Actual issues of external treatment of acne -

Acne (a synonym for acne vulgaris, acne) belongs to a special group of skin diseases – psychosomatic dermatoses.

Acne (Greek άκμή – inflammation of the sebaceous glands) is a polymorphic multifactorial disease of the sebaceous gland apparatus. The used term “acne” emphasizes the chronic, often recurrent course of dermatosis, the complexity of its etiopathogenesis and the need for an integrated approach to the treatment of the disease.

Despite the advent of modern methods of treatment, acne is still one of the most common dermatoses in young people. The incidence of acne not only does not have a clear downward trend, but also increases significantly. Acne is one of the most common skin diseases and during the pubertal (transitional) period is observed in varying degrees of severity in almost 100% of boys and 90% of girls. The peak incidence, as a rule, occurs at 14–17 years of age, which leads to special attention to the treatment of this disease in adolescents. At the same time, a high incidence of the disease was also found in young people aged 18–25 years (up to 80–85%), as well as in those aged 25–34 and 35–44 years, 8 and 3%, respectively. In young men, the disease is more common and severe.

Acne at the age of 12-24 years is called acne vulgaris or acne vulgaris. In most cases, by the age of 18–20 years, signs of spontaneous regression of the disease begin to be noted. In some patients, the disease acquires a chronic relapsing character, in some cases with the formation of “late acne” (acne tarda) by the age of 30-40. It has been proven that in recent years the number of women with late forms of acne has been increasing. According to Ch. Colleir et al (2008), in adolescent patients, the incidence of acne is almost the same in both sexes, while late acne is much more common in women.

Thus, according to various studies, the proportion of patients with acne at the age of 25–40 years is 40–54%. In studies conducted by G. Dummont-Wallon et al. (2008), J. Rosso, C. Williams et al. (2007), the average age of women with acne was 26.5–31.8 years. In a multicenter study conducted in the United States during the period 1990-1999, it was found that the average age of patients with acne increased from 26.5 to 40.5 years.

The detection of severe forms, according to different authors, is 5-14% of the total incidence of acne.

Many patients have a relapsing course, often complicated by the use of many drugs that are used independently and, in most cases, are ineffective.

Why does acne occur? The background for the development of this disease is seborrhea – a special condition associated with hyperproduction of sebum and a change in its composition. Normally, sebum serves to lubricate the surface of the epidermis. The sebaceous glands that produce sebum are located all over the skin, with the exception of the palms and soles, and are usually in close contact with the hair follicles, forming a common sebaceous hair follicle (SFS). According to the degree of fat content, the skin is divided into normolipic (normal fat content), hypolipic (dry), seborrheic (oily) and hyperseborrheic (acne). Seborrheic (oily) skin (lat. sebum – “fat”, rheo – “leak”) is characterized by increased secretion of fat by the sebaceous glands. At first glance, its structure seems rough, similar to the peel of an orange, oily and even oily in appearance. The pores are wide, funnel-shaped, gaping. However, they are empty, there are no sebaceous plugs or comedones (two interpretations are possible – lat. comedo, comedonis – glutton and a synonym for black eel; from novolat. acne comedonica – cyst). With age, the amount of secreted fat decreases and can be normalized.

Hyperseborrheic skin (with symptoms of acne) is characterized by quantitative and qualitative disorders of the fat secretion function and the accumulation of stratum corneum cells in the mouths of the sebaceous glands, as a result of which the formation of the water-lipid mantle becomes uneven and comedones appear in the seborrheic zones. Seborrheic zones are called areas of the skin on which the content of large, multilobular sebaceous glands is increased and there are from 400 to 900 of these glands per 1 cm2.

Seborrheic zones include: scalp, brow area, nose and nasolabial triangle, chin, axilla, chest and back, perineum.

Acne is the result of blockage and inflammation of hyperplastic sebaceous glands. The mechanism of acne development is rather complicated, but the main links of pathogenesis have now been identified:

1) hyperplasia and hypersecretion of the sebaceous glands,

2) follicular hyperkeratosis,

3) colonization of the ducts of the sebaceous glands by propionic acid bacteria,

4) inflammation.

Acne (a synonym for acne vulgaris, acne) belongs to a special group of skin diseases – psychosomatic dermatoses. Acne (Greek άκμή – inflammation of the sebaceous glands) is a polymorphic multifactorial disease of the sebaceous gland apparatus. The used term “acne” emphasizes the chronic, often recurrent course of dermatosis, the complexity of its etiopathogenesis and the need for an integrated approach to the treatment of the disease.

The detection of severe forms, according to different authors, is 5-14% of the total incidence of acne. Many patients have a relapsing course, often complicated by the use of many drugs that are used independently and, in most cases, are ineffective.