There are skin diseases that are treated by both dermatologists and cosmetologists. These include something that everyone may have, something that you may not pay attention to, but that you really want to get rid of, since it affects the aesthetic appearance of the skin. So, these are problems that spoil the appearance and cause not so much physical as mental suffering. We will focus here only on the most common ones - Acne, seborrhea and various formations on the skin.

Acne vulgaris or juvenile acne

Acne– the most common skin disease in adolescents and young people, that is, the most socially active part of the population. This unpleasant disease affects about 85% of people aged 12 to 25 years in European countries, so clear skin at this age is the exception rather than the rule. The presence of inflamed pimples, pustules and ulcers, blackheads (comedones), spots and scars, a greasy, untidy appearance of the skin in the most visible places causes difficulties in communication, professional organization, reduces self-esteem, and often leads to the formation of significant psycho-emotional disorders, even the desire for complete isolation. Some young people stop leaving home, give up school and work, become isolated, and eventually a minor and completely banal skin problem develops into a personal tragedy. A patient who consults a dermatologist about acne has serious psychological problems. Shyness, guilt, a sense of social unacceptability, anger, depression, and disbelief in the possibility of a cure are expressed to varying degrees. Intense experiences aggravate the course of the disease. In stressful situations, patients, especially women, pick at the skin and squeeze out acne, which further worsens the appearance of the skin due to associated inflammation. In such injured areas, scars and spots remain that do not go away for a long time.

Acne– a long-term disease, often exacerbating (in girls, usually monthly) and often resistant to treatment. Currently, we know much more about acne than ten years ago, and a competent specialist can always help a patient. In this regard, the opinion that existed in the past that acne will go away on its own with age, and therefore there is no need to waste effort on treating it, now sounds simply absurd. It is not always possible to immediately find the right individual approach, but the efforts made and perseverance shown are always rewarded with a good result. Specialists have a number of effective medications from different groups in their arsenal. The choice of drug depends on the form of the disease, the prevalence of certain symptoms, the gender of the patient, and the presence of contraindications.

Acne is most often divided into:

1. acne with a predominance of comedones (white and blackheads with mild inflammation);
2. papulopustular acne (there are comedones, inflamed nodules - what are usually called pimples, pustules, sometimes single large painful lumps, gradually turning into ulcers such as boils);
3. conglobate acne (along with all of the above, there are long-term painful lumps that leave pronounced scars after healing).

Over time, most patients develop the habit of squeezing out comedones and pustules, constantly touching the inflamed skin, which is why bloody crusts, spots, and superficial scars are added to everything described.

Many factors take part in the development of acne, the action of which is ultimately realized in the pilosebaceous follicles. Not all follicles are affected, but only those with a special structure, located on the face and in the upper part of the 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 especially actively in adolescence, the size and number of sebaceous glands increase significantly, the production of sebum increases, and its composition changes. In addition, in the development of acne, disruption of the keratinization of the sebaceous gland ducts, difficulty in the outflow of sebum to the surface of the skin, increased proliferation of microbes in accumulated sebum and subsequent inflammation are essential. With the help of modern medicines it is possible to influence almost all factors involved in the development of the disease.

At 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 blackheads), and there are not many inflammatory elements, preparations of retinoic and salicylic acids are used externally. Both acids have the property of dissolving comedones, and salicylic acid has a much weaker effect in this regard. For papulopustular acne, it is advisable to use antibiotics, retinoids, benzoyl peroxide (benzoyl peroxide), traditional external agents (salicylic, chloramphenicol, resorcinol alcohols). Severe forms of acne, including conglobate acne, should be treated with retinoids prescribed orally, and only if there are contraindications, other treatment methods (antibiotics, immunomodulators) should be used. As with papulopustular acne, it is preferable to use a combination of different drugs.

Problems solved during the treatment process and ways to solve them:

• reduction 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);
• preventing the appearance of scars (early initiation of treatment, retinoids, curiosin, contractubex, avoiding trauma 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 sebum production and inflammation, preventing the appearance and elimination of comedones and scars. Two isomers of retinoic acid (tretinoin and isotretinoin) are used for external treatment of acne. For the internal treatment of conglobate acne and common papulopustular acne resistant to other external agents, Roaccutane and Retinol palmitate are used.

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

Retinol palmitate(vitamin A) is a domestic drug, it is produced in capsules for oral use at 33,000 and 100,000 IU, as well as in an oil solution at 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 in effectiveness to Roaccutane, however, it is better tolerated and the cost is significantly 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), Lokatsid – 0.05% cream in tubes of 30 g and 0.1% solution in 15 ml bottles (“Pierre Fabre”, France). External preparations with 13-cis-retinoic acid, which has higher bioavailability, are produced only in Russia - Retinoic ointment 0.1% and 0.05% and Retasol ® (FNPP "Retinoids"). It is recommended to apply ointments and solution to previously cleansed skin 1-2 times a day. Once the effect is achieved, it is recommended to reduce the concentration or reduce the frequency of application of the drug. Duration of treatment is 12–16 weeks.

Drugs from the retinoid group have a number of side effects. The most serious of them are teratogenicity and embryotoxicity. In this regard, women of childbearing age are prescribed retinoids with reliable contraception and a negative pregnancy test. In the outpatient card, when prescribing systemic treatment, a note is usually made about the woman’s awareness of possible side effects, and abroad, dermatologists offer women to fill out and sign a special form in order to avoid further prosecution in the event of side effects. External treatment with drugs of this group is stopped when pregnancy occurs. Retinoids do not have a negative effect on the reproductive function of men.

In the first or second week of treatment, most patients experience an exacerbation reaction, expressed in redness, moderate itching, and peeling of the skin. The patient should be warned about the reaction, and if he is facing important life events at this time, then it is better to postpone the start of treatment. Typically, these phenomena go away on their own within a few days, after which a lasting improvement occurs. Dry lips, cracks in the corners of the mouth, peeling of the skin are common during the treatment process; they are eliminated by using a neutral moisturizing cream for the face and body, hygienic lipstick or lip gel, and limiting the use of detergents when washing and washing. With systemic administration of retinoids, dry nasal mucosa, nosebleeds, conjunctivitis, urethritis, increased levels of transaminases and lipids in the blood, and increased sensitivity of the skin to sunlight are sometimes observed. Taking this into account, before the start of treatment and monthly during treatment, a biochemical blood test is performed, it is recommended to use sun protective creams, and avoid direct sunlight.

