To understand the formation of acne (blackheads), you need to know the normal structure and location of the sebaceous hair follicles.

sebaceous hair follicle

The sebaceous hair follicle (sebaceous hair follicle, hair follicle) consists of 3 elements:

1. hair,
2. hair follicle (bulb)
3. sebaceous gland.

All hair follicles have a sebaceous gland that secretes its secretion into the funnel of the hair follicle. However, there are also free sebaceous glands not associated with hair follicles:

• meibomian glands of the eyelids
• glands of the preputial sac (cavity of the foreskin),
• nipple glands,
• sebaceous glands along the edges of the lips and mucous membrane of the genital organs.

The structure of the sebaceous gland

The sebaceous gland is a simple branched gland and consists of 2 parts: end section and excretory duct. The sebaceous glands have what is called holocrine type of secretion, i.e. during secretion, these cells are completely destroyed and all their contents turn into a secret.

In different parts of the skin, the sebaceous glands differ in size and number. The largest of them are on the face and scalp, they also have the most active secretion. The sebaceous glands are unevenly distributed in the skin. In order decrease in the number of sebaceous glands in the skin can be distinguished:

• face, scalp (400-900 sebaceous glands per 1 square cm),
• ears, upper body, back between the shoulder blades,
• other parts of the body (10-20 times less than on the face).

The terminal section of the sebaceous gland consists of lobules formed by special cells - sebocytes(from lat. sebaceous - sebaceous). Each lobule contains several hundred concentrically (circles around a common center) located sebocytes. There is no lumen in the lobules, and the produced secret ( sebum) enters the excretory duct, which flows into the hair canal.

On the periphery of the sebaceous gland are immature, often dividing cells (they have no lipids and large nuclei). With the help of semi-desmosomes, they are attached to their support - basement membrane. As the cells move away from the basal membrane, they mature: they increase in size, the volume of the nuclei decreases, and fats accumulate inside. Mature cells in the center of the sebaceous gland lose contact with each other and are gradually destroyed. From the destroyed cells, a secret of the sebaceous gland is formed, which is called sebum. Sebum and sebocyte residues accumulate in the excretory duct of the sebaceous gland and in the hair canal.

hair channel(follicular canal) has 2 parts:

1. short upper - acroinfundibular(between the confluence of the excretory duct of the sebaceous gland and the funnel of the hair follicle, from lat. infundibulum - funnel),
2. long lower - infrainfundibular(below the confluence of the excretory duct of the sebaceous gland).

The excretory duct of the sebaceous gland opens into the upper part of the hair canal and is lined with keratinized stratified squamous epithelium(like the epidermis).

According to the size of the sebaceous glands, the sebaceous hair follicles are divided into 3 types:

1. sebaceous hair follicles of terminal hair with small sebaceous glands(eyebrows, eyelid edges, beard area);
2. sebaceous hair follicles average sebaceous glands and short excretory ducts (most common);
3. sebaceous hair follicles large sebaceous glands, wide excretory ducts and wide mouths of the follicle.

The mouths of hair follicles are called pores. The pores are up to 2.5 mm in diameter and are visible to the naked eye. Type 3 follicles are found on the face (up to 800 per square cm) and upper torso. Acne affects only type 3 follicles. In acne patients, these follicles are much larger than usual.

Functions of the sebaceous glands

The secret of the sebaceous glands (sebum) is secreted to the surface of the skin and performs the following functions:

• hair lubricant,
• skin softening (giving softness, elasticity),
• drying protection,
• UV Protection,
• due to bactericidal and fungicidal action protects against fungal and pustular infections. Sapienic acids in the composition of sebum have direct bactericidal activity.

At normal body temperature, sebum reduces the surface tension of sweat, which allows sweat to be evenly distributed on the skin without the formation of separate droplets.

In addition, the sebaceous glands are independent endocrine organ, reacting to changes in the level of androgens - (especially testosterone) and some others. Sebocytes are also capable of synthesizing vitamin D 3.

The sebaceous glands are formed at 13-15 weeks of embryonic development. After birth, they are inactive. Activity increases during puberty. After 40 years, age-related changes and aging of the sebaceous glands become noticeable.

Update: December 2018

The condition of the skin depends on the hormonal background, hygiene habits of a person, the level of immunity and heredity. Inflammation of the sebaceous glands is the most common disease of the dermis, which develops due to the negative impact of these factors. In the medical literature, this condition is referred to as "acne" or "acne", for most people the more familiar word is "pimples". However, regardless of the name, this disease affects appearance a person can lower his self-esteem and push other people away from him. Therefore, its elimination is a priority for most patients.

