- Acne from a scientific point of view
- Why does not everyone develop acne?
- Infections: demodecodex and propion bacilli
- Eat right
- Ultraviolet light and poor hygiene
- Anxiety and depression
- Mechanical factors and household chemicals
- Heredity and the influence of hormones
- How Pimples Occur?
- What acne can be?
- Comedones, or black dots
- Papular acne
- Pustules, or pustules
- Phlegmonic acne
- Necrotic acne
- Drainage acne (conglobates)
- Starting to heal: skin care
- Acne medications: a general overview
- Topical antibacterials
- Basiron AS (benzoyl peroxide)
- Advantages and disadvantages
- Skynorin (azelaic acid)
- Advantages and disadvantages
- Differin (adapalene)
- Advantages and disadvantages
- Reparants and fighting acne scars
- Advantages and disadvantages
- Delex acne gel for blackheads
- Advantages and disadvantages
- Epitonex cream
- Advantages and disadvantages
- Advantages and disadvantages
- Advantages and disadvantages
*A review of the best according to the editors. About the selection criteria. This material is subjective, not an advertisement, and does not serve as a guide to purchase. Before buying it it is necessary to consult with a specialist.
Let’s start with the important facts. Let’s get acquainted a little bit with what acne is, what kind of acne they are, when and why they occur, let’s consider the mechanism of acne formation itself, which appeared on normal skin. Let’s talk a little about how to properly diagnose, what are the general principles of treatment of acne, and then directly and in detail consider the various local remedies: ointments, gels and creams used to treat acne, and sold in the pharmacy without a prescription.
For those who want to go straight to the information on remedies, can go to the section “Medicines for acne”. But we strongly advise reading the material in its entirety. Many causes can be taken into account, and with just the right lifestyle and proper diet get rid of acne, even without the use of drugs. Therefore, there is almost no unnecessary information in this article. It can be considered a sort of popular science lecture, designed for people without a medical background, but with an interest in the natural sciences, medicine and their own health.
So skin has always been a mystery. It would seem that the skin – something that everyone can see, you can touch it, assess its color, condition, moisture, the presence of any rash, and so on. But the causes of skin diseases are still in many ways more mysterious than those of heart, liver and lung diseases. Until now, dermatology is doomed to be largely empirical; skin diseases do not always proceed in the standard way described in textbooks. Skin is much more difficult to examine than blood. For blood, there are quantitative rigorous data (biochemical and general blood tests), but for skin, there are still research methods that imply a high percentage of discrepancies and errors.
The skin is a barrier tissue, the largest and heaviest organ of the human body, in which a lot of blood is deposited. Skin has many functions: in addition to elementary separation of the internal environment from the external world, skin exercises body homeostasis, drains excess fluid and salts in the form of sweat, relieves the kidneys and takes part in the maintenance of normal body temperature.
We all know that animals with skin that lacks sweat glands regulate their body temperature very differently than we do. If we sweat enough, then pigs need to soak in mud, so that the wet skin evaporates more moisture and therefore cools down, and dogs need to stick out their tongue for the same purpose.
But skin doesn’t just synthesize sweat; in addition to sweat glands, we also have sebaceous glands. Sebum is a very important component of normal skin. It creates what is called a thin water-lipid layer, or mantle, which conserves heat, prevents excess fluid from evaporating, protects the skin from dryness and cracking. And, most importantly, this mantle is a normal, biological substrate for the activity of many microorganisms living on the surface of normal skin of a healthy person. These microorganisms prevent the multiplication of pathogens on the skin, such as streptoderma and hornblood infections.
And if you start to break down the formation and excretion of sebum, then there will be such a pathology as pimples, or, scientifically – acne. The pimples themselves are a consequence of the development of the elements of acne, or the elements of acne. What are “pimples” from a scientific point of view?
Acne from a scientific point of view
While a boil is an acute process in which purulent inflammation develops in a single, isolated hair follicle, acne is almost always a multiple, smoldering, chronic-prone process. For the sebaceous glands to work well and not to stagnate sebum, or sebum, it is necessary to keep the outlets of these glands open. But the epidermis cells are constantly dying off, sloughing, and when we wash, we successfully erase them with a washcloth. If dead skin cells clog up the sebaceous gland outlets and soak up that sebum, then there will be, as they say, “clogged pores”.
As they say, fat is fat, it’s a high-calorie nutritious product. Any fat, when oxidized, provides the most calories compared to carbohydrates and proteins. That’s why sebum is a tasty, high-calorie meal for many microbes. Where more fat is produced, and there is a greater risk of first clogged pores, then – acne in various stages of development, and then the pimples. In humans, these areas of the skin with the most developed sebum are the face, back and chest.
