Acne! Not just about Skin

Skin Conditions | July 19, 2016 | Author: Naturopath

Acne! Not just about Skin

Affecting almost 85 percent of the population in Australia, acne is the most common of skin diseases. It affects people mainly aged from 15-25, men and women alike. It usually begins during puberty but that doesn’t make adults an exception to it. A 10-20 percent of adults suffer from acne; sometimes lasting until their 30's or 40's. Ultimately, it imposes serious problems that affect not just one’s looks, but also one’s quality of life.

So what is acne?

Acne is the result of clogged oil glands.Naturally, our skin produces sebum (oil), which is a good thing because it keeps your skin moisturized and helps maintain a dose of good bacteria in it. However, hormonal build-up produces excess sebum resulting to blocked pores. 

Most people who suffer from acne can get it on their face, neck and trunk (chest and back).

Cases can be classified as mild acne (whiteheads and blackheads), moderate (inflamed papules) ad severe (cystic acne). 

Acne is an uncomfortable skin disease that often leads to embarrassment and damaged self-esteem.

What causes acne?

According to various researches, acne is often triggered by many underlying factors.

Hormones are the most common reason. Adolescents tend to have higher levels of androgens (hormones responsible for sexual organs development), making them more susceptible to acne. During this period of hormonal changes, both boys and girls are more likely to develop it. While it is easy to predict in teens, adults can also suffer from acne. According to research, women are its most likely victims. This is for the fact that the hormones of women tend to fluctuate during their period. Polycystic ovarian disease and Mirena implants also cause a lot of hormonal changes in the body making way for the formation of acne.

Genetics also appears to play a huge factor. A person’s genes have the strongest influence on whether they will develop acne or not. Some people are just genetically predisposed to having it. Stress, as it turns out, is also linked to the developing or worsening of acne.

During times of stress, the chemical reactions inside the body due to hormonal changes surges. Pressure from work and school, financial problems, personal crises and relationship breakdowns often lead to increase of a person’s stress level. Poor digestive health can influence inflammation, oxidative stress, glycemic control, tissue lipid content and even mood itself and may have important implications in  acne. The intestinal microflora may also influence acne and there is renewed research of the gut-brain-skin connection in acne. 

The diet

Probably the most controversial factor often causing debates among healthcare professionals, media and support groups is the effect of diet to acne development. Some people claim that eating certain foods worsens their acne or that it actually triggers acne. However, such claims have little to no solid evidence. Although a new study shows that by eating low GI (glycaemic index) foods helps achieve better skin. The low GI diet focuses on eating protein-rich foods such as meat, fish, eggs, milk, nuts and particular fruits and vegetables. The debate on the role of diet in acne development goes a long way. It may have an effect, but only with minimal influence. Naturopathic considerations suggest keeping the bowel moving to allow for detoxification of the body by eating fibre rich foods such as seeds, nuts, fruit and vegetables. 

Lifestyle

in keeping acne at bay exercise is as equally important as the role of hormones. An active lifestyle improves our over-all whole being. Not only does it help in releasing stress, losing and maintaining ideal weight, it also reduces insulin - the hormone that makes you store fat. Being dormant in physical activities allows insulin to rise up in the body, triggering a reaction that constitutes to the formation of acne.

Other contributing factors - include using oil-based cosmetics, hot and humid environments and medications such as steroids, certain contraceptive pills and epilepsy treatments.

What can be done to help?

Probiotics - there appears to be more than enough supportive evidence to suggest that gut microbes and the integrity of the gastrointestinal tract itself, are contributing factors in the acne process. Increasing evidence demonstrates that commensal microorganisms in the human skin microbiome (our own friendly bacteria that lives on out skin) help fight pathogens and maintain homeostasis (balance) of the microbiome.

shutterstock_380527060The overgrowth of Propionibacterium acnes (P. acnes), a commensal skin bacterium (one that lives in the skin but can grow too much) has been associated with the progression of acne vulgaris.

It was found that skin microorganisms can mediate fermentation of glycerol, which is naturally produced in skin, to enhance their inhibitory effects on P. acnes growth (stop the growth).

 

The skin microorganisms, most of which have been identified as Staphylococcus epidermidis (S. epidermidis), can ferment glycerol which inhibits the growth of P. acnes. The probiotic, L. reuteri, has been suggested may be a useful probiotic agent to control the growth of bacteria involved in acne inflammation and prevent acne. Other strains may be useful to help the other contributing factors such as irritable bowel, inflammation. Taking a probiotic, if antibiotic therapy is used, is also highly suggested. Discuss options with your healthcare practitioner. 

Zinc - study suggests that zinc levels may be related to the severity and type of acne lesions in patients with acne vulgaris. Low zinc level may contribute to the formation of acne (often found low in adolescents due to higher needs for growth and sexual development).