Detailed information about the causes of acne, prevention, methods of correct and effective treatment you can find out from this article.

Fundamentals of anatomy

Almost the entire surface of the body is covered with sebaceous glands. These are small formations that produce sebum, with short and branched excretory ducts. A particularly large number of them are located around the hair - on average, there are 7-9 glands around one hair follicle. Also, in most people, their accumulation can be found in the following areas of the body:

• Face. Separately, it should be noted the skin around the lips, forehead and cheeks;
• Back, especially in its upper half;
• Neck and chest;
• Armpits;
• Member and labia minora;
• Skin around the nipples.

Acne can occur anywhere on the body, but these areas are the most commonly problematic. A person has only two places where acne cannot form. These are the palms and feet. In these places, the skin has a special structure - it has a thickened epidermis, there are no sebaceous glands and hair follicles.

Why acne occurs

The causes of inflammation can be divided into 4 main groups: hormonal changes, increased dryness of the skin, excessive production of sebum and infection. In some cases, one person may have several causes of the disease. At the same time, it is important to eliminate each of them in order to obtain the optimal effect from the treatment.

It is also important to consider heredity as a factor in the development of acne. Scientists have proven that parents with severe acne in the present or past, children are more susceptible to this disease. Knowing this fact, it is possible to carry out preventive measures in a timely manner, correcting the condition of the dermis.

Restructuring of the hormonal background

The amount of sebum produced is most affected by the ratio of sex hormones in the blood of a person. Of fundamental importance are:

1. Androgens(testosterone, dihydrotestosterone, DHEA-S). Male hormones lead to increased work of not only sebaceous, but also sweat glands. Therefore, an increase in their concentration can lead to acne;
2. Progesterone. This is the "hormone of pregnancy", which is intensively produced in women after the middle menstrual cycle and immediately after conception. Causes swelling of the excretory duct, which leads to stagnation of sebum;
3. Estrogens(estrone, estriol, estradiol). These substances relieve swelling and restore the patency of the excretory ducts of the glands, somewhat reduce their secretion. A lack of estrogen can also cause acne.

There are moments in the lives of people of both sexes when hormonal changes are the norm. In this case, the formation of acne is a temporary effect and does not require special treatment, except in cases of infection. However, when changing the amount of sex hormones against the background of the disease, it is necessary to carefully approach the issues of therapy. In this case, it may be necessary to consult not only a general practitioner, but also a gynecologist, andrologist or endocrinologist.

To distinguish the disease from the norm, it is necessary to know the periods when hormonal changes occur. These include:

Period	Time of occurrence of hormonal changes	Changes in the ratio of sex hormones
In newborns	From birth to 3-6 months.	In newborn girls, the formation of a "sexual crisis" is possible - a temporary increase in the level of progesterone in the blood, due to its transition from mother to fetus. In this case, the following phenomena occur: breast engorgement; Uterine spotting bleeding; acne; Profuse greyish-white discharge from the vagina.
Puberty in men	From 13 to 20 years old.	There is a significant rise in the concentration of androgens, which can persist for 5-7 years.
The second phase of the menstrual cycle in women	From the middle of the cycle (normally 13-15 days) until the onset of menstrual bleeding.	In the second half of the cycle, normally there is a rise in the level of progesterone, which is a factor in the development of inflammation and blockage of the sebaceous gland.
Pregnancy	From the middle of the cycle (normally 13-15 days) until the birth of the child.	Against the background of normal pregnancy is constantly maintained high level progesterone, which is produced first in the ovaries and then in the placenta of a woman.
Pre- and post-menopause	After 45 years.	Due to a decrease in estrogen levels, a woman can develop acne and a number of other adverse events associated with menopausal syndrome: emotional instability, periods of sweating, insomnia, etc. Treatment of women during this period of life is possible with hormone therapy methods.

Above were listed the conditions in which the occurrence of acne is considered a variant of the norm. In all other cases, the appearance of acne should be considered a sign of the disease.

Increased dry skin

A fairly common cause of inflammation of the skin glands is their blockage with horny scales. With excessive dryness of the skin in a person, its surface layer begins to quickly exfoliate. These particles of the epidermis can close the sebaceous ducts and lead to the formation of acne.