Much of sebum production depends on the influence of hormones, and begins in adolescence. Of course, most people who consult a dermatologist about acne and pimples live in the city, not in the countryside. But it is true that the urban population suffers from acne more often.
There is an opinion that chronic stress, sedentary lifestyle and poor diet are to blame. But this has yet to be proven. But in any case, most often a person becomes ill in youth, and if the first pimples and acne occurred during puberty, then every other patient has the risk of continuing this story of acne into adulthood. But usually after the age of 40 it’s over, although some patients may have active acne formation later in life.
Today’s dermatology journals say that by 2015, there were more than 600 million. The person with acne, acne and pimples. That’s almost 10% of the world’s population. Perhaps among dermatological, skin diseases, this is the most common pathology. First of all, let’s find out what causes acne? After all, puberty occurs in all normal people, except for a small percentage of individuals with severe endocrine pathology. But why is it that not everyone gets pimples and acne??
Why does not everyone develop acne?
If we talk about any disease, talking about the causes, and eliminating them, we can eliminate the consequence, that is the disease itself. But even if acne and pimples, cured by this knowledge will not be completely, almost always the activity of the pathological process can be reduced by following simple rules. And we’ll start with those risk factors, or provocateurs, that in the long evolution of dermatology have regularly been highly suspected by specialists.
Yes, this is the age of evidence-based medicine, and it has yet to be proven by mathematical statistics that these factors certainly influence the onset of acne. Nevertheless, attentive and competent doctors blame the following factors for the occurrence of acne:
- Improper nutrition,
- Poor hygiene and exposure to sunlight,
- chemical and mechanical factors,
- heredity and the influence of hormones,
- Anxiety and stress.
Let’s go into more detail about all of these provoking factors.
Infections: demodecodex and propion bacilli
Scientists have long known special microbes, even hundreds of species that do not need oxygen in the air to develop and multiply. Moreover, there are strict anaerobes that die in the presence of air oxygen. The kind of microbes in question are called propion bacteria. They can be found on healthy skin, so they are not a pathogenic flora. But in case there are pimples and acne, these propion bacteria begin to multiply, and “bloom in full bloom”.
Then they are found in large numbers in the affected sebaceous glands, in their outlets, blocked by sebaceous plugs. Unfortunately, it is still unknown whether this bacteria gets in from the outside and immediately causes acne, or it occurs in all healthy people, and then, for some reason begins to harm us. The fact is that this microbe, which lives in healthy people, is also capable of changing its activity to a large extent, and if sebum begins to be produced in excess, propiona bacillus also begins to multiply, to take over the entire nutritious niche.
There is such a disease as demodechosis, it is caused by a microscopic parasitic mite of the same name. Usually the eyelids, face, ear canal, and chin are affected. The size of this mite does not exceed 0.5 mm, and many doctors: ophthalmologists, dermatologists, say that this mite is just a normal inhabitant of the sebaceous glands outlet ducts, but only if a healthy person has good immunity. Then the demodex mite can not cause significant harm.
Nevertheless, cosmetologists owe a lot to this mite. They learned how to scare their clients, and upon detecting demodex, they immediately offer to pay for treatment for this parasite. Naturally, a large excess of sebum contributes to a significant reproduction of the population of these miniature mites, since sebum is also food for them.
But here’s the problem: when fat starts to be produced in large quantities, then the mites really multiply from the excess food. But no one has ever been able to prove otherwise. These mites cannot start the process of excessive sebum formation leading to acne.
There is a correct statement that almost everything in a person is what he once ate, or drank. Indeed, residents of large cities have an excess of carbohydrates in their diet, including refined carbohydrates, food has a high glycemic index, and they have little physical activity. There is a lot of physical activity in the countryside, and the carbohydrates that enter the bloodstream in excess are quickly disposed of.
There’s been a lot of research. They proved that if you use products with a low glycemic index, less than 40-50, after three months, all patients with acne reduced by half the affected area. The elements are also reduced: mature and immature acne, as well as pimples. Here is the key to the cure: at the links below you can download a table of the glycemic index of various foods. And if within 3 months you will regularly consume products with an index not higher than 50, then you can already achieve a very good result, without the use of drugs, ointments, creams, saving on treatment.
Also, many experts have the opinion that acne occurs with an excess of milk in the food. Milk quite often carries bovine hormones, which in the human body is capable of a minor restructuring in the testosterone. There is an opinion that an excess of vitamin B12 (cyanocobalamin) may also provoke acne, and if acne is already present, this excess worsens the course of the disease. No direct link has yet been found between the appearance of acne and the abuse of fatty and sugary foods.
