Acne are a chronic inflammatory condition, which depend on genetics, nutrition, stress and hormonal dis-balance. Acne start appearing with puberty and can cause problems to women until their forties.
Initial stage in the development of acne is the obstruction of the sebaceous gland canal opening on the skin surface, through which the sebum is being ejected to keep the skin from over drying. Inflammation is considered to be one of the causes of this obstruction. Genetic factors along with the inflammation cause the cells at the canal opening to glue to each other, which creates a plug and prevents the cells to be ejected. The gland then produces the oily matter (sebum) which has nowhere to go, causing it to accumulate and create comedones or blackheads. If in direct contact with air, a comedon will become black and is then called an open comedon, and if not in direct contact with air we are dealing with a closed comedon. Most acne are caused by closed comedones. With further accumulation of sebum the sebaceous gland canal ruptures and the content creates an inflammation, i.e. acne when in contact with the skin. Bacteria has a secondary role in acne development. They feed with the accumulated sebum and then their byproducts benefit the inflammation and the rupture of the sebaceous gland canal. Male hormones, nutrition and stress intensify the sebaceous gland performance and aggravate acne. Acne are an unpredictable ailment prone to rapid improvement and deteriorations. For results to be visible a therapy in duration of 1-2 months is needed.
We can prevent the development of comedons with drugs, destroy the sebaceous glands, perform facial cleansing, use contraception, make nutritional changes, decrease one's stress level and use other various treatments. The basis of acne treatments are topical retinoids with azelaic acid which prevent the clogging of the sebaceous gland canal opening. Antibiotics have an anti-inflammatory role, respectively they reduce the inflammation and with that the appearance of scar tissue and bacteria. The consequences of the inflammation are redness of skin and in cases of severe inflammation, scars. There are other numerous preparations, along with antibiotics, that help with the destruction of bacteria, for example sulfur and benzoyl peroxide... Contraception neutralizes the effect of male hormones and decreases facial oil. The existing comedones should be removed frequently with facial cleansing, while the goal of the therapy is to decrease the development of new ones. Contraception and Roaccutan decrease the size of sebaceous glands while some treatments destroy the glands and thus decrease the olification of skin. Fried food, milk and sugar provoke the inflammation and worsen the acne, which are an inflammatory condition. Therefor, they should be avoided completely. Certain food supplements like zinc, linoleic acid and chromium have a favorable impact on acne.
For more severe cases of acne isotretionin (Roaccutane) is used, along with sulfonyl preparations and other drugs. In the future we expect new drugs with strong anti-inflammatory effects. Recently, numerous treatments and devices had results in keeping acne under control. Once acne are cured, it is necessary to perform therapy for one more year. Final cure for acne is the destruction of sebaceous glands with therapy, i.e. treatments or spontaneously which is unfortunately followed by scaring of the skin. Acne cannot be cured over night since a certain amount of time is needed to destroy the active sebaceous glands. This period cannot be predicted. After the acne are cured, it is necessary to perform therapy in duration of 1 year so they do not return.
The very first step is a dermatologic examination, so that a therapy and other measures and procedures could be determined based on the stage of acne. If appropriate, hormonal examination will be performed to rule out polycistic ovaries as the main cause of the enhanced amount of male hormones. Along with ovaries, adrenal glands an pituitary disorders can cause the production of male hormones. It is necessary to change your nutrition, use anti-comedon creams, to decrease the inflammation. Also frequent facial cleansing treatments are necessary (mechanical cleansing and micro-abrasion with oxygen). Acne should not be popped since it causes scaring. At first sign of deterioration consult with your physician to prevent scars and change therapy.