What are its types-categories acne?

Acne is the most common dermatological problem in adolescents. It is a disease of the sebaceous glands of the skin and pore (channel) through which their content (called sebum) injected into the surface of the skin. It is caused by overproduction of sebum, blockage of this resource, while the condition is aggravated by a germ called acne bacterium propionate ,which causes inflammation. These glands are mainly present in the face (forehead, cheeks, chin) , in the back and chest, where the increased oiliness of the skin is observed.

We can divide acne into three categories. In food acne, which is dominated by the image of "puffy" skin with increased oiliness, the expanded resources, the non-smooth appearance ,with pimples (closed eateries) and blackheads (open eateries). In Inflammatory acne where painful lesions with pus prevail, redness and inflammation. End to cystic acne where the deepest lesions prevail (cysts). Acne is a chronic problem that can spread from one category to another.

What causes it acne;

Acne is usually associated with the hormonal changes that accompany the onset of puberty. The hormones that are mainly associated with acne are the androgens that lead the sebaceous glands to overproduce sebum which also brings oiliness.. That is why acne is found only on oily skin. The etiology of acne, however, is more complex, as the occlusion of the hair follicle is also involved (from keratinization disorder) and a bacterium the "propionic acne bacterium" (This is why some clinical forms of acne are greatly aided by antibiotics). Other less common causes include taking certain medications, especially steroids. (eg anabolic doping or cortisone), the use of inappropriate cosmetics, professional acne (to workers who come into contact with mineral oils), the tropical acne (to workers in areas with excessive heat and humidity)

Common acne. The psychosocial and psychological effects of the disease

THE acne is a very common disease and the possibility of causing significant psychological effects was first described at least before 55 years.
"There is no disease that causes greater psychological trauma, inability to adjust between parents and children, general insecurity and feelings of inferiority and greater mental pain than, what common acne. "

1. Acne and treatment of acne scars is the main reason for visits to a dermatologist.

2. Although in most cases it occurs in adolescence (70% -87%), can often continue into adulthood.

3 Acne can affect any age group, and those with post-adolescent acne are the ones who increasingly visit a dermatologist looking for a cure. In a study almost the 18% women were found to have late-onset disease, starting after their age 25 years.

4.The number of adults with acne seems to be increasing, although the reasons are unclear.

5. Although acne seems to be just an aesthetic problem, however its effects can be much more serious, and cause a heavy emotional and psychological burden on patients.


Adolescent acne

Adolescents are psychologically more vulnerable. They are sensitive to the changes that occur in the body and their appearance. Acne mainly affects young people at a time when they are suffering the most, social and physical change. Studies have shown that acne seems to reduce the quality of life of adolescents and affect their overall self-esteem.. 30% -50% Adolescents experience psychological problems associated with their acne, and although the interaction is complex it may be related to developmental issues of body image, socialization and sexuality.
Acne is the most common skin disease in adolescents. Unlike most other dermatological conditions it can be limited to areas covered by clothing, acne is often visible on the face affecting even more issues related to body image and socialization. Hence, It is not surprising that a vulnerable person with facial acne can develop significant psychosocial disability. Many acne patients have problems with their image and interpersonal relationships. The effects are exacerbated by teasing or sarcasm, criticism of others and the feeling of being on the sidelines. Often ,Embarrassment is a prominent response of acne patients. They usually experience social stress and generally can avoid activities that focus the attention of others on their situation.. These feelings are often associated with the fear of criticism of their face and the social ideal of perfect skin makes their appearance the most important factor.. Adolescents with acne feel uncomfortable and avoid eye contact, lengthen their hair to cover the face and girls often use makeup to minimize the appearance of acne. Studies have shown that acne can significantly affect the choice of clothing in adolescents with acne.

Effects of acne depending on the severity

The relationship between the severity of acne and the emotional discomfort it causes is poorly understood. A student study showed that acne patients experienced a worsening of their disease during examinations. An increase in the severity of acne was significantly associated with increased stress levels (p <0,01) .In a recent survey in which questionnaires were used (questionnaire-based) held between 1.560 Adolescents in Greece found a positive correlation between acne and stress reported by the respondents themselves (P <0,0001) .