Ultraviolet light and poor hygiene
It would seem that if a person rarely washes his face, then he has a lot of sebum on his face, and therefore he has an increased risk of acne and pimples. Alas, it turns out that this is not true: they do not develop acne more often than ordinary people. Washing frequency has no effect on excess sebum. But if a man goes to a hot country, and begins to sweat heavily there, he just starts an increased synthesis of sebum. And if he has had small elements of acne before, they legitimately turn into pimples.
The researchers have blamed the sun, or rather, an excess of ultraviolet light. It destroys many microorganisms, and even helps with a mild form of acne by killing colonies of propionic acid bacteria near the external openings of the vents. But if there is already a severe form of the disease, severe acne, then UV exposure will not only useless, but also harmful. Skin will age early under the influence of harsh quanta of ultraviolet light and may even develop melanoma, one of the most dangerous malignancies.
Anxiety and depression
Depression and anxiety in general worsens the course of all diseases. There is not a single pathology that is improved by anxiety and depression. Here the connection of depression and anxiety with the progression of acne is obvious. There are many studies that have proven that high levels of stress and acne progression, worsening the course of the disease, or the appearance of acne are quite strongly correlated. These studies are relevant to the beauty industry, and, of course, they have also seeped into the fashion “glossy” magazines.
They have even managed to find the “carrier”: it is the adrenal hormone cortisol. the more stress, the greater the release of cortisol, and cortisol worsens the course of acne.
Mechanical factors and household chemicals
In some cases, mechanical, and chemical factors do affect the progression of acne. Most often it is chronic drying of the skin with antibacterial soaps, antiseptics, chlorhexidine and hydrogen peroxide lotions. All this leads to dry and micro-traumatic skin, cracks and irritation of the sebaceous glands. Irritation of the sebaceous glands is a pathway to even greater sebum secretion, forming a vicious cycle. A man is trying to fight sebum, and sebum is trying to fight the fight against it.
Many drugs worsen the course of acne and provoke the formation of pimples, but initially these drugs are unable to cause disease. In such a “sin” are seen lithium salts – drugs used by psychiatrists, glucocorticosteroid hormones, isoniazid, created to treat tuberculosis, and most importantly – various forms of androgens containing testosterone.
Heredity and the influence of hormones
The second time we mention the effects of androgens. The male sex hormones, androgens, are one of the main causes of acne and pimples, especially testosterone. the sebaceous glands respond directly to an increase in its concentration by increasing sebum production. Naturally, hormonal levels are hereditary.
It is known that such a disease as androgenic alopecia, or alopecia, many men are inherited and it is a hereditary trait, saying that the male members of the family have a lot of testosterone. Heredity is also clearly linked to the probable onset of acne and acne. More than 80% of all acne that occurs during puberty is hereditary. Studies have been conducted on both relatives and twins.
It has been found that the susceptibility to acne and acne is not determined by a single gene but is inherited polygenically. The TNF (tumor necrosis factor) gene, for example, many other proteins play a big role in this. In some cases, acne is associated with another rare hereditary pathology. For example, there is Apert syndrome, which occurs with a frequency of 1 in 200000, and along with abnormal development of the hands, skull bones, high intracranial pressure, there is also acne.
It turns out that acne occurs naturally during puberty, when intense puberty begins, approximately from the age of 14 years old, and the synthesis of male sex hormones increases, not only in boys but also in girls. Girls need testosterone, too. Its increased synthesis goes to about the age of 25 years, and if you carefully examine the boys and girls aged 16-17 years, almost all have some elements of acne, but not all will fall ill.
The development of clinical manifestations and vivid symptoms depend on how receptive the sebaceous glands are to androgens, what response they can give, how many receptors to testosterone they have, and this too is fixed by heredity. There are many articles on this subject on medical journal Web sites. Read about the connection between high levels of androgens and acne here on the RMJ website.
The “difficult patient” magazine also tells about the connection between acne and hyperandrogenism in women.
If there are a lot of such receptors inside the sebaceous glands, then there will be more fat under the influence of hormones. Similarly, some sebaceous glands will be more sensitive to testosterone and other people will be less sensitive. It depends on the individual activity of the receptors located in these glands. And if testosterone “orders” the sebaceous glands to start producing as much sebum as possible, the discharge ducts can’t handle the “stated amount of production”. They become clogged with sebum and propionic bacteria begin to multiply, leading to the development of inflammation and the appearance of pimples. How acne occurs due to sebum overproduction? Let’s follow this process in detail.
