Androgen is the main hormone that regulates the activity of human sebaceous glands. Excessive secretion of androgen and exuberant secretion of sebaceous glands will lead to acne.
For women, before or during menstruation, under the influence of decreased estrogen, acne will grow repeatedly, and after menstruation, acne will disappear.
Generally speaking, there are two kinds of acne: open acne (blackhead) and closed acne (bald head). Acne is the result of acne inflammation.
Acne = open acne+closed acne = no acne infection.
Open acne = blackhead
Closed acne = hoary head
Acne = inflamed acne
It is very important to solve the red acne marks in time.
There are four kinds of acne marks: red acne marks, black acne marks, concave acne pits and proliferative acne scars.
Red acne marks are caused by acne inflammation that has not completely subsided and telangiectasia that has not yet contracted. Generally, it will subside by itself within 3 months. If timely and effective improvement measures are taken, the repair can be accelerated.
Black acne marks are caused by melanin deposition after inflammation subsides. According to different personal constitutions, it takes half a year or even several years to gradually subside. All kinds of external products and methods have a slow effect on black acne marks, and it needs long-term persistence to have an effect. If you want to solve the black acne marks quickly, you can choose medical beauty means, such as photon rejuvenation and laser.
Pocket pits are caused by excessive acne inflammation or acne being repeatedly squeezed by external forces, resulting in a large loss of collagen, which causes the dermis to collapse and form pits. Once a pockmark is formed, it cannot disappear by itself. External products are basically ineffective and can only be used for medical beauty, such as micro-needle, radio frequency, hole filling and laser.
Pocket scar is an obvious bulge left by acne inflammation, which is an overgrowth scar. Generally related to personal physique. Pocket scars, like acne pits, can't disappear by themselves once they are formed, and external products have limited effect on them.
Folliculitis may also cause acne. There are many reasons for folliculitis, most of which are fatigue, staying up late, decreased resistance, or improper diet, which leads to bacteria invading the human body and causing inflammation.
Vitamin A can regenerate the skin. The combination with zinc can not only inhibit the proliferation and hyperkeratosis of hair follicle epithelial cells, but also regulate the secretion of sweat glands and reduce the erosion of acidic metabolites on the skin.
Vitamin C can effectively repair the tissue damaged by acne.
Vitamins B2 and B6 can participate in protein's fine metabolism, promote fat metabolism, accelerate cell biological oxidation and calm acne.
Vitamin e has a good acne removing effect. Users should judge whether they meet their own requirements according to their own skin conditions. Vitamin e for acne is a capsule product, which is rich in oil. Vitamin E is not recommended for patients with oily skin.
Oral administration: isotretinoin soft capsule (taken with high-fat food, avoid sunlight)
External use: Adapalene gel (Daphne, face and back at night), benzoyl peroxide gel (Bansai, daytime), Lion King acne cream (used to treat red and swollen acne and formed acne).
Shrinking pores: lactobionic acid stock solution (Huayu wood)
Pocket print: snow-brewed plant extract gel (Centella asiatica component)
Back acne: sulphur soap, ketoconazole lotion (Le Cai)
Cleanliness: facial cleanser (amino acid)
Care: Toner, lotion, sunscreen spray, lip balm.
Others: bubble mask (frequency more than 2 days, 1 time), nasal patch with tear film (physical principle, need to cooperate with pore contraction products)
Eat more: water, fruits (except mangoes), vegetables, light and vitamins (A, B2, B6, C, E).
Eat less: spicy, sweet, greasy, sugar, seafood (shrimp, crab, shells, etc. ), mango.
Eat less: coffee, drinks and wine.
Irrelevant: eggs
Drink more water, sweat more, exercise more and stay up less.
Cleanliness should be in place, wash your face more often, rinse with clean water after washing, and use appropriate facial cleanser.
Avoid eating, eat more fruits and vegetables, eat less sugar and oil, eat less seafood and eat less hair.
Eat more foods rich in vitamin A such as egg yolk and whole milk. Vitamin A can promote epithelial cell proliferation, regulate skin sweat glands and eliminate acne. In addition, beta carotene in carrots, papaya, spinach and other fruits and vegetables can also be converted into vitamin A in the human body. Second, eat more foods rich in vitamin B2, such as green vegetables and milk. Vitamin B2 can keep the hormone balance and protect the skin. Third, eat more foods rich in vitamin B6, such as beans, bananas and wheat germ. Vitamin B6 has the function of anti-dermatitis, also known as "anti-dermatitis vitamin".
