Diagnosis | Acne


The diagnosis of acne vulgaris is made clinically, i.e. on the basis of visible skin changes. Various degrees of severity can be determined according to Pocchi, which are based on the number of comedones, pustules, infiltrates, cysts, fistulas and scar. The classification is made into mild, moderate, severe and very severe acne. Are you interested in diagnostics?

Acne on the back

Acne is particularly difficult to treat on the back, as the affected areas are difficult to reach and the skin is usually affected over a large area. Especially in the case of acne, however, the back is often involved, which is why acne pustules and lumps often appear on the back of men. The causes and factors for acne on the back are really no different from the causes and factors for acne on the face and other parts of the body.

The skin glands are excessively active and produce too much sebum, resulting in a clogging of the pores where the natural bacteria of human skin multiply excessively and cause inflammation. However, some factors favour the development of acne on the back: These include tight, synthetic clothing through which little or no oxygen can reach the skin. The same procedure is used to treat pimples on the back as for acne on other skin areas.

In the case of light pimples, an anti-comedogenic treatment (pimple treatment) is sufficient. However, if the acne is more pronounced, a treatment with benzoyl peroxide and moisturising care is more helpful. In extreme acne stages a systemic therapy with medication may be necessary.

This has to be discussed individually with the treating physician, as these drugs require a doctor’s prescription, as the drugs (e.g. Roaccutane, Isotretinoin, Aknenormin) can cause serious side effects. – Causes

  • Treatment

Therapeutically, there are several possibilities: Lysis is the most important therapeutic measure and is used for acne comedonica and papulopustulosa. It is carried out by means of vitamin A acid/trans-retinoic acid, which is dabbed on the acne and dissolves the cornification.

This removes the sebaceous congestion and prevents the formation of new comedones. However, an effect only occurs after about three weeks and the therapy must be continued until there is no longer any tendency to acne. This can last for years.

In severe inflammatory forms of papulopustular acne, additional antibacterial treatment is given, either locally with antibiotics (erythromycin, clindamycin), benzoyl peroxide or, in the case of abscesses, systemically with the antibiotic tetracycline. As a further option in the case of acne nodulocystica, sebum production can be blocked with isoretinoin/cis-retinoic acid. In women, such a blockade can also be initiated with the antiandrogen cyproterone acetate.

Both the active ingredient erythromycin and isoretinoin are available in the drug group acne fug for the treatment of acne. Finally, the most severe forms of acne can be treated with Dapson, a chemotherapeutic agent. The complicating superinfections of acne are treated antibiotically depending on the germ causing it.

Commonly used measures, however, are not or only weakly effective: Homeopathic medicines can also positively influence acne vulgaris. In this case, however, the skin and appearance of the acne must be considered carefully. Additionally, there is the possibility of mesotherapy.

Home remedies can also be used for acne. Additionally, there is the possibility of mesotherapy. Home remedies can also be used for acne.

  • Lysis of the comedones
  • Antibacterial therapy
  • Reduction of sebum synthesis
  • Specific diets
  • Peelings
  • Cleaning / disinfection of the skin or
  • Application of UV light. The treatment of acne with medication involves high side effects and associated risks, so that it must be carefully considered with the treating physician whether external treatment of acne may not be sufficient. Enclosed is a list of the best known active ingredients of medicines against acne:
  • Erythromycin
  • Doxycycline
  • Isoretinoin
  • Ethinylestradiol + dienogest
  • Minocycline
  • Adapalen
  • Tetracycline
  • Framycetin
  • Tretinoin
  • Ethinylestradiol + chloromadinone
  • Estradiol
  • Estradiol + Prednisolone
  • Sodium bituminosulfonate + chloramphenicol

The hormones and bioactive molecules contained in animal milk are responsible for a variety of skin problems, including severe teenage acne, according to the latest research (including Nurses Health Study II).

The consumption of milk, skimmed milk, curd cheese and cream cheese thus leads to the well-known skin problems. The results of the study were confirmed by associated studies. Further studies in population groups not affected by acne (e.g. Papua New Guinea) clearly show that there is a lack of milk consumption and the consumption of carbohydrates with a high glycemic index.

