What do acne look like on the face?

Pimples, or acne vulgaris (acne), develop against the background of seborrhea, that is, excessive secretion of sebum with altered properties. They occur in areas of the skin that are richest in sebaceous glands. On average, there are 900 glands per 1 cm2 of skin on the face, upper back and chest, while in other areas their number does not exceed 100.

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The reasons that cause the formation of acne include not only excessive secretion of the sebaceous glands, but also hormonal imbalance, infection of the skin by bacteria, and pathology of the hair follicle (for example, ingrown hairs). This condition is most often observed in adolescents, but adults also often face this problem. Acne is one of the most common skin diseases.

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The peak incidence occurs between the ages of 13 and 18 years, and acne appears earlier in girls, but disappears faster. In young people, acne can take severe forms, causing significant cosmetic defects and worsening the quality of life, primarily due to psychological problems. In men, the pathology becomes chronic and by the age of 30-40 turns into late acne.

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The first signs are increased sebum secretion (seborrhea) and microcomedones. You should consult a doctor already during this period to prevent the development of severe forms of the disease.

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Main types of acne

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Depending on the external manifestations, the following types of acne are distinguished:

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1. comedones;
2. papular;
3. pustular;
4. inductive;
5. abscessing, or suppurating indurative;
6. phlegmonous;
7. drain;
8. conglobate.

The choice of treatment methods for inflammatory skin processes depends on their severity. In mild cases, home remedies are sufficient. With a large number of rashes, their deep and merging forms, the help of a dermatologist is necessary.

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The formation of different types of acne occurs in stages. Initially, this is a blockage of the excretory ducts of the sebaceous glands due to increased secretion of sebum, caused by the hypersensitivity of cells to sex hormones. This creates a breeding ground for microorganisms, in particular Propionibacterium acnes. As they multiply, they break down fat to form fatty acids that damage the skin surface. As a result of chemical irritation, an inflammatory process is formed.

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Comedones

The most common type of acne, localized mainly on the face. They form in the hair follicle, which becomes clogged with dead skin cells and excess sebum. Comedones turn into small elevations (papules) with white or black dots in the center.

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This type of acne can be caused by certain foods - rich in animal fat, fried, spicy, salty. They are called comedogenic.

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"Black dots"

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The black plugs on the surface of the papules that open onto the skin are filled with excess oil and skin cells. Their color is not due to the accumulation of dirt, but to improper reflection of light rays from clogged hair follicles, as well as changes in the color of sebum when exposed to air.

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Sometimes the appearance of pathology is associated with improper use of cosmetics based on oils and moisturizing components. Pollution and high environmental humidity matter. Additionally, blackheads can appear due to excessive use of soaps and other cleansers. Dry skin leads to increased sebum production and clogged pores.

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Open comedones often form on the forehead, chin, and nose. Over-the-counter acne medications are usually sufficient to treat them.

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"White heads"

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If the excretory duct of the sebaceous gland and hair follicle is completely blocked, pimples with white purulent heads appear - closed comedones. Their contents do not reach the surface of the skin, accumulating under its top layer and causing the formation of a bubble. Since sebum does not come into contact with air, it does not darken. Such acne can also be combated with the help of cosmetics.

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Non-inflamed comedones are not accompanied by redness and swelling of the skin. They respond quite well to the use of salicylic acid. This substance exfoliates dead cells, opening the exit for excess sebum. Salicylic acid is included in special lotions, toners and moisturizers.

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Pimples with white heads are less treatable. To eliminate them, in addition to salicylic acid, retinoids are used, in particular Differin.

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Papular

When inflamed, comedones turn into papular acne. The process is associated with the proliferation of pathogenic bacteria in the sebaceous glands, which cause inflammation and the formation of pus. Small, soft pink or red bumps form on the skin surface. The skin around them is often slightly hyperemic. These pimples may be sensitive to touch and may be slightly itchy. Squeezing out the contents intensifies the inflammatory process and subsequently leads to the formation of scars.

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A large number of papules is a sign of moderate to severe acne and requires treatment by a dermatologist. Inflammatory acne is less treatable than comedones. To eliminate them, agents based on benzoyl peroxide, topical and oral antibiotics, and isotretinoin preparations are used.

