Hyperactivity of the sebaceous glands. Diseases of the sebaceous glands. Drugs for external correction of acne Drugs that reduce the work of the sebaceous glands. Uninfected non-inflamed comedones

There are skin diseases that are treated by both dermatologists and cosmetologists. These include something that everyone can have, which you can ignore, but which you really want to get rid of, as this affects the aesthetic appearance of the skin. So, these are problems that spoil the appearance and cause not so much physical as moral suffering. Let us dwell here only on the most frequent ones - Acne, seborrhea and various formations on the skin.

Acne vulgaris or juvenile acne

Acne- the most common skin disease in adolescents and young people, that is, the most socially active part of the population. This unpleasant disease affects about 85% of people aged 12 to 25 in European countries, so clear skin at this age is the exception rather than the rule. The presence of inflamed pimples, pustules and abscesses, blackheads (comedones), spots and scars, greasy, untidy appearance of the skin in the most prominent places causes difficulties in communication, professional device, reduces self-esteem, often leads to the formation of significant psycho-emotional disorders, up to the desire to complete isolation. Some young people stop leaving the house, drop out of school and work, become isolated, and in the end, a minor and completely banal skin problem develops into a personal tragedy. A patient who has addressed to a dermatologist about acne has serious psychological problems. Shyness, guilt, a sense of social unacceptability, anger, a state of depression, disbelief in the possibility of a cure are expressed to one degree or another. Intense experiences exacerbate the course of the disease. In stressful situations, patients, especially women, open the skin, squeeze out Acne, which further worsens the appearance of the skin due to the accompanying inflammation. On such injured areas, scars and spots remain that do not go away for a long time.

Acne- a long-term disease, often aggravated (in girls, as a rule, monthly) and often resistant to ongoing treatment. Today we know much more about acne than ten years ago, and a competent specialist can always help the patient. In this regard, the opinion that existed in the past that acne will disappear by itself with age, and therefore it is not worth spending effort on treating them, now sounds simply absurd. It is not always possible to immediately find the right individual approach, but the efforts made and the persistence shown are always rewarded with a good result. In the arsenal of specialists there are a number of effective drugs of different groups. The choice of the drug depends on the form of the disease, the prevalence of certain symptoms, the sex of the patient, the presence of contraindications.

Acne is more often divided into:

1. acne with a predominance of comedones (white and black dots with mild inflammation);
2. papulo-pustular acne (there are comedones, inflamed nodules - what is usually called acne, pustules, sometimes single large painful seals, gradually turning into abscesses such as boils);
3. conglobate acne (along with all of the above, there are long-term painful seals that leave pronounced scars after healing).

Most patients eventually develop the habit of squeezing comedones and pustules, constantly touching the inflamed skin, which is why bloody crusts, spots, superficial scars are added to everything described.

Many factors are involved in the development of acne, the action of which is ultimately realized in the sebaceous hair follicles. Not all follicles are affected, but only those with a special structure, located on the face and upper body, with large sebaceous glands, wide (up to 2.5 mm) ducts and thin, almost invisible hairs. The sebaceous glands are the target organ for sex hormones, especially testosterone. Under the influence of testosterone, produced by the sex glands, especially actively in adolescence, the size and number of sebaceous glands increase significantly, the production of sebum increases, and its composition changes. In addition, in the development of acne, a violation of the keratinization of the ducts of the sebaceous glands, difficulty in the outflow of sebum to the surface of the skin, increased reproduction of microbes in the accumulated sebum and subsequent inflammation are essential. With the help of modern medicines, it is possible to influence almost all the factors involved in the development of the disease.

With the initial manifestations of acne (usually at the age of 8–13 years), when the clinical picture is dominated by increased oily skin and comedones (whitish nodules and black dots), and there are not so many inflammatory elements, retinoic and salicylic acid preparations are used externally. Both acids have the ability to dissolve comedones, and salicylic acid is much weaker in this regard. With papulo-pustular acne, it is advisable to use antibiotics, retinoids, benzoyl peroxide (benzoyl peroxide), traditional external agents (salicylic, chloramphenicol, resorcinol alcohols). Severe forms of acne, including acne conglobata, should be treated with oral retinoids, and only if there are contraindications, other methods of treatment (antibiotics, immunomodulators) are used. As with papulopustular acne, it is preferable to use a combination of different drugs.

Problems solved in the course of treatment and ways to solve them:

• decrease in sebum production (retinoids, especially retinoic acid, hormonal drugs - estrogens, progestins or antiandrogens, spironolactones);
• reduction of inflammation - antibiotics (tetracyclines, erythromycin, lincomycin, clindamycin) and local anti-inflammatory and microcirculation-improving agents, including zinc oxide, sulfur, tar, ichthyol, resorcinol;
• prevention of the appearance and elimination of comedones (retinoids, especially retinoic acid, salicylic alcohol);
• prevention of scarring (early start of treatment, retinoids, curiosin, contractubex, exclusion of injury to rashes).

Features of acne treatment with drugs of different groups

Currently, retinoids are the most effective group of drugs for the treatment of acne. Their use solves several problems at once - reducing the production of sebum and inflammation, preventing the appearance and elimination of comedones and scars. Two isomers of retinoic acid (tretinoin and isotretinoin) are used externally for the treatment of acne. Roaccutane and Retinol palmitate are used for internal treatment of acne conglobata and widespread papulo-pustular acne resistant to other external agents.

Roaccutane (isotretinoin) (Hoffmann-La Roche, Switzerland) is produced in capsules for oral administration of 10 and 20 mg (30 pieces per pack). Assign at the rate of 0.5-1.0 mg / kg of body weight per day, taken in equal parts 2 times a day after meals for 12-16 weeks. If necessary, repeated courses break should be at least 8 weeks. Roaccutane is a highly effective drug, however, its use is limited by high cost and many side effects. Treatment is always carried out under the supervision of a specialist.

Retinol palmitate(vitamin A) - a domestic drug, it is produced in capsules for oral administration of 33,000 and 100,000 IU, as well as in an oil solution of 100,000 IU / ml. Effective doses for acne are at least 300,000 IU per day. The course of treatment is 12-16 weeks. The intervals between courses are 4-8 weeks. Retinol palmitate is inferior to Roaccutane in effectiveness, however, its tolerance is better, and the cost is much lower.

For external treatment of acne, preparations containing all-trans retinoic acid (tretinoin) and 13-cis-retinoic acid (isotretinoin) are used. All-trans-retinoic acid is contained in the following foreign preparations: Retin-A - 0.05% cream in tubes of 30 g (Silag, Switzerland), Lokacid - 0.05% cream in tubes of 30 g and 0.1% solution in 15 ml vials (Pierre Fabre, France). External preparations with 13-cis-retinoic acid, which has a higher bioavailability, are produced only in Russia - Retinoic ointment 0.1% and 0.05% and Retasol ® (FNPP "Retinoids"). Ointments and solution are recommended to be applied to previously cleansed skin 1-2 times a day. Upon reaching the effect, it is recommended to reduce the concentration or reduce the frequency of application of the drug. The duration of treatment is 12-16 weeks.

Drugs from the group of retinoids have a number of side effects. The most serious of them are teratogenicity and embryotoxicity. In this regard, women of childbearing age are prescribed retinoids with reliable contraception and a negative pregnancy test. In the outpatient card, when prescribing systemic treatment, a note is usually made about the woman's awareness of possible side effects, and abroad, dermatologists suggest that women fill out and sign a special form in order to avoid further prosecution in case of side effects. External treatment with drugs of this group is stopped when pregnancy occurs. Retinoids do not have a negative effect on the reproductive function of men.

In the first or second week of treatment, most patients experience an exacerbation reaction, which is expressed in redness, moderate itching, and peeling of the skin. The patient should be warned about the reaction, and if important events in life are coming at this time, then it is better to postpone the start of treatment. Usually these phenomena disappear on their own within a few days, after which there is a persistent improvement. Dryness of the lips, cracks in the corners of the mouth, peeling of the skin are frequent during the treatment process, they are eliminated by using a neutral moisturizer for the face and body, hygienic lipstick or lip gel, limiting the use of detergents when washing and washing. With the systemic administration of retinoids, dryness of the nasal mucosa, nosebleeds, conjunctivitis, urethritis, increased levels of transaminases and lipids in the blood, and increased skin sensitivity to sunlight are sometimes observed. Taking this into account, before the start of treatment and monthly during the course of treatment, a biochemical blood test is performed, it is recommended to use protective sunscreen, avoid direct sunlight.

Contraindications

pregnancy and lactation, abnormalities in the biochemical analysis of blood (hyperlipidemia, increased activity of ALT, AST and alkaline phosphatase), renal and hepatic insufficiency, hypervitaminosis A, drug intolerance. It is impossible to prescribe simultaneously retinoids inside and out, ultraviolet irradiation, preparations with keratolytic and exfoliating effects, exfoliating cosmetic procedures and products (scrubs, peeling). The action of retinoids is weakened by the simultaneous use of glucocorticosteroid drugs and alcohol intake.

Antibiotics

Of the wide range of antibiotics for the treatment of acne, only tetracyclines, erythromycin, lincomycin, josamycin and clindamycin are used. The appointment of antibiotics inside is indicated for the defeat of a large area of ​​the skin, the predominance of pustules. During pregnancy, of these drugs, only erythromycin can be used.

Antibiotics of the tetracycline group have an advantage over other groups, since they are lipophilic and easily reach the main object of their action - the sebaceous glands. They can be prescribed for a long time - 2-3 months in a small dose. In this case, they block the production of bacterial lipases, the main link in the development of inflammation. An essential advantage of this method is the possibility of long-term treatment without disturbing the composition of the intestinal flora. The daily dose of tetracycline is 1000 mg (10 tablets of 0.1 g or 4 tablets of 0.25 g), doxycycline hydrochloride - 50 mg (1 capsule of 0.05 g once a day), unidox solutab - 50 mg ( 1/2 tablet of 0.1 g), metacycline - 600 mg (2 times a day, 0.3 g). Antibiotics of the tetracycline group at the indicated doses are always well tolerated, and side effects characteristic of long-term use at a bacteriostatic dose do not develop. Tetracyclines are contraindicated in concomitant fungal diseases, pregnancy (last trimester), liver dysfunction, leukopenia, children under 8 years of age, kidney disease. During treatment, insolation is not recommended, ultraviolet irradiation, retinoids for internal use, hormonal contraceptives, psychotropic, anticonvulsant and antidiabetic drugs are not prescribed. The absorption of tetracycline is weakened in the presence of food, especially milk and dairy products, as well as trace elements - aluminum, calcium, magnesium, iron. Their use should be avoided during treatment. Tablets are taken separately from meals.

Doxycycline, Metacycline and Unidox Solutab are better absorbed and can be taken with or after meals with plenty of water. Unfortunately, the resistance of microorganisms to the drugs of this group quickly develops, and when re-administered, they are rarely effective.

Erythromycin belongs to the group of macrolides, the daily dose - 500-1000 mg is distributed in 3-4 doses 1-1.5 hours before meals. The drug is produced in tablets or capsules of 0.1, 0.25 and 0.5 g. Possible side effects include nausea, vomiting, diarrhea, liver dysfunction. The drug is contraindicated in case of individual intolerance, liver diseases with impaired function. It should be borne in mind that erythromycin is inactivated by dairy products and acidic drinks, and also increases blood levels and enhances the toxic effect of carbamazepine (tegretol, finlepsin) and theophylline.

Clindamycin (lincomycin group) is prescribed in a daily dose of 0.6 g, divided into 2 doses, is available in capsules of 0.15 g and called Dalacin C - 0.15 and 0.3 g each. The course of treatment is 7-10 days. Possible side effects include dyspepsia (nausea, vomiting, diarrhea), liver dysfunction. The drug is incompatible with erythromycin and vitamins of group B. Lincomycin is prescribed in a daily dose of 1500-2000 mg (2 tablets 3-4 times a day), is available in capsules of 0.25 g. The duration of treatment and side effects are similar to clindamycin.

Josamycin or vilprafen in a daily dose of 1000 mg (1 tab. 2 times a day between meals) is used for 2-4 weeks, then 1 tab. within 8 weeks. Possible side effects include dyspepsia (nausea, vomiting, diarrhea), liver dysfunction. The drug is incompatible with lincomycin, weakens the effect of hormonal contraceptives.

In case of intolerance to antibiotics, they resort to sulfanilamide preparations, usually co-trimoxazole (biseptol, septrin, groseptol, cotrifarm 480). The drug is prescribed at 480-960 mg (1-2 tablets) 2 times a day during or after meals with an interval of 12 hours. During treatment, it is recommended to drink plenty of fluids, monitor the condition of blood and urine, avoid solar and ultraviolet radiation, and do not prescribe ascorbic acid.

It is logical to assume that the local use of the above antibiotics can be much more effective and safer than the internal one. However, studies show that topical erythromycin, clindamycin, and tetracycline are only effective for mild acne, especially when combined with zinc, retinoids, or benzoyl peroxide. External application of 1% erythromycin ointment (Ung. Erythromycini 1%) has a positive effect only in combination with other external and internal agents, the gel with clindamycin Dalacin T (Pharmacy, USA) is more effective. Easy to use Eriderm (Eryderm, Abbott Labor, USA) - 2% solution of erythromycin. Levomycetin, boric, resorcinol alcohols are also used for drying and cauterization of individual rashes. Combined preparations are effective - Zinerit ("Yamanouchi", the Netherlands) - a solution of erythromycin and zinc acetate and Benzamycin, a gel for external use, in tubes of 20 g, ("Rhone-Poulenc Rohrer", USA), containing 3% erythromycin and 5% benzoyl peroxide. All of the above drugs are prescribed 2 times a day. As with oral antibiotics, topical preparations tend to cause the development of antibiotic-resistant strains of microorganisms, so their repeated administration is often ineffective. Resistance of strains of Propionibacterium acnes (the main microorganism that multiplies in the sebaceous glands of patients) to commonly used antibiotics was found in 60% of patients. Strengthening of resistance depends on the duration of therapy, resistance to erythromycin develops more often.

Other antiseptics and disinfectants. One of the successful modern approaches to treatment is the use of benzoyl peroxide - a lipophilic compound due to the presence of a benzoic acid residue in its composition. When applied to the skin, benzoyl peroxide decomposes under the action of air into peroxide and inactive benzoic acid, which remains on the surface of the skin. Active oxygen compounds damage the walls of bacteria, destroying them, the content of fatty acids decreases, which prevents inflammation. At the same time, the same compounds have a damaging effect on the horny scales, which is clinically expressed by skin peeling, which accompanies the therapeutic effect. Benzoyl peroxide preparations do not affect comedones, therefore, if they predominate, they are not used. Different companies offer this drug under the names Benzakne (Polfa, Poland), Desquam (Bristol-Myers, USA), Oxy 5 and Oxy 10 (SmithKline Beach, UK), Baziron (Galderma, France). Benzoyl peroxide is produced in the form of 2%, 5%, and 10% gel, 5% and 10% lotion. Treatment begins with the application of a lower concentration of the drug to the face, then it is increased. A higher concentration is immediately applied to the back and chest. Benzoyl peroxide is applied to previously cleansed skin once a day. Side effects include an exacerbation reaction in the first days of use, dryness and flaking of the skin, discoloration of hair and linen when the drug comes into contact with them. Intolerance is not uncommon, therefore, before starting treatment, it is recommended to conduct a skin test - the drug is applied to a small area of ​​​​the skin of the flexor surface of the forearm for 48 hours. In the absence of itching and redness, you can apply the drug on the face.

A good effect, especially in the presence of comedones, has a combination of local application of benzoyl peroxide in the morning, and Retinoic ointment in the evening.

Azelaic acid inhibits the growth of microorganisms and reduces the content of free fatty acids on the surface of the skin. Cream or gel Skinoren (Schering, Germany), containing 20% ​​and 15% azelaic acid, respectively, is applied to the skin of the face (both on the affected and free areas from rashes) 2 times a day. When applied, local skin irritation is possible. Skinoren is used in the complex therapy of acne; its use as an independent remedy usually does not bring success.

Zinc hyaluronate is part of the Curiosin gel (Gedeon Richter, Hungary), has a healing and antimicrobial effect. It can be used with a small amount of rashes, since the effectiveness of the drug is low. The gel is applied to cleansed skin twice a day, there may be a burning sensation and redness of the skin at the application sites.

Povidone-iodine (Betadine) is used to lubricate pustules in a concentrated (10%) or diluted 1:1 solution with water 1-2 times a day. It is undesirable to use in fair-skinned and red-haired patients due to increased sensitivity to iodine. The diluted solution cannot be stored.

With a small number of comedones in the initial stage of the disease, salicylic alcohol 2-3% is effective. It is used 2 times a day, trying not to apply to the entire affected area in order to avoid overdrying, but only to certain areas.

Sulfur is an anti-inflammatory agent, it is included as one of the components in most external agents (ointments and talkers) traditionally used in the treatment of acne. However, in recent years, its comedogenic effect has been discovered, i.e. it can cause the formation of comedones.

hormone therapy

Therapy with sex hormones is possible only in women. Estrogens (ethinylestradiol) and antiandrogens (cyproterone acetate, spironolactone) can be used for treatment. Estrogens reduce the secretion of the sebaceous glands, however, not as significantly as retinoids. They can be used simultaneously with local administration of retinoic acid, antibiotics or benzoyl peroxide, which increases the therapeutic effect. To achieve a good result, estrogens must be given for a long time - at least 5 cycles. The first signs of improvement are noticeable only towards the end of the second or third cycle. Estrogens have many side effects - nausea, fluid retention in the body, swelling of the legs, weight gain, breast tenderness, skin pigmentation, and an increased risk of vascular thrombosis. Risk factors for side effects include smoking, alcohol consumption, obesity, and vascular disease. Cyproterone acetate for the treatment of acne is used only in combination with estrogens. Of the combined preparations, Diane-35 and Janine (Schering, Germany) are used. The drug is prescribed 1 tablet per day, starting from the first day of the cycle, for 21 days with a break of 7 days. The antiandrogenic drug Cyproterone or Androkur (Schering, Germany) is prescribed 1 tablet (10 mg) per day, starting from the first day of the cycle for 15 days, a new course is started 4 weeks after the start of the first one. Glucocorticosteroid drugs are prescribed orally or parenterally only for abscessing and fulminant acne, which are extremely rare. External use of corticosteroid ointments is not indicated.

Drugs of other groups

Zincteral ("Polfa", Poland) contains zinc sulfate, the deficiency of which is often found in patients with acne. Tablets of 0.124 g are prescribed 1-2 times a day during or immediately after meals for 1-2 months. Nausea may occur during the first week of use. The drug enhances the action of retinoids, but weakens - tetracyclines. Homeopathic treatments include injections of Cutis compositum or Traumeel (Heel, Germany). Phytotherapy is still widely used as adjuvants - applications of gruel from badyagi for resorption of individual large nodes, lotions with green tea, calamus rhizome, raspberry shoots. Inside appoint infusions of plants with estrogenic action (hop cones, sage leaves).

Skin care

Many patients, feeling the increased sebum secretion characteristic of acne, try to wash their face as often as possible using soap and a sponge. At the same time, the skin dries up, but sebum secretion does not become significantly lower, since the washing out of fats occurs only from the surface of the skin, without affecting the sebaceous glands themselves, located in its depths. In this regard, frequent washing of the skin (no more than 1 time per day), the use of sponges and washcloths are not recommended in order to avoid irritation and injury. Now many use antimicrobial soap. But it changes the state of the microbial flora only on the surface of the skin and does not significantly affect the course of the disease. At the same time, antimicrobial additives contained in soap can cause irritation or allergic reactions. To clean the skin, it is better to use a mild neutral soap for sensitive skin or special cosmetics designed for this purpose (cleansing with milk, then tonic), and to eliminate the shine of the face associated with the release of sebum to the surface, use cosmetic wipes or special matting funds. The widely held belief that makeup should not be used for acne has also now been reconsidered. Modern high-quality cosmetics that do not irritate the skin, well mask existing defects, do not significantly disturb perspiration, are not applied to the skin in a thick layer, and can be used during the day. It should be removed at home. Some medicines require the use of sunscreen. It is better to prefer gels and milk, and also be sure to quickly remove them from the skin indoors. Scrubs and peels may be recommended to smooth the surface of the skin and give it freshness, but are contraindicated during treatment with retinoids, benzoyl peroxide and tetracyclines.

The use of therapeutic masks with a drying effect and detergents is limited during treatment with retinoids and alcohol solutions. If there are pustules on the skin and severe inflammation, massage and cosmetic cleaning of the skin are contraindicated.

Diet

Both in the past and now, most dermatologists always recommend a fairly strict diet. Our long-term observations have shown that the benefits of such restrictions are small, and only in a few patients there is a clear relationship between the consumption of certain foods (mainly chocolate) and increased rashes. Usually we recommend that patients follow a reasonable diet, no frills, include more fermented milk products and greens in the diet. However, 2-3 days of fasting during an exacerbation always give a positive result. In general, when prescribing modern therapeutic agents, there is no need to follow any diet to achieve a good result. If the patient is to take part in a festive feast, it is better to cancel oral administration of drugs for 2-3 days and prescribe enterosorbents (Polifepan, Enterosgel, etc.).

• The initial stage - a few small black dots appear on the nose and forehead (usually in children) - Salicylic alcohol, Retinoic ointment, Skinoren, medical cosmetics.
• The same, but with significant oily skin - Retinoic ointment, Salicylic alcohol.
• Numerous black dots and individual inflammatory nodules and pustules - Retinoic ointment, Salicylic alcohol, for pustules - alcohols with antibiotics, Dalacin T, Povidone-iodine.
• The predominance of inflammation with a small number of comedones - Retinoids (Retinoic ointment, Retasol ®), benzoyl peroxide (Benzacne, Desquam, Oxy 5 and Oxy 10, Baziron), external preparations with antibiotics (Dalacin T, Zinerit, Eriderm, Benzamycin).
• The predominance of pustules in a common process (face, back, chest) - antibiotics, in some cases - retinoids inside (Roaccutane, Retinol palmitate), externally - benzoyl peroxide, disinfectants.
• Separate large painful ulcers on the face - antibiotics, externally - antibiotic ointments and benzoyl peroxide.

Seborrhea and seborrheic dermatitis

In recent years, what used to be united by one term “seborrhea” began to be divided into 2 concepts - seborrhea of ​​the head and seborrheic dermatitis (damage to smooth skin).

Seborrheic dermatitis is a chronic inflammatory skin disease. It affects 1-3% of adults (mostly men). Seborrheic dermatitis, along with acne, refers to disorders of sebum secretion. Indeed, both diseases are often combined in the same person and the same areas of the skin are affected - the so-called "seborrheic zones" - the face, chest (decollete area) and the middle part of the back along the spine (interscapular region), where the largest sebaceous glands with wide ducts that secrete a large amount of sebum. The sebaceous glands of this type actively develop and increase in size during puberty. The composition of sebum also changes, it becomes more viscous, the components contained in it contribute to increased keratinization, which corresponds to peeling that is visible to the eye. Smaller glands, but also secreting a large amount of sebum, are located on the scalp. Their purpose is to provide fatty lubrication of the hair, to make it invulnerable to external influences. These glands are also more active during puberty. In adolescents and adults, the mildest form of seborrheic dermatitis is characterized by peeling of the skin and its excessive oiliness without inflammation - on the scalp it is dandruff, and on the face and chest - accumulations of fatty scales in the skin folds - near the wings of the nose, in the nasolabial fold, on the bridge of the nose , less often - on the chest and back. Oily scales soaked in sebum serve as a good breeding ground for the development of lipophilic fungi Malassezia furfur or Pityrosporum ovale. In turn, the immune system reacts to them with the development of allergic dermatitis, the disease enters its second, more unpleasant phase, and ceases to be limited to mild manifestations. There are itching, burning, at first mild, then more intense reddening of the skin, severe peeling, hair loss. The manifestations of the disease are aggravated by the patients themselves - constant combing, attempts to remove crusts, remove accumulations of scales from the hair, the use of "folk" remedies, and the most powerful ones, inevitably lead to increased redness, the appearance of scratches and wounds, the multiplication of other microbes, the development of complications pustular process. Usually in this condition, patients turn to a dermatologist, although everything could be corrected much earlier.

With any manifestation of the disease, attention should be paid to the diet. Sometimes its correction is enough to prevent further development of the disease. Alcohol, sweets and starchy foods should be limited, regardless of the type of food. With itching and inflammation, smoked, salty, pickled foods, spicy seasonings, strong broths, instant coffee, citrus fruits, kiwi, pineapples and juices from them are also temporarily limited.

Treatment depends on the stage of development and the clinical picture of the disease. With the appearance of dandruff without the presence of inflammation, you can limit yourself to only external treatment, in more serious cases, internal treatment is also necessary. External treatment includes keratolytic, glucocorticosteroid, antiseptic, disinfectant and antifungal agents. Antifungal drugs usually start treatment, they can be used for a long time without the risk of side effects. Various dosage forms are used - creams, gels, shampoos. Shampoos with antifungal substances - Nizoral, Keto-plus, Perkhotal, Mycozoral, Sebozol contain 1-2% ketoconazole. Tee/Jel anti-dandruff shampoo contains 0.75% piroctone olamine and 2% salicylic acid. Creams and gels are applied 2 times a day, shampoos - 3 times a week. Various other medicinal substances that also have antifungal properties include zinc pyrithionate, tar, sulfur, resorcinol, and selenium disulfide. Drugs containing these compounds are available in the form of shampoos for the treatment of dandruff (Friderm-tar, Ti / Gel-Nyutar, Friderm-zinc) and ointments for the treatment of smooth skin lesions (Skin-cap, birch tar, tar and sulfur-tar ointment ). Prescription forms are also used: Vidal's milk, alcohol solutions with sulfur, boric acid, tar. After hair treatment, it is obligatory to change combs and hair brushes, hats.

With severe inflammation, anti-inflammatory, antiseptic and disinfectants are used. With wetting and severe swelling of the foci, lotions with resorcinol 1%, decoctions of herbs are used. The crusts are usually lubricated with alcohol solutions (salicylic, resorcinol, boric alcohols). Corticosteroids have a rapid anti-inflammatory effect - they are used on the head in the form of solutions - Elokom, Diprosalik (Schering-Plough USA), Lokoid (Janssen-Silag Belgium), Belosalik (Belupo, Croatia), on seborrheic zones - in the form of ointments and creams - Elokom, Diprosalik, Belosalik, Hydrocortisone ointment. It should be noted that only non-fluorinated glucocorticosteroids in the form of easily absorbed creams and emulsions (Advantan emulsion, Elokom cream, Lokoid cream) or weak (Prednisolone, Hydrocortisone) ointments can be used on the skin of the face, which is much thinner than in other areas. Preparations of this group are not suitable for long-term use due to the risk of undesirable effects - thinning of the skin, vasodilation, the appearance or intensification of acne. When it is possible to remove acute inflammation (usually in 3-5 days), and with residual peeling, they are replaced by preparations containing vitamin A - emulsion-based ointments Videstim ® , Radevit ® (FNPP Retinoids, Russia). It is known that vitamin A (retinol palmitate) reduces sebum secretion by reducing the size of the sebaceous glands and keratinization, and also has the properties of a local immunomodulator. Videstim ® contains 0.5% retinol palmitate on an emulsion basis, Radevit ® contains 1% retinol palmitate, ergocalciferol and tocopherol acetate (vitamins A, D and E). Drugs are used for a long time, including for the purpose of preventing relapses. In recent years, the local immunomodulator pimecrolimus, supplied to Russia under the name Elidel, has also been used in the treatment. Keratolytic agents are used for severe peeling and crusting. Apply sulfur-salicylic ointment 2-5% 1.5-2 hours before washing the hair under a scarf, on the face - 1 hour before washing, 10% urea ointment Karboderm (Ukraine). A particularly good effect is brought by combined preparations that combine the keratolytic properties of salicylic acid and anti-inflammatory glucocorticosteroids - Diprosalik, Belosalik. Internal remedies include vitamin A (retinol palmitate) in a daily dose of 100,000–200,000 IU (once at night for 2 months), B vitamins, in particular brewer's yeast (“Merz” Germany and domestic companies), brewer's yeast with the addition of zinc and selenium Nagipol, multivitamin-mineral complexes, preparations with selenium (Selevit, Triovit), zinc (Zincteral). To reduce fat formation in women, hormone therapy (Diana-35, Janine) and antiandrogens (Androkur) are used - see above. Despite successful therapy, the disease often recurs. A rational approach to diet and a careful selection of skin and hair care products are necessary to maintain a favorable treatment result for as long as possible.

prof. IN AND. Albanova

Oily skin is the cause of many complexes and problems. The owners of such “wealth” note a minimum of positive qualities: it is more elastic, wrinkles do not appear longer, it tolerates stress more calmly. But a huge list of disadvantages outweighs all the advantages of oily skin, and the most significant problems are greasy shine and, of course, acne - acne.

The blockage of the sebaceous glands, caused by various reasons, is to blame for the occurrence of acne. Such a phenomenon as hypersecretion, that is, excessive production of sebum, creates the conditions for the appearance of a sebaceous plug. As a result, pustules appear - pimples with a purulent head and inflamed skin around, and comedones - black dots. Manifestations of acne are unpleasant because blackheads are often located in small groups, attracting attention.