On this basis, eat less high-fat and high-sugar foods, because high-energy foods will increase the secretion of sebaceous glands, leading to the continuous emergence of acne. Also eat less spicy and irritating foods such as peppers, because these foods will stimulate sebum secretion, thus aggravating the condition.
The acne on people's faces is more acne. And the acne on our backs, most people belong to folliculitis. About 90% of people with acne on the back belong to fungal folliculitis, 10% belongs to bacterial folliculitis, and only a few people are caused by acne.
Therefore, to treat back acne, you can go directly to the hospital dermatology clinic and let a professional dermatologist prescribe the corresponding medicine.
If you don't want to go to the hospital, you can try to treat fungal folliculitis first. Because the acne on most people's backs is caused by fungal folliculitis. Even if it is not fungal, the treatment of fungal folliculitis has a certain effect on bacterial folliculitis and acne. The treatment plan is introduced as follows.
For mild &; For moderate folliculitis, it is necessary to pay attention to daily cleaning work to inhibit the growth of fungi. The specific scheme is as follows:
Because the main cause of fungal folliculitis is a fungus called Malassezia. Ketoconazole lotion can effectively inhibit Malassezia, so it has a good therapeutic effect on back acne. So ketoconazole lotion has a good effect on fungal folliculitis.
Because ketoconazole lotion can effectively inhibit Malassezia, and Malassezia is not only the culprit of dandruff, but also the culprit of fungal folliculitis. Many dermatologists will recommend ketoconazole lotion to treat some symptoms caused by malassezia. For example, dandruff in the head, fungal folliculitis in the back, tinea versicolor in the waist, etc.
Attention should be paid to the treatment of fungal folliculitis with ketoconazole lotion;
For shower gel, just buy a refreshing shower gel. If the budget is high, you can also consider shower gel with whitening ingredients. Because after acne, how many will leave acne marks. Using shower gel containing whitening ingredients can accelerate the disappearance of acne marks while removing acne.
Severe folliculitis is not only an infection of fungi and bacteria, but also accompanied by abnormal keratinization of hair follicles.
At this time, acne will not only appear singly or densely, but also form purple nodules. It just feels like a big piece of meat.
If the acne on your back has reached such a serious level, it is strongly recommended to go to the hospital. This is not the degree of self-solving. Please give it to a professional doctor.
If you insist on using the above treatment methods for one month, the effect is still not obvious. Then the acne on your back may be caused by bacterial folliculitis or acne. At this time, I also suggest that you go to the hospital to see a doctor, and leave professional matters to professional people.
But most people, through the above methods, should have cured the acne on their backs. And the rest, even if not cured, will have some improvement.
Pay attention to daily cleaning and use drugs properly. Don't go back to your original life immediately after the acne situation improves. Otherwise, the acne on the back is likely to resurface.
Therefore, after the effect comes out, you should continue to adhere to it for a period of time, wait until it is eradicated, then stop taking the medicine and switch back to the ordinary moisturizing shower gel. This period will take about 1-2 months.
For acne marks, if you don't care, they will disappear naturally after a few months. If you want to get quick results, you can use body lotion containing fruit acid or skin care products containing whitening ingredients, but the effect is limited.
Adapalene belongs to the third generation of tretinoin for external use.
Try to use it at night, because it is sensitive.
Tolerances should be gradually established when using.
It has anti-inflammatory effect.
principle
Regulate keratin metabolism and reduce oil secretion. It can reduce the generation of blackheads, but it cannot directly remove oxidized blackheads.
It is recommended to use SCT for short-term contact therapy, and the steps are as follows:
The content here is excerpted from Professor Yang Xichuan, a dermatologist. And re-typeset
0 1 dry
Drying includes lip dryness, nasal dryness and skin dryness.
Dry lips
Is the most common side effect, almost every patient who takes isotretinoin soft capsules has this experience. You can feel it after taking 1-2 weeks. Of course, this is also a sign to judge the effectiveness of drugs. Usually, proper attention should be paid to strengthening moisturizing, such as applying moisturizing lipstick, which can basically alleviate it.
Because everyone has different tolerance to drugs, some patients can't relieve it even if they take a small dose and strengthen moisturizing, which is serious enough to chapped lips and bleeding. At this time, it is necessary to reduce the dosage of drugs and stop taking drugs if necessary.
Dry nose
About 60% patients who take isotretinoin will feel dry nasal mucosa, and nearly 40% patients will report that the dryness is serious enough to cause nosebleeds. At this time, you can gently smear the nasal cavity with a cotton swab dipped in vaseline or erythromycin ointment to avoid aggravating bleeding.
