Tablets that reduce the work of the sebaceous glands. Oily skin: how to normalize the sebaceous glands? Excess sebum production

1. Washing hair. First, wash your hair with a perm shampoo. Next, we apply conditioner from the same series and other nutritious or medicinal products. Rinse well with water. Remember that therapeutic masks can be done after 4 washings of permed hair. After you dry your hair, you can apply a leave-in product to the ends of your hair.
2. In order to get more defined curls, we apply a suitable styling product to the hair before styling. It can be foam for volume, gel for clear curls, mousses and other products. The choice of means depends on what kind of styling you want to do.
3. Next, we move on to drying our hair. We do this with a hair dryer with a diffuser. You can dry your hair in a normal position, or tilt your head down or to the side. In the salon, after you are given "chemistry", the master must explain how to properly form curls when drying.
4. After drying your hair, your hairstyle is almost ready, if you wish, you can part the curls with your fingers to give more volume. Then spray your curls with hairspray. But do not abuse the varnish, as during sleep, the curls can stick together or deform.

Styling with brushing

This styling is suitable if you want to make soft large curls. It is quite simple to make it, after washing the hair, we comb the hair and, if desired, apply styling products and begin to dry it with a hair dryer with a round brush (brushing). We divide the hair into small strands and dry it, twisting the brush a little. Thanks to this method, the curls will be light and voluminous.

Wet hair styling

This installation method is also very simple. As in other options, I wash my hair with selected products, then apply a gel or spray to wet hair to give the hair a wet effect. Dry naturally.

Styling with curlers

We wind the dried hair on curlers, hold for 20-30 minutes. If necessary, dry with a hairdryer, then remove the curlers, the curls can be separated with your fingers, then they will be more elastic and clear, or you can comb them with a comb to get waves.

There are skin diseases that are treated by both dermatologists and cosmetologists. These include something that everyone can have, which you can ignore, but which you really want to get rid of, as this affects the aesthetic appearance of the skin. So these are the problems that spoil appearance and cause not so much physical as moral suffering. Let us dwell here only on the most frequent ones - Acne, seborrhea and various formations on the skin.

Acne vulgaris or juvenile acne

Acne- the most common skin disease in adolescents and individuals young age, that is, the most socially active part of the population. This unpleasant disease affects about 85% of people aged 12 to 25 in European countries, so clean skin This age is the exception rather than the rule. The presence of inflamed pimples, pustules and abscesses, black dots (comedones), spots and scars, greasy, untidy appearance of the skin in the most prominent places causes difficulties in communication, professional device, reduces self-esteem, often leads to the formation of significant psychoemotional disorders, up to the desire for complete isolation. Some young people stop leaving the house, drop out of school and work, withdraw, and in the end, an insignificant and completely banal skin problem develops into a personal tragedy. A patient who consulted a dermatologist for acne has serious psychological problems. Shyness, guilt, a sense of social unacceptability, anger, a state of depression, disbelief in the possibility of a cure are expressed to one degree or another. Intense experiences exacerbate the course of the disease. IN stressful situations patients, especially women, open the skin, squeeze out Acne, which further worsens the appearance of the skin due to the accompanying inflammation. On such injured areas, scars and spots remain that do not go away for a long time.

Acne- a long-term disease, often aggravated (in girls, as a rule, monthly) and often resistant to ongoing treatment. Today we know much more about acne than ten years ago, and a competent specialist can always help the patient. In this regard, the opinion that existed in the past that acne will disappear by itself with age, and therefore it is not worth spending effort on treating them, now sounds simply absurd. It's not always easy to find the right one individual approach, but the effort and perseverance shown are always rewarded with a good result. In the arsenal of specialists there are whole line effective drugs different groups. The choice of the drug depends on the form of the disease, the prevalence of certain symptoms, the sex of the patient, the presence of contraindications.

Acne is more often divided into:

acne with a predominance of comedones (white and black dots with mild inflammation);
papulo-pustular acne (there are comedones, inflamed nodules - what is usually called acne, pustules, sometimes single large painful seals, gradually turning into abscesses such as boils);
conglobate acne (along with all of the above, there are long-term painful seals that leave pronounced scars after healing).

In most patients, over time, a habit is formed to squeeze out comedones and pustules, constantly touching the inflamed skin, which is why bloody crusts, spots, superficial scars are added to everything described.

Many factors are involved in the development of acne, the action of which is ultimately realized in sebaceous hair follicles. Not all follicles are affected, but only those with a special structure, located on the face and upper body, with large sebaceous glands, wide (up to 2.5 mm) ducts and thin, almost invisible hairs. The sebaceous glands are the target organ for sex hormones, especially testosterone. Under the influence of testosterone produced by the gonads, it is especially active in adolescence, the size and number sebaceous glands significantly increase, the production of sebum increases, its composition changes. In addition, in the development of acne, a violation of the keratinization of the ducts of the sebaceous glands, difficulty in the outflow of sebum to the surface of the skin, increased reproduction of microbes in the accumulated sebum and subsequent inflammation are essential. With the help of modern medicines, it is possible to influence almost all the factors involved in the development of the disease.

