Acne: all what you need to know

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Acne is a very frequent disease. People with the disease tend to ask similar questions about the disease and its treatment. This section deals with some of the most frequently asked questions by people with acne. Remember that your dermatologist is always the best source of specific information about your individual health problems, including acne.
The Questions and Answers section follows:

What Causes Acne?

The causes of acne are related to the changes that occur when young people grow from childhood to adolescence. The hormones that cause physical maturation also cause sebum (oil) to be produced by the sebaceous glands (oil) of the skin. The hormones with the greatest effect on the sebaceous glands are androgens (male hormones), which are present in both women and men, but in larger quantities in men.
The sebaceous glands are located with a hair shaft in a unit called the sebaceous follicle. During puberty, the skin cells lining the follicle begin to dissolve more rapidly. In people who develop acne, the cells dissolve and stick together more than in people who do not develop acne. When the cells mix with the increased amount of sebum produced, they can block the opening of the follicle. In the meantime, the sebaceous glands continue to produce sebum and the follicle swells with sebum.
In addition, a normal skin bacterium called P. acnes begins to proliferate rapidly in the blocked hair follicles. These bacteria produce irritating substances that can lead to inflammation. Sometimes the wall of the follicle bursts and spreads the inflammation to the surrounding skin. This is the process by which acne injuries, from blackheads to pimples to nodules, are formed.
I wash my face several times a day. Why do I still have acne?
Many people still believe that acne is due to dirty skin. The truth is that washing alone is not enough to eliminate or prevent acne. However, washing helps to remove excess surface oil and dead skin cells. Many people use all kinds of products, including alcoholic detergents, and rub hard just to irritate the skin and worsen their acne. Gently wash skin twice a day with water and mild soap. However, acne is actually caused by a variety of biological factors that are beyond the control of washing. For this reason, you should use appropriate acne treatments for acne.

Does Stress Cause Acne?

Stress is most often made responsible for the development of acne. Stress can have many physiological effects on the body, including hormonal changes that can theoretically lead to acne. In some cases, stress can be caused by acne lesions, not vice versa! If acne is treated effectively, stress is unlikely to have much impact on the majority of people.

i never had acne in my teenagers. Why do I have acne now as an adult?
Acne usually starts during puberty and disappears in the early twenties. In some cases, acne can persist into adulthood. These types of acne include severe forms that affect the body as well as the face (which afflict men more than women) and acne associated with the menstrual cycle in women. In other cases, acne may not occur until adulthood. Such acne is more likely to affect women than men.
There are several reasons for this. As women age, the structure of hormonal changes can change itself and eliminate the sebaceous glands to develop acne. Ovarian cysts and pregnancy can also cause hormonal changes that lead to acne. Some women get acne when they stop taking the birth control pill that protects them from acne. Sometimes young women can wear comedogenic cosmetics, i.e. they can create conditions that lead to the formation of comedones.

What role does nutrition play in acne?

Acne is not caused by food. After a strict diet, your skin will not get rid of it. Although some people believe that their acne is worsened by certain foods, especially chocolate, colas, peanuts, seafood and some fatty foods, there is no scientific evidence to suggest that food causes or affects acne. Avoid foods that seem to aggravate your acne, and avoid foods for your general health that seem to aggravate your acne.

Does the Sun help against Acne?

Many patients believe that sunlight improves their acne wounds and go to great lengths to find ultraviolet light sources. There is no evidence that sunlight has any effect on acne. In addition, the sun’s ultraviolet rays increase the risk of skin cancer and premature skin aging. It is therefore not a recommended acne treatment technique, especially since there are many other proven acne treatments. In addition, many acne treatments increase the skin’s sensitivity to ultraviolet light, increasing the risk of exposure to ultraviolet light.

What is the most effective way to treat Acne?

Each acne must be treated individually. If you have not had good results with the acne products you have tried, consider consulting a dermatologist. Your dermatologist will determine which treatments are best for you. For more information on the types of acne treatments that are available, and for basic acne treatment guidelines, please see AcneNet’s bulk acne treatments.

What types of cosmetics and cleaners can a patient with Acne use?

