The comprehensive approach to solving the problem of acne | Ukrainian Medical Journal

Acne is a common problem which can be continued from the teenage acne (persistent acne), if it recurs from adolescence several years after it disappeared (recurrent acne), or it can appear for the first time in adulthood (late onset acne). Some researchers consider late acne only if it appears after 25 years of age. An androgen production increase plays an important role in the alteration of sebum, which is involved in the pathogenesis of adult acne. The correlation between excessive quantity of androgens and the development of acne in adult women has been confirmed in many studies. The reasons for late acne can be different and depend on individual anamnestic data. Hyperandrogenism is not always the cause and component of acne, it must be taken into account during treatment and anti-relapse therapy. The severity of clinical manifestations of acne depends on many factors. Diagnosis of acne is based mostly on clinical picture, but an assessment tool is needed to optimize treatment. In women withhyperandrogenic conditions with manifestations of acne, the reasonable treatment is the use of modern combined oral contraceptives. The usage of combined oral contraceptives, antiandrogens in combination with local therapy is recommended regardless the level of androgens in the blood, even in cases of normoandrogenemia. Spironolactone (Verospiron) and Richter CycleBalance can be used as a combination therapy with Belara® and as a monotherapy for late acne. High antiandrogen activity was noted in Belara® with the progesterone derivative chlormadinone acetate. The properties of chlormadinone acetate are close to the effects of natural progesterone: metabolic neutrality and additional effects, such as a positive effect on the lipid profile, no effect on carbohydrate metabolism, blood pressure, body weight. Belara® does not have a clinically significant effect on hemostasis. Thanks to its ingredients (2000 mg of myo-inositol and 200 mcg of folic acid in one sachet), Richter CycleBalance allows to regulate the menstrual cycle and hormone levels and promotes the physiological functioning of the ovaries, which is extremely important for women with polycystic ovary syndrome. For women of active reproductive age with late acne the combination therapy of Belara® and Richter CycloBalance increases the effectiveness of treatment, results in stable regression of inflammatory and non-inflammatory elements of the rash, and improves the aesthetic condition of the skin.

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