The location of acne in acne caused by hyperactivity of the sebaceous glands is very characteristic: the T-zone, a little less often - the back in the area between the shoulder blades, the chest in the decollete zone. This “geography” of the problem is due to several factors at once:

1. There are more sebaceous glands in these areas
2. Basically, these areas are open, including the back - cold drafts affect this particular area. The temperature difference stimulates the active secretion of sebum.
3. The face and décolleté area experience many negative influences in addition to cold and heat: cosmetics, street dust, regular touches.

Additional stimulation of secretion accelerates clogging of pores, leading to the feeling of a permanent "fat mask". When combined with acne, these sensations can cause the acne to scratch, leading to even more blooming of the skin, the formation of painful, inflamed areas, and sometimes scarring. By the way, squeezing blackheads can lead to the same consequences.

Solving the problem of acne for owners of hyperactive sebaceous glands is quite difficult. Before proceeding with the treatment of acne itself, it is necessary to find out the cause of hypersecretion. It can be like a shift in the hormonal background, a consequence of taking medications, a violation of metabolic processes, an individual feature of the body. In the latter case, there are special techniques that reduce the activity of the sebaceous glands and reduce the likelihood of relapse.

It is undesirable to ignore the manifestation of acne on oily skin. In the absence of adequate treatment, hyperactivity of the sebaceous glands will greatly increase the manifestations of acne, as a result, comedones and pustules may spread beyond the boundaries of the T-zone, damage to large areas, the formation of pustules, and in the most severe cases, cysts.

Acne is a common problem faced by a beautician.

During puberty in girls and boys, there is an increase in the blood concentration of the male sex hormone (primarily dihydrotestosterone), which regulates the secretion of sebum. Pimples (acne) appear on the skin. The severity of the process (acne) depends on internal and external factors.

According to statistics, at the age of 12 to 25 years, the appearance of acne is observed in 85% of people over 25 years old - up to 11%, mostly people with oily skin or a temporary violation of sebum secretion. Propionobacterium acne plays a key role in the development of inflammatory reactions.

In general, the key links in the pathogenesis of acne development can be identified:

• stimulating effect of hormones with androgenic effect on the differentiation of sebocytes,
• hypersecretion of the sebaceous glands,
• follicular hyperkeratosis,
• changes in the composition of sebum,
• activation of microorganisms
• inflammatory response of the immune type,
• psychoemotional disorders,
• hereditary predisposition, etc.

Thus, acne is a multifactorial disease. The problem of acne is one of the most urgent in the work. At the present stage, a universal drug has not been created that would affect all links in the pathogenesis of this process.

Classification

There is no single classification for acne. There are classifications according to etiological, pathogenetic characteristics, according to severity, according to the age factor, according to clinical and morphological features, etc.

A cosmetologist more often has to deal with acne with eruptive comedonal, papulopustular, conglobate elements. Therefore, the classification according to the severity of comedonal eruptive elements takes into account the number of rashes:

• I degree - less than 10 elements;
• II degree-10-25;
• III degree - 26-50;
• IV degree - more than 50 comedones.

Papulopustular acne is also divided according to severity, taking into account the number of rashes:

• I degree - mild form - less than 10 elements,
• II degree - 10-30;
• III degree - 21-30;
• IV degree - more than 30 inflammatory elements and / or more than 50 comedonal.

The presence of conglobate elements indicates a severe form.

The sebaceous glands are sensitive to male sex hormones. Testosterone itself, circulating in the blood, does not activate the sebaceous glands. This occurs in the skin (girls and boys) and the prostate (boys) when testosterone is converted to dihydrotestosterone under the influence of the enzyme 5-a-reductase.

This process can be blocked with drugs. Therefore, in severe cases of acne, a dermatologist should deal with the treatment.

Part of the lighter effects are included in cosmetics, in particular vitamin B6, y-linolenic acid (found in blackcurrant, borage oil).

Substances of plant origin from the family of phytoestrogens that can reduce the secretion of the sebaceous glands are found in hop cones, grapes, nettles, etc.

Some plants contain tannins, essential oils, minerals and other components that reduce sebum production, have astringent antiseptic, anti-inflammatory, soothing properties: horsetail, rosemary, nettle, cedar, fir.

The viscosity of sebum, its composition (the predominance of saturated fatty acids), and the presence of microorganisms also contribute to the formation of acne. The process can be aggravated by improper skin care, the use of cosmetics containing comedogenic substances that cause blockage of the sebaceous glands (formation of comedones), these are solid vegetable oils (coconut and stone fruits), isopropyl palmitate and isopropyl myristate (synthetic fat substitutes), animal fat (water-soluble modification lanolin - ethoxylated lanolin), mineral oils, etc. Their use leads to the appearance of exogenous acne.

Blockage of the sebaceous glands, in turn, can lead to inflammation, as there are conditions for the reproduction of anaerobic bacteria, such as acne propionobacteria.

Ethoxylated alcohols and polyethylene glycols (emulsifiers and solvents) are used in cosmetics and sunscreens; under the action of ultraviolet rays and atmospheric oxygen, they form peroxides, which serve as a source of free radical formation. They are able to cause a special kind - the so-called Mallorca acne.

Exacerbations can lead to prolonged exposure to the sun and overdrying in solariums. A visible improvement often attracts clients to the use of "solar" procedures, but over time the skin will react with an exacerbation, sometimes more pronounced. The bactericidal and drying effect is short-term, reducing the sensitivity of the sebaceous glands.

Treatment

Based on the peculiarities of the pathogenesis of acne and taking into account the severity of the course of this process, it is recommended to carry out treatment, including general and local effects.

In severe conditions, retinoids (Retin-A, Tretinoin), azelaic acid (Skinoren), external comedolytics based on a-hydroxy acids are used topically.

Papulopustular acne (acne papulo-pustulosa) - are non-inflammatory nodules of dense consistency, resulting from blockage of the mouths of sebaceous hair follicles, located in the surface layers of the skin. The contents of the so-called closed comedones (whiteheads) are dense, white in color, and cannot freely stand out on the skin surface. The size of these formations is 0.5-2 mm in diameter, they are often localized on the forehead, around the eyes, on the eyelids, on the cheeks.

Cleansers are regularly used with the addition of disinfectant, anti-inflammatory, bactericidal ingredients, as well as normalizing the secretion of the sebaceous glands. In more severe forms, local antibiotic therapy, drugs that have a sebostatic effect, normalize keratinization processes, and drugs with antiandrogenic properties are used. According to the indications, general therapy, laser treatment are used.

Various antibiotics are used as drugs that inhibit the growth and metabolism of Propionibacterium acnes, colonizing follicles and sebaceous glands. They give an anti-inflammatory effect.

Topically applied ointments, solutions, aerosols, gels:

• tetracycline ointment 3%, tetracycline hydrochloride - 3% ointment - and patented preparations;
• drugs of the lincomycin group - lincomycin hydrochloride in the form of a 2% ointment, clindamycin (dalacin);
• a preparation of a group of antibiotics - macrolides - erythromycin ointment (contains 10,000 IU of erythromycin in 1 g);
• benzoyl peroxide in the form of 5%, 10% gel;
• combined preparation of benzoyl peroxide and erythromycin - gel "Benzamycin", etc.

These drugs have anti-acne properties, having an inhibitory effect on bacteria (primarily P. acnes). It should be remembered that prolonged use of these drugs helps to reduce local immunity, the development of dysbacteriosis.

Allocate drugs:

1) having a sebostatic effect;

2) normalizing processes of keratinization.

Currently, roaccutane (isotretinoin) is considered to be one of the effective drugs for the treatment of numerous recurrent papulopustular forms (with the ineffectiveness of antibiotic therapy and a tendency to scar formation), which has an effect on the pathogenesis of acne. Clinical data show that it is able to reduce sebum production by 80% or even more (according to other authors - up to 95%). The drug interacts with receptors on the surface of keratinocytes, affecting the processes of proliferation and differentiation of cells (epithelial cells and epithelium of the excretory ducts of the sebaceous glands), and reduces the secretory activity of the sebaceous glands. It has an anti-inflammatory effect. Shown only in severe forms. Some authors consider this opinion unfounded. The duration of the course is from 4 months to 1 year (from 0.1 to 1 mg / kg, depending on the severity of the process, 1 time per day after dinner). It is recommended to combine roaccutane with a number of drugs and cosmetic procedures: vitamin E, homeopathy, skinoren, oxygen-ozone therapy, mesotherapy.

An ambiguous approach to the use of this drug is associated with the presence of side effects: it gives the effect of dry skin, cheilitis, conjunctivitis, arthralkin, myalgin, headache, hair loss. It is necessary to exclude the intake of alcohol. Roaccutane has a pronounced teratogenic property.

Retinoids belong to the group of effective pathogenic agents. Topical retinoids can be used as monotherapy or in combination with other agents and procedures (for mild to moderate acne).

Adapalene (differin) - a derivative of naphthalic acid (0.1% gel), is used as monotherapy or in combination with other drugs 1 time per day. The effect is achieved after 2-3 weeks, stable improvement - after 2-3 months. It has teratogenic properties.

From domestic external retinoids, retinoic ointment (0.05-0.1%), retasol solution (0.025% solution) are widely used.

Among the drugs that inhibit lipid peroxidation of cell membranes that have a direct effect on the function of the sebaceous glands, do not increase skin sensitivity to sunlight and do not have teragogenicity (can be used in pregnant women and with atonic skin), it should be noted azelaic acid - the drug Skinoren - 20% cream (international name - azelaic acid, in the Russian Federation the spelling of the non-patented international name is accepted - azelaic acid). The drug is used to treat acne. The mechanism of action is due to inhibition of the synthesis of cellular proteins (moderate cytostatic effect). There is a normalization of keratinization processes in the wall of the hair follicle and blocking of 5-a-reductase, the drug has an antimicrobial effect both on the surface of the skin and in the sebaceous glands, as well as an anti-inflammatory effect (reduces metabolism in neutrophilic granulocytes and the production of free radical oxygen species by them - important factors in maintaining inflammatory process).

With prolonged use, resistance of microorganisms is not formed. The cream is applied 2 times a day to previously cleansed skin affected by acne. The duration of the course is 2-4 months or more if necessary. Improvement is noted after 2-4 weeks of use. Side effect: skin irritation, erythema, burning, itching, peeling are locally noted (it passes on its own during treatment). The main contraindication to the use of the drug is hypersensitivity to the components. Avoid getting the cream in the eyes, on the mucous membranes of the lips, mouth, nose. At the beginning of treatment, Skinoren can be used once a day. Also used are preparations containing a-hydroxy acids that can control keratinization processes that affect inflammatory mediators. There is no consensus on effectiveness. A number of authors note a very moderate effect in superficial forms of acne.

Hormonal anti-acne therapy is used in women with hyperandrogenic acne. Antiandrogenic drugs are used. These include systemic antiandrogens, combined oral contraceptives, spironolactone, cyprosterone acetate (Androcur), finasteride, and the combination drug Diane-35 (cyprosterone acetate + ethinyl estradiol).

The use of these drugs is limited or excluded in men due to the risk of systemic side effects. You can prescribe these drugs only after consulting an endocrinologist, dermatologist and cosmetologist and in cooperation with these specialists.

Along with a positive effect on the course of acne, many drugs, as noted earlier, have a number of disadvantages.

It should also be noted the Curiosin gel, created on the basis of natural components - hyaluronic acid and zinc. Hyaluronic acid and zinc are substances that make up the skin. Hyaluronic acid stimulates epithelization, zinc has anti-inflammatory and antimicrobial properties. Curiosin has a blocking effect on bacterial lipase, reduces the activity of 5-a-reductase, an enzyme localized in the hair follicles and sebaceous glands, as a result of which sebum secretion decreases over time, the appearance of rash elements stops. The drug is also used as a prophylactic.

Curiosin gel is applied to previously cleansed skin with a thin layer 2 times a day, in the morning and in the evening. The course of treatment is 1-2 months. When applied, there is a burning sensation and redness around the papular elements (passes on its own). The positive quality of the drug is its ability to form a cosmetic, rather than retracted scar.

In addition to the listed medications for acne, various cosmetic procedures (peelings, masks, cleansing, etc.), cryotherapy, physiotherapeutic methods of hardware cosmetology, etc. are used.

Acne is one of the most common skin diseases, affecting 90% of adolescents, and often occurs in adults. If we transfer the frequency of acne to a dermatological appointment, then it is safe to say that 6 out of 10 patients per day treat this particular problem.

In order to understand what is the main thing in the treatment of acne, let's recall the pathogenesis of the development of the disease.

Hyperfunction and hypersecretion of the sebaceous glands

The sebaceous glands are located on the entire surface of the skin, except for the palms and soles. But their maximum density (400 - 900 per 1 sq. cm) is on the skin of the face. There are age-related features of the structure of the sebaceous glands. For example, during puberty, the sebaceous glands grow intensively and function, by the age of 40 their number decreases due to atrophy of the small glands.
The secretion of sebum is stimulated by free testosterone of testicular or ovarian origin, dehydroepiandrosterone of adrenal origin. Progesterone also enhances the function of the sebaceous glands due to androgenic and antiestrogenic activity. This explains the increase in greasiness of the skin and the appearance of acne before menstruation.
Sebum contains free and bound fatty acids, triglycerides, metabolites of steroid hormones, squalene, cholesterol, etc. The secretion of the sebaceous glands is a substrate for the reproduction of P.acnes, which by their nature are anaerobes. Free fatty acids are irritating and cause inflammation. Moreover, with increased sebum secretion, the concentration of linolenic acid decreases, thereby leading to an increase in the pH of the skin, a change in the permeability of the epithelium and the growth of microorganisms.

Follicular hyperkeratosis

The lumen of the follicular canal, where the excretory duct of the sebaceous glands opens, is covered with a thin layer of corneocytes, which are easily exfoliated in the nome. In acne, the composition of intercellular lipids changes, as well as the disintegration of keratinocyte desmosomes in the stratum corneum, thus leading to retention hyperkeratosis. Relatively speaking, the excretory duct of the sebaceous gland is clogged with horny masses and comedones are formed. Sebum is not secreted, and the lack of oxygen becomes the optimal breeding ground for P.acnes.

The role of microorganisms

The microbiology of the follicular canal includes the following groups of microorganisms: Gram-positive cocci (staphylococcus and micrococcus), anaerobic diphtheroids (Proprionibacterium acnes and Proprionibacterium granulosum), lipophilic yeast-like fungi (genus Pityrosporum). And this flora is qualitatively identical to that of a normal sebaceous follicle. Staflococci and micrococci are aerobes, therefore they cannot develop in the anaerobic conditions of the infrainfundibulum, where the inflammatory reaction occurs in acne. Therefore, their role in the development of acne is insignificant.
The same applies to the fungal flora, micelle forms, which are usually associated with pathological processes, are not found in acne patients.
The only microorganism that is involved in the development of acne is P.acnes. But their reproduction directly depends on anaerobic conditions, and therefore on hyperkeratosis and increased secretion of sebum. Therefore, antibacterial treatment for acne gives only a short-term result. Its use is justified only in combination, as well as in exacerbations with a predominance of pustular elements and, again, in combination with other pathogenetic methods of treatment.

Inflammation and immune response

In response to the vital activity of P.acnes, the complement system is activated, cytokines are produced and the chemotactic activity of immune cells is activated. But there are a number of studies that prove the possibility of synthesis of inflammatory factors by sebocytes and keratinocytes themselves, without the presence of microorganisms.
As a result, we observe an inflammatory process, which is sometimes not entirely adequate and leads to the development of abscesses and cystic elements with further scarring.

I will not dwell on the classification of acne. We all know her. And the choice of therapy is always based on the predominance of certain elements of a skin rash on the patient's skin. However, based on the above, the main "points of application" in the pathogenetic treatment of acne should always be primarily the secretion of sebum and hyperkeratosis.

In this article, we also do not talk about hormone therapy for acne. Although in most adult women (but adolescents are no exception), the most common cause of acne is polycystic ovaries or hyperandrogenism of another origin. And without the correction of the hormonal background in these cases can not do. Therefore, dermatologists should always deal with the problem of acne in cooperation with a gynecologist.

acne therapy

We divide into the following types of acne treatment methods:

• Systemic therapy: systemic retinoids, hormonal therapy (COCs, antiandrogens), antiandrogens of non-hormonal origin (flutopharm, spironolactone), antibacterial drugs (as part of complex therapy).
• Topical agents: topical retinoids, benzoyl peroxide preparations, azelaic acid, topical antibiotics (usually included in preparations containing benzoyl peroxide or retinoids), etc.
• Physiotherapy treatment (artificial ultraviolet, IPL, non-ablative lasers 1450 nm, 1390 nm, photodynamic therapy).
• Cosmetic procedures: therapeutic skin cleansing, peelings containing salicylic acid, retinol, etc.

In fact, it is rarely possible to achieve a good result using only one method of treatment. We usually combine topical therapy with physiotherapy or cosmetic procedures, or systemic hormone replacement therapy with topical therapy. The exception is the use of systemic retinoids, where, as a rule, no additional interventions are required.

A large and very promising section is laser treatment. I’ll make a reservation right away that we will call laser treatment all light techniques that are not always a laser, but often broadband light, but for ease of perception, first of all, by patients, we will combine these methods.

In this article, we would like to present our own method of acne treatment using the combined use of several laser systems. Thus, in one procedure, we manage to influence all the links in the pathogenesis of the development of acne and achieve maximum results in a fairly short period of time.

In our clinic, we have been using phototherapy for the treatment of acne for a long time, we also use ablative lasers to eliminate the consequences of acne (secondary pigmentation, scars). In this technique, we have combined infrared lifting, superficial laser peeling and phototherapy with a 420 nm filter.

Stages of laser acne treatment "Triple Therapy"

1. Infrared lifting carried out on a BBL Sciton unit with a Skin Tyte filter (1400 nm). The mechanism of action is the absorption of a wavelength of 1400 nm by water in the deep layers of the skin. Thus, there is an active heating of the sebaceous glands and a decrease in the secretion of sebum, as well as a reduction in the glands in volume. In addition, due to the effect of heat on extracellular structures, collagen denaturation occurs and fibroblasts are stimulated. Due to this, the patient sees not only a decrease in sebum secretion, but also a decrease in the depth of atrophic scars, narrowing of pores and a general skin lifting. Thus, the first and main pathogenetic mechanism for the development of acne

We carried out Skin Tyte infrared lifting in the in-motion mode (in motion) with parameters of 60 J, 150 ms, 30 C. This technique allows you to maintain the temperature at the exposure site for a long time and is completely comfortable for the patient. The temperature was controlled with an infrared thermometer. The target temperature data on the skin surface is 40-42 C.

2. The second stage of the procedure - laser peeling performed using a Sciton erbium laser Contour scanner. The wavelength of 2940 nm is very actively absorbed by water, which allows for skin resurfacing with little or no coagulation of the surrounding tissues, and the evaporation is very “clean”. This minimizes the rehabilitation period and possible side effects of ablation procedures. Scanner Contour with adjustment of the depth of exposure and the size of the treated area of ​​the skin, allows you to carry out the procedure precisely, with uniform coverage and a minimum number of overlaps. We used a grinding depth of 10 microns, which corresponds to the stratum corneum of the epidermis. The skin lesions are small, the procedure is carried out without any anesthesia and the rehabilitation period is short. On skin areas with more active acne rashes and severe hyperkeratosis, stagnant spots, we increased the depth of grinding to 20 microns. We consider deeper exposure to be inappropriate, since at the next stage of the procedure, phototherapy is performed with a 420 nm filter, and this spectrum is very close to ultraviolet.

This stage allows you to significantly reduce keratinization, including in the mouths of the follicles, the discharge of sebum improves, the inflammatory process decreases, and the color evens out, secondary pigmentation brightens.

3. Immediately after laser peeling, the entire surface of the skin was treated BBL nozzle with 420 nm filter. This is the spectrum of visible light, but it lies on the border with ultraviolet, therefore it has all the antiseptic properties of the latter. The target for this step of the procedure is P.acnes. In addition to bactericidal, this light has an anti-inflammatory effect and significantly reduces the number of inflammatory elements on the skin. Two passes were made, each with a power of 6 J and a pulse duration of 150 ms.

At this stage, it would be very effective to apply a photosensitizing agent (Metvix or ALA), thus making the procedure also a photodynamic treatment. But, unfortunately, none of these drugs is registered in Ukraine. In addition, the use of photosensitizers significantly increases its cost, as well as the rehabilitation period.

The whole procedure takes about 1 hour. It does not even require topical anesthesia and is very well tolerated by patients.

The rehabilitation period averages 5 days and consists of slight erythema and peeling, which begins on the 2nd day.

During the rehabilitation period, patients took prophylactic antiherpetic drugs (Valtrex 500 mg per day), as well as used a topical antibacterial drug and sunscreens.

The procedure is carried out once a month. In between treatments, patients continue topical acne therapy.

All treated patients note a significant reduction in the number of comedones, pustules and inflammatory elements. Decreased sebuminess of the skin. Secondary pigmentation is lightened, the resolution of stagnant spots is accelerated. All patients also noted a decrease in pores and smoothing of the skin surface, small atrophic scars become somewhat less noticeable.

This procedure allows us to influence all the links in the pathogenesis of acne development. Of course, like all other methods, it works well in combination with the use of topical remedies at home. But it is a fast and effective method of achieving remission in most acne patients.

Article by Sharapova D.A.
for Les Nouvelles Esthetiques Ukraine

Acne - acne, blackheads, abscesses, inflammation of the sebaceous gland - a skin disease in which the ducts of the sebaceous glands are filled with dust and dead cells of the epidermis, forming a plug and creating conditions for the development of a purulent process.

There are many sebaceous glands in the skin, they are involved in the creation of a water-fat mantle that protects the skin from drying out and bacteriological attacks.

In their structure, they resemble microcapsules and are located near the hair follicles.

In a week, the fatty glands of a healthy person are able to produce approximately 140 g of sebum.

Acne can affect anyone, regardless of gender or age.

Internal causes

Hormonal shifts: androgens tend to stimulate the production of sebum, and estrogens tend to reduce its production.

In certain periods of life, hormonal imbalance is considered the norm that does not require correction:

• during puberty of young men, the saturation of blood with androgens increases and remains high for 5-7 years: from thirteen to twenty years of age;
• fluctuations in the level of steroids in the female body manifests itself in the second phase of the ovulatory cycle, and it provokes the formation of acne about 3-5 days before menstruation; isolated elements of acne on the eve of menstruation can appear even in women who do not suffer from acne.

Hormonal imbalance outside of physiological periods requires diagnosis and treatment. It can be, for example, a consequence of polycystic ovaries, abortion, pregnancy and childbirth.

Drug-induced acne may appear in response to hormonal therapy, is characterized by sudden onset and a direct relationship with the start of treatment with corticosteroids or with the abolition of hormonal contraceptives.

• Malfunctions in the digestive system: according to statistics, half of patients with acne have inflammation of the stomach (gastritis), and a third have dysbacteriosis and other intestinal problems. Moreover, there is a dependence of the localization of acne on the location of the source. With pathological processes in the large intestine, acne elements appear above the upper lip, in the small intestine - the rash spreads over the forehead. Malfunctions in the gallbladder are marked by acne on the forehead, and in the pancreas - on the cheeks and nose.
• Diseases, one of the manifestations of which is severe dryness of the skin: vitamin deficiency, diabetes mellitus, severe infectious and some mental illnesses. As well as age over 45 years, when skin aging is manifested by a decrease in the skin's ability to retain moisture and requires additional moisture.
• Hyperkeratosis of the skin and hair follicles, in which the horny cells of the skin thicken and contribute to the formation of congestion in the excretory duct of the sebaceous gland. It develops under the action of lubricating oils, petroleum products, chlorine-containing substances on the skin, and its appearance is also possible with prolonged rubbing or squeezing with clothing (elastic bands, caps). Follicular hyperkeratosis, narrowing the duct of the gland, further prevents the discharge of fat.
• A reduced psycho-emotional status does not directly affect the occurrence of acne, but it can unsettle the hormonal balance and weaken the immune defense mechanism. As a result, even conditionally pathogenic microorganisms can cause painful manifestations. Propionibacterium acne bacteria play a major role in the development of acne. According to statistics, people in a state of prolonged depression are 40% more likely to develop acne.
• Seborrhea is a skin disease, the only manifestation of which is oily skin. Its sources are presumably neuroendocrine pathologies and the innate tendency of the skin to increased fat formation.

It can form on any hairy area of ​​the body. The disease, first of all, causes aesthetic inconvenience.

You can read about markers of autoimmune pathologies.

A normal level of serotonin in the blood of a person keeps a person in good shape and in a good mood, but this does not mean that an increased level of the hormone is good. How to recognize that there is excess serotonin in the blood, read.

External causes

1. Climatic conditions: humid hot or frosty dry air of the street, unfavorable indoor climate (hot radiators dry the air) equally negatively affect the condition of the skin.
2. Excessive cleanliness also serves as a source of acne: too frequent bathing or showering with hot water and ordinary soap dries the skin and destroys the protective water-fat mantle.
3. Excessive UV exposure(both from sunlight and in solariums) increases the production of sebum, while at the same time overdrying the stratum corneum, which favors the formation of acne.
4. Comedogenic cosmetics containing peach, corn, almond oil, lanolin, petroleum jelly, etc., which contribute to the formation of intraductal plugs. Attempts to mask pimples under a layer of such cosmetics only exacerbate the problem, contributing to the appearance of new elements of acne. When purchasing a cosmetic product (decorative or for skin care), you need to give preference to products labeled non comedogenic (non-comedogenic).
5. Attempts to squeeze out acne elements in order to get rid of them on their own, as a rule, lead to a sad result. Squeezing drives the infection inside, into the deeper layers of the skin, and it infects healthy tissues with bacilli. It is especially risky to squeeze out acne in the area of ​​​​the nasolabial triangle: there is a high probability of infection with the bloodstream in the membranes of the brain and the development of meningitis. For the same reason, you should not use a scrub for acne.

Symptoms

The main manifestation of the disease is acne, the elements of which successively go through several stages of development.

The primary element that appears on the skin due to the blockage of the duct of the sebaceous gland with a mass of dead epithelial cells and dust mixed with sebum is the comedon.

The inflammatory process covers the contents of the duct, and a papule is formed that does not have a cavity, a reddish nodule that rises above the surface of healthy skin. Inside the papule, temperature, humidity and an abundance of nutrient material contribute to the active reproduction of bacteria.

The life process of microorganisms melts the duct plug with the formation of purulent sacs - pustules.

Deep pustules heal with the formation of a scar, and superficial ones, if not squeezed out, disappear without a trace or leave pigmented areas behind.

Classification of acne elements in acne

Uninfected non-inflamed comedones

• Milium- small, no more than 2 mm, soft painless whitish dots. They are located mainly around the eyes and on the cheeks.
• Open (black) comedone- the plug that closed the duct becomes black due to the oxidation of dust and fat content, this is a dense, painless nodule. The safest element of acne.
• Closed (white) comedone- a pimple of the correct rounded shape, with a diameter of more than 2 mm, painless and soft. Prone to festering.

Types of acne

Infected inflamed comedones

• Papule - a red nodule up to 2 mm in diameter, rises above the skin, dense. With light pressure, pain is felt.
• A pustule is a round sac with purulent contents, dense and very painful.
• Indurative - a pustule, a nodule located on inflamed, edematous, hyperemic skin. Both the element and the skin are very tense, tight and painful.
• Conglobate - confluent acne, dense, significantly rising above the skin, moderately painful. They are located mainly on the back.
• Phlegmonous - deep blue-purple large, dense, sharply painful elements of acne that have deeply invaded the skin.

According to the severity of the course, it is customary to distinguish 4 degrees, depending on the number of elements and the depth of the skin lesion.

Localization

Almost all skin contains adipose glands, they are located most densely near the hair: one hair follicle is surrounded by 7 to 9 adipose glands.

Their number is also large in seborrheic areas: face (mainly T-zone: chin - nose - forehead), chest, back, shoulders.

But the feet and palms are covered with a special, thicker epidermis, in which there are no hair follicles and fatty glands.

Inflammation of the sebaceous glands - treatment

Acne therapy is a long process, it may take 4 months, in some cases up to six months.

The main directions in the treatment process of acne:

• treat existing primary elements - comedones;
• reduce the production of sebum;
• reduce inflammation;
• prevent the appearance of new elements.

Acne is characterized by a persistent course and requires an integrated approach with the active use of local and sometimes general therapeutic effects.

Hygiene procedures for acne. It is necessary to wash the affected areas twice a day with water at room temperature. The skin after water procedures should be dried with blotting movements, in no case should be rubbed with a towel. Do not use alcohol lotions and scrubs.

Diet. The diet should include a large amount of green vegetables and fruits, dairy products, lean meat and fish.

Limit your intake of coffee, sugar and salt.

Exclude alcohol, flour, fatty meat, pickled and smoked cheeses (suluguni, cheese), cocoa and chocolate, nuts, carbonated sweet drinks.