It is generally believed that there is a linear relationship between the clinical severity of acne and the deterioration of quality of life. However, This deterioration also depends on a person's ability to cope with various problems as there are people with an objectively minor acne problem who may experience severe subjective dysfunction., and greatly affect their quality of life.17 Thus, Acne can have a devastating effect on patients' lives, often independent of its severity.

THE heavy acne is associated with increased depression, anxiety, poor self-esteem and poor self-esteem.19,20 Psychiatric symptoms are more common in more severe acne and in the advanced stages of adolescence.
THE acne is associated with an increased risk of depression, anxiety and suicidal tendencies and there are some interesting differences between the sexes.
It has been suggested that patients with moderate to severe acne suffer from poor body image, low self-esteem, social isolation and restriction of activities. As an emotional impact, increased levels of stress have also been reported, anger, depression and frustration. In study 615 school children with acne, teenage girls found to be more vulnerable than boys to the negative psychological effects of acne, and stress levels were higher.27 Given the fact that acne causes psychological pain, can also affect the social, professional and academic performance of adolescents.
In addition, suicidal ideation (about 6% -7% in patients with acne) and suicide attempts associated with the negative psychosocial effects of acne have also been reported. 480 patients with various skin conditions revealed that the highest incidence of depression and suicidal ideation was found in patients with severe forms of acne and severe psoriasis, while patients with mild to moderate acne were on the same level as those with atopic dermatitis, moderately severe forms of psoriasis and gyroid alopecia.
Acne mainly affects the quality of life, and there is not always a correlation between the severity of acne and its impact on quality of life. The magnitude of anxiety and depression is proportional to the degree of deterioration in quality of life due to acne. Patients with greater social sensitivity experience poorer quality of life compared to other patients with the same severity of acne. Anger, similarly, associated with poorer quality of life and less satisfaction with treatment, independent of other variables.
Studies on the psychosocial effect of acne have shown dissatisfaction with appearance, the embarrassment,self-esteem and lack of self-confidence in acne patients. Social dysfunction has also been observed, including concerns about social relations with the opposite sex, public appearances, interaction with strangers and business opportunities.In addition, Acne is associated with stress, depression, Anger and decreased physical satisfaction. It has been shown to be negatively associated with the intention to participate in sports and exercise., perhaps as a result of the fear that acne patients experience about the criticism they will receive from those around them. In a study among students in Scotland, the 10% avoided swimming and other sports, due to the embarrassment caused by acne. Acne has also been shown to adversely affect school and extracurricular activities. Self-esteem issues are also likely to lie behind higher unemployment rates among acne patients, however there is also a bias according to which acne patients are more likely to be rejected by a prospective employer. There are also studies that report that up to 20% Adolescents with acne have trouble building relationships because of their acne, or express concerns about socialization, their appearance in public places and their contact with the opposite sex. Acne and its effects on the appearance and therefore on the self-confidence of patients seem to be related to depression, the social withdrawal and anger they experience.

It can create a vicious circle: It is not just acne that can lead to emotional distress, but the stress caused to an acne patient can worsen the skin condition itself at a time when patients are less able to deal with extra stress..
During adolescence, the incidence of acne increases with age and growth. To the girls, The onset of menstruation is associated with an increased incidence of acne. The only relationship between sex and acne according to the literature is that quality of life and sexual satisfaction deteriorate in women with polycystic ovary syndrome and acne.
The effect of acne on a particular patient is not always easy to assess clinically. It has been reported that both women and men find the effects of acne on appearance to be the most annoying aspect of their disease and the negative effects of acne occur in both older and younger patients.. Even mild acne can be a major problem for some patients, deterioration of their quality of life and, in some cases, of their social functionality.

Reducing the psychosocial effects of acne

Acne is not a minor disease compared to other chronic diseases.53 Even if acne is not associated with serious morbidity, mortality or physical disability, However, reducing the psychosocial effect of acne is considered one of the guiding principles for the clinical management of acne.. Effective and safe acne treatments are available today, but there are still many who do not consider acne a problem that needs to be treated. All of the above effects of acne highlight the importance of immediate and proper treatment as well as psychiatric control and support for acne patients.. Improving acne, after proper treatment has been shown to lead to increased self-esteem, self-confidence and social functionality.

