Similar to other folliculitis and acne, the differences and how to treat themDermatologist Jaewi Cho

 

 

 

What is folliculitis?

 

 

Acne and folliculitis, commonalities and differences

 

So, what do acne and folliculitis have in common and what are the differences?

 

In both folliculitis and acne, erythema, papules, and pustules can all be observed. Folliculitis is characteristically observed with a little more dilation of the blood vessels. Acne sufferers have comedones that are not seen in folliculitis. This is the most important clinical feature that differentiates these two diseases.

 

Causes of acne

 

First, let's take a look at the causes of acne. Those of you who have raised children will know this. When I was in elementary school, I had a clean face, but as I hit puberty, I started to get pimples on my forehead. This is because as they enter puberty, the influence of androgens, which are male hormones, dominate. As androgens increase, sebum secretion increases. In particular, sebum production begins to be produced in the forehead. That's why pimples appear in their place. In some cases, pimples may also appear on the nose.

 

In some cases, acne-like lesions are concentrated on the hairline. In this case, unless you have a good reason for acne, your hair products, especially those that you color frequently, or the ingredients in shampoos and conditioners don't work for your skin. The fragrances and preservatives in the products irritate the skin on the forehead, causing acne. If this is the case, you can replace them and replace them with gentler products, and this phenomenon may go away.

 

Why increased sebum secretion causes acne

 

So why does increased sebum production cause acne? First, there is a functional and structural problem with the sebaceous glands, and second, as sebum secretion increases, many acne-causing pathogens enter their place. This is called colonization, and it colonizes and forms pimples in its place.

 

 

The picture above shows the functional and structural changes in the sebaceous glands.

 

A typical sebaceous glands schematic diagram shows the sebaceous glands underneath and the sebaceous glands at the top of the hair follicle, where the sebaceous glands are connected to the skin. As the amount of sebum in the upper part of the hair follicle increases, the cells in the upper part of the hair follicle proliferate. This will expand into a funnel as shown in the picture on the right. And this is where sebum accumulates and keratin-like keratin accumulates, creating what is commonly called an open comedone, a comedone. This will be the first button on acne.

 

There are also normal bacteria that live near the sebaceous glands and on the skin. When exposed to ultraviolet rays on a regular basis, active oxygen is produced in the skin, and when they accumulate, they cause damage to the skin. A fungus called C. acnes acts as a defense system against free radicals. These antioxidant enzymes act as a defense in our skin, and when sebum production increases, these bacteria are present on the surface of the skin, then move down to the sebaceous glands, where they form colonies and trigger acne.

 

What makes acne worse

 

Let's take a look at what makes acne worse. First of all, acne gets worse if you have poor eating habits. For example, if you have poor eating habits, such as eating white flour foods, high sugar foods, or frequent junk food, your acne will get worse. Sleep is also very important. As time passes, our body releases more stress hormones and stimulates the secretion of sebum. That's why it's so important to get a good night's sleep early. My advice is to go to bed before 11 p.m. This is because stress hormones stimulate the secretion of sebum, which helps bacteria become more active.

 

In addition, poor makeup and cleansing habits make acne worse. Most people think that washing thoroughly will improve breakouts, but washing your face too thoroughly can actually weaken your skin barrier.

 

Lastly, we're talking about gut bacteria. There are a lot of bacteria in the gut that make my skin bad. The bacteria that live in this gut make a lot of metabolites, and they circulate through the blood, and then they come to the skin and turn the skin upside down. Therefore, it is sometimes recommended to take probiotics that are good for the body.

 

Acne-like symptoms, demodectic worms

 

Next, let's take a look at demodectic worms. The characteristic symptoms of folliculitis are twofold. First of all, my face is always red or red. You can see thin dilation of blood vessels in the skin of the reddened face. On top of that, pimple-like inflammatory lesions begin to appear one by one. However, unlike common acne, there are people who talk a lot about itching at night. We'll come back to why later.

 

The fungus follicles also live around the eyes. As a result, not only the face, but also the area around the upper and lower eyelids becomes red and inflammatory reactions occur. It can also be confused with things like styes. So, if you have styes in your eyes or if you get redness over and over again, you should suspect folliculitis around your eyes.

 

Now, let's take a closer look at demodectic worms. One of the demodectic fungi that lives on human skin is a fungus called Demodex folliculorum or Demodex brevis. Folliculorum develops mainly around the hair follicles. It attaches itself to the cells around the hair follicles and feeds on the skin cells. Brevis is a little shorter in size than folliculorum, and it lives mainly around the sebaceous glands. These two bacteria are present together in a place called the sebaceous gland unit where acne occurs, so when there is an inflammatory reaction here, the clinical picture is bound to resemble acne.

 

So, are all of these bacteria bad? Not necessarily. These are bacteria that everyone has and that live on our skin. These bacteria act like police officers, preying on other microbes that live on our skin and controlling their numbers. However, when their numbers increase, skin diseases occur.

 

When to have demodectic worms tested

 

Here's a summary of when you need a demodectic test. My face is always red, but I keep getting troubles on top of that red skin, I don't think it's acne, or I treated the acne but it keeps coming back, or after being under extreme stress or exposure to strong UV rays and exfoliating, one day I suddenly noticed something on my face, but it still hasn't gone away. In this case, it is necessary to test for demodectic worms.