Many factors influence the degree of moisture in the skin. The most important of them are:

• Age over 40. Over the years, the body's ability to restore is inevitably depleted. It is more difficult for the cells of the dermis to retain the required amount of moisture and trace elements, so it must be additionally moisturized with the help of cosmetics;
• Climate. This term refers not only to weather conditions, but also to the surrounding microclimate: indoor temperature, air humidity, the use of gadgets to control temperature.
  • Negative influence renders dry and frosty air, low air humidity, the use of air conditioners, heat convectors, heat guns, etc.;
  • positive influence has warm and humid air (optimal is sea), air humidifiers for rooms. If it is necessary to use thermal elements or air conditioners, it is recommended to combine them with air humidifiers.
• Hot bath or shower. The surface of the skin healthy person protected by a lipid layer that prevents it from drying out. water with high temperature destroys this natural defense, which can be a factor in the occurrence of acne;
• Hygiene products. Using ordinary soap to wash the skin of the face or intimate areas can cause it increased dryness. Since the protective layers of the dermis are more vulnerable in these areas, special lines must be used to care for them. hygiene products, for example: milk or facial wash, micellar water, tonic lotion, intimate hygiene soap and others.
• Skin diseases such as allergic dermatitis, psoriasis, eczema, etc.;
• Endocrine diseases, for example: diabetes, hypothyroidism, Itsenko-Cushing's syndrome/disease.

In the treatment of inflammation of the sebaceous glands, the identification of harmful factors is of great importance. Therapy can long time do not bring any effect if the cause of acne formation is not identified and eliminated.

Excess sebum production

At the moment, only three reasons are reliably known that can enhance the work of the glands: an increased content of androgens (described above), certain foods and the disease "seborrhea". In the course of research by domestic doctors, it was determined that products with a high content of fatty acids have the greatest harm to the skin. These include:

• Chocolate and cocoa;
• Nuts;
• Some types of cheese: feta cheese, suluguni, pigtail cheese and other pickled cheeses;
• Fatty meats (veal, beef, lamb, etc.) and products of their processing.

Carbonated and caffeinated drinks can also become a factor in the development of acne. Some scientists believe that the substances contained in them also increase the production of fat.

Next significant factor is a disease, the only sign of which is the presence of oily skin. Until now, scientists have not identified the causes of seborrhea. It is believed that this disorder is inherited and develops under the influence of adverse factors (described above).

Joining the infection

Microorganisms are the main cause of inflammation. When certain bacteria penetrate the skin, immune processes are activated, pus is formed, and surrounding tissues are damaged. Against the background of an unfavorable course of the disease, bacteria can spread to neighboring areas and contribute to the formation of large conglomerates of acne.

At the moment, the role of only one type of microbe in the development of acne has been proven - Propionobacterium Acne ( Latin name- Propionibacterium acne). That is why in the treatment of patients with this disease, antimicrobials of local or general action are necessarily used.

Appearance and symptoms

Basically, there are two groups of acne. The first includes acne that occurs only due to blockage of the excretory ducts. The second option develops with a combination of inflammation with the closure of the mouth of the gland. They must be distinguished from each other, since the tactics of treatment depend on this. Each type has its own characteristics such as appearance, tenderness, and firmness when palpated.

To determine your acne variant, it is enough to use the information from the table below:

Non-inflammatory (blockage only)

Appearance: Small white dots, no more than 1-2 mm. More often, blockage of the sebaceous gland is located on the eyelid, around the eyes or on the cheeks. Soreness : No Consistency : Soft

Closed (white) comedones Appearance: Small white pimples larger than 2 mm, rounded regular shape. Soreness : No Consistency: Soft

Open comedones ("blackheads") Appearance: The shape is similar to white comedones, with one exception - at the top there is a small hole with black content. It contains a mixture of dust, horny scales and sebaceous fluid. Soreness : No Consistency: Dense

Inflammation + blockage of the sebaceous duct

Papular Appearance: Pimples of red or bright pink color, rising above the skin. Size up to 1-2 cm. Soreness : Pain when palpated Consistency: Dense, similar to small knots

Pustular Appearance: Rounded formations with purulent contents inside (yellow or brown-green) Soreness : Sharply painful Consistency: Dense, when probing, an elastic cavity is felt.

Inductive Appearance: With this form, the focus should not be on the pimple itself, but on the skin around it. If it becomes red, inflamed, there may be a slight swelling - they talk about the indurative form of acne. Soreness: Painful acne and skin around it Consistency: Tight formation and surrounding skin.

