Acne, commonly known as pimples, most frequently occurs on the face, neck, chest, back, shoulders, and arms. It is a condition caused by the blockage of oil glands in the skin. It most commonly appears during adolescence, and patients generally have oily skin. Acne may improve with age, but untreated acne can leave permanent scars. Furthermore, acne can cause disfigurement and psychological distress. For these reasons, acne should be treated by specialist physicians.
Several factors are thought to play a role in the formation of acne:
• Male hormones rise during puberty, stimulating and enlarging the sebaceous glands in the skin.
• Sebaceous glands produce an oily substance called sebum. Sebum (oil) becomes sticky in the oil duct and can cause the duct to become clogged.
• Bacteria multiply in the oil ducts. These bacteria release chemical substances that create a reaction, making it easier to block the oil ducts. Blocked oil ducts lead to the appearance of pimples called comedones, which are either without a head or have a blackhead. Then, sebum, bacteria, and cells accumulate, causing redness, swelling, and inflamed types of acne.
Does diet play a role in acne?
Acne is not caused by food. Restrictive diets will not improve your skin. For many years, chocolate and fatty foods have been blamed as acne causes, but this has not been scientifically proven.
What kind of cleansing should be done for acne?
Daily facial care should involve washing the face with a cleanser and lukewarm water. Milk-based cleansers should be avoided. Cleansers with a pH of 5.5 should be preferred. Washing too frequently and excessive scrubbing can irritate acne.
How are cosmetics used on acne?
People with acne can comfortably use eye makeup, blush, and lipstick. It's important that foundation and powder applied to the skin's surface are oil-free and water-based. Ideally, the product should be labeled "non-comedogenic" and "oil-free." Oil-free powders can be used as concealer. Hair sprays and gels should be kept away from the face.
Is there a connection between acne and internal diseases?
Today we know that acne is not caused by an internal disease. Only in cases of persistent acne that doesn't respond to treatment, or is accompanied by hair loss or increased hair growth, may there be a sexual hormone imbalance. In these cases, your dermatologist will order some tests.
Can stress cause acne?
Stress is not a primary cause of acne, but it can trigger or worsen breakouts due to the release of certain hormones during stressful periods.
Does sex life have an effect on acne?
Scientific studies have found no link between sexual activity and acne.
General information about acne treatment:
Acne can be treated effectively, but treatment is slow. Improvements in acne treatment begin in the 2nd-3rd month and complete resolution is achieved between 4-8 months. It's possible for acne to worsen, especially in the first month. Improvements take time. Dermatologists determine treatments based on the type of acne. Sometimes, acne-like rashes can be caused by other factors, such as makeup, lotions, or medications. It's important to clearly mention all medications and products you are using when consulting your dermatologist.
Your dermatologist may recommend creams, gels, or lotions that prevent the blockage of oil ducts and reduce bacteria. These products can often cause dryness, redness, and peeling. Initially, the medication is applied in a very thin layer; if necessary, it can be applied every other day instead of daily during the first week of treatment.
Antibiotics reduce bacteria in the hair follicles, which reduces redness and inflammation. Birth control pills are also used for this purpose because they significantly improve acne in women.
Treatment for mild acne:
Mild acne manifests as blackheads (open comedones) or as bumps and bumps, and is treated with various gels, solutions, and lotions. The use of extra vitamins and minerals has not been shown to be beneficial in treatment. Wash your face with water using a mild cleanser. Apply acne products to all affected areas, not just dabbing onto individual pimples.
If you experience irritation due to medication, discontinue treatment and consult your doctor.
For mild acne, topical medications, which are applied to the skin, are often preferred.
• Benzoyl peroxide (Aknefug, Benzac, Aksil, Benzamycin)
• Azelaic acid (Skinoren, Azelderm)
• Antibiotics: Clindamycin, Erythromycin, Tetracycline (Cleocin, Aknilox, Eryacne, Imex)
• Retinoids: Tretionin, Isotretinoin, Adapalene (Tretin, Acnelyse, Isotrexin, Differin)
Treatment with fruit acids - Peeling:
In recent years, fruit acids have also begun to play a role in acne treatment. Examples of these products, considered semi-cosmetic and semi-medicinal, include glycolic acid, lactic acid, and mandelic acid. They are available in cream and gel forms with concentrations of 5-20% for at-home application. They are used to aid in acne treatment or for post-treatment care. They are also recommended for controlling oiliness in oily skin and treating mild acne caused by oiliness. Fruit acids exfoliate and renew the skin, keeping pores clean and thus preventing acne. High-concentration formulas of fruit acids (50-90%) are also used in in-office treatments. In this application, under doctor supervision, the acid solution is applied to the skin, left for a few minutes, and then washed off. These applications can be repeated at intervals of 1-4 weeks.
Peeling can be used as a supportive treatment for acne. In addition, it is an effective method for reducing scarring after treatment.
Depending on the type, severity, and extent of your acne, your doctor may prescribe one or more of the medications listed above.
The aforementioned treatment methods provide temporary relief from acne, and patients may sometimes need to continue these treatments for years. However, the systemic retinoid medication known as "Roaccutane" causes permanent relief from acne after a certain dose is used. Therefore, it has become a popular choice among both doctors and patients in recent years. For detailed information about "Roaccutane," you can review the topic titled "Treatment of Severe Acne."
Treatment of severe acne:
Severe acne manifests as cysts and inflamed nodules on the face and sometimes on the back and buttocks.
Today, severe acne can be completely eliminated with medications containing systemic retinoids called "isotretinoin" (Zoretanin, Aknetrent, Roaccutane).
The most common side effects of isotretinoin are:
• Teratogenic side effect: Female patients should not become pregnant while using these medications. Pregnancy is prohibited and inadvisable for up to one month after the completion of treatment. Retinoids do not cause infertility.
• Dryness: Retinoids can cause excessive dryness of the skin and mucous membranes (nose, lips, and eyes).
• Changes in blood values: blood fat levels may increase (triglycerides and cholesterol); liver enzymes may also temporarily rise.
During retinoid treatment such as Roaccutane, patients should be closely monitored and checked at specific intervals, and blood tests should be performed. Therefore, the physician must be sufficiently expert and experienced in this area, and the patient must adhere to the scheduled follow-up dates.
Treatment of acne (pimple) scars:
Acne scars are classified into two main groups: superficial and deep.
Superficial acne (pimple) scars:
These are scars that affect the upper layer of the skin. These scars appear especially after acne treatment and are seen as slight pits and depressions on a background of redness. Superficial acne scars can usually be removed with superficial skin peeling methods such as chemical peels, but acne scars that do not heal can be easily treated with fractional laser.
Deep acne scars:
• Ice-pick acne scars: These are pinpoint pits, usually less than 2 mm in diameter, that appear on the skin as if punctured with an ice pick. Although these scars are not very large, they can be extremely deep, sometimes reaching the subcutaneous fat layer. Therefore, the best treatment for ice-pick acne scars is laser treatment. Among laser systems, the most effective and also the one with the fewest side effects is the fractional CO2 laser system.
• Box car acne scars: These are acne scars that form in a round or oval shape.
• Rolling scar (wavy) acne scar: These types of acne scars, which are usually deep, result from the upper layer of skin being pushed inwards by the lower layers. This type of acne scar is the most difficult to treat, but fractional CO2 laser treatment shows up to 80% improvement.
Fractional CO2 laser therapy is the most effective treatment method worldwide for all types of scars (acne scars, burn scars, wound scars).
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