Papular acne is the formation of papules on the skin, which are bumps with a hard consistency and a size of more than 1 centimeter. They are visible to the naked eye and can be felt under the finger when touched. Follicular lesions are mainly located on the facial skin in the T-zone, that is, on the forehead, nose and chin. This is an area of increased sebum and sebum production.
Papular acne is the most common and problematic form of acne. Treatment of papular acne requires medication and proper care.
What is acne?
Acne is a chronic inflammatory disease that manifests itself in the form of comedones (closed, open), papules, pustules, nodes, and other inflammatory elements18.
This is a multifactorial disease. In its pathogenesis, a significant role is played by heredity, hyperandrogenism, and a genetically determined type of sebum production18. The following main links in the pathogenesis of acne18 are distinguished:
- inflammation;
- increased sebum production;
- excessive follicular hyperkeratosis;
- propionibacteria proliferation.
Inflammation in acne is primary; it precedes hyperkeratosis in the follicles18.
Acne occurs in seborrheic areas where a large number of sebaceous glands are located29. The largest number of them is located on the back, face, and scalp29.
Acne usually first appears during adolescence. Of course, this is due to the riot of hormones. But it happens that the onset of the disease occurs much later. Girls sometimes complain that acne* appears at the most inopportune moment, without even suspecting that acne may be associated with their menstrual cycle. If in this case you do not take COCs, it will be impossible to get rid of acne before its next phase.
Reasons for lack of results in acne treatment:
Home care is also often a problem. There are options when home care is not adjusted at all, and the patient continues to torture his skin with all available and advertised products, or there is no care at all. Of these two evils, lack of care is perhaps the best option. One common mistake is hoping to get rid of acne only with the help of a treatment, such as a medicated cream.
cosmetologist Yuliana Shiyan
Comment from a cosmetologist:I often hear during consultations: “I tried this cream, it didn’t help me . It is obvious that the patient has unrealistic hopes for the cream. Therapeutic home care, of course, will contribute to cleansing the skin, but this is an auxiliary element, and not the basis of treatment. Just like procedures, they are a vital element in treatment, but in themselves they provide only a short-term effect. Everything should be in moderation and in totality.
Constant change of doctors during treatment
I have been working with problem skin for many years and I can certainly say that this is one of the most common reasons. Sometimes there is a need to change a doctor when there are doubts about the doctor’s competence. And more often, the patient goes from doctor to doctor because no one prescribes a magic pill and after a couple of cleanings for some reason there is no result or drugs are prescribed that the patient is afraid to take. And every time, the next dermatologist (cosmetologist) starts from scratch. As a result, the result is zero, invaluable time wasted, and as a result, complete disappointment!
Fear of taking prescribed treatment for acne
Acne. What to do?
Before a patient sees a doctor, he studies “a lot of things” on the Internet. The patient is infested with myths and negativity regarding combined oral contraceptives and retinoids, which are often the mainstay in the treatment of acne. And not just a basis, but irreplaceable drugs in most cases.
Practice shows that those who put off this treatment for years still decide on it in the end. And on top of years of torment from acne, you get severe scars and blemishes on your tormented skin, and of course, several courses of laser resurfacing to get rid of them.
You need to know that the doctor always prescribes treatment in proportion to the severity of the disease. If the cause of acne is a hormonal imbalance, you cannot do without COCs. If the acne is severe, then you can apply creams to your face and cleanse your intestines as much as you like; only retinoids will save you.
Amateur performance
Discontinue medications at the first signs of skin clearing. A good result is very relaxing. Quickly forgotten:
- that the ointment is prescribed for 6 months, not 3 months
- that the procedure is mandatory at each stage
- that you don’t need to take the first cream you see off the shelf
- that the New Year's table is for beloved relatives, but not for beloved skin
- “Cumulative dose of retinoids? What is this? Doctor, you probably just forgot to tell me..."
We completed the treatment and with a clear conscience returned to our previous diet and prohibited skin care (for example, oils or creams based on them). Many patients are convinced that high-quality skin treatment is a guarantee of the absence of acne in the future. And no matter how sad it is to talk about it, such conviction is often the fault of the attending physician.
Why? Because he didn't spend enough time explaining that acne susceptibility doesn't go away, even if your face clears up. After the main treatment, supportive, powerful home care is still prescribed for some time, continuing to work with the causes of acne, if it is nutrition and/or internal diseases.
Acneiform dermatoses
This is a group of diseases characterized by symptoms very similar to those found in acne. They differ from acne in pathogenetic and etiological mechanisms. The following acneiform dermatoses exist29:
- medicinal (caused by taking certain medications);
- doping (the cause of subcutaneous acne* is the use of anabolic drugs and B vitamins);
- alogen (this includes chloracne, iodacne, bromacne).
There are also androgenic, corticosteroid, and other types of acne29.
It is necessary to differentiate between acne and acneiform dermatoses, since the ability to effectively and quickly remove acne on the forehead and other parts of the face and body depends on the correct diagnosis.
When people encounter acneiform dermatoses, they cannot always distinguish them from acne, so it is important to entrust the diagnosis to a specialist. After collecting anamnesis and conducting research, he will be able to identify factors that provoke rashes and give recommendations for treating the disease.
Why acne on the forehead does not go away: what to do?
There are several reasons why acne on the forehead does not go away for a long time:
- Incorrect diagnosis. If the doctor initially made the diagnosis incorrectly, the selected course of treatment will not be successful.