Contraindications

pregnancy and lactation, abnormalities in biochemical blood tests (hyperlipidemia, increased activity of ALT, AST and alkaline phosphatase), renal and liver failure, hypervitaminosis A, drug intolerance. Retinoids cannot be prescribed simultaneously internally and externally, ultraviolet irradiation, drugs with keratolytic and exfoliating effects, exfoliating cosmetic procedures and products (scrubs, peeling). The effect of retinoids is weakened by the simultaneous use of glucocorticosteroid drugs and alcohol intake.

Antibiotics

Of the wide range of antibiotics used to treat acne, only tetracyclines, erythromycin, lincomycin, josamycin and clindamycin are used. Prescription of antibiotics orally is indicated when a large area of ​​skin is affected, with a predominance of pustules. During pregnancy, only erythromycin can be used among these drugs.

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 prescribed for a 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. A significant advantage of this method is the possibility of long-term treatment without disturbing the composition of the 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 is 50 mg (1 capsule of 0.05 g once a day), Unidox Solutab is 50 mg ( 1/2 tablet of 0.1 g), metacycline - 600 mg (2 times a day, 0.3 g). Antibiotics of the tetracycline group in 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, and kidney disease. During treatment, insolation is not recommended, ultraviolet irradiation, retinoids for internal use, hormonal contraceptives, psychotropic, anticonvulsant and antidiabetic drugs are not prescribed. The absorption of tetracycline is weakened 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 plenty of water. Unfortunately, resistance of microorganisms to drugs in this group quickly develops, and when re-prescribed they are rarely effective.

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

Clindamycin (lincomycin group) is prescribed in a daily dose of 0.6 g, divided into 2 doses, available in capsules of 0.15 g and under the name Dalacin C - 0.15 and 0.3 g. 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 B vitamins. Lincomycin is prescribed in a daily dose of 1500–2000 mg (2 tablets 3–4 times a day), available in capsules of 0.25 g. The duration of treatment and side effects are similar to clindamycin.

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

If antibiotics are intolerant, they resort to sulfonamide drugs, usually co-trimoxazole (Biseptol, Septrin, Groseptol, Cotripharm 480). The drug is prescribed 480-960 mg (1-2 tablets) 2 times a day during or after meals with an interval of 12 hours. During treatment, it is recommended to drink plenty of fluids, monitor the condition of the blood and urine, avoid solar and ultraviolet irradiation, and do not prescribe ascorbic acid.

It is logical to assume that local use of the above antibiotics may be much more effective and safer than internal use. However, research shows that topical use of erythromycin, clindamycin and tetracycline is effective only for mild acne, especially in combination with zinc, retinoids or benzoyl peroxide. External use of 1% erythromycin ointment (Ung. Erythromycini 1%) has a positive effect only in combination with other external and internal agents; gel with clindamycin Dalacin T (Pharmacia, USA) is more effective. Easy to use Eryderm (Abbott Labor, USA) – 2% solution of erythromycin. Levomycetin, boric, and resorcinol alcohols are also used to dry and cauterize individual rashes. Combination preparations that are effective are Zinerit (Yamanouchi, Netherlands) - a solution of erythromycin and zinc acetate and Benzamycin, gel for external use, in 20 g tubes (Rhone-Poulenc Rorer, USA), containing 3% erythromycin and 5% benzoyl peroxide. All of the above drugs are prescribed 2 times a day. Like antibiotics prescribed orally, external medications tend to cause the development of antibiotic-resistant strains of microorganisms, so their repeated prescription is often ineffective. Resistance of Propionibacterium acnes strains (the main microorganism that multiplies in the sebaceous glands of patients) to commonly used antibiotics was found in 60% of patients. Increased resistance depends on the duration of therapy; resistance to erythromycin develops more often.

Other antiseptics and disinfectants. One of the successful modern approaches to treatment is the use of benzoyl peroxide, a lipophilic compound due to the presence of a benzoic acid residue in its composition. Benzoyl peroxide applied to the skin breaks down under the influence 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, and the content of fatty acids decreases, which prevents inflammation. At the same time, the same compounds also have a damaging effect on the horny scales, which is clinically expressed by peeling of the skin that accompanies the therapeutic effect. Benzoyl peroxide preparations have no effect on comedones, so they are not used if they predominate. Various companies offer this drug under the names Benzacne (Polfa, Poland), Desquam (Bristol-Myers, USA), Oxy 5 and Oxy 10 (SmithKline Beecham, UK), Baziron (Galderma, France). Benzoyl peroxide is available in the form of 2%, 5%, and 10% gel, 5% and 10% lotion. Treatment begins with applying a lower concentration of the drug to the face, then it is increased. A higher concentration is immediately applied to the back and chest. 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 underwear when the drug comes in contact with them. Intolerance is common, so before starting treatment it is recommended to conduct a skin test - the drug is applied to a small area of ​​skin on the flexor surface of the forearm for 48 hours. If there is no itching or redness, you can apply the drug to your face.

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

Azelaic acid inhibits the growth of microorganisms and reduces the content of free fatty acids on the skin surface. Skinoren cream or gel (“Schering”, Germany), containing 20% ​​and 15% azelaic acid, respectively, is applied to the facial skin (both affected and rash-free areas) 2 times a day. When used, local skin irritation is possible. Skinoren is used in the complex treatment of 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 effect. It can be used for a small number of rashes, since the effectiveness of the drug is low. The gel is applied to cleansed skin twice a day; a burning sensation and redness of the skin at the application sites are possible.

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.

For a small number of comedones in the initial stage of the disease, salicylic alcohol 2–3% is effective. It is used 2 times a day, being careful not to apply to the entire affected area to avoid drying it out, but only to individual areas.

Sulfur is an anti-inflammatory agent; it is included as one of the components in most external agents (ointments and mash) traditionally used in the treatment of acne. However, in recent years, its comedogenic effect has been discovered, i.e. it can cause the formation of comedones.

Hormone therapy

Sex hormone therapy is only possible for women. Estrogens (ethinyl estradiol) and antiandrogens (cyproterone acetate, spironolactone) can be used for treatment. Estrogens reduce the secretion of sebaceous glands, although not as significantly as retinoids. They can be used simultaneously with topical retinoic acid, antibiotics or benzoyl peroxide, which increases the therapeutic effect. To achieve a good result, estrogens must 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. Estrogen has many side effects - nausea, fluid retention in the body, swelling of the legs, weight gain, breast tenderness, skin pigmentation, increased risk of vascular thrombosis. Risk factors for side effects include smoking, alcohol consumption, obesity, and vascular diseases. Cyproterone acetate for the treatment of acne is used only in combination with estrogens. Among the combined drugs, 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 Androcur (“Schering”, Germany) is prescribed 1 tablet (10 mg) per day, starting from the first day of the cycle for 15 days, a new course begins 4 weeks after the start of the first. Glucocorticosteroid drugs are prescribed orally or parenterally only for abscess and fulminant acne, which is extremely rare. External use of corticosteroid ointments is not indicated.