Treatment of the underlying disease, if it is detected: gastrointestinal diseases, endocrine and gynecological diseases, sanitation of foci of a dormant infection (tonsillitis, sinusitis, carious teeth).

Topical treatment involves the use of exfoliating, antibacterial, containing vitamin A (retinol) preparations. Means with a combined action have been developed that have a complex effect on the skin.

The drug is applied to dry, clean skin twice a day, after washing, left for half an hour, then the residue is removed.

General treatment is required for moderate to severe acne.

Antibacterial agents of the macrolide group (metacycline, doxycycline) and tetracycline (josamycin, erythromycin) are used.

Which drug is suitable for the patient, the doctor decides on an individual basis.

Treatment with antibiotics is required for a long time, threatens with complications from other organs and requires taking into account the compatibility of drugs.

Taking antibiotics is incompatible with alcohol: severe damage to the liver and kidneys is possible.

Adjustment of hormonal balance under the supervision of a gynecologist.

Vitamin therapy and immunomodulators are used to normalize metabolic processes and strengthen immunity.

One of the important hormones of the thyroid gland is the hormone. What is this hormone and what is it responsible for - the topic of this article.

Recipes for the preparation of meadowsweet for the treatment of endocrine diseases are presented.

Folk remedies

The use of traditional medicine recipes requires a competent approach, it is necessary to take into account the condition of the skin.

• Lemon and honey, taken in equal proportions, are rubbed. The mixture is applied to the skin, left for 10 minutes, then washed off with cool water. Lemon dries, and honey has an antibacterial effect.
• Potato mask made from raw grated potatoes with the addition of 1 egg white. Apply the mask for 20 minutes, then rinse with cool water. Gets rid of black comedones.
• Mask of apples and horseradish: finely grate in equal proportions. Apply once every 7 days for 15-20 minutes.
• Mask honey and mummy. Dilute 5 g of mummy with one teaspoon of water, add 1 teaspoon of honey to it. Apply for 20-25 minutes. Then wash off with cool water. Repeat the process every other day or two.
• Cucumber mask is made from grated cucumber and applied for 20 minutes. Whitens red spots after acne.
• Chamomile and sage: mix in equal proportions, brew at the rate of 1 tablespoon per 1 glass of water. Use for lotions, you can in the form of ice cubes from this decoction. Anti-inflammatory effect, with prolonged use, the pores narrow and black comedones disappear.
• Calendula with honey Add 1 teaspoon of calendula tincture and honey to 1 glass of water. For very sensitive skin prone to irritation, use for lotions and washings.
• Celandine is used for severe acne lesions, a handful of celandine is brewed in 1 liter of water, insisted for 2 hours and used for lotions or baths.
• Dandelion officinalis. Brew 1 tablespoon of raw materials with 1 glass of water, boil for 10 minutes, let it brew for half an hour. Take half a glass 3 times a day 15 minutes before meals. In the same way, a decoction of burdock root is made and taken.

Prevention measures include a balanced diet, adherence to hygiene skills, prevention of overdrying of the skin, timely diagnosis and treatment of diseases, and sanitation of foci of infection in the body.

Related video

Since the school bench, everyone knows that the purpose of the sebaceous glands is to produce a fatty secret to protect the skin. Under the influence of various factors, pollution, clogging of pores and, as a result, inflammation of the sebaceous glands often occurs. There are many causes of pathological processes on the face, finding out which will make it easier to deal with them.

Causes of inflammation of the sebaceous glands

As a result of the action of one or several factors at once, pores become clogged with excess sebum. Such a blockage causes inflammation in the form of acne, pimples, abscesses, edema, nodules containing pus, sebaceous plugs. A dermatologist will help to find out the origin of the disease of the sebaceous glands and prescribe the correct treatment.

Read also: A pimple popped up in a certain area of ​​​​the face

Salon treatments for sebaceous glands on the face

If the inflammatory process is in the initial stage, then face skin treatment you can start in a beauty salon and support with folk remedies. The beautician can offer the following physiotherapy:

• – Galvanization, vacuum or mechanical cleaning of the face will help clear problem areas.
• – In the process of microdermabrasion, the skin is polished with the help of aluminum oxide crystals. As a result, the upper dead cells are removed, blood circulation is improved, and the skin condition improves.
• – Laser resurfacing involves the removal of upper dead skin cells with a laser.
• – Mesotherapy is the introduction of a drug that relieves inflammation.
• – Acid peeling helps to start the mechanism of the resumption of the work of the glands with the help of acid solutions that penetrate deep into the epidermis.
• – The use of cosmetic devices during the decontamination procedure allows you to get rid of excess skin secretions, helps to cleanse the skin from impurities.

Cosmetics to eliminate inflammation of the sebaceous glands

Read also: Levomekol ointment for the treatment of acne on the face

Traditional medicine recipes to normalize the sebaceous glands

Treatment of inflammatory processes on the face with folk remedies involves the use of inexpensive and affordable means:

• Rose water and lemon juice are taken in equal proportions. The mixture is wiped on the face, and after an hour, washed off with warm water.
• - In the morning and evening, it is good to use a lotion to moisturize the skin, prepared from a tablespoon of rose water, a teaspoon of vinegar, 3 drops of camphor, 5 drops of glycerin.
• – Treatment of inflamed skin at home can be carried out using ice cubes based on decoctions of medicinal herbs.
• - Crushed orange peel, diluted with pure boiled water to the consistency of sour cream, is an excellent tool for improving the secretion of the sebaceous glands.
• - The antibacterial effect of tar soap has a beneficial effect on inflamed areas of the skin, it does an excellent job of cleaning the face from subcutaneous acne.
• - Freshly cut aloe leaves should be applied to ripened abscesses. The juice of this plant promotes the release of pus.
• - A compress with ichthyol ointment or Vishnevsky ointment will speed up the process of maturation of the abscess and its extraction.
• - Synthomycin ointment will quickly cope with internal skin inflammation.

Treatment prescribed by a doctor, in combination with salon procedures and traditional medicine, can give a good, but short-term effect, if no prevention is done.

Sebaceous glands on the face- one of the most important organs of external secretion, on which the condition, appearance of our skin, its youth depends. If these small secretory organs function normally, then we are not afraid of acne, inflammation, oily sheen and other “charms” of problem skin. However, if we have been struggling with the problems that are characteristic of oily or combination skin for most of our conscious life, then closer to the age of 40 years we will be able to notice a number of enlarged sebaceous glands on the face and small whitish depressed "pimples" that appear in their place, which are random appear on various parts of the face or even the body. It is extremely difficult not to get rid of this defect, but you should not give up!

Enlargement of the sebaceous glands on the face: hyperplasia

Hyperplasia of the sebaceous glands on the face is the "technical" scientific name for benign formations on the skin (in translation, hyperplasia means "excessive formation", "increased formation"). These specific skin growths form over time as a result of chronic dysfunction of the sebaceous glands: this problem goes hand in hand with imperfections such as enlarged pores and oily skin. Hypersecretion of sebum leads to blockage of the sebaceous glands, and the secret accumulates in them over time, and the glands themselves increase in size. At the same time, the sebaceous glands and nearby pores become clogged in a very specific way, forming hard (rarely soft) white or yellowish elevations with a “crater” in the center on the skin. In fact, a depression in the center of these formations is the main diagnostic criterion, thanks to which it can be clearly stated that you are dealing with sebaceous hyperplasia, and not with something else like milia or acne. Sometimes enlarged sebaceous glands can change color (blush with inflammation) or sprout with vessels (at a more advanced age with rosacea). You should also be aware that some manifestations of inflammation or hyperplasia of the sebaceous glands on the face may superficially resemble a form of skin cancer known as basal cell carcinoma. To rule out an alarming diagnosis, a dermatologist may perform a biopsy - take a tiny scraping from the tumor and examine it for abnormal cells.

Although these formations are not as painful or inflamed as acne breakouts, they are quite stubborn: enlarged sebaceous glands on the lyceum do not go away, regardless of the thoroughness of facial skin care and the adequacy of the choice of cosmetics. These pesky bumps are not just clogged pores or milia, but rather a more persistent problem, which in medicine is called "sebaceous gland hyperplasia." In this condition, additional damage can be caused by another factor - sunlight. The fact is that ultraviolet provokes not only damage to the skin, but also intensive production of sebum. As for dislocation, these neoplasms associated with an increase in the sebaceous glands are usually “scattered” throughout the face and are extremely rarely located close to each other, although this also happens. Sebaceous hyperplasia most often occurs on the forehead and in the central part of the face, but can also occur anywhere on the body, especially in areas where the most sebaceous glands are located.

Treatment of hyperplasia of the sebaceous glands on the face

Treatment of sebaceous hyperplasia should not be started on its own, this problem requires a visit to a dermatologist. Although, of course, there are products you can use at home to keep these unsightly growths under control and keep your skin as even as possible. However, doctors have more options and can offer you several options for the treatment of sebaceous hyperplasia on the face. The following sebaceous gland treatments are currently available (singly or in combination).

• Peels: as a rule, these are chemical mono- or combined peels, more often based on salicylic or trichloroacetic acid.
• With an electric needle: this method, which works on the same principle as electrolysis, causes the blockage of the sebaceous gland to break down. After the procedure, a small scab forms at the site of the removed hyperplasia, which soon naturally exfoliates.
• Photodynamic therapy is a technique based on the use of a laser beam to damage unwanted cells and formations. In this case, the skin is pre-treated with a special gel that reacts to light radiation. To completely get rid of sebaceous hyperplasia, several sessions of this procedure are often required.
• Liquid nitrogen - in this case, the removal of enlarged sebaceous glands on the face seems to be quite a risky undertaking. The fact is that if the reagent penetrates too deeply into the skin, you can end up with a scar or post-inflammatory hyperpigmentation, while it is very difficult to control the “behavior” of liquid nitrogen.
• Prescription topical retinoids or azelaic acid: This treatment for facial sebaceous glands can reduce hyperplasia, but will not completely solve the problem.
• Surgical excision (excision) can also lead to scarring, so is considered a last resort option.
• Hormonal medications (antiandrogens) reduce the level of the hormone testosterone, which can be a key factor in the development of the problem of sebaceous hyperplasia (testosterone affects the activity of the sebaceous glands and can stimulate the growth of hyperplasia). This method, like surgical excision, is a last resort, which is used only if safer methods of treatment have not helped.

Before considering and choosing any of these options, you should know that, like acne, sebaceous hyperplasia on the face cannot be completely cured - this pathology can only be brought under control. So, enlarged sebaceous glands on the face can be reduced or removed, but their hyperactivity will remain at the same level. This is likely to lead to the formation of new hyperplasia, especially in the absence of proper home skin care. Thus, if you decide to remove hyperplasia in one of the listed ways, get ready to carefully and regularly care for your skin with the help of appropriate cosmetics.

Skin care for diseases of the sebaceous glands

After treating sebaceous hyperplasia, choose a few key foods to prevent the formation of new "bumps" on the skin. Chief among them are the tools that perform two main tasks in our case.

1. Normalize the activity of the sebaceous glands (seboregulation).
2. Provide proper cleansing of dead skin particles (exfoliation).

To do this, you should choose products with sufficiently high concentrations of salicylic acid, as an option - fruit acids. Salicylic acid is considered to be more gentle, and in addition, it reduces inflammation in the sebaceous glands on the face. The next group of products worthy of our attention are products containing retinol: studies have shown that they can be effective in reducing the number of enlarged sebaceous glands on the face, as well as their diameter. Retinoids in cosmetics help control the growth of skin cells that can clog pores, have anti-inflammatory effects, and also regulate sebum production. Another ingredient that helps with diseases of the sebaceous glands is vitamin B3, also known as nicotinamide (niacinamide) or niacin. This component provides several benefits at once: a reduction in inflammation and a decrease in cell proliferation that accompanies the development of sebaceous gland hyperplasia. A trio of these ingredients in various products (serums, cleansing gels, creams) helps to significantly reduce the risk of recurrence of enlarged sebaceous glands on the face.

These were the best skin care products for sebaceous hyperplasia on the face. As for scrubs, gommages, you should not particularly rely on them: not a single mechanical exfoliant in the world, regardless of composition or price, can eliminate either inflammation of the sebaceous glands on the face or their hyperplasia. The fact is that inflammation in the sebaceous glands and their blockage are “rooted” deep enough that scrubs cannot reach the source of the problem. Moreover, if you try hard to "scrape off" these formations on the skin, you can get additional inflammation, dryness and irritation on the skin. However, regular and delicate exfoliation (1-2 times a week) of dead epidermal cells is extremely important - without this, care will be incomplete and ineffective. Remember: without a full cleansing, blockage of the sebaceous glands on the face is inevitable. It is also important to make sure that your skin is protected with sunscreen before going out, as UV exposure exacerbates the problem of hyperplasia.

The sebaceous glands are organs of internal secretion located on the entire surface of the skin, except for the palms and soles of the feet, where the skin has a thickened epidermis. They vary in size, are localized in different areas of the skin and have a different structure. The sebaceous glands are observed in large quantities on the cheeks and chin, as well as in the scalp. Small accumulations of sebaceous glands are found in areas devoid of hair, in particular on the lips, in the corners of the mouth, nipples, clitoris, foreskin, glans penis.

Blockage of the sebaceous gland can occur anywhere on the skin. These glands are very important because they protect the skin from external factors such as dust, dirt, and sunlight.

Inflammation of the sebaceous glands is a fairly common disease of the dermis, which develops as a result of exposure to negative factors. In medicine, the pathological condition is called acne, blackheads or pimples.

Treat diseases of the sebaceous glands can be local therapy and antibiotics, subject to personal hygiene and correction of the daily diet.

How is the sebaceous gland and what is it

Histology is the study of the structure of the sebaceous glands. The sebaceous glands are distributed throughout the human body, except for the feet and palms. They can be associated with hair follicles, as well as exist separately. Usually, each hair follicle may be surrounded by several sebaceous glands. In an enlarged view, you can see their lobed structure, in which the segments, as it were, depart from the central branch, resembling a bunch of hanging berries. Of these, the sebaceous substance of the skin is distributed throughout the body along the hair. In areas of the body where there is no hair, the glands still exist.

The structure of iron resembles alveoli, which consist of several parts or branch. Basically, they are surrounded by thin muscle structures.

A large number of sebaceous glands are found on the face, especially on the chin, as well as on the nipples and genitals. The structure of the sebaceous glands in different places is different. In areas where there are no hair follicles, free glands are located. Inside they contain a secret and an excretory duct. The secret is a special bag with a capsule that contains the substance.

Throughout life, the sebaceous glands are constantly changing. They are active and well developed at the time of birth. During the first year of life, their growth especially predominates against the background of reduced secretion of the sebaceous glands. In the future, they atrophy to a certain extent, in particular, on the skin of the legs and back.

The action of the sebaceous glands intensifies during puberty, which is the reason for the appearance of acne in adolescents. In older people, there is a decrease in their number.

Fat on the skin is secreted by the sebaceous gland. It consists of water, casein, organic elements, acids and salt. Together with fat, fatty acids and products of hormone metabolism are released. Sebum is synthesized mainly under the influence of the male hormone androgen. It first reaches the hair follicle, then goes outside, forming a greasy film.

A large amount of fat is found in the sebaceous glands on the face. When the functioning of the sebaceous glands is disturbed, acne appears. The process is characterized by active secretion of fat. It is colorless and odorless. The active production of sebum is stimulated by hormones: testosterone and androgen, while estrogens, on the contrary, suppress the process.

Fat has a protective function and warns against various negative environmental influences. The substance acts as a lubricant, has a waterproof and warming effect, moisturizes and saturates the skin with vitamins. The main function of sebum is to maintain normal moisture levels in the skin.

The function and work of the gland

The sebaceous glands perform a number of important functions for the human body, the main ones are:

• Protecting the body from bacteria and pathogens. Fat is constantly released with acids that prevent the penetration of pathogenic flora;
• Anti-inflammatory function, protection against viruses;
• Providing the required amount of vitamin E;
• Softening hair and skin, increasing skin elasticity;
• Protection from harmful UV rays;
• Active response to the work of hormones. The production of fat depends on the hormonal balance, the effect of greasiness can increase or decrease with a change in the quantitative composition of hormones in the blood;
• Synthesis of vitamin d3.

The work of the sebaceous glands is normal when there is no increased oiliness and shine on the skin and acne does not appear. The secretion of the secretion of the sebaceous gland is considered normal when it is enough to perform all the necessary functions of protecting the skin, without disturbing a normal lifestyle. Pathologies of the glands in most cases occur in adolescents.

The work of the sebaceous glands in the elderly

In most cases, after fifty, people experience skin aging. The skin begins to lose elasticity and firmness, moisture. The sebaceous glands are located close to the outer surface of the skin, they form special cavities that are filled with horny mass, which leads to dryness of the skin and the appearance of wrinkles. Over the years, the body's ability to recover is depleted. The cells of the dermis begin not to retain the required amount of moisture and trace elements. You can partially solve the problem with the help of moisturizing cosmetics, however, it is completely impossible to stop the natural biological process.

An elderly person has practically no sebaceous glands on the skin. The body in old age ceases to have the function of thermoregulation, which is why old people freeze very much, dress warmly. The skin begins to lose its luster and gloss, becomes dull, turns yellow.

The sebaceous glands are located in large numbers on the face. The state, appearance of the skin, its youth depends on these most important organs of external secretion. If the functioning of the secretory organs is normal, then acne, inflammation and oily sheen do not appear. In violation of the sebaceous glands, we can talk about problem skin.

The work of the sebaceous glands is activated under the influence of hormonal changes. Most often this occurs during puberty at a transitional age, in women during pregnancy and after childbirth, after past illnesses.

Excessive activity of the sebaceous glands leads to the fact that the pores are clogged with secretions. Blockage, in turn, provokes subcutaneous inflammation in the capsule of the gland. This condition appears as a result of dust, dirt, sweat, dead cells, bacteria and other microorganisms entering the capsule of the gland. Inflammation can turn into a purulent process, acne, abscesses may appear, there is a risk of tumor formation on the skin.

In most cases, dysfunction of the sebaceous glands on the face is revealed by their increase - hyperplasia. The problem appears against the background of chronic dysfunction of the sebaceous glands.

Hypersecretion of sebum leads to blockage of the sebaceous glands, and the secret accumulates in them over time, and the glands themselves increase in size. At the same time, the sebaceous glands and closely spaced pores become clogged, forming hard (rarely soft) white or yellowish elevations with a crater in the middle on the skin. Sometimes enlarged sebaceous glands can change color (blush with inflammation) or sprout with vessels (after the age of 50 - with rosacea).

These neoplasms can be localized throughout the face and are extremely rarely located close to each other, although this location is no exception. Hyperplasia of the sebaceous glands most often occurs on the forehead and in the central part of the face, but can also occur anywhere on the body, especially in areas where the most sebaceous glands are located.

The sebaceous glands on the head in men

Violation of personal hygiene rules is the main cause of health problems. If a man uses someone else's towel, a common body wash, rarely takes a bath, then the fat from the skin is washed off badly. Fat accumulates in the glands and clogs them. This leads to the formation of white pimples.

Another cause of inflammation of the sebaceous glands in men is hormonal failure. The condition is characteristic of adolescents, when hormonal changes occur in the body during puberty. Characteristic for this period are the formation of various rashes on the body, including on the penis area. This is not a pathology. The period of hormonal restructuring will end, and the glands will disappear on their own.

Inflammatory diseases of the urethral canal lead to various infections of the skin of the penis. Bacteria are the cause of inflammation in most cases. If there are various injuries on the skin of the penis, then the microbe can settle on the wound surface. It causes necrosis of epidermal cells. Dead cells accumulate in the glands, they suppurate. The glands on the penis can have a different shape and color, depending on the disease that caused them. Rashes on the penis can take the form of:

• Circle with white content;
• White neoplasms;
• Watery vesicles localized around the head of the penis;
• Pustules with brown or green content.

The condition requires medical intervention, neglect is fraught with a complication of the condition and the spread of the inflammatory process.

Treatment is carried out using topical drugs, therapy with antibiotics and laser removal or electrocoagulation.

Sebaceous glands on the skin of the eyelids

The eyelids are one of the most important barriers that protect the eyes from the negative influence of the external environment and various pathogenic agents. There are many glands on the eyelids, the secret of which forms a tear film that protects the eyeball from drying out and has bactericidal properties.

At the roots of the eyelashes are the sebaceous glands, and on the free edge of the eyelid in the form of a grayish line, there are numerous openings of the meibomian glands. About 40 of these glands are located in the upper eyelid and about 30 in the lower. They are close to each other. The main function of the meibomian glands is to produce secretions that are involved in the formation of the lipid layer of the tear film. The layer plays an important role in maintaining moisture on the exposed surface of the eye. With dysfunction of the meibomian glands, blepharitis develops.

Blepharitis is an inflammation of the eyelids, which is manifested by itching, redness and thickening (swelling) of the edge of the eyelid, often reveals the formation of scales and crusts at the roots of the eyelashes, a sticky yellow secret appears, at the same time there is increased eye fatigue, eyelash loss and photophobia.

There are several types of blepharitis depending on localization: anterior, posterior, mixed blepharitis. Anterior blepharitis develops as a result of the penetration of a staphylococcal infection or seborrhea. Pathology is manifested by redness and expansion of the capillaries of the outer edges of the eyelids. Scales are dry, brittle and hard, located at the base of the eyelashes.

Posterior blepharitis is manifested against the background of dysfunctions or inflammation of the meibomian glands. With blepharitis, the excretion of the secret of the meibomian glands is disturbed as a result of its thickening, the formation of plugs in the ducts of the glands. The secret changed in concentration, the remnants of cosmetics and keratinized cells of the epidermis of the skin of the eyelids accumulate in the ducts and interfere with the secretion. Clogged ducts of the glands become the optimal breeding ground for mites and bacteria, which are the causative agents of inflammatory processes on the eyelids.

Skin diseases

The condition of the skin depends on the hormonal background, hygiene habits of a person, the immune system, and heredity. Diseases of the sebaceous glands develop as a result of dystrophic changes, malformations, functional disorders, tumors, inflammation of the sebaceous glands. The reason for the appearance of such changes are hormonal disruptions, metabolic disorders and lesions of the central or autonomic peripheral nervous system.

In most cases, dysfunction of the endocrine glands leads to disruption of the sebaceous glands. Such a pathological process causes blockage of the ducts, which leads to the appearance of:

• Seborrhea. Appears as a result of violations of secretory functions. With this disease, sebaceous-horn plugs appear in the ducts of the glands;
• skin atheroma. They are tumor-like formations resulting from blockage of the sebaceous glands;
• Rosacea. The disease is characterized by reddening of the skin of the face, vasodilation, the appearance of pustules.

Inflammation of the sebaceous glands is common and is characterized by the appearance of acne. It captures the walls of the glands and the tissues around them. The inflammatory process can move to the deeper layers of the skin, affecting the subcutaneous tissue.

There are two types of acne. The first includes acne that occurs only as a result of blockage of the excretory ducts. The second option develops with a combination of inflammation with the closure of the mouth of the gland. The distinction between types and the correct definition of the disease allows you to choose the appropriate treatment tactics.

Non-inflammatory types caused only by blockage include:

1. Milia. Pathology is manifested by small white dots with a diameter of about 1 - 2 mm. Basically, blockage of the sebaceous gland is localized on the eyelid, around the eyes or on the cheeks. The formations are non-painful, soft.
2. Closed (white) comedones. They are pimples of a small size, white, about 2 mm in diameter, rounded, regular in shape, have a soft structure, non-painful.
3. Open comedones (black dots). The shape of these formations is similar to white comedones, only at the top there is a small hole with black contents (dust, horny scales, sebaceous fluid). The consistency of the formation is dense, there is no pain when probing.

Formations caused by inflammation, combined with blockage of the sebaceous flow, include:

1. Papular. They are pimples of red or bright pink color, towering on the skin. The size of acne is 1-2 cm. When probing, there is pain, the formations are dense, have the form of small nodules.
2. Pustular. They have a rounded shape with purulent content inside (yellow or brown-green). They are distinguished by sharp soreness and density, when probing, an elastic cavity is felt.
3. Inductive. With this type of disease, the skin around acne is red and painful, and swelling is also observed. Formations and surrounding skin are dense.
4. Conglobate. These are huge confluent eels, the size of which can reach 10 cm. They are mainly localized on the back. They may have a flesh color or a reddish tint. Formations are dense, noticeably elevated above the skin. Pain may appear on palpation.
5. Phlegmonous. Formations in this type of skin disease are dense, large, purple-cyanotic, deeply penetrating into the skin. They are characterized by severe pain.

Fat secreted by the skin and how to reduce its production

Normally, the sebaceous glands are attached to the hair follicles and secrete sebum. The substance protects the skin, helps retain moisture and prevents dryness of the skin. In the case when an excess amount of fat is produced, the hair follicle is blocked. This leads to clogged pores and the appearance of acne, and if bacteria get there, an inflammatory process develops. The condition requires treatment, neglect leads to the appearance of purulent acne: blackheads and acne.

You need to reduce the production of sebum in the ways recommended by a dermatologist. All methods used must be agreed with a specialist so as not to aggravate the condition and prevent possible complications.

You can reduce the production of sebum with the use of medicines. Effective:

• Preparations with retinoids. Retinoid preparations come in the form of tablets (isotretinoin) and in the form of creams or gels (tretinoin, adapalene, tazarotene). Oral retinoids are more effective than creams or gels. However, experts prefer local remedies because they are safer and rarely cause side effects.
• Androgen inhibitors. These drugs help reduce the amount of sebum produced by the body. Preparations can be either oral or topical.
• Contraceptive drugs with estrogen. Drugs in this group reduce the amount of androgens in the body, and this, in turn, reduces the production of sebum.
• Light therapy and laser therapy. In some cases, dermatologists recommend light or laser therapy in conjunction with other treatments.

You can reduce the production of sebum if you wash your face with cleansers containing salicylic acid, since the substance dissolves in lipids and can easily penetrate into the pores, clean them and rid the skin of excess oil. If there are purulent acne, the substance will help eliminate swelling and prevent the appearance of new ones.

The face should be washed no more than 2 times a day with warm water to dissolve the fat and clean the pores. When washing, it is advised to do a light facial massage with your fingertips, which will help to properly distribute excess sebum. It is very important to wash your face thoroughly if you have applied cosmetic or sunscreen with moisture protection.

Moisturize skin with excess fat with hyaluronic acid with vitamin B6. The product is an intensely moisturizing serum that helps regulate skin sebum (a secret secreted by the sebaceous glands). Contains fatty acids and esters. Under the influence of bacteria, they decompose into saturated fatty acids. For full absorption of the serum and the best effect, it is recommended to use it under rolling with a mesoscooter.

To moisturize oily skin, an excellent tool is an alginate mask - charcoal.

The mask contains charcoal and perfectly cleanses the skin, eliminates excess sebum, normalizes the functioning of the sebaceous glands, and has an antiseptic and anti-inflammatory effect.

The cause of excess sebum production may be a deficiency of vitamins b5 (pantothenic acid) and b2. Replenishment of the body with these components will reduce the percentage of sebum and normalize its production.

Clay masks are an excellent moisturizer. Clay or mineral masks are great for detoxifying, reducing impurities, and unclogging pores. An effective way is to moisturize the skin with argan oil, which reduces the production of sebum and helps to maintain its natural balance of production.

It is important to adjust the diet, often excess skin secretion is associated with digestive and intestinal problems. Probiotics are good for gut health. It is recommended to drink kefir, eat Greek yogurt, sour cream and other foods that contain bacteria that are good for the intestines. Omega-3 fatty acids found in fish and monounsaturated fats found in nuts are also helpful.

Sebaceous plugs and consequences

Sebaceous plugs cause dysfunction of the skin, which leads to inflammation. Sebaceous plug is a good breeding ground for microorganisms, and can easily cause inflammation. Severe forms of acne can lead to deep scar defects. The pores are clogged with dead skin cells, bacteria, microorganisms, sebum.

As a result of constant stretching of the wall of the follicle (pore), the skin loses its elasticity. Micromuscles responsible for the tone of the mouth of the follicle and the timely evacuation of fat, atrophy. Fatty cysts and deep cracks appear at the site of former comedones.

Altered sebum composition and abnormal acidity (pH) irritate the skin and especially the walls of the follicle. The walls also change, their thickening occurs. In some cases, a capsule of dense connective tissue appears around the irritating plug.

Sebaceous plugs occur on the nose, chin, cheeks and on the head near the hairline, as sebum production is increased in these places. The consequence of sebaceous plugs are abscesses, skin inflammations, atheromas, various tumors, acne, pimples.

Causes of traffic jams

Sebaceous plugs can be formed under the influence of both external and internal factors.

External factors include bad habits that lead to a large amount of toxins entering the body. These habits include smoking, alcohol abuse. The cause of the appearance of sebaceous plugs can be:

Internal factors that provoke the appearance of sebaceous plugs include:

• Hormonal imbalance;
• Unbalanced diet;
• Allergic reaction to cosmetics and drugs;
• Hyperkeratosis;
• Demodicosis (presence of mites in the skin);
• Stressful and elevated psycho-emotional states;
• The period of the monthly cycle or the period of pregnancy.