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Pustular

These are pustules, often developing from comedones with white heads. A red, inflamed rim appears around the lesion. The pathological formation itself is filled with white or yellow pus. It may have an irregular shape; pustular acne often merges with each other and protrudes above the surface of the skin. Typically, the appearance of pustular elements is not associated with severe bacterial infection.

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You should avoid squeezing pimples, which causes dark spots (hyperpigmentation) or scarring on the skin.

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Indurative or nodal

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A type of subcutaneous pimples that look like large, painful bumps or nodules. They appear when the sebaceous gland duct is completely blocked, irritation and inflammation of the surrounding skin tissue.

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These are dense formations to the touch. Acne penetrates deep into the skin structures and is often painful. When such formations appear, the help of a doctor is necessary. Usually, drug treatment with Isotretinoin preparations for internal use for six months is sufficient.

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Abscessing

When indurative acne suppurates due to the proliferation of pathogenic bacteria, cystic formations are formed - abscessed acne. They are filled with purulent contents and resemble boils. The formations are painful, usually soft to the touch, and after their opening deep atrophic scars form.

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The course of the disease is relapsing. The help of a dermatologist is necessary, and often consultation with other specialists is required, for example, an endocrinologist or immunologist. Isotretinoin is used for treatment. The abscess can be removed surgically.

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Nodular and abscessed acne often appears with a hereditary predisposition. They can be observed simultaneously with comedones, occur with the progression of papular or pustular forms, and also combine into nodular abscess formations.

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Phlegmonous

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They appear when inflammation penetrates into the deep layers of the skin, resulting in the formation of tiny cavities filled with purulent contents. On the surface of the skin this is manifested by the appearance of widespread lumpiness. Gradually, the phlegmonous cavities merge into large foci, forming nodes of a red-violet hue.

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Phlegmonous formations gradually break through and the purulent contents, often mixed with blood, come out through several holes. The course of the disease is long, it is very difficult to treat.

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Conglobate

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This is one of the most severe forms of acne. Conglobate acne often appears on the back, neck, chest, and buttocks. They represent many inflamed follicles that merge with neighboring areas of inflammation.

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Such acne appears on the body of an adult, usually in men. They may be associated with the use of testosterone or anabolic steroids. Another name for them is fulminant. The onset of the disease can occur as arthritis, followed by profuse formation of acne throughout the body. For adequate treatment of the condition, it is necessary to consult a dermatologist.

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Acne conglobata can accompany the genetic disease Klinefelter syndrome (trisomy XXY). In this case, they can occur on any part of the body above the knees. The pathology is accompanied by purulent damage to the joints and kidneys.

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Degrees of severity and principles of treatment

What pimples and in what quantity are observed with different severity of acne:

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1. mild: less than 20 blackheads or white heads, less than 15 papules or pustules, and a total number of pimples of no more than 30;
2. moderate severity: from 20 to 100 comedones, up to 50 inflamed pimples or the total number of lesions up to 125;
3. severe: there are several abscessed blackheads of a dark red or purple hue.

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How to deal with them?

For mild cases, it is enough to use special cosmetic lotions for 2 months. Moderate severity of the lesion requires medication. Treatment lasts several weeks, and often the severity of acne even increases in the first time after it begins.

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In the severe stage, the main goal is to reduce inflammation and scarring. The doctor can prescribe a variety of medications and physical procedures that improve the appearance of the skin and the condition of the sebaceous glands.

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Topical therapy is used to treat different types of acne. These are medications applied directly to the affected area - a variety of ointments and creams for acne. They contain substances such as benzoyl peroxide, resorcinol, salicylic acid, sulfur and zinc derivatives. Prescription medications, such as antibacterial creams and ointments with retinoids, are also used.

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For systemic therapy, tablet medications are used. Antibiotics are prescribed - tetracycline, doxycycline, erythromycin. They destroy bacteria that cause inflammation and suppuration of acne. If necessary, the doctor prescribes other medications:

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1. oral contraceptives to normalize hormonal levels in women;
2. spironolactone;
3. antiandrogenic substances;
4. isotretinoin (vitamin A derivative).

Isotretinoin preparations are very effective in the treatment of acne. However, due to a sufficient number of side effects and contraindications, they should only be prescribed by a doctor.

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Other types of acne

In addition to acne, pimples can also occur due to certain diseases.