Drugs of other groups

Zincteral (Polfa, Poland) contains zinc sulfate, a 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. There may be nausea in the first week of use. The drug enhances the effect of retinoids, but weakens the effect of tetracyclines. Homeopathic treatments include injections of Cutis compositum or Traumeel (Heel, Germany). Herbal medicine is still widely used as an auxiliary means - applications of badyagi pulp for resorption of individual large nodes, lotions with green tea, calamus rhizome, raspberry shoots. Infusions of plants with estrogenic effects (hop cones, sage leaves) are prescribed internally.

Skin care

Many patients, feeling increased sebum secretion, characteristic of acne, try to wash their face as often as possible with soap and a sponge. At the same time, the skin dries out, but sebum secretion does not become significantly lower, since fat is washed out only from the surface of the skin, without affecting the sebaceous glands themselves, located in its depths. In this regard, frequent washing of the skin (no more than once a day), or the use of sponges and washcloths is not recommended to avoid irritation and injury. Many people now use antimicrobial soap. But it changes the state of the microbial flora only on the surface of the skin and does not have a significant effect on the course of the disease. At the same time, antimicrobial additives contained in soap can cause irritation or allergic reactions. To cleanse the skin, it is better to use soft neutral soap for sensitive skin or special cosmetics 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, use cosmetic wipes or special mattifying wipes means. The widely held belief that decorative cosmetics should not be used for acne has also now been revised. Modern high-quality cosmetics that do not irritate the skin, mask existing defects well, do not significantly disturb sweating, and are not applied to the skin in a thick layer and can be used during the day. It should be removed at home. Some medications 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.

The use of therapeutic masks with a 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 cleansing of the skin are contraindicated.

Diet

Both in the past and now, most dermatologists always recommend following a fairly strict diet. Our long-term observations have shown that the benefit of such restrictions is small, and only in a few patients there is a clear connection between eating certain foods (mainly chocolate) and increasing rashes. We usually recommend that patients adhere to a reasonable diet, without excesses, and include more fermented milk products and greens in their diet. However, 2-3 days of fasting during an exacerbation always gives a 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 stop taking oral medications for 2-3 days and prescribe enterosorbents (Polyphepan, Enterosgel, etc.).

• Initial stage - a few small black dots appear on the nose and forehead (usually in children) - Salicylic alcohol, Retinoic ointment, Skinoren, medicinal cosmetics.
• The same, but for significantly oily skin - Retinoic ointment, Salicylic alcohol.
• Numerous black spots and individual inflammatory nodules and pustules - Retinoic ointment, Salicylic alcohol, on pustules - alcohols with antibiotics, Dalatsin 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 internally (Roaccutane, Retinol palmitate), externally - benzoyl peroxide, disinfectants.
• Individual large painful ulcers on the face - antibiotics, externally - antibiotic ointments and benzoyl peroxide.

Seborrhea and seborrheic dermatitis

In recent years, what was previously united by one term “seborrhea” has begun to be divided into 2 concepts – seborrhea of ​​the head and seborrheic dermatitis (damage to smooth skin).

Seborrheic dermatitis– chronic inflammatory skin disease. It affects 1-3% of adults (mostly men). Seborrheic dermatitis, along with acne, is a disorder of sebum secretion. Indeed, both diseases are often combined in the same person and affect the same areas of the skin - the so-called “seborrheic zones” - the face, chest (décolleté area) and the middle part of the back along the spine (interscapular region), where the largest sebaceous glands with wide ducts that secrete large amounts of sebum. 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 it contains contribute to increased keratinization, which corresponds to peeling visible to the eye. Smaller glands, but also secreting large amounts of sebum, are located on the scalp. Their purpose is to provide fat lubrication to the hair and make it invulnerable to external influences. These glands also become more active during puberty. In adolescents and adults, the mildest form of seborrheic dermatitis is characterized by flaking of the skin and its excess oiliness without inflammation - on the scalp it is dandruff, and on the face and chest - accumulations of fatty scales in the 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. Fatty 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 reacts to them with the development of allergic dermatitis, the disease enters its second, more unpleasant phase, and is no longer limited to mild manifestations. Itching, burning, at first mild, then more intense redness of the skin, severe peeling, and hair loss appear. The manifestations of the disease are aggravated by the patients themselves - constant scratching, 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 proliferation of other microbes, and the development of complications of the pustular process. It is usually in this condition that patients turn to a dermatologist, although everything could have been corrected much earlier.

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

Treatment depends on the stage of development and clinical picture of the disease. If dandruff appears without 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 antifungal agents. Antifungal drugs are usually the starting point for treatment and can be used long-term without the risk of side effects. Various dosage forms are used - creams, gels, shampoos. Shampoos with antifungal substances - Nizoral, Keto-plus, Perhotal, Mycozoral, Sebozol contain 1-2% ketoconazole. Ti/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 other medicinal substances that also have antifungal properties include zinc pyrithioneate, tar, sulfur, resorcinol and selenium disulfide. Medicines containing these compounds are available in the form of shampoos for the treatment of dandruff (Friderm-tar, Ti/Jel-Newtar, 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 milk, alcohol solutions with sulfur, boric acid, tar. After hair treatment, it is necessary to change combs, hair brushes, and hats.