How to treat clogged glands

Both medicinal and alternative medicine methods can be used to treat clogged glands. Before starting treatment, you should consult a dermatologist or cosmetologist who will help you choose the right treatment option.

Drug treatment

• It is recommended to wipe the skin of the face with a 1% solution of salicylic acid. The procedure should be carried out twice a day.
• The drug Zinerit is effective. The product should be applied to previously cleansed skin in the morning and before bedtime. Zineryt should be used every other day.
• taking nystatin. The topical preparation helps to normalize the production of sebum.
• Retinoid products help reduce sebum formation.
• Hormonal drugs - antiandrogens, reduce testosterone levels, thus normalizing the work of the sebaceous glands.

ethnoscience

Traditional medicine methods will help eliminate the problem with clogged pores and restore skin elasticity and healthy appearance.

Hardware methods

As a result of an increased amount of sebum, bacteria actively multiply and inflammatory foci appear. The solution to the problem can be cleaning - this is the process of cleansing the skin of the face from impurities, sebum, blockages of the sebaceous glands, as well as from the layer of dead cells that prevent the penetration of beneficial substances. If inflammatory acne contains a large amount of secretion on the surface, and there are more than ten of them, then cleaning cannot be done. With the use of medicines, inflammation is removed, after which they only begin to clean the skin. There are several types of facial cleansing: manual (manual); chemical (using fruit acids) and hardware.

Manual cleaning as a mono-procedure is rarely used, since this method is not suitable for dry, thin, sensitive skin with rosacea (dilated capillaries). Often they combine hardware techniques and manual cleaning, especially if it is oily, problematic or combination skin.

Hardware methods include: ultrasonic, galvanic, vacuum, diamond-vacuum cleaning and vibrating.

• Ultrasonic cleaning is the most applicable. The procedure is carried out using a special device with a nozzle in the form of a spatula. With its help, an ultrasonic acoustic wave is applied to the surface of the skin. Under the influence of the wave, vibration massage is carried out at the cellular level. High-frequency sound vibrations penetrate and remove particles of dead skin, massage and remove excess sebum. The procedure is often combined with manual cleaning, especially if the skin is normal or oily.
• Brushing is a mechanical action using special brushes.
• Galvanic cleaning involves a combination of exposure to galvanic currents with alkaline solutions. The method is rarely used. These treatments are not suitable for dry, thin, sensitive skin.
• Diamond-vacuum cleaning is a method of hardware cleansing of the skin with diamond-coated nozzles. The procedure uses vacuum suction as an added function.
• Cryotherapy is the treatment of problem areas of the face with liquid nitrogen;
• Cleaning with an electric needle is similar in principle to electrolysis and leads to the fact that the blockage of the sebaceous gland is destroyed. After the procedure, a small scab is formed at the site of the removed hyperplasia, which soon peels off on its own and falls out.
• Microdermabrasion and laser peeling are performed using a special microparticle powder.

Treatment in clinics and salons

A dermatologist or cosmetologist should treat acne, acne and pimples. The treatment, organized in specialized clinics and qualified salons, allows you to restore the beauty and health of the skin in a safe and clinically proven way.

Specialists cleansing obstructions of the skin of the face in the following ways:

• Chemical cleaning. Fruit acids are used, which warm up the skin and dissolve sebaceous plugs (partially).
• - Mechanical cleaning. The face is steamed and the rashes are squeezed out manually. The method is not considered effective, since the rashes soon reappear.
• Cold hydrogenation. It is carried out using a hydrogenating gel. In the process of hydrogenation, the stratum corneum and the underlying layer are moistened, keratinized cells soften, pores open, comedones lighten.
• Laser therapy. The procedure is carried out with a laser, is painless and leaves no marks on the face.

Facial pore cleansing

Deep cleansing of the skin of the face leads to oxygen saturation of the cells, which contributes to their proper functioning, regeneration and prevents the appearance of irritations and peeling areas. Gentle cleaning of pores from all kinds of contaminants is carried out by hardware methods in salons. Methods for cleansing pores at home using available ingredients are also effective. Effective compresses, rubbing with decoctions of herbs and ice prepared on their basis, bursting baths to remove dirt, masks for deep cleansing.

Oatmeal mask

1 st. l. oatmeal flakes is brewed with water for dry skin or milk for oily. The mask not only cleans the pores on the nose and cheeks, but also optimally saturates the skin with the microelements it needs.

with yeast

1 st. l. yeast to gruel is diluted with 3% hydrogen peroxide, with dry skin you can add cream. The mask allows you to narrow the pores on sluggish skin.

with cabbage

A handful of sauerkraut should be crushed and applied to the face. The acids help dissolve all the fat and have a mild bleaching effect.

Masks should be done at least once a week. After the mask, it is not allowed to moisturize the skin with oil or cream, as this leads to clogging of enlarged pores.

Prevention

To prevent the formation of blockages with sebaceous fat and the appearance of inflammation on the skin, it is necessary to monitor the cleanliness of the skin, eat right, and give up bad habits. Facial skin care should be after determining the type of skin. It is important to follow the instructions of the beautician and dermatologist.

Should:

• Drink plenty of fluids daily to maintain water balance in the body;
• Instead of soap for washing, use a liquid gel that does not have an aggressive composition and does not dry out the skin;
• Before going to bed, thoroughly cleanse your face of cosmetics;
• Do not squeeze out acne, carry out all procedures with the skin with cleanly washed hands;
• Refuse fatty, spicy foods, give preference to fruits and vegetables;
• Use high-quality cosmetics and personal hygiene products, buy only products from trusted companies;
• Choose cosmetics and skin care products that are appropriate for your skin type.

Periodic visits to a beautician and proper care will allow you to enjoy the beauty and health of your skin for many years.

Sebaceous hyperplasia is a common benign condition in middle-aged and elderly people. Lesions can be single or multiple, localizing on the face they look like yellowish soft small formations, especially often located on the nose, cheeks and forehead.

The chest, areola, buccal mucosa, scrotum, foreskin, and vulva are also affected. Among the rare variants, giant, linear, diffuse and family forms are noted.

Etiology and pathogenesis

The sebaceous glands are located on the entire surface of the skin, with the exception of the palms and soles. They are associated with hair follicles, rarely open directly to the surface of the epithelium, including on the lips, buccal mucosa, genitals, nipples and eyelids. The largest in the largest number are located on the face, chest, upper back.

They are formed by lobules opening into the excretory duct. The life cycle of a sebocyte (the cell that produces sebum) begins at the periphery in a rapidly dividing layer. Then the cells mature, accumulate more and more fats and migrate to the central excretory duct. Here, mature sebocytes break down and secrete fat. This process takes about 1 month.

The sebaceous glands are very sensitive to the action of male androgen hormones. Although their number remains virtually unchanged throughout a person's life, their size and activity vary with age and blood hormone levels. Cells on the skin of the face and scalp are most sensitive to the hormonal balance.

After the maximum development at the age of 20-30 years, sebocytes begin to multiply and release fat more and more slowly. This leads to the accumulation of cells in the mouths of the hair follicles. Therefore, the causes of sebaceous gland hyperplasia are often physiological, associated with an age-related decrease in the level of sex hormones.

Pathology is also associated with the use of the drug Cyclosporine A in patients who have undergone organ transplantation. The mechanism of this phenomenon is not clear. There is evidence from a study of patients undergoing kidney transplantation. They show that the appearance of hyperplasia of the sebaceous glands in such patients in 46% of cases indicates non-melanoma.

In some cases, there is a hereditary predisposition to the disease. It begins during puberty, proceeds with a large number of lesions and only progresses with age.

Hyperplasia of the sebaceous glands is not malignant, but it is included in the so-called Muir-Torre syndrome. This is a rare genetic disease, accompanied by colon cancer, keratoacanthoma and adenoma of the sebaceous glands, as well as oncohematological processes. However, isolated hyperplasia is not a precursor to Muir-Torre syndrome or bowel cancer.

The pathological condition is not associated with the presence of any virus or bacteria in the skin, so it is not contagious.

Symptoms

Patients go to the doctor because of a cosmetic defect or fear of skin cancer. Pathology is not accompanied by unpleasant sensations. The lesion appears as a soft yellowish lesion with a smooth or slightly uneven surface. There may be one or more lesions on the face. Sometimes they are injured when shaving, redden, bleed. The size of such papules is from 2 to 9 mm. In their center there is a depression, inside which a small ball of sebum is visible. A single pathological element is often called an adenoma.

Sometimes papules may be accompanied by telangiectasias, as in. How to distinguish sebaceous hyperplasia from cancer in this case? Doctors use a simple and atraumatic method for examining the skin.

Often, patients with this disease complain of acne and dry hair. These manifestations require additional treatment.

Diagnosis and differential diagnosis

If an enlarged sebaceous gland is found, it is necessary to differentiate its hyperplasia and other diseases:

• angiofibroma;
• intradermal nevus;
• tumor of the sebaceous gland;
• nevus of Yadasson;
• nodular elastosis;
• milia;
• skin sarcoidosis;
• and others.

Only a dermatologist can accurately distinguish these diseases. A biopsy is used to rule out skin cancer.

Microscopic examination of the obtained biopsy material reveals individual enlarged glands with dilated sebaceous ducts. In the lobules, the content of immature sebocytes with large nuclei and a low concentration of fat is increased.

In clinically clear cases, an additional examination is not prescribed.

Treatment

This pathology is completely safe. Treatment of hyperplasia of the sebaceous glands is carried out only with a cosmetic defect, permanent trauma or skin irritation. Usually they are removed, but the foci are prone to recurrence and scarring.

Defect removal is carried out in the following ways:

• photodynamic therapy in combination with the use of 5-aminolevulinic acid, which allows you to eliminate the lesion with the help of ordinary light, 3-4 procedures are needed, which are most effective for multiple foci;
• cryotherapy - freezing the focus with liquid nitrogen, after which a small crust remains, which separates after a few days, the advantage of this method is almost complete painlessness;
• electrocoagulation;
• treatment with chemicals, for example, trichloroacetic acid;
• scalpel excision.

One of the most common interventions for this pathology is. The procedure is performed under local anesthesia and is a cauterization of the gland with a heated metal electrode. It lasts about 15 minutes and allows you to completely remove the pathological focus. A small crust forms at the site of coagulation, which separates on its own after 2 weeks.

Treatment of hyperplasia of the sebaceous glands with a laser is often used: argon, carbon dioxide or pulsed. Laser exposure is as effective as electrocoagulation, but less painful and less often accompanied by scarring. The procedure is performed under local anesthesia and lasts 30 minutes. Its wide distribution is hindered by the high cost of equipment and the need for additional staff training. After laser exposure for 10 days, the skin is completely restored.

After mechanical removal, temporary hyperpigmentation of the skin or the formation of a small scar is possible.

Relative contraindications for removal using physical methods:

• oncological diseases;
• decompensated diabetes mellitus;
• increased blood pressure above 180/100 mm Hg;
• symptoms of thyrotoxicosis;
• severe heart rhythm disturbances (frequent ventricular extrasystole, tachysystolic form of atrial fibrillation, and others);
• angina pectoris III-IV FC;
• blood diseases with hemorrhagic syndrome and bleeding;
• active form of tuberculosis;
• mental disorders.

Medical therapy

Medical treatment of sebaceous gland hyperplasia is less effective. Oral isotretinoin preparations are used for 2-6 weeks. After completion of such a course, the rash often recurs. These drugs should be prescribed only by a specialist, taking into account all contraindications and restrictions.

Isotretinoin (Roaccutane) is usually prescribed only in severe cases, with a significant cosmetic defect, in men or postmenopausal women. It reduces the size of the sebaceous glands and the production of sebum. This drug is contraindicated during pregnancy and breastfeeding, children under 12 years of age, patients with liver failure, severe hyperlipidemia (high levels of lipids, especially cholesterol, in the blood).

Ointments and creams with retinoids are considered less effective, but safer. One of the modern preparations of this group is a gel and cream. It is formulated to treat acne and contains the synthetic retinoid adapalene. This agent acts on the processes of superficial keratinization of the epidermis, preventing blockage of the excretory ducts of the sebaceous glands by dead cells. In addition, it also has an anti-inflammatory effect. However, Differin and other retinoids do not regulate the work of the sebaceous glands themselves, therefore, they do not eliminate the cause of the pathology.

Differin is applied to clean skin 1 time per day (at night), the effect becomes pronounced after 3 months of regular use. It is contraindicated in pregnant and lactating women. Side effects include flaking and redness of the skin. This drug is best used after the removal of the sebaceous gland to prevent recurrence of lesions.

With the development of inflammation or skin irritation, antimicrobial drugs for external use are additionally prescribed, for example, Metrogyl gel. It fights pathogens well and prevents inflammation. Apply the gel to the skin twice a day for 3 months. Side effects are very rare and include irritation and rash.

Folk remedies

One of the most popular remedies for getting rid of sebaceous hyperplasia on the head or any other part of the body is apple cider vinegar. It normalizes the acidity of the surface layer of the skin and regulates the sebaceous glands. Apple cider vinegar dissolves fatty deposits in the excretory ducts and prevents their reappearance.

To enhance the effect, this substance can be mixed with peppermint oil and used as a tonic. You need to treat your face with a cotton pad 2 times a day. After a week, the manifestations of pathology should decrease significantly. If this does not happen, you should consult a dermatologist.

Peppermint essential oil has an antiseptic and anti-inflammatory effect, which helps in the treatment of the pathological condition. It eliminates excess sebum and restores the normal activity of sebocytes. Instead of oil, you can use the juice squeezed from the leaves of this plant. It is necessary to treat the skin with oil or mint juice at night.

Lemon essential oil works great too. It is a powerful antiseptic with astringent properties. Applying a few drops of lemon essential oil to the affected area will help the skin recover, and regular use will prevent the recurrence of the disease. An additional benefit is moisturizing and relieving signs of inflammation. As with mint, freshly squeezed lemon juice can be used in place of the essential oil.

Update: December 2018

The condition of the skin depends on the hormonal background, hygiene habits of a person, the level of immunity and heredity. Inflammation of the sebaceous glands is the most common disease of the dermis, which develops due to the negative impact of these factors. In the medical literature, this condition is referred to as "acne" or "acne", for most people the more familiar word is "pimples". However, regardless of the name, this disease affects the appearance of a person, can reduce his self-esteem and repel other people from him. Therefore, its elimination is a priority for most patients.

You can learn detailed information about the causes of acne, prevention, methods of correct and effective treatment from this article.

Fundamentals of anatomy

Almost the entire surface of the body is covered with sebaceous glands. These are small formations that produce sebum, with short and branched excretory ducts. A particularly large number of them are located around the hair - on average, there are 7-9 glands around one hair follicle. Also, in most people, their accumulation can be found in the following areas of the body:

• Face. Separately, it should be noted the skin around the lips, forehead and cheeks;
• Back, especially in its upper half;
• Neck and chest;
• Armpits;
• Member and labia minora;
• Skin around the nipples.

Acne can occur anywhere on the body, but these areas are the most commonly problematic. A person has only two places where acne cannot form. These are the palms and feet. In these places, the skin has a special structure - it has a thickened epidermis, there are no sebaceous glands and hair follicles.

Why acne occurs

The causes of inflammation can be divided into 4 main groups: hormonal changes, increased dryness of the skin, excessive production of sebum and infection. In some cases, one person may have several causes of the disease. At the same time, it is important to eliminate each of them in order to obtain the optimal effect from the treatment.

It is also important to consider heredity as a factor in the development of acne. Scientists have proven that parents with severe acne in the present or past, children are more susceptible to this disease. Knowing this fact, it is possible to carry out preventive measures in a timely manner, correcting the condition of the dermis.

Restructuring of the hormonal background

The amount of sebum produced is most affected by the ratio of sex hormones in the blood of a person. Of fundamental importance are:

1. Androgens(testosterone, dihydrotestosterone, DHEA-S). Male hormones lead to increased work of not only sebaceous, but also sweat glands. Therefore, an increase in their concentration can lead to acne;
2. Progesterone. This is the "hormone of pregnancy", which is intensively produced in women after the middle of the menstrual cycle and immediately after conception. Causes swelling of the excretory duct, which leads to stagnation of sebum;
3. Estrogens(estrone, estriol, estradiol). These substances relieve swelling and restore the patency of the excretory ducts of the glands, somewhat reduce their secretion. A lack of estrogen can also cause acne.

There are moments in the lives of people of both sexes when hormonal changes are the norm. In this case, the formation of acne is a temporary effect and does not require special treatment, except in cases of infection. However, when changing the amount of sex hormones against the background of the disease, it is necessary to carefully approach the issues of therapy. In this case, it may be necessary to consult not only a general practitioner, but also a gynecologist, andrologist or endocrinologist.

To distinguish the disease from the norm, it is necessary to know the periods when hormonal changes occur. These include:

Period	Time of occurrence of hormonal changes	Changes in the ratio of sex hormones
In newborns	From birth to 3-6 months.	In newborn girls, the formation of a "sexual crisis" is possible - a temporary increase in the level of progesterone in the blood, due to its transition from mother to fetus. In this case, the following phenomena occur: breast engorgement; Uterine spotting bleeding; acne; Profuse greyish-white discharge from the vagina.
Puberty in men	From 13 to 20 years old.	There is a significant rise in the concentration of androgens, which can persist for 5-7 years.
The second phase of the menstrual cycle in women	From the middle of the cycle (normally 13-15 days) until the onset of menstrual bleeding.	In the second half of the cycle, normally there is a rise in the level of progesterone, which is a factor in the development of inflammation and blockage of the sebaceous gland.
Pregnancy	From the middle of the cycle (normally 13-15 days) until the birth of the child.	Against the background of a normal pregnancy, a high level of progesterone is constantly maintained, which is produced first in the ovaries, and then in the woman's placenta.
Pre- and post-menopause	After 45 years.	Due to a decrease in estrogen levels, a woman can develop acne and a number of other adverse events associated with menopausal syndrome: emotional instability, periods of sweating, insomnia, etc. Treatment of women during this period of life is possible with hormone therapy methods.

Above were listed the conditions in which the occurrence of acne is considered a variant of the norm. In all other cases, the appearance of acne should be considered a sign of the disease.

Increased dry skin

A fairly common cause of inflammation of the skin glands is their blockage with horny scales. With excessive dryness of the skin in a person, its surface layer begins to quickly exfoliate. These particles of the epidermis can close the sebaceous ducts and lead to the formation of acne.

Many factors influence the degree of moisture in the skin. The most important of them are:

• Age over 40. Over the years, the body's ability to restore is inevitably depleted. It is more difficult for the cells of the dermis to retain the required amount of moisture and trace elements, so it must be additionally moisturized with the help of cosmetics;
• Climate. This term refers not only to weather conditions, but also to the surrounding microclimate: indoor temperature, air humidity, the use of gadgets to control temperature.
  • Negative influence renders dry and frosty air, low air humidity, the use of air conditioners, heat convectors, heat guns, etc.;
  • positive influence has warm and humid air (optimal is sea), air humidifiers for rooms. If it is necessary to use thermal elements or air conditioners, it is recommended to combine them with air humidifiers.
• Hot bath or shower. The surface of the skin in a healthy person is protected by a lipid layer that prevents it from drying out. High temperature water destroys this natural defense, which can be a factor in acne;
• Hygiene products. Using ordinary soap to wash the skin of the face or intimate areas can cause its increased dryness. Since the protective layers of the dermis are more vulnerable in these areas, it is necessary to use special lines of hygiene products to care for them, for example: milk or face wash, micellar water, tonic lotion, intimate hygiene soap and others.
• Skin diseases such as allergic dermatitis, psoriasis, eczema, etc.;
• Endocrine diseases, for example: diabetes mellitus, hypothyroidism, Itsenko-Cushing's syndrome / disease.

In the treatment of inflammation of the sebaceous glands, the identification of harmful factors is of great importance. Therapy may not bring any effect for a long time if the cause of acne formation is not identified and eliminated.

Excess sebum production

At the moment, only three reasons are reliably known that can enhance the work of the glands: an increased content of androgens (described above), certain foods and the disease "seborrhea". In the course of research by domestic doctors, it was determined that products with a high content of fatty acids have the greatest harm to the skin. These include:

• Chocolate and cocoa;
• Nuts;
• Some types of cheese: feta cheese, suluguni, pigtail cheese and other pickled cheeses;
• Fatty meats (veal, beef, lamb, etc.) and products of their processing.

Carbonated and caffeinated drinks can also become a factor in the development of acne. Some scientists believe that the substances contained in them also increase the production of fat.

The next significant factor is the disease, the only sign of which is the presence of oily skin. Until now, scientists have not identified the causes of seborrhea. It is believed that this disorder is inherited and develops under the influence of adverse factors (described above).

Joining the infection

Microorganisms are the main cause of inflammation. When certain bacteria penetrate the skin, immune processes are activated, pus is formed, and surrounding tissues are damaged. Against the background of an unfavorable course of the disease, bacteria can spread to neighboring areas and contribute to the formation of large conglomerates of acne.

At the moment, the role of only one type of microbes in the development of acne has been proven - Propionobacterium Acne (Latin name - Propionibacterium acne). That is why in the treatment of patients with this disease, antimicrobials of local or general action are necessarily used.

Appearance and symptoms

Basically, there are two groups of acne. The first includes acne that occurs only due to blockage of the excretory ducts. The second option develops with a combination of inflammation with the closure of the mouth of the gland. They must be distinguished from each other, since the tactics of treatment depend on this. Each of the species has its own characteristic features, such as appearance, soreness and density when palpated.

To determine your acne variant, it is enough to use the information from the table below:

Non-inflammatory (blockage only)

Appearance: Small white dots, no more than 1-2 mm. More often, blockage of the sebaceous gland is located on the eyelid, around the eyes or on the cheeks. Soreness: No Consistency: Soft

Closed (white) comedones Appearance: Small white pimples larger than 2 mm, rounded regular shape. Soreness: No Consistency: Soft

Open comedones ("blackheads") Appearance: The shape is similar to white comedones, with one exception - at the top there is a small hole with black contents. It contains a mixture of dust, horny scales and sebaceous fluid. Soreness: No Consistency: Dense

Inflammation + blockage of the sebaceous duct

papular Appearance: Pimples of red or bright pink color, rising above the skin. Size up to 1-2 cm. Soreness: Pain when palpated Consistency: Dense, similar to small knots

Pustular Appearance: Rounded formations with purulent contents inside (yellow or brown-green) Soreness: Sharply painful Consistency: Dense, when probing, an elastic cavity is felt.

Inductive Appearance: With this form, the focus should not be on the pimple itself, but on the skin around it. If it becomes red, inflamed, there may be a slight swelling - they talk about the indurative form of acne. Soreness: Painful acne and skin around it Consistency: Tight formation and surrounding skin.

Conglobate Appearance: These are huge confluent blackheads that can be up to 10 cm in size. As a rule, they are located on the back. May be flesh-colored or reddish. They rise significantly above the skin. Soreness: Pain may be felt when palpated Consistency: Dense

Phlegmonous Appearance: Large, purplish-bluish acne, penetrating deep into the dermis. Soreness: There is a sharp soreness. Consistency: Dense

After determining the type of acne, it is also necessary to find out the severity of the disease. Only then can the optimal treatment option be determined. It is strongly recommended to consult a dermatologist for this purpose, as self-treatment can lead to incomplete recovery from the disease and irreversible damage to the skin.

The severity of the disease

To find out how severe the disease is, it is enough to determine the nature of acne and count the number of these elements. Currently, there are the following criteria for pathology:

• Light degree. A person has only non-inflammatory elements or the number of papules, pustules less than 10;
• Moderate course. The number of papules and pustules is from 10 to 40;
• Severe illness. Papules and pustules in total more than 40 (all over the body) or the presence of indurative, conglobate acne is noted.

It should be noted that any severity of acne is treated at home. However, the more severe the pathology is, the higher the risk of irreversible skin damage.

Treatment

Therapy of any form of the disease is recommended to be carried out under the supervision of a general practitioner or dermatovenereologist, who will determine the optimal tactics. The treatment regimen for blockage of the sebaceous glands is determined by the severity of the disease and the cause that caused the development of acne. In cases where it is not possible to find out the cause, the doctor is guided solely by the severity of the disease.

Definitions of treatment tactics

There are several areas of acne therapy - diet, cosmetic procedures (daily skin care), the use of topical drugs and systemic treatment. Diet changes are indicated for all patients. For the rest of the nuances, there are the following recommendations for the selection of the volume of therapeutic measures:

Severity	hygiene care	Tactics
Light	It is possible to use conventional moisturizing skin care products: foam or milk for washing, micellar water, tonic lotions. For intimate hygiene, it is possible to use special soap from Carefree, Nivea, Dove. It is impossible to use products containing lactic acid without the appointment of a gynecologist - these are medicinal preparations that are not suitable for daily hygiene in case of inflammation of the sebaceous glands on the labia or in the groin.	It is enough to use only local medicines.
Medium		Priority is given to local pharmaceuticals. In some cases, a short course of systemic therapy is recommended for a person.
heavy	The use of specialized cosmetics is recommended. For this purpose, you can use the line of funds "Xemoz" from the company "Uriage", "Aisida" and others.	The appointment of general therapy with the use of local treatment is mandatory.

Diet

It has been proven that a small change in diet can significantly reduce the number of acne. The exclusion of certain products allows you to reduce the secretion of the sebaceous glands and eliminate one of the risk factors for acne.

• It is recommended to exclude: carbonated drinks, cocoa, nuts, pickled cheeses (brynza, suluguni, etc.);
• Should be limited: chocolate, meat with a high content of fatty acids (veal, pork, lamb and others), coffee.

Cosmetic skin care

Elimination of acne must necessarily include this component of therapy. It is needed to increase the moisture of the skin and reduce flaking - this will help reduce the likelihood of blockage of the glands. For optimal results, the following hygiene guidelines must be observed:

1. Problem areas of the skin should be washed 2 times a day. More frequent or less frequent care can negatively affect the condition of the skin;
2. Water for procedures should be used at room temperature, as large temperature changes cause severe peeling of the epidermis;
3. After washing, the skin should be blotted with a soft towel, and not rubbed with it;
4. It is necessary to abandon the use of alcohol-containing lotions, sharply alkaline or acidic agents. Their pH (acidity) should be neutral or slightly deviate from this value (pH = 7±1.5);
5. Scrubs should not be used, as mechanical irritation of the dermis can increase the production of sebum;
6. For additional moisturizing of the skin, you can use Physiogel or Cetafil cream, 1-2 times a day. According to national guidelines, these products are optimally suited for the complex treatment of acne.

The selection of daily care products is carried out with the help of the attending doctor. As already mentioned, for this purpose, you can use both general cosmetic lines (Nivea, Dove, etc.) and specialized products (Aisida, Xemoz, and others).

Local therapy

This treatment method consists in applying drugs to problem areas of the skin. At the moment, there are several groups of drugs for topical use. These are antiseptic and keratolytic (exfoliating) substances, preparations with vitamin A and combined agents. The standard treatment regimen involves the use of one pharmacological drug from each group, or a drug with a combined effect.

Preparations with retinoic acid

This group has a complex effect on the dermis - they reduce the activity of the inflammatory process, prevent the excessive formation of horny scales and weaken the sebaceous glands. Currently, Adapalen (Differin) is considered the optimal pharmacological preparation. It is highly effective and easy to use, but it acts rather slowly - the first effects of its use develop after 4-6 weeks.

Adapalene is available in the form of a gel and cream, applied once a day, at bedtime, at the end of hygiene procedures. After that, the face is not wiped and not moisturized. The average course duration is 3 months.

Antimicrobial treatment

Medicines from this group should be prescribed in the presence of inflammation of the sebaceous glands, that is, when papules, pustules, conglobates and other elements occur. At the moment, dermatologists recommend using one of the following antibacterial agents:

Active substance	Trade names (under which they are sold in a pharmacy)	Exfoliating (keratolytic) effect	How long does it take for the effect to develop?
Benzoyl peroxide	Proderm - cream; Baziron AS - gel; Eclaran - gel; Desquam - gel, lotion.	There is an additional desquamating effect	At least 4 weeks later. The optimal duration of treatment is 2-4 months.
Azelaic acid	Azelic - gel; Skinoren - gel, cream; Azix-Derm - cream; Skinoclear - gel, cream.
Clindamycin	Mirrorin - solution; Dalacin - gel.	Not	During the first week. The maximum duration of therapy is 6 weeks.

It is necessary to apply any antibacterial drug 2 times / day after washing on clean, dry skin. He needs to give time to act for 20-30 minutes. During this time, do not wipe or wet the skin.

Combined drugs

This group was developed by pharmacologists for the convenience of patients. The presence in one "bottle" of several active ingredients allows you not to buy several drugs, but to limit yourself to one. Also, combined products are easier to use - one application of them allows you to have a complex effect on the dermis.

Here are the most common and effective combinations:

Name	Combined Effects	Substances to be combined	special instructions
Isotrexin	Antimicrobial + retinoic acid	Isotretinoin + erythromycin	Not used in severe illness. Contraindicated in pregnancy and lactation.
Klenzit S		Adapalene + clindamycin	At the beginning of therapy, it can increase the manifestations of the disease (negative effects disappear within a week). With continued irritation of the dermis, its use should be discontinued.
Zenerite	Antibacterial + zinc (anti-inflammatory effect)	Erythromycin + Zinc Acetate	Improvement occurs no earlier than after 2 weeks of regular use. Comes complete with an applicator - convenient for use on any part of the body.