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Psoriatic acne

Psoriatic acne, or guttate psoriasis, is not associated with blockage of the excretory ducts of the sebaceous glands and hair follicles. They are also not associated with pathogenic microbial flora of the skin. Psoriatic acne is multiple small painless yellow-pink pimples. They appear on the back and chest, then spread to the legs, less often to the face, ears, and scalp. In children, such pimples are often located around the anus, leading to severe itching.

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The rash is usually associated with the activation of Candida fungi or yeast microorganisms that cause seborrheic dermatitis. Less commonly, it is caused by staphylococcus or papillomavirus. Immune system disorders affect the skin, leading to the appearance of small pimples. The disease is treated with glucocorticoids and ultraviolet irradiation.

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Rosacea

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The disease is caused by an increased reaction of the skin to external irritation and increased permeability of blood capillaries. It appears as small red spots on the cheeks and nose. If larger vessels are affected, purple spots form in their place.

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Increased vascular permeability is due to their altered reactivity to signals from the nervous system. Therefore, rosacea lesions become brighter after drinking hot drinks, spicy food, or, for example, when coming from a frost into a warm room. Rosacea breakouts are not associated with infection and require different treatment than regular acne.

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Newborn acne

The elements are localized on the face and head of a newborn and infant. They look like small white pimples, less often tubercles (papules) and pustules. Such acne differs from an allergic rash by the unchanged surrounding skin, the absence of itching and the absence of association with the use of new types of food. The general condition of the child does not change.

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By three months the rash usually goes away. Its occurrence is due to hormonal imbalances in the mother during pregnancy. If neonatal acne persists in a child older than one year, this is no longer the norm and requires contacting a dermatologist.

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Acne in children

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This form of the disease is accompanied by the appearance in young children of a large number of inflammatory elements - papules (red bumps) and pustules (pustules). Usually the pathology is caused by disturbances in the child’s endocrine system - adrenal hyperplasia, tumors that produce androgens. Therefore, when a rash appears, a thorough examination is necessary.

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Inverse acne

Damage to the sebaceous glands in this pathology is accompanied by inflammation of the nearby sweat glands. As a result, large ulcers are formed that break through the skin. Typically, lesions are located under the arms, around the nipples, in the umbilical area and perineum.

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Inverse acne occurs secondary to severe acne. Their appearance is promoted by skin irritation, sweating, obesity, and mechanical stress. They look like small elevated formations that gradually soften and open with the release of pus. Gradually, the lesion heals and scars with the formation of a rather large retracted scar. The course of the disease is long and difficult to treat.

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How to remove acne scars on your face, read the previous article.

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Lightning acne

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This is a severe complication of ordinary inflammatory acne in youth. Against the background of a stable course of the disease, the temperature suddenly rises and signs of intoxication appear. Pustules appear on the skin of the entire body, with the exception of the head, quickly necrotizing with the formation of ulcers and subsequent scarring.

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Acne fulminans most often affects adolescents 15-18 years of age with concomitant diseases of the digestive organs, such as colitis or Crohn's disease. It is assumed that irrational treatment of acne with antibiotics, retinoids, and hormones plays a certain role in their appearance.

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Tropical acne

Appears mainly in young women after using sunscreen cosmetics and exposure to the sun or in a solarium. It is caused by the comedogenic effect of such cosmetics, associated with blockage of the excretory ducts of the sebaceous glands with oxidized cocoa, sea buckthorn, and coconut oils contained in it.

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The face, neck, shoulders, and arms are affected. White-headed comedones, papules and pustules appear on the skin. The rash appears in summer and disappears in winter.

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Excoriated acne

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This type of acne is a complication of common acne in people with obsessive-compulsive disorder, more often in women. Having noticed a pimple, they immediately begin to squeeze it out, scratch it and damage the skin. As a result, a bacterial infection occurs, purulent elements appear, which heal with the formation of scars.

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Acne caused by endocrine diseases

Part of the pathogenesis of acne is a disturbance in the metabolism of hormones, primarily sex hormones. Therefore, many diseases accompanied by hormonal imbalance are accompanied by different types of acne. These include:

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1. adrenogenital syndrome;
2. polycystic ovary syndrome;
3. adrenal tumor;
4. Itsenko-Cushing syndrome;
5. some pituitary tumors;
6. diabetes mellitus and others.

