Acne (derived from Greek), literary means skin eruption. Acne is caused when structures containing hair follicles and associated sebaceous glands get clogged. Acne can be mild, moderate to severe. More than 85% of teenagers are affected by acne and acne often continues in adulthood. Acne during adolescence usually affects the facial skin and sometimes chest and back. Acne on the body (body acne) often develops in adulthood and mostly affects the arms, chest and back. While the term “acne” usually includes several different forms of acne such as acne vulgaris (most common acne) or cystic acne, the condition acne rosacea is not a true type of acne and is better described as rosacea.
Acne lesions start as a blockage (comedo) in the hair follicle. Stimulated by a number of factors, the sebaceous glands in the skin produce more sebum (an natural oily substance), which is secreted around hair follicles to lubricate hair and skin. Increased sebum production mixed with dead skin cells can clog skin pores, resulting in whiteheads (closed comedo) or blackheads (open comedo). When the bacteria P. acnes is introduced into the mix, the lesion may become inflamed resulting in a red appearance (the common pimple or zit).
Acne can be caused by any of these factors:
- Overactive sebaceous glands: stimulated by hormones
- Stress: increased stress results in increased stress hormones secreted by the adrenal glands, which could stimulate the sebaceous glands
- Inflammation: bacteria start an inflammatory response and touching or scratching the pimple will make it worse
- Genetics. Sometimes there is a tendency for acne to run in families
- Carbohydrates: it has been suggested that refined sugars and rapidly digested carbohydrate foods (white bread, sodas) cause insulin peaks and the related insulin-like growth factor 1 (IGF-1), which is thought to cause changes in the skin that are favorable for acne development
- Accumulation of dead skin cells: when your skin does not shed dead skin cells evenly, they start to clump together
- Diet: While diet is often blamed for the development of acne, there is little scientific evidence that diet plays a major role in acne. However, a link between acne and the consumption of milk and some dairy products such as cottage cheese and cream cheese has been described. Some suggest that certain bovine hormones in milk are to blame.
- (Over-)use of steroids (for certain medical conditions or body building)
- Hormones: hormones, which fluctuate during puberty, during the menstrual cycle or when the body is under lots of stress, often play a role in the development of acne
To successfully eliminate acne, a person needs to avoid stress, eat a healthy diet (eliminate refined sugar, milk and saturated fat) and treat the skin areas affected by acne. Start with a gentle cleanser to remove excess oil on the skin. It is important not to wash the skin too much or use harsh soaps, as that may lead to further skin irritation. Gentle skin cleansers may contain a gentle skin exfoliator (such as the beta-hydroxy acid salicylic acid) or more powerful alpha-hydroxy acids, to remove dead skin cells.
Over-the-counter acne treatments (many are herbal-based) are often successful in eliminating acne. For body acne or back acne, there are many effective body acne treatments available that treat acne with a combination of salicylic acid and herbal extracts. Another frequently used OTC acne ingredient is benzoyl peroxide, which will kill bacteria and dissolves the sebum/keratin plug. A side effect of benzoyl peroxide is that it can dry out and bleach the skin.
Acne that is more severe, such as cystic acne (which produces deep painful skin lesions), is best treated by a dermatologist. Severe cases of acne could result in permanent scars, if the inflammation is not cleared up quickly enough. The more severe acne can be treated with oral and topical antibiotics. These treatments are focused on the elimination of bacterial infections and reducing the inflammatory response. Topical acne prescriptions include clindamycin, erythromycin and tetracycline. Oral antibiotics include doxycycline and tetracycline.
Retinoids (forms of vitamin A) speed up the life cycle of cells lining the hair follicle, making it less likely that a skin pore will become clogged. Prescription strength vitamin A (tretinoin) can cause skin rashes and peeling skin, so vitamin A treatment is not for everyone.
B vitamins may support your overall acne treatment regimen as B vitamins help the body cope during stress. Vitamin B5 is good for skin both in topical applications or when taken orally. Vitamins C, D and E are also considered good for healthy skin. It has been reported that people with acne are deficient in vitamin A and E.
Adult acne sufferers who wish to normalize their body’s hormonal balance, may benefit from two herbal supplements: Indole-3-Carbinol (I3C) and chaste berry. I3C is a natural phytochemical present in vegetables such as broccoli, cabbage and kale and is a powerful antioxidant. I3C can restore hormonal balance in men in women. Chaste berry can restore hormonal balance in men and women by acting on FSH and LH in the pituitary.