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Acne vulgaris (lat. Acne vulgaris) is one of the most common dermatoses encountered by young people. Until recently, it was considered a disease of adolescence. However, acne adults can also be affected. People over 30 years old with complaints of black dots or inflammatory rashes on the face are increasingly turning to dermatological offices.
Acne problem
Due to the prevalence of acne, diagnosis is not a problem. The changes are mostly located on the face, but in 30% of them they appear on the torso as well. Based on the clinical assessment, the doctor determines the type of acne and chooses the appropriate treatment depending on the severity.
The pathophysiology of acne has been thoroughly studied. Four main factors are responsible for the formation of skin rashes. One of the above-mentioned elements that influence the appearance of acne (in adolescence and adulthood) is the excessive production of sebum. It is believed that the cause of increased secretion of each fat is the action of hormones, androgens, especially dihydrotestosterone (DHT). However, the level of androgens in the plasma is elevated in only a few patients.
Increased production of sebum together with hyperkeratinization of hair follicles leads to the formation of microhot spots filled with sebum and keratin. The cavity is clogged, the fatty mass continues to accumulate, and commensal bacteria Propionibacterium acnes living in the sebaceous unit receive an excess of lipids for hydrolysis. A large amount of free fatty acids is produced, which irritates the walls of the sebaceous glands. In addition, the bacteria themselves can potentially activate the immune response. This results in the formation of black dots and inflammatory changes (papules, pustules, or nodules).
It should be emphasized that acne is not a disease of dirty hands, as some patients believe, or the result of insufficient hygiene. Therefore, you should not wash excessively, as this may have unpleasant consequences. As a result of intensive procedures, the skin becomes dry, and the production of sebum, which is already increased, is stimulated. Acne, on the other hand, is associated with hormones, and premenstrual exacerbation of dermatosis is observed in approximately 60% of women.
Acne and diet
Food stress can also aggravate the course of the disease. However, a direct connection with the diet has not been proven. Some studies suggest a link between the insulin-like growth factor IGF-1, which leads to clinical improvement in some patients after the introduction of products with a low glycemic index into the diet. Likewise, the role of solar radiation is not entirely clear. Patients observe a temporary improvement in the condition of the skin under the influence of sunlight, but the effect is short-lived, and with prolonged exposure, many complain of increased changes. The explanation may lie in the stimulation of epidermal keratosis by UV radiation, which leads to the obstruction of the follicles described above. It should be borne in mind that exposure to the sun is not advisable when using some medications during acne therapy.