Zinc and Selenium have know antioxidant affects and may be beneficial in reducing oxidative stress. Supplementation may be necessary.

Zinc rich foods include meat, egg yolks, oysters and sea food, whole grains, sunflower and pumpkin seeds. Selenium is found in barley, brazil   nuts,cashews,peanuts, broccoli,eggs, garlic, oysters, tuna, mackerel, crab and onions.

Magnesium - deficiency is associated with oxidative stress, inflammatory states, premenstrual symptoms(helps with the hormonal component), anxiety and blood sugar irregularities. RDI for adults is 350-450mg/day. Some food sources include almonds and cashews, cocoa (this is why you crave chocolate) eggs, kelp and leafy green vegetables.

Vitamin B6 - aids neurotransmitter synthesis(your brain chemicals that help with stress and happiness), supports the nervous system, reduces androgen and oestrogen response (addressing the hormonal component), is required for detox, carbohydrate metabolism, required for the synthesis of essential fatty acids metabolites and improves oxygen to the tissues. Some food sources include Avocado, bananas, carrot, chicken, egg yolk, fish, sunflower seeds and walnuts.

Fish oil -there is some evidence that fish oil supplementation is associated  with an improvement in ratings of overall acne severity, especially for individuals  with moderate and severe acne. Fish oil acts on prostaglandin levels  in the body which help with inflammation. It is suggested a dose of EPA to 3–6 grams daily.  

Cucuma longa the active ingredient from Turmeric may also help as it is found to reduce inflammatory mediators.

Chaste Tree (Vitex agnus Castus L) -a study has found that the  chaste tree herb taken for at least 3 months resulted in improvement of both female and male patients with acne. This is believed to be due to its  anti androgenic effect(the hormone responsible) .Vitex has been traditionally used for the regulation of hormonal conditions. It is advised not to take Chaste Tree with other hormonal drugs- HRT, progesterone drugs or the contraceptive pill and in the first stage of pregnancy.

Tea Tree oil (Melaleuca alternifolia) essential oil used topically - has antimicrobial and anti-inflammatory properties. Use products containing this ingredient to reduce bacterial and fungal growth, such as skin cleansers and spot treatments.
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Skin Care - establish a good skin care regime. Excess sebum (oil) on the surface of the skin will attract dirt and encourage bacteria growth.

A good routine of regular cleansing morning and night and particularly after exercise and sport will help.

Use a skin mask rather than aggressive scrubs that can damage the skin surface and promote bacterial invasion or gentle pat your skin rather than “scrub”.

Use products suitable for your skin type that also contain antimicrobial ingredients.



Other - bacteria and fungus can spread easily so it is important to change your pillow slip and wash or put your pillow in the sun regularly. Change your towel and your shirt after use so as not to spread bacteria. Cosmetic and cosmetic brushes can be a breeding ground for bacteria so it is important to regularly replace products and wash brushes after use. Have clean hand when touching skin and wash afterwards so as to avoid spreading bacteria.

Topical retinoids are widely used to treat and prevent blackheads and whiteheads, derived mainly from Vitamin A - causing skin to peel, unblocking the pores. Using topical retinoid may have a possible side effect on pregnant women and a few others like skin irritation and sun sensitivity.

Antibiotics - reduce acne bacteria in the skin. They are to be used on mild to moderate inflammatory acne that hasn't improved from other treatments. Possible side effects often include itching and burning feeling. Antibiotics can come in two different forms – applied directly to the skin or taken orally. Antibiotics applied on the skin contain active ingredients clindamycin or erythromycin, which have minimal irritation but takes longer to be effective. Antibiotic tablets/capsules include doxycycline, tetracycline and erythromycin and can sometimes cause upset stomach, light-headedness or dizziness. Your GP will recommend the most suitable treatment for you and that, which may be more effective for you.

Moderate to severe acne, when not treated immediately, can leave a permanent scar. It’s better to consult your Naturopath or GP for treatment advice or if you need to be referred to a dermatologist.    

References

  • http://www.acne.org.au/
  • https://au.news.yahoo.com/thewest/lifestyle/a/31702536/solutions-to-pimples-and-adult-acne/
  • http://www.healthdirect.gov.au/acne
  • http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3038963/
  • http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4135093/
  • http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3543297/
  • http://www.ncbi.nlm.nih.gov/pubmed/22367948
  • http://www.ncbi.nlm.nih.gov/pubmed/24265031
  • http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1360273/
  • Mills,S;Bone, K;Principles and Practices of Phytomedicine Medicine,2009,Churchill Livingstone, Sydney Aust ,p.332
  • Osiecki,H;The Nutrient Bible 9th Edition, Bio concepts publishing QLD, Aust
  • Sarris, J; Wardle, J; Clinical Naturopathy 2e,2014 Churchill Livingstone, Sydney Aust,Pg.529
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