For severe inflammation, anti-inflammatory, antiseptic and disinfectants are used. For weeping and severe swelling of the lesions, lotions with resorcinol 1% and herbal decoctions are used. The crusts are usually lubricated with alcohol solutions (salicylic, resorcinol, boric alcohols). 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-Cilag Belgium), Belosalik (Belupo, Croatia), on seborrheic areas - in the form of ointments and creams - Elokom, Diprosalik, Belosalik, Hydrocortisone ointment. It should be noted that on the skin of the face, which is much thinner than in other areas, only non-fluorinated glucocorticosteroids can be used in the form of easily absorbed creams and emulsions (Advantan emulsion, Elokom cream, Lokoid cream) or weak (Prednisolone, Hydrocortisone) ointments. Drugs in this group are not suitable for long-term use due to the risk of unwanted effects - thinning of the skin, dilation of blood vessels, appearance or worsening of acne. When it is possible to relieve acute inflammation (usually in 3-5 days), and with residual peeling, they are replaced by drugs 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 ® – 1% retinol palmitate, ergocalciferol and tocopherol acetate (vitamins A, D and E). The 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 treatment. Keratolytic agents are used for severe peeling and crusting. Apply sulfur-salicylic ointment 2-5% 1.5-2 hours before washing hair under a scarf, on the face - 1 hour before washing, 10% ointment with urea Carboderm (Ukraine). A particularly good effect is brought by combination drugs 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 sebum production in women, hormone therapy (Diane-35, Janine) and antiandrogens (Androcur) are used - see above. Despite successful therapy, the disease often recurs. A rational approach to diet and careful selection of skin and hair care products are necessary to maintain a favorable treatment result for as long as possible.

prof. V.I. Albanova

Sebum plays an important role: it protects our skin from pathogenic bacteria, and also protects it from losing excess moisture. But it happens that the sebaceous glands produce excess sebum. Why does this happen and how to get rid of unpleasant oily shine?

How to get rid of excess sebum

Increased sebum secretion: causes

There may be several reasons for malfunction of the sebaceous glands:

· poor nutrition. Usually, changes in the state of skin secretion directly depend on the amount of sweet and starchy foods in your diet. It is worth reducing the consumption of these products, and the condition of the skin improves significantly;

· improper washing. It seems that by washing our face more often, we cleanse our skin of harmful bacteria and its condition should improve. However, this does not happen. The fact is that by our actions we force the sebaceous glands to work more intensely. To maintain the skin in normal condition, two washes are enough: in the morning and in the evening. During the day, excess sebum can be removed using mattifying wipes;

· incorrect rhythm of life. Problems at work, loans, problems in your personal life - all this has become the norm for a modern person. Meanwhile, frequent stress and overwork negatively affect the condition of our body and especially the condition of the skin;

· improper metabolism. Some diseases can cause metabolic disorders in the body. It is important to consult a specialist in a timely manner and not self-medicate.

Having learned more about the reasons for increased sebum secretion, let's talk about how to deal with it.

How to reduce sebum on face

Decoctions of medicinal herbs help bring the skin into good condition due to the tannins, beneficial acids and trace elements they contain. By rubbing your face every morning with an ice cube made from a decoction of chamomile, calendula or green tea, you can quickly improve skin tone and tighten pores.

Regular use of simple cosmetic masks will significantly improve the condition of oily skin:

· Mix blue clay with water until it reaches the consistency of sour cream. Apply to cleansed skin and leave for about half an hour. Wash off without using soap;

· In a bowl, beat one egg with a couple of drops of lemon juice. Add oatmeal. Keep the resulting mixture on your face for 20 minutes;

· Grind the cucumber to a paste and mix with two tablespoons of aloe juice. Apply the mask with massaging movements and leave for 20 minutes. Rinse off with cool water. Zucchini can be used instead of cucumber.

The tips discussed above really help improve your skin condition. However, they only fight visible signs and give temporary results. To normalize the functioning of the sebaceous glands, it is necessary to eliminate the cause of the malfunction in the body. Remember that only a dermatologist should do this.

Oily skin is one of the common skin types, which is characterized by excessive activity of the sebaceous glands, a rough, loose texture with enlarged pores, an unhealthy color and an oily sheen. It should be noted that this is one of the four existing types of dermis, i.e. a variant of the norm, and not as a separate disease.

Very often comedones (blackheads), acne, sebaceous gland cysts, seborrhea appear on such skin, i.e. there is a tendency to these negative phenomena, but oily skin does not mean problematic skin; with proper care, all these troubles can be avoided.

Oily facial skin - causes

• Genetic predisposition. In this case, the dermis does not change throughout life and remains oily, but such cases are few, only 5-8% of all cases.
• Adolescence. Most often, teenagers are the owner of this feature, but by the age of 25-30, oily skin turns into combination skin.
• Increased work of the sebaceous glands. This may be due to hereditary predisposition, disorders of the gastrointestinal tract (cholecystitis, colitis, constipation), hormonal changes, nutrition (indulgence in spicy, fatty, starchy foods, alcohol, soda), work in conditions of elevated temperatures and dust, exposure to cigarette smoke, sunlight radiation.
• Hormonal reasons. Oily skin is typical during puberty, the second phase of the menstrual cycle, menopause, pregnancy, and prolonged stressful situations. It also happens against the background of hormonal treatment or long-term use of oral contraceptives, as well as abrupt cessation of taking hormones.
• Endocrine system disorders. With hypothyroidism, there is a general dryness of the skin and oily dermis on the face.
• Immunity disorder. A decrease in the body's immune defense can also manifest itself as this symptom.
• Improper hygiene care: aggressive cleansing of the skin with alcohol-containing cosmetics and scrubs, constant degreasing of problem areas, use of fatty creams, etc. Removal of the surface lipid layer leads to even greater compensatory work of the sebaceous glands. Frequent exfoliation injures the epidermis and activates the production of sebum, which is produced to protect the damaged surface. Oily creams clog pores even more and mix with sebum. Therefore, you should start looking for the answer to the question of why facial skin is oily from yourself.

Diseases in which one of the symptoms is oily skin:

• diabetes mellitus is a multisystem pathology that affects all organs and systems;
• cachexia, wasting in women– lack of building material for the synthesis of female hormones, against the background of which the level of male hormones increases;
• obesity – oily skin as a result of poor nutrition and excessive sweating;
• ovarian tumors, polycystic ovary syndrome– the phenomenon, again, is a consequence of increased levels of male hormones;
• hyperandrogenism in men– increased levels of male hormones in representatives of the stronger sex against the backdrop of a passion for bodybuilding, sports and the use of synthetic testosterone for muscle growth;
• hypertrichosis is a disease characterized by excessive hairiness and changes in hormone levels, which, again, causes oily skin;
• liver diseases, such as fatty degeneration, hepatitis, since the liver performs an intoxication function, including removing excess hormones. A characteristic symptom is oily skin of the nasolabial folds and forehead.

When to see a doctor

Actually, you should consult a doctor in all cases when such a symptom occurs for no apparent reason, especially in adulthood. All complications require treatment - boils, carbuncles, phlegmon.

The fact is that sebum is an excellent breeding ground for the development of bacteria, especially Staphylococcus aureus, propionobacteria and streptococcus. By causing local inflammatory processes and actively multiplying, bacteria can infect healthy tissues and spread throughout the body, causing an extensive infectious process that can be fatal.