Conglobate Appearance: These are huge confluent blackheads that can be up to 10 cm in size. As a rule, they are located on the back. May be flesh-colored or reddish. They rise significantly above the skin. Soreness: Pain may be felt when palpated Consistency: Dense

Phlegmonous Appearance: Large, purplish-bluish acne, penetrating deep into the dermis. Soreness: There is a sharp soreness. Consistency: Dense

After determining the type of acne, it is also necessary to find out the severity of the disease. Only then can one determine best option therapy. It is strongly recommended to consult a dermatologist for this purpose, as self-treatment can lead to incomplete recovery from the disease and irreversible damage to the skin.

The severity of the disease

To find out how severe the disease is, it is enough to determine the nature of acne and count the number of these elements. Currently, there are the following criteria for pathology:

• Light degree. A person has only non-inflammatory elements or the number of papules, pustules less than 10;
• Moderate course. The number of papules and pustules is from 10 to 40;
• Severe illness. Papules and pustules in total more than 40 (all over the body) or the presence of indurative, conglobate acne is noted.

It should be noted that any severity of acne is treated at home. However, the more severe the pathology is, the higher the risk of irreversible skin damage.

Treatment

Therapy of any form of the disease is recommended to be carried out under the supervision of a general practitioner or dermatovenereologist, who will determine the optimal tactics. The treatment regimen for blockage of the sebaceous glands is determined by the severity of the disease and the cause that caused the development of acne. In cases where it is not possible to find out the cause, the doctor is guided solely by the severity of the disease.

Definitions of treatment tactics

There are several areas of acne therapy - diet, cosmetic procedures(daily skin care), the use of topical preparations and systemic treatment. Diet changes are indicated for all patients. For the rest of the nuances, there are the following recommendations for the selection of the volume of therapeutic measures:

Severity	hygiene care	Tactics
Light	It is possible to use conventional moisturizing skin care products: foam or milk for washing, micellar water, tonic lotions. For intimate hygiene, it is possible to use special soap from Carefree, Nivea, Dove. You can not use products containing lactic acid without the appointment of a gynecologist - this medical preparations, which are not suitable for daily hygiene with inflammation of the sebaceous glands on the labia or in the groin.	It is enough to use only local medicines.
Medium		Priority is given to local pharmaceuticals. In some cases, a short course of systemic therapy is recommended for a person.
heavy	The use of specialized cosmetics is recommended. For this purpose, you can use the line of funds "Xemoz" from the company "Uriage", "Aisida" and others.	The appointment of general therapy with the use of local treatment is mandatory.

Diet

It has been proven that a small change in diet can significantly reduce the number of acne. The exclusion of certain products allows you to reduce the secretion of the sebaceous glands and eliminate one of the risk factors for acne.

• It is recommended to exclude: carbonated drinks, cocoa, nuts, pickled cheeses (brynza, suluguni, etc.);
• Should be limited: chocolate, meat with a high content of fatty acids (veal, pork, lamb and others), coffee.

Cosmetic skin care

Acne removal must include this component therapy. It is needed to increase the moisture of the skin and reduce flaking - this will help reduce the likelihood of blockage of the glands. For optimal results, the following hygiene guidelines must be observed:

1. Problem areas of the skin should be washed 2 times a day. More frequent or less frequent care can negatively affect the condition of the skin;
2. Water for procedures should be used at room temperature, as large temperature changes cause severe peeling of the epidermis;
3. After washing, the skin should be blotted with a soft towel, and not rubbed with it;
4. It is necessary to abandon the use of alcohol-containing lotions, sharply alkaline or acidic agents. Their pH (acidity) should be neutral or slightly deviate from this value (pH = 7±1.5);
5. Scrubs should not be used, as mechanical irritation of the dermis can increase the production of sebum;
6. For additional moisturizing of the skin, you can use Physiogel or Cetafil cream, 1-2 times a day. According to national guidelines, these products are optimally suited for the complex treatment of acne.

The selection of daily care products is carried out with the help of the attending doctor. As already mentioned, for this purpose, you can use both general cosmetic lines (Nivea, Dove, etc.) and specialized products (Aisida, Xemoz, and others).

Local therapy

This healing method It consists in applying drugs to problem areas of the skin. At the moment, there are several groups of drugs for topical use. These are antiseptic and keratolytic (exfoliating) substances, preparations with vitamin A and combined agents. The standard treatment regimen involves the use of one pharmacological drug from each group, or a drug with a combined effect.

