Analysis of factors complicating the course of acne

Abstract

Acne is among the most common conditions encountered in dermatological practice. In recent decades, there has been an increase in severe, complicated forms of acne. Objective — to analyze the factors that affect the deterioration of the clinical course of acne and stimulate the development of moderate and severe forms of acne. Materials and methods. For 3 years (2020—2023) we monitored 95 patients aged 18 to 35 years (45 men and 50 women), suffering from moderate to severe forms of acne. Before starting treatment, all patients completed a special questionnaire developed by us and taking into account known trigger factors. Results and discussion. Factors stimulating the transformation of mild acne into moderate and severe forms of the disease differ in groups of men and women. Among men, stress worsened the clinical course of dermatosis in 5 (11.1 %) cases, in women — in 9 (18 %). Among the factors that influenced the course of acne in women, we can distinguish the use of contraceptives 2 (4 %) and dysmenorrhea in 4 (8 %) people. 2 (4 %) patients clearly noted an improvement in the course of acne after withdrawal of contraceptives. Alcohol stimulated exacerbation of acne in 3 (6.7 %) men. Not sticking to the diet more often contributed to the exacerbation of acne in women — 9 (18 %), compared to only 6 (13.3 %) in men. A significant role in the stimulation of acne activity was played by irrational antibacterial topical therapy: 2 (4.4 %) men and 4 (8 %) women used topical drugs with clindamycin and erythromycin for a long time. There were cases of prolonged use of topical corticosteroids (for more than 3 months), which significantly worsened the clinical course of acne, in one case led to the development of steroid rosacea. 7 (14 %) women and 3 (6.7 %) men associated exacerbation of the disease with the intervention of a cosmetologist who did mechanical cleaning during the activation of acne. 5 (11.1 %) men and 3 (6 %) women were associated with worsening of the course of acne after SARS-CoV-2 infection. Also, the most common factor in acne exacerbation was self-medication: 7 (15.5 %) men and 6 (12 %) women. Some patients were unable to isolate any of the known trigger factors of acne: 9 (20 %) men, 3 (6 %) women. Conclusions. The study made it possible to identify a number of factors that affect the severity of the clinical course of acne. The most common triggers were psycho-emotional stress (18.0 % of women and 11.1 % of men), diet disorders (18 % of women and 13.3 % of men), self-treatment (15.5 % of men and 12 % of women), the COVID-19 pandemic (11.1 % of men and 6.0% of women), the intervention of cosmetologists with irrational aesthetic procedures (6.7 % of men and 14.0 % of women). Thus, the identified trigger factors of acne have gender, nutritional, behavioral characteristics, which requires further study and development of algorithms for their elimination and correction.