This glycemic index is considered a measure of the influence on the blood sugar level: a high glycemic index stands for a strong increase in the blood sugar level. The substances contained in cow’s milk are naturally intended for rearing calves and are intended to cause them to grow rapidly. If a person consumes these substances through the consumption of dairy products, there is an increase in IGF-1, a messenger substance which, if strongly increased, can cause insulin resistance and acne.

Acne can be prevented to a large extent by healthy, natural nutrition: To avoid are for it: Well suitable for a healthy way of life are against it:

  • Milk, whey, whey protein concentrates (protein power drinks), yoghurt, cheese
  • Cocoa, candy, chocolate, sugar
  • Carbohydrates with a high glycemic index (French fries, white flour products)
  • Alcohol
  • Nicotine/smoking
  • Soya products
  • Green tea
  • Vegetables
  • Regular sport (exercise and healthy weight)

The market for acne treatment cosmetics is quite large according to the demand and almost every cosmetic company carries an extra line against impure skin. So there are various creams, gels, washing lotions and facial serums to buy, which promise a pure and radiant skin. The really effective creams for severe acne usually contain at least one of the following four ingredients.

Locally used antibiotics such as tetracycline, clindamycin, erytromycin are applied to the skin in the form of ointments. They reduce inflammation by slowing down the spread of acne bacteria (Propionibacterium acnes). In order to obtain a long-lasting effect and to prevent the development of resistance it is recommended to use other preparations containing additionally 5% benzoyl peroxide in parallel to the topical application of antibiotics.

In addition, care must be taken not to exceed an application period of 8-12 weeks, as after this time the effectiveness on the bacteria is cancelled. A cream or ointment containing antibiotics is only available on prescription from a pharmacy. Pregnant and nursing mothers should urgently refrain from using antibiotics.

2) Azelaic acid Azelaic acid has a threefold positive effect on acne. Also creams and ointments containing azelaic acid are only available on prescription from a pharmacy and, unlike antibiotics, are better tolerated and thus also compatible with pregnancy and breastfeeding. 3) Benzoyl peroxide (BPO) Benzoyl peroxide has an antibacterial effect as it destroys the membrane of acne bacteria (propionibacteria).

In this way, the infestation of the skin with the bacteria is reduced and the bacteria still do not form a resistance to the remedy, as is the case with antibiotics. BPO is used in ointments and creams in a concentration of 3 – 10 %. Possible contraindication for the use of BPO is an allergy to this active substance.

As a side effect of the application, the skin may dry out, which may be accompanied by a feeling of tension, desquamation and redness. In this case the concentration of BPO in the product should be reduced and/or the product should be used less frequently. Ointments and creams containing benzoyl peroxide are also freely available without prescription and can be used in combination with antibiotics and retinoids.

4) Retinoids Tretinoin, Isotretinoin and Adapalene belong to the group of retinoids and are chemically produced active ingredients against acne which are related to vitamin A. They influence the growth and maturation of cells and have anti-inflammatory and comedolytic effects. As a result, pimples are opened and reduced.

Side effects are often local skin reactions such as redness, burning and scaling, so that accompanying skin care is recommended. In addition, it is important to know that the skin becomes photosensitive due to the application of retinoids and that under UV irradiation pigment disorders and sun allergies may occur. It follows that under retinoid therapy excessive sun exposure has to be avoided and a strong sun protection factor has to be applied.

Retinoids are suspected to cause depression and psychological syndromes such as anxiety and panic disorders by entering the metabolism. Retinoids are only available on prescription in pharmacies and are absolutely not indicated for pregnancy and lactation! – comedolytic (skin impurities are dissolved, pimples disappear)

  • Antimicrobial (kills bacteria)
  • Anti-inflammatory entzündungshemmend

Most cosmetic products against impure skin and acne dry out the skin severely, leading to a feeling of tension, redness and scaling. For this reason, an accompanying moisturizer is recommended to reduce skin irritations as much as possible. According to the original interests this additional care should not contain any pimple-promoting (comedogenic) ingredients.