With the initial manifestations of acne (usually at the age of 8–13 years), when the clinical picture is dominated by increased oily skin and comedones (whitish nodules and black dots), and there are not so many inflammatory elements, retinoic and salicylic acid preparations are used externally. Both acids have the ability to dissolve comedones, and salicylic acid is much weaker in this regard. With papulo-pustular acne, it is advisable to use antibiotics, retinoids, benzoyl peroxide (benzoyl peroxide), traditional external agents (salicylic, chloramphenicol, resorcinol alcohols). severe forms acne, including acne conglobata, should be treated with oral retinoids, and only if there are contraindications, other methods of treatment (antibiotics, immunomodulators) are used. As with papulopustular acne, it is preferable to use a combination of different drugs.

Problems solved in the course of treatment and ways to solve them:

decrease in sebum production (retinoids, especially retinoic acid, hormonal drugs - estrogens, progestins or antiandrogens, spironolactones);
reduction of inflammation - antibiotics (tetracyclines, erythromycin, lincomycin, clindamycin) and local anti-inflammatory and microcirculation-improving agents, including zinc oxide, sulfur, tar, ichthyol, resorcinol;
prevention of the appearance and elimination of comedones (retinoids, especially retinoic acid, salicylic alcohol);
prevention of scarring (early start of treatment, retinoids, curiosin, contractubex, exclusion of injury to rashes).

Features of acne treatment with drugs of different groups

Currently, retinoids are the most effective group of drugs for the treatment of acne. Their use solves several problems at once - reducing the production of sebum and inflammation, preventing the appearance and elimination of comedones and scars. Two isomers of retinoic acid (tretinoin and isotretinoin) are used externally for the treatment of acne. Roaccutane and Retinol palmitate are used for internal treatment of acne conglobata and widespread papulo-pustular acne resistant to other external agents.

Roaccutane (isotretinoin) (Hoffmann-La Roche, Switzerland) is produced in capsules for oral administration 10 and 20 mg (30 pieces per pack). Assign at the rate of 0.5-1.0 mg / kg of body weight per day, taken in equal parts 2 times a day after meals for 12-16 weeks. If necessary repeated courses the break must be at least 8 weeks. Roaccutane is a highly effective drug, however, its use is limited high cost and many side effects. Treatment is always carried out under the supervision of a specialist.

Retinol palmitate(vitamin A) - domestic drug, it is produced in capsules for oral administration of 33,000 and 100,000 IU, as well as in an oil solution of 100,000 IU / ml. Effective doses for acne are at least 300,000 IU per day. The course of treatment is 12-16 weeks. The intervals between courses are 4-8 weeks. Retinol palmitate is inferior to Roaccutane in effectiveness, however, its tolerance is better, and the cost is much lower.

For external treatment of acne, preparations containing all-trans retinoic acid (tretinoin) and 13-cis-retinoic acid (isotretinoin) are used. All-trans-retinoic acid is contained in the following foreign preparations: Retin-A - 0.05% cream in tubes of 30 g (Silag, Switzerland), Lokacid - 0.05% cream in tubes of 30 g and 0.1% solution in 15 ml vials (Pierre Fabre, France). External preparations with 13-cis-retinoic acid, which has a higher bioavailability, are produced only in Russia - Retinoic ointment 0.1% and 0.05% and Retasol ® (FNPP "Retinoids"). Ointments and solution are recommended to be applied to previously cleansed skin 1-2 times a day. Upon reaching the effect, it is recommended to reduce the concentration or reduce the frequency of application of the drug. The duration of treatment is 12-16 weeks.

Drugs from the group of retinoids have a number of side effects. The most serious of them are teratogenicity and embryotoxicity. In this regard, women childbearing age retinoids are prescribed with reliable contraception and negative test for pregnancy. IN outpatient card upon appointment systemic treatment they usually make a note about the woman's awareness of possible side effects, and abroad dermatologists suggest that women fill out and sign a special form in order to avoid further prosecution in case of side effects. External treatment with drugs of this group is stopped when pregnancy occurs. negative influence on reproductive function men do not have retinoids.

In the first or second week of treatment, most patients experience an exacerbation reaction, which is expressed in redness, moderate itching, and peeling of the skin. The patient should be warned about the reaction, and if important events in life are coming at this time, then it is better to postpone the start of treatment. Usually these phenomena disappear on their own within a few days, after which there is a persistent improvement. Dryness of the lips, cracks in the corners of the mouth, peeling of the skin are frequent during the treatment process, they are eliminated by using a neutral moisturizer for the face and body, hygienic lipstick or lip gel, limiting the use of detergents when washing and washing. With the systemic administration of retinoids, dryness of the nasal mucosa, nosebleeds, conjunctivitis, urethritis, increased levels of transaminases and lipids in the blood, increased skin sensitivity to sunbeams. Taking this into account, before the start of treatment and monthly during the course of treatment, a biochemical blood test is performed, it is recommended to use protective sunscreen, avoid direct sunlight.

