diane, dianette).
- Retinoids. These are drugs widely used in the treatment of acne disease. They are also very potent drugs and even when used topically, can be responsible for several side effects (skin flaking and erythema). The most commonly used molecules are isotretinoin (roaccutan, aisoskin, isoriac, isotrex), tretionine (retin, avesanoid), adapalene (differin, epiduo).
Scar therapy
Acne scarring is undoubtedly the most common and most prevalent of facial blemishes.
Treatment of scars varies according to their spread and depth.
- Glycolic acid creams. Used in creams it can be the treatment of first choice in mild forms. It acts by creating an exfoliation of the skin.
- Glycolic acid peel. The mechanism of action is the same as for creams. The increased depth of exfoliating action also induces significant stimulation of collagen and elastin.
- Dermabrasion. Technique used to eliminate particularly deep scars. It relies on the use of special machines that abrade scar skin by brushing it at high speed.
The dermo-aesthetic treatments described must strictly be performed at dermatology offices or of aesthetic medicine .