How Pimples Occur?
The beginning of this process is the growth, multiplication of skin and epidermal cells, but not on the surface of the skin, but inside the hair follicle. When the skin is healthy, it pushes outward from the pore where the hair grows, to the surface. But with the increased secretion of sebum these dead skin flakes do not come out and slough off, but stick together in a dead fatty lump.
This lump, soaked in fat, like putty, seals the pore of the hair follicle, and this condition is called microcomedon, or sebaceous plug. The very microorganisms that we talked about above, cover this dead mass of cells and fat on the outside, and begin to absorb this organics, as a result, the micro-cork is oxidized by air oxygen.
Oxidized organic takes on a dark color, and it is already – the usual blackheads, “forerunners” of acne and pimples. In addition, male sex hormones not only increase the amount of sebum, they change its composition, and it becomes thicker than normal. This leads to seborrhea, an excess of sebum on the surface of the skin, and the microorganisms induce additional inflammation with all the signs.
The body’s response occurs, and the inflammatory cascade results in a variety of forms of acne. If there is severe inflammation, it can break through, not outward, but deep into the skin and form deep nodules. The end of the inflammatory process is the destruction of these inflamed tissues, leading to the formation of scars that also need to be treated.
What acne can be?
So what are they like?? Here are the classic varieties of the different variants of acne:
Comedones, or black dots
They are miniature, but deep “wells”, the ducts of the glands, in which a large amount of fat accumulates, but so far without festering, without inflammation. On the outside, this sebaceous well is blocked by an air-oxidized plug, a plug of dead skin cells together with sebum. Sometimes they can be yellow, the color can merge with the skin, and remain invisible. If a comedon is squeezed out, a whitish or yellowish mass, a “cast” of the sebaceous oil duct, appears on the surface. It looks like a whitish worm, with a black head.
A papule is a bump. It is a cone-like element, and it has a thickened inflammation at its base, which is how it differs from comedones. As the papules develop, skin itching occurs. They resemble small red bumps, colloquially called “pimples under the skin.
Pustules, or pustules
The next stage in the development of comedones is pustule, pustule acne. A pustule is a pustule. The element of the rash is an already painful nodule, the size of a pea, bright red, and covered with a purulent head on top. Under this purulent head is a white, also purulent rod. If nothing is done to the pustule, pus dries up on its own, crusts form, and then heals. Already at this stage, it will eventually form a small scar.
If the inflammation penetrates even deeper, then a tubercular, or indurative (thickened) element emerges. Here the inflammatory infiltration (inflammation) already extends far enough away from the hair follicle, deep within the skin. Such a pimple can be as big as a bean. During festering, it is painful, it always comes out a lot of pus, and after healing, the scar remains larger than in the pustular stage, it is already quite a visible scar.
Phlegmon – a spreading purulent inflammation. These blackheads are entire cavities filled with pus. If you press on them with the probe, you get the phenomenon of fluctuation, that is, the feeling that under the probe is not dense skin, but some liquid covered with a thin layer of tissue. They are scarred reddish, deep-lying, hard to treat, and after healing, they leave behind rough scars.
They are characterized by necrosis, or necrosis in the center. They are prone to recurrence, and are most often located on the border of the scalp, on the temples, on the forehead. When they heal, they leave irregularly shaped scars that look like deep pockmarks.
Drainage acne (conglobates)
Perhaps the most severe form of acne, which occurs not only in boys and girls, but also in adults. They are a conglomerate of acne that develops because an infection has already set in.
These occur most often in immunocompromised people. Pus under high pressure, in the ducts of the sebaceous gland, finds its way out not to the outside, but to the sides, resulting in “daughter” abscesses, which are called cystic. As a result, they open up into many fistulas, and profuse pus is excreted with a thick, mucus-like consistency. The tissue around them overgrows, becomes inflamed, these blackheads do not heal for a long time. New conglobates erupt next to each other and the process repeats endlessly.
After healing, rough and deep scars appear, which have a whitish tinge and extend over a long period of time, resembling bridges. Conglobates severely disfigure the face, cause skin tightness, and severe pain during their development. In addition to the face, they can also appear on the neck, back and chest. They tend to recur frequently. This form lasts for a long time, for several months and sometimes several years.
These are small, round, white, dense cysts the size of a grain of wheat. They are most commonly found on the cheekbones and temples. Their difference is that they can form on the skin not only in adults, but also in healthy children. Their difference is the absence of inflammation, so they do not cause any worries or complaints.
