你了解痤疮吗?度过了青春期的你还有可能得痤疮!!

2015-11-06 zhaoshuang 译 MedSci原创

 

青春痘、粉刺、黑头、白头粉刺……谁不害怕?痤疮在美国是最常见的皮肤病(在中国也很常见,它困扰着许许多多的年轻人)。

痤疮的范围可以从轻度粉刺,黑头、白头粉刺和丘疹到重度炎症脓肿和结节。

痤疮可发生在任何年龄,但主要影响青春期的男孩、女孩。统计数据显示,80%的青春期孩子都有痤疮,也有越来越多的30-50岁或者年纪更大的女性会出现痤疮。资料还显示甚至连新生儿也可能出现痤疮。

痤疮通常在8-12岁时出现,作为青春期的一个标志。女孩一般会在14-17岁普遍出现痤疮,男孩则在16-19岁普遍出现,到25岁时则会自然消退。也有大约12%的女性和3%的男性要等到44岁左右才能消退。约有80%的人会在11-30岁这段时间内出现痤疮,女性在25-30岁第一次出现痤疮也是很正常的。

痤疮没有种族差异,具有家族遗传性。父母有过痤疮,孩子很有可能也会出现。

了解导致痤疮的原因和解决办法可以减轻甚至消除痤疮带来的负面的生理和心理影响。

导致痤疮的因素有哪些?

皮肤表面的小孔叫做毛囊、皮脂腺毛囊或毛孔,毛囊内皮脂腺产生油脂,防止头发和皮肤干燥。死皮细胞通常会上升到皮肤表面然后脱落。

在青春期,荷尔蒙会导致油脂分泌过盛,过盛的油脂和死皮细胞一起排出体外,如果排除过程中堵塞了毛孔就会形成痤疮。一旦皮肤表面的痤疮丙酸杆菌进入了被堵塞的毛孔,便会迅速繁殖,引起炎症。如果炎症深入到皮肤,就会出现痤疮囊肿或结节。

痤疮没有传染性,也不是由油腻食物、巧克力、化妆品或者生活压力所造成的。除开荷尔蒙因素,高血糖也和痤疮有联系。油性化妆品应该避免,因为它会阻塞毛孔;环境刺激物,如污染和高湿度空气中也是一个重要因素。吸烟可以使成人痤疮程度加重。

正确处理痤疮的方法:

有证据证实,痤疮对人的自尊是有影响的,会导致焦虑、自卑,工作和学习的积极性降低、交际圈变窄,从而使学生学习成绩下降,在学校里可能会受到其他同学的欺凌和隔离。青少年抑郁症和“自杀”念想都与痤疮有关系。痤疮消退后,可能会在皮肤上形成黑斑(完全消退需要几个月到几年),囊肿结节性痤疮则会形成永久疤痕。

适当的治疗可以对痤疮起到帮助和预防作用。

痤疮的类型:

皮肤科医生根据痤疮的严重程度将其分为四类:

1级(轻度):主要局限于白头粉刺和黑头粉刺,丘疹和脓疱

2级(中等或脓疱性痤疮):多个丘疹和脓疱,大多局限于脸上

3级(中度严重:结节囊性痤疮):许多丘疹和脓疱;偶尔出现炎症结节;背部和胸部可能受到影响

4级(重度结节囊性痤疮):许多大型的,有疼痛感的脓疱和结节;炎症。

治疗方法取决于痤疮的类型。

痤疮的注意事项:

1为了防止油脂积累,应当早晚用温水配合温和的、非研磨性的洗面奶洗脸。运动过后尤其是戴头盔和帽子运动过后出汗很容易使毛孔堵塞,所以建议在运动过后也要洗脸。

2应当避免毛巾、网状棉或者其他一些会刺激皮肤的物品。使用温和的、不含酒精的护肤产品。紧肤水、柔肤液、皮死皮膏会刺激皮肤并使其变得干燥,使痤疮看起来更糟糕。同时擦洗痤疮也是无用的,只会使痤疮更加严重。

3 不应当随时用手去触碰痤疮,因为油脂会和手上的污垢混在使其程度加重。同样,挤压痤疮也会使痤疮的消除时间延长并且可能形成疤痕。

4 因为头发上的油脂可以沾到脸上,所以经常洗头会对减轻痤疮有帮助。油性头发可以每天洗一次。

5 不推荐有痤疮的人在阳光下暴晒,也不推荐日光浴。日晒可以不仅损害皮肤而且还会使患黑色素瘤皮肤癌的风险增加75%。此外,一些治疗痤疮的药物会使皮肤对紫外线变得特别敏感。

