The things on the face, neck, back and trunk, caused by the activity of the sebaceous glands, seen as puffy from the skin, and can be inflamed from time to time are called acne. It is the most common dermatological disease in adolescence. It occurs in most individuals aged 12-18 years.
What Will We Learn?
Factors Causing Acne Occurrence
Many factors play a role in its formation. In genetically susceptible individuals, thickening of the hair-sebaceous gland duct, where the oil secretion is thrown out of the skin, and the tendency of the duct to become blocked due to the stickiness of the cells there are an important factor.
Other factors are that the increased oil secretion (sebum) during puberty accumulates in this channel and forms black or white dots called comedones. Physical factors, as well as genetic factors, play a role in the clogging of pores. Physical factors include the use of oily creams, hot weather, increased sweating, make-up and not using suitable skin cleansers.
The sebum in these clogged pores is caused by bacteria settling and causing an inflammation there. In acne that occurs in this way, redness and inflamed acne can be seen on our skin.
Can Medications Cause Acne To Proliferate?
Some drugs such as Corticosteroids (Cortisone), Hormones, some psychiatric drugs, Tuberculosis drugs, Epilepsy drugs, and Vitamins can cause acne formation or further increase in acne. In addition, concealer foundation and similar make-up products can cause acne problems by clogging the pores in the applied area.
How Is Acne Treatment Planned?
Treatment varies depending on the patient’s body structure. The severity of acne matters. There is no single treatment & several treatments can be applied together. Patience is the most important step in acne treatment.
The effects of the treatment begin to be seen with at least 2-3 months of treatment. In addition, lesions may recur even after treatment ends. After the treatment ends, the recommended cream should be continued 1-2 days a week.
How Is Acne Treated?
There are many treatment alternatives for a very common disease such as acne. While only washing products and creams may be sufficient in mild acne, oral pills are required in moderate-severe acne and hormonal acne.
Among these pills, the most commonly used are antibiotics, vitamin A derivatives and birth control drugs, but they should be administered under the supervision and control of a doctor.
Apart from this, laser, chemical peeling, acne peeling, injection of drugs into the skin are among the methods used. It should be noted that every patient is different, which means that the same treatment will not work for every patient.
Today, there are 4 ways to treat acne:
1) Supportive Treatment
This treatment is used for the patient whose acne is not excessive and products are recommended to clean the skin.
2) Topical Treatment
It can be used alone in those with mild acne. They must be used regularly to be effective. During this treatment, it may cause side effects such as redness, dandruff and itching.
These effects last 2-3 weeks, then decrease. In order to prevent these side effects, it should be applied 2-3 times a night at the beginning, after a few hours, it should be washed and the time should be increased. If necessary, the treatment should be continued after a break for a while.
It should be applied to all oily skin, not just acne. At this stage, comedolytics (azelaic acid, retinoic acid, benzoyl peroxide, salicylic acid, etc.), antibiotics (tetracycline, nadifloxacin, clindamycin, sodium sulfacetamide, azithromycin) or their combinations are recommended and used for a certain period of time.
3) Systemic Treatment
Oral antibiotics are preferred in patients with more severe acne or who do not benefit from creams. The duration of treatment should not exceed 3-4 months. It should never be used alone, it should be used together with the cream that will prevent antibiotic resistance recommended by the physician.
Otherwise, super bacteria that are resistant to all antibiotics will develop. This is the treatment of antibiotics (azithromycin, tetracycline) and isotretinoin, a derivative of vitamin A. The dermatologist should decide how much these drugs will be used.
4) Isotretinoin Treatment
Isotretinoin treatment is the only treatment that is effective for all known acne forms on the market. After treatment, it provides a definitive solution in many patients, and then reduces the recurrence of lesions. It is possible for the disease to recur after all other treatments. However, it recurs in much fewer patients after isotretinoin treatment.
Although this treatment is very effective, it also has various side effects, but most of these side effects disappear during or after the treatment. Please note that such drugs should be used only in doses to be determined by the doctor.
The most important side effect is the dryness of the skin. It can increase blood lipids and rarely adversely affect liver tests. For this reason, you will need to have blood tests at certain intervals, usually with the decision of your doctor.
It is recommended that women of childbearing age should be protected with at least two methods of contraception. Pregnancy test should be done before the treatment, pregnancy test may be requested during the treatment. It is possible to get pregnant 2 months after stopping the treatment.
4) Other Methods
Peeling cream specially developed for acne or chemical peeling treatments can be applied. In addition, due to the lightening of acne after sun exposure, various light treatments and laser treatments have started to be used today.
For this purpose, there are studies on KTP (potassium titanyl phosphate) laser, 585 and 595-nm pulsed dye laser, diode laser, radiofrequency and phototherapy.
The efficacy of these treatments is different and controversial, and their costs are high. Especially in the treatment of acne scars, ablative (treatment by peeling the skin) and nonablative lasers are successfully applied.
Various combinations of the treatments mentioned in the first four items may be recommended by the physician.
What Happens If Acne Is Not Treated?
In fact, this depends on the type of acne. If you have 1 acne per month or a week on your face, you don’t have to worry too much about it. However, if your acne is excessive, you should definitely discuss this with a dermatologist.
Acne is a disease that needs to be treated because it is chronic, causes psychological stress, and can leave permanent scars if left untreated.
Patients who do not apply for treatment are generally those who have lost their belief that their disease will pass, or who do not see acne as a disease and think that it will pass without treatment.
Therefore, one should know that this disease, which is seen in adolescence when body and self anxiety is high, and affects the psychology of patients, is a treatable disease and should seek appropriate treatment by consulting a dermatologist.
In addition, it should be waited for at least 2-3 weeks for the treatments given to take effect. For this reason, the most important point in treatment is to be patient, in harmony with the physician, and to follow the recommendations given.
Compliance with the patient will make it easier to achieve the desired result in this disease, which has many treatment options.
How To Treat Acne Scars and Stains?
In the early stages, spots can be completely and quickly eliminated with some spot creams and sun protection.
Scars are difficult to treat and require patience. They may not even disappear completely. For this reason, it is very important to prevent the formation of scars by giving treatment as early as possible in people with acne.
In deeper scars, deep peeling, dermabrasion, PRP, dermaroller, laser applications or several treatments can be performed together.
How Should Skin Cleanliness Be?
One hundred should not be washed more than twice a day. As soap, cleansers with a pH close to normal skin (5.5-7), called “Sindet”, which do not cause irritation and dryness on the skin, should be used. You should avoid cleansers bought from cosmetic markets or not approved by the Ministry of Health.
You should choose products recommended by your doctor according to your skin type. Since excessive washing and rubbing can aggravate acne, the use of brushes and fibers should be avoided.
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