Contraindications

pregnancy and lactation, deviations in biochemical analysis blood (hyperlipidemia, increased activity of ALT, AST and alkaline phosphatase), renal and liver failure, hypervitaminosis A, drug intolerance. It is impossible to prescribe simultaneously retinoids inside and outside, ultraviolet irradiation, drugs with keratolytic and exfoliating effects, exfoliating cosmetic procedures and means (scrubs, peeling). The action of retinoids is weakened by the simultaneous use of glucocorticosteroid drugs and alcohol intake.

Antibiotics

Of the wide range of antibiotics for the treatment of acne, only tetracyclines, erythromycin, lincomycin, josamycin and clindamycin are used. Oral antibiotics are indicated for lesions large area skin, the predominance of pustules. During pregnancy, of these drugs, only erythromycin can be used.

Antibiotics of the tetracycline group have an advantage over other groups, since they are lipophilic and easily reach the main object of their action - the sebaceous glands. They can be assigned to long time– 2-3 months in a small dose. In this case, they block the production of bacterial lipases, the main link in the development of inflammation. An important advantage of this method is the possibility long-term treatment without breaking the composition intestinal flora. The daily dose of tetracycline is 1000 mg (10 tablets of 0.1 g or 4 tablets of 0.25 g), doxycycline hydrochloride - 50 mg (1 capsule of 0.05 g once a day), unidox solutab - 50 mg ( 1/2 tablet of 0.1 g), metacycline - 600 mg (2 times a day, 0.3 g). Antibiotics of the tetracycline group at the indicated doses are always well tolerated, and side effects characteristic of long-term use at a bacteriostatic dose do not develop. Tetracyclines are contraindicated in concomitant fungal diseases, pregnancy (last trimester), liver dysfunction, leukopenia, children under 8 years of age, kidney disease. During treatment, insolation is not recommended, ultraviolet irradiation is not prescribed, retinoids for internal use, hormonal contraceptives, psychotropic, anticonvulsant and antidiabetic drugs. Tetracycline absorption is impaired in the presence of food, especially milk and fermented milk products, as well as trace elements - aluminum, calcium, magnesium, iron. Their use should be avoided during treatment. Tablets are taken separately from meals.

Doxycycline, Metacycline and Unidox Solutab are better absorbed and can be taken with or after meals with a glass of water. big amount water. Unfortunately, the resistance of microorganisms to the drugs of this group quickly develops, and when re-administered, they are rarely effective.

Erythromycin belongs to the group of macrolides, the daily dose - 500-1000 mg is distributed in 3-4 doses 1-1.5 hours before meals. The drug is produced in tablets or capsules of 0.1, 0.25 and 0.5 g. Possible side effects include nausea, vomiting, diarrhea, liver dysfunction. The drug is contraindicated in individual intolerance, liver diseases with violation of its function. It should be borne in mind that erythromycin is inactivated by dairy products and sour drinks, and also increases blood levels and enhances toxic effect carbamazepine (tegretol, finlepsin) and theophylline.

Clindamycin (lincomycin group) is prescribed in daily dose 0.6 g, divided into 2 doses, is available in capsules of 0.15 g and under the name Dalacin C - 0.15 and 0.3 g each. The course of treatment is 7-10 days. Possible side effects include dyspepsia (nausea, vomiting, diarrhea), liver dysfunction. The drug is incompatible with erythromycin and vitamins of group B. Lincomycin is prescribed in a daily dose of 1500-2000 mg (2 tablets 3-4 times a day), is available in capsules of 0.25 g. Duration of treatment and side effects similar to clindamycin.

Josamycin or vilprafen in a daily dose of 1000 mg (1 tab. 2 times a day between meals) is used for 2-4 weeks, then 1 tab. within 8 weeks. Possible side effects include dyspepsia (nausea, vomiting, diarrhea), liver dysfunction. The drug is incompatible with lincomycin, weakens the effect hormonal contraceptives.

In case of intolerance to antibiotics, they resort to sulfanilamide preparations, usually co-trimoxazole (biseptol, septrin, groseptol, cotrifarm 480). The drug is prescribed at 480-960 mg (1-2 tablets) 2 times a day during or after meals with an interval of 12 hours. Recommended during treatment plentiful drink, monitor the state of blood and urine, avoid sun and ultraviolet irradiation do not prescribe ascorbic acid.

It is logical to assume that the local use of the above antibiotics can be much more effective and safer than the internal one. However, studies show that topical application of erythromycin, clindamycin, and tetracycline is only effective for mild acne especially in combination with zinc, retinoids or benzoyl peroxide. External use of 1% erythromycin ointment (Ung. Erythromycini 1%) has positive effect only in combination with other external and internal agents, the gel with clindamycin Dalacin T (Pharmacy, USA) is more effective. Easy to use Eriderm (Eryderm, Abbott Labor, USA) - 2% solution of erythromycin. Levomycetin, boric, resorcinol alcohols are also used for drying and cauterization of individual rashes. Effective combined preparations- Zineryt ("Yamanouchi", the Netherlands) - a solution of erythromycin and zinc acetate and Benzamycin, a gel for external use, in tubes of 20 g, ("Rhone-Poulenc Rohrer", USA), containing 3% erythromycin and 5% benzoyl peroxide. All of the above drugs are prescribed 2 times a day. As with oral antibiotics, topical preparations tend to cause the development of antibiotic-resistant strains of microorganisms, so their repeated administration is often ineffective. Resistance of strains of Propionibacterium acnes (the main microorganism that multiplies in the sebaceous glands of patients) to commonly used antibiotics was found in 60% of patients. Strengthening of resistance depends on the duration of therapy, resistance to erythromycin develops more often.

