What is Acne, Diet & Healthfoods for Acne.

What is acne

Acne is a skin condition that occurs when the oil-secreting (sebaceous) glands in the skin become clogged with oil and dead skin cells, which then cause inflammation or infection. In the teenage years the oil glands associated with hair follicles secrete more oil, which clogs the skin pores and enables bacteria to grow. When the body works to kill the bacteria, whiteheads, blackheads, and pimples form in these areas. Blackheads are not caused by dirt, but by skin pigment mixed into the oily plug. In severe cases, cysts (fluid-filled bumps larger than pimples) may develop under the skin.

How is it treated

Treatment is aimed at cleaning out the clogged pores, keeping them free of oil and dirt, and reducing inflammation. A mild case of acne can be treated externally with topical treatment such as beroxyl peroxide, Retin A, or an antibiotic. More severe cases may require oral antibiotics. An oral medication called Accutane is available for severe acne. However, Accutane must be taken under strict medical supervision (usually by a dermatologist).

How long will the effects last

Acne may persist for years, but usually improves after several weeks of treatment. Treatment may be required continuously or intermittently, depending upon the severity of the condition. Acne often worsens before menstrual periods due to hormonal changes. Since lifestyle and environment influence the degree of acne, treatment results may vary as lifestyle and environment change.

How can I take care of myself

* Wash your face two to three times a day with mild soap. In addition, use a mild drying agent after washing, once or twice daily. Effective over-the-counter products contain sulfur, salicylic acid, or benzoyl peroxide. For mild cases, it is reasonable to experiment with these products to see what is effective.
* Wash hands more frequently and avoid putting your fingers and hands to the face unnecessarily. Do not squeeze, pick, scratch, or rub your skin. Scars may form if you squeeze pimples.
* Shampoo hair at least twice a week. pull hair away from your face when you sleep. Style it away from your face during the day.
* Avoid over-exposure to the sun.
* Avoid extreme stress.
* Get adequate rest.
* Exercise regularly. Howard Eisenson, M.D.

What is acne

Acne is an abnormal response in the skin to the hormone testosterone, which is produced naturally by the body.

Acne vulgaris, the most common type of acne, which occurs during puberty, and affects the hair-bearing areas of the face, back and chest. It is more common in boys, 30%-40% of whom have acne before the ages of 18-19. In girls the peak incidence is between 16-18 years old. Adult acne is a less common form affecting 1% of men and 5% of women aged 40 or over.

How does it occur

There are three essential processes which contribute to the development of acne: The overproduction of sebum: Sebum is an oily substance which is produced by specialised glands (sebaceous glands) situated in the hair follicle. It travels from the gland to the skin surface along the hair ducts (known as sebaceous ducts) and gives the skin a normal, oily or greasy texture. The sebaceous glands are first activated at puberty under the influence of the hormone testosterone and start to lubricate the skin. Where there is increased sensitivity of the gland to testosterone then abnormally high levels of sebum secretion occur. The overactive gland results in the development of inflammatory spots and pimples in the oil-producing areas of the skin. Blockage of the hair duct: In normal skin, the cells which line the hair duct continually grow and die, and are shed into the duct and then onto the surface of the skin. In those with acne, the cells, in reacting abnormally to testosterone, become "sticky" and progressively silt up the duct. This leads to a partial obstruction to the flow of sebum with consequent pooling of sebum in the hair duct. The oil solidifies and forms a "plug" causing a complete blockage of the duct.

Inflammation: When the blockage becomes complete, a very rapid build up of sebum in the hair duct occurs. This is broken down by bacteria, normally resident in healthy skin, with the production of inflammatory chemicals. These penetrate the skin causing redness and swelling which lead on to the development of a new spot. pus cells are drawn in towards the inflammatory spot which can then form a 'pustule'. The pus-filled spot can burst on to the skin surface after which the inflammation settles down. If the spot is squeezed, the pus can rupture into the skin layer causing even more inflammation and eventually scarring occurs.

Why does it occur

Excess sweating: Up to 15% of sufferers find that their acne flares up with excess perspiration, and is probably due to water causing a blockage of the hair duct.