Preparations with retinoic acid

This group has a complex effect on the dermis - they reduce the activity of the inflammatory process, prevent the excessive formation of horny scales and weaken the sebaceous glands. Currently, Adapalen (Differin) is considered the optimal pharmacological preparation. It is highly effective and easy to use, but it acts rather slowly - the first effects of its use develop after 4-6 weeks.

Adapalene is available in the form of a gel and cream, applied once a day, at bedtime, at the end of hygiene procedures. After that, the face is not wiped and not moisturized. The average course duration is 3 months.

Antimicrobial treatment

Medicines from this group should be prescribed in the presence of inflammation of the sebaceous glands, that is, when papules, pustules, conglobates and other elements occur. At the moment, dermatologists recommend using one of the following antibacterial agents:

Active substance	Trade names (under which they are sold in a pharmacy)	Exfoliating (keratolytic) effect	How long does it take for the effect to develop?
Benzoyl peroxide	Proderm - cream; Baziron AS - gel; Eclaran - gel; Desquam - gel, lotion.	There is an additional desquamating effect	At least 4 weeks later. The optimal duration of treatment is 2-4 months.
Azelaic acid	Azelic - gel; Skinoren - gel, cream; Azix-Derm — cream; Skinoclear - gel, cream.
Clindamycin	Mirrorin - solution; Dalacin - gel.	Not	During the first week. The maximum duration of therapy is 6 weeks.

It is necessary to apply any antibacterial drug 2 times / day after washing on clean, dry skin. He needs to give time to act for 20-30 minutes. During this time, do not wipe or wet the skin.

Combined drugs

This group was developed by pharmacologists for the convenience of patients. The presence in one "bottle" of several active ingredients allows you not to buy several drugs, but to limit yourself to one. Also, combined products are easier to use - one application of them allows you to have a complex effect on the dermis.

Here are the most common and effective combinations:

Name	Combined Effects	Substances to be combined	special instructions
Isotrexin	Antimicrobial + retinoic acid	Isotretinoin + erythromycin	Not used in severe illness. Contraindicated in pregnancy and lactation.
Klenzit S		Adapalene + clindamycin	At the beginning of therapy, it can increase the manifestations of the disease (negative effects disappear within a week). With continued irritation of the dermis, its use should be discontinued.
Zenerite	Antibacterial + zinc (anti-inflammatory effect)	Erythromycin + Zinc Acetate	Improvement occurs no earlier than after 2 weeks of regular use. Comes complete with an applicator - convenient for use on any part of the body.

General treatment methods

This method of therapy is resorted to only in severe stages of the disease or on an individual basis with moderate severity (for example, with the ineffectiveness of local treatment). The main goals when using drugs with a systemic effect are the elimination of harmful microbes, the reduction of desquamation of the epidermis, or the elimination of the causes of the disease.

Antibiotic therapy

Acne pathogens show the least resistance to two groups of antibiotics - tetracyclines and macrolides. These groups include different drugs, from which it is necessary to choose one that is optimally suitable for a particular patient. This task for the attending physician - it is strongly not recommended to prescribe treatment on your own.

At the moment, in order to eliminate purulent inflammation of the sebaceous glands, the following antibiotics are widely used:

During therapy, the following principles must be observed:

1. The minimum course of therapy is 10 days. This duration prevents the formation of resistance in bacteria to the antibiotic, which will allow in the future to conduct a second course in case of recurrence of the disease;
2. You should not interrupt the course of antibiotics, except in cases of intolerance;
3. In the presence of concomitant pathologies (diabetes, atrial fibrillation, thrombosis of arteries or veins, etc.), doses and type antimicrobial agent it is necessary to coordinate with the doctor, since drugs can affect each other;
4. Alcohol should be completely avoided while taking medications, as the combination can lead to severe liver damage.

Retinoic acid preparations

According to modern recommendations, for the treatment of severe forms of acne, only one pharmacological preparation from this group is used - Isotretinoin (Acnecutane, Roaccutane). It reduces the work of the sebaceous glands throughout the body and reduces the peeling of the epidermis. Despite its high efficiency, retinoic acid has a large amount side effects. Of these, dyspeptic disorders (nausea, loose stools, abdominal pain), weakness, dizziness, and decreased performance are most often manifested in patients.

It is important to note that it is only used for severe acne resistant to other therapies. Isotretinoin absolutely contraindicated during pregnancy, at the time of its reception, a woman needs to take care of adequate contraception.

Hormonal correction

This procedure is carried out only as prescribed by a gynecologist. It is indicated for women who have a hormonal disorder confirmed by laboratory methods. For this purpose, various drugs can be used, depending on whether a woman is planning a pregnancy in the next 6 months or not.