The social, psychological and emotional damage that can result from acne, especially in its most severe clinical forms, has been reported to be similar to that associated with epilepsy, asthma, diabetes, Musculoskeletal pain or arthritis. Patients may be more prone to depression, the stress, social withdrawal and anger, without taking into account that acne scars can lead to lifelong self-esteem problems.


What role does diet play in acne;

Contrary to many people's beliefs, diet does not cause acne. That's why no diet ,as strict as it is, It is not going to "cleanse" a person suffering from acne. However, patients with acne report that their acne is aggravated by eating certain foods.. Sugar and simple carbohydrates can trigger acne. The foods to look out for are::


– Fatty foods such as Potato Chips, Pizza, French fries and cookies

– White bread, pasta and potatoes (foods rich in starch)

– Carbonated soft drinks (a lot of sugar)

– Probably dairy products


These foods increase blood glucose levels, resulting in insulin secretion. Insulin promotes increased oiliness of the skin and thus clogs the pores.

also, Sudden weight gain can make acne worse.


What is the best treatment for her acne;

Every acne patient should be treated as a separate case. In general, however, for one mild acne local treatment is sufficient (along with some changes in the way of facial care), while in moderate and serious Acne needs systematic treatment (pills) the / and a combination of local and systemic treatment. In cases of acne that exists hormonal problem which causes and aggravates it, this must definitely be addressed first, otherwise acne treatment will never be effective enough.

Photobionic treatment of acne with its system KLOX

The biophotonic treatment system of the Canadian company KLOX is a new pioneering treatment for the treatment of serious cases of acne. It is aimed at serious cases of acne who do not want to be treated with isotretinoin pills (Pill therapy requires monthly laboratory tests, dietary restrictions and avoidance of alcohol intake. also, avoid pregnancy for 1 time at least). On the contrary the treatment with “light bulb” of KLOX (Multi-LED lamp that produces blue light with a wavelength of 446nm) uses a chromophore gel (which acts as a wavelength converter) which converts the blue light emitted by the lamp into a blue range, green yellow and red light wavelengths which cause the release of oxygen free radicals which act therapeutically. Blue light also kills acne bacterial propionate by activating bacterial porphyrins. This treatment does not require the controls and restrictions that isotretinoin pill therapy has and can be done at any age..

The treatment lasts overall 12 weeks (24 therapeutic sessions)and requires two sessions per week (which must be time apart, eg Monday and Thursday) ,while each session lasts just 30 minutes!


I pay a lot of attention to my cleanliness and I wash my face morning and night. Because the acne he insists on me;

Acne is not caused by poor skin cleanliness! So washing your face alone can not cure acne. But washing the face (with special cleansers for acne prone skin) is an integral part of the treatment because it removes excess oil from the skin. If there is a greasy film on the face no topical treatment (creams, gel) can not penetrate and be effective. Also the skin is "clogged" and the acne itself worsens.

What is the role of facial cleansing in the treatment of acne?

The "deep" cleansing of the face helps a lot in the treatment of itchy acne. Cleansing may be called deep but it is not deep, is affected only the epidermis. After removing the contaminants with emulsion and lotion, facial peeling for the removal of dead cells and better extraction of sebum. With the help of steam from a special machine we proceed to the opening of the pores, with gentle movements and finish the treatment with a suitable antiseptic and soothing mask. In cases of cystic acne, we avoid deep cleansing because the pressure can lead to the opening of the cyst inwards and the movement of inflammation inside the skin.. For this reason, cleansing should only be done by a trained beautician or dermatologist. After deep cleansing, the oiliness on the skin decreases, clean the hair follicles ("resources") so the skin does not become inflamed, the skin breathes better and responds better to treatments with topical acne medications and dermocosmetics

Stress causes or worsens it acne;

Stress seems to play a role in the appearance or worsening of acne, as well as stress hormones (mainly cortisone) together with testosterone cause an increase in sebum production.


