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Imagine waking up the morning of prom, or your wedding day, or a big job interview…
试想 你在某个即将面临舞会 婚礼 或重要面试的早晨醒来
and sure enough, you look in the mirror to find your forehead is covered in zits! It's happened to lots of us.
果然 照镜子看见额头上冒了好多痘！ 很多人都经历过这种事
Acne, or acne vulgaris, is the most common skin disease in humans.
粉刺或寻常性痤疮是人类最常见的皮肤疾病
It affects about 80% of people at some point in their lives.
大约80%的人在人生中的某个时期会为其所困
Most people get acne between the ages of 11 and 30, but sometimes older people continue to struggle with it, too.
大多数人在11岁到30岁之间长粉刺 但有时候 一些人年纪大了也还在为此苦恼
Acne happens when follicles and pores become clogged with dead skin cells and oils. And … it sucks.
当毛囊和毛孔被死皮细胞和油脂堵塞时 就会长粉刺 这…真是糟糕透了
But by studying how acne forms, doctors have developed ways to prevent and treat it.
但通过研究粉刺的形成 医生们已经找到了防治它的办法
It all starts with your skin: a complex organ made up of two layers and lots of nerves, blood vessels, and glands.
一切从你的皮肤说起 这是个复杂的器官 它有两层 包括大量的神经 血管和腺体
Your skin cells regenerate about once a month, so you constantly have dead skin cells sloughing off,
你的皮肤细胞大约每月再生一次 所以不断有死皮细胞脱落
and new skin cells rising to the surface.
由新的皮肤细胞取而代之
This whole skin-replacement thing isn't much of a problem, on its own.
这整个皮肤新旧更替的过程本身并没什么问题
But lots of these dead skin cells come out through your pores. And pores make things more complicated.
但大量的死皮细胞要经由你的毛孔排出 是毛孔让事情变得更复杂
Skin pores are essentially just openings for tiny hairs.
皮肤的毛孔本质上只为细小的毛发的张开
Hair follicles, the root ends of the hairs, are embedded in your skin
毛囊 即毛发的根部 在皮肤的内部
and surrounded by clusters of sebaceous glands, special glands that produce sebum.
被一组皮脂腺包围着 这种特殊的腺体能产生皮脂
Sebum is that oily, waxy stuff that comes out of your pores.
皮脂是从你毛孔里排出的油腻的蜡状物质
It helps keep your skin waterproof and moisturized: it keeps excess water out of your body,
它帮助皮肤防水和保湿 并把多余的水分排出体外
and it keeps water already inside you from getting out through your skin. So, sebum is important.
不让体内已有的水分通过皮肤流失出去 由此看来 皮脂很重要
But things can go very wrong if your sebum production gets out of whack.
但是如果皮脂分泌出现问题 事情就严重了
When your body doesn't produce enough sebum, your skin can dry out,
当身体不能产生足够的皮脂时 皮肤会变干
making you more susceptible to bacterial or fungal infections.
使你更容易被细菌或真菌感染
But if your body produces too much sebum, it can build up inside your pores, trap dead skin cells, and cause a blockage.
但如果身体产生过多的皮脂 它会在毛孔里堆积起来 妨碍死皮细胞排出 从而造成阻塞
Increased sebum production is one of the major factors involved in the development of acne.
皮脂分泌增加是粉刺产生的主要原因之一
Increased keratin production is another one. Keratin is a protein produced by your hair follicles.
另一个是角蛋白增多 角蛋白是毛囊分泌的一种蛋白质
It gives structure to each strand of hair, as well as the top layer of your skin.
它是毛发和皮肤表皮层的主要构成物质
But when the hair follicles produce too much keratin, the extra protein binds together dead skin cells,
但如果毛囊分泌了过多的角蛋白 多余的蛋白质会将死皮细胞绑在一起
so they can't just shed out of the pore like they normally would.
如此死皮细胞就无法正常地从毛孔排出
You end up with a blockage that then traps more dead skin cells, plus sebum.
最后形成堵塞 使更多的死皮细胞和皮脂陷在毛孔里
Once the pore is officially clogged, it becomes a breeding ground for colonies of bacteria — especially Propionibacterium acnes.
一旦毛孔被完全堵住 它就成了细菌繁殖的温床 尤其是痤疮丙酸杆菌
That's a species of commensal bacteria, which basically means it's friendly.
这是一种共生细菌 也就意味着它本质上是友好的
It naturally lives on your skin, and it's not harmful … most of the time.
它自然存在于你的皮肤上 大多数情况下它是无害的
The commensal bacteria that make up your microbiome probably even help prevent other,
这种共生细菌是人体菌群的一部分 也许还可以帮助防止其他
more harmful bacteria from colonizing on your skin.