General treatment methods

This method of therapy is resorted to only in severe stages of the disease or on an individual basis with moderate severity (for example, with the ineffectiveness of local treatment). The main goals when using drugs with a systemic effect are the elimination of harmful microbes, the reduction of desquamation of the epidermis, or the elimination of the causes of the disease.

Antibiotic therapy

Acne pathogens show the least resistance to two groups of antibiotics - tetracyclines and macrolides. These groups include different drugs, from which it is necessary to choose one that is best suited for a particular patient. This task for the attending physician - it is strongly not recommended to prescribe treatment on your own.

At the moment, in order to eliminate purulent inflammation of the sebaceous glands, the following antibiotics are widely used:

During therapy, the following principles must be observed:

1. The minimum course of therapy is 10 days. This duration prevents the formation of resistance in bacteria to the antibiotic, which will allow in the future to conduct a second course in case of recurrence of the disease;
2. You should not interrupt the course of antibiotics, except in cases of intolerance;
3. In the presence of concomitant pathologies (diabetes, atrial fibrillation, thrombosis of arteries or veins, etc.), the dose and type of antimicrobial agent must be agreed with the doctor, since drugs can affect each other;
4. Alcohol should be completely avoided while taking medications, as the combination can lead to severe liver damage.

Retinoic acid preparations

According to modern recommendations, for the treatment of severe forms of acne, only one pharmacological preparation from this group is used - Isotretinoin (Acnecutane, Roaccutane). It reduces the work of the sebaceous glands throughout the body and reduces the peeling of the epidermis. Despite its high efficiency, retinoic acid has a large number of side effects. Of these, dyspeptic disorders (nausea, loose stools, abdominal pain), weakness, dizziness, and decreased performance are most often manifested in patients.

It is important to note that it is only used for severe acne resistant to other therapies. Isotretinoin absolutely contraindicated during pregnancy, at the time of its reception, a woman needs to take care of adequate contraception.

Hormonal correction

This procedure is carried out only as prescribed by a gynecologist. It is indicated for women who have a hormonal disorder confirmed by laboratory methods. For this purpose, various drugs can be used, depending on whether a woman is planning a pregnancy in the next 6 months or not.

If there are no plans to conceive, hormonal contraceptives are usually recommended, in the form of pills, applicators, vaginal rings, implants, etc. When planning pregnancy, it is possible to use "cyclic hormone therapy" - estrogen in the first phase of the cycle and progesterone after the middle of the menstrual cycle.

Elimination of acne during pregnancy

This is a rather complex issue that has not been finally resolved to date. The fact is that before prescribing the drug to a pregnant woman, full-fledged clinical trials should be carried out on this particular group of people. However, pharmacological companies and independent associations of doctors are wary of conducting these experiments, because of the likelihood of complications in the fetus or mother. Therefore, no topical preparation has been confirmed to be safe.

Nevertheless, the accumulated experience of domestic doctors allows the following scheme to be used for the treatment of pregnant or breastfeeding women:

1. Diet, with the exclusion of all products that increase the production of sebum (chocolate, nuts, fatty meats, etc.);
2. Daily hygiene care for affected skin, using moisturizing funds;
3. It is possible to use azelaic acid preparations, but only with the permission of a dermatologist, gynecologist or therapist;
4. In severe purulent acne, Josamycin may be prescribed after the 14th week of pregnancy.

Regardless of the gestational age, it is forbidden to use retinoic acid preparations (both local and systemic) and tetracycline antibiotics. These drugs have a pronounced side effect on the development of the fetus.

Prevention

Measures to prevent the development or reduce the intensity of acne are recommended to start from puberty (13-15 years). It is at this time that the period of activity of the sebaceous glands begins, which can lead to the formation of acne. Preventive measures are quite simple, they include:

• A diet aimed at reducing the production of sebaceous secretion;
• Daily washing, using moisturizing cosmetic lines;
• Prevention of excessive drying of the skin (from exposure to temperatures, dry air, chemicals, etc.).

FAQ

Question:
How to suspect the presence of a hormonal disorder in a woman as the cause of acne?

First of all, you should pay attention to the regularity of the menstrual cycle. Also, very heavy or scanty discharge, the presence of spotting between periods, male pattern hair growth (along the midline of the abdomen, on the back, in the chin area, on the cheeks or under the nose) are also considered a pathological sign.

Question:
Can you pop pimples on your own?

No, because this procedure leads to an increase in the inflammatory process. Also, the possibility of pus entering the bloodstream and the development of a severe infection (sepsis or meningitis) is not excluded.

Question:
Why is it impossible to dry the skin with inflammation of the sebaceous glands on the face?

At the same time, its peeling intensifies, and the horny scales close more of the excretory ducts of the sebaceous glands. Accordingly, the number of comedones, milia and other acne elements increases in a person.

Question:
Can physical therapy be used to treat acne?

Indications for physiotherapy are quite limited - this is the presence of comedones or milia in a limited area of ​​\u200b\u200bthe body. However, its effectiveness has not been proven in scientific studies. Physiotherapy contraindicated with inflammatory acne (papules, pustules, conglobates, etc.), as it leads to increased blood supply to tissues and aggravates inflammation.

Question:
Are there any features of the treatment of blockage of the sebaceous glands in a child?

Acne in newborns, in the vast majority of cases, resolves on its own and does not require therapy. Most often, teenagers face this problem. The treatment regimen for children older than 8 years is carried out in the same way as for adults. If the child is younger, it is necessary to abandon retinoic acid preparations and the use of systemic antibiotics (except for Josamycin).

How to properly organize care if you have oily facial skin, what to do to normalize the work of the sebaceous glands and make the skin well-groomed and beautiful? First of all, you should deal with the information on this issue.

A hallmark of oily skin is the excessive activity of the sebaceous glands, which provokes coarsening of the texture, unhealthy color of the skin and their shine. In addition, expanding pores and comedones, acne, and sebaceous gland cysts become very common problems. For competent care of oily facial skin, it is necessary to organize the correct diet, as well as use special external products.

This applies to self-care at home, and professional techniques. It is important to regularly carry out procedures such as cleansing, peeling, making masks. To find out the causes of excessive function of the sebaceous glands, you should visit such specialists as a dermatologist, cosmetologist and endocrinologist.

Oily skin is typical for people of adolescence and young age, but most often this type of skin transforms into combination skin by the age of about thirty years. Excessively active function of the sebaceous glands is explained by the following reasons:

• genetic predisposition;
• fluctuations in hormonal status;
• digestive pathologies;
• irrational nutrition;
• non-compliance with the rules of skin care.

With a hereditary predisposition to oily skin, it is important to take into account the fact that as you grow older, your skin type will not change, so efforts should be directed to correct regular care and choosing the right cosmetics for care.

Endocrine causes often play a role in puberty. A high concentration of testosterone leads to an increase in the size of the sebaceous glands, and also enhances their secretion. In addition, another hormone that affects the functioning of the sebaceous glands is adrenaline, the concentration of which increases if the body is under stress.

Also, oily skin increases with improper use of hormonal contraception. Sometimes women face the problem of very oily skin in case of polycystic ovaries, pregnancy, menopause.

Improper diet is also a fairly common cause of oily facial skin. It includes frequent intake of fatty and spicy foods, flour, sweets, alcohol and fast food. Often, people with oily skin have pathologies of the digestive system, such as colitis, cholecystitis, and constipation. It is worth noting that long work in a dusty or polluted space also increases the oiliness of the skin.

It is important to know that a common mistake in solving the problem is the excessive use of scrubs, aggressive cosmetic products containing alcohol. If you often degrease the skin, then you can aggravate the situation, since the cells

epidermis in response to getting rid of the fatty layer only increase the secretion. If you get carried away with scrubs and peeling, then this provokes the occurrence of non-healing microtraumas of the skin of the face, which will lead to an increase in the intensity of the secretion of fatty secretions.

Features of oily skin type

The characteristic features of oily skin include:

• localization of the most disadvantaged zones within the T-region (chin, nose, forehead);
• the skin is shiny, untidy, rough, uneven, dull, with a gray tint;
• difficulty applying makeup;
• combination with oily hair;
• blockage of pores, leading to their expansion;
• a tendency to the appearance of comedones (black dots) and milia, that is, whiteheads;
• the appearance of vascular networks;
• better ability to retain moisture;
• less sensitivity to the action of low temperature, sun, wind;
• late appearance of wrinkles.

Oily skin care tips

Before organizing facial skin care, it is necessary to determine the goals that are planned to be achieved. When

oily skin needs to properly remove the secretion of the sebaceous glands and take measures to reduce their activity, open the pores. The rules for oily skin care include the following items.

1. Minimization or elimination of negative effects on the skin. It is necessary to stop using alcohol-containing lotions, excessive scrubbing, greasy creams and do not neglect the removal of makeup at night.
2. Diet correction. It should include lean meats, fish, and fruits and vegetables. It is better to refuse the use of spices, smoked, sweet and flour. It is also important to take vitamin complexes if these nutrients are not enough in food.
3. Organization of proper home care. It should include cleansing, hydration and nutrition. The complex of products should be used taking into account the characteristics of the skin type. Mousses, gels, foams for oily skin have an anti-inflammatory effect. Wash with warm water. Peeling and scrub should not be used more than once or twice a week. After washing, wipe your face with tonic. This procedure is necessary for disinfection and tightening of the skin. After that, you can apply the cream.
4. The use of folk remedies. It is useful to wash with warm decoctions of herbs, such as chamomile, horsetail, nettle, lime blossom. In addition, cosmetic clay masks give a good effect.
5. The right choice of decorative cosmetics. Here it is better to opt for light tonal foundations, matting powders. Do not use creamy textures of blush and eye shadow.

If you follow these rules, then you can minimize all the problems that occur due to improper functioning of the sebaceous glands. Enough attention should be paid to care and lifestyle management so that the skin feels very good and looks better.

Professional care for oily skin

In-salon skin care treatments may include:

1. Make-up removal with the involvement of special emulsion agents.
2. Deep cleansing using enzyme peeling, vaporization, instrumental, ultrasonic and dry cleaning.
3. The use of ampoule serum products.
4. Facial massage.
5. The use of cosmetic masks with various types of actions for cleansing, relieving inflammation, and regulating the active functioning of the sebaceous glands.
6. Use of finishing products (creams) for oily skin types.

Thus, the correct care of oily skin is a very laborious process. It includes not only home procedures, but also professional techniques, as well as lifestyle correction. With some effort, you can eliminate the problems of oily facial skin and normalize the functioning of the sebaceous glands. An important point is the regularity of care. It is important to pay attention to the procedures every day, adhering to the planned course and not neglecting the advice of a beautician.

The sebaceous glands are located in the skin on many parts of the body, especially on the face. The glands secrete a secret that is needed to support the antimicrobial and barrier functions of the hair and epidermis, it also gives the skin softness and elasticity.

Appearance and functioning of the sebaceous glands:

This is how the sebaceous glands work.

How do sebaceous plugs form? Effects

Due to the formation of sebaceous plugs on the face, the functions of the skin are disrupted, which leads to inflammation.

On the face, mainly sebaceous plugs occur: on the nose, chin, cheeks and on the head near the hairline, since in these places the secretion of sebum is increased.

On the face, mainly sebaceous plugs occur in the form of various acne.

It's important to know! In some cases, a large release of fat is a sign of a nervous and mental disorder in a person.

During blockage, pores can become clogged:

1. Horny cells.
2. bacteria.
3. Microorganisms.
4. Skin fat.

Abscesses, skin inflammations, atheromas, various tumors, acne, pimples - all this can be the consequences of blockage.

There are three types of diseases.

Abscesses, skin inflammations, atheromas, various tumors, acne, pimples and poor health can be consequences of blockage.

seborrhea

The disease appears due to metabolic disorders of the body, during puberty. Most often it manifests itself in the form of acne.

Rosacea (acne)

They arise as a result of damage to the vessels located next to the trigeminal nerve.

The cause may be disorders in the gastrointestinal tract, is also formed due to neurological disorders in women during menopause.

Zheleznitsa

This disease is characterized by the manifestation of rashes in the form of red spots on the skin surface.

It is recommended to consult a doctor before starting treatment. It is required to exclude salty and spicy foods from the diet at the time of treatment.

Mostly, develops due to a reaction to many cosmetic products(creams, mascaras, etc.).

Reasons for the formation of sebaceous plugs

The appearance of sebaceous plugs on the skin of the face is influenced by some factors, both external and internal in nature - that is, associated with the influence of the environment and directly the internal processes of the body.

Abundant application of cosmetics can lead to blockage of the sebaceous glands.

External factors:

Internal factors:

1. Hormonal failure in the body.
2. Unbalanced and malnutrition.
3. Transitional age.
4. Allergic reaction to many cosmetics and drugs.
5. The disease is hyperkeratosis (the causes of the disease are frequent external effects on the skin or beriberi).
6. Demodicosis disease (mites in the skin).
7. Stress and depression.
8. During menstruation in women.

Clogged sebaceous glands on the face. How to treat at home

Several folk ways to treat blockage of the sebaceous glands on the face.

steam baths

Made over boiled water. You can also optionally add sage or chamomile leaves to the decoction.

Steam baths are made over boiled water. You can also optionally add sage or chamomile leaves to the decoction.

Recipe: one tbsp. a spoonful of raw materials is poured with hot water (300 ml) and infused for twenty minutes.

Application: wash off all make-up. Pour the broth into a wide, shallow basin and hold the face covered with a towel over it. The procedure is carried out for 15 minutes.

clay mask

You can use white, green and blue clay. Water is added to the clay until a thick mass is obtained.

Application: Apply to the skin and wash off after 20 minutes.

For a clay mask, you can use white, green and blue clay.

Egg white

An egg white mask also has an effective effect. It's simple: the protein is whipped until foam is obtained.

Application: the resulting mass is applied to the face. And after drying, it is washed off with warm water and a moisturizer is applied. Protein foam mask it is recommended to do it several times a week.

An egg white mask also has an effective effect. It's simple: the protein is whipped until foam is obtained.

Infusion of yarrow

Yarrow flowers are suitable both fresh and dry. One teaspoon of flowers pour a glass of hot water and leave to infuse for 15 minutes.

Application: used for face wash in the morning. Before going to bed, you can make a lotion by dipping gauze in a tepid infusion and then applying it to the skin of the face. This lotion has a cleansing effect and narrows the pores.

For infusion for washing, yarrow flowers are suitable, both fresh and dry.

Celandine grass

Finely chop the washed celandine grass (with a blender, knife) - you get about 4 tbsp. spoons of herbal mass. Pour this mass with water (5-6 glasses) and cook for about five minutes. The infusion should be infused for 7 hours.

Application: the washed face is wiped with a napkin, previously moistened with infusion. Do this procedure at least twice a day.

Lotions are also made before going to bed, applying a napkin moistened with infusion to the skin for 15 minutes.

Wipe the washed face with a napkin previously moistened with celandine infusion. Do this procedure at least twice a day.

Pore ​​Cleansing Lotion

To 1 teaspoon of sugar, add the same amount of baking soda, pour a glass of hot water and mix.

Application: wipe the face with lotion in the morning and evening.

The above remedies will help cleanse the pores and dry the skin.

To 1 teaspoon of sugar, add the same amount of baking soda, pour a glass of hot water and mix. Wipe the face with the resulting lotion.

What pharmaceutical preparations to treat clogged sebaceous glands on the face:

1. Wipe the skin of the face with a 1% solution of salicylic acid twice a day.
   It is important to use exactly 1% salicylic acid, 2% will burn the skin.
2. The drug "Zinerit". In the morning and evening, the ointment is applied to clean skin of the face. It is applied every other day.
3. Taking drugs that normalize sebum formation - "Erythromycin", "Nystatin".

Blockage of the sebaceous glands on the face. Treatment with hardware methods

Hardware makes the skin lighter and younger, evens out the relief, cleanses the pores. The method of treatment is determined by the beautician.

Common hardware treatments:

• ultrasonic cleaning;
• microdermabrasion;
• electrotherapy (exposure to the skin with current);
• cryotherapy (treatment of problem areas of the face with liquid nitrogen);
• laser peeling.

During laser peeling, microdermabrasion and ultrasonic cleaning, the skin is treated with a special powder of microparticles.

During laser peeling, microdermabrasion and ultrasonic cleaning, the skin is treated with a special powder of microparticles. The results don't keep you waiting.

Blockage of the sebaceous glands on the face. Treatment in clinics and beauty salons

Specialists in clinics and salons can offer several professional procedures for cleaning sebaceous plugs:

1. Dry cleaning - fruit acids are used for the procedure, which warm up the skin and dissolve sebaceous plugs (partially).
2. Mechanical cleaning - steaming the face and squeezing out the rashes manually. There are doubts about this method of cleaning, as the rash will soon reappear.
3. Laser therapy - getting rid of sebaceous plugs with a laser. This procedure is painless and leaves no marks on the face.

Prevention of the formation of sebaceous plugs on the face

To avoid the formation of sebaceous plugs on the face, it is necessary to properly care for the skin, as well as follow and listen to the advice of doctors.

1. It is necessary to consume plenty of fluids per day to maintain the water balance in the body;
2. Instead of soap for washing, it is better to use liquid gel;
3. Be sure to completely cleanse your face before going to bed from cosmetics;
4. In no case do not squeeze out acne;
5. Eat more fruits and vegetables;
6. Use proven and high-quality cosmetics for the face. It is not recommended to apply cosmetics every day;
7. To refuse from bad habits;
8. Choose cosmetics and hygiene products according to your skin type.

Remember! At any age, a problem such as blockage of the sebaceous glands on the face may arise, the treatment of which must be carried out only after finding out the cause of the formation.

Use proven and high-quality facial cosmetics. It is not recommended to apply cosmetics every day.

This problem causes a lot of inconvenience. It spoils both appearance and mood. That's why you need to take care of your skin, and in case of progression of the disease, consult a doctor.

Facial pore cleansing at home

For the best cleansing of the pores, there has not yet been invented a more effective and simple means than conventional steam baths. What do these procedures give the skin?

They perfectly cleanse the pores of the face, reduce them, dissolve fat, which often accumulates in the pores, relieve stress well, tone and perfectly moisturize the skin.

The hot steam acts on the blood vessels, which dilate. As a result, metabolic processes and blood supply to the skin are significantly improved, old cells are removed. The skin becomes softer and more tender to the touch, a blush appears.

Steam baths perfectly cleanse the pores of the face, reduce them, dissolve the fat that often accumulates in the pores, relieve stress well, tone up and perfectly moisturize the skin.

The steam bath is an excellent addition to other procedures. For example, it is recommended to do it before applying a nourishing, rejuvenating or moisturizing mask or before applying a scrub.

Owners of oily and normal skin can perform these thermal procedures twice a month, but for dry skin, using steam baths more than once a month is not recommended at all.

In order for the effect of the bath to be stronger it is necessary to use essential oil or infusions and decoctions of medicinal herbs instead of plain boiled water.

Chamomile

This plant perfectly soothes the skin, relieves itching, peeling and irritation. It is necessary to prepare an infusion from chamomile, and then heat it until steam appears.

Chamomile perfectly soothes the skin, relieves itching, peeling and irritation.

After that, you need to put the saucepan on the table and tilt your head over it. In order for the steam to go in the direction of the face, you need to additionally cover yourself with a large thick towel. You need to keep your face over the steam for about fifteen minutes.

Bay leaf

This plant improves blood circulation, has excellent bactericidal properties, helps to cope with acne and inflammation on the skin.

Liquorice root

From licorice, you can prepare a decoction for a steam bath. This plant perfectly softens the skin, removes toxins and toxins, perfectly cleanses the pores.

Essential oils

Essential oils can also be used in steam baths. However, they must first be dissolved in a small amount of some fat-containing product, such as vegetable oil or milk.

Essential oils can also be used in steam baths.

Despite the usefulness of these procedures, there are some contraindications to their use.

These are, first of all, inflammatory processes on the skin, as well as rosacea. If the skin is very dry and sensitive, steam baths should be taken with particular care.

In this video you will be told about the causes of problematic skin and its treatment.

From this video you will learn about the reasons for the malfunction of the sebaceous glands.

This video will give you practical tips on how to care for your sebaceous and sweat glands.

There are skin diseases that are treated by both dermatologists and cosmetologists. These include something that everyone can have, which you can ignore, but which you really want to get rid of, as this affects the aesthetic appearance of the skin. So, these are problems that spoil the appearance and cause not so much physical as moral suffering. Let us dwell here only on the most frequent ones - Acne, seborrhea and various formations on the skin.

Acne vulgaris or juvenile acne

Acne- the most common skin disease in adolescents and young people, that is, the most socially active part of the population. This unpleasant disease affects about 85% of people aged 12 to 25 in European countries, so clear skin at this age is the exception rather than the rule. The presence of inflamed pimples, pustules and abscesses, blackheads (comedones), spots and scars, greasy, untidy appearance of the skin in the most prominent places causes difficulties in communication, professional device, reduces self-esteem, often leads to the formation of significant psycho-emotional disorders, up to the desire to complete isolation. Some young people stop leaving the house, drop out of school and work, become isolated, and in the end, a minor and completely banal skin problem develops into a personal tragedy. A patient who has addressed to a dermatologist about acne has serious psychological problems. Shyness, guilt, a sense of social unacceptability, anger, a state of depression, disbelief in the possibility of a cure are expressed to one degree or another. Intense experiences exacerbate the course of the disease. In stressful situations, patients, especially women, open the skin, squeeze out Acne, which further worsens the appearance of the skin due to the accompanying inflammation. On such injured areas, scars and spots remain that do not go away for a long time.

Acne- a long-term disease, often aggravated (in girls, as a rule, monthly) and often resistant to ongoing treatment. Today we know much more about acne than ten years ago, and a competent specialist can always help the patient. In this regard, the opinion that existed in the past that acne will disappear by itself with age, and therefore it is not worth spending effort on treating them, now sounds simply absurd. It is not always possible to immediately find the right individual approach, but the efforts made and the persistence shown are always rewarded with a good result. In the arsenal of specialists there are a number of effective drugs of different groups. The choice of the drug depends on the form of the disease, the prevalence of certain symptoms, the sex of the patient, the presence of contraindications.

Acne is more often divided into:

1. acne with a predominance of comedones (white and black dots with mild inflammation);
2. papulo-pustular acne (there are comedones, inflamed nodules - what is usually called acne, pustules, sometimes single large painful seals, gradually turning into abscesses such as boils);
3. conglobate acne (along with all of the above, there are long-term painful seals that leave pronounced scars after healing).

Most patients eventually develop the habit of squeezing comedones and pustules, constantly touching the inflamed skin, which is why bloody crusts, spots, superficial scars are added to everything described.

Many factors are involved in the development of acne, the action of which is ultimately realized in the sebaceous hair follicles. Not all follicles are affected, but only those with a special structure, located on the face and upper body, with large sebaceous glands, wide (up to 2.5 mm) ducts and thin, almost invisible hairs. The sebaceous glands are the target organ for sex hormones, especially testosterone. Under the influence of testosterone, produced by the sex glands, especially actively in adolescence, the size and number of sebaceous glands increase significantly, the production of sebum increases, and its composition changes. In addition, in the development of acne, a violation of the keratinization of the ducts of the sebaceous glands, difficulty in the outflow of sebum to the surface of the skin, increased reproduction of microbes in the accumulated sebum and subsequent inflammation are essential. With the help of modern medicines, it is possible to influence almost all the factors involved in the development of the disease.

With the initial manifestations of acne (usually at the age of 8–13 years), when the clinical picture is dominated by increased oily skin and comedones (whitish nodules and black dots), and there are not so many inflammatory elements, retinoic and salicylic acid preparations are used externally. Both acids have the ability to dissolve comedones, and salicylic acid is much weaker in this regard. With papulo-pustular acne, it is advisable to use antibiotics, retinoids, benzoyl peroxide (benzoyl peroxide), traditional external agents (salicylic, chloramphenicol, resorcinol alcohols). Severe forms of acne, including acne conglobata, should be treated with oral retinoids, and only if there are contraindications, other methods of treatment (antibiotics, immunomodulators) are used. As with papulopustular acne, it is preferable to use a combination of different drugs.

Problems solved in the course of treatment and ways to solve them:

• decrease in sebum production (retinoids, especially retinoic acid, hormonal drugs - estrogens, progestins or antiandrogens, spironolactones);
• reduction of inflammation - antibiotics (tetracyclines, erythromycin, lincomycin, clindamycin) and local anti-inflammatory and microcirculation-improving agents, including zinc oxide, sulfur, tar, ichthyol, resorcinol;
• prevention of the appearance and elimination of comedones (retinoids, especially retinoic acid, salicylic alcohol);
• prevention of scarring (early start of treatment, retinoids, curiosin, contractubex, exclusion of injury to rashes).

Features of acne treatment with drugs of different groups

Currently, retinoids are the most effective group of drugs for the treatment of acne. Their use solves several problems at once - reducing the production of sebum and inflammation, preventing the appearance and elimination of comedones and scars. Two isomers of retinoic acid (tretinoin and isotretinoin) are used externally for the treatment of acne. Roaccutane and Retinol palmitate are used for internal treatment of acne conglobata and widespread papulo-pustular acne resistant to other external agents.

Roaccutane (isotretinoin) (Hoffmann-La Roche, Switzerland) is produced in capsules for oral administration of 10 and 20 mg (30 pieces per pack). Assign at the rate of 0.5-1.0 mg / kg of body weight per day, taken in equal parts 2 times a day after meals for 12-16 weeks. If necessary, repeated courses break should be at least 8 weeks. Roaccutane is a highly effective drug, however, its use is limited by high cost and many side effects. Treatment is always carried out under the supervision of a specialist.

Retinol palmitate(vitamin A) - a domestic drug, it is produced in capsules for oral administration of 33,000 and 100,000 IU, as well as in an oil solution of 100,000 IU / ml. Effective doses for acne are at least 300,000 IU per day. The course of treatment is 12-16 weeks. The intervals between courses are 4-8 weeks. Retinol palmitate is inferior to Roaccutane in effectiveness, however, its tolerance is better, and the cost is much lower.

For external treatment of acne, preparations containing all-trans retinoic acid (tretinoin) and 13-cis-retinoic acid (isotretinoin) are used. All-trans-retinoic acid is contained in the following foreign preparations: Retin-A - 0.05% cream in tubes of 30 g (Silag, Switzerland), Lokacid - 0.05% cream in tubes of 30 g and 0.1% solution in 15 ml vials (Pierre Fabre, France). External preparations with 13-cis-retinoic acid, which has a higher bioavailability, are produced only in Russia - Retinoic ointment 0.1% and 0.05% and Retasol ® (FNPP "Retinoids"). Ointments and solution are recommended to be applied to previously cleansed skin 1-2 times a day. Upon reaching the effect, it is recommended to reduce the concentration or reduce the frequency of application of the drug. The duration of treatment is 12-16 weeks.

Drugs from the group of retinoids have a number of side effects. The most serious of them are teratogenicity and embryotoxicity. In this regard, women of childbearing age are prescribed retinoids with reliable contraception and a negative pregnancy test. In the outpatient card, when prescribing systemic treatment, a note is usually made about the woman's awareness of possible side effects, and abroad, dermatologists suggest that women fill out and sign a special form in order to avoid further prosecution in case of side effects. External treatment with drugs of this group is stopped when pregnancy occurs. Retinoids do not have a negative effect on the reproductive function of men.

In the first or second week of treatment, most patients experience an exacerbation reaction, which is expressed in redness, moderate itching, and peeling of the skin. The patient should be warned about the reaction, and if important events in life are coming at this time, then it is better to postpone the start of treatment. Usually these phenomena disappear on their own within a few days, after which there is a persistent improvement. Dryness of the lips, cracks in the corners of the mouth, peeling of the skin are frequent during the treatment process, they are eliminated by using a neutral moisturizer for the face and body, hygienic lipstick or lip gel, limiting the use of detergents when washing and washing. With the systemic administration of retinoids, dryness of the nasal mucosa, nosebleeds, conjunctivitis, urethritis, increased levels of transaminases and lipids in the blood, and increased skin sensitivity to sunlight are sometimes observed. Taking this into account, before the start of treatment and monthly during the course of treatment, a biochemical blood test is performed, it is recommended to use protective sunscreen, avoid direct sunlight.

Contraindications

pregnancy and lactation, abnormalities in the biochemical analysis of blood (hyperlipidemia, increased activity of ALT, AST and alkaline phosphatase), renal and hepatic insufficiency, hypervitaminosis A, drug intolerance. It is impossible to prescribe simultaneously retinoids inside and out, ultraviolet irradiation, preparations with keratolytic and exfoliating effects, exfoliating cosmetic procedures and products (scrubs, peeling). The action of retinoids is weakened by the simultaneous use of glucocorticosteroid drugs and alcohol intake.

