Understanding acne - causes, treatment options and pathogenesis

Acne is one of the most common skin problems worldwide and affects millions of people, regardless of gender and age. This inflammatory skin condition can not only cause physical discomfort, but also has far-reaching psychological effects on those affected.

Epidemiology shows that acne mainly occurs in adolescence, but adults are also frequently affected. The pathogenesis of this disease is complex and includes genetic, hormonal and environmental factors that lead to different types of acne. acne can lead to different types of acne. From non-inflammatory forms to more rare variants such as acne inversathe presentation and severity of symptoms varies greatly.

In this article we will discuss the different aspects of acne acne: its causes, symptoms, diagnostic methods, treatment options and the role of the nutritionas well as common myths surrounding this widespread disease.

Epidemiology of the acne

Acne is one of the most common skin diseases and affects many people worldwide. Around 70 to 95 percent of all adolescents show Acne skin changes. The highest incidence usually occurs between the ages of 15 and 18.

In most cases, the acne disappears spontaneously after puberty. However, 2 to 7 percent of those affected suffer considerable scarring. In around 10 percent, the acne persist beyond the age of 25, which indicates a chronic course.

Medical treatment is necessary for 15 to 30 percent of adolescents, as they suffer from severe forms of acne. acne suffer from severe forms of acne. These cases often require systemic therapies.

Frequency at a glance:

• 70-95%: Adolescents with acne lesions
• 2-7%: With scarring
• 10%: Chronic acne over 25 years
• 15-30%: In need of treatment due to severe acne

To summarize Acne is a common condition that affects young people in particular and can have a significant impact on their lives.

Pathogenesis of acne

Acne vulgaris is a widespread skin disease that mainly affects adolescents. The pathogenesis is complex and influenced by genetic and environmental factors. Hereditary factors play a significant role. You can inherit a genetic predisposition to conditions such as seborrhea and sebaceous gland condition.

Acne occurs in various forms. The degrees of severity include:

1. Acne comedonicaCharacterized by open blackheads.
2. Acne papulopustulosa: manifested by inflammatory papules and pustules.
3. Acne conglobataA severe form with cystic changes.

Special forms of acne can be caused by allergic reactions. These can be triggered by ingredients in care products, medication or food.

In more severe forms, inflamed pimples can leave visible scars. This makes treatment more difficult and can lead to psychological stress. Systemic therapy is therefore often necessary.

The management of acne involves taking all these factors into account in order to optimize individual treatment.

Types of acne

Acne is not the same as acne. There are various forms that differ in their type and severity. They range from rather mild to extremely severe variants that require special treatments.

Non-inflammatory acne

Non-inflammatory acne is mainly characterized by comedones, better known as blackheads. These are characterized by sebaceous plugs in the skin follicles. A distinction is made between open blackheads, which are visible on the surface of the skin, and closed blackheads, which close the follicle. These closed blackheads can develop into inflammatory blackheads. acne develop. Non-inflammatory acne is often described as mild acne and describes what many describe as simple pimples or blackheads, but which can be persistent.

Inflammatory acne

Inflammatory acnelike acne vulgaris, is a chronic skin disease that often occurs during puberty. It manifests itself as pimples, comedones and inflamed pustules. The inflammatory acne is divided into different degrees of severity:

• Acne comedonicaPredominantly with open blackheads.
• Acne papulopustulosaInflammatory pustules and papules that also affect the face and back.
• Acne conglobataThe most severe form with painful lumps that leave scars.

Medical therapy is often necessary to treat this form, which can take over three months. Adolescents in particular can be affected by acne not only physically but also emotionally.

Causes and risk factors

Acne is often caused by an excess of male sex hormones, particularly androgens. This often occurs during puberty and can also affect women in adulthood.

Another important factor is genetic predisposition. Children have a higher risk, acne if both parents were affected when they were young.

Stress is also a significant factor that acne can aggravate acne. Mental stress can, along with hormones and genetic factors, Acne promote.

Certain medications, such as corticosteroids and hormonal contraceptives, can also promote acne. acne cause or intensify acne. This depends on the composition of the medication.

Environmental factors also play a role. High humidity and the use of occlusive cosmetics or cleaning agents can lead to the formation of acne contribute to the development of acne.