If there are no plans to conceive, hormonal contraceptives are usually recommended, in the form of pills, applicators, vaginal rings, implants, etc. When planning pregnancy, it is possible to use "cyclic hormone therapy" - estrogens in the first phase of the cycle and progesterone after the middle of the menstrual cycle.

Elimination of acne during pregnancy

This is a rather complex issue that has not been finally resolved to date. The fact is that before prescribing the drug to a pregnant woman, full-fledged clinical trials on this group of people. However, pharmacological companies and independent associations of doctors are wary of conducting these experiments, because of the likelihood of complications in the fetus or mother. Therefore, no topical preparation has been confirmed to be safe.

Nevertheless, the accumulated experience of domestic doctors allows the following scheme to be used for the treatment of pregnant or breastfeeding women:

1. Diet, with the exclusion of all products that increase the production of sebum (chocolate, nuts, fatty meats, etc.);
2. Daily hygiene care for affected skin, using moisturizing funds;
3. It is possible to use azelaic acid preparations, but only with the permission of a dermatologist, gynecologist or therapist;
4. In severe purulent acne, Josamycin may be prescribed after the 14th week of pregnancy.

Regardless of the gestational age, it is forbidden to use retinoic acid preparations (both local and systemic) and tetracycline antibiotics. These drugs have a pronounced side effect on fetal development.

Prevention

Measures to prevent the development or reduce the intensity of acne are recommended to start from puberty (13-15 years). It is at this time that the period of activity of the sebaceous glands begins, which can lead to the formation of acne. Preventive measures are quite simple, they include:

• A diet aimed at reducing the production of sebaceous secretion;
• Daily washing, using moisturizing cosmetic lines;
• Prevention of excessive drying of the skin (from exposure to temperatures, dry air, chemicals, etc.).

FAQ

Question:
How to suspect the presence of a hormonal disorder in a woman as the cause of acne?

First of all, you should pay attention to the regularity of the menstrual cycle. Also pathological sign very heavy or scanty discharge, spotting between periods, male pattern hair growth (along the midline of the abdomen, on the back, in the chin area, on the cheeks or under the nose) are considered.

Question:
Can you pop pimples on your own?

No, because this procedure leads to an increase in the inflammatory process. Also, the possibility of pus entering the bloodstream and the development of a severe infection (sepsis or meningitis) is not excluded.

Question:
Why is it impossible to dry the skin with inflammation of the sebaceous glands on the face?

At the same time, its peeling intensifies, and the horny scales close more of the excretory ducts of the sebaceous glands. Accordingly, the number of comedones, milia and other acne elements increases in a person.

Question:
Can physical therapy be used to treat acne?

Indications for physiotherapy are quite limited - this is the presence of comedones or milia in a limited area of ​​\u200b\u200bthe body. However, its effectiveness has not been proven in scientific studies. Physiotherapy contraindicated with inflammatory acne (papules, pustules, conglobates, etc.), as it leads to increased blood supply to tissues and aggravates inflammation.

Question:
Are there any features of the treatment of blockage of the sebaceous glands in a child?

Acne in newborns, in the vast majority of cases, resolves on its own and does not require therapy. Most often, teenagers face this problem. The treatment regimen for children older than 8 years is carried out in the same way as for adults. If the child is younger, it is necessary to abandon retinoic acid preparations and the use of systemic antibiotics (except for Josamycin).

The skin covers protect a person from the effects of the external environment, temperature changes and various injuries. Thanks to the glands, the skin is involved in metabolism and removes harmful substances from the body through the pores.

The sebaceous glands are localized mainly in the upper half of the body, especially on the face. They are located in the reticular layer of the dermis hair follicles. There are separate elements that secrete a secret directly onto the skin. In other cases, the excretory ducts of the sebaceous gland open into the hair follicle.

There are two types of sweat glands: eccrine and apocrine. The former are localized throughout the human body, the latter are responsible for the formation of odor during the period of hormonal adjustment and are located in the place of accumulation of hair - in the groin, armpits, on the forehead.

Structure

The anatomy of the sebaceous gland resembles a bunch of grapes: alveolar sacs with branches. The end parts are composed of two types of cells:

• Undifferentiated elements ready for division.
• Cells in different stages of fatty degeneration. They produce lipids and, dying, turn into sebum.

The sweat glands have a simple structure - a glomerulus, where the excretory duct is located and secretion is produced. They are located inside the dermis, and their terminal sections extend to the outer surface of the skin.