更有害的 细菌在皮肤上繁殖
So having colonies of Propionibacterium acnes living on you isn't a bad thing.
这样看来 痤疮丙酸杆菌在皮肤上繁殖也不是什么坏事
You want them there — as long as they stay on the surface of your skin.
你需要他们——只要它们老实地呆在皮肤表面
When the bacteria find their way deep into skin pores where they don't belong, that's when they can cause an infection.
当这种细菌找到方法深入毛孔内部 然而它们并不属于这里 这时它们就会引发感染
And infections often cause inflammation.
感染通常会导致炎症
When you get an infection, your immune system responds by increasing blood flow to the area
被感染时 免疫系统会做出回应 增加流向这个区域的血液
and sending extra immune cells and enzymes to fight off the infection.
并派出更多的免疫细胞和生物酶以抵御感染
That inflammation usually causes redness,pain,and swelling,
这种炎症经常会导致皮肤发红 疼痛 起肿块
which can contribute to some of the most several symptoms of ance.
然后引发一些最严重的粉刺症状
Different combinations of symptoms cause different kinds of acne, with names you've probably heard before:
不同症状的组合产生不同的粉刺 它们的名字你可能以前都听说过
Blackheads, whiteheads, pimples, pustules … technically, they all mean different things.
黑头 白头 面疱 脓包……从专业角度来说 他们是不一样的
The scientific term for a clogged pore is a comedo, which actually used to mean a parasitic worm.
粉刺是毛孔阻塞的专业叫法 过去常被用来表示一种 寄生虫
People started using the term to refer to a clogged pore because the stuff that comes out when you squeeze it looks kind of like a worm.
人们开始用粉刺指代阻塞的毛孔是因为 从毛孔里挤出来的东西看起来像一条蠕虫
When the main symptom is just that the pore is clogged, without much inflammation, that's either a blackhead or a whitehead.
当主要症状还只是毛孔被阻塞 没多少炎症的时候 这时就是黑头粉刺或者白头粉刺
Blackheads are what it's called when the comedo is open.
粉刺还是张开状态时叫黑头
The trapped sebum and dead skin cells become oxidized,
被阻塞的皮脂和死皮细胞发生氧化
which turns the surface of the clogged material into a dark color, kind of like how silver tarnishes.
使得阻塞物的 表面物质变成黑色 类似银器的腐蚀过程
When the comedo closes, skin cells grow over the top of the plug and stop this oxidation from happening,
当粉刺闭合 生长的皮肤细胞将闭合口盖住 阻止了这种氧化
so the whitish color of the sebum shows through. That's called a whitehead.
透过皮肤看到的皮脂混合物就成了白色 这就是白头粉刺
When there's a comedo plus an infection that causes inflammation, that's a different kind of acne: pimples!
粉刺加上感染会引发炎症 这就是另一种粉刺：面疱！
The typical reddish bumpy kind are more specifically called papules.
这种典型的红色小肿块 更具体地说 就是丘疹
If the inflammation gets really bad, sometimes the bumps start leaking fluid or bacteria-filled pus.
如果感染变得很严重 这些肿块有时会流出液体 或者充满细菌的脓液
Those kind are categorized as pustules, and they're usually a much brighter red, or sometimes white from the oozing fluid.
这种是脓疱 他们通常更加红亮 有时候因为装满了渗液而发白
The most severe kind of acne is generally called cystic acne.
最严重的一种是囊性痤疮
That's when the infection takes root in the deepest layers of the skin.
这时感染已侵入皮肤的最深处
Sometimes the infection causes more solid bumps to form, called nodules.
有时感染会产生更硬的肿块 称之为结节
And sometimes the infection causes pus-filled bumps, called cysts. So that's how acne happens.
也有时感染会导致充满脓液的肿块 称之为囊肿 这就是痤疮怎么形成的
But what causes it in the first place?
但最根本的原因是什么？
What makes healthy pores become clogged, infected, and sometimes ooze-y?
是什么让原本健康的毛孔堵塞 感染 有时候还流脓呢？
Again, there are a few different factors involved. Genetics seem to be important, for one thing.
同样的 有几个不同的因素 一方面 基因很重要
So if your parents had acne, you're more likely to have it too.
如果你的父母生过痤疮 那么很可能你也会有
Hormones also have a huge influence on acne — specifically, androgen hormones, like testosterone,
同时激素的影响也非常大 特别是雄性激素 像睾丸素
which influence the development of both the male and female reproductive systems.
它会影响男性和女性的生殖系统的发育
Which explains why acne is so much more of a problem during puberty.
这就解释了为什么粉刺多发于青春期
Androgen hormones are linked to sebum production.