Other antiseptics and disinfectants. One of the successful modern approaches treatment is the use of benzoyl peroxide - a lipophilic compound due to the presence of a benzoic acid residue in its composition. When applied to the skin, benzoyl peroxide decomposes under the action of air into peroxide and inactive benzoic acid, which remains on the surface of the skin. Active oxygen compounds damage the walls of bacteria, destroying them, reducing the content fatty acids which prevents inflammation. At the same time, the same compounds have a damaging effect on horny scales, which is clinically expressed by skin peeling accompanying healing effect. Benzoyl peroxide preparations do not affect comedones, therefore, if they predominate, they are not used. Different companies offer this drug under the names Benzakne (Polfa, Poland), Desquam (Bristol-Myers, USA), Oxy 5 and Oxy 10 (SmithKline Beach, UK), Baziron (Galderma, France). Benzoyl peroxide is produced in the form of 2%, 5%, and 10% gel, 5% and 10% lotion. Treatment begins with the application of a lower concentration of the drug to the face, then it is increased. On the back and chest immediately apply more high concentration. Benzoyl peroxide is applied to previously cleansed skin once a day. Side effects include an exacerbation reaction in the first days of use, dryness and flaking of the skin, discoloration of hair and linen when the drug comes into contact with them. Intolerance is not uncommon, therefore, before starting treatment, it is recommended to conduct a skin test - the drug is applied to a small area of the skin of the flexor surface of the forearm for 48 hours. In the absence of itching and redness, you can apply the drug on the face.

A good effect, especially in the presence of comedones, has a combination local application benzoyl peroxide in the morning and Retinoic ointment in the evening.

Azelaic acid inhibits the growth of microorganisms and reduces the content of free fatty acids on the surface of the skin. Cream or gel Skinoren (Schering, Germany), containing 20% and 15% azelaic acid, respectively, is applied to the skin of the face (both on the affected and free areas from rashes) 2 times a day. When applied, local skin irritation is possible. Skinoren is used in complex therapy acne, its use as an independent remedy usually does not bring success.

Zinc hyaluronate is part of the Curiosin gel (Gedeon Richter, Hungary), has a healing and antimicrobial action. It can be used with a small amount of rashes, since the effectiveness of the drug is low. The gel is applied to cleansed skin twice a day, there may be a burning sensation and redness of the skin at the application sites.

Povidone-iodine (Betadine) is used to lubricate pustules in a concentrated (10%) or diluted 1:1 solution with water 1-2 times a day. It is undesirable to use in fair-skinned and red-haired patients due to increased sensitivity to iodine. The diluted solution cannot be stored.

With a small number of comedones in initial stage diseases effective salicylic alcohol 2-3%. It is used 2 times a day, trying not to apply to the entire affected area in order to avoid overdrying, but only to certain areas.

Sulfur is an anti-inflammatory agent, it is included as one of the components in most external agents (ointments and talkers) traditionally used in the treatment of acne. However, in last years found its comedogenic effect, ie. it can cause the formation of comedones.

hormone therapy

Therapy with sex hormones is possible only in women. Estrogens (ethinylestradiol) and antiandrogens (cyproterone acetate, spironolactone) can be used for treatment. Estrogens reduce the secretion of the sebaceous glands, however, not as significantly as retinoids. They can be used simultaneously with local administration of retinoic acid, antibiotics or benzoyl peroxide, which increases the therapeutic effect. For achievement good result estrogens should be given for a long time - at least 5 cycles. The first signs of improvement are noticeable only towards the end of the second or third cycle. Estrogens have many side effects - nausea, fluid retention in the body, swelling of the legs, weight gain, breast tenderness, skin pigmentation, and an increased risk of vascular thrombosis. Risk factors for side effects include smoking, alcohol consumption, obesity, and vascular disease. Cyproterone acetate for the treatment of acne is used only in combination with estrogens. Of the combined preparations, Diane-35 and Janine (Schering, Germany) are used. The drug is prescribed 1 tablet per day, starting from the first day of the cycle, for 21 days with a break of 7 days. The antiandrogenic drug Cyproterone or Androkur (Schering, Germany) is prescribed 1 tablet (10 mg) per day, starting from the first day of the cycle for 15 days, a new course is started 4 weeks after the start of the first one. Glucocorticosteroid drugs are prescribed orally or parenterally only for abscessing and fulminant acne, which are extremely rare. External use of corticosteroid ointments is not indicated.

Drugs of other groups

Zincteral ("Polfa", Poland) contains zinc sulfate, the deficiency of which is often found in patients with acne. Tablets of 0.124 g are prescribed 1-2 times a day during or immediately after meals for 1-2 months. Nausea may occur during the first week of use. The drug enhances the action of retinoids, but weakens - tetracyclines. homeopathic remedies treatments include injections of Cutis compositum or Traumeel (Heel, Germany). Phytotherapy is still widely used as aids- applications of slurry from badyagi for resorption of individual large knots, lotions with green tea, calamus rhizome, raspberry shoots. Inside appoint infusions of plants with estrogenic action (hop cones, sage leaves).