Functions

Functions performed by the sebaceous gland:

• softening of the skin;
• protection of the epidermis from damage during friction;
• with the breakdown of lipids - the formation of acids that are involved in the formation of surface immunity.

Function of the sweat gland:

• participation in metabolic processes;
• withdrawal of nitrogenous compounds, reducing the load on the kidneys;
• thermoregulation, cooling the body in the hot season.

Typical diseases and their symptoms

Pathologies of the sebaceous and sweat glands negatively affect the quality of life of a person and require an appeal to a medical specialist.

1. Acne (acne) is an inflammatory process characterized by blockage of the sebaceous glands.

Why does the disease appear:

• hormonal metabolism disorders (during puberty, during the period of bearing a child);
• malfunction of the adrenal glands;
• diseases of the gastrointestinal tract caused by the predominance of carbohydrates in the diet;
• stressful situations;
• taking GCS;
• improper skin care;
• inflammation of the sebaceous glands and ducts.

Symptoms include the appearance of a rash on the skin with the formation of papules, pustules and nodules. Comedones are filled with purulent contents, painful on palpation, acne larger than 5 mm, can leave scars or bumps on the skin.

1. Seborrhea is a chronic ailment in which there is an increase in the secretion of the gland and increased production of sebum.

Symptoms:

• shiny skin;
• dilated excretory ducts;
• rashes in the form of red spots, plaques with crusts;
• severe itching;
• scales on the head;
• greasy, matted hair.

1. Hydradenitis is a disease that is associated with blockage of the sweat glands.

• Hormonal changes - pregnancy, menopause.
• Diaper rash with infection in the wound.

Often the disease occurs in the armpit and in the groin area. The patient complains of fever, weakness. Visually, the disease manifests itself in the form of a cyanotic nodule. The skin around swells, redness of the inflamed area is noted. Due to the attachment of infection, the nodule is filled with pus.

1. Hyperhidrosis is a disease characterized by increased work sweat gland.

• chronic infectious diseases;
• stress;
• tight shoes or clothes;
• flat feet;
• fungal attack.

Partial hyperhidrosis is a reaction of the body to a stressful situation, manifested in cases of psychological attack.

In true disease, perspiration occurs constantly. The secret has an unpleasant putrefactive odor, sticky consistency.

Inflammation treatment

Therapy of each ailment requires the advice of a specialist. Often pathological process prone to self-destruction.

1. Acne treatment consists of the following steps:

• identification of the cause that caused the formation of a rash;
• treatment of concomitant pathology;
• removal of formed acne;
• topical use of antibiotics to reduce inflammation;
• diet compliance.

1. Therapy for seborrhea:

• balanced diet;
• wiping the skin with a 2% solution salicylic alcohol twice a day;
• antifungal agents;
• use of special shampoos for hair;
• physiotherapy to improve trophism in tissues and detachment of the affected epithelium.

1. Hydradenitis is treated:

• reduction of inflammation of the sweat glands by treatment with antiseptics;
• the use of antimicrobial ointments;
• personal hygiene.

If the effect of the therapy is insufficient, surgical intervention is indicated followed by injections of antibiotics.

1. Measures to get rid of hyperhidrosis include:

• foot baths with oak bark, chamomile or potassium permanganate;
• regular use of powders with talc or zinc;
• frequent change of socks, drying shoes;
• restriction of fluid intake;
• sedatives and sedatives in stressful cases.

Preventive actions

To prevent blockage of the sebaceous and sweat glands, the following rules should be observed:

1. Limitation of sweets, smoked and fatty foods.
2. Getting rid of bad habits.
3. Frequent walks to fresh air, sunbathing.
4. Compliance with the rules of personal hygiene.
5. Contrasting wash in the morning.

Inflammatory diseases of the gland are an unpleasant ailment that requires specialist advice and lifestyle changes.

Sweat and sebaceous glands: Video

Human skin has appendages - sebaceous and sweat glands. They serve to ensure, from damage and excretion from the human body urea, ammonia, uric acid, i.e. metabolic products.

The glandular epithelium exceeds the surface of the epidermis by 600 times.

Sebaceous glands under a microscope

The full development of the sebaceous glands falls on the period of puberty. They are located mainly face, head and upper back. But on the soles and palms they are not at all.

The sebaceous glands secrete sebum, which plays the role of a fatty lubricant for the epidermis and hair. Thanks to sebum, the skin softens, retains its elasticity, does not allow the development of microorganisms and reduces the effects of friction on skin areas that are in contact with each other. Per day, the sebaceous glands are able to produce on average twenty grams of sebum.