To summarize:

• HormonesExcess, especially androgens
• GeneticsFamilial predisposition
• Stress: Psychological stress
• Medication: Corticosteroids, contraceptives
• Environment: Humidity, Cosmetics

These factors vary from person to person and can cause different forms of acne acne.

Symptoms of acne

Acne is often first manifested by blackheads, also known as comedones. These can be open or closed. Open blackheads appear black because melanin oxidizes in the air. Closed blackheads, on the other hand, look white.

Other symptoms are papules and pustules. Papules are small, firm nodules, while pustules are pus-filled blisters that may be surrounded by a red blush.

In more severe forms of acnesuch as acne conglobata, large, painful lumps can occur. Abscesses and deep scars can also be the result.

The T-zone of the face is particularly affected, i.e. the forehead, chin and nose. The cheeks, back and chest can also acne develop acne. These skin blemishes can lead to psychological stress.

Scarring and its effects

Inflammatory acne can leave scars. Particularly severe forms, such as acne conglobata, are typically characterized by scarring. These scars look different. There are small, deep pits like ice-pick scars or larger hollows and even raised, hypertrophic scars.

According to acne pigment changes can also occur. This hyperpigmentation often changes the appearance of the skin negatively and can also contribute to scarring.

Scars often affect self-esteem and can increase social anxiety. Without proper treatment, the situation can worsen, which may require specialized scar treatments.

Scarring and its effects

Acne-related inflammation can lead to scars. Particularly severe forms such as acne conglobata often leave visible scars. These scars can take various forms:

• Ice pick scarsSmall, deep pits in the skin.
• Larger pitsShallow but wider pits.
• Hypertrophic scars: Raised and thick scars.

After the inflammatory lesions have healed, hyperpigmentation often occurs. This further changes the skin structure and can impair the appearance.

Scarring is not just an aesthetic problem. Those affected often experience psychological and social stress. The visible signs are often perceived as stigmatizing. This can have a negative impact on self-esteem and social interactions.

A lack of or inappropriate treatment of acne increases the risk of deep scars. This makes specialized treatments necessary. For severe forms of acne timely and effective treatment is important to avoid long-term consequences.

Diagnostic methods

The diagnosis of acne is often made on the basis of its typical appearance. Pustules, blackheads and pimples are particularly noticeable in adolescents during puberty. This information is crucial: When did the acne appeared? How quickly did it worsen? Are there familial clusters?

The doctor asks about the use of cosmetics, medication and dietary habits. These factors can acne influence acne. In severe cases, the doctor may take pus secretions from the pustules or blood samples to make a clear diagnosis and rule out other skin diseases. A swab of inflamed skin areas helps to identify bacterial infections and find the right treatment.

Modern diagnostic procedures

Modern diagnoses are often based on the external appearance of pustules, blackheads and spots. The doctor also takes into account the course of the acne and familial clusters. A blood sample or purulent wound secretion may be necessary for diagnosis, especially in severe forms.

Additional information on cosmetics, medication and dietary habits of the patient are important. A dermatologist should be consulted for an accurate diagnosis of acneform and the best therapy. This procedure ensures the most suitable individual treatment.

Treatment options

The treatment of acne aims to reduce sebum production, normalize the keratinization process and reduce inflammation. Early treatment is important to prevent scarring and psychological stress. Depending on the severity of the acne different therapies are used, which can be both topical and systemic.

Topical therapies

Topical treatments are applied directly to the skin. Clascoterone 1% cream is an example, which is applied twice daily. Salicylic acid, known for its keratolytic and antibacterial properties, is often used to treat comedones. For mild to moderate acne such therapies are often effective. Sometimes they are combined with oral antibiotics to achieve better results. Caution is advised with high doses of salicylic acid, as this can lead to kidney damage.

Systemic therapies

Systemic therapies are oral medications that work throughout the body. Isotretinoin is a strong retinoid that is often used to treat severe forms of acne acne. However, it can cause side effects such as dry skin or hair loss. Women taking this medication should take extreme care not to become pregnant, as isotretinoin can cause severe fetal malformations. Oral antibiotics in combination with topical treatments are also common approaches, especially in moderate to severe cases. acne.