Skin care

Many patients, feeling the increased sebum secretion characteristic of acne, try to wash their face as often as possible using soap and a sponge. At the same time, the skin dries up, but sebum secretion does not become significantly lower, since the washing out of fats occurs only from the surface of the skin, without affecting the sebaceous glands themselves, located in its depths. For this reason, it is not recommended frequent washing skin (no more than 1 time per day), the use of sponges and washcloths to avoid irritation and injury. Now many use antimicrobial soap. But it changes the state of the microbial flora only on the surface of the skin and does not significantly affect the course of the disease. At the same time, antimicrobial additives contained in soap can cause irritation or allergic reactions. To clean the skin, it is better to use a mild neutral soap for sensitive skin or special cosmetical tools intended for this purpose (cleansing with milk, then tonic), and to eliminate the shine of the face associated with the release of sebum to the surface, cosmetic wipes or special matting agents. The widely held belief that makeup should not be used for acne has also now been reconsidered. Modern high-quality cosmetics that do not irritate the skin, well mask existing defects, do not significantly disturb perspiration, are not applied to the skin in a thick layer, and can be used during the day. It should be removed at home. Some medicines require the use of sunscreen. It is better to prefer gels and milk, and also be sure to quickly remove them from the skin indoors. Scrubs and peels may be recommended to smooth the surface of the skin and give it freshness, but are contraindicated during treatment with retinoids, benzoyl peroxide and tetracyclines.

Application medical masks with drying effect and detergents is limited during treatment with retinoids and alcohol solutions. If there are pustules on the skin and severe inflammation, massage and cosmetic cleaning of the skin are contraindicated.

Diet

Both in the past and now, most dermatologists always recommend adherence to a fairly strict diet. Our long-term observations have shown that the benefits of such restrictions are small, and only in a few patients there is a clear relationship between the consumption of certain foods (mainly chocolate) and increased rashes. Usually we recommend that patients follow a reasonable diet, no frills, include more fermented milk products and greens in the diet. However, 2-3 days of fasting during an exacerbation always give positive result. In general, when prescribing modern therapeutic agents, there is no need to follow any diet to achieve a good result. If the patient is to take part in a festive feast, it is better to cancel oral administration of drugs for 2-3 days and prescribe enterosorbents (Polifepan, Enterosgel, etc.).

The initial stage - a few small black dots appear on the nose and forehead (usually in children) - Salicylic alcohol, Retinoic ointment, Skinoren, medical cosmetics.
The same, but with significant oily skin - Retinoic ointment, Salicylic alcohol.
Numerous black dots and separate inflammatory nodules and pustules - Retinoic ointment, Salicylic alcohol, for pustules - alcohols with antibiotics, Dalacin T, Povidone-iodine.
The predominance of inflammation with a small number of comedones - Retinoids (Retinoic ointment, Retasol ®), benzoyl peroxide (Benzacne, Desquam, Oxy 5 and Oxy 10, Baziron), external preparations with antibiotics (Dalacin T, Zinerit, Eriderm, Benzamycin).
The predominance of pustules in a common process (face, back, chest) - antibiotics, in some cases - retinoids inside (Roaccutane, Retinol palmitate), externally - benzoyl peroxide, disinfectants.
Separate large painful ulcers on the face - antibiotics, externally - antibiotic ointments and benzoyl peroxide.

Seborrhea and seborrheic dermatitis

In recent years, what used to be united by one term “seborrhea” began to be divided into 2 concepts - seborrhea of the head and seborrheic dermatitis (damage to smooth skin).

Seborrheic dermatitis – chronic inflammatory disease skin. It affects 1-3% of adults (mostly men). Seborrheic dermatitis, along with acne, refers to disorders of sebum secretion. Indeed, both diseases are often combined in the same person and the same areas of the skin are affected - the so-called "seborrheic zones" - the face, chest (decollete) and middle part back along the spine (interscapular region), where the largest sebaceous glands with wide ducts are located, releasing a large amount of sebum. The sebaceous glands of this type actively develop and increase in size during puberty. The composition of sebum also changes, it becomes more viscous, the components contained in it contribute to increased keratinization, which corresponds to peeling that is visible to the eye. Smaller glands, but also secreting a large amount of sebum, are located on the scalp. Their purpose is to provide fatty lubrication of the hair, to make it invulnerable to external influences. These glands are also more active during puberty. In adolescents and adults, the most mild form seborrheic dermatitis is characterized by peeling of the skin and its excessive oiliness without inflammation - on the scalp it is dandruff, and on the face and chest - accumulations of fatty scales in skin folds- near the wings of the nose, in the nasolabial fold, on the bridge of the nose, less often - on the chest and back. Oily scales soaked in sebum serve as a good breeding ground for the development of lipophilic fungi Malassezia furfur or Pityrosporum ovale. In turn, the immune system responds to them by developing allergic dermatitis, the disease enters its second, more unpleasant phase, and ceases to be limited to mild manifestations. There are itching, burning, at first mild, then more intense reddening of the skin, severe peeling, hair loss. The manifestations of the disease are aggravated by the patients themselves - constant combing, attempts to remove crusts, remove accumulations of scales from the hair, the use of "folk" remedies, and the most powerful ones, inevitably lead to increased redness, the appearance of scratches and wounds, the multiplication of other microbes, the development of complications pustular process. Usually in this condition, patients turn to a dermatologist, although everything could be corrected much earlier.

