Standard acne

Standard acne is a chronic disease of the sebaceous glands. Due to the age of occurrence of skin lesions, the following are distinguished:

- juvenile acne - beginning at school age,
- late acne - concerns 30-40 years old women, the most common location is the lower part of the face and neck; relationship with hormonal balance;

The disease is characterized by the appearance of facial skin and / or back, chest inflammation of a non-inflammatory nature (closed and open comedones) and inflammatory (papules, pustules, cysts), as well as effusions (post-inflammatory hyperpigmentation, scarring).

Causes of acne’s formation:

1) hormonal disorders - increased sensitivity of sebaceous glands to endogenous testosterone,
2) abnormal keratosis within the sebaceous glands,
3) overproduction of sebum, disturbed composition of lipids in sebum,
4) secondary colonization by Propionibacterium acnes, Staphylococcus aureus, as well as Malassezia yeasts;

Sequence of affairs in acne: excessive stimulation by androgen hormones of sebaceous glands leads to increased production of sebum (with disturbed composition and proportions of particular lipids). In addition, in the ostium of these glands, there is an abnormal keratosis of the cells that plug its outlet. A cluster of cells and sebum closes the ostium - a blackhead is formed. The situation is conducive to the multiplication of saprophytic bacteria and yeasts. The enzymes they separate break down tallow into irritating free fatty acids, and bacterial antigens and irritants that penetrate the hair follicle wall cause the development of inflammation - pustules and cysts form on the skin.

Factors predisposing to the occurrence or severity of acne lesions:

- genetic tendencies - a positive interview with parents or siblings,
- sex - boys are more often and more seriously ill due to hormonal conditions,
- age - changes most often affect teenagers, but 30-40 year olds may also appear, as well as in newborns (caused by the presence of mother hormones and disappear spontaneously after 1-3 months),
- cosmetics, e.g. some powders and roses, causing changes mainly on the cheeks (cosmetic acne),
- lmedicines - androgens (taking testosterone or other anabolics), topically and generally administered corticosteroids and vitamin B12, iodine, bromine, barbiturates, lithium (drug-induced acne),
- chemical compounds - in people having professional contact with chlorine, oils, tars (professional acne),
- diet - eating large amounts of milk and foods with a high glycemic index may increase the course of the disease,
- ultraviolet radiation - in the initial stage of exposure, about half of the patients cause improvement (seborrhea is reduced), then the skin changes and skin discoloration,
- environmental factors; stress, air pollution, etc .;

They do not affect the disease: hygiene, sexual activity.
Acne is also not an infectious disease, because the bacteria and yeasts involved in the formation of inflammatory changes are the physiological flora of the human skin.

Due to the presence or prevalence of individual efflorescence on the skin, we divide acne into:

1) comedo acne,
2) papulopostular acne,
3) phlegmonous acne,
4) acne keloid;

Special characters:

1) fulminant acne - affects boys and young men, includes, in addition to the face, back and chest, it runs with general symptoms (arthralgia, fever),
2) reverse acne - lesions of tonsils are mainly located in armpits and groin,
3) acne induced - mainly affects girls, typical acne lesions are minimal, infiltrates, scratches, blemishes and scars which are the result of mechanical attempts to remove (squeeze) skin lesions

Acne treatment

The main principle of effective therapy is to realize that acne is a chronic disease, but in the vast majority it is completely curable. The basis of therapeutic success is good cooperation with a dermatologist, systematic use of prescribed drugs and awareness that the effects of treatment can be seen only a few weeks after its beginning. An effective therapy consists of pharmacological treatment, treatments to support and home care.


1) retinoids (eg tretinoin - Locacid, Atrederm; isotretinoin - Isotrex; adapalene - Differin; tazarotene - Zorac)

- first line drugs in all forms of acne,
- they work against the skin,
- reduce the bacterial population on the skin,
- they can dry the skin,
- it can not be used during pregnancy and breastfeeding,
- use once a day in the evening on the entire occupied area,
- it is recommended to use for up to 2 years from the end of intensive acne therapy to maintain the effects;

2) benzoyl peroxide (e.g., Akneroxid, Benzacne, Brevoxyl):

- has antibacterial properties without the risk of bacterial resistance,
- reduces the number of comedones
- it can dry and irritate the skin,
- also in combination with an antibiotic (Duac) or retinoid (Epiduo),
- can be used during pregnancy and breastfeeding,
- causes discoloration of clothes, towels,
- use 1-2 times a day;

3) antibiotics (1% clindamycin - e.g. Clindacne, Dalacin T, 2.5% erythromycin - e.g. Aknemycin, Davercin):

- antibacterial effect,
- use in the form of papules and pustules,
- high resistance of bacteria,
- they should not be used as monotherapy,
- the use of erythromycin is allowed in pregnant women,
- most often in combination with other preparations (eg Aknemycin Plus: erythromycin + tretinoin; Isotrexin: erythromycin + isotretinoin; Duac: clindamycin + benzoyl peroxide, Zineryt: erythromycin + zinc),
- 2 x daily applicatione,
- treatment time: 3-4 months;

4) azelaic acid (Skinoren, Acnederm):

- antibacterial and anti-fungal effects,
- it inhibits melanogenesis, lightens post-inflammatory discolorations,
- second-line drug - use in moderate acne inflammation and acne vulgaris,
- very good tolerance,
- can be used during the summer, in pregnant and lactating women,
- application 1-2 x a day;


1) antibiotics (tetracyclines, e.g., limecycline - Tetralysal, doxycycline - Unidox Solutab, tetracycline hydrochloride - Tetracyclinum, macrolides, e.g. azithromycin - Sumamed):

in patients with moderate inflammatory acne (maculopapular pustular),
antibacterial and anti-inflammatory effects,
restrictions in use in the summer due to the photosensitizing nature (mainly tetracycline and doxycycline),
duration of therapy about 6-12 weeks,
should always be used in combination with topical retinoid and / or benzoyl peroxide,
tetracycline must not be used in pregnant or breast-feeding women and in children up to 12 years of age;

