When mentioning the word “acne”, most people will think of a health problem of a generally mild nature, which appears at puberty and disappears by the age of majority. However, this is not the case in all cases.
Acne affects adults, in a not inconsiderable proportion of people, it can be resistant to conventional treatment and, in addition, cause sequelae in the form of permanent scars that significantly affect quality of life.
How does acne occur?
It is a pathology of an organ of the skin, the pilosebaceous follicle. This structure mainly comprises the hair and the sebaceous gland, responsible for producing the fat that covers the skin. In acne there are a series of alterations of this organ that determine the production of the disease: increased production of sebum or fat, clogging or obstruction of the follicular canal (the hole or canal through which the hair leaves the skin), bacterial infection and inflammation .
Usually and in practically all people, the time of puberty is accompanied by hormonal changes that determine an increase in fat and a plugging of the follicular channels that cause acne. In certain people, this hormonal state can persist into adulthood . They are patients with a tendency to oily skin, who may not even have had acne in adolescence and who, from the age of 25-30, develop more inflamed pimples and bumps, which appear under the skin, last for weeks, and they heal leaving marks or scars .
Youth acne corresponds to the classic “pimples” in the area of the forehead and nose, with little inflammation, or with pustules (pimples of pus) that heal easily with treatment with creams. In contrast, adult acne can form larger, deeper, more inflamed pimples or bumps, and with greater capacity to leave scars.
In men , adult acne also affects the back and chest, and can persist for decades. In women, it is very characteristic that deep pimples or lumps affect the areas of the jaw or around the mouth, and that they worsen the days before menstruation.
- In man, the diagnosis is visual and does not usually require complementary tests .
- In women, it is convenient to rule out a hormonal problem , mainly the polycystic ovary. In this disease, cysts form on the ovaries that cause an imbalance of the hormonal system. It can be the cause of menstruation irregularities, acne, increased oiliness in the skin and hair, increased hair on certain areas of the face and body (hirsutism) and, sometimes, thinning of the hair (alopecia). The polycystic ovary can also be accompanied by peripheral insulin resistance, an alteration in metabolism that can lead to true diabetes.
Treatment may be different for men or women depending on the existence or not of associated hormonal problems.
- Regardless of the sex of the patient, adult acnes are usually treated with courses of oral antibiotics , such as tetracyclines.
- In cases resistant to the usual treatment, or with a tendency to reproduce after it, the indicated drug is isotretinoin , a synthetic derivative of vitamin A. It is prescribed under the medical supervision of a specialist (dermatologist) at the best skin specialist delhi for a period of 6-8 months, and it must be taken into account that it produces discomfort or typical side effects such as dry skin and lips, and sensitivity to the sun. If it is prescribed for a woman of childbearing age, she must take measures to avoid an unwanted pregnancy during treatment and one month after it has ended, since isotretinoin causes malformations in the fetus.
- In women in whom the problem has a hormonal basis, the most effective treatment is a contraceptive .
The relationship of acne to certain foods in the diet is controversial. The popular belief that a diet rich in chocolate or cold cuts causes more acne has not been fully confirmed. However, new studies published recently have associated certain types of acne with a diet rich in sugars. A good advice is to avoid the abusive consumption of sweets, which are not beneficial to health in any case.
In women with a background hormonal imbalance, an important aspect of treatment is the control of overweight , which can prevent the tendency to develop diabetes.
Itching, itchy skin in. Sensation that encourages scratching, may be caused by a skin disease or other organs.
What is it?
Itching is a sensation on the skin that encourages scratching. It can be very annoying and impede daily activities. It is very important to study an itch to rule out that it is not caused by a disease of the skin or a disease of other organs.
Itching can be caused by a skin disease, or by internal diseases. In many cases, no illness can be found to explain it. Some patients may have itching of psychosomatic origin , which is known as psychogenic itching.
In the face of a recent-onset itch, the doctor must first rule out skin diseases. In general, these diseases cause signs in the skin that guide towards the diagnosis. However, there are situations in which the visible signs on the skin are very subtle or even non-existent. For example:
- The dry skin may be a frequent cause of pruritus, especially in the elderly. The abuse of soaps and detergents on the skin can be a cause.
- Patients with severe kidney or liver diseases may be itchy with no apparent signs on their skin, although changes in skin color or texture may be seen.
- Diabetic patients may have generalized itching with no obvious skin changes.
- Some serious diseases, such as lymphoma (cancer of the lymph nodes) can also initially manifest with itching.
In the event of unexplained itching , your doctor will probably order a complete blood and / or urine test, and a chest X-ray. In other cases, other tests may be necessary, such as stool analysis, biopsies and / or tests to rule out diseases of other organs.
Treatment should be that of the disease causing the itching. In addition, the use of medications in creams, baths or pills to relieve it, such as corticosteroids or antihistamines, can be helpful . In some cases, ultraviolet rays ( phototherapy ) can also be used .