Acne Treatment

Symptoms

Acne is a collective name for diseases of the sebaceous gland apparatus and hair follicles. The skin disease occurs predominantly puberty. Not all forms require treatment. However, a minority of patients suffer from severe acne, which should be treated in order to avoid long courses of the disease and scars if necessary. Areas of the body rich in sebaceous glands, such as the face, neck, chest and back, are particularly affected:

  • Blackheads (comedones)
  • Pimples
  • Papules, pustules
  • Nodes
  • Oily skin
  • Scarring in severe forms of progression

Acne forms

Three different main forms of acne vulgaris are distinguished:

  • Acne comedonica: closed and open blackheads, non-inflammatory.
  • Acne papulopustulosa: inflamed papules and pustules.
  • Acne conglobata: Severe special form with inflammatory nodules, abscesses, cysts and scars.

Causes

The following factors play an important role in the development of acne:

  • Genetic predisposition
  • Overproduction of sebum (seborrhea), enlargement of the sebaceous glands.
  • Male sex hormones (androgens).
  • Hyperkeratosis in the excretory duct of the sebaceous glands, hyperproliferation of keratinocytes.
  • Bacterial colonization of the follicular excretory duct with propionibacteria.
  • Rupture of the follicle, inflammatory reaction in the dermis.

Diagnosis

The diagnosis is usually made on the basis of the typical appearance. Severe forms of acne belong to medical treatment to prevent complications such as scarring and psychosocial problems.

Nonpharmacologic treatment

  • Cleansing, degreasing and disinfection: thorough degreasing with a soap or tonics allows the active ingredient to act on the target and is the basis of acne therapy.
  • As a rule, pimples and blackheads should not be squeezed. This promotes inflammation and thus delays healing. Likewise, this favors the formation of scars.
  • Avoid taking anabolic steroids and other acne-causing drugs.

Local drug treatment

Local therapy is suitable for patients with mild to moderate acne: retinoids affect skin formation and dissolve blackheads. Caution: these drugs are harmful to fertility and should not be used during pregnancy:

  • Tretinoin (Airol)
  • Adapalene (Differin)
  • Motretinide (Tasmaderm)
  • Trifarotene (Aklief)

External antibiotics work against acne bacteria:

Benzoyl peroxide (e.g., Aknefug, Benzac, Lubexyl) is a peroxide with antimicrobial, antiseborrheic, bleaching and keratolytic properties. Azelaic acid (Skinoren) is antibacterial, influences skin formation and is weakly anti-inflammatory. Salicylic acid in deep concentrations is comedolytic, antimicrobial and anti-inflammatory. It is present in detergents or alcoholic solutions for degreasing. Sulfur and sulfur compounds combinations: It has been shown that better results can be obtained by combining different substances than with the respective monotherapy.

Systemic drug treatment.

Systemic therapy is primarily suitable for patients with severe forms of acne. Retinoids taken internally, such as isotretinoin (Roaccutane, generics), are considered the most effective drugs for treating severe acne. They normalize hyperkeratosis and decrease sebaceous gland secretion. Retinoids are harmful to fertility and should not be taken during pregnancy! Tetracyclines are effective against acne bacteria and have anti-inflammatory properties:

Some oral contraceptives (birth control pills) contain an antiandrogenic progestin such as cyproterone acetate (Diane 35, generic) or drospirenone (Yasmin, generic). They are suitable for women who also want oral hormonal contraception.