Antibiotics

Of the wide range of antibiotics for the treatment of acne, only tetracyclines, erythromycin, lincomycin, josamycin and clindamycin are used. The appointment of antibiotics inside is indicated for the defeat of a large area of ​​the skin, the predominance of pustules. During pregnancy, of these drugs, only erythromycin can be used.

Antibiotics of the tetracycline group have an advantage over other groups, since they are lipophilic and easily reach the main object of their action - the sebaceous glands. They can be prescribed for a long time - 2-3 months in a small dose. In this case, they block the production of bacterial lipases, the main link in the development of inflammation. An essential advantage of this method is the possibility of long-term treatment without disturbing the composition of the intestinal flora. The daily dose of tetracycline is 1000 mg (10 tablets of 0.1 g or 4 tablets of 0.25 g), doxycycline hydrochloride - 50 mg (1 capsule of 0.05 g once a day), unidox solutab - 50 mg ( 1/2 tablet of 0.1 g), metacycline - 600 mg (2 times a day, 0.3 g). Antibiotics of the tetracycline group at the indicated doses are always well tolerated, and side effects characteristic of long-term use at a bacteriostatic dose do not develop. Tetracyclines are contraindicated in concomitant fungal diseases, pregnancy (last trimester), liver dysfunction, leukopenia, children under 8 years of age, kidney disease. During treatment, insolation is not recommended, ultraviolet irradiation, retinoids for internal use, hormonal contraceptives, psychotropic, anticonvulsant and antidiabetic drugs are not prescribed. The absorption of tetracycline is weakened in the presence of food, especially milk and dairy products, as well as trace elements - aluminum, calcium, magnesium, iron. Their use should be avoided during treatment. Tablets are taken separately from meals.

Doxycycline, Metacycline and Unidox Solutab are better absorbed and can be taken with or after meals with plenty of water. Unfortunately, the resistance of microorganisms to the drugs of this group quickly develops, and when re-administered, they are rarely effective.

Erythromycin belongs to the group of macrolides, the daily dose - 500-1000 mg is distributed in 3-4 doses 1-1.5 hours before meals. The drug is produced in tablets or capsules of 0.1, 0.25 and 0.5 g. Possible side effects include nausea, vomiting, diarrhea, liver dysfunction. The drug is contraindicated in case of individual intolerance, liver diseases with impaired function. It should be borne in mind that erythromycin is inactivated by dairy products and acidic drinks, and also increases blood levels and enhances the toxic effect of carbamazepine (tegretol, finlepsin) and theophylline.

Clindamycin (lincomycin group) is prescribed in a daily dose of 0.6 g, divided into 2 doses, is available in capsules of 0.15 g and called Dalacin C - 0.15 and 0.3 g each. The course of treatment is 7-10 days. Possible side effects include dyspepsia (nausea, vomiting, diarrhea), liver dysfunction. The drug is incompatible with erythromycin and vitamins of group B. Lincomycin is prescribed in a daily dose of 1500-2000 mg (2 tablets 3-4 times a day), is available in capsules of 0.25 g. The duration of treatment and side effects are similar to clindamycin.

Josamycin or vilprafen in a daily dose of 1000 mg (1 tab. 2 times a day between meals) is used for 2-4 weeks, then 1 tab. within 8 weeks. Possible side effects include dyspepsia (nausea, vomiting, diarrhea), liver dysfunction. The drug is incompatible with lincomycin, weakens the effect of hormonal contraceptives.

In case of intolerance to antibiotics, they resort to sulfanilamide preparations, usually co-trimoxazole (biseptol, septrin, groseptol, cotrifarm 480). The drug is prescribed at 480-960 mg (1-2 tablets) 2 times a day during or after meals with an interval of 12 hours. During treatment, it is recommended to drink plenty of fluids, monitor the condition of blood and urine, avoid solar and ultraviolet radiation, and do not prescribe ascorbic acid.

It is logical to assume that the local use of the above antibiotics can be much more effective and safer than the internal one. However, studies show that topical erythromycin, clindamycin, and tetracycline are only effective for mild acne, especially when combined with zinc, retinoids, or benzoyl peroxide. External application of 1% erythromycin ointment (Ung. Erythromycini 1%) has a positive effect only in combination with other external and internal agents, the gel with clindamycin Dalacin T (Pharmacy, USA) is more effective. Easy to use Eriderm (Eryderm, Abbott Labor, USA) - 2% solution of erythromycin. Levomycetin, boric, resorcinol alcohols are also used for drying and cauterization of individual rashes. Combined preparations are effective - Zinerit ("Yamanouchi", the Netherlands) - a solution of erythromycin and zinc acetate and Benzamycin, a gel for external use, in tubes of 20 g, ("Rhone-Poulenc Rohrer", USA), containing 3% erythromycin and 5% benzoyl peroxide. All of the above drugs are prescribed 2 times a day. As with oral antibiotics, topical preparations tend to cause the development of antibiotic-resistant strains of microorganisms, so their repeated administration is often ineffective. Resistance of strains of Propionibacterium acnes (the main microorganism that multiplies in the sebaceous glands of patients) to commonly used antibiotics was found in 60% of patients. Strengthening of resistance depends on the duration of therapy, resistance to erythromycin develops more often.

Other antiseptics and disinfectants. One of the successful modern approaches to treatment is the use of benzoyl peroxide - a lipophilic compound due to the presence of a benzoic acid residue in its composition. When applied to the skin, benzoyl peroxide decomposes under the action of air into peroxide and inactive benzoic acid, which remains on the surface of the skin. Active oxygen compounds damage the walls of bacteria, destroying them, the content of fatty acids decreases, which prevents inflammation. At the same time, the same compounds have a damaging effect on the horny scales, which is clinically expressed by skin peeling, which accompanies the therapeutic effect. Benzoyl peroxide preparations do not affect comedones, therefore, if they predominate, they are not used. Different companies offer this drug under the names Benzakne (Polfa, Poland), Desquam (Bristol-Myers, USA), Oxy 5 and Oxy 10 (SmithKline Beach, UK), Baziron (Galderma, France). Benzoyl peroxide is produced in the form of 2%, 5%, and 10% gel, 5% and 10% lotion. Treatment begins with the application of a lower concentration of the drug to the face, then it is increased. A higher concentration is immediately applied to the back and chest. Benzoyl peroxide is applied to previously cleansed skin once a day. Side effects include an exacerbation reaction in the first days of use, dryness and flaking of the skin, discoloration of hair and linen when the drug comes into contact with them. Intolerance is not uncommon, therefore, before starting treatment, it is recommended to conduct a skin test - the drug is applied to a small area of ​​​​the skin of the flexor surface of the forearm for 48 hours. In the absence of itching and redness, you can apply the drug on the face.

A good effect, especially in the presence of comedones, has a combination of local application of benzoyl peroxide in the morning, and Retinoic ointment in the evening.

Azelaic acid inhibits the growth of microorganisms and reduces the content of free fatty acids on the surface of the skin. Cream or gel Skinoren (Schering, Germany), containing 20% ​​and 15% azelaic acid, respectively, is applied to the skin of the face (both on the affected and free areas from rashes) 2 times a day. When applied, local skin irritation is possible. Skinoren is used in the complex therapy of acne; its use as an independent remedy usually does not bring success.

Zinc hyaluronate is part of the Curiosin gel (Gedeon Richter, Hungary), has a healing and antimicrobial effect. It can be used with a small amount of rashes, since the effectiveness of the drug is low. The gel is applied to cleansed skin twice a day, there may be a burning sensation and redness of the skin at the application sites.

Povidone-iodine (Betadine) is used to lubricate pustules in a concentrated (10%) or diluted 1:1 solution with water 1-2 times a day. It is undesirable to use in fair-skinned and red-haired patients due to increased sensitivity to iodine. The diluted solution cannot be stored.

With a small number of comedones in the initial stage of the disease, salicylic alcohol 2-3% is effective. It is used 2 times a day, trying not to apply to the entire affected area in order to avoid overdrying, but only to certain areas.

Sulfur is an anti-inflammatory agent, it is included as one of the components in most external agents (ointments and talkers) traditionally used in the treatment of acne. However, in recent years, its comedogenic effect has been discovered, i.e. it can cause the formation of comedones.

hormone therapy

Therapy with sex hormones is possible only in women. Estrogens (ethinylestradiol) and antiandrogens (cyproterone acetate, spironolactone) can be used for treatment. Estrogens reduce the secretion of the sebaceous glands, however, not as significantly as retinoids. They can be used simultaneously with local administration of retinoic acid, antibiotics or benzoyl peroxide, which increases the therapeutic effect. To achieve a good result, estrogens must be given for a long time - at least 5 cycles. The first signs of improvement are noticeable only towards the end of the second or third cycle. Estrogens have many side effects - nausea, fluid retention in the body, swelling of the legs, weight gain, breast tenderness, skin pigmentation, and an increased risk of vascular thrombosis. Risk factors for side effects include smoking, alcohol consumption, obesity, and vascular disease. Cyproterone acetate for the treatment of acne is used only in combination with estrogens. Of the combined preparations, Diane-35 and Janine (Schering, Germany) are used. The drug is prescribed 1 tablet per day, starting from the first day of the cycle, for 21 days with a break of 7 days. The antiandrogenic drug Cyproterone or Androkur (Schering, Germany) is prescribed 1 tablet (10 mg) per day, starting from the first day of the cycle for 15 days, a new course is started 4 weeks after the start of the first one. Glucocorticosteroid drugs are prescribed orally or parenterally only for abscessing and fulminant acne, which are extremely rare. External use of corticosteroid ointments is not indicated.

Drugs of other groups

Zincteral ("Polfa", Poland) contains zinc sulfate, the deficiency of which is often found in patients with acne. Tablets of 0.124 g are prescribed 1-2 times a day during or immediately after meals for 1-2 months. Nausea may occur during the first week of use. The drug enhances the action of retinoids, but weakens - tetracyclines. Homeopathic treatments include injections of Cutis compositum or Traumeel (Heel, Germany). Phytotherapy is still widely used as adjuvants - applications of gruel from badyagi for resorption of individual large nodes, lotions with green tea, calamus rhizome, raspberry shoots. Inside appoint infusions of plants with estrogenic action (hop cones, sage leaves).

Skin care

Many patients, feeling the increased sebum secretion characteristic of acne, try to wash their face as often as possible using soap and a sponge. At the same time, the skin dries up, but sebum secretion does not become significantly lower, since the washing out of fats occurs only from the surface of the skin, without affecting the sebaceous glands themselves, located in its depths. In this regard, frequent washing of the skin (no more than 1 time per day), the use of sponges and washcloths are not recommended in order to avoid irritation and injury. Now many use antimicrobial soap. But it changes the state of the microbial flora only on the surface of the skin and does not significantly affect the course of the disease. At the same time, antimicrobial additives contained in soap can cause irritation or allergic reactions. To clean the skin, it is better to use a mild neutral soap for sensitive skin or special cosmetics designed for this purpose (cleansing with milk, then tonic), and to eliminate the shine of the face associated with the release of sebum to the surface, use cosmetic wipes or special matting funds. The widely held belief that makeup should not be used for acne has also now been reconsidered. Modern high-quality cosmetics that do not irritate the skin, well mask existing defects, do not significantly disturb perspiration, are not applied to the skin in a thick layer, and can be used during the day. It should be removed at home. Some medicines require the use of sunscreen. It is better to prefer gels and milk, and also be sure to quickly remove them from the skin indoors. Scrubs and peels may be recommended to smooth the surface of the skin and give it freshness, but are contraindicated during treatment with retinoids, benzoyl peroxide and tetracyclines.

The use of therapeutic masks with a drying effect and detergents is limited during treatment with retinoids and alcohol solutions. If there are pustules on the skin and severe inflammation, massage and cosmetic cleaning of the skin are contraindicated.

Diet

Both in the past and now, most dermatologists always recommend a fairly strict diet. Our long-term observations have shown that the benefits of such restrictions are small, and only in a few patients there is a clear relationship between the consumption of certain foods (mainly chocolate) and increased rashes. Usually we recommend that patients follow a reasonable diet, no frills, include more fermented milk products and greens in the diet. However, 2-3 days of fasting during an exacerbation always give a positive result. In general, when prescribing modern therapeutic agents, there is no need to follow any diet to achieve a good result. If the patient is to take part in a festive feast, it is better to cancel oral administration of drugs for 2-3 days and prescribe enterosorbents (Polifepan, Enterosgel, etc.).

• The initial stage - a few small black dots appear on the nose and forehead (usually in children) - Salicylic alcohol, Retinoic ointment, Skinoren, medical cosmetics.
• The same, but with significant oily skin - Retinoic ointment, Salicylic alcohol.
• Numerous black dots and individual inflammatory nodules and pustules - Retinoic ointment, Salicylic alcohol, for pustules - alcohols with antibiotics, Dalacin T, Povidone-iodine.
• The predominance of inflammation with a small number of comedones - Retinoids (Retinoic ointment, Retasol ®), benzoyl peroxide (Benzacne, Desquam, Oxy 5 and Oxy 10, Baziron), external preparations with antibiotics (Dalacin T, Zinerit, Eriderm, Benzamycin).
• The predominance of pustules in a common process (face, back, chest) - antibiotics, in some cases - retinoids inside (Roaccutane, Retinol palmitate), externally - benzoyl peroxide, disinfectants.
• Separate large painful ulcers on the face - antibiotics, externally - antibiotic ointments and benzoyl peroxide.

Seborrhea and seborrheic dermatitis

In recent years, what used to be united by one term “seborrhea” began to be divided into 2 concepts - seborrhea of ​​the head and seborrheic dermatitis (damage to smooth skin).

Seborrheic dermatitis is a chronic inflammatory skin disease. It affects 1-3% of adults (mostly men). Seborrheic dermatitis, along with acne, refers to disorders of sebum secretion. Indeed, both diseases are often combined in the same person and the same areas of the skin are affected - the so-called "seborrheic zones" - the face, chest (decollete area) and the middle part of the back along the spine (interscapular region), where the largest sebaceous glands with wide ducts that secrete a large amount of sebum. The sebaceous glands of this type actively develop and increase in size during puberty. The composition of sebum also changes, it becomes more viscous, the components contained in it contribute to increased keratinization, which corresponds to peeling that is visible to the eye. Smaller glands, but also secreting a large amount of sebum, are located on the scalp. Their purpose is to provide fatty lubrication of the hair, to make it invulnerable to external influences. These glands are also more active during puberty. In adolescents and adults, the mildest form of seborrheic dermatitis is characterized by peeling of the skin and its excessive oiliness without inflammation - on the scalp it is dandruff, and on the face and chest - accumulations of fatty scales in the skin folds - near the wings of the nose, in the nasolabial fold, on the bridge of the nose , less often - on the chest and back. Oily scales soaked in sebum serve as a good breeding ground for the development of lipophilic fungi Malassezia furfur or Pityrosporum ovale. In turn, the immune system reacts to them with the development of allergic dermatitis, the disease enters its second, more unpleasant phase, and ceases to be limited to mild manifestations. There are itching, burning, at first mild, then more intense reddening of the skin, severe peeling, hair loss. The manifestations of the disease are aggravated by the patients themselves - constant combing, attempts to remove crusts, remove accumulations of scales from the hair, the use of "folk" remedies, and the most powerful ones, inevitably lead to increased redness, the appearance of scratches and wounds, the multiplication of other microbes, the development of complications pustular process. Usually in this condition, patients turn to a dermatologist, although everything could be corrected much earlier.

With any manifestation of the disease, attention should be paid to the diet. Sometimes its correction is enough to prevent further development of the disease. Alcohol, sweets and starchy foods should be limited, regardless of the type of food. With itching and inflammation, smoked, salty, pickled foods, spicy seasonings, strong broths, instant coffee, citrus fruits, kiwi, pineapples and juices from them are also temporarily limited.

Treatment depends on the stage of development and the clinical picture of the disease. With the appearance of dandruff without the presence of inflammation, you can limit yourself to only external treatment, in more serious cases, internal treatment is also necessary. External treatment includes keratolytic, glucocorticosteroid, antiseptic, disinfectant and antifungal agents. Antifungal drugs usually start treatment, they can be used for a long time without the risk of side effects. Various dosage forms are used - creams, gels, shampoos. Shampoos with antifungal substances - Nizoral, Keto-plus, Perkhotal, Mycozoral, Sebozol contain 1-2% ketoconazole. Tee/Jel anti-dandruff shampoo contains 0.75% piroctone olamine and 2% salicylic acid. Creams and gels are applied 2 times a day, shampoos - 3 times a week. Various other medicinal substances that also have antifungal properties include zinc pyrithionate, tar, sulfur, resorcinol, and selenium disulfide. Drugs containing these compounds are available in the form of shampoos for the treatment of dandruff (Friderm-tar, Ti / Gel-Nyutar, Friderm-zinc) and ointments for the treatment of smooth skin lesions (Skin-cap, birch tar, tar and sulfur-tar ointment ). Prescription forms are also used: Vidal's milk, alcohol solutions with sulfur, boric acid, tar. After hair treatment, it is obligatory to change combs and hair brushes, hats.

With severe inflammation, anti-inflammatory, antiseptic and disinfectants are used. With wetting and severe swelling of the foci, lotions with resorcinol 1%, decoctions of herbs are used. The crusts are usually lubricated with alcohol solutions (salicylic, resorcinol, boric alcohols). Corticosteroids have a rapid anti-inflammatory effect - they are used on the head in the form of solutions - Elokom, Diprosalik (Schering-Plough USA), Lokoid (Janssen-Silag Belgium), Belosalik (Belupo, Croatia), on seborrheic zones - in the form of ointments and creams - Elokom, Diprosalik, Belosalik, Hydrocortisone ointment. It should be noted that only non-fluorinated glucocorticosteroids in the form of easily absorbed creams and emulsions (Advantan emulsion, Elokom cream, Lokoid cream) or weak (Prednisolone, Hydrocortisone) ointments can be used on the skin of the face, which is much thinner than in other areas. Preparations of this group are not suitable for long-term use due to the risk of undesirable effects - thinning of the skin, vasodilation, the appearance or intensification of acne. When it is possible to remove acute inflammation (usually in 3-5 days), and with residual peeling, they are replaced by preparations containing vitamin A - emulsion-based ointments Videstim ® , Radevit ® (FNPP Retinoids, Russia). It is known that vitamin A (retinol palmitate) reduces sebum secretion by reducing the size of the sebaceous glands and keratinization, and also has the properties of a local immunomodulator. Videstim ® contains 0.5% retinol palmitate on an emulsion basis, Radevit ® contains 1% retinol palmitate, ergocalciferol and tocopherol acetate (vitamins A, D and E). Drugs are used for a long time, including for the purpose of preventing relapses. In recent years, the local immunomodulator pimecrolimus, supplied to Russia under the name Elidel, has also been used in the treatment. Keratolytic agents are used for severe peeling and crusting. Apply sulfur-salicylic ointment 2-5% 1.5-2 hours before washing the hair under a scarf, on the face - 1 hour before washing, 10% urea ointment Karboderm (Ukraine). A particularly good effect is brought by combined preparations that combine the keratolytic properties of salicylic acid and anti-inflammatory glucocorticosteroids - Diprosalik, Belosalik. Internal remedies include vitamin A (retinol palmitate) in a daily dose of 100,000–200,000 IU (once at night for 2 months), B vitamins, in particular brewer's yeast (“Merz” Germany and domestic companies), brewer's yeast with the addition of zinc and selenium Nagipol, multivitamin-mineral complexes, preparations with selenium (Selevit, Triovit), zinc (Zincteral). To reduce fat formation in women, hormone therapy (Diana-35, Janine) and antiandrogens (Androkur) are used - see above. Despite successful therapy, the disease often recurs. A rational approach to diet and a careful selection of skin and hair care products are necessary to maintain a favorable treatment result for as long as possible.

prof. IN AND. Albanova

Seborrhea, dandruff, blepharitis, barley, ostiofolliculitis, folliculitis, acne, sycosis, furuncle, furunculosis, carbuncle, what do these skin disorders have in common? What unites them is that they all arise due to a violation of the secretory function of the sebaceous glands located in different parts of the skin. As soon as the sebaceous gland, for some reason, begins to release an excess amount of sebum onto the surface of the skin, it becomes an excellent food for various microorganisms (bacteria, fungi, mites), which are almost always present on the surface of the skin. Microorganisms, penetrating into the sebaceous glands, with “good nutrition”, begin to actively multiply there. For the body, these are foreign bodies, like a splinter that has fallen under the skin, and it begins to get rid of uninvited guests, isolating them and subsequently getting rid of the rejection of the stratum corneum or through inflammation (abscess) in more severe cases, followed by removal from the body, through pus, of their products vital activity.

Increased sebum secretion can lead, for example, to hair loss on the head and even to persistent male pattern baldness. The excretory ducts of the sebaceous glands of the scalp are dilated, the hair becomes greasy, shiny, and easily falls out.

Skin disorders of this type are more susceptible to people with choleric and sanguine temperament.

The main causes of increased activity of the sebaceous glands

1. Violation of fat metabolism in the body due to functional disorders or diseases: liver, gallbladder, pancreas, intestines.
2. Endocrine disorders (diabetes mellitus, obesity).
3. Dysfunction of the gonads. The intense secretion of sex hormones during puberty (especially the male sex hormone testosterone, which is present to some extent in both sexes) stimulates an increase in the activity of the sebaceous glands of the skin (acne usually appears during puberty).
4. Premenstrual hormonal changes.
5. The use of hormonal contraceptives or their cancellation, taking other hormonal drugs (glucocorticoids).
6. Hereditary predisposition.

Contributing factors

1. Internal "slagging" of the body, caused by malnutrition and other causes, such as contaminated food and water.
2. Severe stress can disrupt hormonal balance, lead to increased manipulation of wounds and skin injury.
3. External factors: skin damage (scratches, abrasions, abrasions, etc.), contamination with dust particles, coal, etc.
4. Abuse of alcohol-containing cosmetic products.
5. Overheating, excessive sun exposure, alcoholism.
6. Visiting countries with a hot climate and high levels of bacterial contamination.

For the normal secretory function of the sebaceous glands, it is necessary to provide:

1. Prevention of abuse of hot, fatty, fried, spicy, salty, sour and fermented foods. Dairy products, white bread, sweets, potatoes, meat, fish, mushrooms should be avoided. Avoid spices. In acute conditions, a diet is needed that helps cleanse the body of toxins and toxins with the use of salads, sprouted grains and vegetable juices. Give preference to softer foods like rice, oatmeal, apple dessert. Aloe juice helps with almost all types of skin rashes. Useful herbs with a bitter taste that help cleanse the liver: gentian, barberry, honeysuckle, Baikal skullcap, rhubarb, golden seal, echinocea. You can drink tea from herbs that purify the blood: burdock (root), dandelion (root), clover. In chronic diseases, emollient and tonic herbs are required: marshmallow, licorice, etc.
2. Elimination of the pathology of the gastrointestinal tract, if any: hepatitis, biliary dyskinesia, dysbacteriosis, constipation.
3. Normal functioning of the gonads during puberty.
4. Elimination of endocrine disorders, if any: diabetes, obesity.
5. Avoiding prolonged exposure to the sun or heat, excessive hot baths or saunas.
6. Avoidance of severe stress, anger, irritability. Avoid prolonged depression, suppressed emotions.
7. Carrying out regular cleansing of the skin, blood, liver, large intestine (with chronic constipation).
8. Washing the skin with soap, such as dectar, at least two or three times a week.

The sebaceous glands are located in the skin on many parts of the body, especially on the face. The glands secrete a secret that is needed to support the antimicrobial and barrier functions of the hair and epidermis, it also gives the skin softness and elasticity.

Appearance and functioning of the sebaceous glands:

This is how the sebaceous glands work.

How do sebaceous plugs form? Effects

Due to the formation of sebaceous plugs on the face, the functions of the skin are disrupted, which leads to inflammation.

On the face, mainly sebaceous plugs occur: on the nose, chin, cheeks and on the head near the hairline, since in these places the secretion of sebum is increased.

On the face, mainly sebaceous plugs occur in the form of various acne.

It's important to know! In some cases, a large release of fat is a sign of a nervous and mental disorder in a person.

During blockage, pores can become clogged:

1. Horny cells.
2. bacteria.
3. Microorganisms.
4. Skin fat.

Abscesses, skin inflammations, atheromas, various tumors, acne, pimples - all this can be the consequences of blockage.

There are three types of diseases.

Abscesses, skin inflammations, atheromas, various tumors, acne, pimples and poor health can be consequences of blockage.

seborrhea

The disease appears due to metabolic disorders of the body, during puberty. Most often it manifests itself in the form of acne.

Rosacea (acne)

They arise as a result of damage to the vessels located next to the trigeminal nerve.

The cause may be disorders in the gastrointestinal tract, is also formed due to neurological disorders in women during menopause.

Zheleznitsa

This disease is characterized by the manifestation of rashes in the form of red spots on the skin surface.

It is recommended to consult a doctor before starting treatment. It is required to exclude salty and spicy foods from the diet at the time of treatment.

Mostly, develops due to a reaction to many cosmetic products(creams, mascaras, etc.).

Reasons for the formation of sebaceous plugs

The appearance of sebaceous plugs on the skin of the face is influenced by some factors, both external and internal in nature - that is, associated with the influence of the environment and directly the internal processes of the body.

Abundant application of cosmetics can lead to blockage of the sebaceous glands.

External factors:

Internal factors:

1. Hormonal failure in the body.
2. Unbalanced and malnutrition.
3. Transitional age.
4. Allergic reaction to many cosmetics and drugs.
5. The disease is hyperkeratosis (the causes of the disease are frequent external effects on the skin or beriberi).
6. Demodicosis disease (mites in the skin).
7. Stress and depression.
8. During menstruation in women.

Clogged sebaceous glands on the face. How to treat at home

Several folk ways to treat blockage of the sebaceous glands on the face.

steam baths

Made over boiled water. You can also optionally add sage or chamomile leaves to the decoction.

Steam baths are made over boiled water. You can also optionally add sage or chamomile leaves to the decoction.

Recipe: one tbsp. a spoonful of raw materials is poured with hot water (300 ml) and infused for twenty minutes.

Application: wash off all make-up. Pour the broth into a wide, shallow basin and hold the face covered with a towel over it. The procedure is carried out for 15 minutes.

clay mask

You can use white, green and blue clay. Water is added to the clay until a thick mass is obtained.

Application: Apply to the skin and wash off after 20 minutes.

For a clay mask, you can use white, green and blue clay.

Egg white

An egg white mask also has an effective effect. It's simple: the protein is whipped until foam is obtained.

Application: the resulting mass is applied to the face. And after drying, it is washed off with warm water and a moisturizer is applied. Protein foam mask it is recommended to do it several times a week.

An egg white mask also has an effective effect. It's simple: the protein is whipped until foam is obtained.

Infusion of yarrow

Yarrow flowers are suitable both fresh and dry. One teaspoon of flowers pour a glass of hot water and leave to infuse for 15 minutes.

Application: used for face wash in the morning. Before going to bed, you can make a lotion by dipping gauze in a tepid infusion and then applying it to the skin of the face. This lotion has a cleansing effect and narrows the pores.

For infusion for washing, yarrow flowers are suitable, both fresh and dry.

Celandine grass

Finely chop the washed celandine grass (with a blender, knife) - you get about 4 tbsp. spoons of herbal mass. Pour this mass with water (5-6 glasses) and cook for about five minutes. The infusion should be infused for 7 hours.

Application: the washed face is wiped with a napkin, previously moistened with infusion. Do this procedure at least twice a day.

Lotions are also made before going to bed, applying a napkin moistened with infusion to the skin for 15 minutes.

Wipe the washed face with a napkin previously moistened with celandine infusion. Do this procedure at least twice a day.

Pore ​​Cleansing Lotion

To 1 teaspoon of sugar, add the same amount of baking soda, pour a glass of hot water and mix.

Application: wipe the face with lotion in the morning and evening.

The above remedies will help cleanse the pores and dry the skin.

To 1 teaspoon of sugar, add the same amount of baking soda, pour a glass of hot water and mix. Wipe the face with the resulting lotion.

What pharmaceutical preparations to treat clogged sebaceous glands on the face:

1. Wipe the skin of the face with a 1% solution of salicylic acid twice a day.
   It is important to use exactly 1% salicylic acid, 2% will burn the skin.
2. The drug "Zinerit". In the morning and evening, the ointment is applied to clean skin of the face. It is applied every other day.
3. Taking drugs that normalize sebum formation - "Erythromycin", "Nystatin".

Blockage of the sebaceous glands on the face. Treatment with hardware methods

Hardware makes the skin lighter and younger, evens out the relief, cleanses the pores. The method of treatment is determined by the beautician.

Common hardware treatments:

• ultrasonic cleaning;
• microdermabrasion;
• electrotherapy (exposure to the skin with current);
• cryotherapy (treatment of problem areas of the face with liquid nitrogen);
• laser peeling.

During laser peeling, microdermabrasion and ultrasonic cleaning, the skin is treated with a special powder of microparticles.

During laser peeling, microdermabrasion and ultrasonic cleaning, the skin is treated with a special powder of microparticles. The results don't keep you waiting.