Characteristics of oily and combination skin

Localization

Most often these are the T-zones on the face: forehead, chin and nose. On the body - back and chest. Often accompanied by oily hair.

Appearance

Oily, thickened, rough, unkempt and shiny and uneven surface of the skin, with a grayish, dull color. Often the appearance resembles an orange peel - the pores are clearly visible and, with proper care, practically gape or are filled with liquid fat. With insufficient or improper care, pores become clogged - comedones, as well as acne and milia, form. Seborrhea and thaleangiectasia are possible.

Oily skin has its advantages: the constantly present natural oily mantle protects the skin from adverse external influences, prevents photoaging and loss of elasticity. It has been proven that people with this type of dermis age more slowly - wrinkles appear later and are less noticeable.

What should those with oily skin do?

• First of all, the negative influence of aggressive and inappropriate cosmetics and cleaning methods, which we discussed above, in the causes of the problem (alcohol-containing products, frequent peeling, etc.) is eliminated to the maximum.
• Fatty, fried, salty, smoked, pickled and sweet foods are excluded from the diet, or at least limited.
• The basis of the diet should be lean fish, white meat, veal, vegetables, fruits, bran.
• Under no circumstances should you go to bed with decorative cosmetics on your face. Ideally, you should cleanse your face immediately after returning home.

How to get rid of oily skin on the face - treatment

The solution to this problem is always complex, and there is no universal tablet that would normalize the condition of the skin. Treatment always begins with a blood test (for sugar, hormones), studying hereditary predisposition, medical history, etc.

How to care for oily skin

Daily care has several goals:

• removing excess sebum (but not overdrying);
• opening and cleansing pores;
• decreased activity of the sebaceous glands.

Care for oily skin can be divided into professional care, which is carried out in beauty salons and beauty salons, and home care, which is available to everyone.

Home Remedies for Oily Skin

Like any other type, oily skin needs cleansing, moisturizing and nourishing.

• You should wash your face 2-3 times a week using a special mousse, foam or gel for oily skin. These products have a sebum-regulating and cleansing effect, eliminate inflammation without overdrying.
• When cleaning, do not use various washcloths, sponges, as well as alkaline soap and too hot water. Initially, the effect will be very good, and the cleansed dermis will delight you with matteness. But after 10-15 minutes the oily sheen will appear again, because... both hot water and mechanical stress further stimulate the activity of the sebaceous glands. It is ideal to do everything with your fingertips or a cotton pad, without fanaticism, using warm or cool water.
• Instead of water, you can use an infusion of herbs: chamomile, mint, nettle, linden blossom, or use bottled water.
• After washing, the face is dried naturally and treated with a suitable tonic or lotion.
• The final step is to apply cream for oily or combination skin. A good cream has a light texture, absorbs quickly, leaves no residue and must protect against UV radiation.
• Deep cleansing - peeling - can be done once a week. But for cleansing, it is not recommended to use scrubs in the form of compositions that need to be applied to the skin and actively massaged. It is better to use film masks that effectively remove fat, dead epithelium, dirt, without injury or activation of the sebaceous glands.
• 1-2 times a week you can make homemade masks for oily skin from green or blue clay, which have an adsorbing effect, as well as fruit masks based on apples, kiwi, with the addition of lemon juice, which help normalize the functioning of the sebaceous glands. Oil from raw potato pulp has a positive effect.
• Weekly lotions with sea salt, which are made using melt water (1 teaspoon of salt per 500 ml of water) and left for 5-10 minutes, have a good effect.
• You should choose decorative cosmetics with special care, especially foundation and makeup base - the products should also be light, quickly absorbed and easily washed off. It is best not to use foundations and powders.
• During the day, you should not touch your face with your hands, because... dirt and bacteria from their surface easily penetrate the pores and aggravate the situation.

The salon care procedure includes the following steps:

• removing makeup using special bactericidal emulsions;
• cleansing and toning with tonics and lotions;
• deep cleansing of facial skin and elimination of hyperkeratosis using one of the following methods:
  • Enzyme peeling – cleansing with a special enzymatic composition that breaks down dead particles of epithelium and impurities;
  • Disincrustation - galvanic cleaning using special solutions that liquefy old comedones and blackheads;
  • Vaporization - gentle exposure to a steam jet at 40-50 C for 20 minutes, which leads to the opening and cleansing of pores, softening of dead epithelium;
  • Ultrasonic cleaning– exposure to ultrasonic waves to cleanse desquamated epithelium and comedones. Ultrasonic waves also provide micromassage, activating blood circulation and increasing tone;
  • Instrumental cleaning– cleansing the skin of comedones, blackheads and whiteheads using tools – Uno spoon, loop, Vidal needle. In rare cases, a special brush is also used, but selectively, in the most clogged areas;
  • Dry cleaning– the use of a gel with glycolic acid, which allows you to remove surface “plugs”, tighten pores, and normalize the activity of the sebaceous glands;
• application of ampoule products, various serums;
• gentle facial massage (according to Jacquet, lymphatic drainage);
• applying a mask that has anti-inflammatory, bactericidal, sebum-regulating, keratolytic and immunomodulatory effects;
• applying a special cream.

From hardware cosmetology, darsonvalization, chromotherapy, ultraphonophoresis, non-invasive mesotherapy, mud applications, biorevitalization, cryomassage have a good effect. These methods dry the skin, improve microcirculation and tissue nutrition, and also reduce the activity of the sebaceous glands.

At the end of the session, the cosmetologist should advise products and methods for home care and determine the frequency of salon procedures.

Drug treatment for oily skin

Preparations containing the following active ingredients are used:

• Azaleic acid– antibacterial, anti-inflammatory and exfoliating effect;
• Zinc – keratolytic effect;
• Sulfur – suppresses the secretion of the sebaceous glands;
• D-Panthenol, dexpanthenol– recovery after physiotherapy, cleansing, normalization of cell metabolism;
• Adapalene – prevention of comedones, anti-inflammatory effect;
• Benzoyl peroxide– exfoliating effect, promotes cell renewal;
• Copper – regulator of sebum production;
• Isotretinoid – breaks down the stratum corneum and inhibits fat synthesis;
• Bacteriocins and pyocyanins– metabolic products of microorganisms that increase the immune properties of the dermis and participate in its regeneration;
• Vitamins PP and group B– have a beneficial effect on the condition of the dermis, blood circulation and fat metabolism.