雄性激素会影响皮脂的分泌
So during puberty, when the hormones are highly active, there's an increase in sebum production.
所以在激素高度活跃的青春期 皮脂分泌也会增加
Increased stress has been thought to increase hormone production, as well.
同时 人们认为压力的增大会导致激素水平的上升
So if you find yourself breaking out the day before a big test, that's probably why.
所以 如果你发现自己在大考前一天粉刺爆发 这也许就是原因
When you're stressed, you produce more hormones, which then increases your sebum production.
当压力增大 激素水平会上升 从而导致皮脂分泌增加
Since sebum is an oil, a lot of people say that greasy foods will cause acne.
鉴于皮脂是一种油脂 很多人因此认为油腻的食物会导致粉刺
Sometimes you'll also hear that dairy makes it worse, or even more specific foods, like chocolate.
有时也会听说乳制品会导致粉刺恶化 或者其它更想当然的食物 比如巧克力
But the truth is, scientists aren't really sure how or whether diet and acne are connected.
但事实是 科学家们并不确定饮食和粉刺是怎样关联的 或者是否相关
There have been lots of studies investigating this, and some do suggest a possible link. But others don't.
很多研究机构调查过这个 有一些表示两者或许有关联 另外一些却表示没有
We need more comprehensive, controlled trials with plenty of subjects before we can come to any real conclusions.
我们需要研究主题足够多的更全面的对照实验 在得出任何真实结论之前
Doctors do acknowledge that there's anecdotal evidence,
医生们承认确实有传闻方面的证据 然后他们又说
and they say that if changing your diet has helped with your acne, then it makes sense for you to stick with it.
如果改变饮食对你的粉刺有帮助 那坚持下去就会有效果
There just isn't enough evidence to support the idea that diet has a role in acne in general.
然而确实没有足够的证据 来支持饮食通常能够影响粉刺这一观点
But we do know that exposure to other topical oils, like some cosmetics or moisturizers,
我们知道 涂抹其它局部外用油脂 例如化妆品和护肤品会导致粉刺
can cause acne by blocking your pores with extra oils and trapping sebum.
因为它们多余的油脂会堵塞你的毛孔 并使你自身的皮脂无法排出
It's easy to avoid the problem, though — just look for products that say they're non-comedogenic,
想要避免这个问题很简单 只要选择有不致粉刺说明的产品就可以了
which means that they shouldn't clog your pores.
这意味着它们不会堵塞你的毛孔
But the natural oil on your face isn't really a problem.
人脸上的天然油脂是没问题的
You’ll often hear that you should wash your face a lot to help prevent acne,
你可能经常听到人们说 多洗脸可以预防粉刺
but acne isn't caused by dirt or by the natural oil that's already on the surface of your skin.
但是粉刺不是因为脏或者皮肤表面的天然油脂引起的
And washing your face too much can actually irritate your skin, making acne worse.
而且过于频繁地洗脸反而会刺激皮肤 使粉刺变得更糟
To treat acne, the goal is to reduce the factors that come together to cause breakouts.
治疗粉刺是要减少那些综合起来会让你爆痘的因素
The one thing you shouldn't do is pop a zit.
万万不能挤痘痘
The big risk is that you'll push the infection out of the hair follicle and into the surrounding skin, instead of out to the surface.
这么做风险很大 你会把感染挤出毛孔 影响周围的皮肤 而不是把感染排出去
Plus, you'll irritate the area, causing more inflammation and making the acne take longer to heal.
而且 你会刺激这个区域 导致更多的炎症 使粉刺需要更长的时间来愈合
You might also spread bacteria to non-affected pores.
你也可能会把细菌扩散到没有受感染的毛孔里去
Instead, treatments try to lower sebum production, stop dead cells from clumping together in the pore as much,
与此相反 治疗在于努力减少皮脂分泌 尽量防止死细胞在毛孔里凝结
prevent bacterial growth, and lower inflammation.
防止细菌繁殖 减少炎症
Treatments can range from mild to aggressive, depending on how severe the symptoms are.
治疗方法从温和到猛烈有不同的级别 具体视症状的严重情况而定
For mild acne like blackheads and whiteheads, you can usually use topical over-the-counter medications.
对于像黑头和白头这样的轻度粉刺 用局部外用的 非处方药就可以了
One of the most effective is benzoyl peroxide, a chemical compound that's really good at killing bacteria.
氧化苯甲酰是最有效的药物之一 这种化学合成物 对于杀菌非常有效
It decomposes into super reactive forms of oxygen, which bind to and destroy the molecules the bacteria need to survive.
它分解成的超级氧化因子 可以绑定 破坏 细菌生存所需的分子
Another common treatment is salicylic acid, which doesn't kill the bacteria, but stops them from replicating.