Drug treatments (e.g. antibiotics, benzoyl peroxide)

Antibiotics aim to combat inflammation caused by bacteria in the sebaceous follicles. They often also have an anti-inflammatory effect. Benzoyl peroxide is another commonly used agent that is available in concentrations of 2.5% to 10%. It has antibacterial and keratolytic effects, but higher concentrations can cause skin irritation. Hormonal treatments, such as the combination of ethinylestradiol with anti-androgenic substances, are often used in women to regulate sebum production.

These treatments aim to clear the skin and improve the quality of life of those affected. The choice of therapy depends heavily on the individual situation and the form of acne depends.

Role of the nutrition with acne

The diet can influence skin health, even if no food Acne directly triggers acne. Some studies suggest that dairy products and carbohydrate-rich foods with a high glycemic index can worsen the appearance of the skin.

Possible factors:

• High glycemic index: Foods that raise blood sugar levels quickly could be involved in the development of acne play a role in the development of acne.
• Dairy products: Can stimulate sebum production, which can lead to clogged pores.

However, there is no clear scientific evidence that shows a direct link between certain foods such as chocolate, meat and dairy products. acne confirmed. An anti-inflammatory dietrich in vegetables and fiber may have positive effects.

It is important that the role of nutrition in acne is still being researched further. However, a balanced diet could make a positive contribution to skin health.

Myths about acne

Myth 1: Only teenagers are affected.
Acne is common in adolescents, but it can also affect adults, which disproves the myth of "pure youth".

Myth 2: Acne is more pronounced in boys.
Boys are often more affected during puberty. But Acne remains a problem for both sexes.

Myth 3: All forms of acne are equally severe.
There are different degrees of severity: from acne comedonica to acne conglobata. This shows that not all forms are equally treatable.

Myth 4: Acne is only caused by a lack of hygiene.
Acne has genetic and hormonal components. Inadequate hygiene is not the only cause.

Practical care tips for acne patients

When it comes to facial care, it is important to choose gentle products. Use syndets that have been specially developed for blemished skin.

Avoid greasy cosmetics. Instead, light moisturizers with an oil-in-water base are ideal. They nourish the skin without weighing it down.

If you acne with make-up, it is important to use non-comedogenic products. Antiseptic concealers can also be helpful.

To avoid skin damage, you should not squeeze out blackheads and pimples yourself. This can cause inflammation and scarring.

Avoid possible triggers:

• Occlusive cosmeticsProducts that clog the pores.
• High humidityCan increase the skin's oil production.
• Certain nutritionSome foods can Acne aggravate acne.

A conscious approach to these factors can relieve the skin. Follow these tips to optimize the care of your skin and acne better under control.

Course of the disease and prognosis

Acne can manifest itself in different forms. Around 40 percent of adolescents suffer from a mild, physiological form of acne. However, around 60 percent experience clinical acne with more severe symptoms.

In most cases, untreated acne disappears by the age of 25. However, sometimes symptoms can persist until the age of 40 or longer. Stress and psychological strain can play a significant role. They influence the course of acne and sometimes lead to sudden outbreaks at an older age.

Severe forms of acnesuch as acne conglobata, can leave deep scars without appropriate treatment. Systemic therapy may be necessary here.

Important points for therapy

• Maintenance therapyCan last several years.
• GoalAvoid relapses and support natural regression.

Overall, the right treatment is crucial to favorably influence the course of the disease and avoid scarring.

Conclusion and outlook

Acne is a disease that can occur in various forms and degrees of severity. From mild to severe acne each form requires specific treatment. As hormonal and hereditary factors play a role, the therapy should be individually adapted.

A healthy lifestyle that promotes an anti-inflammatory diet can improve the condition of the skin. This applies to all age groups. Especially with severe acne it is important to consult a dermatologist. Severe acne can be not only physically but also psychologically stressful.

Maintenance therapy is essential to prevent relapses. This can take several years and ends when the natural regression phase has been reached. Early and targeted treatment can significantly improve quality of life.

Outlook:

• Therapy adaptation: Regular visits to the dermatologist for optimal treatment.
• Lifestyle: Integration of anti-inflammatory foods.
• Mental health: Support through counseling is important.

In the future, advances in research should provide in-depth insights into the acne treatment acne treatment. This will give affected people hope for a further improvement in their quality of life.