Search for cosmetics and toiletries “non-comedogenic”. These products are formulated to not cause acne.
Some acne medications cause severe irritation or dryness, especially during the first few weeks of treatment, and some cosmetics and detergents may even increase this effect. The choice of cosmetics and detergents should be discussed with your dermatologist or pharmacist.
Solid basic make-up should be avoided. Most acne patients should choose powder redness and powder eye shadow over cream products because they are less irritating and non-comedogenic. Camouflage techniques can be used effectively by applying green cosmetics under cover to red acne lesions to promote colour change.

Is it harmful to overwrite my mistakes?

Yes, in general, acne lesions should not be selected or pressed by the patient. In particular, inflammatory acne lesions should never be compressed. Clamping together pushes infected material deeper into the skin, resulting in further inflammation and possible scarring.

Can anything be done about acne scars?

The best way to prevent scars is to get rid of acne. Dermatologists can use different methods to improve acne scars. The treatment must always be individually tailored to the patient. Chemical peelings can be used on some patients, while dermabrasion or laser abrasion can be beneficial on other patients. It is important that acne is well controlled before each procedure to reduce scarring.

How long do I have to wait to see the visible results of using my acne medication?

The improvement time depends on the product used, but in almost all cases it is more weeks or months than days. Most dermatologists would recommend using a drug or combination of drugs daily for 4 to 8 weeks before changing treatment. It is very important that patients are aware of this delay so that they are not discouraged and stop taking their medication. Conversely, if you do not notice any changes, you can consult your dermatologist to see if it is necessary to change the treatment.

Would taking my medication more often than prescribed speed up the healing process of my acne?

Do not always use your medication exactly as prescribed by your dermatologist. The more frequent use of topical medications than prescribed can lead to major skin irritation, redness and follicular blockages, which can delay the healing time. If oral medications are taken more often than prescribed, they will not work better, but the risk of side effects is higher.

My current treatment seems to work on the points I treat, but I continue to get new Acne points. What should I do?

Topical acne medications are designed to be used on all areas that are prone to acne, not just on individual lesions. Part of the goal is to treat the skin before lesions form and prevent their formation, not just to treat existing lesions. Patients are generally advised to treat all areas (forehead, cheeks, chin and nose) that appear more likely than individual lesions.

My face is clear! Can I stop taking my medication now?

If your dermatologist tells you that you can stop, stop, but follow your dermatologist’s instructions. Often patients suddenly stop taking their medication to see their acne worsen a few weeks later. If you are using more than one product, it may be recommended to stop one medication at a time and evaluate the results before stopping all at once. Ask your dermatologist before stopping taking your medication.

Is the time I take my medication important?

Consult your dermatologist or pharmacist. If you take one dose of antibiotic a day, you can probably take it in the morning, at noon or in the evening, although you should choose a time of day and stay with it throughout the treatment. With oral medications prescribed twice daily or three times daily, you should do your best to distribute the doses evenly. Some antibiotics require you to take them on an empty or almost empty stomach. For optimal results with topical treatments, you must strictly observe your dermatologist’s recommendations. For example, if you are asked to apply benzoyl peroxide in the morning and a topical retinoid before bedtime, it is important to follow these instructions closely. For example, if the two were used together before bedtime, you could reduce the effectiveness of the treatment by chemical reactions that make them less effective.

I have difficulty remembering to take my oral medications every day. What is a good way to remember? What should I use if I miss a dose?

This is a common problem. Many patients try to associate taking their medications with a daily life event such as brushing their teeth or applying makeup. It is also useful to keep the drug close to where memory activity is performed.
In most cases, if you miss a day of oral treatment, do not double the next day, but resume your daily treatment as soon as possible – but there may be different instructions for different oral medications. Ask your dermatologist or pharmacist what to do if you miss a dose of your medication.

I used topical benzoyl peroxide and an oral antibiotic for my acne and noticed blue-black and brown markers on my face and some discoloration on my body. Marks are particularly visible in acne scars and recently healed lesions.

Is it a side effect of the drugs and is it permanent?

