* Acne harms the self-esteem of adolescents, who are the ones most
affected by it.
* 40% of them feel self-conscious about a problem that requires medical treatment and emotional support.
Acne is the most frequent disorder in the human being and particularly affects adolescents. It has been estimated that 3.5 million Spanish youngsters suffer from this multifactorial skin complaint, which is generated in the pilosebaceous follicles of the face, chest or back. Although it is generally a mild complaint, it can become serious, affect your quality of life and cause other important disorders such as depression, anxiety or social phobia. The subtlety of the dermatologist in detecting and directing the psychological state of mind of the youngsters constitutes one of the fundamental pillars on which the treatment is based, so that they can receive the emotional support that they require. It needs to be treated actively and it should not be regarded just as “a normal thing at that age” which will go away on its own.
Acne begins in adolescence, a very important stage in physical and emotional development, and in which one’s image is fundamental. So we frequently see how this disorder, though it is not at all serious, can create important psychological problems. Many girls dare not leave the house when their pimples are at their worst, and sometimes, their reaction is self-harm: they squeeze the spots and cause wounds to solve the problem of the visual effect of the pimples, but these blemishes may leave scars in visable areas that are difficult to erase.
• Excessive secretion of grease. Skin development undergone in adolescence through hormonal stimulation brings about an increase in the formation of grease, which, in excess, can clog the pores and form the inicial lesion which is the defining characteristic of acne: a pimple or comedone.
• Bacterial overgrowth. With hyperseborrhea, our cutaneous bacterial flora is in optimum conditions to grow and raise the probability of infecting the comedones, thus producing papules and pustules (“spots”), which are also characteristic of acne.
• Androgenic stimulation. Masculine (androgenous) hormones tend to spike during puberty. One of the actions that the androgens promote is the rise in production of grease in the pilosebaceous follicle system.
• Follicular keratinization disorder. This means that in people with acne, the cells of the walls of the pores tend to organise themselves in an anomalous way and thus facilitate the clogging of the pilosebaceous orifice. This is, without a doubt, the most important factor in the origin of the acne.
In most cases, diet does not play an important role in the origin of this disorder.The only thing shown to affect the worsening of the acne in a short period of time is the consumption of an excess of easily-absorbed sugars. Other foods (sausages, nuts …) have not been shown to play any role in this regard.
• Keratolytics. These are substances that unclog the pores by dissolving the material that is obstructing them. They include various acids: salicylic, glycolic, retinoic and lactic, among others.
• Seborrhea regulators. They reduce the production of grease and improve the structure of the cells of the pilosebaceous orifice so that it does not get obstructed. They are the cornerstone of the treatment of acne. They are called retinoids (derivatives of vitamin A), and they can be taken topically (tretinoin, isotretinoin, adapalene) or orally (isotretinoin).
• Anti-inflammatory and antibacterial treatments. They improve the signs of inflammation (redness, swelling, pain) and they reduce the bacterial population. Amongst them you will find, above all, benzoyl peroxide and adapalene.
• Antibiotics. They can be taken either topically or orally. Tetracyclines are used mostly (clindamycin, doxycycline, minocycline). It must be borne in mind that antibiotics should never be used as the only treatment, since they contribute to the bacteria becoming resistant to them over the passage of time.
With the combination of these therapeutic options or just the use of one (isotretinoin), it is possible to control or cure adolescent acne through simple treatments and with a high level of safety.
Let us study your case. Our specialists in Dermatology at HC Marbella will evaluate your case and will suggest the best therapeutic option for you.
Sources: Fundación Piel Sana de la AEDV (Foundation for Healthy Skin) / Academia Española de Dermatología (Spanish Academy of Dermatology).
May 15, 2019
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