Blockage of the sebaceous glands on the face. Treatment in clinics and beauty salons

Specialists in clinics and salons can offer several professional procedures for cleaning sebaceous plugs:

1. Dry cleaning - fruit acids are used for the procedure, which warm up the skin and dissolve sebaceous plugs (partially).
2. Mechanical cleaning - steaming the face and squeezing out the rashes manually. There are doubts about this method of cleaning, as the rash will soon reappear.
3. Laser therapy - getting rid of sebaceous plugs with a laser. This procedure is painless and leaves no marks on the face.

Prevention of the formation of sebaceous plugs on the face

To avoid the formation of sebaceous plugs on the face, it is necessary to properly care for the skin, as well as follow and listen to the advice of doctors.

1. It is necessary to consume plenty of fluids per day to maintain the water balance in the body;
2. Instead of soap for washing, it is better to use liquid gel;
3. Be sure to completely cleanse your face before going to bed from cosmetics;
4. In no case do not squeeze out acne;
5. Eat more fruits and vegetables;
6. Use proven and high-quality cosmetics for the face. It is not recommended to apply cosmetics every day;
7. To refuse from bad habits;
8. Choose cosmetics and hygiene products according to your skin type.

Remember! At any age, a problem such as blockage of the sebaceous glands on the face may arise, the treatment of which must be carried out only after finding out the cause of the formation.

Use proven and high-quality facial cosmetics. It is not recommended to apply cosmetics every day.

This problem causes a lot of inconvenience. It spoils both appearance and mood. That's why you need to take care of your skin, and in case of progression of the disease, consult a doctor.

Facial pore cleansing at home

For the best cleansing of the pores, there has not yet been invented a more effective and simple means than conventional steam baths. What do these procedures give the skin?

They perfectly cleanse the pores of the face, reduce them, dissolve fat, which often accumulates in the pores, relieve stress well, tone and perfectly moisturize the skin.

The hot steam acts on the blood vessels, which dilate. As a result, metabolic processes and blood supply to the skin are significantly improved, old cells are removed. The skin becomes softer and more tender to the touch, a blush appears.

Steam baths perfectly cleanse the pores of the face, reduce them, dissolve the fat that often accumulates in the pores, relieve stress well, tone up and perfectly moisturize the skin.

The steam bath is an excellent addition to other procedures. For example, it is recommended to do it before applying a nourishing, rejuvenating or moisturizing mask or before applying a scrub.

Owners of oily and normal skin can perform these thermal procedures twice a month, but for dry skin, using steam baths more than once a month is not recommended at all.

In order for the effect of the bath to be stronger it is necessary to use essential oil or infusions and decoctions of medicinal herbs instead of plain boiled water.

Chamomile

This plant perfectly soothes the skin, relieves itching, peeling and irritation. It is necessary to prepare an infusion from chamomile, and then heat it until steam appears.

Chamomile perfectly soothes the skin, relieves itching, peeling and irritation.

After that, you need to put the saucepan on the table and tilt your head over it. In order for the steam to go in the direction of the face, you need to additionally cover yourself with a large thick towel. You need to keep your face over the steam for about fifteen minutes.

Bay leaf

This plant improves blood circulation, has excellent bactericidal properties, helps to cope with acne and inflammation on the skin.

Liquorice root

From licorice, you can prepare a decoction for a steam bath. This plant perfectly softens the skin, removes toxins and toxins, perfectly cleanses the pores.

Essential oils

Essential oils can also be used in steam baths. However, they must first be dissolved in a small amount of some fat-containing product, such as vegetable oil or milk.

Essential oils can also be used in steam baths.

Despite the usefulness of these procedures, there are some contraindications to their use.

These are, first of all, inflammatory processes on the skin, as well as rosacea. If the skin is very dry and sensitive, steam baths should be taken with particular care.

In this video you will be told about the causes of problematic skin and its treatment.

From this video you will learn about the reasons for the malfunction of the sebaceous glands.

This video will give you practical tips on how to care for your sebaceous and sweat glands.

How to properly organize care if you have oily facial skin, what to do to normalize the work of the sebaceous glands and make the skin well-groomed and beautiful? First of all, you should deal with the information on this issue.

A hallmark of oily skin is the excessive activity of the sebaceous glands, which provokes coarsening of the texture, unhealthy color of the skin and their shine. In addition, expanding pores and comedones, acne, and sebaceous gland cysts become very common problems. For competent care of oily facial skin, it is necessary to organize the correct diet, as well as use special external products.

This applies to self-care at home, and professional techniques. It is important to regularly carry out procedures such as cleansing, peeling, making masks. To find out the causes of excessive function of the sebaceous glands, you should visit such specialists as a dermatologist, cosmetologist and endocrinologist.

Oily skin is typical for people of adolescence and young age, but most often this type of skin transforms into combination skin by the age of about thirty years. Excessively active function of the sebaceous glands is explained by the following reasons:

• genetic predisposition;
• fluctuations in hormonal status;
• digestive pathologies;
• irrational nutrition;
• non-compliance with the rules of skin care.

With a hereditary predisposition to oily skin, it is important to take into account the fact that as you grow older, your skin type will not change, so efforts should be directed to correct regular care and choosing the right cosmetics for care.

Endocrine causes often play a role in puberty. A high concentration of testosterone leads to an increase in the size of the sebaceous glands, and also enhances their secretion. In addition, another hormone that affects the functioning of the sebaceous glands is adrenaline, the concentration of which increases if the body is under stress.

Also, oily skin increases with improper use of hormonal contraception. Sometimes women face the problem of very oily skin in case of polycystic ovaries, pregnancy, menopause.

Improper diet is also a fairly common cause of oily facial skin. It includes frequent intake of fatty and spicy foods, flour, sweets, alcohol and fast food. Often, people with oily skin have pathologies of the digestive system, such as colitis, cholecystitis, and constipation. It is worth noting that long work in a dusty or polluted space also increases the oiliness of the skin.

It is important to know that a common mistake in solving the problem is the excessive use of scrubs, aggressive cosmetic products containing alcohol. If you often degrease the skin, then you can aggravate the situation, since the cells

epidermis in response to getting rid of the fatty layer only increase the secretion. If you get carried away with scrubs and peeling, then this provokes the occurrence of non-healing microtraumas of the skin of the face, which will lead to an increase in the intensity of the secretion of fatty secretions.

Features of oily skin type

The characteristic features of oily skin include:

• localization of the most disadvantaged zones within the T-region (chin, nose, forehead);
• the skin is shiny, untidy, rough, uneven, dull, with a gray tint;
• difficulty applying makeup;
• combination with oily hair;
• blockage of pores, leading to their expansion;
• a tendency to the appearance of comedones (black dots) and milia, that is, whiteheads;
• the appearance of vascular networks;
• better ability to retain moisture;
• less sensitivity to the action of low temperature, sun, wind;
• late appearance of wrinkles.

Oily skin care tips

Before organizing facial skin care, it is necessary to determine the goals that are planned to be achieved. When

oily skin needs to properly remove the secretion of the sebaceous glands and take measures to reduce their activity, open the pores. The rules for oily skin care include the following items.

1. Minimization or elimination of negative effects on the skin. It is necessary to stop using alcohol-containing lotions, excessive scrubbing, greasy creams and do not neglect the removal of makeup at night.
2. Diet correction. It should include lean meats, fish, and fruits and vegetables. It is better to refuse the use of spices, smoked, sweet and flour. It is also important to take vitamin complexes if these nutrients are not enough in food.
3. Organization of proper home care. It should include cleansing, hydration and nutrition. The complex of products should be used taking into account the characteristics of the skin type. Mousses, gels, foams for oily skin have an anti-inflammatory effect. Wash with warm water. Peeling and scrub should not be used more than once or twice a week. After washing, wipe your face with tonic. This procedure is necessary for disinfection and tightening of the skin. After that, you can apply the cream.
4. The use of folk remedies. It is useful to wash with warm decoctions of herbs, such as chamomile, horsetail, nettle, lime blossom. In addition, cosmetic clay masks give a good effect.
5. The right choice of decorative cosmetics. Here it is better to opt for light tonal foundations, matting powders. Do not use creamy textures of blush and eye shadow.

If you follow these rules, then you can minimize all the problems that occur due to improper functioning of the sebaceous glands. Enough attention should be paid to care and lifestyle management so that the skin feels very good and looks better.

Professional care for oily skin

In-salon skin care treatments may include:

1. Make-up removal with the involvement of special emulsion agents.
2. Deep cleansing using enzyme peeling, vaporization, instrumental, ultrasonic and dry cleaning.
3. The use of ampoule serum products.
4. Facial massage.
5. The use of cosmetic masks with various types of actions for cleansing, relieving inflammation, and regulating the active functioning of the sebaceous glands.
6. Use of finishing products (creams) for oily skin types.

Thus, the correct care of oily skin is a very laborious process. It includes not only home procedures, but also professional techniques, as well as lifestyle correction. With some effort, you can eliminate the problems of oily facial skin and normalize the functioning of the sebaceous glands. An important point is the regularity of care. It is important to pay attention to the procedures every day, adhering to the planned course and not neglecting the advice of a beautician.

(oily skin) may be part of the normal puberty process associated with hormonal changes in the body. This condition is accompanied by increased production of sebum, the formation of blackheads and acne. But sometimes even after this period, enlarged pores remain on the skin, which often become clogged and inflamed due to increased secretion of the sebaceous glands.

Causes and symptoms of oily skin

Among the reasons for the pathological increase in secretion are:

• hormonal imbalance;
• taking various medications;
• malnutrition;
• individual characteristics of the body.

Blockage of the duct of the gland manifests itself in the form of the formation of a sebaceous plug. Subsequently, an element of inflammation forms in this place, a pustule with purulent contents may appear. Rashes are localized in the chest area, between the shoulder blades and on the face - in places where the sebaceous glands are most concentrated.

Oily skin has its advantages: it is less prone to age-related changes, more elastic and resistant to dehydration. However, the signs of hypersecretion of the sebaceous glands should not be ignored, as this can lead to severe forms of acne with the subsequent formation of scars and scars.

Methods for the diagnosis and treatment of hypersecretion of the sebaceous glands

Diagnosis is aimed at determining the cause that caused the activation of the secretory function of the glands. The condition that provoked an increase in secretion is being corrected, as well as local measures for the care of oily skin. Recommended diet high in dairy products, exclusion of spicy, fatty, pickled foods, alcoholic beverages. It will be useful to give up smoking, introduce dosed physical activity into the daily routine.

Light acid peels, masks with cosmetic clay, and the selection of cosmetics help to normalize the condition of the pores. The correct algorithm for cleansing, moisturizing and nourishing the skin helps prevent the accumulation of sebaceous glands and blockage of the ducts, normalizes the blood supply to the skin in problem areas.

Oily skin prevention

The versatility and safety of the halotherapy method allow it to be successfully used in the treatment of skin diseases. The main therapeutic factor is a highly dispersed salt aerosol, which has a pronounced sanogenic and anti-inflammatory effect. Once on problem areas, haloaerosol has a cleansing effect, stimulating blood and lymph circulation in the deep layers of the skin.

Halotherapy in the treatment of hypersecretion of the sebaceous glands is used as an element of cosmetology programs aimed at normalizing the biocenosis of the skin. Salt particles, which are in the atmosphere of the halochamber, have bactericidal properties, thus, during the procedure, a person is in a pure hypobacterial environment. A preventive visit to the salt cave for oily skin is also recommended - the optimal course of procedures consists of 10-12 sessions.

Diseases of the sebaceous glands, such as oily seborrhea, acne and redheads, are not only a cosmetic defect, but also a serious problem. As a result of the hyperactivity of the gland, shine appears on the skin, small droplets of fat accumulations appear, fatty ducts expand, blockage of pores, inflammation, and acne occur.

Overproduction of oil by the sebaceous glands is a common problem faced both during the transition period and throughout life. Experts associate the disease with external and internal factors.

The most common causes of acne are internal causes:

1. Hormonal disbalance. In adolescence, this is associated with puberty. In adults, increased sebum secretion is associated with increased production of the male sex hormone - testosterone. The cause of the problem is polycystic or ovarian dysfunction. The hormone progesterone also affects skin problems.
2. genetic predisposition. In case of skin problems in parents or in the family, children also have a chance of increased activity of the sebaceous glands. Heredity is associated with congenital disorders in the functioning of the epithelium, deformation of the sebaceous glands, and excessive production of testosterone.
3. Chronic diseases. Hyperactivity of the sebaceous glands indicates violations in the work of internal organs. Common causes are malfunctions of the gastrointestinal tract, gastritis, dysbacteriosis, adrenal diseases, cholelithiasis, infectious inflammation in the body, and disorders of the autonomic system.

External causes include harmful environmental factors, as well as features of life and skin care:

1. Cosmetic products. The wrong choice of basic skin care products leads to deterioration of the skin condition. The excessive use of products containing alcohol, oils, glycerin, and frequent scrubbing negatively affect the epidermis.
2. Violation of hygiene rules. Improper skin care: infrequent or excessive cleansing, frequent use of nutritious products and exfoliation lead to a decrease in natural protection and an imbalance in the acid-base balance.
3. Wrong nutrition. An unbalanced diet, including foods containing fats, simple carbohydrates, iodine, leads to disruption of the digestive system, dysbacteriosis, changes in skin condition. Lack of vitamins also provokes the development of skin diseases.
4. Environmental impact. The work of the sebaceous glands is affected by external factors: frostbite, dry air in the room, frequent exposure to ultraviolet rays.

General principles of treatment

Violation of the sebaceous glands requires an integrated approach and an accurate determination of the cause that caused the development of the pathology.

Experts distinguish 3 degrees of severity of the problem:

• mild - expressed in increased skin luster and local acne;
• medium - expressed in blockage of pores, acne formation, inflammation of skin areas;
• severe - the inflammatory process is clearly expressed, covers large areas of the skin.

Treatment depends on the severity of the problem. In most cases, it is enough to change the principles of skin care and competent selection of cosmetic products.

General therapy for disorders of the sebaceous glands is carried out in several areas:

• Comprehensive examination and treatment of chronic diseases. The patient needs to undergo an examination and identify the existing violations in the work of internal organs. Drug therapy is aimed at eliminating foci of inflammation, normalizing the functioning of the gastrointestinal tract, liver, kidneys, and improving the body's metabolic processes.
• Power correction. The patient is advised to follow a proper diet. Fried and fatty foods, alcohol, carbonated drinks, semi-finished products are completely excluded from it. Preference is given to fresh vegetables, fruits, slow carbohydrates.

• Vitamin therapy. Vitamin complexes are added to the diet. Particular attention is paid to vitamins A, E, B, C, D.
• Skin care. To reduce the symptoms of inflammation, it is important to choose the right cosmetic products for basic care. It includes anti-inflammatory alcohol-free lotions, creams and gels with light textures. From decorative cosmetics, matte products are used.
• Medical therapy. It involves the use of drugs with antiseptic, antimicrobial, keratolytic or antibacterial action.

How to get rid of sebaceous glands: drug treatment

Medical treatment is necessary in case of moderate or severe disease. The selection of drugs is made only by a specialist, depending on the underlying causes.

Medical therapy includes the following:

• the use of local preparations;
• antibacterial treatment;
• normalization of hormonal levels.

Features of local therapy

Experts identify several groups of drugs that have shown high efficiency when applied topically.

1. Preparations with retinoic acid. Means help to reduce the inflammatory process, normalize the work of the sebaceous glands. Adapalene is considered the optimal drug. The tool is used once a day, has a cumulative effect. Requires long-term use.
2. Antimicrobials. Antimicrobial treatment is prescribed when papules and pustules appear. As drugs for topical use, Proderm, Eclaran, Azelik, Skinoren, Zerkalin, Dalacin are used. The drugs are used 1-2 times a day.
3. Combined drugs. The main advantage of this product line is an integrated approach and extended action. The composition includes several active components that allow you to solve the problem. Of the most effective, Isotrexin, Klenzit, Zinerit are isolated.

Antibacterial therapy

In difficult cases, with violations of the sebaceous glands, a bacterial infection may join. In such situations, the use of antibiotic therapy is required.

According to studies, bacteria have the least resistance to tetracycline antibiotics and macrolides. In the case of purulent inflammations that provoke malfunctions of the sebaceous glands, Erythromycin, Josamycin, Dixycycline, Metacycline or Oxytetracycline are prescribed.

To relieve the symptoms of hyperactivity of the sebaceous glands on the face, it is necessary to conduct a full course of treatment, it ranges from 5 to 10 days. Antibacterial treatment is not allowed to be interrupted. The reason for stopping the drug may be individual intolerance to the active substance. Dosage and treatment regimen is prescribed only by a specialist.

hormone therapy

Treatment of the sebaceous glands with hormone therapy is possible only after passing laboratory tests and consulting a gynecologist.

For therapy, drugs are selected that allow you to adjust the hormonal background of a woman. In most cases, these are hormonal contraceptives. They are produced in the form of tablets, rings, applicators, implants. Correction with contraceptives is possible only if the woman does not intend to have children in the next six months.

In the case of pregnancy planning, cyclic hormone therapy is prescribed. It involves the use of estrogens at the beginning of the cycle and progesterone in its second half.

Salon methods for solving the problem

The increased separation of the sebaceous glands allows you to treat both cosmetic products and salon methods. They are prescribed if necessary, exposure to the deeper layers of the epidermis.

Salon procedures are prescribed after a comprehensive examination and are an effective addition to medical treatment.

If you have oily skin type on your face, then a lot of fat is released through the skin ducts. Those who do not regularly cleanse the skin with lotions, facial cleansers, do not make cleansing masks, do not steam the skin and do not remove acne are at risk. Soon the pores will become clogged and acne will appear in places on the skin. The secretion of excessive secretion of the sebaceous glands must be stabilized. Especially, their active work is typical for teenagers, but acne also occurs in middle-aged and elderly people. What measures to take to reduce the activity of the secret produced by the sebaceous glands? In addition to external skin care, take care of proper nutrition, drink, in addition to boiled, mineral and filtered water from wells, take a shower daily.

If you have too oily skin on your face, pay attention to whether your metabolism is correct, are there any vegetative-vascular dystonia or malfunctions in the hormonal system, or maybe your kidneys are sick? When you find out in which organs there are malfunctions and engage in their targeted treatment, then the skin condition will improve. There will be less secretion of fat from the sebaceous glands.

Many do not understand that if doctors advise not to eat a lot of fried, smoked, salty or fatty marinades, then you need to listen. Otherwise, over time, failures in the work of internal organs occur. The body is slagged and more toxins are released through the skin. So sebaceous plugs appear in the ducts, and then acne ripens. Enter into the diet more salads from a variety of vegetables, eat fruits, boil meat with fish. Now you know what products to use. So, less fat will be secreted in the sebaceous glands, and your physical activity will increase due to a balanced diet.

If you have oily skin, make sure to cleanse it at least once a week. Any high-quality scrub is suitable for this. Often it contains fruit acids, which contribute to the cleansing of pores. Use a facial cleanser or gel in the morning. You can also use baby soap, and then wipe the skin with a cotton swab dipped in lotion. A tonic, a clay mask (suitable for black, with white and red) has a good effect on the condition of the sebaceous glands. After it, the secretion of fat on the skin can be significantly reduced.

The reasons

Let us consider in more detail the reasons why there is an excessive secretion of fat from the sebaceous glands on the skin:

• - You are in adolescence, puberty is actively underway, which means hormonal changes in the whole body.
• - Hereditary predisposition. Oily skin type in one of the parents or both.
  Your metabolism is wrong now.
• -Used various low-quality and cheap cosmetics.
• -Eat a lot of sweet, too fatty, like spicy with spices.
• -Gastrointestinal tract in poor condition, some organs require therapy.
• - You have recently taken medications that cause excess sebum production on the skin.
• - Often experience stress.
• - The liver is sick and urgently needs treatment.

If you want your body to work without failures, take care of your skin. If it is clean, well-groomed, some of the toxins are removed from the body through sweat.

For normal functioning of the sebaceous glands you must not only eat right, but also train them:

• -After washing your face in the morning or evening, pat your face with clean hands. 2-3 minutes is enough. So you activate the blood flow to the skin and the sebaceous glands will better feed on blood through the blood vessels.
• -If you do not have heart problems, visit saunas with your family or friends at least once a month. Not exactly sure what condition your “main motor” is in? Go see a cardiologist and ask for a referral for a cardiogram.
• - In the morning and in the evening you can take a contrast shower. The sebaceous glands are activated and will work more moderately, evenly releasing fat.
• -Many doctors recommend a special talker. It is an effective pore opener. Sebaceous plugs come out on their own. Ask for it in pharmacies, where some mixtures are prepared on their own. It is quite accessible and inexpensive.

What foods damage the sebaceous glands

Consider, using what, you aggravate the condition of the skin:

1. -Alcohol. If you abuse alcoholic beverages of any strength, this can provoke spasms in the excretory ducts. The sebaceous glands can become clogged and lipomas or wen appear.
2. -Discard foods that can be stored for a long time. They have too many preservatives. They have a bad effect on the functioning of the sebaceous glands.
3. - Sweets with muffin. If you love sweet and starchy foods, then you risk disrupting the glands that excrete the secret. After eating these products, the production of fat on the skin increases, the skin begins to shine. Then there are sebaceous plugs in the ducts and eels ripen.

How to properly organize care if you have oily facial skin, what to do to normalize the work of the sebaceous glands and make the skin well-groomed and beautiful? First of all, you should deal with the information on this issue.

A hallmark of oily skin is the excessive activity of the sebaceous glands, which provokes coarsening of the texture, unhealthy color of the skin and their shine. In addition, expanding pores and comedones, acne, and sebaceous gland cysts become very common problems. For competent care of oily facial skin, it is necessary to organize the correct diet, as well as use special external products.

This applies to self-care at home, and professional techniques. It is important to regularly carry out procedures such as cleansing, peeling, making masks. To find out the causes of excessive function of the sebaceous glands, you should visit such specialists as a dermatologist, cosmetologist and endocrinologist.

Oily skin is typical for people of adolescence and young age, but most often this type of skin transforms into combination skin by the age of about thirty years. Excessively active function of the sebaceous glands is explained by the following reasons:

• genetic predisposition;
• fluctuations in hormonal status;
• digestive pathologies;
• irrational nutrition;
• non-compliance with the rules of skin care.

With a hereditary predisposition to oily skin, it is important to take into account the fact that as you grow older, your skin type will not change, so efforts should be directed to correct regular care and choosing the right cosmetics for care.

Endocrine causes often play a role in puberty. A high concentration of testosterone leads to an increase in the size of the sebaceous glands, and also enhances their secretion. In addition, another hormone that affects the functioning of the sebaceous glands is adrenaline, the concentration of which increases if the body is under stress.

Also, oily skin increases with improper use of hormonal contraception. Sometimes women face the problem of very oily skin in case of polycystic ovaries, pregnancy, menopause.

Improper diet is also a fairly common cause of oily facial skin. It includes frequent intake of fatty and spicy foods, flour, sweets, alcohol and fast food. Often, people with oily skin have pathologies of the digestive system, such as colitis, cholecystitis, and constipation. It is worth noting that long work in a dusty or polluted space also increases the oiliness of the skin.

It is important to know that a common mistake in solving the problem is the excessive use of scrubs, aggressive cosmetic products containing alcohol. If you often degrease the skin, then you can aggravate the situation, since the cells
epidermis in response to getting rid of the fatty layer only increase the secretion. If you get carried away with scrubs and peeling, then this provokes the occurrence of non-healing microtraumas of the skin of the face, which will lead to an increase in the intensity of the secretion of fatty secretions.

Features of oily skin type

The characteristic features of oily skin include:

• localization of the most disadvantaged zones within the T-region (chin, nose, forehead);
• the skin is shiny, untidy, rough, uneven, dull, with a gray tint;
• difficulty applying makeup;
• combination with oily hair;
• blockage of pores, leading to their expansion;
• a tendency to the appearance of comedones (black dots) and milia, that is, whiteheads;
• the appearance of vascular networks;
• better ability to retain moisture;
• less sensitivity to the action of low temperature, sun, wind;
• late appearance of wrinkles.

Oily skin care tips

Before organizing facial skin care, it is necessary to determine the goals that are planned to be achieved. When

oily skin needs to properly remove the secretion of the sebaceous glands and take measures to reduce their activity, open the pores. The rules for oily skin care include the following items.

1. Minimization or elimination of negative effects on the skin. It is necessary to stop using alcohol-containing lotions, excessive scrubbing, greasy creams and do not neglect the removal of makeup at night.
2. Diet correction. It should include lean meats, fish, and fruits and vegetables. It is better to refuse the use of spices, smoked, sweet and flour. It is also important to take vitamin complexes if these nutrients are not enough in food.
3. Organization of proper home care. It should include cleansing, hydration and nutrition. The complex of products should be used taking into account the characteristics of the skin type. Mousses, gels, foams for oily skin have an anti-inflammatory effect. Wash with warm water. Peeling and scrub should not be used more than once or twice a week. After washing, wipe your face with tonic. This procedure is necessary for disinfection and tightening of the skin. After that, you can apply the cream.
4. The use of folk remedies. It is useful to wash with warm decoctions of herbs, such as chamomile, horsetail, nettle, lime blossom. In addition, cosmetic clay masks give a good effect.
5. The right choice of decorative cosmetics. Here it is better to opt for light tonal foundations, matting powders. Do not use creamy textures of blush and eye shadow.

If you follow these rules, then you can minimize all the problems that occur due to improper functioning of the sebaceous glands. Enough attention should be paid to care and lifestyle management so that the skin feels very good and looks better.

Professional care for oily skin

In-salon skin care treatments may include:

1. Make-up removal with the involvement of special emulsion agents.
2. Deep cleansing using enzyme peeling, vaporization, instrumental, ultrasonic and dry cleaning.
3. The use of ampoule serum products.
4. Facial massage.
5. The use of cosmetic masks with various types of actions for cleansing, relieving inflammation, and regulating the active functioning of the sebaceous glands.
6. Use of finishing products (creams) for oily skin types.

Thus, the correct care of oily skin is a very laborious process. It includes not only home procedures, but also professional techniques, as well as lifestyle correction. With some effort, you can eliminate the problems of oily facial skin and normalize the functioning of the sebaceous glands. An important point is the regularity of care. It is important to pay attention to the procedures every day, adhering to the planned course and not neglecting the advice of a beautician.

If you have oily skin type on your face, then a lot of fat is released through the skin ducts. Those who do not regularly cleanse the skin with lotions, facial cleansers, do not make cleansing masks, do not steam the skin and do not remove acne are at risk. Soon the pores will become clogged and acne will appear in places on the skin. The secretion of excessive secretion of the sebaceous glands must be stabilized. Especially, their active work is typical for teenagers, but acne also occurs in middle-aged and elderly people. What measures to take to reduce the activity of the secret produced by the sebaceous glands? In addition to external skin care, take care of proper nutrition, drink, in addition to boiled, mineral and filtered water from wells, take a shower daily.

If you have too oily skin on your face, pay attention to whether your metabolism is correct, are there any vegetative-vascular dystonia or malfunctions in the hormonal system, or maybe your kidneys are sick? When you find out in which organs there are malfunctions and engage in their targeted treatment, then the skin condition will improve. There will be less secretion of fat from the sebaceous glands.

Many do not understand that if doctors advise not to eat a lot of fried, smoked, salty or fatty marinades, then you need to listen. Otherwise, over time, failures in the work of internal organs occur. The body is slagged and more toxins are released through the skin. So sebaceous plugs appear in the ducts, and then acne ripens. Enter into the diet more salads from a variety of vegetables, eat fruits, boil meat with fish. Now you know what products to use. So, less fat will be secreted in the sebaceous glands, and your physical activity will increase due to a balanced diet.

If you have oily skin, make sure to cleanse it at least once a week. Any high-quality scrub is suitable for this. Often it contains fruit acids, which contribute to the cleansing of pores. Use a facial cleanser or gel in the morning. You can also use baby soap, and then wipe the skin with a cotton swab dipped in lotion. A tonic, a clay mask (suitable for black, with white and red) has a good effect on the condition of the sebaceous glands. After it, the secretion of fat on the skin can be significantly reduced.

The reasons

Let us consider in more detail the reasons why there is an excessive secretion of fat from the sebaceous glands on the skin:

• - You are in adolescence, puberty is actively underway, which means hormonal changes in the whole body.
• - Hereditary predisposition. Oily skin type in one of the parents or both.
  Your metabolism is wrong now.
• -Used various low-quality and cheap cosmetics.
• -Eat a lot of sweet, too fatty, like spicy with spices.
• -Gastrointestinal tract in poor condition, some organs require therapy.
• - You have recently taken medications that cause excess sebum production on the skin.
• - Often experience stress.
• - The liver is sick and urgently needs treatment.

If you want your body to work without failures, take care of your skin. If it is clean, well-groomed, some of the toxins are removed from the body through sweat.

For normal functioning of the sebaceous glands you must not only eat right, but also train them:

• -After washing your face in the morning or evening, pat your face with clean hands. 2-3 minutes is enough. So you activate the blood flow to the skin and the sebaceous glands will better feed on blood through the blood vessels.
• -If you do not have heart problems, visit saunas with your family or friends at least once a month. Not exactly sure what condition your “main motor” is in? Go see a cardiologist and ask for a referral for a cardiogram.
• - In the morning and in the evening you can take a contrast shower. The sebaceous glands are activated and will work more moderately, evenly releasing fat.
• -Many doctors recommend a special talker. It is an effective pore opener. Sebaceous plugs come out on their own. Ask for it in pharmacies, where some mixtures are prepared on their own. It is quite accessible and inexpensive.