Rare forms

What to do if acne appears

Acne of any type requires long-term treatment. Sometimes improvement occurs immediately, but more often the skin condition does not change during the first weeks or months. The patient should not take too many medications at once. This can cause dry skin and the body's response in the form of increased sebum production.

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If any skin formations appear, an examination by a dermatologist is necessary. This is necessary in order to distinguish acne from other skin diseases, such as:

Just yesterday our skin was smooth and impeccably clean - and today these disgusting red bumps suddenly appeared on it. Common situation? For sure. And the solution, it would seem, is known - press! But don't rush to the mirror.

What are the types of acne and how to deal with them – the question is not as simple as it seems. Any dermatologist will remember dozens of cases when, as a result of self-medication or unprofessional medical care, completely harmless rashes turned into real acne with very unpleasant consequences.

In this review, TecRussia.ru deals with the problem in order: from the causes of its occurrence to the main approaches to treatment and prevention, but we still recommend entrusting individual diagnosis and therapy to a qualified specialist.

Where and how do acne appear, what are they?

The sebaceous glands are located under each pore on the human skin, at the base of the hair follicle. Their task is to provide hydration to the skin and protect it from negative external influences. Problems begin in case of excessive production of sebum, which clogs the skin pores (you can find out why this happens in the article “Acne: causes, symptoms, complications”).

If the pore is partially closed and there is air access into it, blackheads form, which look like black dots surrounded by inflamed skin. In a completely clogged pore, like in a container, bacteria begin to multiply, causing inflammation and suppuration. When the wall of the hair follicle bursts under the pressure of pus, a “classic” pimple forms on the skin.

Most often, acne appears in the locations of the largest sebaceous glands - on the face (forehead, temples, cheeks, nose, chin), under the hair on the head, on the neck, chest, shoulders, upper back. The variety of types of acne has led to the creation of several classifications: according to the severity of manifestations on the skin, according to the degree of inflammation, clinical division according to the reasons for their appearance, etc.

“Theory of species”: pimples, blackheads, acne

In the most general form, all our pimples belong to one of two types:

1. inflammatory – immediately catches the eye due to its size; the skin around becomes thinner and redder, purulent contents visible through it; when palpated, they usually cause painful or uncomfortable sensations.
2. without inflammatory process – practically non-contrasting with the skin, they look like small tubercles or dots of different colors. But it is enough to introduce an infection into them through negligence or due to improper care, and they instantly move into the first category with all the ensuing consequences.

Acne without inflammation is called comedones. They occur when the ducts of the sebaceous glands or the mouths of the hair follicles become clogged with plugs of thickened sebum and dead epithelial cells. Comedones are:

1. Open – look like black or brown dots. This is the result of a clogged pore on the upper side, near the surface of the skin. Initially, the stuck lard has the appearance of a transparent or white mass, which over time, under the influence of oxidation, first acquires a yellowish and then a characteristic black color. The size of such a pimple is 1-2 mm, the color can vary - from light yellow to brown or dark gray, but there will always be a black dot in the center. For treatment, regular home or cosmetic care is quite enough; open comedones do not cause much trouble until they become infected and the inflammatory process begins.

1. Closed – have the appearance of white tubercles or dots, often called milia or wen (the latter is not entirely correct, since a wen is another independent skin formation). They occur when the lower part of the pore is blocked from the inside. Their structure is similar to blood clots, which do not have the opportunity to come to the surface naturally. The size of a closed comedon can reach 2-3 mm, while sometimes they are invisible externally and can only be determined by touch. Most often they form on the forehead, cheeks, cheekbones, and chin, but do not cause physical discomfort. Despite their apparent harmlessness, milia are quite dangerous - they tend to combine with neighboring inflamed pimples, forming a large subcutaneous cavity that gradually fills with pus. Attempts to remove them at home usually lead to infection, so it is better to entrust this task to a professional cosmetologist.

Inflammatory acne is divided into:

1. Papules (red pimples) – develop when infection enters the comedones. They reach sizes from 0.1 to 1 cm, look like red or pink balls protruding above the surface of the skin, there is no white head. If a papule has formed at the site of an open comedone, then a dark plug can often be seen through the skin. Superficial papules of small size after recovery, as a rule, do not leave noticeable consequences in the form of scars, but a dark spot may remain for a short time.
2. Pustules (purulent pimples) – formations ranging in size from 0.1 to 1 cm with purulent contents and a white head, surrounded by inflamed skin. They are formed from papules, but sometimes they can arise independently. They are cone-shaped, flat or spherical in shape. The color of the pustule can vary from white to yellow or green, the latter shades indicating the presence of a secondary infection that requires immediate treatment by a qualified dermatologist. The danger of this type of acne is that at the time of acute inflammation or self-squeezing, there is a high probability of infection entering the blood.

