Acne: treatment for pimply skin

cne is a skin condition that manifests itself in several types of rashes:

This disease mainly affects adolescents, but also children and adults.
The acne that most people suffer from is called acne vulgaris (or vulgar acne).

All injuries to the skin begin with acne as micro-blackheads.
Doctors usually divide acne into four degrees, by type and number of lesions:

  1. Acne comedonica, characterized by open blackheads
  2. Acne papulo-pustulosa
  3. Acne cystica (severe form)
  4. Nodulocystic acne (severe form).

Pustules and cysts characterize the group of inflammatory acne.


Acne types

Acne comedonica or acne of the
first degree In this phase, the skin begins to show typical signs of acne:

  • oily skin,
  • open blackheads, which are sometimes very numerous,
  • some spots.

There is no inflammation.
Acne of the first degree often occurs in adolescence.
Many adults have mild acne, which manifests itself in the form of small, black dots on:

This type of acne is generally easy to keep under control and scarring can be avoided.
The mild acne can progress to the second and third degrees if left untreated.

Acne falls into the “mild” category of:

  • less than 20 pimples or black dots,
  • less than 15 inflamed nodules,
  • less than 30 skin lesions in total.

The mild acne is usually treated with over-the-counter, locally applied medications.
It can take up to eight weeks for a significant improvement to be observed.

Acne papulo-pustulosa or acne of the
second degree 
Acne papulo-pustulosa is a mixed form: not all lesions are inflamed.
Possible severity levels are:

  • mild
  • moderate.

It can be confined to a specific zone or occur diffusely.
Open blackheads (black dots) and closed blackheads (white papules) are present in greater numbers. In the case of acne of the second degree, larger patchy changes may occur.
As a rule, they are red and/or filled with pus and have open and closed blackheads.
The acne papulo-pustulosa shows the following characteristics:

  • visible inflammation on the skin;
  • Papules and pustules are smaller than 5 mm in diameter and appear more frequently;
  • Rashes are clearly visible.

The spots (spots) can appear in different areas of the face, for example:

  • Nose
  • Forehead.

Adult women often develop spots and rashes on:

  • Chin
  • Cheeks
  • Lower jaw.

The rashes especially worsen:

Another factor for distinguishing the phases in mild acne are typical spots for the respective stages of the disease.
Average acne is characterized by:

  • new spots,
  • healed spots,
  • some scars.

The second degree acne can also be treated with over-the-counter medicines.

Second-degree acne is considered moderate if the patient:

  • between 20 and 100 pimples or black dots,
  • between 15 and 50 inflamed bulges,
  • has 30 to 125 skin injuries in total.

Acne cystica or acne of the
third degree Acne is considered serious. The main difference between this phase and second-degree acne is:

  • severity of inflammation,
  • appearance of cysts.

The skin is now visibly inflamed and reddened.
The usual signs of acne (blackheads, red and yellow pimples) are present, but more extensive and pronounced.
The severe form of acne not only appears on the face, but also affects other parts of the body, such as:

  • Neck
  • Breast
  • Shoulder
  • upper back,
  • Face.

There is a risk of scarring.
In case of severe acne, it is important to consult a dermatologist to begin adequate therapy.

Third-degree acne is treated exclusively with systemic medications (in oral form) or with prescription local remedies.
If the third-degree acne is not treated, it can progress to the fourth degree.

Nodulocystic acne or acne of
the fourth degree The fourth degree is the most severe form.
Papules and pustules of acne are:

  • also in this phase typical signs,
  • much more numerous,
  • diffuse,
  • inflamed.

Patients with this type of acne often have large cysts or nodules.
A cyst is a spherical structure filled with pus, over 5 mm in diameter.
Nodules are raised, hard skin lesions.

This type of acne shows numerous:

  • Blackhead
  • Papules
  • Pustules
  • Node
  • Cysts.

There is a high degree of inflammation and pronounced rashes.
The cystic acne causes pain on the skin.

This severe acne extends over the entire face and can affect:

  • the whole back,
  • Breast
  • Shoulder
  • Arms.

The infection is profound and diffuse.
Unfortunately, among the complications of acne, there are also scarrings.
It is inevitable that a fourth-degree acne is treated by a dermatologist.

Variants of acne

Some types of acne do not belong to the classic categories.
Most of them occur rarely, here are some examples:

Acne conglobata
This type of acne affects more men than women and is most common between the ages of 18 and 30.

Acne conglobata:

  • is a very severe form of acne;
  • is characterized by the formation of deep lesions: cysts, pustules, nodes and abscesses;
  • leads to the union of various rashes.

This form of acne mainly affiliates:

  • shoulders and arms,
  • Buttocks.
  • Back.

Against this rare and serious inflammatory acne, aggressive therapy is needed. But even under therapy, the consequence of acne conglobata is permanent scarring.

Acne fulminans
This rare type of acne:

  • is aggressive,
  • is painful,
  • causes inflammation and serious lesions similar to acne conglobata, with bleeding ulcers and crusts.