They are located rather superficially - in the papillary and reticular layers. Up to three sebaceous glands are located next to each hair. Their ducts usually lead to the hair follicle and only in areas without hair they secrete their secret to the surface of the skin. With an increase in the function of the glands, the hair and skin become excessively oily. And when they are blocked may arise acne . If the functions of the sebaceous glands, on the contrary, are reduced, then the skin becomes dry.

These glands are simple in structure. alveolar having branched terminal sections. The extraction of the secret takes place holocrine type. The structure of the end sections includes two types sebocyte cells. The first type is unspecialized cells capable of mitotic division. The second type is cells that are at various stages of fatty degeneration.

The first type of cells is the upper layer of the terminal section, while cells are located inside that produce fat droplets in the cytoplasm. When a lot of fat is formed, they begin to gradually shift towards the excretory duct, die and, disintegrating, turn into sebum, which then enters the hair funnel.

Another appendage of the skin - sweat glands play an equally important role in protecting the body. Their main task is to excrete sweat. It evaporates from the surface of the skin, thereby causing it to cool. The secretions of these glands are odorless. So the body is saved from overheating on hot days. This is a function eccrine sweat glands, which are located on the skin everywhere.

There are more apocrine sweat glands that give a person his own scent. They are located in certain places where hairline is present. They are in armpits, in the area anus, genitals and forehead skin.

The second function of the sweat glands is removal of excess waste substances from the body. They greatly facilitate the work of the kidneys, removing a sufficiently large amount of minerals through the skin. This function is performed mainly by apocrine glands.

In structure, they are simple tubular, consist of a tubular excretory duct and the same rather long end section, which is twisted in the form of a ball. These glomeruli are located deep in the reticular layer of the dermis, and the excretory ducts come to the surface of the skin in the form of sweat pores.

eccrine secretory cells are dark and light. Dark cells secrete organic macromolecules, and light cells preferentially metal ions and water.

At apocrine glands a slightly different function, it is mainly associated with the work of the sex glands.

Sebaceous glands are microscopic glands in the skin that secrete an oily, waxy substance called sebum. Its function is to lubricate and protect the skin and hair from water. In humans, the sebaceous glands are distributed throughout the body, except for the soles, palms, and eyelids; in large numbers they are located on the face and head. There are several diseases directly related to the work of these secretory formations: acne, atheroma, hyperplasia, adenoma and cancer of the sebaceous glands.

Sebum

The sebaceous glands secrete a special secret - sebum, which includes triglyceride oils, wax, squalene and metabolites. This substance is produced and released by special cells, which is why the omentums are classified as holocrine glands. A disorder characterized by high oiliness of the skin caused by excess sebum is called seborrhea. Fat keeps the skin and hair elastic. It has no odor, which, however, can be caused by bacterial growth. Sebum is the cause of increased "greasy" hair in hot climates or when not washed for several days. Earwax also partially consists of this substance.

Functions

All sebaceous glands in the human body are similar to each other and produce sebum during the holocrine process. The wax esters that make up fat are unique components that are not produced in any other part of the body. Sebum is 45% insoluble fatty acids, known for their antimicrobial activity. In addition, due to the secretion of the sebaceous glands, vitamin E is transported to the upper layers of the skin of the face. Fats help maintain the integrity of the skin barrier and have anti-inflammatory properties.

According to the latest scientific data, sebum secretion can be considered as a delivery system for antioxidants, antimicrobial fats, pheromones and moisture to the stratum corneum of cells. It is also known that in the last trimester of pregnancy, the sebaceous glands of the embryo produce the original lubricant that protects its skin from amniotic fluid. Together with the apocrine secretory system, omentums play an important role in thermoregulation. In hot conditions, they prevent moisture loss, and in cold conditions, they protect the skin and hair from rain.

Pathology

Among the disorders associated with the formation of sebum, inflammation of the sebaceous glands and hair loss are distinguished. Fat and keratin can create hyperkeratotic plugs in the pores, called "microacne". The prescription drug Isotretinoin significantly reduces the amount of fat produced and is used when a disorder such as inflammation of the sebaceous glands occurs. Treatment may also include the use of benzoyl peroxide, antibiotics, retinoids, antiseborrheic drugs, endocrine therapy, salicylic and azelaic acid, and keratolytic soaps. They are able to prevent clogging of pores, prevent the growth of bacteria, have an anti-inflammatory effect and regulate hormones.