另一种常用的药物是水杨酸 它不会杀灭细菌 但是能阻止细菌繁殖
It can also break down skin cells and keratin to help unclog the pores.
它还可以分解皮肤细胞和角蛋白以保证毛孔畅通
Inflammatory acne, like papular pimples or cystic acne, sometimes needs stronger treatment to reduce the inflammation.
炎症型痤疮 比如丘疹和囊性痤疮 有时需要药效更强劲的药物 来消减炎症
That usually means prescription meds.
通常是指处方药
###Antibiotics — the kind that are also used to treat other bacterial infections,
抗生素——这类药通常也用于其它细菌感染
from strep throat to urinary tract infections — can be used to treat acne.
从咽喉炎到尿路感染——可以用来治疗粉刺
They stop bacterial growth and reduce inflammation.
他们可以阻止细菌繁殖 减少感染
Another kind of treatment involves retinoids, which are compounds related to vitamin A.
另一种药物是类维生素A 是维生素A的化合物
Retinoids work by binding to skin cell receptors to remove dead skin cells and encourage healthy skin cell growth.
类维生素A通过与皮肤细胞上的受体结合 移除死细胞 促进健康细胞生长
So retinoids work really well to unclog pores full of dead skin cells. They're anti-inflammatory, too.
所以维生素A能有效疏通因充满死皮细胞而被阻塞的毛孔 它也是消炎药
In severe cystic acne cases, stronger retinoids actually work at the deeper layers of skin
囊性痤疮严重时 药效更强劲的类维生素A实际上作用于皮肤的更深层
to reduce the size of the oil glands so they produce less sebum.
它可以缩减皮脂腺的尺寸 从而减少皮脂的分泌
And since hormones are a big factor in sebum production,
由于激素对皮脂分泌有重要影响
using birth control or corticosteroids can regulate female hormones and reduce the amount of androgen hormones being produced.
使用避孕药 或类固醇 可以调节女性的激素分泌 减少雄激素的分泌
Fewer androgen receptors at work means less sebum production, which means less acne.
（因雄激素减少导致）起作用的雄激素受体减少 皮脂分泌就会减少 痤疮自然也减少
Sometimes, severe, cystic acne will leave scarring, but there are ways to reduce it.
有时候严重的囊性痤疮会留疤 但是有方法消淡
These procedures don't necessarily treat or prevent the acne itself,
这些治疗程序不是治疗或阻止痤疮本身
but they can reduce the bumps and scars left over from bad breakouts.
但是他们可以减少痘痘和爆痘后留下的疤痕
Dermabrasion uses a gentle sanding tool to wear down layers of the skin that have scarred over from cystic acne,
磨皮是用轻柔的打磨工具磨去因囊性痤疮留疤的皮肤层
but it only works for people with lighter skin.
但这只对皮肤薄的人有用
This procedure has mostly been replaced by laser resurfacing,
这种疗法基本上已经被激光疗法所取代了
which uses laser pulses to remove skin layer by layer until the scar has smoothed out.
激光疗法是用激光脉冲一层一层地除去皮肤细胞直到疤痕被消除
Then there are chemical peels, which use compounds like salicylic acid or retinoic acid to perform
此外还有化学换肤 用水杨酸或维生素A酸之类的化合物作用于
what's basically a controlled injury to the top layer of skin, killing the top layer of cells.
表层皮肤的控制性损伤 杀死表层皮肤细胞
The dead skin cells peel off, revealing healthy skin cells underneath.
死皮细胞脱落 露出健康的皮肤细胞来
Luckily, most people grow out of the acne-ridden years of puberty,
幸运的是 大多数人只在青春期长痘
though some people will continue to have acne well into their 40s and 50s.
虽然有些人一直到了40岁 50岁还在长痘
But even though a bad breakout might make you self-conscious,
尽管一次糟糕的爆痘可能会使你不舒服
it's normal, it's treatable, and it's not life-threatening.
但这是正常的 可治愈的 也没有生命危险
So take care of your skin, talk to your doctor about prescription treatments if you want them,
所以照顾好你的皮肤 如果需要的话 向你的医生咨询一下治疗处方
and trust that your acne will probably get better with age.
要相信你的粉刺情况也许随着年龄变大越来越好
And then you get to look forward to wrinkles!
然后就等着皱纹出现吧！
Thanks for watching this episode of SciShow, brought to you by our patrons on Patreon.
感谢观看这期由Patreon上的赞助人赞助的Scishow
If you want to help support this show, just go to patreon.com/scishow.
如果你想赞助这档节目 点击 patreon.com／sicshow
And don't forget to go to youtube.com/scishow and subscribe!
不要忘了到youtube.com/scishow订阅我们！