Fluid Retention: pre-menstrual fluid retention can cause a worsening of acne. Diet: Chocolate, nuts and coffee may aggravate acne. External/occupational factors: Exposure to a variety of oils, whether cooking, industrial or mineral, can cause 'oil folliculitis'. Acne can develop in these cases either as a result of direct contact with oil on exposed areas of skin such as the forearms, or as a result of wearing oil stained work clothes. Industrial exposure to chemicals used in the production of plastics, insecticides and fungicides may also produce severe acne.

Drugs: The contraceptive pill, steroid drugs and hormones such as androgens and progesterone can induce acne.

What are the symptoms

The clinical appearance is that of a collection of hair follicles plugged with sebaceous material, called a 'comedo'. Some of these comedos can be inflamed and others are non-inflammatory.

Non-inflammatory comedos: These are more common in younger people and may allow the sebum to travel onto the skin surface and are known as an open comedos or blackheads. The colour of the open comedo is due to melanin pigment. By contrast the closed comedo, or whitehead, develops when the duct is blocked, and appears as small, pale, slightly raised spots.

Inflammatory comedos: These are small red lumps referred to as papules, and if infected with pus they progress on to become pustules. These papules and pustules may reside superficially on the skin surface, or much deeper in the skin where they can form hard nodules and cysts. These deep inflammatory swellings are always associated with scarring which can be present for life. The scar may be raised up on the skin surface (called a keloid scar) or depressed beneath the skin (an atrophic scar).

What is the treatment

In most adolescents, acne clears spontaneously with minimal scarring. The spots are not infectious and they can be treated even if they do not clear up immediately.

Topical treatments: A simple effective treatment is to hold a hot wet clean flannel on the face, followed by rubbing a plain soap onto the skin. An antiseptic such as Savlon solution, diluted with water (1 part antiseptic to 10 parts water), is an excellent alternative for controlling greasy skin. Benzoyl peroxide: This is available over the counter from retail pharmacies, and is marketed under the brand names of Quinoderm, panoxyl, or Acnegel. It should be massaged on the skin and acts as a peeling and anti-blackhead agent. Regular use should loosen the blackheads and allow them to be shed from the skin. In addition, Benzoyl peroxide has an antibacterial effect. However, care must be taken as it may irritate the skin at first, although the skin becomes more tolerant with further applications. Vitamin A derivatives : These are best used where the hair canal is plugged solid and its major action is to cause softening and expulsion of the blackhead and to prevent it from reforming. Chemically known as tretinoin and isotretinoin, they are available in lotion, gel and cream forms, prescribed by a Gp. The product is irritating to the skin and so its use must be confined to once per day, over an eight week period. Topical Antibiotics: These are prescribed by the Gp and include Tetracycline, Erythromycin, and Clindamycin. They are present in an alcoholic solution and work by being absorbed into the skin. They act by reducing the level of bacteria and the amount of inflammation. Topical treatments are applied directly to the skin and are particularly useful in mild cases. They should be applied twice daily to all affected areas regardless of whether the spots are present or not.

Oral treatments:

There are three types of oral therapy: antibiotics, hormones and retinoids. Antibiotics: These reduce the presence of skin bacteria and inflammation. The most frequently prescribed is tetracycline or oxytetracycline, but others, notably erythromycin, doxycycline, and minocycline are alternatives. Despite some reports of side effects with minocycline such as liver disease, or SLE also known as Lupus, the drug is now thought to be safe Hormonal treatment: The contraceptive pill (Dianette brand) has a dual purpose role and contains hormones which are helpful in reducing grease production. Retinoids (Isotretinoin): This is used in very severe acne and is prescribed only under hospital supervison. It dramatically controls all the factors which cause acne. Side effects include drying of the lips and skin and, most importantly it can harm an unborn baby. Treatment of Scars:

Dermabrasion: patients with severe acne and who have intractable scarring may be considered for an operation called dermabrasion. In this operation, performed by plastic surgeons, the skin is planed down to remove the scars. The success rate is highly variable, ranging from 25%-70%, and is an operation which is recommended only to those who are particularly motivated towards this form of treatment.

