ACNE
Acne vulgaris (common acne) is the most common skin disorder affecting over 17 million Americans. Nearly 100% of teenagers suffer some degree of acne. Although less common in adults and the elderly, it can occur as a persistent or new problem in these age groups. Hormone levels, diet, heredity, medications and external toxins can all contribute to acne. Medications known to cause acne include steroid hormones (corticosteroids, testosterone, and progestins), isoniazid (a tuberculosis drug), lithium, Dilantin, and numerous other drugs. Cosmetic products can be culprits, especially if mineral oil or petroleum is in the product. Other chemicals that may cause acne include ammonia, artificial colors, ethanol (common drinking alcohol), EDTA (a common preservative), formaldehydes, nitrates and artificial fragrances. Poor hygiene is not a direct cause of acne.
The three mainstays of standard medical therapy for acne are benzoyl peroxide, antibiotics, and retinoids. Topical benzoyl peroxide is available in over the counter creams and gels as well as in prescription strengths. It can be very effective in milder cases but does have an irritating effect on the skin. A common skin bacterium Propionbacterium acnes is on each persons skin but it can aggravate acne. Topical and oral antibiotics are often effective in reducing this bacteria and controlling the acne. Bacterial resistance to the antibiotic is very common with extended use. The oral antibiotics, which are typically taken for several years, will alter normal intestinal bacteria and can lead to chronic digestive difficulties such as irritable bowel or yeast overgrowth. I do not recommend this approach since the benefits of treatment are outweighed by the risks. The most common and effective treatments are Vitamin A derivatives called retinoids.
The integrative approach to treating acne is through a combination of diet, herbs, vitamins, minerals and stress reduction. The most important is eating a diet high in green vegetables and eliminating sugar, fried foods, animal fats, hydrogenated oils, margarine, dairy products, and most processed foods full of chemicals. Topically applied herbs with some success include Cadendula officinalis and tea tree oil. Azelaic acid, a naturally occurring substance, has antibiotic activity against the bacteria on the skin and appears to be quite safe.
Traditional Chinese medicine and Ayurvedic medicine both have developed approaches to treat acne. Consult an experienced practitioner for help.
Vitamin supplements that may
be helpful include ascorbic acid, bioflavonoids, Vitamin E,
Vitamin A and Vitamin
B5 (pantothenic
acid). Minerals that could be useful include zinc,
selenium and chromium.
Stress increases the production of the adrenal hormone
cortisol. Prolonged excessive cortisol levels can increase
acne. Lowering
stress by proper sleep, regular exercise, meditation,
and counseling can be helpful.
Daniel Blodgett MD