Starting to heal: skin care
Let’s assume that the reader has understood how to eat right, tried to somehow change the internal attitude towards life, to avoid stress and anxiety, began to wash properly, and lead a healthy lifestyle. Now all that is left to learn how to properly care for your skin, and by appointment a doctor to use local, over-the-counter remedies. How to properly care for your skin?
Skin – is not the floor in the intensive care unit, to lubricate it with antiseptics and wash it all the time is strictly prohibited. As mentioned above, the production of sebum will compensatively increase, and the skin will become dry and irritated. Here are the basic principles of skin care in the presence of acne, in the early stages, when the skin has comedones, papules, that is, pustules, and pustular elements of acne:
- To avoid skin dryness, do not wash your face more than twice a day;
- Use lukewarm water and mild soap such as baby soap with glycerin;
- In any case, do not clean the skin of the face scrub, various exfoliants. The maximum that is allowed of scrubs is to use them only when there is absolutely no festering, that is, when there are only “black spots,” comedones, or pustules. But if there is even one small pustule or pustule, scrubs are strictly prohibited. If you use a scrub, then the finest consistency, and not more often than once a week;
- completely refuse all kinds of antibacterial soaps and all antiseptic skin preparations, including those advertised from the screens and pages of magazines;
- the hardest point for the fair sex: avoid makeup. Naturally, the larger the cosmetic defect, the more you want to use makeup to cover it up. If you do use makeup, it should be water-based, and it is imperative that your face be completely cleansed before going to bed. When buying cosmetics do not spare money, and be sure to find out whether it is not only hypoallergenic, but also non-comedogenic, does not provoke the formation of plugs in the sebaceous ducts of the sebaceous glands, and whether it clogs pores;
- Try to take a non-greasy cream, and even if you have dry skin. If you want to achieve intensive hydration, then look for facial care products among the quality cosmetics, which are offered in pharmacies to people with atopic dermatitis, emollients (Bioderma, Uriage, etc.).
- It is possible that the acne may still be caused not only by propion bacteria, but also by pathogenic flora that joined later, so try to always use only individual disposable tissues, and do not take common towels;
- If you dermatologist prescribes topical products, you should apply them only on clean skin, after thoroughly removing not only makeup, but also cleansers.
And the most important recommendation. Prepare to work long and hard to get rid of these unpleasant formations on the skin. Know that everything you do is not only to remove existing blackheads and pimples. The most important thing is to work constantly on prevention, so that they stop forming and the skin gradually clears up. And just like that, it takes not only weeks, but many months of monitoring and persistent treatment.
Acne medications: a general overview
Severe forms of acne, when there is suppuration, fistulas, tissue necrosis, are treated for a long time, including hospitalization and possible surgery. The following products are for guidance only and should only be used as prescribed by your physician, taking into account the indications and the absence of contraindications. For each drug, a price range current for spring 2021 is given. All drug information is taken solely from official, open sources, is not advertising or anti-advertising, and many are included in national and international clinical guidelines for the treatment of acne and protocols for the management of patients with acne.
The following groups of remedies are used to treat various forms of acne:
- Various antiseptics that are not antibiotics at the same time. These are just the subject of today’s examination, e.g. Differin, Basiron. Most often these are ointments, creams and gels for topical use;
- Topical ointments, gels and creams that contain antibiotics;
- Antibiotics that are prescribed as pills, orally, and have a systemic effect. The most common are representatives of the erythromycin group, tetracycline and lincosamides, either alone or in combination. They are the ones that can inhibit the growth of propionic bacteria;
- Reparants to restore the skin, anti-inflammatory drugs for local use, as well as products to combat the formation of scars, which appear in the place of acne and pimples after the resolution of the element through suppuration.
Severe forms of acne are treated with serious medications that, if self-treated or used incorrectly, can also cause severe complications and side effects. These are:
- Retinoids, of which Roaccutane is a prominent representative;
- Oral contraceptives, which are prescribed only to women after consultation with a gynecologist and gynecologist-endocrinologist, such as Yarin, Cez, etc. They must be taken very carefully, as they affect the entire hormonal status of the body;
Drugs are also used to combat high levels of testosterone androgens, such as Androcur, and other means. These, too, are prescribed only for severe forms, and will not be discussed in this review.
|Topical antibacterial agents||1||Basiron AS (benzoyl peroxide)||866 €|
|2||Skynorin (azelaic acid)||859 €|
|3||Differin (adapalene)||794 €|
|Reparants and the fight against scarring after acne||1||Curiosin||486 €|
|2||Delex acne gel for acne||318 €|
|3||Epitonex Cream||413 €|
These products reduce sebum secretion, reduce the concentration of fat and fatty acids in the follicles, promotes the sloughing of skin scales, and reduce the formation of plugs. They have a primary anticomedon effect, and when applied to the skin, they are almost not absorbed internally. Also, these drugs can reduce the synthesis of cellular proteins, this is necessary to reduce the formation of dead keratinocytes, have an anti-inflammatory effect, and are used, as a rule, a course not shorter than one and a half months. Let’s look at some of them.