Hormone therapy

Prescribed for menopause (Livial, Divina, etc.), hormonal imbalance (Belara, Yarina, etc.) for course treatment (see).

Antibacterial treatment

As a rule, antibiotics are not prescribed either locally or systemically, but only in case of bacterial and purulent complications. Antiseptics and exfoliants are used for local treatment.

Phytotherapy

Prescribed for local use. Concentrated plant extracts are diluted in cool boiled water and used as a lotion for wiping after cleansing procedures.

• Chamomile extract. Has an antiseptic, cleansing and softening effect. Eliminates inflammation.
• Sage extract. Characterized by a calming, regenerating, bactericidal effect.
• Calendula. Heals damage and has a regenerating effect.
• Oak bark has a tanning, drying effect.
• Green tea extract. Has an antioxidant effect, cleanses the surface of the dermis from toxins.

Oil for oily skin

The oil is used instead of night cream, applying it in a thin layer to the cleaned surface. It would seem, how can fatty oil itself improve the condition of the dermis? Oil compositions help cleanse clogged pores from dirt and hard fat, regulate sebum production, and help cell regeneration.

• Hazelnut oil– a basic base that can be used without additives or with the addition of other oils. Cleanses, tightens pores, smoothes and restores skin;
• Grapeseed oil– moisturizes the skin and tightens pores;
• Black currant oil– has antibacterial activity, maintains skin elasticity, tones it.
• Sesame oil – normalizes the activity of the sebaceous glands and tightens pores.
• Almond oil– cleanses pores, reduces redness.
• Tea tree oil– relieves acne and normalizes the biocenosis of the dermis.
• Lavender oil mattifies the skin and has a pronounced anti-inflammatory effect.

Hazelnut oil is taken as a basis (50% of the mixture) and other oils from the list above are added to it at 10%. You can also use essential oils (sandalwood, juniper, bergamot, grapefruit, cedar), but they should be added 1-2 drops to the base oil mixture.

With proper care and a healthy lifestyle, oily skin ceases to be a problem, but rather turns into a virtue, preserving the appearance of youth of the face and protecting it from adverse external influences.

– a type of skin caused by excessive activity of the sebaceous glands and characterized by a rough texture, unhealthy color and shine. Those with oily skin face enlarged pores, comedones, sebaceous gland cysts, acne, and manifestations of seborrhea. Oily skin requires increased attention to existing problems, a certain diet, proper home and professional care (cleansing, masks, peelings, mesotherapy), and competent selection of cosmetics. To find out the causes of oily skin, consultations with a cosmetologist, dermatologist, and endocrinologist are necessary.

Among the nutritional reasons that contribute to the appearance of oily skin, one should highlight the abuse of fatty or spicy foods, as well as flour products, sweets, fast food, carbonated drinks, and alcohol. Quite often, people with oily skin suffer from diseases of the gastrointestinal tract (cholecystitis, colitis, constipation, etc.). Long stays and work in dirty and dusty rooms have a negative impact on the condition of the skin.

A typical mistake of those with oily skin is overly active and aggressive cleansing of the skin using alcohol-containing cosmetics and scrubs. Regular degreasing of problem areas of the skin with tonics and lotions only leads to aggravation of the problem: in response to the removal of the surface lipid layer, the epidermis reacts by increasing the secretion of glandular secretions. Frequent mechanical cleansing and peeling of the face causes microtrauma to the epidermis and intense sebum production. Using inappropriate creams and skin care products can also increase the problem of oily skin.

Characteristics of oily skin

Most often, oily skin is localized in the so-called T-zone, which includes the forehead, nose and chin. Externally, oily skin appears shiny, oily, unkempt, thick, and rough, and often has an uneven surface, dull color, and a grayish tint. Makeup does not apply well to oily skin; Foundations and powders remove oily shine only temporarily. Areas of problem skin are also found on the body, usually in the chest and back; Oily skin of the face and body is often combined with oily hair.

Insufficient cleansing of the skin from excess sebum leads to the fact that the sebaceous secretion, along with dead skin flakes and dust, clogs the pores and contributes to their funnel-shaped expansion. Often, oily, porous skin looks like an orange peel. In addition to excessive shine and enlarged pores, oily skin is prone to the formation of comedones (black plugs in the openings of the sebaceous glands) and milia (whiteheads), and acne. Spider veins (telangiectasia) are more often visible on it. If, against the background of increased sebum production, its qualitative composition also changes, a pathological condition such as seborrhea occurs.

Despite all the disadvantages of oily skin, it also has certain advantages. Thus, it retains moisture better, and, therefore, is more protected and less sensitive to the effects of various adverse atmospheric factors (wind, sunlight, low temperatures). Thanks to this, this skin type is less susceptible to photoaging, retains its elasticity longer, and age-related wrinkles appear later in women with oily skin than in women with other skin types.

If inflammation persists on oily skin for a long time, you should consult a dermatologist to rule out demodicosis. To find out the causes of increased oily skin, consultation and examination of a dermatologist, gastroenterologist, endocrinologist, or gynecologist-endocrinologist may be required.

Features of oily skin care

The main tasks of caring for oily skin are removing excess sebum, opening pores, and reducing the activity of the sebaceous glands. First of all, it is necessary to minimize or completely eliminate the negative impact on the skin (refuse to use alcohol-containing lotions, fatty creams, frequent skin scrubbing, etc.). It is strictly unacceptable to leave decorative cosmetics on the skin overnight. The basis of the diet of the owner of oily skin should be lean meats, fish, vegetables, fruits, bran, cereals; Spices, smoked meats, baked goods and baked goods, and sweets should be limited as much as possible. Food should be rich in vitamins, especially group B.

It is advisable to divide the actual care for oily skin into home and professional care. Daily self-care for oily skin involves cleansing, moisturizing and nourishing procedures. First of all, you need to wash your face twice a day using a special foam, gel and mousse for oily skin. As a rule, such products have an anti-inflammatory and sebum-regulating effect, but do not dry out the skin. When washing, you should not use a washcloth or sponge, or hot water, as these products will further stimulate the secretion of sebum. It is preferable to lather the skin with a cotton pad or fingertips, and rinse off the cleanser with warm or cool water. Traditional medicine recommends for oily skin washing and steam baths with herbal decoctions (chamomile, linden blossom, horsetail, mint, nettle) while taking these infusions orally.

More thorough cleansing of oily skin through cosmetic peeling can be done once or maximum twice a week. In addition to the scrub, you can use peeling-gommage to deep cleanse the skin: such film masks effectively remove dead horn cells, dust particles and excess sebum without damaging the skin. Once a week it is useful to make clay masks that have an adsorbing effect, or fruit masks that have the effect of tightening pores.