I have never had acne as a teenager. Acne can occur in adulthood;

Yes, There are forms of acne that either persist into adulthood (pre-existing severe acne during adolescence) or start from the beginning in adulthood. In cases where acne starts in old age, a hormonal test should be done (to rule out conditions such as cysts and ovarian tumors). In the case of polycystic ovary syndrome there is an increased production of androgens which lead to the appearance and worsening of acne . Many women experience an increase in acne around their age 30 years when they stop taking birth control pills because they want to have children (contraceptives did not allow acne to occur). Other causes are the use of inappropriate cosmetics (eg "heavy" cosmetics for mature skin at younger ages) which cause or worsen acne, "painting" for many hours daily ,especially if the woman does not thoroughly wash her face before falling asleep. Also overweight and obese women have increased production of androgens in excess adipose tissue (which converts estrogen to androgens)

The sun helps in acne;

Many patients report improvement in their acne during the summer months and especially during their vacation at sea.. The sun can help relieve acne thanks to its mild anti-inflammatory action. Also with tanning many of the signs of acne are hidden and a false improvement appears! Also the improvement of acne in summer can be related to other reasons such as sea water iodine, the reduced stress of the holidays Mrs.. But before deciding whether the sun really helps, we must always take into account the immediate and long-term risks to the skin of sun exposure. (increased risk of skin cancers , premature aging of the skin). In addition, most acne treatments increase the skin's sensitivity to ultraviolet radiation and should not be combined with excessive sun exposure..

What kind of cosmetics and cleansers should someone suffering from use acne;

For acne patients there are currently specialized lines of dermocosmetics which are best to look for in pharmacies. In general, we should prefer products that have the indication "non-oily products - oil free product" or "for oily skin with a tendency to acne - for oily acneique skin". This applies to all facial products such as cleansers, sunscreen, moisturizers, make up etc.

Because it is forbidden to "tease-press" the acne lesions with my hands;

We advise our patients ,as much as possible, not to bother acne lesions with their hands. This is because the pressure pushes a portion of the inflammatory contents of the lesion deeper inside the skin.. That is, we take the problem deeper into the skin! Acne is known to be more difficult to treat and the more likely it is to leave scars. (acne scars).

There is a cure for the signs (scars) which leaves the acne;

In addition to traditional treatments (dermabrasion with microcrystals, chemical peeling) Today we have specialized targeted treatments that destroy the acne scar (which is located inside the skin under the "dent" we see. This destruction is done with the fractional laser CO2 or the fractional RF (radiofrequency) either by microneedling. In the same session we apply autologous PRP mesotherapy which offers growth factors for faster skin regeneration. The treatment of this serious aesthetic problem should be done when we have treated the active phase of acne and always during the months with limited sunshine.

How long do I have to wait to see the result of acne treatment;

Acne is a chronic problem and the effect of treatment may not be very immediate. It usually takes time 4 at least weeks for topical treatment to begin to show results. But even systemic treatment with pills requires a corresponding amount of time. Acne patients need to be aware of this and not rush into discouraging their treatment.

My face is cleansed. I can completely stop treating acne;

Acne treatment should be differentiated only after consultation and supervision by a dermatologist. Patients who abruptly discontinued treatment on their own initiative, found very soon with a new outbreak of their acne. The dermatologist also knows which treatments are suitable for maintaining a good result, which treatments are suitable for summer etc..

Acne and dairy products. They are related;

Research suggests that dairy products, and especially milk, contribute to the appearance and worsening of acne. Further research is needed to confirm the exact relationship between the two, however it is possible that the hormones found in cow's milk trigger the symptoms. This hypothesis is based on studies performed on milk - which contained hormones- of pregnant cows. This milk contains increased levels of progesterone and other steroid hormones that stimulate the sebaceous glands and worsen acne..

Acne and chocolate. They are related;

ΔThere is no scientifically proven study to prove that chocolate causes acne. Of course the consumption of any food that is rich in fat and sugar (high glycemic index foods), such as chocolate are associated with the appearance of acne. Cocoa on the contrary, seems to improve acne since unlike milk chocolate it does not contain butter, sugar and whole milk, but contains ingredients that help the proper functioning of hormones and the appearance of the skin. In conclusion the chocolate as food is guilty because it belongs to the category of fatty and sweet foods. The other culprits are the other foods that belong to this category. Prefer, dark and not milk chocolate or white chocolate. Health chocolate or couverture contains flavonoids (which are antioxidants) due to the cocoa it contains in contrast to milk and white.

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