International Alliance of Dermatologists Acne Treatment. Combined drugs in the external treatment of acne: current data

Melanoma Diagnosis Day is a noble charity event. Today, melanoma poses a challenge to man. It is screening examinations with dermatoscopy that solve the problem of early diagnosis of skin melanoma and save thousands of lives.

Dreval D.A.

Candidate of Medical Sciences, dermatologist, oncologist, member of the International and Russian Society of Dermatoscopy



Skin Melanoma Diagnosis Day not only allows you to examine a large number of patients in one day, but is also a powerful tool for educating the population and fostering a culture of caring about your health. The wide and growing interest in this event among the medical community from year to year indicates the undoubted benefits of holding such events.

Zinkevich M.V.



Melanoma is one of the most aggressive malignant skin tumors. However, a study of more than 26,000 thin melanoma patients in Australia showed that if melanoma is detected and treated in the earliest stages, when the tumor is less than 1 mm thick, the survival rate of patients 20 years after tumor removal is 95%. Detection of melanoma so early and achievement of high survival rates through minimally invasive therapeutic interventions are possible if two conditions are met. The first is the use of modern methods for early diagnosis of malignant skin tumors, the main and most accessible of which is dermatoscopy. And the second is public awareness about the early signs of malignant skin tumors and available medical care to ensure timely treatment of patients.

Michenko A.V.

Dermatovenerologist, Candidate of Medical Sciences, Leading Researcher of the Department of Clinical Dermatovenereology and Cosmetology of the State Budgetary Institution of Healthcare MNPTSDC DZM



For me, DDM is a unique idea, an event that unites the interests of patients, dermatologists and scientists involved in the diagnosis of skin melanoma.

Thanks to the La Roche-Posay brand, it has become possible to train doctors in all regions of the Russian Federation, share experience and approaches to diagnosing malignant skin tumors.

I am confident that such consistent work has qualitatively changed the level of identification of patients with melanoma at an early stage, and, accordingly, made it possible to save their lives.

The more we spread knowledge about melanoma, the risks associated with insolation and their prevention, the greater will be our successes in treatment and, most importantly, in the prevention of this terrible disease.

Carrying out DDM, the "SkinChecker" project of the La Roche Posay brand is an extremely important mission that should receive maximum support not only from the professional community, the media, Internet resources, but also from our patients.

Krylov A.V.

Dermatovenereologist, head of the dermatology department of the Allergomed Clinic MC, teacher at the Laser Medicine Center of PSPbSMU named after Acad. I.P. Pavlova



Unfortunately, skin melanoma is more often diagnosed at those stages of the disease when surgical treatment alone is not enough for recovery. The tumor does not manifest any subjective sensations (itching, pain, etc.) for a long time, but this does not mean that it is “inactive.” Take advantage of the unique opportunity to be examined as part of Melanoma Diagnosis Day - perhaps you are at risk? A timely examination by a dermatologist can save your life!

Sergeev Yuri Yurievich

Dermatovenerologist, Member of the Board of the Society of Dermatoscopy and Optical Diagnostics of the Skin



Skin melanoma today is an extremely pressing problem. Among patients aged 20-25 years, this disease is the 4th mostprevalenceamongothersoncological diseases.

Every year, 56.7% of patients with skin melanoma receive treatment for locally advanced disease. Most of them subsequently die from the progression of the tumor process. 5-year survival ratesti, according to V.M.Merabishvilicomposedis 35% in men and 53% in women.

TakimThus, the importance of measures aimed at prevention and early diagnosis of such an unfavorable prognosis of cancer can hardly be overestimated.

Gelfond M.L.

Doctor of Medical Sciences, Professor, Surgeon-Oncologist, Federal State Budgetary Institution Research Institute of Oncology named after. N.N.Petrova



Skin melanoma- one ofthe most dangerousmalignant tumors. Pannual incidence ratemelanomais steadily increasing by 2.6-11.7% in different countries and, according to experts, is doubling in the currentevery decade. The disease can develop independently, but is often maskedunder the guise of “ordinary moles”,does not cause concern to people and creates significant difficulties in terms of early diagnosis and,respectively,forecastfor the lives of patients.

The peak development of acne occurs during puberty (puberty). At this time, for many teenagers it turns into a tragedy: youthful maximalism does not allow them to look “pimply.” As the period ends, for most it goes away without a trace. With a mild form of the disease, there is no need for serious treatment. In some cases, the disease continues to develop over a long period. And then acne treatment must be carried out together with specialists.

Mechanisms of acne occurrence

During puberty, adolescents begin to produce male sex hormones - androgens. Natural hormonal changes occur in the body. They are the cause of the development of teenage acne.