After washing your face, you need to blot it with a soft towel or napkin and wipe it with a tonic for oily skin - such products contain disinfecting, sebum-regulating and pore-tightening components. The finishing touch to daily care for oily skin is the application of a cream designed for this skin type. Typically, creams, emulsions or hydrogels for oily skin have a liquid consistency and are quickly absorbed without leaving a shiny shine.

When choosing decorative cosmetics for daytime makeup, you need to pay attention to the quality, composition of the product and recommendations for use from the manufacturers. For oily skin, it is better to choose light foundations, foundations and powders with a mattifying effect that eliminate excess shine. You should avoid using cream blush, eye shadow, and liquid eyeliner - otherwise, cosmetics may “float” on your face within a couple of hours after application.

Oily facial skin is a problem that many people suffer from. It provokes annoying shine and acne. To eliminate oily facial skin, drying cosmetics are usually used, the manufacturers of which promise a quickly achievable effect.

However, they will provide a stable result if the cause of oily skin is eliminated. Therefore, the first step in solving a dermal problem is to normalize the functioning of the sebaceous glands.

Signs and origins of oily facial skin

Oily skin is the result of overproduction of oil by the sebaceous glands. These glands are located under the surface of the skin.

Sebum is a substance made up of fats. It's not too bad as it protects and moisturizes the skin and keeps the hair on your head shiny and healthy.

Too much sebum, however, can lead to oily skin, which can lead to clogged pores and acne.

The occurrence of comedones (blackheads), fatty gland cysts, etc. is also not uncommon. The skin is similar to an orange peel because it has pores.

An undeniable advantage for people with oily skin is that wrinkles begin to appear later.

The epidermis shiny from greasy is an unpleasant phenomenon for its owners. Due to the excessive work of the fat glands, a rough, porous texture with an unhealthy tone and a greasy sheen is formed on the skin; the surface of the skin can be overdried, like parchment.

Genetics, hormonal changes, or even stress can increase sebum production.

Oily tissue on the face is localized in the T-zone: forehead, chin and nose. On the body, the greasy epidermis is located on the back and chest. The properties of oily skin also appear on oily hair on the head.

This happens for the following reasons:

1. Genetically determined. Under these circumstances, the epidermis is oily throughout life.
2. Adolescence. Teenagers are familiar with the manifestations of oily skin, which by the age of 25-30 becomes combination.
3. Intensive work of fat glands. This is associated with an inherited predisposition to oily skin, disrupted processes in the gastrointestinal tract (cholecystitis, colitis, constipation), and hormonal changes. The reason for the excessive productivity of fat on the skin surface is diet (addiction to spicy, fatty, starchy foods, alcohol, soda), work at elevated temperatures, being in a room smoked by cigarettes, under UV radiation.
4. Hormonal. This happens during puberty and the 2nd phase of the menstrual cycle. Hormonal disruption occurs during menopause, pregnancy, and stress. This also occurs due to treatment with hormones or their sudden use, or prolonged use of oral contraceptives.
5. Disorders in the functioning of the endocrine system. This occurs when, with hypothyroidism, both dry skin and oily epidermis on the face are noted.

Reduced immunity also affects the appearance of the sebaceous surface of the epidermis.

7 diseases that cause oily skin

The doctor will be able to find out why the patient’s facial skin is oily. Because sebaceous epidermis also appears in patients:

• diabetes mellitus;
• cachexia (exhaustion);
• obesity;
• with tumors, polycystic ovary syndrome;
• hyperandrogenism;
• hypertrichosis;
• with liver diseases.

Poor hygienic care with the use of aggressive cleansing of the skin surface with alcohol-containing cosmetics contributes to the appearance of excess fat on the skin.

This can also be caused by the use of scrubs, regular degreasing of the epidermis, consumption of fatty creams, etc.

You should not rely only on your own knowledge. It is better to trust a dermatologist who will determine the cause of excessive greasiness on the surface of the skin. This will prevent serious health problems.

What to do if your facial skin is oily? How can you help yourself?

10 rules for oily skin

You should adhere to rules aimed at preventing diseases of the oily skin surface. Here is their list:

1. Eliminate (limit) consumption of fatty and fried foods. It is better to say “no” to salty and smoked, pickled and sweet foods. Preferred menu items include dishes made from lean fish and white meat, vegetables and fruits, and bran.
2. Cosmetics are chosen with a reduced lipid content and those in which antibacterial and antiseptic substances are represented by ethanol up to 10%.
3. Avoid touching your face with unwashed hands.

It is preferable to purchase hypoallergenic cosmetics that include plant extracts to soothe sensitive and irritated skin.

Choose all care products labeled “for combination or oily skin.”

Compliance with the following rules is also important:

1. Choose the right wash (gel or foam, it is better to avoid milk). The use of soap, washcloths, and hot water is prohibited.
2. Once every 7 days, use regular peeling, facial cleansing (for example).
3. Use UV protective cream UVA and UVB all year round (for example, Bioderma AKN).
4. Do not use foundation frequently, reduce its use to twice a week.
5. Decorative cosmetics should be chosen wisely, for example, powder with minerals.
6. It is permissible to use homemade masks no more than 1-2 times every 7 days. For the procedures, white, green, blue clay, apples, kiwi, and lemon juice are used. A positive result is achieved with a mask of porridge-like fresh potatoes.
7. Lotions with sea salt work effectively. They are performed once every 7 days, using 500 ml of melt water and 1 tsp for the solution. salt. Leave the product on for 5-10 minutes.
8. Moisturize your skin only with creams and serums designed for combination or oily skin.
9. Consider products with retinol. The drug with vitamin A accelerates cell turnover, making it one of the best ways to combat aging. It also works wonders on acne. Differin recently became available over the counter without a prescription.
10. Going to the sauna helps.

Green pharmacy (5 healing herbs)

How to get rid of the problem at home? It is advisable to treat sebaceous skin with herbaceous plants.

The presence of flavonoids, tannins, saponins (nitrogen-free and alkali-free organic natural substances), silicic acid, plant hormones and microelements have a positive effect on the sebaceous epidermis.

