The acne is a skin disease common in adolescents and young adults, reaching boys and girls.
This is an inflammatory sebaceous gland of the face and trunk.
Acne is not contagious. It corresponds to the reaction of the skin to different changes in the pubertal period. The intensity of this reaction varies from one individual to another.
Although acne is rarely a serious illness, however, it deserves a careful treatment because of the risk of scarring.
In acne, first the oil glands work excessively and, secondly, the removal of sebum is blocked by the formation of plugs the hole in these glands.
This accumulation of sebum in the sebaceous glands is responsible for the formation of microcysts.
Some of these microcysts are able to open up to the surface of the skin and then form comedones, microcysts, while others become infected, leading to the development of papulopustular or nodules.
The main risk of long-term acne is scarring atrophic (thinning of the skin).
The sebaceous gland is subjected to multiple stimuli: sun, heat, cold, stress, hormones, androgens (male hormones).
However, diet does not seem to play a role in the development of acne.
Acne usually begins during adolescence, with a maximum around the age of 17.
The locations of acne are the face, neck, chest and shoulders.
The signs of acne are varied, they can involve:
- An oily, shiny with enlarged pores. - The open comedones or blackheads. - The closed comedones or whiteheads. - The erythematous papules (raised red lesions) in case of inflammation of the microcysts. - The pustules (superficial purulent collections) in case of infection of microcysts. - Nodules (collections of pus deep).
We distinguish rétentionnelles acne, predominantly comedones, inflammatory acne where papules, nodules and pustules predominate.
Diseases whose symptoms are similar?
We must differentiate mainly juvenile acne and other forms of acne:
- Acne late (after age 30 years) should be investigated in women an overproduction of androgens (male hormones).
- Acne drug: it is pustular acne triggered by a medication. The drugs most often responsible are corticosteroids, some hormonal treatments (including some oral contraceptives), certain anticonvulsants, vitamin B12, certain antidepressants.
- Acne professional: following the exposure of the skin oils (garage) or hydocarbures (metallurgy).
- Cosmetic Acne: Following the application of cosmetic creams too greasy.
In most cases no examination is indicated in the exploration of acne.
A hormonal assessment shall be sought only in rare cases of acne in women.
Two major classes of acne treatments can be proposed, local treatments and systemic therapies (oral):
- Local treatments consist of applying to areas prone to acne creams, gels or lotions.
For the treatment of acne rétentionnelles be used in priority:
- Vitamin A acid (tretinoin), isotretinoin and adapalene: free removal of the sebaceous glands and allow the elimination and prevention of comedones and microcysts .- creams with fruit acids (AHA) facilitate the removal of blackheads.
For the treatment of inflammatory acne, it is preferable to use:
- Benzoyl peroxide: this changes the microcysts of superinfection by decreasing bacterial multiplication. - The salts of zinc affect the inflammatory component of acne .- Topical antibiotics: fight also against superinfection of microcysts.
The general treatment (oral) may be proposed in the more severe forms of acne:
- Antibiotics: oral, for periods of three months, is a powerful treatment lutant against superinfection.
- The oral isotretinoin decreases significantly, and usually final, the production of sebum by the sebaceous glands. However, this treatment is reserved for the most severe forms of acne because of its possible side effects. In women, effective contraception is a sine qua non of this treatment can cause serious fetal malformations.
- The pill Diane 35 for women is effective in the medium and minor acne by reducing sebum production. Appearance of the results after 6 months.
What should you do?
- Tell your doctor about taking medications or oral contraceptives.
- Avoid the use of makeup products not suitable for young skin prone to acne.
- Avoid touching, fiddling and penetrate acne lesions.
- Understand that the effectiveness of treatment, local and / or generally occurs after a few weeks and it is a long-term treatment.
- Understand that the sun worsens acne, and then use non-comedogenic sunscreen.
- Understand that treatment well, but stopped too soon always leads to relapse.
- Morning and evening, cleanse the skin without irritating, using the toilet for a cleansing gel or surgras bread rather than regular soap.
- When shaving, use preferably a shaving foam suitable for acne-prone skin.
The development of acne is in the form of periods of relapses and remissions. In women, an accentuation of acne before menstruation is common.
The natural history of acne is a self-limiting around the age of 25 years, persistent acne in adulthood is not exceptional.
The majority of acne leave no scar.
The Cystic-Acne is a rare and severe acne, more common in men.
This form of acne is characterized by the formation of nodules deeper, which will secondarily develop into abscesses that can leave scars in the long term.
Frequent handling of his acne lesions by the patient can also cause scarring.
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