1. Nodes – deep papules of bright red, bluish or purple color, ranging in size from 1 to 3 cm, can be located throughout the entire depth of the skin. Painful to the touch and at rest, after recovery they leave pigment spots, atrophic or keloid scars of significant size.
2. Cysts - a dense subcutaneous formation filled with purulent contents. When several cysts appear next to each other, they tend to merge, forming a whole chain connected by fistulas (a narrow channel in the tissues). They are difficult to completely cure and always leave noticeable marks on the skin.

Classification of acne according to severity of manifestations

Dermatologists distinguish 4 degrees (stages) of acne, each of which has its own severe symptoms:

10-11) the appearance of acne of various types - blackheads, comedones, redheads, pustules - in the face, shoulders, upper back. It occurs at any age, and is also typical for women before or during their menstrual periods. Self-treatment at home is possible, but if after 2-3 weeks there are no results, a consultation with a dermatologist is necessary, otherwise the situation is likely to develop into the next stage, and scars may subsequently remain on the skin.

Medical classification of acne

In clinical medicine, acne is usually divided and structured based on the reasons for its appearance:

1. Children's – appear in newborns due to the hormonal effects of the mother’s body on the fetus during intrauterine development. Most often these are white closed comedones located on the nose, forehead, and cheeks. A few weeks after birth they go away on their own. But the appearance of the same pimples in older children is already a reason to consult a dermatologist.
2. Teenage or youthful acne to one degree or another affects more than half of boys and girls (more often the latter due to the peculiarities of the sebaceous glands) during puberty. They are located mainly on the face, back and shoulders. Caused by a change in the amount of production and quality composition of sebum, which becomes thicker and more viscous, prone to clogging pores. By the time the “adolescence” ends, they go away on their own, provided that fairly simple rules of home care are followed. If after 18-20 years the acne still does not go away, you may need more serious treatment from a dermatologist or cosmetologist.

1. Adults – appear in approximately 5% of the sexually mature population over 20 years of age. It can be:

1. late acne, not past puberty; inverse acne – a chronic form of acne with frequent relapses, characterized by the addition of an inflammatory process in the apocrine sweat glands, located mostly in the armpits, groin area, and around the areolas;
2. "bodybuilder acne" – associated with taking steroids and various specialized drugs that affect the hormonal levels of athletes; spherical (accumulated, conglobate) acne - the fusion of individual comedones with the formation of spherical dense infiltrates of a blue-purple color, filled with pus.
3. Exogenous acne, that is, caused by harmful external influences - inhalation, ingestion, contact with the skin of certain toxic substances - for example, incorrectly selected or incorrectly applied cosmetics, low-quality household chemicals. The appearance of acne can be the result of a long stay in a hot climate, when the sebaceous glands begin to produce more secretion to moisturize and protect the skin, or an allergic reaction to active solar radiation.
4. Pimples caused by mechanical stress, in particular due to the habit of constantly rubbing or stroking certain areas of the skin, due to artificial blockage of pores (plaster cast, tight tight clothing, constant friction of foreign objects against the skin).

There are several additional types of acne, which to one degree or another relate to the above classification:

1. Hormonal – caused by changes in the balance of hormones in the body. This could be premenstrual acne in women, acne due to malfunctions of the endocrine glands, as well as “side effects” from long-term use of certain medications.
2. Stressful – arise as a consequence of nervous tension, which negatively affects the immune system and hormonal levels (by the way, this is what explains the well-known “phenomenon” of acne appearing on the eve of a first date or other important event).
3. Against the background of reduced immunity, arising, for example, due to certain intestinal diseases.
4. Against the background of hyperkeratosis, which is accompanied by a thickening of the stratum corneum of the skin, its overflowing with toxins and bacteria.
5. From excessive skin hygiene. As a result of excessive cleanliness and increased use of antibacterial hygiene products, the skin becomes excessively dry, its protective sebaceous layer is washed away, opening access to the pores for infections.

