Acne vulgaris (cystic acne or just pimples) is a typical human skin disease, characterized by locations of skin with seborrhea (scaly red skin), comedones (blackheads and whiteheads), papules (pinheads), pustules (zits), nodules (large papules) and possibly scarring. Get Rid Acne Fast.
Pimples influences usually skin with the densest populace of sebaceous hairs foillicle; these locations feature the face, the upper part of the chest, and the back. Serious pimples is inflamed, however pimples can easily additionally manifest in non-inflammatory types.
The lesions are created by modifications in pilosebaceous units, skin frameworks consisting of a hair follicle and its linked sebaceous gland, changes that need androgen stimulation.
Pimples happens most commonly throughout adolescence, and frequently proceeds into their adult years. In adolescence, acne is normally created by an increase in testosterone, which accrues throughout puberty, regardless of sex. For the majority of individuals, acne lessens over time and often tends to fade away– or at the very least decrease– by age 25. There is, nonetheless, no way to forecast just how long it will certainly take to vanish entirely, and some people will certainly carry this condition well into their thirties, forties, and past.
A couple of the big nodules were formerly called cysts and the term nodulocystic has been made use of to explain severe cases of inflammatory pimples. The cysts, or boils that accompany cystic pimples, can easily appear on the rear ends, groin, and armpit location, and anywhere else where sweat collects in hair follicles and sweating ducts. Cystic acne influences deeper skin tissue than does typical acne.
Aside from scarring, its main results are mental, such as reduced self-esteem and in very extreme cases, depression or suicide. Pimples typically appears during adolescence, when individuals currently usually tend to be most socially insecure. Early and aggressive treatment is therefore proposed by some to decrease the general long-term impact to individuals.
Acne as a term for the skin disease was in the 19th Century, the English borrowed into German, where reference was made to a late Latin source, which in turn by a transcription error from the Greek accusative plural (with m).
According to Kluge was the introduction in English meaningflower in original English rosy-drop, the Online Etymology Dictionary According derived from the pointed-shaped appearance of acne lesions papule and pustule is Ακμή akin to Greek άκρος, Akros, pointed(compare German medical use in the extremities, and acrobat ) and cognate with the Latin acutus, acuteand German corner.
Acne is the most common skin disease. 70 to 95 percent of all teenagers have acne lesions, are particularly affected the face and upper trunk area. The incidence of the disease has its maximum at the age of 15 to 18 years. In the majority of cases occurs after puberty, spontaneous regression, which is 2 to 7 percent, with significant scarring. In 10 percent of cases, the disease persists until about the 25th Years beyond. 10 to 30 percent of those affected require drug therapy.
The best known and most common is acne vulgaris, or common acne, and sometimes acne simplex called. Usually means that the acne caused by increased androgen during puberty occurs and no later than the beginning of the third decade of life fades away. Because their causes lie in changes in body metabolism, acne vulgaris is one of the endogenous forms of acne. Get Rid Acne
By age can be distinguished in the following:
• Acne neonatorum: acne in newborns
• Acne infantum: acne before in pubertal children (from the third month of life)
• Acne tarda: acne in adult advanced age, this is usually after 25 Of age.
The cause of acne is endogenous in principle, possible at any age. In particular, prepubertal and adult advanced age come as a background metabolic diseases considered. Acne can also be caused from the outside.
Various forms of acne
• Acne aestivalis, also known asMallorca acne”, appears after UV exposure. Background are probably reactions of free radicals with lipids from oily cosmetics, sunscreens and the body’s own sebum, clearly indicating the pro-inflammatory substances.
• Acne cosmetica occurs after application comedogenic cosmetics on.
• Acne medicamentosa is created by using barbiturate – lithium – or kortikosteroidhaltiger drugs, anabolic steroid abuse and overdoses of vitamin B6, B12 and D2.
• Acne venenata – theKontaktakne”. These include chlorine, oil and tar acne.
The Acne inversa is a common severe inflammation of the sebaceous glands and terminal hair, preferably in intertriginous areas such as armpits, groin and buttocks.
The pathogenesis is not fully understood, it appears as a specific exogenous factor often tobacco smoke play a role.
On the extent or severity of the acne comedones distinguishes it from the Papulopustulosa acne and acne conglobata. The skin of acne comedones from comedones and a few at most, very mild inflammation (papules ) dominated.
Scarring is not to be feared. When acne papulo-pustulosa dominate papules and pustules, scarring due to inflammatory processes is possible. Acne conglobata describes the occurrence of additional Fistelkomedonen nodes and, subsequently threatened with significant scarring.
Due to increased production of sebum (seborrhea) and keratinization in the output of the sebaceous gland follicle to form comedones. They become inflamed, the papules, pustules, or nodules. Acne is one of the polymorphic (polymorphic) skin diseases with a complex genetic background. Studies on homozygous twins showed that both twins in 98 percent of the cases regarding age at onset, and number of comedones
Talgproduktionsrate were affected very similarly. In contrast, a study with heterozygous twins, that in half the cases only one twin was affected.. Even in these cases there was little to no similarities in the production of sebum and Komedonenzahl was observed to run in families: When both parents had acne, then this is for their children Akneerkrankungsrisiko more than 50 percent.