It is not possible to make general statements about the side effects of drugs that apply to individual cases. A dermatologist should be consulted. In this case, the facial impressions and body discolourations described by the patient fall within the range of side effects of some antibiotics.
Unique pigment patterns sometimes appear in acne patients treated with certain oral antibiotics, particularly minocycline. Pigment patterns may appear:

  • Localized blue-black or brown spots in and around acne scars and in areas of past acne inflammation.
  • A “muddy skin” that can cover most of the body.
  • Diffuse brownish pigmentation of the feet and legs.
    The side effects of pigmentation gradually disappear after treatment.
    Each side effect of a drug should be noted by the patient and brought to the attention of the physician. Although most side effects are temporary, they should be discussed with the doctor and monitored.

My doctor prescribes a topical retinoid for my acne. He said that a retinoid is a substance associated with vitamin A.

If the drug is combined with vitamin A, shouldn’t vitamin A supplements be useful to get rid of Acne?

Dietary vitamin A is essential for good health, especially vision. It has a beneficial effect on the health of the skin. High doses of vitamin A for the treatment of acne are not recommended for safety reasons. Retinoids and retinoid-like substances used for the topical treatment of acne are specially produced for their strong effect on the cleavage of the cell layer in the sebaceous follicle. Their use must be supervised by a dermatologist.
Dietary vitamin A has many effects on the health of the human body. Vitamin A is essential for good vision. Extreme vitamin A deficiency can lead to blindness, which is usually accompanied by dry, scaly skin. An overdose of vitamin A well above the recommended daily intake (RDA) of 5,000 IU can be almost as catastrophic. An extreme overdose of vitamin A can cause blistering and peeling of the skin, which occurs first in the first researchers in the North Pole who almost died after eating polar bear liver, which has an exceptionally high level of vitamin A.
Topical retinoids are usually prescribed for the treatment of moderate to severe acne. Side effects include redness, peeling and dryness of the skin, itching and burning. These side effects can usually be controlled by adjusting the amount and timing of retinoid application to the skin. The dosage adjustment should be discussed with the dermatologist who prescribed the treatment.

Are there specific Acne treatments for people with dark skin? Are there treatments that are specifically harmful to matte skin?

There is no specific acne treatment for matt skin. Acne treatments are generally as safe and effective for dark skin as for light skin. Some acne scar treatments can cause a temporary lightening of dark skin.
Acne is a common skin condition that has the same causes and progresses in all skin colors.
Very dark or black skin may be less hydrated than light skin. Topical anti-acne agents such as benzoyl peroxide, which have a drying effect on the skin, should be used under the supervision of a dermatologist. Benzoyl peroxide is also a powerful bleaching agent and should therefore be used with caution to prevent accidental discoloration of hair, towels or clothing stains.
Dark skin tends to develop post-inflammatory hyperpigmentation (skin that is too dark when the skin is inflamed). Severe inflammatory acne may cause brown spots. Stains disappear over time; a dermatologist may recommend cosmetic measures to make the stains less noticeable until they disappear. Some acne treatments, such as topical retinoids and azelaic acid, may also help reduce discoloration.
Removal of acne scars by dermabrasion or chemical peeling may temporarily lighten or darken the dark skin in the treated areas. The scar treatment should be discussed with a dermatologist or dermatologist before it is performed.
Changes in melanin pigmentation (dark pigments that give the skin its color) such as vitiligo and melasma are not associated with acne, but can occur simultaneously with acne. The diagnosis and treatment of melanin pigment disorders such as vitiligo requires a dermatologist with the necessary knowledge and experience to treat these conditions.

Is acne, which first occurs in adulthood, different from acne, which occurs in puberty?

Acne has a specific definition as a sebaceous follicular disease. This definition is applicable to acne that occurs at any age. However, it may be relevant to look for an underlying cause of acne that develops for the first time in adulthood.
The current understanding of the causes of acne vulgaris is described in the main text Why and how acne develops section. In short, acne vulgaris occurs when excessive sebum production and abnormal cell growth and death in the sebaceous follicle lead to blockage of the follicles with a mixture of sebum and cell debris and the formation of comedones. Follicular bacteria, mainly Propionibacterium acnes, the most common bacterial colonizer of tallow follicles, can contribute to acne inflammation by releasing metabolites that trigger an inflammatory response. It is believed that pathogenic events in the sebaceous follicle are largely due to changes in androgenic (male) hormone levels in the body, usually associated with growth and development between the ages of 10 and 12.