2) hormones:

- only in women,
- antiandrogen preparations (Diane-35, Yasmine, Jeanine, etc.),
- especially recommended in patients with cystic lesions in the lower part of the face and on the neck, intensifying before menstruation,
- a method of treatment for women with so-called late acne,
- duration of treatment approx. 6 months;

3) isotretinoin (e.g., Izotek, Curacne, Tretinex, Aknenormin):

- vitamin A derivative (13-cis vitamin A), in medicine since 1983,
- the only drug affecting all the mechanisms involved in the pathogenesis of acne,
- indicated for the treatment of severe forms of acne (phlegmon, cystic), in the case of tendency to scarring and to moderate acne resistant to previous forms of treatment,
- causes a permanent reduction in the size of the sebaceous glands (up to 90%),
- the recommended daily dose of 0.2-1.0 mg / kg body weight,
- recommended total dose: 120 mg / kg m.c. in the case of face changes and 150 mg / kg m.c. in the case of the location on the back - the average duration of treatment is about 6 months,
- a highly teratogenic medicine (fetal malformation) - it is imperative that women use effective contraception throughout the treatment period and 1 month after the end of therapy, the need for a monthly check on the effectiveness of contraception (pregnancy tests),,
- no effect on spermatogenesis in menn,
- Honorary blood donors should not give it over the course of treatment and up to a month after the end of therapy,
- side effects: exacerbation of acne lesions in the 1st month of treatment, dry skin (mainly the backs of the hands) and mucous membranes, joint pain, headache, - mood changes, dusk deterioration, contact lens intolerance - the severity of symptoms depends on the dose of the drug,
- changes in laboratory tests: increase in transaminase levels, influence on the lipid metabolism (increase in triglycerides and possibly cholesterol),
- laboratory tests (blood count, transaminase, lipidogram, glucose) are performed twice: before and after the treatment, more often - in the case of deviations or after a significant increase in the dose,
- the drug should not be combined with topical anti-acne preparations (increased skin dryness),
- the drug should not be combined with oral antibiotics from the tetracycline group (risk of increased intracranial pressure),
- there is no need to use hepatoprotective medications at normal transaminase levels, however, additional supplementation of vitamin A should be avoided,
- the medicine should be taken with a meal,
- you must not drink alcohol during treatment,
- recommended intensive moisturizing of the face and the whole body, including hands, labial lip (moisturizing lipids), or the use of appropriate moisturizing nasal sprays (eg Sterimar) and conjunctival eye drops (eg Lacrimal) during treatment),
- limitations in use in the summer - in combination with ultraviolet increases the drying of the skin - the need to use creams with SPF> 30 and moisturizing creams and sunglasses,
- contraindications to treatment: pregnancy, breast-feeding, children <12 years of age, severe liver disease,
- in the period of 3-6 months after the end of treatment, no aesthetic procedures should be performed due to the impaired wound healing process and the risk of pathological scars;

Dietary supplements

1) LAKTOCER + Zn is a modern preparation that helps reduce the number and severity of acne lesions. It contains lactoferrin and zinc.

The active ingredients contained in the preparation work:

- antibacterial - inhibit the growth of bacteria responsible for the formation of acne lesions,
- anti-inflammatory - reduce inflammation,
- regulate the secretion of sebum,
- soothe irritations and accelerate healing;

2) GLAMUREN is a modern preparation, developed for the sake of beautiful and healthy skin in people prone to seborrhoea (oily and mixed skin) and the formation of acne lesions.

It includes:

- natural silicon, obtained from bamboo shoots,
- flavonoids, present in the extract of the tricolor violet,
- lactoferrin, contained in the complex of bioactive dairy proteins,
- zinc and vitamins from group B;

Active ingredients contained in the GLAMUREN preparation:

- regulate the secretion of sebum,
- have anti-inflammatory effects,
- soothe irritations and accelerate healing,
- inhibit the growth of bacteria responsible for the formation of acne lesions;

Treatment facility

Dermatological treatments may support the process of active pharmacological treatment and / or removal of permanent acne lesions (hyperpigmentation, scarring).

1) chemical peels:

- AHA - glycolic, almond, pyruvic - are mainly used in acne and moderate inflammation; regulate sebaceous glands, reduce seborrhoea, reduce the number of blackheads, restore the proper skin tone,
- salicylic acid - reduction of comedones and seborrhea,
- trichloroacetic acid - removal of acne scars and post-inflammatory hyperpigmentation,

2) microdermabrasion, hydradermabrasion:

- cleanses the skin of blackheads and dead cells of the stratum corneum,
- supports the treatment of active acnea,
- increases the penetration and effect of antiacne drugs,
- smoothes out small scars, brightens minor discolorations, narrows pores,

3) fractional lasers (Fraxel, Multixel-CO2) (Fraxel, Multixel-CO2) - removal of atrophic scars, narrowing of enlarged pores,

4) fillers:

- indications: atrophic scars,
- preparations of hyaluronic acid are most often used,
- the procedure is repeated every 6-12 months,
- after applying the filler an immediate effect of significant smoothing of the skin is obtained, in addition, the given hyaluronic acid stimulates the synthesis of collagen at the site of the scar;

Care products

1) Avene - series: Cleanance, Clean-Ac,
2) Bioderma: Sebium series,
3) Iwostin: Purritin series,
4) SVR: the Lysalpha series,
5) La Roche-Posay: the Effaclar series,
6) Pharmena: Accos series;