- Self-medication. If the patient decides to get rid of acne on the forehead on his own, he risks not only not making progress, but also aggravating the problem. For example, there are a number of cosmetic procedures, including home ones, that cannot be performed during acne exacerbation - peelings, scrubbing, massages, etc. Cosmetologists and dermatologists know about this; specialists reschedule the session until the disease reaches remission. Patients may neglect this recommendation, injuring the skin and further spreading the infection.
- Unexplained causes of rashes. Late acne in women often occurs due to hormonal imbalances. Acne can develop against the background of polycystic ovary syndrome and other diseases. In this case, an integrated approach to treatment is necessary, visiting specialized specialists (gynecologist, endocrinologist, etc.).
- Neglecting specialist recommendations. A dermatologist may prescribe one or more medications that must be used strictly according to instructions. Thus, Clindovit® gel is applied twice a day, and it is recommended to combine it with benzoyl peroxide or azelaic acid (for example, Azelik® gel) to reduce the risk of developing antibiotic resistance28.
- Expecting results too quickly. It takes a lot of time to get rid of acne. Depending on the severity of the acne, treatment may take from several weeks to several months.
To choose the right treatment, it is important to understand why the rash appears. Along with pathogenetic therapy, which involves influencing the main factors of acne development (inflammation, propionibacteria, increased sebum production and hyperkeratinization), etiological treatment can be prescribed. It, for example, includes correction of hormone levels, treatment of gynecological diseases or gastrointestinal diseases.
Treatment for acne cannot be quick, but in order to minimize recovery time it is important to follow the recommendations of a specialist. You cannot interrupt the course of therapy on your own. Do not forget about the importance of caring for problem skin, as this can affect the result of treatment and the duration of remission.
"Eternal" pimple
Natalya Sokolova, head of the clinic of the Akmola Regional Dermatovenerological Dispensary, told the Good Health magazine about how to distinguish a wen from a pimple and how to get rid of it.
The accumulation of sebum can be called differently - a sebaceous cyst, a lipoma, but the popular definition of “fat” is most often used. In any case, this is a formation in which fat accumulates.
“A person can diagnose it himself - most often wen appear on the face, back, hands, hips, legs,” says Natalya Evgenievna. – Often a wen passes itself off as an ordinary subcutaneous pimple. But the difference is that the pimple goes away, but the wen does not. If you press on it, nothing hurts - it may even be soft to the touch.
Wen can reach a diameter of 5 cm. Of course, if a person has “grown” it to this size, he needs to see a doctor.
– Why do they appear on the body?
– There are several versions. The ducts of the sebaceous gland can become clogged and clogged, causing a fat capsule to form in this area over time. We also noticed that wen appears in an area where the number of fat cells increases. There is also a version that due to diet, fat thickens, is difficult to excrete and remains under the skin.
– Is there a category of people who most often encounter lipoma?
– No, wen appears in both men and women, adults and even children. By the way, children under five years old should not remove it.
– Should I worry if a wen appears on my body?
– In most cases, there is no cause for concern, unless the wen is gigantic in size. And yet, a person must understand that a wen is a benign skin tumor. If it hurts or begins to grow rapidly, then you need to see a doctor.
– Is it possible to squeeze out a wen?
– It is not advisable to squeeze out. Microbes that are in the closed cavity of the cyst, when ruptured, end up on healthy skin, which is not good. Moreover, if it bursts inside, it can even lead to sepsis.
– What methods can you use to get rid of wen? Or will the person have to live with him until the end of his days?
– Before starting treatment, the doctor must make sure that it is definitely a wen. Ultrasound examination will help him with this. A biopsy will also need to be done.
If the lipoma is small, you can inject a substance into the wen that will absorb the fat. If the doctor sees that the wen is growing, especially on the head, in the eye area, or spoils the patient’s appearance, he may suggest a surgical method. I must warn you that after such treatment scars remain on the body. You can also “pump out” this wen using a puncture, but this method is not suitable in all cases. Modern medicine also offers laser removal of the wen - it is easier to tolerate than surgery and does not leave any traces. It is very important, after removing a lipoma, to send its contents for histology to make sure that it is not a malignant tumor.
– Do wen come back?
– If the fat was not completely pumped out, then the wen will probably fill with fat again.
– Many people believe that they can get rid of lipoma with the help of traditional medicine. Is it true?
– Many people make some kind of compresses, rub the wen, drink decoctions, and even try to lose weight in the hope that the fat will resolve. I have to disappoint adherents of traditional medicine that their methods practically do not work.
– Can a person take any measures to protect against wen?
– It is within his power to maintain hygiene and prevent injury to the skin. Of course, you should watch your diet
If small pimples appear on your forehead, it’s time to see a dermatologist!
Acne and other dermatological diseases should be treated by a dermatologist. If you have acne on your face and it doesn't go away for a long time, consult a specialist.
Acne cannot be cured once and for all. This is a chronic disease prone to relapse18. It is necessary to constantly be monitored by a specialist. If the treatment does not produce results, he will correct it.
For mild to moderate acne, topical antibiotics can be prescribed, for example, Clindovit® gel 18, 6. This is a drug whose main active ingredient is clindamycin phosphate 6. The drug exhibits antibacterial activity against propionibacteria and reduces the level of free fatty acids on the skin6.
*acne
