Among chronic inflammatory dermatoses of non-infectious origin, acne occupies an exceptional position. Acne is one of the most common skin diseases in young people, found in 85% of boys and girls aged 12-20 years, the peak incidence occurs at 16 years of age. Approximately 95-100% of adolescent boys and 83-85% of adolescent girls aged 16-17 develop acne. 42.5% of men and 50.9% of women continue to get sick until the age of 20. After 40 years, 1% of men and 5% of women still have acne (late acne, acne tarda). Recently, there has been a noticeable trend towards an increase in the number of women over the age of 25 with late acne, who require an individual approach to prescribing therapy.
Find out in the article on estet-portal.
- Main causes of acne in adolescence
- Physiology of the development of the disease and the causes of acne at the cellular level
- Regulation of sebum secretion as one of the main causes of acne
- P. acnes – as one of the main
- causes of acne Main causes of acne in adolescence
Severe forms, leading to significant cosmetic defects in the form of hypo- and hypertrophic scars, account for 5-15% of all cases of acne. 30-50% of adolescents experience psychological distress associated with acne, including image evaluation, social difficulties, anxiety, depression, low self-esteem. 
The causes of acne,
especially the comedonal type, during puberty are associated with the onset of androgen stimulation, which may be the first sign of maturation in girls. Without a source of androgens, the sebaceous glands remain small, however, the peripheral conversion of testosterone to dihydrotestosterone leads to an increase in glands in the so-called sebaceous areas (face, back, chest) during puberty, and in other areas – no, which may be the main cause of acne in this age period.
Physiology of the development of the disease and the causes of acne at the cellular level
Today, the main causes of acne have been clearly identified:
2. pathological desquamation of the epithelium of sebocyte follicles;
3. reproduction of Propionibacterium acnes (P. acnes);4. inflammatory process.
We examined 75 patients with
papulo-pustular form of acne
aged 10-25 years, who had the determination of the functional state of the skin using the Soft Plus apparatus. Parameters such as humidity, fat content, temperature, elasticity, pH and melanin level were determined. Bacteriological cultures were also carried out using the method of imprints from the surface of the skin with the determination of the sensitivity of microflora to antibacterial drugs.
Approaches to the treatment of severe forms of acne
It was concluded
that the skin moisture level of all the examined patients was significantly reduced, the index of fat content skin? significantly higher than in the control group, What about skin pH? significantly different from the control group with a shift towards an acidic environment, which may play an additional role among the causes of acne.
Regulation of sebum secretion as one of the main causes of acne
Human sebum, which is secreted by the sebaceous glands, consists of squalene, triglycerides, cholesterol esters and wax. When passing through the hair follicle, bacterial lipases under the influence of P. acnes hydrolyze part of the triglycerides. The mixture of lipids that reaches the surface of the skin consists of free fatty acids, a large amount of mono- and diglycerides.
The saturation of sebum with triglycerides, wax and cholesterol esters distinguishes it from the fat lipids of other human organs.
Mechanisms of regulation of sebum production are not fully defined. Cell culture of isolated human sebaceous gland, primary sebocytes, sebocyte lines, mouse and hamster models were studied in various experimental models. The sebaceous glands have been shown to be regulated by androgens and retinoids. It has been proven that peroxisomes of proliferation-activating melanocortin receptors, corticotropin-binding hormone, and growth factor receptors play an important role in the functioning of the sebaceous glands. Melanocortins include melanocyte-stimulating and adrenocorticotropic hormones. In addition, it has been shown that neuroendocrine mechanisms can influence the sebaceous glands and sebum production, which must be distinguished among non-infectious causes of acne.
Fibroblast growth factor-1 and -2 receptors are expressed by the epidermis and skin appendages. Somatic mutations at the same loci can also cause acne. But it is not fully understood how this mutation affects the development of the sebaceous gland and
acne formation.
P. acnes – as one of the main causes of acne
Three pillars of modern topical acne management causes of acne – it's a diet. In provoking and manifesting acne plays the tendency of the population to Western diets, which is characterized by the content of foods with a high glycemic index and the risk of developing metabolic syndrome with the formation of insulin resistance and, as a result, the manifestation of hyperandrogenism. This is due to the similarity of the structure of the insulin receptor and cytochrome P450c17 in the adrenal glands and gonads due to the presence of the amino acid serine. When the latter is phosphorylated, on the one hand, a decrease in the sensitivity of insulin receptors with the development of insulin resistance and the subsequent formation of the metabolic syndrome, and on the other hand? at the same time manifestation of adrenal-ovarian hyperandrogenism.
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