The start of a new series with the A – Z of common conditions. Some posts will be new and others will recycle previous posts with any relevant updates. I have received several emails in the last couple of months about acne and so I am posting the article from April again.
Acne is the curse of the teen years and also as we go through hormonal changes later in life.. There is also a strong link to diet, especially the the over indulgence in sugars.
Some organs play a major role in our survival and others can be removed without impacting our general health in any significant way. As we have evolved, so an organ’s function may have changed to accommodate our modern environment, especially if their role is protective as in the case of the liver and the elimination of toxins. In this polluted world our body is under increasing stress and keeping the individual organs healthy ensures the general well-being of the entire body.
The skin in in fact our largest organ and weighs 12% to 15% of our body weight and has three vital roles to play. It protects us from external contaminants, acts as a temperature and moisture controller and is essential in the elimination of waste products.
There is a complex structure to our skin that is invisible to the naked eye and apart from slapping a bit of moisturiser on last thing at night; most of us are unaware of the crucial role that it plays in our general health.
Because of the skin’s role in the elimination of waste products and as a barrier to external contaminants it comes under increasing stress as we get older. Free radicals attack it from the outside from chemicals in household cleaners, cigarette smoke, pollution and ultra-violet light. From the inside it is the victim of a poor diet low in essential fatty acids, processed foods, food intolerances and toxins produced from an inefficient and under nourished operating system.
Some of the signs of skin under stress are acne, cold sores, eczema, psoriasis, hives, impetigo, shingles, warts and of course wrinkles. Today I am going to be covering acne, a bane for teenagers but can also come back to haunt us in our middle years as we go through another hormonal change.
I remember as a teenager getting a few spots at certain times of the month but was thankfully clear of major acne outbreaks. I did have a friend at school that was devastatingly affected by the condition and when you are a 16 year old girl or boy it can have a detrimental impact on not just your physical appearance but also your mental and emotional health.
Let’s face it, spots that are on your back and covered up on your arms are unsightly and irritating but if your face is covered in blackheads, whiteheads and scarring then it can result in lack of self-esteem that can last for years afterwards. In severe cases acne can lead to severe depression, withdrawal from both school and social activities and suicide.
Unfortunately even when the acne has departed in can leave scarring which varies in severity and often because it is deep and pitted it remains for a lifetime. The reason that it is so deep is because of the inflammation in the dermal layer of the skin which heals abnormally leaving the pitted surface.
The numbers across the western world when added together make acne the 8th common disease in the world. It is estimated that it affects over 80% of teenagers adding up to a huge 600 million people worldwide.
There are a number of suspected causes and I will take a brief look at these.
Most of us will associate spots that appeared during our teen years with hormonal changes after puberty. Sex hormones called androgens result in several changes within the body but also in the skin. The trillions of pores on the surface of our skin are really minute openings into canals called follicles. In each follicle you will find a hair and a sebaceous (oil) gland. This helps keep our skin supple and hydrated and also assists in the disposal of old skin cells that we are shedding continuously.
At puberty and for girls each month the surge of hormones results in a change in the follicle causing them to grow larger and produce more oil. Whilst this affects both sexes in the teen years it also affects women who become pregnant at any age or who suffer from PCOS (polycystic ovary syndrome). PCOS is caused by a woman producing too many of the male androgens affecting her menstrual cycle and ability to become pregnant.
With teenagers it is not just the increase in androgens such as testosterone which can cause acne. At that age there is a growth spurt particularly in boys that can take place between the ages of 16 and 24 and the hormone responsible for this is GH or HGH.
Additionally IGF-1 is a hormone that is similar in structure to Insulin and plays a role in growth in both teenagers and later with a different affect in adults can result in a similar response.
It is unusual for acne to develop after the body has completed its growth cycle in the early to mid-twenties.
It is believed that around 75% of acne could be genetic which is supported by studies with twins and also with immediate family members. Polygenic inheritance pattern controls our height, skin colour, eye colour and also it is believed our weight. Rather than just one gene being involved it requires a combination of two or more genes to affect these characteristics. Certain genes have now been identified that could be related to acne and that is an ongoing study.
This genetic link is reinforced by the incidences of severe acne associated with a dysfunctional immune system. This is not lifestyle related but an inherent over sensitivity to bacteria that results in an unusually aggressive immune system response. When bacteria are detected by the body the immune system produces large amounts of inflammatory cytokines. These induce white blood cells to unleash destructive enzymes and free radicals into the site of infection. Because this response is unusually aggressive it can cause damage to the surrounding tissue. This in turn results in another release of cytokines and it becomes a perpetual cycle resulting in long term inflammation and of course the associated acne. In this type of environment bacteria thrive rather than be killed off.
With the other form of genetic dysfunctional immune response the white cells themselves are under powered and do not have the ability to deal with any harmful bacteria that they encounter. Usually white blood cells work on the principal of divide and conquer, they are designed to ingest any bacteria they come across, isolating the bacteria in a special casing called a phagosome and then pumping toxic enzymes inside to kill it. It is then broken up into small particles that are absorbed back into the immune system. The system then takes these particles and designs anti-bodies that will be able to fight future infections of this bacteria.
In a faulty immune system the white cell takes in the bacteria but is not equipped to kill them adequately. They keep trying however, exhausting themselves in the process and dying. This releases the bacteria still alive and allows it to thrive. It also means that the immune system does not get the chance to develop anti-bodies to fight that particular strain of bacteria leading to long term infections.