Basiron AS (benzoyl peroxide)
Basiron contains benzoyl peroxide, in a concentration of 5%, and for a relatively large tube weighing 40 g, you have to pay from 680 to 860 rubles. It’s a white antibacterial gel made in France by Galoderma. It not only destroys germs, but also removes excessive keratinized skin, improves blood flow and reduces sebum production. The drug also works as a keratolytic, and increases oxygen penetration into the tissue. In addition to vulgar acne, as well as various other forms of acne and acne, can be used in the presence of trophic ulcers of the shin, including diabetes and severe forms of varicose veins.
It is usually applied once a day on clean and dry skin, but a stable remission requires at least three months. There are two forms of Basiron, five percent gel and ten percent gel. Begin treatment for acne with 5% gel, it is used for up to 3 weeks, and then switched to a 10% release form, and it is used until the disappearance of acne.
Advantages and disadvantages
Slight dryness, redness, and burning of the skin may be among the side reactions. It should not be applied to mucous membranes, but may be combined with other topical medications and antibiotics. Basiron AS may be applied to the skin of pregnant and nursing women, but with caution. The drug is not recommended for use in children under 12 years of age.
Skynorin (azelaic acid)
Azelaic acid or Skynorin is a product of Leo Pharma, Italy and is available in a 20% cream in 30g tubes. This is an effective skin protector, available as a cream and gel, and costs around 1500 rubles. For one small package. It improves keratinocyte function, inhibits sebum secretion, fights germs and reduces skin oiliness, but is not an antibiotic. The drug is able to regulate local cellular immunity, has anti-inflammatory effect. The product has shown high antimicrobial activity just against propionic bacteria breeding in the sebaceous glands and their derivative ducts in the occurrence of acne. The drug can also reduce inflammation by reducing metabolism, that is, the rate of metabolism in neutrophils, the most active white blood cells. This leads to a decrease in reactive oxygen species, and inhibition of inflammation, respectively, reduces festering.
The medicine, as in the previous case, should be applied twice a day: in the morning and in the evening on clean and dry skin, lightly rubbing. Skynoren is quite economical to use. Improvement in vulgar forms of acne can be noticed after a month. The drug is also indicated for the treatment of melasma.
Advantages and disadvantages
The drug is well tolerated, not absorbed into the systemic blood stream, but must always be applied on clean and dry skin. Side effects from Skynoren are rare. The only thing that can be is a local irritation, slight burning and peeling. Most often the symptoms go away on their own after a few days, not requiring withdrawal of the drug. The product is contraindicated in children under 12 years of age.
This is also a drug from the French company Galderma, it comes in a cream and tube of 30 g, and will cost from 800 to 1020 rubles. Adapalene is close in chemical structure to retinoids. It reduces inflammation, improves differentiation in the epidermis and normalizes biochemical processes in keratinocytes. But it does not have the systemic side effects typical of retinoids. It is usually used once a day before going to bed, a steady improvement also does not come quickly, after three months of treatment. But the first results can already be noticed after 4 weeks. If it is smeared in excess, often and in large quantities, then you should not expect faster improvement.
Advantages and disadvantages
Skin irritation may occur as a mild side effect, in which case treatment should be stopped. It is possible to apply Differin and Basiron simultaneously in a combined treatment. Adapalene is contraindicated in pregnant and lactating women, as well as in hypersensitive. As you can see, in previous cases it was still possible to apply these local remedies in pregnant women. And here Differin is related to retinoids, and retinoids are strictly contraindicated for pregnant women, as they cause a proven teratogenic effect, so it is better not to risk.
Reparants and fighting acne scars
The big plus of means of this section in their safety: they can harm much less, than drugs, about which it was told above. Of course, there are drugs for acne that can cause a lot of harm in the wrong hands, such as the same retinoids, or oral contraceptives. They should only be prescribed by a doctor, so we did not talk about them in detail.