Other causes are:
Bacteria: Recent research results show that it was not for the beginning of the inflammatory process of acne excessive settlement (hyper-colonization) with Propionibacterium acnes required. However, those bacteria play to fill the resulting wound, for the remainder of the inflammatory process involved.
Androgens: androgens stimulate the growth of sebaceous gland volume (sebaceous gland) as well as the keratinocyte proliferation and the formation of a proliferation hyperkeratosis in the duct of the affected follicle.
Ligands of peroxisome (PPARs): Human sebaceous glands are richly decorated with PPAR. Among the various PPAR subtypes is particularly PPARa in the regulation of lipid synthesis. The 5-lipoxygenase product leukotriene B4 (LTB4) is one of the most powerful naturally occurring PPARa ligands, together with androgens stimulate the sebaceous lipid synthesis.
Comedogenic substances: substances interfere comedogenic cosmetics because some of their material properties, the shedding of corneocytes (retention hyperkeratosis ) and thus promote the formation of comedones (comedogenesis).
Smoking: Studies have shown that cigarette smoke large amounts of arachidonic acid and contains polycyclic aromatic hydrocarbons. These initiate a phospholipase A2 -dependent signaling pathway that can stimulate the proinflammatory effects of arachidonic acid further.
Stress: The stress hormone CRH is capable of the lipid genesis and the conversion of DHEA to testosterone in the sebocytes influence. To what extent this affects in practice and whether the finding opens up new therapeutic approaches, remains to be established.
Consequences and Complications
Inflammation can Aknebedingte with redness, swelling, itching and pain go hand in hand. In addition, greater risk of inflammatory lymph node swelling, headache, fever and sepsis. In the way of contact infection, the onset of folliculitis / furunculosis are favored. Severity, ie highly inflammatory acne with scarring associated. Furthermore, the acne on psychological and social problems result from the data subject, because as stigmatizing is felt. Phobic disorders, neuroses, relationship problems, bullying of those affected by its social environment, depression and suicidal tendencies are possible.
Except in mild cases of acne treatment is a skin doctor (dermatologist recommended). There are several drugs and supportive therapy methods. The drug therapy attempts to reduce the production of sebum, the Verhornungsvorgang in the excretory duct of the sebaceous gland follicle normalize bacteria to fight and to influence the inflammatory reaction favorable.
α-hydroxy carboxylic acids, to the natural fruit acids includeact comedolytic. For acne, in addition to glycolic or lactic acid, malic acid, citric acid and mandelic acid used. Using 10-15% cream preparations there is a reduction of the cohesion of follicular corneocytes in the lower layers of the stratum corneum, and finally the Komedolyse. In most cases, but this is a 3-month treatment is necessary. It also gives a prophylaxis against Komedonenneubildung. In contrast to treatment with benzoyl peroxide, retinoids, or salicylic acid occurs in the use of alpha hydroxy acids to non- epidermal water loss. This was repeated at 2-week intervals peeling with glycolic acid 30% from the second treatment was found to be significantly effective.
Antibiotics are those bacteria fight, the sebaceous and later in the inflammatory lesions of acne colonize. Antibiotics may also have anti-inflammatory and indirectly counteract the keratinisation. A distinction between topical (local) and systemic (body wide) effective antibiotic drugs. Through the digestive tract fed antibiotics intestinal problems (eg diarrhea) have resulted. The contraceptive effect of the contraceptive pill can be affected accordingly. Common antibiotics such as: minocycline (internally).
Benzoyl peroxide (abbreviated: BPO)
Benzoyl peroxide acts as a potent oxidant anti-bacterial and keratolytic. There are BPO preparations at levels of 2.5% to 10%, a gel, cream or washing suspension. Mean a higher BPO content is not necessarily better effect strengthened, but in some cases, the skin irritation. Contact allergic reactions occur in approximately 10% of cases, the drug should be discontinued then.
Hormones (women only)
The hormonal therapy for women includes the administration of an antiandrogen acting substances, they influenced the production of sebum and sebaceous Verhornungsvorgänge. Usually this is the synthetic estrogen ethinyl estradiol, combined with an antiandrogen acting, synthetic progestin (about cyproterone acetate, drospirenone) taken. Corresponding hormone preparations are the same contraception.
Linoleic acid cream is used as a basis magisterial formulas are used. In a study from 1998 showed that externally applied linoleic acid reduces the size of microcomedones within one month of almost 25%.
Slight case of acne and provides moderate severity, the external (topical) application of retinoids on. These include tretinoin, isotretinoin, Motretinid, adapalene and tazarotene. Retinoids act primarily on topical application comedolytic. Side effects can include itching, burning and redness of the skin. adapalene, a synthetic derivative of naphthoic acid, assign thethird-generation retinoids (polyaromatic retinoids), shows a low concentration (0.1%) good results with relatively few side effects.