An increase in androgen levels leads to excessive sebum production. It accumulates in the ducts of the sebaceous glands and contributes to an increase in the number of bacteria. Bacteria feed on sebum and multiply, resulting in an inflammatory process.

The surface cells of the skin clog the secretion of the sebaceous glands and a pimple occurs.

In any case, you should consult a doctor to find out how to deal with acne.

Basic principles of treatment

There is no universal procedure or miracle cream for treating acne. The problem requires a special approach - drawing up an individual treatment program. It should take into account age, gender, duration of the disease, the severity and nature of the lesion, the form of acne, and the results of laboratory tests.

To understand how to treat acne, you need to find out the causes of its occurrence. This skin disease cannot be considered separately as just a cosmetic skin defect. The roots of its manifestation can lie very deep.

Medical examination of the body

Tests for the presence of acne are prescribed in the following cases:

1. 1. Development of the disease after 20 years.
2. 2. Clinical signs of hyperandrogenism in women.
3. 3. Menstrual irregularities.
4. 4. Excess weight.
5. 5. Presence of acanthosis nigricans.

Any treatment of acne in order to avoid the development of complications should be carried out under the supervision of a dermatologist.

The dermatologist prescribes a general blood test and a hormone test. Next, culture cultures are shown to determine the presence or absence of microbes in the pores. The body's sensitivity to antibiotics is also checked in order to select the correct medications.

Based on all the results obtained, the general condition of the body is determined. If there are bad indicators in blood tests, the patient is referred to a therapist.

Degrees of skin diseases and methods of their treatment

The International Alliance of Dermatologists distinguishes 3 degrees of skin damage and recommendations on how to treat acne with medication.

1. 1. First degree. When you can count up to 10 elements (acne) on your face. Treatment is prescribed only externally:

• a drug that reduces sebum production;
• a medicine that fights bacteria on the face;
• a medicine that eliminates hyperkeratosis - excessive thickening of the stratum corneum of the epidermis.

1. 2. Second degree. You can already count from 10 to 40 pimples on your facial skin. In such a difficult case, there are two ways to cure acne: external and internal.

Externally, the same medications that are used for the first degree help in treating acne.

For indoor use, two features must be taken into account:

• Girls (women) should use a hormonal contraceptive with an official indication for the treatment of second-degree acne. It contains an antiandrogenic factor, reduces the level of male sex hormones and is good in the treatment of acne;
• Antibiotics are used to treat acne in both sexes. This is doxycycline, which is administered orally for 3 months. The skin renewal cycle lasts 28 days: it must undergo three renewals for the skin to become acne-free.

1. 3. Third degree. Characterized by localization on the skin of 40 or more acne; in fact, the entire face is covered with them.

External treatment for the third degree is not provided. The only way is internal use of the drug roaccutane (isotretinoin). This medicine prevents the secretion of sebum from the sebaceous glands, deprives bacteria of food, and causes drying of the skin. It should only be prescribed by a doctor, because although it gives the most effective results, it also has serious side effects.

Rules for facial skin care for acne

There are rules for combating acne, following which you can achieve the desired results. Squeezing pimples is strictly prohibited. After all, when pressure is applied to them, purulent contents move into the deeper layers of the skin. Thus, acne spreads even more.

To wash your face, you need to use products for oily and problem skin. To avoid further spread of infection on the skin, it is better to wipe your face only with disposable towels. After washing your face, apply any anti-acne product to your skin.

Acne treatment also includes following a special diet. A competent nutritionist must select an individual diet, in which the consumption of sweet, salty, and fatty foods is usually prohibited. The main emphasis in food should be on plant foods.

None of the currently existing methods and procedures can guarantee a complete cure for acne. Only a persistent desire, expressed in complex actions and taking preventive measures, will help get rid of the disease forever.

Good afternoon everyone. Let's continue the topic of acne. and this has already been written about. Announcement: how to open a pimple correctly, 3 stages of skin inflammation, what medications are prescribed to treat acne.

Many teenagers believe that the main reason for the appearance of pimples on the face is poor diet. This is a big misconception. It has long been known that the main cause of acne is

- increasing the level of male sex hormones - androgens - in the body.

During puberty, the level of male sex hormones increases in both boys and girls. In girls, this is due to the fact that female sex hormones are formed from male sex hormones;

- increased sebum production.

The high sensitivity of the sebaceous glands to androgens causes them to produce huge amounts of sebum;

- microbial inflammation.

Microbes receive high-quality nutrition - sebum, and multiply successfully, which causes inflammation on the skin;

- increased keratinization of the skin.