Some acne researchers believe that although this understanding is generally correct, there is still more to learn about the causes of acne vulgaris.

Acne that occurs after the age of 25 to 30 years is (1) a recurrence of acne that disappeared after adolescence, (2) an acne flare-up after a period of relative calm, for example during pregnancy, or (3) an acne that first occurs in a person who has never had acne.
Acne that occurs in adulthood can be difficult to treat if there are several recurrences. Some patients with severe recurrent acne have been treated several times with the potent systemic isotretinoin drug.
Acne outbreaks associated with pregnancy or menstruation are due to changes in hormonal patterns.
Acne, which occurs for the first time in adulthood, should be investigated for any underlying cause. Drugs that can induce acne include anabolic steroids (sometimes used unlawfully by athletes to multiply), some antiepileptics, isoniazid and rifampin antituberculosis drugs, lithium and drugs containing iodine. Chlorinated industrial chemicals can trigger an occupational skin disease, chloracne. Chronic physical pressure on the skin, for example from a backpack and its straps, or from a violin stuck against the angle of the jaw and chin, can trigger a mechanism called an acne mechanism. Some metabolic diseases can cause changes in hormonal balance that can trigger acne.
Some lesions that resemble acne may be other skin conditions such as folliculitis infection and inflammation of hair follicles that require different treatment for acne. Acne, which first appears in adulthood, should be examined and treated by a dermatologist.

My 15-year-old daughter has what I would call a very mild case of acne. She made things worse by constantly picking up and pressing.

She looks in the mirror for hours looking for a black spot or a weak spot. Does she need psychological support?

Excessive picking and crushing of otherwise mild acne is a condition called excoriated acne, which is most commonly observed in young women. A dermatologist can offer effective advice.
The typical person with sore irritated acne is a person who is often a young woman who is so desperate with her appearance because of acne that she literally tries to “push the acne out of existence”. Acne is often very mild, but the person’s face can be constantly covered with red compression marks and open wounds in which lesions have been opened.
The word excoriate means to scratch or grind the skin. Excoriated acne is a medically recognized disease that should be discussed with a dermatologist. From time to time giving in to a temptation to squeeze a blackhead is not defined as excoriated acne. Hours in front of a mirror, by pressing and selecting each weak point, is a definition of abraded acne. A dermatologist can advise the patient about a treatment in which he or she can participate, but do not touch the patient.

can the rate of secretion or the consistency of sebum be modified by diet? If possible, should a change in diet not be regarded as acne treatment?

It has never been proven that diet plays a role in the cause or treatment of acne. Dietary manipulation can play a role in the treatment of certain skin diseases, but not in the treatment of acne.
The cause of nutrition is one of the most persistent myths about acne. Foods, such as chocolate or fatty foods, do not cause acne, but some foods seem to make acne worse for some people. The following can cause it or make it worse:

  • Hereditary factors
  • An increase in male hormones found in men and women.
  • Menstruation
  • Emotional stress
  • Oils and fats from cosmetics, working environment, etc.
    It has been shown that no food is effective in the prevention or treatment of acne. A healthy diet is of course necessary for good overall health.

Shouldn’t I just try to remove the sebum from my body?

No. If the sebum is not blocked in the pores, it helps to keep the skin healthy.

Why does acne usually start at puberty?

Nobody is sure. What we know is that the sebaceous glands that produce sebum become much bigger during puberty than before.

Why does the skin around a pimple turn red?

This redness is caused by the inflammatory reaction of the body. Inflammation is a marker that your immune system is fighting an infection. However, the inflammatory response does not always work perfectly and can even cause scars.

If my skin turns red, does that mean I get scars?

Normally not. Even if there is no lasting scar, the repercussions of the inflammatory reaction can leave the red skin for months, sometimes longer than a year.

What are free radicals?

Free radicals are by-products of oxidation in your body. We all need oxidation as part of our life process, but there is concern that the accumulation of non-recycled free radicals contributes to many conditions, including skin damage. Antioxidants, including many of the active ingredients in Acuzin, help prevent the accumulation of free radicals.

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