What foods damage the sebaceous glands

Consider, using what, you aggravate the condition of the skin:

1. -Alcohol. If you abuse alcoholic beverages of any strength, this can provoke spasms in the excretory ducts. The sebaceous glands can become clogged and lipomas or wen appear.
2. -Discard foods that can be stored for a long time. They have too many preservatives. They have a bad effect on the functioning of the sebaceous glands.
3. - Sweets with muffin. If you love sweet and starchy foods, then you risk disrupting the glands that excrete the secret. After eating these products, the production of fat on the skin increases, the skin begins to shine. Then there are sebaceous plugs in the ducts and eels ripen.

Read also: How to disguise a scar on a girl's eyebrows if hair does not grow

This can be normalized, both with medicines and with the help of folk remedies. Before buying and using any medicine, consult your doctor or read the instructions carefully.

Folk recipes

To narrow pores reduce the work of the sebaceous glands, use a decoction with horsetail. Requires 1 tbsp. l. horsetail in dry form, finely crushed pour water - 1 cup. Then boil for 20 minutes. on a small fire. Cool the finished broth, strain through gauze or large bandages folded several times. Dip a cotton pad into it and apply it to enlarged, clogged pores. The procedure will take 15 minutes. Do it 2 times a day.

Wash with gel or foam, baby soap, and then rinse your face with calendula tincture: 1 tsp. plants in a dry crushed form, pour 1 cup of boiling water. The antiseptic properties of calendula will not allow inflammation to spread to the face and other parts of the body.

Over the weekend, take a steam bath for your face. Boil a pot of potatoes, knead it a little, sit over it, cover yourself with a large terry towel and let your face steam out. The pores will open and black acne will come out on its own. It remains to wrap your finger in a bandage, moisten it with peroxide and wipe problem areas (forehead, nose, chin) to remove greasy plugs.

To normalize the metabolism, and so that the secret from the sebaceous ducts in women is less, drink brewer's yeast. Buy them at a pharmacy or in a supermarket. Well-established, taken orally, a decoction of burdock root. Buy it at the pharmacy. Requires 2 tbsp. l. Put on the bottom of the pan and pour 2 cups of boiling water. Let it cook on low heat for about 20 minutes. Leave it on the stove all night. In the morning, strain and divide into 4 equal parts. Drink 1 during the day before meals. So, normalize the work of the glands that produce fat.

Seborrhea on the face: disruption of the sebaceous glands

Have you begun to notice shine, increased fat content, peeling, redness of the skin on the face, which intensify every day and become more pronounced? Are you struggling with this defect, but the problem is only getting worse? Perhaps you have seborrhea. What kind of disease it is, what causes it, how it is treated, what consequences it threatens, as well as other interesting, useful information you will find in our article.

What information will you learn:

What is seborrhea

Seborrhea on the face occurs with an unstable hormonal level

Seborrhea is a dermatological disease in which the functioning of the sebaceous glands is disrupted.

Most often, pathology occurs during puberty, when the hormonal level in the body is not stable.

There are the following types of seborrhea:

• oily;
• dry;
• mixed.

These varieties of the disease have their own symptoms that require competent and professional treatment.

To successfully get rid of the pathology, you should seek help from a dermatologist who will accurately determine the type of seborrhea and select the correct individual medication.

What causes the development of the disease

The causes of seborrheic dermatitis are the following factors:

• a decrease in the body's immune defenses as a result of a reduced level of hemoglobin or beriberi;
• disturbed balance of sex hormones;
• dysfunction of the digestive tract;
• liver diseases, as a result of which insufficient blood filtration occurs;
• bacteria, fungi or viruses that penetrate the pores of the skin;
• psycho-emotional overload and constant stress;
• malfunctions of the endocrine glands and the endocrine system;
• diabetes;
• obesity of the body, causing disruption of the activity of many organs and systems;
• malnutrition with the abuse of fatty, fried, spicy and sweet foods;
• insufficient or illiterate care of their skin type, in which very often patients use compounds that dry out the skin surface, to which the dermis reacts with even more sebum secretion.

Types of seborrhea

This disease can manifest itself differently on the skin depending on the type of seborrheic dermatitis.

Oily seborrhea of ​​the face is characterized by the following features:

• increased secretion of fat, when the epidermis becomes oily, shiny, shiny, the pores increase in size, and the quality of the sebum changes;
• comedones, formed as a result of blockage of the follicles when dirt and dust are attached, in the form of black dots;
• acne, blackheads, after which scars and scars remain on the skin;
• abscesses provoked by acne along with microorganisms and bacteria that have fallen into a nutritious, fatty environment;
• cysts (atheromas) that appear in places of opened abscesses due to increased production and accumulation of fatty secretion;
• greasy hair on the head, starting to shine within a few hours after washing it. They become sticky, oily (especially at the roots), large dandruff is formed that adheres tightly to the hairs.

Dry seborrhea is characterized by:

• excessively dry epidermis due to a decrease or complete cessation of sebum production, in which the face is not equipped with a natural lubricant that protects it from drying out;
• peeling, redness, itching and roughness of the skin, when the epidermis begins to crack due to increased dryness, followed by the appearance of characteristic scales;
• fine dandruff forms on the head in its hairy part, easily crumbling and covering the shoulders when moving. Most often, the hair begins to fall out intensively, because, having lost the necessary fatty lubrication, they become unnecessarily brittle.

With dry seborrhea, the affected area is flaky and inflamed.

Symptoms of mixed seborrhea are called:

• the presence of both dry and oily areas on the face, which are characterized by all the above signs;
• joint neighborhood of oily and dry seborrhea on the same area of ​​the face (rare).

What should be the diet

The type of food consumed by a person directly affects the condition of his skin, so it is very important to follow a balanced diet with the inclusion in the diet:

• oat bran, the main advantage of which is the ability to bind and remove harmful toxins and decay products remaining on the intestinal walls, poisoning the entire body, contributing to the deterioration of the skin surface;
• your menu should consist of cereals, milk soups without meat broth, boiled or steamed fish, poultry, beef, dairy products, fresh, raw vegetables and fruits. They contain valuable vitamins, microelements, as well as fiber, which absorbs all harmful metabolic products and quickly removes them from the body;
• minimize the amount of salt, spicy foods, sweets and spices that provoke the production of a large amount of sebum;
• Replace butter with vegetable oil (sunflower, linseed or olive oil).

Make sure you have regular bowel movements. Constipation, especially prolonged, ensures the entry into the blood of putrefactive substances, decomposition products, which are delivered to the skin through the bloodstream.

Ointments for the treatment of seborrhea

Please note that only a dermatologist should prescribe an ointment after examining the skin and identifying the type of seborrheic dermatitis, since only in this case the treatment will be really effective.

Here are the names of the most common drugs for general information:

• 5% sulfur-salicylic ointment, used in the form of a bandage with a bandage, a dense layer of the product, applied and fixed on problem areas of the skin. It must be changed once a day;
• zinc ointment, which perfectly dries the skin, regulates the production of sebum, eliminates inflammation, helps to quickly get rid of acne due to a pronounced antiseptic and regenerating effect;
• hydrocortisone ointment with hormonal action, usually prescribed for weeping seborrheic dermatitis, which is characterized by the formation of redness, severe peeling of the skin with the release of a liquid yellowish exudate. This composition should be used very carefully, gradually reducing the applied dose of the drug, since abrupt cancellation can lead to an aggravation of the disease;
• ketoconazole, related to antifungal agents. It kills candida fungi and helps in the treatment of both dry and oily seborrhea caused by these types of pathogens;
• salicylic paste, which quickly eliminates inflammation, inhibits the growth of bacteria, microbes, dries, whitens the skin surface and promotes its rapid renewal;
• lamisil, based on an antibacterial and antifungal component, which is effective against yeast microorganisms and pathogenic bacteria (staphylococci, streptococci);
• cream "flucinar", containing an active active ingredient called flucinol acetonide, which has a powerful antiseptic and anti-itching effect on the skin. In addition, it quickly eliminates redness of the epidermis, therefore it is used for the complex treatment of any type of seborrhea;
• cream "beolosalik", which is a combination drug with betamethasone and salicylic acid, which perfectly copes with all kinds of inflammatory reactions. It is prescribed for the treatment of dry seborrheic dermatitis.

Folk methods of treatment

Traditional medicine offers a wide range of natural-based remedies, which, in combination with well-prescribed therapeutic, drug treatment, will contribute to the speedy recovery and healing of the epidermis.

• Mix 100 milliliters of ordinary table vinegar and purified water. Pour 20 grams of fresh nettle leaves crushed into gruel with this solution. Put the composition on the fire and boil over low heat for 20 minutes. Then remove from heat, cool, strain and wipe the problem areas of the face with oily seborrhea twice a day with a cotton pad soaked in this decoction;
• chop the leaves and stems of fresh St. John's wort into a homogeneous mass, squeeze the juice slightly and boil a little (about 15 - 20 minutes). Cool the mass and mix it with soft butter in a ratio of 2: 1, where the first number is the grass, and the second is the fat base. This ointment will help with the dry form of seborrheic dermatitis;
• a decoction of calendula (marigold) is effective for mixed seborrhea, as it relieves inflammation, redness, itching and normalizes sebum secretion. They should wipe the affected areas of the skin 2 times a day.

Video: Treatment of oily seborrhea on the face

Get well and be beautiful!

Three steps to healthy skin: suppress the activity of bacteria that cause inflammation, normalize the activity of the sebaceous glands, remove scars and stagnant spots.

Why does the skin become problematic? The reason is in the activity of the sebaceous glands of the skin, which lie in its deep layers. According to the amount of sebum secretion, the skin is divided into three types - dry, oily, normal and combination. Oily skin (all over the face) and combination skin (T-zone - nose, forehead and chin) are characterized by large sebaceous glands with abundant sebum secretion and wide mouths, which are mistakenly called "pores" by the people. Most people think that these "pores" or "blackheads" are skin glands that should be treated with creams and ointments. However, the sebaceous glands themselves are located deep, in the lowest parts of the skin, from there a thin convoluted excretory duct leads, opening at the mouth on the surface. Therefore, so often the use of only creams and lotions for the treatment of deep acne is ineffective.

Normally, the sebaceous glands are designed to produce sebum in order to protect and strengthen the skin, but under the influence of improper care, poor ecology, dietary habits and hormonal levels, their work fails.

In addition to the amount of sebum secreted, its density also matters. The thicker the secret, the harder it is for it to stand out. An abundant thick secret literally "bursts" the walls of the gland, which is why seals of different diameters are visible on the skin: from tiny balls to rather large nodes, over which the skin color can even change, acquiring a slightly bluish tint. The accumulation of sebaceous secretion attracts bacteria that live on the skin, since sebaceous secretion is an excellent breeding ground for them. As they multiply, they cause inflammation, soreness, and redness of the skin. When the main defect is not eliminated - congestive accumulation of fat - such local inflammation can "smolder" for weeks, forming blackheads or pimples.

A difficult pimple is worse than a difficult teenager

The owner of a pimple, wanting to get rid of such a dubious “decoration” as quickly as possible, often tries to squeeze it out, but nothing happens, because the stagnant secret simply cannot pass through the narrowed duct of the sebaceous gland. Another option for the wrong approach to the problem is cauterization of the skin over the pimple with various solutions, ointments and creams. But they are not able to penetrate into the deeper layers of the skin and open the stagnant conglomerate. Gradually, a chronic pimple disappears on its own, but bluish, then brownish pigmentation, and often an atrophic scar, remains in its place for a long time.

What to do? In order for a congestive pimple to go away quickly, it is advisable to help the skin get rid of it. It is very simple - you need to use a method called electrocoagulation with the "opening" of the channel to remove the contents of the pimple, and then inject an antibiotic or an oxygen-ozone mixture under it to quickly suppress bacterial inflammation. After such a manipulation, healing is very fast, however, pigmentation and a scar can still form, therefore, as soon as a pimple has formed, it is advisable to consult a dermatologist.

Atrophic scars after acne can be eliminated by injections of high molecular weight hyaluronic acid and regular application of retinol cream. The younger the scars, the better they respond to treatment. For the same purpose, as well as to even out skin tone, a median trichloroacetic (TCA) peeling is used, which stimulates skin renewal and actively exfoliates its upper layers. Usually these are 4 procedures with an interval of a month. They are carried out in the autumn-winter period (from October to February), when the sun is not very active, and the likelihood of pigmentation formation after the procedure is low. The resorption of bluish spots can be significantly accelerated with the help of oxygen therapy (ozone) and mesotherapy with vitamin complexes and antioxidants.

Skin and nutrition

The state of skin secretion depends on the nature of nutrition: the more abundant the intake of sweets, the more thick, plentiful and “tasty” for bacteria sebum is produced.

What to do? Sometimes a change in diet with a restriction of sweets and starchy foods improves the condition of the skin without treatment.

In some cases, acne on the face is allergic in origin and is associated with intolerance to certain types of food. Then the rash intensifies after various kinds of feasts. For such patients, a combination of skin rashes with other manifestations is characteristic: for example, fatigue, headache, digestive disorders, bad breath, general skin sensitivity with a tendency to itching and redness. A surge in patients with this kind of acne to the dermatologist is observed after the celebration of the New Year, and in the summer after returning from vacations from Turkey and Egypt with their plentiful buffet.

What to do? For a food intolerance rash, the best treatment is a diet based on a blood test for food compatibility. This is an immunological analysis with an assessment of specific antibodies (Ig G and IgE) to various products, the number and activity of cells that mediate an allergic reaction.

Skin and ecology

An important factor in the development of "acne" is the thickening of the uppermost layers of the skin, which narrow the excretory duct of the sebaceous gland and contribute to stagnation in it. Thickening of the skin develops in response to external influences, such as solar radiation and unfavorable urban ecology. Many people who suffer from acne notice an improvement in the summer while relaxing on the sea. This is due to the beneficial effects of fresh air on the skin. However, upon returning to the metropolis in 10-20 days, the skin condition worsens, its thickening affects, which developed during sunburn as a protective reaction to solar radiation.

What to do? For such patients, chemical peels are an excellent treatment, thinning the top layer of the skin and releasing the tight sebaceous duct. Peeling with salicylic acid is ideal, which not only thins the top layer of the skin, but also has a disinfecting and anti-inflammatory effect. When using salicylic peeling, an immediate effect is observed in the form of drying up of inflammatory elements. In addition to salicylic, in some cases other types of peels are used: with glycolic, lactic and other fruit acids, retinol peeling. The latter is a little uncomfortable, as it can cause an exacerbation of acne, which is practically not observed with salicylic and glycol peels. What type of peeling will be most optimal in each case - the doctor decides. Usually this is a course procedure consisting of 4-10 peels once every 7-14 days, which are carried out in the autumn-winter period. However, according to indications, salicylic peeling can also be used in summer. It is a well-tolerated, fast procedure that takes 10-15 minutes.

Attention! Do not confuse chemical peeling with a scrub or gommage that mechanically cleans the surface of the skin. The last two remedies are used to prevent acne and increase the effectiveness of washing. Moreover, if there are active inflamed pimples on the skin, these agents cannot be used, as they can injure the skin and spread the infection over its surface.

skin and hormones

For adolescents and young adults, the main cause of acne is a sharp increase in sebum secretion and thickening of the upper layers of the skin from the onset of puberty.

What to do? In this case, the ideal solution would be a combination of local homeopathic treatment aimed at thinning the thickened sebum, and the use of peels with salicylic or glycolic acid. In the acute period, when bright red swollen nodules are present on the face, electrocoagulation, local antibiotic or ozone therapy will be effective. At the first stages of treatment, the so-called "cleansing" may be appropriate, when the sebaceous glands are mechanically released from the secret that clogs them. Cleansing is not a real therapeutic measure, since in the absence of systematic treatment, the sebaceous glands very quickly “clog” again, but in the early stages it can be useful to ensure access of drugs to the walls of the gland.

In some cases, a very good effect in inflammatory acne is given by an undeservedly forgotten quartz lamp, which was previously widely used to treat skin diseases. Currently, such a lamp can be purchased at home. However, only a specialist can give recommendations on the purchase of such a lamp and recommend a course, since in some cases its use will be contraindicated, which, by the way, applies to any method of treatment.

skin and age

Often, acne worries middle-aged people, when the first wrinkles already appear, but the “problem” of the skin still persists. The reasons are age-related thickening of the skin, a decrease in local immunity and endocrine disorders. At this age, acne is located mainly on the oval of the face and on the cheeks, where thin convoluted glands lie.

What to do? The combination of peeling (with salicylic or glycolic acid) with mesoimmunocorrection gives the best result. Mesoimmunocorrection - the use of mesotherapy products with hyaluronic acid, vitamins, amino acids that stimulate the skin's immunity, promote its hydration, enhance local metabolism and blood circulation. The combination of these methods not only has an "anti-acne" effectiveness, but also contributes to the prevention of age-related changes. The skin becomes more elastic, even and fresh, which is important for most patients over the age of 30.

Attention! A radical remedy that permanently or permanently reduces the secretion of the sebaceous glands and thins the upper parts of the skin (and therefore cures acne) is a vitamin A preparation - Roaccutane, which is taken daily for several months and has a cumulative effect. However, you should not flatter yourself and self-medicate. This drug is indicated only in cases of severe or moderate course of the disease, and its appointment requires a preliminary examination, has contraindications and can sometimes be tolerated with the development of dry skin or other manifestations that are eliminated by certain therapeutic measures. Treatment should be under the supervision of a physician and against the background of regular evaluation of blood tests.

Home care for problem skin

Maximum attention should be paid to cleansing. Currently, gel-based cleansers with an increased pH are widely used. They irritate the skin less, but often “under-wash” it. This is easy to determine by swiping your finger across your cheek after washing. Ideally, clean skin resists, literally “creaks” from cleanliness. If the skin is undercleansed, there will be a feeling of "film". Therefore, experienced dermatologists often recommend that their patients wash their faces with ... soap. But the choice of soap is also a responsible matter, varieties with moisturizing ingredients are categorically not suitable. There are also gels that wash the skin well, but it is better to entrust their choice to a dermatologist.

Of great importance is the choice of means of care. Problematic skin does not tolerate creams with a dense texture, since the mouths of the glands are instantly clogged with the fatty base of the cream. At the same time, alcohol and other drying “wipes”, “burners” and cleansers severely dehydrate the skin. This leads to the development of the phenomenon of the so-called "oily dry skin" - the mouths of the glands are clogged with fat, and the surface of the skin is overdried. The ideal choice in this case is a lightweight gel-based serum with no or minimal fat content. It is also better to entrust the choice of serum to a dermatocosmetologist. Sometimes it's best to choose a serum marketed as "anti-ageing" despite its amazing anti-acne ingredients.

Professional approach to problematic skin

In general, the treatment of problematic skin is complex. In the acute stage, when there is inflammation, redness and soreness, methods that suppress inflammation are used: electrocoagulation, antibiotics, salicylic peeling, oxygen therapy. After that, you should deal with the normalization of the activity of the sebaceous glands and the restoration of skin immunity with the help of peelings, mesoimmunocorrection, homeopathic mesotherapy, taking Roaccutane. This is the longest and most multi-stage stage of treatment, since it is necessary to change the natural features of the skin and increase its immunity.

At the final stage, the effects of acne (scars, congestive cyanotic spots on the skin) are eliminated with the help of TCA peels, mesotherapy with high molecular weight hyaluronic acid, regular use of regenerating serums and creams.

Finding it difficult to understand the multitude of methods? Not at all. An experienced doctor will quickly select the right treatment regimen on an individual basis. All these procedures are carried out quickly and painlessly. They may be preceded by a soothing and relaxing massage treatment, also effective for problematic skin. For example, a deep lift-massage performed on a device that imitates a pinch massage according to Jacquet, aimed at kneading deep stagnant elements and draining the sebaceous glands. This is a cozy and pleasant procedure during which people fall asleep, especially when they come after a working day. It can be combined with other types of treatment (as a preparatory stage for salicylic peeling, mesotherapy) to combine relaxing care and treatment of problem skin.

Medications for external correction of acne

Benzoyl peroxide preparations: Eclaran (5% and 10% gel), Baziron (gel 2.5%, 5%, 10%), Desquam, Cleramed, Benzacne, Ugresol (10%).

These drugs cause the formation of reactive oxygen species, resulting in unfavorable conditions for the life of propionic bacteria, and also have a drying and keratolytic effect.

External dosage forms containing benzoyl peroxide do not cause the emergence of resistant strains of propionobacteria.

Preparations can bleach hair and colored fabrics. The simultaneous use of other keratolytic agents and agents containing alcohol and perfumes should be avoided. They have an irritating effect (may cause exacerbation), increase skin sensitivity to UV radiation, can provoke allergic dermatitis, and are not combined with cosmetic anti-acne procedures.

Azelaic acid preparations (AZA)(Skinoren (20% cream, 15% gel)). Azelaic acid is a naturally occurring saturated dicarboxylic acid found in rye, wheat, and barley. It has an anti-inflammatory effect by inhibiting the growth of bacteria and the formation of free oxygen forms by neutrophils, an antibacterial effect by inhibiting the synthesis of bacterial protein.

It has a comedolytic and whitening effect, normalizes retention hyperkeratosis. AZA does not have teratogenic and mutagenic effects, is non-toxic, and does not cause the development of resistant flora. Simultaneous use with iodine- and bromine-containing substances, vitamins B6 and B12, as well as with local and systemic glucocorticosteroids is not recommended.

It should be remembered that Skinoren can cause an exacerbation in the first weeks of use, the therapeutic effect appears after 4 weeks. Avoid use in severe frost and heat. Use only on the recommendation and under the supervision of a dermatologist. Often causes skin irritation, does not combine with cosmetic anti-acne treatments.

Retinoids- natural or synthetic compounds that exhibit a similar effect to retinol (vitamin A). Tretinoin, isotretinoin, motretinide, adapalene are used in external medicinal and cosmetic products for acne correction.

Retinoids penetrate the skin directly through the stratum corneum (transepidermal route) and through the excretory ducts of the glands (transfollicular route). The transfollicular route allows you to get an increased concentration of retinoids directly in the follicles, which is especially valuable for acne correction.

Tretinoin preparations with erythromycin: Aknemycin, Klinesfar, Erilik.

Tretinoin preparations: Airol (0.05% lotion, 0.1% cream, 0.025%, 0.05%, 0.1% gel), Atrederm (0.05% and 0.1% solution), Lokacid (0.05% cream ), Tretinoin, Retin-A (0.05% cream), 0.1% Retin-A micro gel, 0.025% Avita cream

Isotretinoin preparations: Isotrex, Retinoic ointment (0.025%. 0.05%), Retasol solution 0.025%.

Isotretinoin preparations with erythromycin: Isotrexin

Adapalene- a derivative of naphthoic acid with retinoid-like action.

Adapalene preparations: Differin 0.1% gel, 0.1% cream.

They have a comedolytic and keratolytic effect, inhibit the growth and reproduction of propionic bacteria by creating aerobic conditions in the cavity of the sebaceous gland. It is not recommended to combine with other drugs and cosmetic procedures that enhance the desquamation of the epidermis (systemic retinoids, cryotherapy, peels, cosmetic cleansing, dermabrasion, keratolytics).

During the treatment period, direct sunlight and artificial UV light and the application of preparations to already tanned skin should be avoided. May exacerbate the disease. Use only on the recommendation and under the supervision of a dermatologist. Causes skin irritation.

Antibacterial drugs(Zinerite lotion - erythromycin-zinc complex, Erifluid - 4% erythromycin solution, Dalacin - (clindamycin 1% liniment and lotion). Reduce the inflammatory response by reducing the amount of fatty acids, suppressing leukocyte chemotaxis, growth and reproduction of propionic bacteria.

Can cause the formation of resistant strains of bacteria with prolonged use. Rarely cause allergic reactions. It goes well with cosmetic anti-acne procedures.

Currently, preference is given to combined preparations with seboregulatory and antibacterial action, which have a low irritant potential.

Zenerite.

The active ingredients of the drug are 4% erythromycin and 1.2% zinc acetate, dissolved in a lotion that also contains ethanol and a skin softening agent - diisopropyl sebacate. Erythromycin is a broad-spectrum antibiotic that inhibits the growth of pathogenic and conditionally pathogenic bacterial microflora (Propionebacteries acne), reduces the migration of neutrophils, providing an anti-inflammatory effect.

Zinc acetate reduces inflammation (inhibits bacterial lipases, accelerates regeneration and promotes the incorporation of polyunsaturated fatty acids into phospholipids), reduces sebum production (blocker of 5-a reductase), acts as a bacteriostatic (including erythromycin-resistant strains), reduces adhesive ability of epithelial cells, preventing the formation of comedones and potentiating the penetration of erythromycin into the skin.

The drug can be used in adolescents, as well as during pregnancy and lactation. Due to its low irritant potential, it is well combined with cosmetic anti-acne treatments.

Zinc preparations(Curiosin (zinc hyaluronate - 0.1% gel, solution, Zinerite - erythromycin-zinc complex, lotion). Zinc has an antiseptic, regenerating and sebum-regulating effect.

The main active ingredient is zinc hyaluronate. It has a regenerating, antimicrobial, anti-inflammatory and sebum-regulating effect. Has no annoying potential.

Especially recommended for sensitive and irritated skin with acne. Due to the presence of hyaluronic acid (according to modern requirements for the management of wound surfaces and the treatment of damaged skin), it promotes rapid physiological regeneration of the skin, and is the best way to prevent scars, including post-acne.

Recommended for the treatment of acne, as well as damaged skin (dermatitis from insolation, thermal damage, mechanical damage, etc.). It has no gender and age restrictions, does not cause photosensitivity, does not form microflora resistance. When applied, it does not leave marks on clothes and skin.

Metronidazole preparations(Metrogil gel 1%, Rozamet). Metronidazole has an anti-inflammatory effect, is highly active against anaerobic bacteria, protozoa, demodex mites. Not prescribed for pregnant, lactating. Apply 2 times a day either in a thin layer or locally on previously cleansed skin.

For post-acne correction: Contractubex (Merz, Germany) - contains onion extract, heparin, allantoin, hydroxybenzoate. Gel for correction of scars.

Medicines are prescribed by a doctor.

Correction with medicinal cosmetics

Therapeutic anti-acne cosmetics are used for the purpose of:

Leveling the phenomena of follicular keratosis, reducing inflammation, reducing the production of sebum;
- providing delicate care that does not irritate the skin, moisturizing, preventing it from overdrying;
- providing full photoprotection of the skin;
- anti-acne cosmetics should not contain hormones, antibiotics, retinoids, comedogenic substances.

Modern pharmaceutical anti-acne cosmetics contain AN and BH acids, less often other keratolytics, plant-derived 5-alpha-reductase blockers (sabal extract, isoflavones, creeping serenoa, green tea, etc., y-linolenic acid), antiseptics (bactymilene, triclosan, plant extracts, etc.), regenerating agents (bisabolol, panthenol, allantoin, etc.), vitamins (A, C, etc.), trace elements (zinc, copper, etc.), essential fatty acids (primrose oil, borage, black currants), moisturizing components, fat sorbents (silicon, aluminum and calcium silicates, polymer granules, etc.). As a rule, anti-acne cosmetics offer comprehensive skin care that provides complete skin cleansing, moisturizing, seboregulation, anti-inflammatory care and photoprotection.

Biologically active substances most often found in cosmetic preparations.

Azelaic acid- natural dicarboxylic acid. It has antimicrobial activity, normalizes keratinization. Often causes skin irritation.

Glycolic acid is one of the a-hydroxy acids. Causes exfoliation of horny scales, reduces hyperkeratosis of the ducts of the sebaceous glands, promotes a deeper penetration of other biologically active substances. It also has an irritating effect.

Salicylic acid- β-hydroxy acid - has an exfoliating and anti-inflammatory effect. Soluble in fats, so it penetrates well into the sebaceous gland. May irritate the skin.

Table 18. Hydroxy acids used in cosmetics (Ernandez E., Kryuchkova M., 2000)

a-hydroxy acids
	Glycolic acid
	Lactic acid
	Apple acid
	Lemon acid
a-hydroxycaprylic acid	a-hydroxycaprylic acid
Mixed fruit acids	Fruit Acid Blend
Sugar cane extract	Sugar cane extract
β-hydroxy acids
	Salicylic acid
b-hydroxybutanoic acid	p-hydroxybutyric acid
	Tropic acid
Trethocic acid	Tretocanic acid

To level the irritating potential of the above components of medical cosmetics, plant extracts are used that have the same effect, but do not cause irritation, as well as soothing and anti-inflammatory substances.

The former include extracts of chamomile, calendula, birch, celandine, etc. The latter include restructuring oils rich in essential fatty acids (borage, blackcurrant, evening primrose, etc.), lecithin, regenerating components (panthenol, allantoin, etc.)

A.G. Bashura, S.G. Tkachenko