The keratinized skin scales block the exit for sebum, the gland becomes clogged and the inflamed secretion cannot come out.

Acne has nothing to do with malnutrition, dysbiosis or other causes.

There is another misconception: cleansing your face gets rid of pimples or blackheads. This is a very dangerous lie. Cleansing your face is practically squeezing out pimples. What happens under the skin when we squeeze out pimples.

When they try to squeeze out a pimple, its contents - pus - come out. But if the plug blocking the pimple is dense, then mechanical pressure breaks the walls of the duct under the skin and the contents spread throughout the surrounding area. This leads to the fact that,

firstly, neighboring ducts become infected and new pimples appear,

secondly, once microbes enter the bloodstream, they spread throughout the body, which is why you can die from blood poisoning,

thirdly, the vessels on the face are close to the vessels of the brain, so infection can enter the brain, which will lead to meningitis (a deadly disease).

If you can’t squeeze it out, then how to get rid of single pimples that protrude above the skin in the form of pustules.

How to open a pimple correctly

Abscesses protruding above the surface of the skin are not squeezed out, but opened. I offer you a small instruction on how to open a pimple according to the rules.

By opening a pimple in this way, you deprive the pus of the opportunity to accumulate in the depths and periodically, until the inflammation subsides, it will come out.

But if there are a lot of acne on the face: from 10 and above, then it is necessary to additionally treat the skin with special products. We'll tell you about them.

The International Alliance of Dermatologists on Acne classifies skin inflammation as follows:

If there are less than 10 pimples on the face, then this is stage 1 acne.

If the number of acne is from 10 to 40, it is grade 2 acne.

There are more than 40 pimples, they merge with each other - stage 3 acne.

Treatment of acne with varying degrees of acne:

Stage 1 acne is treated only with external means.

Stage 2 acne is treated with external agents and medications taken orally.

For grade 3 acne, external treatment is ineffective. There is only one drug that treats stage 3.

Remedies for acne on the face

Skin care products for stage 1 acne:

The following products will help you take care of your skin with stage 2 acne:

1. External means are the same as those indicated above.

2. There are two features for internal use.

The first feature: in the case of girls, girls must also influence the internal state of the body: reduce the production of male hormones, since in adolescence they are the source of acne.

Pay attention to the location of pimples on the skin. Often in girls with hormonal disorders, acne is located in the lower part of the face. They resemble a horseshoe or triangle in arrangement. This acne arrangement even has a name: the Griffitz triangle. In this place, the sweat glands are most sensitive to hormonal changes. Therefore, doctors advise such girls to consult a gynecologist.

For girls, there is a whole class of hormonal drugs that improve the condition of their facial skin. They are suitable not only for teenage girls, but also for other ages, since women's skin also needs hormonal support.

We offer you one of them. This contraceptive is called Jess and it has an official indication for the treatment of stage 2 acne.

It contains a substance that reduces the level of male androgen hormones.

In addition, this drug does not retain fluid, which means that body weight will not be gained when taking it.

Read his instructions. And I’ll emphasize again: you should definitely consult a gynecologist.

The second feature: for both girls and boys, dermatologists suggest taking an antibiotic orally, which is called doxycycline.

It is taken for 3 months. These deadlines must be maintained, since the skin is renewed once every 28 days and 3 skin renewals must take place in order for the result to be visible.

For skin with stage 3 acne, topical products do not help.

In this case, the only medicine that helps is used. I emphasize: the only thing, there are no others. It is used internally. Its name is roaccutane.

Roaccutane blocks the release of sebum from the sebaceous glands and deprives microbes of food. It also dries out the skin. In a word, it gives the best results.

Roaccutane is prescribed only by a doctor.

I would like to remind you that skin renewal occurs after 3 months. Therefore, be patient: only after 3 months you will see the result.

I'll put an end to this. I wish everyone health and a speedy recovery.

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The position remains valid for the second semester of 2013.

During 2005-2012 At the EuroFemme clinic, more than 8.5 thousand men and women who contacted us for acne have been successfully treated. Studying the medical history and previous treatment of our patients, consulting work in other clinics and on network resources (ugrei.net), communication with colleagues from Russia and foreign countries at conferences and during teleconferences, as well as our own long-term studies of clinical characteristics, examination data, quality life, behavioral and socio-psychological characteristics in the population of people suffering from acne, give us reason to make the following statement:

• In the dermatological community there is some significant for therapy concepts the etiology and pathogenesis of acne, which to a large extent often contradict each other. This can and is already leading to possible errors in management patients with acne.
• There has been a shift in the treatment of acne towards use some doctors means and methods, objectively not corresponding clinical and pathogenetic characteristics of the disease. The number is increasing unproven treatment practices and skin care.
• The main problem in treating many cases of acne is low compliance- non-compliance with treatment regimens by patients.
• Initial preferences and beliefs patients are provided influence on tactics and effectiveness treatment. These beliefs may not correspond to reality and are formed on a social and economic basis, including under the influence of aggressive and unfounded advertising.