With any manifestation of the disease, attention should be paid to the diet. Sometimes its correction is enough to prevent further development illness. Alcohol, sweets and starchy foods should be limited, regardless of the type of food. With itching and inflammation, smoked, salted, pickled foods are also temporarily limited, spicy seasonings, strong broths, instant coffee, citrus fruits, kiwi, pineapples and juices from them.

Treatment depends on the stage of development and clinical picture diseases. With the appearance of dandruff without the presence of inflammation, you can limit yourself to only external treatment, in more serious cases, internal treatment is also necessary. External treatment includes keratolytic, glucocorticosteroid, antiseptic, disinfectant and antifungals. Antifungal drugs usually start treatment, they can be used for a long time without the risk of side effects. Various dosage forms are used - creams, gels, shampoos. Shampoos with antifungal substances - Nizoral, Keto-plus, Perkhotal, Mycozoral, Sebozol contain 1-2% ketoconazole. Tee/Jel anti-dandruff shampoo contains 0.75% piroctone olamine and 2% salicylic acid. Creams and gels are applied 2 times a day, shampoos - 3 times a week. Various others medicinal substances that also have antifungal properties include zinc pyrithionate, tar, sulfur, resorcinol, and selenium disulfide. Medications, including these compounds, are available in the form of shampoos for the treatment of dandruff (Friderm-tar, Ti / Gel-Nyutar, Friderm-zinc) and ointments for the treatment of smooth skin lesions (Skin-cap, Birch tar, tar and sulfur-tar ointments). Prescription forms are also used: Vidal's milk, alcohol solutions with sulfur, boric acid, tar. After hair treatment, it is obligatory to change combs and hair brushes, hats.

With severe inflammation, anti-inflammatory, antiseptic and disinfectants are used. With wetting and severe swelling of the foci, lotions with resorcinol 1%, decoctions of herbs are used. The crusts are usually lubricated with alcohol solutions (salicylic, resorcinol, boric alcohol). Corticosteroids have a rapid anti-inflammatory effect - they are used on the head in the form of solutions - Elokom, Diprosalik (Schering-Plough USA), Lokoid (Janssen-Silag Belgium), Belosalik (Belupo, Croatia), on seborrheic zones - in the form of ointments and creams - Elokom, Diprosalik, Belosalik, Hydrocortisone ointment. It should be noted that only non-fluorinated glucocorticosteroids in the form of easily absorbed creams and emulsions (Advantan emulsion, Elokom cream, Lokoid cream) or weak (Prednisolone, Hydrocortisone) ointments can be used on the skin of the face, which is much thinner than in other areas. This group of drugs is not suitable for long-term use due to the risk of unwanted effects- thinning of the skin, dilation of blood vessels, the appearance or intensification of acne. When you can take off acute inflammation(usually in 3-5 days), and with residual peeling, they are replaced by preparations containing vitamin A - emulsion-based ointments Videstim ® , Radevit ® (FNPP Retinoids, Russia). It is known that vitamin A (retinol palmitate) reduces sebum secretion by reducing the size of the sebaceous glands and keratinization, and also has the properties of a local immunomodulator. Videstim ® contains 0.5% retinol palmitate on an emulsion basis, Radevit ® contains 1% retinol palmitate, ergocalciferol and tocopherol acetate (vitamins A, D and E). Drugs are used for a long time, including for the purpose of preventing relapses. In recent years, the local immunomodulator pimecrolimus, supplied to Russia under the name Elidel, has also been used in the treatment. Keratolytic agents are used for severe peeling and crusting. Sulfur-salicylic ointment 2-5% is used 1.5-2 hours before washing the hair under a scarf, on the face - 1 hour before washing, 10% urea ointment Karboderm (Ukraine). Especially good effect bring combined preparations that combine the keratolytic properties of salicylic acid and anti-inflammatory glucocorticosteroids - Diprosalik, Belosalik. Internal remedies include vitamin A (retinol palmitate) in a daily dose of 100,000–200,000 IU (once at night for 2 months), B vitamins, in particular brewer's yeast (“Merz” Germany and domestic companies), brewer's yeast with the addition of zinc and selenium Nagipol, multivitamin-mineral complexes, preparations with selenium (Selevit, Triovit), zinc (Zincteral). To reduce fat formation in women, hormone therapy (Diana-35, Janine) and antiandrogens (Androkur) are used - see above. Despite successful therapy, the disease often recurs. A rational approach to diet and a careful selection of skin and hair care products are necessary to maintain a favorable treatment result for as long as possible.

prof. IN AND. Albanova

Every girl strives to ensure that her face looks beautiful, and her skin is uniform, matte, clean. But not everyone can achieve this. Oily facial skin is becoming an increasingly common problem of modern girls. And it's not just an unpleasant greasy sheen. Oily skin is enlarged pores, a tendency to form comedones, acne, inflammation. Because of all this, you have to use a large amount of decorative cosmetics that mask defects. Under a thick layer of cosmetics, the skin fades, even more sebaceous fat is released, more and more new problems appear. To break this vicious circle, you need to act in stages. First, let's figure out why the skin of the face becomes oily.