In severe or otherwise therapy-resistant cases of acne, the retinoid isotretinoin are used systemically. Ideally, this way the production of sebum is permanently reduced. The side effects can include severe peeling of the skin, dry skin, hair loss, nose bleeds, depression and joint pain and damage to the liver (according to the prescribed dose). Pregnancy must be in each case for the duration of therapy and to exclude a subsequent safe distance as they could cause severe malformations in the unborn baby. To ensure contraception is women with systemic isotretinoin therapy is usually the pill prescribed.
Treatment with sunlight or ultraviolet radiation is controversial. Although UV radiation is able to have an antibacterial effect, but at the same time, the proliferation hyperkeratosis are encouraged. As a result, threaten the formation of new comedones. Moreover, it may be phototoxic effects occur, especially when used externally to-apply drugs, sunscreens and cosmetics.
The aromatic ß – hydroxy Salicylic acid has keratolytic and antibacterial. In concentrations of up to two per cent salicylic acid in cosmetic products contain, thus achieving only a superficialpeel effect”. Only five percent achieve concentrations from komedolytischen effect. In large areas at higher doses, such as the treatment of acne scars requires the risk of kidney damage. This was repeated at 2-week intervals peeling with 30% salicylic acid was found to be significant from the second treatment effectively.
Zinc and zinc compounds
Zinc is an essential trace element for human body. The pathogenesis of acne and wound healing processes may increase the physiological needs of the patient. Can not these additional requirements will be met from food alone, it seems sensible to use supportive acne zinc supplements. Chronic overdose should be avoided, however, it threatens copper deficiency and, subsequently, the occurrence of hypochromic anemia. For topical acne therapy zinc compounds are generally with the antibiotic erythromycin, and clindamycin combined. The antiseptic effective zinc oxide is a component of zinc ointment, which alone or in combination with an antibiotic can be used for wound treatment.
The vaccination with homologous vaccines car is an old, western Europe that is little known about the inflammatory acne lesions form of therapy. This requires a puncture from an infected lesion can be removed and sent to a lab. The production of Autovakzins takes about three weeks. The preparation is then over a period of eight to ten weeks, once weekly subcutaneous injection. Clinical tests have shown so far only indications of possible immunological effects. Evidence for safety and efficacy in acne have not been provided, an appropriate placebo-controlled double-blind study is still lacking.
Acne and diet
Until now, a general correlation between diet and the occurrence of acne is not scientifically proven. Some proponents of this theory really complain about the lack of reliable scientific studies on the subject, but without such a study may present itself.
Certain known metabolic diseases that occur due to lack food and cause acne either, or at least unfavorable influence can be. These include lack of nutrition-related cases of PCOS, the hyperandrogenism has resulted acne. Pathologically elevated blood sugar, as in cases of untreated diabetes mellitus can occur, the bacterial colonization and subsequent inflammation of the skin to promote what might have adverse effects on the expression of an already existing acne.
A group of researchers at the University of Melbourne examined the impact of glycemic load on hormones and the progression or treatment of acne vulgaris in 43 male volunteers over twelve weeks. After this period the number of lesions increased in the group with low glycemic load by about eight percent more than in the control group. These results were however not confirmed by a similar study.
A retrospective-statistical, non-placebo-controlled study conducted in 2005 by Clement Adebamowo (Boston / USA), claims found through analysis of survey responses from more than 47,000 nurses a statistical association between the consumption of certain dairy products and the occurrence of acne in young women have.
Errors and Prejudices
•Acne is a sign of poor personal hygiene. – Acne cannot be viewed as a lack of personal hygiene, improved constantly washing the skin is usually not. On the contrary – by too frequent washing of the acid mantle of the skin is damaged, so that might worsen the disease. Therefore, patients should only be a maximum of twice daily washing with a pH-neutral (pH 5.5) skin cleanser.
•Sexual thoughts and actions lead to acne.- While the adolescent acne often manifested simultaneously with the awakening of sexuality, but it corresponds to a gross misunderstanding of endocrinological background to understand the skin disease as a result of sexual thoughts and actions.
•Blackheads and pimples should express it. – The expressions of acne lesions is not a viable alternative to drug therapy, should be made only in exceptional cases and by trained personnel. Improper conduct threatened the rupture of the follicle or the enlargement of the wound, abscess, smear infections, and additional scarring.
•Acne is caused by foods that cannot tolerate the body. – The acne is not a symptom of an allergy or a symptom of food intolerance.
•Acne is hereditary. – Acne vulgaris is a multifactorial disease with genetic predisposition. This means that can be Inherited predisposing factors for the disease, such as seborrhea and the condition of the sebaceous glands, not the acne itself It is a polygenic, autosomal – dominant inheritance with different penetrance of.