Acne treatment

The main rule, which doctors and cosmetologists tirelessly remind us of, is to never squeeze out pimples yourself! The result of such home self-treatment can be a variety of consequences - from the spread of acne and secondary blood infection to the appearance of scars and age spots. Acne therapy is a complex process that includes several stages:

1. Prevention of the formation of new comedones, which includes the selection of products for the care of problem skin, general improvement of the body - normalization of nutrition, increased immunity, assessment of the effect of medications taken on the body.
2. Removal of already formed comedones using drugs with a comedolytic component - mainly azelaic acid, benzoyl peroxide, adapalene, tretinoin, tazarotene, etc. are used.
3. Reducing the volume of sebum secretion (a reduction of up to 30% or higher is required) through the use of drugs from the group of retinoids and hormones.
4. Exfoliation of dead cells from the surface of the skin using peels based on retinoids, salicylic or glycolic acids.
5. Facial cleansing with ultrasound and other low-traumatic hardware methods is an alternative to chemical salon peels.
6. Treatment of inflammatory processes with external and internal antibacterial drugs.
7. Cosmetological elimination of the consequences of acne - various types of dermabrasion, laser resurfacing, cryotherapy, mesotherapy, ozone therapy, etc. (see also the article “Acne Scars: 15 Ways to Get Rid of Scars”)
8. If necessary, parallel normalization of the functioning of body systems is carried out - treatment of chronic systemic, gynecological, endocrine, gastrointestinal diseases.

Preventing acne

To prevent the appearance or recurrence of acne, just follow a few simple rules:

1. Cleansing the skin in the morning and evening with soft water-soluble products and specially selected tonics that simultaneously moisturize the skin.
2. Removing makeup every night is mandatory, especially if it uses thick foundation or liquid powder.
3. The temperature of the water for washing should be moderately comfortable - cool or slightly warm.
4. Depending on the condition and type of skin, it is necessary to regularly perform exfoliation - exfoliation of dead epidermal cells. For this purpose, scrubs (mechanical peeling) and chemical peeling (products based on tretinoin, salicylic or glycolic acids) are used. To avoid increased stress on the skin, it is not recommended to use both types of exfoliants at the same time. It is preferable to choose chemical peeling, as scrubs can harm healthy skin.
5. The skin needs hydration and a supply of antioxidants from home care products that are correctly selected by type.
6. External use of antibacterial agents, for example, based on benzene peroxide.
7. Regular use of sunscreen, especially after exfoliating treatments, such as mattifying foundation with SPF.
8. Regularly changing clothes, bed linen and face towels prevents possible contact of bacteria with the skin.

From this article you will learn:

1. acne on the face: causes of appearance,
2. acne on the face - photo, how they differ from acne,
3. acne - treatment.

Facial acne is a disease in which plugs consisting of sebum and desquamated skin cells form in the skin pores. The disease is usually called by the terms: acne or acne, and acne itself is often called acne vulgaris or comedones.

Acne is usually divided into two types –

1. Closed acne (Fig. 1-3) –
   they are white in color and look like white bumps on the surface of the skin. The plugs inside them are not visible.

1. Open acne (Fig. 4-6) –
   plugs are clearly visible inside the pores, because are black. The dark color of corks is not caused by dirt, as is commonly believed, but by the skin pigment melanin.

Acne: photo

Almost all people have acne on their nose. Acne on the forehead, chin, and cheeks is quite common.

In many articles, incompetent authors often call acne vulgaris - pimples. Although acne and pimples are completely different things, which are even treated differently... With acne, there are fat plugs in the skin pores, with a complete absence of inflammation inside and around them. A pimple is a hair follicle that has already festered under a plug, around which inflammation develops (Fig. 7).

In dermatology there is also the term Acne. This term combines both acne and pimples, and also includes the consequences of the healing of large pimples and cysts - scars and age spots.

Acne on the face: causes of formation

Hair follicles and the sebaceous glands located around them take part in the formation of acne. From such follicles hairs grow on the face, penetrating the surface of the skin through the skin pores (Fig. 8a). The sebaceous glands, in turn, produce sebum, which penetrates through ducts first into the lumen of the hair follicle, and then through the pores onto the surface of the skin.

The appearance of acne is associated with 2 main factors:

1. Increasing the production of sebum by the sebaceous glands -
   it usually occurs in adolescents during puberty. During this period, the amount of hormones (androgens) in the blood increases, which are produced both in men and in smaller quantities in women. Androgens tend to enhance the function of the sebaceous glands.

