Acne (acne vulgaris or acne vulgaris) is a common skin disease characterized by seborrhea (increased fat content), comedones (black dots), pustules (red ulcers) and scars afterwards.[1] Acne mainly appears on areas of the skin where there are many sebaceous glands: first of all, it is the face, chest and back. As a rule, acne is inflammatory in nature, but inflammation may be absent, depending on the form. Acne most often occurs in adolescence, but it can also be present in adults.[2]

Acne and bodybuilding are closely related. Firstly, because bodybuilding involves a high-calorie (high-carbohydrate) diet, and this is one of the provoking factors of acne. Secondly, anabolic steroids are often used in bodybuilding, which are also one of the main causes of acne. In this article, we will look at the most typical forms of acne and give treatment recommendations based on modern scientific data. Acne is a dermatological problem, the solution of which is currently very expensive, so the main purpose of the article is to save you from unnecessary costs and give qualified highly effective advice on solving the problem yourself.

All acne can be divided into two forms:

Inflammatory - acne vulgaris, acne conglobata and fulminance. We will not consider each form separately, because they have the same mechanism of development and the same principles of treatment.
Non-inflammatory - comedones and follicular keratosis can be included in the same group.

The treatment of acne depends on the type of acne. Let's consider separately the treatment of inflammatory and non-inflammatory forms. The treatment algorithm is presented in the form of successive stages, which are based on the official methodological manual Ramos-e-Silva M, Carneiro SC (2009) with additions by experts.Stop at the stage where you will achieve your therapeutic goal.

Treatment of the inflammatory form

• Make-up to mask acne (a spot corrector or foundation with a green tint may be suitable to neutralize red)
• Preventive measures
• The abolition of anabolic steroids or the transition to low-androgenic
• The use of monophasic hormonal contraceptives with antiandrogenic activity by women: Diana-35, jes, yarina, tri-mercy.
• Reduced carbohydrate intake. Eliminate simple carbohydrates from the diet. Also exclude fatty foods, fried and spicy dishes. Try to consume more fiber-rich foods.
• More often, take water treatments using soap with a pH equal to 5.5 of the skin. When maintaining a skin pH of 5.5, the highest bactericidal effect is observed, exceeding 90%. In vitro, P. acnes grows well at pH values between 6 and 6.5 and growth decreases markedly at pH values less than 6. There is a myth about the miraculous effect of household soap, but this is not true. Household soap is highly alkaline with a pH of 11-12 (!), alkali converts the keratin component of the hair and the upper layer of the skin (epidermis) into easily water-soluble alkaline albuminates, which are removed when washing, and this reduces the content of so-called sulfhydryl groups in the skin, the absence of which contributes to skin deterioration. However, the skin should not be greasy or dirty. Always take a bath after exercising or sweating.
• Take more fresh vegetables and fruits, especially foods rich in vitamins of group B. Brewer's yeast is often recommended.
• Smoking can contribute to the worsening of acne effects.

Therapeutic measures

• Visit a solarium - sometimes ultraviolet baths can completely eliminate acne. At the same time, such a duration of exposure is required that erythema (slight redness of the skin) occurs, which activates local skin resistance. In Europe, the USA, Canada, Brazil, Ireland and many other countries, access to the solarium is prohibited for persons under 18 years of age. The association of frequent visits to the solarium with the risk of skin cancer has been proven. Therefore, regular exposure should not exceed 2 sessions per week and 30 sessions per year.
• Wipe the problem areas of the skin with salicylic acid 1-2 times a day. Salicylic acid is available at any pharmacy at a low price. Additionally, you can wipe the skin with a decoction of oak bark, chamomile, tincture of calendula, 3% hydrogen peroxide, although the effectiveness of these external remedies is low.
• If salicylic acid does not bring relief, replace it with Skinorene cream based on azelaic acid.
• To increase the effectiveness of acne treatment, add the drug Zinerite, which contains zinc and erythromycin that destroys bacteria, or the drug Baziron (benzoyl peroxide) - suppressing sebum secretion and destroying bacteria. It is advisable to alternate these drugs, as the effectiveness may decrease over time. Also, a recent study showed that resveratrol increases the effectiveness of benzoyl peroxide.
• In women, COCs with antiandrogenic effects are used with great success: Jes, Diana-35, Yarina, Logest, Janine, Tri-Mercy, Belara, etc.
• If the high oil content of the skin persists (manifests itself in the form of shine and touch), also start taking the drug Accutane (Isotretinoin, Roaccutane, Erase), which suppresses the activity of the sebaceous glands (very effective on steroid courses). It should be used as a last resort, when nothing helps anymore. Strictly as prescribed by a dermatologist. This is a pretty serious drug, with a huge list of side effects.
• If, despite the treatment, new inflamed acne appears, it is necessary to resort to the use of antibiotics. The optimal choice is Clindamycin inside. Doxycycline can also be used, but it is less effective. The average duration of antibiotic treatment is 10 days. Noticeable improvements usually occur on 3-4 days, but you should not finish the course ahead of time.
• In severe cases, a blood purification procedure may be required - plasmapheresis, etc.
• Wipe the problem areas with a 5% iodine solution, apply overnight both point-by-point and on the entire face, relieves inflammation, dries the skin.
• Buy 2 vials (40 ml each) of 2% salicylic alcohol at the pharmacy, a package of ampoules of 1% Dioxidine solution (amp. 10.0), a bottle of Dimexide and a package of Metronidazole tablets. Open all ampoules of dioxydine, mix it with the entire volume of salicylic alcohol, add 1 table. a spoonful of dimexide and 4 tablespoons. spoonfuls of boiled water. Then crush 3 metronidazole tablets, pour into the solution and shake until maximum dissolution. To avoid drying, add 1 bottle (25 ml) of Glycerin. Wipe it 2 times a day... the author is Vitaly Maksimovich Chernyavsky, a dermatologist, who has been practicing since 1981)
• Treat the whole body with 2% salicylic alcohol, then apply 3-4 vials of sulfur ointment to the whole body, preheating the ointment in a water bath. The treatment is a week. Throw away the bed linen after that.

When large single rashes with purulent contents (cysts) appear in everyday life, mechanical removal or "extrusion" is very often used. It is undesirable to do this, since pus can penetrate into the surrounding tissues and increase the inflammatory process, not to mention infection in the blood and dissemination throughout the body.

Even the ancient Greek surgeons said, where the pus is, open it there. This principle remains relevant at the present time. To remove suppurated acne, you can use a needle from a syringe. The procedure consists in guiding the end of the needle 2-3 mm into the center of the formation (pretreated with an alcohol solution or other antiseptic) and creating a small incision, after which the pus is removed in the usual way. Re-treat the place with a cotton swab soaked with antiseptic. With this approach, the purulent contents easily come out, the inflammation passes quickly (usually by day 2) and scars do not form.

Anabolic drugs may only be used by a doctor's prescription and are contraindicated in children. The information provided does not call for the use or distribution of potent substances and is aimed solely at reducing the risk of complications and side effects.