Causes of oily skin

Increased activity of the sebaceous glands may be the result of hormonal changes in the body. That is why most often the skin becomes oily in adolescence - at the time of puberty. In addition, the sebaceous glands can be activated due to pregnancy, during menopause, before menstrual bleeding.
Sometimes the skin becomes oily due to malnutrition. A large number of fatty, spicy, smoked and salty foods lead to malfunctions in the intestines, which will certainly affect the skin.
Cosmetics, oddly enough, can also be the cause of increased oiliness of the face. Poor-quality products that completely clog pores do not allow sebum to come out, which increases their production. In addition, makeup should be removed every evening, using special means deeply cleansing the skin.
If the increased secretion of sebaceous fat has appeared recently, this may be due to the intake of certain drugs. Certain groups of drugs have such by-effect- the appearance of oily skin.
Sometimes the skin can become oily only on hot days of the year. This is a completely natural manifestation of the body - the epidermis protects itself from overdrying. In this case, you just need to take better care of your face.
Chronic infectious diseases, heredity, elevated level testosterone in the body, disorders in the liver and pancreas, prolonged stress and nervous experiences - all this can provoke active work sebaceous glands.

To find out the true cause of this cosmetic problem, you need to analyze the quality of your life, your diet, the time when excessive oily skin appeared. Try to understand what caused this condition. You may need to see a doctor for this. In the meantime, let's talk about how to care for oily skin in order to normalize the functioning of the sebaceous glands.

Many of us try to take care of our facial skin, but we often make mistakes, due to which the condition of the epidermis becomes even more deplorable.

Girls with oily skin often wipe their face with alcohol-based tonics and lotions. This is fundamentally wrong. Alcohol dries out the skin, causing the pores to produce even more oil to get rid of that dryness. It is necessary to wipe the face with alcohol-containing compounds no more than a couple of times a week.
Oily skin types should not be exfoliated frequently. The constant removal of the keratinized layer of the skin leads to an increase in the work of the sebaceous glands.
You can't wash your face hot water, this also leads to the active production of sebum. You need to wash with cool water - it will not only cleanse the skin, but also narrow the pores.
You should also not steam your face - this will open the already enlarged pores.
Use skin care products that suit your skin type. Oily cream clogs pores, causing them to clog, which invariably leads to oily skin and acne.
If the cause of increased fat content is hormonal, you should talk to your doctor about taking oral contraceptives. Their reception normalizes hormonal background, some of them are prescribed even for men.
Try to eat right - less fat and starchy foods, more fresh fruits and vegetables. This will benefit not only your skin, but also your figure. Drink decoctions to improve metabolism medicinal herbs.
To improve the appearance of the skin, you can use special matting wipes that can be used anywhere. In summer, do not forget to moisturize your skin with micellar water. This will save your face from an unpleasant oily sheen.

In addition, you need to monitor your face, regularly remove makeup in the evenings, use only high-quality cosmetics. By improving the quality of life and changing the principles of skin care, you can achieve good results.

Rubbing oily skin

Oily skin implies the presence of a thin layer of fat on the surface of the dermis, which casts an unpleasant sheen. To get rid of it, you need to wipe the skin special formulations capable of suppressing the activity of the sebaceous glands.

One of the best means for oily skin Apple vinegar. Dissolve three tablespoons of vinegar in a glass of water and wipe the skin with this composition several times a day. The effect of matte skin will be noticeable after a week of regular use. Store the prepared solution in the refrigerator, closed.

Herbal rubbing and washing very well help. Make a decoction of one or more herbs and wipe your face with it daily - in the morning and in the evening after removing makeup. Calendula will help get rid of acne and inflammation, the sequence will heal and dry open wounds, oak bark will suppress the activity of the sebaceous glands, nettle will put pores in order, plantain will cope with acne due to its antiseptic properties.

Another effective method take off excessive fat content and narrow the pores - this is rubbing the skin with ice. In the morning, ice rubbing will invigorate the skin and relieve morning puffiness. And in the evening, ice will soothe the skin after removing makeup. Instead of plain water for freezing ice cubes, you can use herbal decoctions, cucumber water, fruit and berry juices. In addition, you only need to prepare the product once - then the finished ice cubes will always be at hand.

There are many recipes that will help you make your skin matte and velvety.