But remedies that restore the skin, prevent inflammation, scar tissue formation, drying – sold without a prescription. Therefore, they can be considered first-line remedies. They contain boric acid, various prescriptions preventing fungal and microbial infection, sulfur, zinc, some irritating substances that improve blood circulation. They can be used prophylactically, and to treat inflammation and prevent scarring. Let’s take a closer look at some of these agents.
Hungarian company Gedeon Richter has long and successfully produced Curiosin, its international nonproprietary name is zinc hyaluronate, that is, the zinc salt of hyaluronic acid, which has high activity as a component of connective tissue. This is not a cheap product: in February 2021 you will have to pay between 470 and 615 roubles for a small tube of gel weighing 15 g.
When used regularly, Curiosin heals wounds, and stimulates this healing, hyaluronic acid affects the regeneration of the skin and improves its elasticity. As a result of applying Curiosin to healing acne, this gel forms a special film, accelerates the creation of new blood vessels, granulation and the appearance of new epithelium, and hyaluronic acid is a donor for the synthesis of new collagen fibers.
Zinc is needed here for disinfection, it exhibits antimicrobial properties. Also zinc is considered an antioxidant cation, it reduces free-radical oxidation, or antioxidant stress, and it is one of the results of any inflammation. Curiosin is a kind of antimicrobial biological bandage, and at the same time it keeps the damaged skin layers moisturized. The presence of hyaluronic acid allows acne to heal without leaving scars, and zinc inhibits the activity of the very propion bacteria that are to blame for the formation of acne.
The drug is indicated for the topical treatment of all forms of acne, or acne, mild to moderate acne. Curiosin is primarily applied to papulopustular acne, and to comedones. It should be applied twice a day with a thin layer, pre-cleaning the skin. The duration of the course is determined by the physician, a dressing is not required.
Advantages and disadvantages
Hyaluronic acid avoids scarring, zinc inhibits propionic bacteria: Curiosin is directly designed for the prevention and treatment of acne. The only contraindications to use are hypersensitivity, pregnancy and breastfeeding, as well as intolerance to chicken and poultry proteins. After all, hyaluronic acid, is taken from the connective tissue of poultry.
Side effects include a very rare tingling sensation at the application site, which quickly subsides. If Curiosin is applied to dry skin, and on quite a large area, it may cause a tightening sensation of the skin. The drug is good for both prevention and treatment of these types of acne. Perhaps the disadvantage is the relatively high cost for a small-sized tube. It doesn’t stain your underwear or skin.
Delex acne gel for blackheads
The line of drugs produced by the domestic company Health-gel is a special gel, gel forte, moisturizing gel and lotion. Delex acne gel from acne in a volume of 30 ml will cost from 200 to 400 rubles. This preparation contains extracts of various plants, menthol, purified sulfur, sodium hydroxide.
As a result of Delex Acne penetration into the sebaceous gland duct, inflammation is stopped, sulfur reduces the production of sebum. And procomedones that already exist may even dissolve, at least pale and reduced in size. When applied systematically, the skin becomes velvety and matte. The drug is also recommended if the acne is complicated by the presence of demodex, that is, skin mites, which, as we know, very much dislike sulfur. It is desirable to apply the drug to the skin of the face if there is excessive greasiness, in adults and teenagers, to treat reddened and inflamed elements of acne.
The product should be applied once to twice a day in the morning and evening, and left on all day, or all night. However, the skin of the face must be cleansed beforehand, and if the skin is very oily, the product is applied to the entire face. If the skin is combination, it can be applied only to the areas of acne accumulation or already inflamed pimples. Treatment time – from 7 to 14 days, but there may be a longer course, until the inflammation completely disappears. But this is decided by the doctor, a dermatologist or dermatocosmetologist.
Advantages and disadvantages
It is a much cheaper product than Curiosin, and the volume of the tube is twice as much. The remedy is simple to use, it is good for prevention and treatment, and its disadvantage may be the recommendation to use it only for oily or combination skin.
This cream in the volume of 35 ml will cost from 300 to 550 rubles, it is a domestic parapharmaceutical. It is used for fresh acne after-effects. Its purpose is to prevent the formation of scars. Once a fresh scar has appeared as a result of a dynamic change in the element of acne, it should be regularly lubricated with Epitonex cream, rubbing a small amount of it into the scar until completely absorbed.
The active agents in this preparation include aloe and onion extracts to improve the immune system and blood circulation, rose hip extract, Japanese Sophora, beeswax and allantoin. In addition to acne scars, Epitonex can also be used in the occurrence of atrophic scars after furuncles, in the occurrence of various scars, the appearance of stretch marks, for example, after pregnancy.