The position of EuroFemme doctors regarding the pathogenesis of acne

1. The leading cause of acne is inflammation in the area of ​​the pilosebaceous follicles. The development of inflammation has different mechanisms with the leading influence of neuroendocrine factors.
2. Microorganism Propionibacterium acnes is neither the only and unambiguous causative factor of inflammation, nor the main target for acne therapy.
3. Diet, including foods with a high glycemic index, as well as milk and dairy products, plays a role in the development of acne.

Position of EuroFemme doctors on acne treatment tactics

EuroFemme doctors are currently guided by the following main documents in the management of acne: Clinical recommendations of the Russian Society of Dermatovenerologists (as revised in 2010), as well as recommendations of the Global Alliance for the Improvement of Acne Therapy (as revised in 2009).

Based on the positions of evidence-based medicine and taking into account their own experience in observing, examining and treating patients with acne, EuroFemme doctors state:

1. Due to the resistance of skin bacteria to antimicrobial agents, the prescription of both local and systemic antibiotics without testing to determine the number and sensitivity of microbes isolated from the surface of the skin (and not from the discharge!) is not recommended.
2. Self-medication of adult patients with acne with any topical antibiotics is undesirable and should be avoided. Self-treatment with systemic antibiotics of any class is unacceptable. The use of combined external medications with antibiotics without examination is not recommended.
3. Self-medication of any patients with any form of acne with any form of topical retinoids, including those in combination preparations, is not recommended.
4. Self-medication of acne with hormonal contraception is unacceptable. Prescribing hormonal contraceptives by a dermatologist is undesirable. The use of antiandrogens and combined contraceptives in the treatment of acne in women is possible strictly according to indications and after consultation with a gynecologist-endocrinologist.

EuroFemme doctors' position on the use of isotretinoin

1. Doctors at EuroFemme are wary of the increasing use of systemic isotretinoin as a treatment of choice in the treatment of mild forms of acne.
2. The use of systemic isotretinoin should not serve as a means to relieve the physician and patient from the need to adhere to a treatment regimen with other effective methods.
3. EuroFemme doctors support the statement of the American Academy of Dermatology about the inadmissibility of independent use, exchange, distribution and uncontrolled sale of systemic isotretinoin by patients.
4. EuroFemme doctors express deep concern about the direct and indirect advertising of systemic isotretinoin and other retinoids in the media.
5. EuroFemme has introduced a safety and compliance monitoring program for treatment with systemic isotretinoin.

EuroFemme's position on acne treatments

1. Acne is a disease, not a cosmetic defect of the skin. “Treatment” of acne by non-dermatologists, beauty salons and aesthetic centers is undesirable.
2. Substituting pathogenetically based acne treatment with cosmetic procedures is unacceptable. Often it is a violation of medical ethics, since it gives priority not to the patient’s health, but to his wishes, and instead of a reliable and long-term effect, it offers a temporary, although easier to achieve, cosmetic effect.
3. Of the many procedures offered by the cosmetology industry, only peelings and some types of phototherapy have proven effectiveness as aids in the treatment of acne.
4. None of the cosmetic methods is more effective than drug treatment for acne.
5. Most phototherapy methods, including acne treatment with lasers, blue light and pulsed light, have not been proven effective in clinical studies.

EuroFemme's position on doctor-patient relationships in acne

1. The doctor’s inability to explain the treatment regimen to the patient and motivate it to comply with it often leads to the failure of treatment using methods with scientifically proven effectiveness.
2. Low compliance, that is, patients' non-compliance with the treatment regimen, is the main reason for the ineffectiveness of external acne therapy.
3. Patients should not force doctors to suggest certain acne treatment methods. The initial beliefs of patients are influenced by the socio-economic environment, that is, they can be instilled in them by direct or indirect advertising of the pharmaceutical or cosmetology industry.
4. Only a doctor can determine the need to choose a particular remedy and method of acne treatment based on the objective characteristics of the disease and the characteristics of the patient, and not other factors.

