Acne or acne – it is one of the most widespread skin diseases and occurs in almost 100% of young people during puberty. The appearance of acne in older people is called acne tarda, and is more common in females.
Almost 50% of women aged 25-40 suffer from this problem. In most women, the disease has a continuous course, the onset of which falls on adolescence. Much less often, acne debuts at the age of 25 years and older, and even more rarely there is an intermittent course of the disease, with periods of exacerbations and remissions. Taking into account the etiological factors of the disease, acne treatment should be carried out by a dermatologist together with a gynecologist-endocrinologist.
Etiological factors in the development of acne: genetics and hormones
There are several leading factors in the etiology of acne development. First of all, these are violations in the work of the endocrine system. Human skin and its appendages have steroid-sensitive receptors, and their activity directly depends on the concentration of hormones in the blood.
First of all, from excessive production of androgens. Hyperandoregenia stimulates the production of sebum, which leads to blockage of the ducts of the sebaceous hair follicles and creates favorable conditions for the reproduction of bacteria.
Hyperandrogenism is a genetic condition, so acne is a disease with a high family predisposition. It is known that the stronger the manifestations of acne observed in relatives, the more severe the course of this will be. diseases in offspring.
In addition, factors such as psycho-emotional disorders, mechanical trauma to the skin, eating large amounts of carbohydrates, and smoking also predispose to the occurrence of acne.
Basic clinical forms and classification of acne
Among the clinical manifestations of acne, the most widespread variant is the papulo-pustular form of acne – in 70-80% of patients, the comedonal form and acne conglobata are less common – in 15-20% of patients. Acne appears mainly on the face, less often – in the upper third of the body – on the back, shoulders and chest. Severe nodular cystic forms of acne are extremely rare. The American Academy of Cosmetology defines 4 levels of acne severity:
- 1st degree – closed and open comedones, up to 10 papules,
- 2nd degree – comedones and papules, up to 10 pustules;
- 3rd degree – comedones and papulopustular rash up to 3 knots;
- 4th degree – a significant inflammatory process in the deep layers of the skin with the formation of a large number of nodes and cysts.
Depending on the localization and prevalence of acne, all patients with acne are divided into the following subgroups:
- subgroup A – acne is localized in one area, for example, only on the face;
- subgroup B – acne is localized in two areas, for example, face and back;
- subgroup С – acne spreads over three or more areas, such as the face, back, and chest.
Features of the diagnostic process of acne in women
Acne diagnostics includes a complete dermatological and hormonal-endocrinological examination. The diagnostic process should begin with a full history taking, focusing on genetic, gynecological and endocrinological data. Patients are prescribed a hormonal blood test with the determination of the level of androgens, thyroid hormones and pituitary gland.
If necessary, an ultrasound examination of the adrenal glands and pelvic organs, tomography and radiography of the skull are performed. Non-invasive dermatological methods include sebometry, corneometry, pH-metry, as well as the study of skin microrelief.
Components complex treatment of acne in women
Treatment tactics for acne in women depends on the stage, prevalence of the disease, as well as the state of the hormonal background. At the 1st degree of acne, local therapy is performed, retinoids are the drugs of choice. Grade 2 acne requires the addition of systemic therapy, usually antibiotics. Clindamycin remains the most effective against acne to date.
Read on the topic: "Topical retinoids in the treatment of acne"
In severe forms of acne in women, the appointment of combined oral contraceptives with a pronounced antiandrogenic effect in combination with anti-acne drugs and systemic antibiotics is indicated. As an additional local therapy, high-quality medical cosmetics are recommended. When choosing cosmetic products, it is necessary to take into account the patient's skin type, the degree of oiliness and moisture content of the skin, as well as its pH.
To eliminate such post-acne manifestations as scars and dyschromia, it is recommended to use chemical peels, electrophoresis, cryo- and mesotherapy, laser skin resurfacing. Acne treatment is often a rather lengthy and complex process that requires correction of the usual lifestyle and strictly individually selected drug therapy. However, by adhering to all the recommendations of doctors, you can permanently get rid of the problem of acne.
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