Skin xerosis
Usually accompanied by a certain degree of itching or rash (retinoic acid dermatitis), such as erythema rash on the arms, neck or cheeks. This is the second common side effect of isotretinoin soft capsules. Almost half of patients who use this medicine have this side effect, but it can be alleviated by paying attention to moisturizing at ordinary times.
In addition, people with a history of allergies, eczema and allergic asthma are more likely to have severe skin dryness and itching. Moreover, this side effect is often dose-dependent, especially in patients who take high doses of isotretinoin soft capsules, which are more prone to dry skin and mucous membranes.
Dry eyes
About 40% people who take isotretinoin have dry eyes. For most people, this side effect is only temporary and can be relieved and disappeared in the first two months of treatment. However, about 25% patients had dry eye during the whole treatment.
In addition, some patients, especially those who wear contact lenses, will also have conjunctivitis (congestion and red eyes). Usually, the use of artificial tears helps to relieve the symptoms of dry eye.
02 pain
Pain includes joint, muscle and bone pain; Headache; Chest pain.
Pain in joints, muscles and bones
Although the most common side effects of isotretinoin involve skin and mucosa, some patients may have musculoskeletal side effects: 28% patients have back pain; 29% often have joint pain; 26% people have experienced muscle soreness.
Usually, these symptoms will disappear after the first month of treatment. However, some patients continue to suffer from pain during the whole treatment period, with 5% patients treated with low dose and 8-9% patients treated with high dose. They report persistent pain within one year after treatment, but for subsequent persistent pain, other factors should also be excluded.
have a headache
During isotretinoin treatment, 10%- 12% patients reported headaches.
Headache does not seem to be dose-dependent, because patients with lower doses have the same headache risk as patients with higher doses.
Most of the time, the headache caused by isotretinoin is mild and not serious.
chest pain
Two studies reported that a small number of patients taking isotretinoin had chest pain. Although it is not clear how isotretinoin causes chest pain, it is a serious side effect. Patients with chest pain during taking isotretinoin should seek medical attention immediately and stop taking the medicine.
03 sensitive
Sensitivity including facial flushing, increased sensitivity to sunlight.
facial flushing
Some people may feel that their skin is easily flushed and sensitive after taking medicine, and they often doubt whether they are "rose acne", so they have to report their medical history in detail when they see a doctor. Whether it is flushing after taking medicine or frequent flushing before drug treatment, the symptoms of flushing are further aggravated after drug treatment.
If it appears after taking the medicine, it is likely to be related to the medicine. Isotretinoin may indeed cause flushing, but this adverse reaction is not particularly common (usually in large doses, but it may also occur in small doses), and usually it can gradually disappear after stopping taking the drug. In the process of treatment, if the symptoms of flushing are mild and have little effect, it is not necessary to stop taking the medicine, but we should also pay attention to avoiding facial irritation and avoiding factors that aggravate flushing as much as possible, such as
However, if flushing often occurs before drug treatment, it is necessary to rule out whether there are other skin diseases, including rose acne, which is frightening. Of course, acne itself may also cause barrier damage, leading to facial skin sensitivity.
Increased sensitivity to sunlight
Increased sensitivity to sunlight is another relatively common side effect of taking isotretinoin. 5%- 12% patients reported increased sensitivity to sunlight and increased risk of sunburn.
Sensitivity to sunlight is related to dose. Patients receiving high dose (more than 0.5mg/kg/ day) are more likely to have this side effect than patients receiving low dose treatment.
However, no matter the dose, side effects may occur. Therefore, preventive measures should be taken when taking isotretinoin, such as applying sunscreen regularly, playing with umbrellas and wearing wide-brimmed hats.
Temporary deterioration of acne
Temporary aggravation of acne, also known as "acne rash", may occur in about 30%-35% of patients at the initial stage of medication, especially in the first 1-2 months.
The specific mechanism is not clear, but we can understand that drugs (tretinoin) accelerate the aging and death of acne, especially in patients with intensive acne, giant acne and deeper acne (common in cheeks and mandible), and it is likely that acne will temporarily worsen when facial inflammation is serious.
Usually, if the degree of acne is not serious, it is not necessary to stop taking the medicine, which is temporary and can be relieved by continuous treatment. However, if the degree of acne is serious, it is necessary to stop taking drugs and take small doses of hormone drugs when necessary.
05 visual effect
In addition to the dry eye mentioned above, the vision of the eyes may also be affected.
There are 5%- 10% patients who may have vision changes, and the most common is decreased vision at night. There are also cases of excessive sensitivity to strong light and changes in color vision.
Retinoic acid competitively inhibits retinal dehydrogenase in eyes and reduces the production of rhodopsin, which may be the cause of night blindness.
06 chronic fatigue
Chronic fatigue is also a common side effect of isotretinoin, and sometimes it may be serious enough to need to stop treatment.