痤疮的治疗

1非处方治疗

(1)市面上的一些霜剂、洗剂以及肥皂可以降低油脂分泌、消除黑头或白头粉刺。

(2)一些含有过氧化苯甲酰或水杨酸的非处方药物对轻度痤疮有清理作用。

(3)没有一种适合所有人的痤疮治疗方法,痤疮也不可能短时间一下就消除,非处方治疗往往需要4-6周才能看到是否有疗效。

为了防止痤疮进一步发展,痤疮清理干净都应当继续坚持治疗一段时间。

2 处方治疗

处方治疗主要针对非处方药物无法缓解的、程度严重的、分布广泛的痤疮,包括囊肿结节。
儿科医生、家庭医生或者皮肤科医生可以根据痤疮的具体情况提供积极的处方治疗。

常规的临床治疗大多应用于局部皮肤。旨在杀死细菌或减少油脂分泌。他们可能包含类维生素A、过氧化苯甲酰、抗生素或水杨酸。

当单纯局部皮肤治疗效果欠佳或者痤疮表现出来的特点是红肿的囊肿结节时,则需要全身系统治疗。

全身系统治疗包括抗生素、激素和异维甲酸治疗。


通常需要坚持4-6个月的抗生素(主要是四环素)配合局部治疗以达到杀灭细菌减少炎症的效果,通常治疗6周后开始有所改善。四环素的副作用包括使皮肤对阳光和紫外线的敏感性增强。

激素疗法对女性尤其是经期前后突发的痤疮有所帮助,联合cyprindiol便是一种激素治疗,可以减少皮脂分泌,以及降低对抗生素的耐药性,治疗2-6个月能够取得显著改善。其副作用主要包括经间期出血、头痛、乳房胀痛、性功能下降。同时还与乳腺癌有关。

3 其它治疗痤疮包括:

(1)激光和其它光源疗法,降低了痤疮丙酸杆菌。
(2)由皮肤科医生进行化学换肤,治疗黑头粉刺和丘疹。
(3)引流和提取,去除药物治疗效果欠佳的大痤疮和囊肿
(4)必要时往囊肿内部注射用药,可以使其快速消退。

原始出处:

Yvette Brazier .Acne: what causes it and how to relieve it.Medical News Today Thursday 5 November 2015

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    2016-11-07 laoli

    有价值!

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=154177, encodeId=bd051541e7f5, content=有价值!, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLC1BMzZWdMSPQWuib6BtQGicK8ygGBM6YakpfkRc67soFSuKbZr86enL1KggQZEZbgWSeicJibafmYfQ3AibicIHMwwicmDShfRFvvI38/0, createdBy=272a110164, createdName=laoli, createdTime=Mon Nov 07 22:30:40 CST 2016, time=2016-11-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=152962, encodeId=3a7b152962b6, content=翻译的很好, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55d21732407, createdName=WEIXIN1719e47f, createdTime=Wed Nov 02 21:48:10 CST 2016, time=2016-11-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=152961, encodeId=79a51529615d, content=迟发性痤疮,临床挺多的, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55d21732407, createdName=WEIXIN1719e47f, createdTime=Wed Nov 02 21:47:57 CST 2016, time=2016-11-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=61661, encodeId=821261661f9, content=哪样东西?, beContent=null, objectType=article, channel=null, level=null, likeNumber=103, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d5571624672, createdName=Wuyue6233, createdTime=Thu Jan 28 00:25:00 CST 2016, time=2016-01-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=44285, encodeId=9a404428518, content=青春痘, beContent=null, objectType=article, channel=null, level=null, likeNumber=127, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=974f1667182, createdName=杨晨舟, createdTime=Tue Dec 01 16:41:00 CST 2015, time=2015-12-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1275489, encodeId=f0bc12e5489a4, content=<a href='/topic/show?id=5d0299032b9' target=_blank style='color:#2F92EE;'>#青春期#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99032, encryptionId=5d0299032b9, topicName=青春期)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4ba8129, createdName=zhzhxiang, createdTime=Sun Nov 08 07:58:00 CST 2015, time=2015-11-08, status=1, ipAttribution=)]
    2016-11-02 WEIXIN1719e47f

    翻译的很好

    0

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    2016-11-02 WEIXIN1719e47f

    迟发性痤疮,临床挺多的

    0

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    2016-01-28 Wuyue6233

    哪样东西?

    0

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    2015-12-01 杨晨舟

    青春痘

    0

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