Advantages and disadvantages
The drug can be purchased in pharmacies, online stores, it is quite active, available, is inexpensive, and can be used both for the treatment and prevention of scars and scars. Of the side effects, there are allergic reactions consisting in the appearance of hives and itching. Quite often this is the first reaction to treatment, and it soon passes, then Epitonex need not be canceled. The only contraindication to use is individual intolerance to the preparation.
Another representative of products that prevent the formation of scars after acne is Fermenkol. It is a gel, in a small tube weighing 30 g, but its cost is much higher than both Curiosin and Epitonex combined. It costs considerably more, from 1400 to 2200 rubles. What is the reason for such a high price??
The thing is that Fermenkol contains as much as 9 protease enzymes, which destroy collagen, of which scars and scars are formed. So we can say that Fermenkol simply dissolves and destroys the scar, while it is “young and fresh”. These collagenases have been obtained from the digestive organs of various marine invertebrates, and these enzymes have a molecular weight of about 20 to 100 kilodaltons. Other than proteases, there were no additional ingredients. There are no other lipoproteins, pigments or dyes, or polysaccharides in Fermencol. “The “highlight” of Fermenkol is the breakdown of exactly those collagen molecules that have a swirling or nodular pattern, and it is these molecules that are characteristic of fresh hypertrophic or keloidal scars.
Fermenkol is indicated both for treatment and for the correction of acne or acne sequelae. It can be used both for treatment and prevention, including scars and scars after burns and surgery. It is advisable to begin using Fermenkol 3 weeks after a burn, surgery, or after the opening of an element of acne, when fresh scar tissue has already appeared.
Fermenkol is available not only as a gel, but also as a powder. If you have the powder, you need to dissolve it in a small amount of distilled water or saline, according to the instructions, moisten a napkin with this solution, and put it on the scar area for 30 minutes. Such applications should be performed twice a day, for 1 month. The following gel is also used.
Advantages and disadvantages
The drug acts specifically on the scar tissue, is hypoallergenic and can be used not only in applications at home, but also deep into the tissue of scars and scars with the help of physical therapy means, including means of home physical therapy: electrophoresis or phonophoresis. This also makes Fermenkol widely used in various cosmetic salons.
The only contraindication, other than individual intolerance, is trying to apply Fermenkol for the treatment of stretch marks, as well as atrophic and hypertrophic scars. These scars are not designed for Fermenkol. Therefore, only a dermatocosmetologist, as a specialist, can determine whether this remedy is necessary or not. But scars that occur after acne, pimples and acne are treatable with Fermencol. Its only serious disadvantage is its rather high price.
Another special drug for treating scars and scars after acne and pimples is Contraktubex. It is a triple combination of onion extract, allantoin and sodium heparinate. It is a topical remedy in the form of a gel, in a small tube weighing 20 grams. Costs Contraktubex from 530 to 600 rubles, and is produced in Germany by Merz.
Each of these components does its job. The onion extract fights inflammation and improves blood circulation by irritating the deeper layers of the skin. Heparin fights thrombosis, thinning the blood and increasing its fluidity, and allantoin has a keratolytic effect, and prevents fibroblasts from synthesizing scar tissue. As a result, the cells regenerate gently, without hyperplasia. Colloidal fibroblasts, which are to blame for the appearance of scar tissue, are inhibited by the application of Contraktubex. In as little as 4 hours the ingredients of the gel penetrate deep into the dermis and reach the connective tissue.
Of the indications for use – a variety of types of scars, including atrophic scars, which can also form after certain types of acne, acne and furunculosis. The drug is also used for the prevention and treatment of contractures of joints associated with external scarring, traumatic tendon contractures, scars and scars after operations, injuries and burns. Also means can prevent the formation of scars.
Contraktubex is usually applied 2 to 4 times a day to the already formed scars and, depending on the indication, area, age and density of the scar, the course of treatment may last from one month to one year.
Advantages and disadvantages
Of course, the cost of the drug is quite high, especially if it is planned to be used for a long time. But this remedy is quite effective. Side effects, usually itching and redness of the skin, occur, but not more often than 10% of all prescriptions. Contact dermatitis and flaking at the application site are very rare. At the same time, the drug is contraindicated for pregnant, lactating women and children under 1 year old.
Note ! If the patient treats the scars with any medication, it is necessary to avoid ultraviolet insolation, i.e. tanning, and going to the solarium, try not to be in the cold, not to take cold baths, showers and wraparounds. They help to intensify scarring. Also intensive massage is very undesirable, which can weaken the effect of Contraktubex and enhance the formation of scars.