A study found that as many as a quarter of patients feel tired in the first month of treatment, and many patients continue to feel this side effect during treatment.
Like other side effects, fatigue seems to be dose-related. A study found that only a few patients who took low doses of isotretinoin felt tired.
Sleepiness is also one of the manifestations of chronic fatigue, but it has little effect. Some patients put forward according to their own experience that drinking more water can relieve drowsiness, and the authenticity remains to be investigated.
07 alopecia
Hair loss is also a common side effect of isotretinoin, but the probability of occurrence is not very high. 9% patients were interviewed.
Hair loss does not seem to be dose-dependent, because taking a lower dose of isotretinoin does not reduce the possibility of this side effect. In fact, this kind of hair loss belongs to static hair loss, which is only temporary and can be recovered after treatment.
According to a study, patients may find hair loss early after starting isotretinoin treatment, but this side effect usually disappears quickly. Moreover, a study also reported an unusual side effect, that is, after taking isotretinoin, the texture of patients' hair changed from straight to curly.
08 Menstrual influence
Drugs may have an effect on menstruation. If the effect is not great, there is no need to stop taking drugs, and in order to ensure the therapeutic effect, there is no need to stop taking drugs during menstruation.
If menstruation is abnormal before medication, such as less delay and fewer times, it is necessary to further rule out whether there are endocrine abnormalities, such as polycystic or hyperandrogenism.
Other side effects
In addition to the above-mentioned common side effects, there are some other serious side effects, such as teratogenesis, abnormal liver function, depression and so on.
grow abnormally
Isotretinoin has teratogenic effect (dose-independent), which can lead to spontaneous abortion and serious life-threatening congenital malformation. Embryonic diseases associated with isotretinoin exposure in early pregnancy include craniofacial malformation, cardiac malformation, thymus malformation and central nervous system malformation.
Because you need to make sure that you are not pregnant before you start taking isotretinoin soft capsules, and all women of childbearing age must strictly use contraception during and after treatment 1 month.
Although according to the current evidence, it has not been found that the use of isotretinoin in men will cause fetal abnormalities, it is necessary to explain the possible risks to patients. For safety reasons, it is recommended to stop taking drugs for one month.
Abnormal liver function
Among the patients treated with isotretinoin, 20%-50% patients have elevated serum triglycerides, with or without elevated cholesterol, which is rare, mainly in the first two months of treatment. It is usually a transient increase, so serious that treatment is rarely stopped.
15%-20% patients with acne may have a slight increase in liver transaminase during medication, mainly in the early stage of drug treatment, but it is usually transient and will return to normal level with the continuous medication. Of course, if the level of liver transaminase exceeds 3 times the normal value, it is recommended to stop isotretinoin treatment.
Don't worry if there is an increase in blood lipids. You can continue to take medicine and pay attention to avoid high-fat diet. Most of them can be recovered.
depressed
In recent years, more and more people have begun to pay attention to the psychological problems of young people, such as suicide and depression, and acne itself occurs at this age. It is also suggested that isotretinoin may be related to depression and suicide, but some recent studies have put forward different views.
According to a systematic review, the data related to suicide behavior and depression during isotretinoin treatment are not enough to determine the causal relationship between them. Some authors suggest that psychological pain caused by severe acne may be a contributing factor to suicide or depression during medication, rather than the use of isotretinoin.
A study involving 3775 patients (age 18- 19) shows that suicidal ideation is obviously more common in patients with severe acne than in patients with mild or no acne. In addition, a retrospective cohort study (n=5756) found that the suicide attempt rate of patients treated with isotretinoin was higher than that of the general population, and it was also found that the suicide attempt rate of this population increased before isotretinoin treatment, but there was no statistical significance.
In general, the relationship between isotretinoin and depression and suicide has not been determined. Patients should be informed of the possible relationship between isotretinoin and depression and suicide, and pay close attention to whether patients have depression or suicidal thoughts.
label
Although many common side effects are listed here, some are not, but in fact, the probability of most side effects is very low. Some side effects have little effect on patients and are basically tolerable. Moreover, the severity and risk of most side effects are related to the dosage of the drug. Generally speaking, it is recommended to take a small dose, which will be more tolerant.
In fact, no drug is absolutely safe, and there are more or less risks. Whether to take it or not requires a professional doctor to weigh and judge according to the specific situation of the patient. Don't use drugs without authorization.
Finally, the purpose of this popular science is to let everyone know more about the drug itself and avoid some unnecessary panic during the treatment.
The content here is excerpted from Professor Yang Xichuan, a dermatologist. And re-typeset