Features of managing patients with age-related dyschromia, acne and post-acne

The condition of the skin and its various changes – it is the main subject of study of dermatology. Among the many reasons why patients seek help from dermatologists, one of the most common are acne, post-acne, and age-related skin changes. In an interview for estet-portal.com, Doctor of Medical Sciences, Professor-Consultant of the OKVD, Head of the Department of Dermatology and Cosmetology of the Donetsk National Medical University Protsenko Tatyana Vitalievna talks about the features of managing patients with age-related dyschromia, acne and post-acne.

Why does age-related dyschromia occur and who is most susceptible to this process?

Age dyschromia occurs due to at least two reasons. First – because of what happens inside the body.

It is the appearance of pigmentation that is sometimes the very first sign that makes you turn to an internist, whether it be a gynecologist, endocrinologist or therapist, so as not to miss the onset of diseases, the first symptom of which is – these are changes in skin color and color uniformity.

But, whatever the internal causes, external care, first of all, and only then treatment, can greatly slow down, and sometimes even prevent the appearance of age-related or any other form of dyschromia.

What methods help to control and slow down this process?

First of all, to really control the process, you need to understand the causes of dyschromia. If the reason is simply the abuse of insolation, solariums, any artificial light source and improper care after that – this is one situation, it is solved only by external means. Here, a good beautician, together with a good dermatologist, can really fix the problem and reverse it. Another question is if the increased sensitivity of melanocytes is connected not only with an external factor, but with some kind of hormonal dysfunction. In women, these can be perimenopausal changes, early menopause, some kind of hormonal pathology that is being formed, does not yet give the disease, but the sex hormones in the skin are already changing its sensitivity to external factors. It could be liver disease because, if something goes wrong in it, hormones are metabolized incorrectly. It could be thyroid dysfunction. As you can see, there are many causes inside the body that the skin can react to. That is why the first visit should not only be to a beautician, but also to a good dermatologist, and why a good dermatologist is always a beautician, and a good beautician always has knowledge of dermatology.

What is the peculiarity of topical treatment of acne and post-acne?

Acne is so common, and has such varying degrees of severity – from a mild degree, due to which they do not turn to specialists, to severe disfiguring forms of the disease. And we have accepted standards for managing such patients. We can really change the course of the disease with certain drugs, we can prevent the development of severe forms of the disease. But systemic preparations cannot be drunk endlessly, and sometimes they are simply not needed, and in this case, instead of external preparations, in which someone proved or showed by what mechanism we can really achieve control over the function of the sebaceous gland, here on the first place of course are topical retinoids. There are a lot of them and they are in medical preparations, cosmetology programs and systems, in chemical peels. There is a very wide range of effects when drugs are used that cause the sebaceous gland to conditionally dry out. And now the controlled process of influencing the sebaceous gland is very well solved by retinoids. But any stick always has two ends. Retinoids are great for treating sebaceous glands, but they dry out the stratum corneum, so when we treat acne, we must always be aware of the obligatory symptom of dry and irritated skin, and retinoids always need to be accompanied. But not just accompanied by moisturizers, but those moisturizers that restore the lipids of the stratum corneum. That is why, in cosmetology, there is even a whole science about the functioning of the stratum corneum – corneotherapy, which studies methods of influence aimed at strengthening the stratum corneum, regardless of whether

Does the effectiveness of topical preparations depend on the hormonal background of the patient?

The purpose does not depend, but the effectiveness will depend, because if there is some kind of kardash inside the body, then the best, most powerful drug can be discredited. It will still work, whether systemic or topical retinoid, it will still give its effect, but by prescribing drugs, we expect to turn the tide. If we have not figured out the cause of the increased function of the sebaceous gland, and this sometimes happens due to hormonal disorders, in this case we will not get the result that this drug can give when properly prescribed.

What modern methods in cosmetology are the most effective in combating these skin problems?

I will never say any one technique – it would be wrong, because how many types of skin there are, how many skin conditions and body conditions.

The same person at different times of the year, at puberty or early reproductive age, cannot have any one technique, so the best option – when there is a combination of methods of influence.

But the direction of these methods of influence is quite well calculated by us. We must regulate or prescribe drugs that regulate the activity of the sebaceous glands, whether they are cosmetic or medical products. We sometimes have to update the skin – these are any peeling effects, be it chemical peels or any others, the same laser resurfacing or microdermabrasion, but these techniques cannot work on their own. There must be an impact program that provides for the stages of exposure, adherence to the principles of both cleansing, and basic therapy, and necessarily supporting care, and above all, all these programs must be accompanied by an initial diagnosis of the skin condition - it is she who determines the choice of technique for a specific day of appointment.