(Jrt)
Acne
Acne is a dermatitis (skin disease) inflammatory follicles pilosébacés (oil secreting glands, the root hairs) with training comedones.
Typically, it begins at puberty and affects nearly 90% of adolescents, more or less severe. It ceases spontaneously, usually in late adolescence.
It has, in most cases, no serious biological itself, but may lead to repercussions on the self-image and social life of a young person. It is the source of over 20% of consultations with the dermatologist.
Perhaps
The word Acne, taken first in English, has an ancient origin and is perhaps a misunderstanding of Greek word akmê (ακμη), which means peak summit.
Epidemiology
The teenage acne marks the 85% of people, all ethnicities. This skin disease afflicts mostly young people aged 11 to 20 years, but it can also affect adults of all ages.
Causes
The genetic factor is the sole cause recognized so far, but stress, hygiene, environment and food can also affect the appearance of acne.
A hyperseborrhee
An excessive production of sebum, origin hormonal and confers a shiny appearance to the skin.
The oil serves to protect the skin from external aggression, forming a thin film lipid at its surface. At puberty, the sharp increase in the rate of circulating hormones (testosterone in particular) causes an excess of activity glands pilosébacées (using an enzyme: the 5-alpha reductase)
The obstruction of follicles
The chaotic proliferation of cells promotes overproduction of sebum and its retention where the multiplication of white dots. The thickening of the outer part of the gland can also cause inflammation of hair follicles. The obstruction of a gland filled with an excess of oil leads to a comédon, who will, in keratinising become a black dot.
The proliferation of bacteria
Propionibacterium acnes is a bacterium that normally lives at everyone, in the follicles. It does not cause infection, but aggravates inflammation of the follicle when there is an excess sebum, the origin of red buttons.
Other factors
* A genetic factor has been advanced.
* Hormonal factors are also dominate: more common among young men, with relative exacerbation in women during menstruation
* The stress is suspected but no study allows the state.
* Exposure to the sun (bronzing thick skin, and aggravates acne, despite an improvement transitional early exposure!)
* Exposure to certain pollutants, including chlorine, the Seveso disaster has had among its consequences trigger an outbreak of acne among the population affected by dioxins. Some pesticides, perhaps because of their character endocrine disruptor seem to be able to trigger episodes of acne called "chlorine" or chloracne.
* The relationship between acne and food (meats, chocolate) is not proven, but some fatty food may contain benzene and chlorine pollutants that might induce or exacerbate acne.
Forms typical
We are looking for injuries following often associated, varying severity and extent variable. The regions most common are the face, neck, chest, shoulders, back.
* Hyperseborrhée (oily skin)
* Blackheads and black point
* Papules: papules are storeys of the skin, inflammatory (red hot, tuméfiées, sometimes painful), which follow a comédon (= microkyste), less than 5 mm in diameter. They disappear on their own, or give a pustule.
* Pustules: they contain a yellow purulent content.
* Nodules: nodules are inflammatory lesions deep, more than 5 mm in diameter. She eventually break and leave a scar on the skin.
Cystic Acne
It combines all the injuries, with pustules in large numbers, scarring, reaching the trunk, back, buttocks.
Acne Conglobata
Acne very serious, profuse, long time. Key man preferentially. There are elementary lesions associated with abscesses, fistulas, scars creusantes or relief (scar "Keloid"). It involves a major social handicap and should be handled very quickly and efficiently.
Other forms
* Acne neonatal
* Acne caused by medications (estro-progestin, corticosteroids, anti-epileptic drugs, androgens, lithium, ...)
* Acne professional (oils, cosmetics, ...)
* Acne secondary to a general sickness (hormonal disease, polycystic ovaries, hirsutism, ...)
* Acne caused by rosacea (couperose)
Treatment
Acne is a condition often benign moving towards the disappearance spontaneously in a few years. Abstentions treatment is sometimes preferable if the patient does not feel gene. Otherwise, treatment is possible.
In case of treatment, it should be considered in conjunction with a physician. It is essentially local and also relies on good hygiene (cleaning of the skin). In all cases, treatment should be continued for a long time (several months).
There are products that address the bacterium (Propionibacterium acnes), acting on other mediators of inflammation, such as nicotinamide, a molecule present naturally in many foods. On the other hand, zinc reduces the secretion of sebum. Some contraceptive pills are also having a positive effect among young girls.
Acne rétentionnelle (oily skin, comedones, cysts)
* Treatment by retinoids premises.
Example: Vitamin A acid cream 1 times a day in the evening on skin dry and clean. side effects: irritation at the beginning of treatment, eczema (rarely), photosensitivity (= intolerance sun).
Read also Acne
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