Clay. Help get rid of fat clay masks. Best of all, masks made of white, blue and black clay will cope with the problem. For greater effect, they can be bred not on water, but on a decoction of herbs.
Kefir, lemon and oatmeal. These components are widely used in the fight against the activity of the sebaceous glands. If you combine them in one mask, you get an incredibly effective remedy that will cope with even the most oily skin. Mix a tablespoon of warm yogurt with the juice of half a lemon. Add a handful of ground oatmeal to the mass to make a gruel. Apply to cleansed skin and leave on for 30 minutes. Oatmeal absorbs sebum, lemon dries and whitens the skin, kefir softens the effect of lemon and nourishes the skin with vitamins. The matte effect is noticeable after the first application.
starch and cucumber juice. Mix cucumber juice with starch and apply the mass on your face. Wash off with cool water after 20 minutes.
Egg white. Protein is another effective remedy for oily skin. It can be used as independent remedy and as part of multi-component masks. Whisk the protein with kefir and lemon juice and apply on face, leave for 15 minutes. If your face feels a little tight after rinsing, apply to your skin. thin layer light cream.
Banana. This fruit contains a lot of starch, which means it will help make your face velvety and matte. Just mash the pulp of a banana with a fork or blender, apply the pulp on your face. Hold for 10 minutes, then wash with warm water.
Radish and cucumber. Radish suppresses the activity of the sebaceous glands, and cucumber nourishes and moisturizes the skin of the face. Mix the crushed pulp of vegetables with a grater and apply it on your face. Vegetable juice can be stored in the refrigerator and wiped on the face daily.

Natural masks are not only effective and absolutely harmless. They are also easy to prepare, which makes them accessible to everyone.

Oily facial skin is not a reason to be smeared huge amount powder and create the effect of a “plastered” face. A few rules for caring for this type of skin, changing eating habits, folk recipes masks and wipes will help you eliminate this cosmetic defect. Use natural remedies to combat oily skin and be perfect!

Video: what to do if you have oily problem skin

Seborrhea, dandruff, blepharitis, barley, ostiofolliculitis, folliculitis, acne, sycosis, furuncle, furunculosis, carbuncle, what do these skin disorders have in common? What unites them is that they all arise due to a violation of the secretory function of the sebaceous glands located on different areas skin cover. As soon as the sebaceous gland, for some reason, begins to release an excess amount of sebum onto the surface of the skin, it becomes an excellent food for various microorganisms (bacteria, fungi, mites), which are almost always present on the surface of the skin. Microorganisms, penetrating into the sebaceous glands, with “ good nutrition” begin to multiply actively there. For the body it foreign bodies, like a splinter that got under the skin and he begins to get rid of uninvited guests, isolating them and subsequently getting rid of the rejection of the stratum corneum or through inflammation (abscess) in more severe cases, followed by removal from the body, through pus, of their metabolic products.

Increased sebum secretion can lead, for example, to hair loss on the head and even to persistent male pattern baldness. The excretory ducts of the sebaceous glands of the scalp are dilated, the hair becomes greasy, shiny, and easily falls out.

Skin disorders of this type are more susceptible to people with choleric and sanguine temperament.

The main causes of increased activity of the sebaceous glands

1. Violation fat metabolism in the body due to functional disorders or diseases: liver, gallbladder, pancreas, intestines.
2. Endocrine disorders ( diabetes, obesity).
3. Dysfunction of the gonads. The intense secretion of sex hormones during puberty (especially the male sex hormone testosterone, which is present to some extent in both sexes) stimulates an increase in the activity of the sebaceous glands of the skin (acne usually appears during puberty).
4. Premenstrual hormonal changes.
5. Use of hormonal contraceptives or their cancellation, taking other hormonal drugs(glucocorticoids).
6. Hereditary predisposition.

Contributing factors

1. Internal “slagging” of the body caused by malnutrition and other causes, such as contaminated food and water.
2. Severe stress can disrupt hormonal balance, lead to increased manipulation of wounds and injury to the skin.
3. External factors: skin damage (scratches, abrasions, abrasions, etc.), contamination with particles of dust, coal, etc.
4. Abuse of alcohol-containing cosmetic products.
5. Overheating, excessive sun exposure, alcoholism.
6. Visiting countries with a hot climate and high levels of bacterial contamination.

For the normal secretory function of the sebaceous glands, it is necessary to provide:

1. Prevention of abuse of hot, fatty, fried, spicy, salty, sour and fermented foods. Dairy products, white bread, sweets, potatoes, meat, fish, mushrooms should be avoided. Avoid spices. At acute conditions a diet is needed that helps cleanse the body of toxins and toxins with the use of salads, sprouted grains and vegetable juices. Give preference to softer foods like rice, oatmeal, apple dessert. Almost all types skin rashes aloe juice helps. Useful herbs with a bitter taste that help cleanse the liver: gentian, barberry, honeysuckle, Baikal skullcap, rhubarb, golden seal, echinocea. You can drink tea from herbs that purify the blood: burdock (root), dandelion (root), clover. At chronic diseases softening and tonic herbs are required: marshmallow, licorice, etc.
2. Elimination of pathology gastrointestinal tract, if any: hepatitis, biliary dyskinesia, dysbacteriosis, constipation.
3. Normal operation sex glands during puberty.
4. Elimination endocrine disorders if any: diabetes mellitus, obesity.
5. Avoiding prolonged exposure to the sun or heat, excessive hot baths or saunas.
6. Avoidance severe stress, anger, irritability. To not allow prolonged depressions, repressed emotions.
7. Carrying out regular cleansing of the skin, blood, liver, large intestine (with chronic constipation).
8. Washing the skin with soap, such as dectar, at least two or three times a week.