It can start very suddenly and occasionally take on serious forms within a few weeks.
The characteristic that distinguishes acne fulminans from other types is the possibility of causing the following symptoms:

Acne inversa
This disorder is associated with acne, but it only affects certain sweat-producing glands (apocrine glands).
The normal sweat glands are activated by heat; Elements that stimulate the apocrine glands are, on the contrary:

  • Stress
  • hormonal alterations such as the menstrual cycle,
  • sexual stimulation.

Acne inversa manifests itself:

  • under the armpits,
  • under the breast,
  • in the anal or genital area (buttocks and genitals).

Acne rosacea Acne rosacea
is a dermatosis that has severe symptoms similar to juvenile acne. Acne rosacea or copper rose is characterized by the following symptoms:
1. Red face 2. Visible capillaries on the face

3. Red eyes
4. Lacrimation
5. Occasional itching on the skin

Acne excoriata
Acne excoriata occurs when the pimples are scratched or squeezed so badly that the skin is injured.

Acne in children and newborns

Newborn exanthema
Newborn exanthema (or erythema toxicum neonatorum) can occur immediately after birth and lasts a little longer than a month.
It is characterized by red spots or red pimples with a small white dot in the center.
She has a mild course, therapy is not required.

Acne infantum
This is a very common disorder.
The children develop inflammatory skin lesions, similar to juvenile acne, especially on the cheeks.
Usually, this acne occurs in male infants and is already present at birth or develops in the first weeks of life.
Causes include:

  • maternal hormones,
  • beginning activity of the testicles of the newborn.

This form of acne heals on its own over the course of a month, once the baby has eliminated the circulating hormones.
Some authors recommend treatment similar to that in adults, however, tetracyclines should be avoided because of discoloration of the teeth.

Acne tarda or adult acne This form of acne
can also affect adults, especially women between 30 and 45 years of age.
Adult acne can also affect people who have not suffered from acne during puberty.

Causes of inflamed boils in forty-year-olds are:

  • pharmaceuticals (cortisone or hormone treatments),
  • Stress
  • excessive use of cosmetics.

Causes of acne

Possible causes are:

1. Oily skin: Too much sebum produced by the follicles
2. Accumulation of dead cells in the pores, which leads to constriction.
3. Infections: Penetration of bacteria into the pores.
4. Hormones. During puberty, androgenic hormone levels increase in boys and girls, especially testosterone. These hormones cause increased sebum production in the sebaceous glands of the skin.
5. Nutrition: milk and sugar; some experts believe that milk proteins and sweets favor the appearance of acne.

Acne is not contagious.

Causes of acne during lactation?

The cause may be hormonal, especially in conjunction with the hormones that return to normality after the birth of the child.
Most mothers have acne after pregnancy, even if they are not breastfeeding.
Other causes include:

  • Stress
  • Hormone fluctuations.

Treatment for acne

Oral medications for acne should not be used during pregnancy, especially during the first three months.

Treatments for acne include:

Creams and ointments. Lotions against acne can:

  • dry the oil,
  • kill bacteria,
  • promote the rejection of dead cells.

Over-the-counter ointments contain:

  • Benzoyl peroxide
  • Sulfur
  • acetylic acid,
  • Azelaic acid (Skinoren).

Local treatments on prescription. If the acne does not respond to over-the-counter treatment, then the dermatologist may recommend drugs from the group of A vitamins:

  • tretinoin (Retin-A®),
  • Adapalene (Differin®)

Antibiotics. For second- to fourth-degree acne, a short cycle of topical or oral antibiotics may be required.
Doctors usually prescribe:

  • Clindamycin (Zindaclin 1% Gel)
  • Tetracycline

Antibiotics can cause side effects, such as:

  • stomach pain,
  • dizziness,
  • Pigmentation disorders on the skin.

Isotretinoin. In the case of deep-seated cysts, antibiotics may not be sufficient. Isotretinoin (Roaccutane, Aknenormin) belongs to the retinoids and is an effective drug that is very effective for scarring of cystic acne, as well as acne that does not respond to other treatments.

This medicine is available as:

  • Capsule
  • Cream
  • Lotion
  • Gel.

Pregnant women must not take this drug.

Hormone therapy and birth control pills Oral contraceptives
can improve acne in women.
For example, “Zoely” contains:

  • an estrogen (estradiol),
  • a progesterone (nomegestrol acetate).

However, oral contraceptives can cause other side effects, such as:

The most serious complication is an increase in risk of:

Chemical peeling for acne
The peeling is a treatment for peeling the skin and causes:

  • removal of dead cells,
  • Promotion of cell regeneration.

The peeling can have a superficial or deep effect.
This form of treatment is mainly used to reduce acne scars.

Lasers and phototherapy for acne
Laser therapy and phototherapy reach the deepest layers of the skin without damaging the surface.
Laser treatment aims to damage the sebaceous glands and thus reduce oil production.

Phototherapy uses ultraviolet rays to destroy the bacteria (Propionibacterium acnes).
These therapies can also:

  • improve skin structure,
  • reduce the severity of scarring.

How long does acne last? When will it pass again?

With most therapies prescribed for acne, it is possible that no results will be achieved in the first four to eight weeks, the skin may even get worse instead of better.
Juvenile acne usually ends around the age of 18.

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