1. Keratosis of the epithelium of the hair follicle -
   The inner walls of all hair follicles are covered with epithelial cells. These cells, like any other cells on the surface of the skin and mucous membranes, are gradually exfoliated, and new ones appear in their place. A disruption in the rate of keratinization of epithelial cells (called keratosis) leads to an increase in the number of exfoliated dead cells in the lumen of the follicle.

As a result of these two processes, skin pores become clogged with plugs consisting of sebum and desquamated epithelial cells. Moreover, the sebaceous glands still continue to produce sebum. But due to the plugs, it can no longer reach the surface of the skin and accumulates in the lumen of the hair follicle, stretching its walls (Fig. 8b).

If such plugs form deep in the skin pore (closer to the hair follicle), then closed whiteheads appear (Fig. 9,1,2,3). If plugs form in the upper part of the skin pores, then open blackheads with black heads are formed (Fig. 10,4,5,6).

How do pimples form from acne? –

If bacteria brought from the surface of the skin are inside the clogged hair follicle, inflammation develops, which consists of the formation of pus inside the follicle. This is a real pimple (Fig. 7), and not an acne.

You will find more information on the treatment of acne in our article:
→ “All about acne treatment”

Acne on the face: predisposing factors

The main reason for acne is the increased production of androgens during puberty. However, this is not the only factor that contributes to the appearance of acne. Predisposing factors are also:

1. Fat-based cosmetics –
   Skin care products and cosmetics can cause acne if they are oil-based. For the face, it is advisable to use products that are water-based (such products do not clog skin pores).

1. Birth control pills and hormonal changes –
   Women may experience a regular exacerbation of acne once a month, associated with hormonal changes in the premenstrual period. Birth control pills can only stimulate acne if the pill contains only pure progesterone.

1. Medications -
   If you are taking anticonvulsants, bromides, lithium, iodides, prednisolone or its analogues, as well as steroid hormones (usually taken by athletes), keep in mind that they can stimulate the appearance of acne.
2. Increased sweating -
   If, due to physiology or due to increased physical activity or work conditions, you often sweat, this can aggravate your acne.

Acne: treatment at home

How to get rid of acne?... The most difficult thing in treating acne is making the right choice of preparations for treating facial skin. Anti-acne products are sold in pharmacies and on the Internet in huge quantities. Moreover, many of them are practically ineffective, and only a dermatologist or cosmetologist can correctly evaluate and select drugs for treatment.

1. It is better to start treatment of acne in adolescents as early as possible, because... in this case, it is possible to prevent the transformation of acne into pimples, after which scars and age spots remain on the skin.

1. Treatment of acne in women is carried out in the same way as for other groups of patients (you will see basic therapy below). If the effect of basic therapy is insufficient, birth control pills or spironolactone may be prescribed.

Acne treatment regimen –

Below you can familiarize yourself in detail with the groups of drugs outlined in the scheme.

1. Retinoids –

Preparations of the Retinoid group belong to vitamin A derivatives. And this is probably the best remedy for acne. The use of retinoids helps remove existing plugs (blackheads) from the skin pores, and also helps prevent the appearance of new acne. The highest effectiveness is with retinoids in the form of lotions; Gels are slightly inferior to them, and creams are the least effective.

Modern retinoid drugs are made on the basis of Tretinoin, Adapalene or Tazarotene. Keep in mind that preparations with retinoids can be either single-component or combined. Monocomponent retinoids are used when there is acne on the skin (without acne), and combined retinoids are used when there is a mixed form, i.e. when the skin has both blackheads and pimples.

Monocomponent retinoids -
1) with tretinoin: Retin-A (USA), Lokacid (France) and Airol (Switzerland)
2) with adapalene: Differin (France), Clenzit (India), Deriva (India)
3) based on tazarotene: Zorak (Germany), Tazret-gel (India).

Combined drugs -
Retinoids are usually combined with either an antibiotic or benzoyl peroxide. These components are very effective when, in addition to acne, there are inflamed pimples on the skin.

1) “Epiduo” (France), “Effezel” (France) – retinoid Adapalene + benzoyl peroxide,
2) “Deriva-S”, “Klenzit-S” - contain Adapalene + the antibiotic clindamycin.