1. Chamomile is a natural antiseptic with anti-inflammatory effect. Its extract can cleanse and soften the skin surface of the face, restore elasticity and smoothness.
2. Salvia officinalis has bactericidal, soothing, regenerating powers. Calendula officinalis has the ability to heal and restore damaged epidermis.
3. Oak (birch) bark is famous for its antiseptic and tanning qualities. Tricolor violet extract is aimed at cleansing, stimulating metabolic processes and ridding the body of harmful substances.
4. Green tea extract has the role of an antioxidant, which reduces the effect of free radicals on the skin.
5. An extract from dandelion root increases the body's protective powers, helps in the functioning of the liver, gall bladder, and kidneys. The plant extract is involved in releasing the body from metabolic products, which has a positive effect on the surface of the skin.

Each patient selects an herb that is effective on the oily dermis individually. Replace water when washing with herbal infusions of chamomile, mint, nettle, and linden blossom.

Oils for oily skin

Oil formulations are used instead of night cream. They are applied in a thin layer to a clean skin surface.

Oils act on pores clogged with dirt and hard fat, regulate sebum production, and affect cell regeneration.

Which oils to use? Here is their list:

1. Hazelnut in pure form or as part of other oils. Under the influence of the product, the surface of the skin is cleansed, smoothed and restored, the pores are tightened.
2. Grape seeds, after which the surface of the dermis looks moisturized and without noticeable pores.
3. Berries, buds, black currant leaves - the product is endowed with antibacterial properties, the skin after it becomes elastic, the tone increases.
4. Sesame seeds, which influence the normalization of the functioning of the sebaceous glands, narrowing of pores.
5. Almond kernels, which cope with cleaning pores and irritation of red spots.
6. Tea tree leaves - the oily composition saves from acne and normalizes the condition of the dermis.
7. Lavender restores dullness to the skin and has an anti-inflammatory effect on the dermis.

Use hazelnut oil (50% of mixing) with the addition of 10% of other selected oils. If you take essential oils (from sandalwood, rosemary, juniper, bergamot, grapefruit, cedar), add 1-2 drops to the base oil composition.

Cosmetic treatments for oily skin

What to do if your skin is oily and acne appears? To eliminate the problem of oily skin, it is permissible to include the following measures:

• using scrubs (from almond, apricot, salt, clay, etc.), this will even out and cleanse the skin;
• use (lactic, pyruvic, trichloroacetic, glycolic, etc.), this will reduce pH, regulate sebum production and reduce the fat content of the dermis;
• consumption of masks (mud, clay, seaweed based), and this will disinfect, soothe the skin surface and remove excess fatty formations.

Question - answer

Of course, oily skin also needs regular moisturizing. With this type of skin, fat interferes with normal cell respiration, pores become clogged, and even collagen production deteriorates. This is why it is important to cleanse the skin surface and then remember to moisturize it.

To do this, you can use special special napkins. They gently wipe the face, which removes excess sebum without spoiling the makeup. It is also worth carrying powder with you, which after a while can hide the defect.

This is explained by the fact that after using a paper towel, a person immediately throws it away. But the towel often remains too wet, and this is an ideal environment for bacteria to multiply. As a result, they end up on the skin surface, which, especially on oily skin, can lead to inflammation.

TOP 5 treatment methods

Skin with excess oil content that is prone to peeling requires additional treatment prescribed by a dermatologist or cosmetologist.

The course of treatment is determined by a specialist after receiving the results of a blood test (glucose, hormones), familiarization with hereditary predispositions, medical history, etc.

The skin surface can be cured of oiliness using hardware measures:

1. . The beam induces photochemical transformations in the dermis. During the sessions, the epidermis is smoothed, renewed and regenerated. Its elasticity and tone change for the better.
2. Microdermabrasion of the dermis. Based on the action of an abundance of microscopic particles. They will polish the skin without pain, eliminate wrinkles, tighten pores, and reduce stretch marks.
3. Iontophoresis. It acts on the sebaceous dermis. As a result, blood flow to it, nutrition and microcirculation improves. The treatment restores the skin surface due to deep diffusion of nutrients and eliminates oiliness.
4. Cavitation (ultrasonic) peeling. With a shock wave, it cleanses the skin without pain, removes excess sebum from the pores of the hair follicles, and cleanses the keratinized dermis.
5. Based on mechanical vibrations. The procedure achieves massage, destruction of fibrous tissue, lymphatic drainage (removal of excess fluid). The technique prevents oil from clogging the hair follicles and reduces skin rashes and irritation on the dermis.

Darsonvalization with pulsed high-frequency current affects the skin with vacuum electrodes. As a result, the skin dries out, nutrition and tissue restoration are enhanced.

The doctor decides at the appointment which method of treating oily dermis is suitable for a particular patient.

10 medications that normalize fat metabolism

After visiting a dermatologist at home, you can use medications that include the following active ingredients:

• azaleic acid as an antibacterial, anti-inflammatory and skin exfoliant;
• zinc, which has a keratolytic orientation;
• sulfur with the property of blocking the production of oil by the sebaceous glands;
• , dexpanthenol, used in the recovery process at the end of physiotherapy, for cleaning, regulation of metabolic processes in dermal cells;
• adapalene, as a preventive substance against the formation of comedones and inflammation on the skin surface;
• benzoyl peroxide for exfoliation of keratinized dermis and renovation of cellular structure;
• copper, which regulates sebum production;
• isotretinoid with a splitting effect on the stratum corneum and suppression of the synthesis of fat formation;
• bacteriocins and pyocyanins are products of metabolic processes in microorganisms that increase the immunity of the epidermis and are involved in restoration;
• vitamins PP and group B, which have a positive effect on the dermis, blood supply and fat metabolism in it.

Drug therapy against oily dermis at home is carried out, following the doctor’s recommendations.

Expert opinion

Anna Avaliani

practicing cosmetologist

Reducing the consumption of fats in food will not change the situation much. Be sure to use special products when washing your face; water simply cannot thoroughly cleanse the skin. But do not overdo it, as this can lead to excessive degreasing or drying out.

Aisha Baron

plastic surgeon

To wash your face, use gels, foams suitable for your skin type, and cold water. Use toners, and moisturize your skin with cream before applying cosmetics. I also recommend not to forget about sunscreen. Cleanse your skin daily in the evening to remove dirt and makeup. And apply the cream again, only at night. These are simple rules, but they will help maintain the beauty of your skin.

Proper care and a healthy lifestyle will eliminate excess oily skin. It makes the surface of the dermis attractive, eliminates acne and greasy shine. At the same time, it is not difficult to maintain the visual youth of the face.

To do this, you should follow simple rules and take care of your skin. If you cannot solve the problem of excess fat on your own, you should consult a doctor.