The most common of the bacterial infections associated with acne is Propionibacterium acnes (P. acnes) is a bacteria that grows deep inside of pores where it obtains its energy from the oil in the follicle canal. It is anaerobic which means that unlike most bacteria it is tolerant to oxygen so the low oxygen, oil rich environment of the follicle is perfect for its growth. Because it forms clumps of bacteria it can block and protect itself within the canal leading to persistent infections into the 20s and beyond. Unfortunately the bacteria have become resistant to a number of the anti-biotics used to treat acne including Penicillin.
There have been many assumptions made over the years about acne and its causes. Including the fact that some teenagers do not have a close relationship with cleanliness, that poor diet full of fats and sugars is to blame and the habit of the young today to spend more time indoors rather than out in the fresh air. In reality I believe there is an element of all of these factors involved. And in particular the increase in the use of both male and female facial and body beauty products.
Today we are spoiled for choice when we buy skin products in the pharmacies, supermarkets and online. The prices also vary from very cheap to extremely expensive but unfortunately whilst simple is better, cheap may not be so. Many cheap skin products have ingredients that could irritate skin further. This also applies for make-up that teenage girls are going to use to cover up spots and scars.
Most acne prescribed medication is designed to dry up the oil that feed the bacteria and may be causing the outbreak in the first place. This can result in dry and flaky skin and irritated patches.
The temptation is to buy moisturisers that are heavy and greasy to counteract the dryness but it is better when suffering from acne to use a light weight moisturiser with ingredients such as glycerine that will not clog your pores with more grease. Avoid those that have ingredients such as cocoa butter for example.
The one lifestyle activity which is definitely implicated in causing skin irritation and increasing the chances of acne is smoking.
You might find the following daily cleansing ritual helpful.
A mild cleanser for the face (ask advice on your skin type) Using your fingers gently massage the skin for a few minutes. Wipe off the excess with a clean cotton wool wipe. Then rinse your face in lukewarm warm water to remove all the lotion. Pat the skin dry and then apply the light moisturiser. You can use a mild exfoliant (and I mean mild) once or twice a week which can be helpful in cleaning the skin slightly more thoroughly.
These days there are a lot of products on the market but do be careful about just buying off the shelf. Ask advice from a pharmacist and check for side effects.
There are a number of prescribed medications available now to treat acne including topical creams. Antibiotics are also prescribed but there is a danger that this will then create a resistance to future antibiotics if over used. For girls sometimes being prescribed birth control pills can regulate hormone levels reducing the surge of hormones each month. I do advice however that you do not self-medicate by buying products online. Get professional guidance and if you add to your acne scarring by using the wrong product it will stay with you for life.
You must be extremely careful with your skin as whilst it does a very tough job it is also very delicate. I have found that taking Echinacea for six weeks at a time may help boost immune system function. https://smorgasbordinvitation.wordpress.com/2015/12/02/the-medicine-womans-treasure-chest-a-little-herbal-health-insurance-echinacea/
Also you may find taking Grapefruit seed extract to help control an overgrowth of Candida Albicans, which as a fungal infection of the intestines, does impact the efficiency of the immune system.
Topically, apart from the cleansing regime I have already mentioned, you may find that a couple of drops of tea tree oil mixed with your morning and night time moisturiser may also help kill off the bacteria. Do monitor and if it causes any irritation or redness of the skin stop using.
In addition to echinacea other herbal remedies can be useful for skin complaints including Saw Palmetto and Agnus Castus to help normalise hormonal levels. If you are considering taking any herbal remedy I do suggest that you talk to a qualified assistant in your local health food shop.. They should have received training in the uses for any of their products but do ask first.
The fact that the incidences of acne is certain cultures that are not exposed to the less healthy aspects of our western diet is virtually non-existent, leads to the assumption that sugars, trans fats and other additives in our food are contributing to acne. It also confirms of course the genetic link to the disease especially when those populations have remained isolated.
As you will have seen there is a genetic link to a dysfunctional immune system that results in persistent acne but there are also dietary and lifestyle related immune system issues that need to be addressed with a balanced diet and exercise.
It is tough when you are a teenager to stick to a really healthy diet when your friends are enjoying burgers, pizzas and other great tasting food. Nobody wants to be the odd person out but tough as it is, it is so important to eat a mainly fresh unprocessed diet with lots of vegetables and fruits with the antioxidants needed for a healthy immune system and of course skin health. Also lean protein and good fats and most importantly plenty of water to keep the skin hydrated.
Foods that might be helpful in cleansing the body of toxins and therefore reducing the triggers for acne include the following: beetroot, artichoke, hot water and lemon juice first thing in the morning, beans such as chickpeas which helps moderate hormone excretion, fresh vegetables of any kind and fruits such as oranges which are high in Vitamin C. Dried apricots are a good snack as well as nuts and seeds containing zinc which is good for skin healing. Vitamin E is also essential for skin health and having half an avocado on a salad or on its own daily will provide you with that vitamin and healthy fat.
One of the key factors of ridding the body of toxins is drinking water and this also helps prevent the skin from becoming dry and even more irritated.
Sally Cronin – Just Food For Health 2007
Please feel free to share this post and thanks for dropping by.. Sally