Application scheme –
Retinoids are used only once a day (at night) - 20 minutes after washing your face with a mild cleanser. The course of treatment is at least 3 months, but you will see a good result within 5-6 weeks. You need to start using the drug 3 times a week, gradually moving to daily use. In this case, the skin will not be very irritated and will quickly get used to it.

1. slight burning or skin irritation may occur,
2. retinoids should not be used together with peeling products (significant skin irritation is possible),
3. increased skin sensitivity to the sun (be sure to use sun protection on sunny days).

2. Azelaic acid –

Preparations based on azelaic acid exfoliate dead layers of skin, helping to remove traffic jams, and also have an antibacterial effect. For acne, azelaic acid is prescribed as an independent treatment, and for acne with pimples - as an addition to benzoyl peroxide or antibiotic gel.

For oily skin it is better to use gels, and for dry skin - creams with azelaic acid. Examples of drugs: Skinoren (Germany), Azix-derm (India), Azogel (Russia), Acne-derma (Poland).

Features of application –
The drug is applied 2 times a day to areas of the skin that have acne. The effect will be noticeable within 1 month from the start of treatment. The course of treatment is at least 3 months. The positive features of azelaic acid are that it does not increase skin sensitivity to the sun, prevents the appearance of age spots, and also causes less skin irritation.

3. Salicylic acid –

Acetylsalicylic acid has the property of dissolving the fatty substrate that makes up acne, as well as exfoliating dead skin cells. Acne preparations based on salicylic acid come in 0.5% or 2% concentrations, both in the form of lotions and gels. An example is the “Clearasil” line of products in the form of lotion, cream and gel.

For acne, salicylic acid has a good effect, but it is still at least 2 times lower than from the use of retinoids. But the use of salicylic acid not for acne, but for pimples, is generally ineffective and simply makes no sense.

Features of application –
Be prepared for the fact that if you regularly use products with salicylic acid, your skin will become red and flaky. If you have dark skin, keep in mind that salicylic acid, when used regularly, will cause pigment spots to appear on the skin.

4. Treatment of acne with antibiotics -

Treatment of acne with antibiotics cannot be effective because acne is not an inflammatory or infected formation. An acne is a pore clogged with sebum, in the depths of which sebum secreted by the sebaceous glands accumulates. Therefore, antibiotics are not used for acne, but for acne, on the contrary, this is one of the main types of treatment.

Summary -

Above we have listed an exhaustive list of drugs that are used specifically for acne. If the result of treatment with these drugs was insufficient, then similar drugs with higher concentrations of active elements are selected.

Important: if you have not only acne, but also pimples at the same time -
in this case, in addition to retinoids and azelaic acid, the following groups of drugs are used:

1. gels, lotions and creams with benzoyl peroxide (very effective!),
2. or antibiotics in the form of gels for topical use.

You can find out about the properties and brands of these drugs in the article: “Drugs for the treatment of acne”

Three additional rules for treating acne at home -

In addition to the basic treatment with retinoids, azelaic or salicylic acids, you must always follow three important rules...

Mild peeling preparations can be used periodically. You can do this peeling even at home, but you just need to use professional products for home use, but not soda, aspirin or lemon. Such products most often contain glycolic acid, which exfoliates dead surface skin cells, which also helps open pores.

→ special toners for cleansing oily skin,
→ special cosmetic strips (Fig. 19), which are attached to the surface of the skin on the nose, forehead, cheeks or chin to remove sebum from the pores (Nivea, “Propeller”, etc.).
→ special cosmetic masks will help draw out sebum from the skin.

Is it possible to squeeze out blackheads?

You need to make sure to keep your hands away from blackheads. This is due to the fact that squeezing out acne can: firstly, lead to deep infection and the development of purulent pimples, and secondly, in some cases, when compressed (especially closed acne), the membrane in which the sebaceous gland fat is located ruptures.

This leads to sebaceous gland fat not reaching the surface of the skin, but deep into the soft tissues, which will cause inflammation in the deep layers of the skin and suppuration. It is best to use special strips and treatment masks designed to extract sebum from the pores.

But in some cases, dermatologists and cosmetologists still recommend acne removal. This is done using special tools “comedone extractors” (Fig. 20 and video).

Squeezing out blackheads: video

We hope that our article on the topic: How to remove acne from your face was useful to you!

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