References

1. Clinical recommendations of the Russian Society of Dermatovenerologists and Cosmetologists. M., 2010
2. New insights into the management of acne: An update from the Global Alliance to Improve Outcomes in Acne Group. J Am Acad Dermatol 2009;60:S1-50
3. Kim RH, Armstrong AW. Current state of acne treatment: Highlighting lasers, photodynamic therapy, and chemical peels Dermatology Online Journal 17 (3): 2
4. AAD Position Statement on Isotretinoin (Approved by the Board of Directors December 9, 2000; Amended by the Board of Directors March 25, 2003, March 11, 2004 and November 13, 2010)

please tell me how to cure acne and got the best answer

Answer from Martha[guru]
There is a separate method for treating acne for girls and women. Modern treatment is offered by the International Alliance of Dermatologists for Acne.
Test:
If there are less than 10 pimples on the face, then this is stage 1 acne.
If acne is from 10 to 40 - degree 2
There are more than 40 pimples and they merge with each other - grade 3
Stage 1 acne is treated only with external means. Stage 2 acne is treated both externally and with medications taken orally. For stage 3 acne, external treatment is ineffective, and there is only one drug that treats stage 3 acne.
Under the influence of androgens - male sex hormones - the sebaceous gland that surrounds the hair begins to secrete a huge amount of sebum. Microbes happily live, feed and multiply in sebum. As a result, inflammation of the sebaceous gland occurs and a pimple appears on the surface. This is also associated with increased keratinization of the skin - its scales block the exit of contents from the sebaceous gland.
Causes of acne:
- increasing the level of male sex hormones – androgens – in the body. During puberty, both boys and girls experience increased levels of male sex hormones. In girls, this is due to the fact that female sex hormones are formed from male sex hormones;
- increased sebum production. The high sensitivity of the sebaceous glands to androgens causes them to produce huge amounts of sebum;
- microbial inflammation. Microbes receive high-quality nutrition - sebum, and multiply successfully, which causes inflammation on the skin;
- increased keratinization of the skin. The keratinized skin scales block the exit for sebum, the gland becomes clogged and the inflamed secretion cannot come out.
Acne has nothing to do with eating disorders, dysbacteriosis or other causes.
When a pimple is squeezed, all the pus flows into the inner layers of the skin, infects the neighboring sebaceous glands and the inflammation spreads. Therefore, it is better not to squeeze pimples, but to properly care for your face. Squeezing pimples, including the so-called “facial cleansing” in a salon, is an absolute violation of all modern standards for acne treatment.
Treatment of stage 2 acne for girls
You should wash your face with special cleansers: for oily and problem skin
You should wipe your face with disposable napkins or disposable towels to avoid re-infection.
In the evenings, you should use a drug that helps reduce keratinization of the skin, such as Differin. It should be applied to the face in a very thin layer. The drug dissolves keratinized scales and releases sebum and acne.
In girls, one of the stages of treatment allows you to fight the root cause - reduce the level of male sex hormones. This consists of taking hormonal contraceptives that contain an antiandrogenic factor. These are not any contraceptives; the instructions must contain a special inscription: “treatment of moderate forms of acne (acne).” A doctor must prescribe a course of hormonal treatment.
The minimum treatment period for acne is 3 months. The skin renews itself after 28 days, and to normalize it requires at least 3 renewal cycles, that is, 3 months.

Reply from *** [newbie]
masks from white clay need to be made - just mix with water until the consistency of sour cream, smear your face, wash off when dry.

Reply from Smitt06[guru]
klerasil

Reply from JUDO[guru]
Go to the dermatologist!
and do not self-medicate.

Reply from Paulin[guru]
Go to a decent cosmetologist.

Reply from Lyudmila Shevchenko (Yatsenko)[guru]

Reply from Tatyana Lagunova[guru]
1. I categorically DO NOT advise GIRLS to take HORMONAL contraceptives! ! Not a single pimple in the world is worth the losses that a fragile girl’s body will suffer as a result: from menstrual irregularities to incessant uterine bleeding and infertility! !
2. I absolutely disagree with the opinion that the appearance of acne (acne) has NOTHING to do with diet. Related! ! And you should eat right - wholesome, healthy food: fresh juices in the morning, fruits and raw vegetables, cottage cheese, cereals, fish and much more. Not chips and Coca-Cola! !
3. You CANNOT squeeze pimples!
4. You should take very good care of your face: DO NOT use creams, use Safeguard soap, boil face towels, do not touch your face with dirty hands. Pimples must be cauterized with boric alcohol.
5. This is an age-related problem associated with the “game” of hormones - with age everything should normalize. I recommend visiting an endocrinologist.
Acne is not so much an external problem as an INTERNAL one!