( For the texts and pictures books, publications, guidelines for example in awmf.org and contributions of colleagues were consulted.)

 

Acne (Greek = growth-flowering) is an inflammatory disease of the sebaceous glands. It usually begins at puberty between the 10th and 13th year and lasts for five to ten years, with some people even until after 30 years or even longer. It occurs mainly in the sebaceous glands of skin such as the face, neck and neckline, at the back and rarely on the upper arms or neck. The cause of acne is unclear substantially. Several factors seem to lead to the creation of this skin condition or at least to play a favorable role:

1 Genetic disposition for oily skin

2 Reinforced, hormonal (androgen) controlled stimulation of the sebaceous glands (sebum –  oily skin)

3 clogging of the sebaceous glands → formation of blackheads : comedones

4 Proliferation of the skin and acne bacteria in the sebaceous glands

5 Application substances that promote blackheads (some cosmetics, oils, iodine, chlorine,   bromine).
6 Taking certain medications: High-dose vitamin B, lithium, barbiturates, etc. smoking,   stress, lack of sleep

Forms of acne:

Depending on the predominance of individual acne lesions and severity of different forms of acne are the following:

acne vulgarisacne

comedogenic

papular-pustular acne

acne conglobata (severe form of acne) with deep and permanent scarring node.

Therapy

Treatment is always individual and depends on the severity and location of the acne. It is either external (local), or additionally treated with an oral drug (systemic) for more  severe acne. Complementary chemical peeling can be applied. The cleaning and care of the skin with specially formulated for acne-prone skin products is important to improve the skin’s appearance.

1 The increased sebum flow is treated by frequent cleaning with degreasing substances (synthetic detergents, paper towels, alcohol solutions and sebum reducing drugs (vitamin A acid, pill, drying preparations).

2 The keratinization of the follicular (pores) is affected with abrasive particles (peeling) or medication (vitamin A acid , salicylic acid).

3 The inflammation is treated with local and oral administration of antibiotics (clindamycin, tetracycline, erythromycin), and locally by preparations containing benzoyl peroxide. Antibiotics may be required in low dose over a long period.

4 In very severe cases with scars risk of vitamin A acid is added internally. The treatment is highly effective, but must be continued over a longer period (6 months – 1 year). But it requires precise adherence to treatment instructions. Women should not become pregnant during treatment. Every 4 weeks must be performed a blood test and a pregnancy test . Sun exposure and alcohol consumption must be reduced.

 What can you do in addition?

Inner and metabolic diseases, and intestinal colonization defects need to be treated concomitantly. New is proven in many studies, the over decades denied influence of diet on the development and course of acne. Here in particular the unfavorable influence of the consumption of milk products and of high-glycemic carbohydrates (sugar, sweets, white flour products), chocolate and animal fats, as well as the potentiation by smoking were revealed.

Eat healthy (salads, raw and fresh vegetables, lean meats and fish, dairy products). Little sweet (sugar, chocolate, sweets, cakes, sweet fruit).

Whole grain and brown bread than white flour products. Low-fat foods.

Vitamin B-containing vitamin supplements, iodine or bromine rich products are not recommended.

Cleanse your face thoroughly at night and apply the medication regularly.

Do not push or scratch even your “pimples” around! Let the professional cleansing trained aestheticians, you can otherwise easily cause permanent scars!

 Cosmetic preparations can greatly aggravate acne. Please use appropriate cosmetics for acne skin (“non-comedogenic”) and only after consultation with your doctor or aesthetician.

 Acne-scars

 Agenst acne scars laser treatments, chemical peels, surgical scar correction, freezing and grinding treatments are possible. The latest procedures are fractional CO2 and Er: YAG laser treatments and deep peels with various acids. Surgical procedures and grinding treatments are used in special situations scars. Better, of course, to prevent by timely treatment scarring.

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