Where can I get further information

Apart from contacting your Gp, the following organisation may be of further help: Acne Support Group
pO Box 230

Telephone: 020 8561 6868


1 MCbrIDE, S.R., SIMpSON, N.B. (1996) Acne Vulgaris: dermatology update. Update, 53(1) July pp.26-31.

2. WEBSTER, G.F., (1995) Inflammation in acne. Journal of the American Academy of Dermatology, 33(2 pt1) pp.247-55

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If you have acne, diet adjustments, vitamin and mineral supplements, and topical treatment can help lessen the problem and reduce or eliminate your need for drugs.

Before you read further about specific treatments, you should know that in certain areas of the world acne had never or rarely been seen until the people there switched from native foods to a typical Western fined-food diet. Those native foods were whole, natural, unprocessed and unrefined.

"Mainstream" medical treatment for acne generally disregards dietary advice. Mainstream treatments include topical benzyl peroxide, retinoic acid, and topical as -well as oral antibiotics. When acne is more severe, birth control pills are sometimes recommended to women for their estrogen effects, and occasionally both oral and injectable synthetic cortisone-like medicines. Lastly, mainstream treatment for severe acne sometimes uses an unnatural, synthetic form of vitamin A which is very effective against acne, but in some cases causes birth defects and growth of excess bone adjacent to vertebrae.

The natural nutritional approach to acne treatment always includes recommendations for diet change. Building on observations of native peoples who had little or no acne, nutrition-oriented health care professionals advise elimination of sugar and refined carbohydrate, and a reduction in saturated fat. Since some doctors suspect a relationship between bowel health and acne, its also wisest to include as many vegetables as possible in the diet along with sources of bulk and fiber such as root vegetables, whole grains, seeds and beans.

For a minority of individuals with acne, food allergy detection and elimination can help. Acne that is aggravated by food allergy is more likely in those 25 years of age or older, and in people with a personal or family history of allergy.

Retinoic acid, a naturally occurring, acidic form of vitamin A, is a treatment shared by nutritionally oriented and "mainstream" health care professionals. Although helpful against mild to moderate acne, for some people it causes too much reddening and irritation.

Azaleic acid is a naturally occurring compound available in most natural food stores which helps some people with acne. Some individuals are considerably helped, and some have very little help from it. As its relatively inexpensive, it's at least worth a try.

Zinc supplements are usually as helpful as antibiotics are for acne. I usually recommend zinc picolinate 30 milligrams three times daily to start, taped to twice or even once daily for maintenance purposes. Since zinc could possible lower body copper levels when taken over several months time, I usually recommend copper sebacate (seb-ah-kate) 4 milligrams daily, to be taken at a different time of day than zinc.

Naturally occurring vitamin A has long been used by nutritional and natural practitioners in acne treatment. The quantities sometimes used, up to 300,000 units daily, have definite potential for adverse effects, so these amounts should never be used in self-care, but only if you're working with a health care professional skilled and knowledgeable in nutritional and natural therapies. If you need to find one near you, you might contact the American College of Advanccrnent in Medicine for a referral. I will give you their number in a minute.

When extra vitamin A is taken, it's best to take extra vitamin E also, to prevent overly rapid break down of the vitamin A. I usually recommend 400 to 800 units of vitamin E daily.

Men with acne are frequently helped by selenium supplements, 200 to 300 micrograms (not milligrams) daily. Unfortunately, selenium isn't as helpful for women.

For women with premenstrual or cyclic flares of acne, vitamin B6 is very helpful. I usually recommend 200 to 300 milligrams daily.

Whenever individual vitamins and minerals are taken, it's wisest to "back them up" with a multiple vitamin-mineral supplement.

Some of the people I've worked with have had "colonics" done by naturopathic doctors or other qualified health care professionals. The majority who've had "colonics" have reported noticeable improvement.

Because of differences in age, sex, metabolism, or potential allergy, these diet and supplement therapies may not be suitable for you. Consult a health care professional skilled in nutritional and natural therapies. To locate one near you, you might call the American College of Advancement in Medicine at 800-532-3688 or the American Association of Naturopadic physicians at 206-323-7610.

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