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Acne

acne, skin, vitamin, help, sebum, also, outbreaks, scarring, face, pimples, more, lesions, cystic, women, pregnancy, self-care, use, inflamed, cosmetics, causes, may, topical, often, trigger, whiteheads, called, blackheads

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Acne

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In this Article:
  • What is Acne?
  • Key Symptoms
  • What Causes Acne?
  • Treatment and Prevention
  • How Supplements Can Help
  • Self-Care Remedies
  • When to Call a Doctor

    What is Acne?


    Acne is a chronic skin condition characterized by outbreaks of pimples and other eruptions, most often on the face but also on the neck, shoulders, upper back, chest, and buttocks. Acne occurs when the sebaceous, or oil, glands at the base of hair follicles in the skin secrete too much sebum, a thick oily substance that keeps the skin lubricated and moist.

    Excess sebum can back up and clog pores, forming light-colored bumps, called whiteheads, and dark-colored spots, called blackheads. If a clogged pore becomes infected by bacteria normally found on the surface of the skin, the result can be a raised inflamed blemish or a pus-filled pimple.

    There are two forms of acne. The milder is common acne, also known as acne vulgaris, and it's generally limited to whiteheads, blackheads, bumps, and pimples. In the more severe form of acne, called cystic acne, painful, inflamed fluid-filled cysts and thick, firm painless lumps appear in clusters beneath the surface of the skin. Cystic acne and chronic common acne can lead to permanent pitting and scarring, especially if skin lesions are picked at or squeezed, or if your skin type is naturally prone to scarring.

    Acne occurs most often among teenagers, for whom it can be an embarrassing and emotionally distressing condition. Because male hormones, or androgens, promote overproduction of sebum, boys are more likely than girls to develop acne. Acne eruptions tend to wane after age 20, although in some people they can persist well into middle age. Hormonal imbalances during menstrual periods and pregnancy can also trigger outbreaks in women.

    Except when it causes widespread skin lesions and scarring, acne is usually a harmless condition that clears up by itself. Although it can't be prevented or cured, most acne cases can be controlled with simple self-care measures, over-the-counter topical medications, and supplements, especially vitamin A, which helps to regulate sebum production.

    Key Symptoms


    * Whiteheads, blackheads, inflamed bumps, and pus-filled pimples, mainly on the face, but also on the shoulders, neck, back, chest, and buttocks
    * In cases of cystic acne, clusters of painful fluid-filled cysts; red or purple inflamed areas on the skin; and thick, hard lumps below the skin surface
    * Pitting, pockmarks, and scarring resulting from chronic or cystic acne

    What Causes Acne?


    The exact cause of acne is not completely understood. However, the increased production of sebum associated with acne outbreaks seems clearly linked to hormonal imbalances. The overproduction of androgens in teenage boys, for example, and the hormonal fluctuations of menstruation and pregnancy in women are both factors in the development of acne.

    Other factors influencing acne include heredity, emotional stress, and certain medications--especially corticosteroids, oral contraceptives, and other drugs that affect hormone levels. (Oral contraceptives, for instance, are actually prescribed to "even out" natural monthly imbalances in hormone output.)

    Cosmetics, tight clothes, and anything else that can block skin pores can also trigger acne. Even climate changes may play a role. Some doctors and acne sufferers believe that certain foods or food allergies play a role in some acne outbreaks as well.

    Contrary to popular belief, however, there is no evidence that drinking colas or eating chocolate, nuts, shellfish, or fatty foods will lead to acne.

    Treatment and Prevention


    Regular, careful washing of the face and the application of over-the-counter topical anti-acne preparations are usually enough to control outbreaks. Supplements that help moderate sebum production, regulate hormonal imbalances, or boost the immune system are often beneficial as well. Those recommended for acne control here can be safely combined and taken long-term, and they can be used along with conventional acne medications.

    For severe cases of acne, a doctor may prescribe oral or topical antibiotics or tretinoin (Retin-A, Retinoic Acid), a synthetic form of vitamin A that is applied topically to treat whiteheads and blackheads (and, less successfully, pimples). Oral tretinoin (Accutane) may be used to treat severe cystic acne. Because tretinoin can cause birth defects, women who are pregnant or contemplating pregnancy should not take it and those considering its use should be meticulous about using a reliable contraceptive.

    In 1997, the Food and Drug Administration (FDA) approved a topical synthetic form of vitamin A for acne (and psoriasis). The drug, tazarotone, is sold under the brand name, Tazorac. Although the same restrictions regarding pregnancy apply to its use, many of the serious reactions linked to oral tretinoin are avoided. Side effects include local irritation such as stinging, redness, and itching. It typically takes six to eight weeks to see the full benefit of this drug for acne.

    There are a number of procedures that dermatologists perform that can help control problem lesions and prevent scarring. For blackheads and whiteheads (known as comedones), a special loop extractor helps with comedone removal, literally pulling bacterial matter out of the pimples. (Some people learn to do this themselves.) For severe acne, steroid drugs may be injected directly into cysts to reduce inflammation and shrink the lesions. Chemical peels are also sometimes effective for superficial acne scars.

    For deeper scars, there are a number of new surgical procedures that can produce dramatic results. Collagen injections involve inserting this natural body protein under the skin to "fill in" the depressions. For more extensive scarring, a surgical procedure called dermabrasion can be very effective; a high-speed brush removes surface skin to minimize and reshape the scars. During laser treatments, the newest innovation that seems to produce the most lasting results, surgeons use various wavelengths and intensities of light to recontour scar tissue.

    How Supplements Can Help


    Nutrients that assist in the normal processing of hormones in the liver and tissues can lessen the intensity and frequency of acne episodes. In fact, many naturopathic physicians (naturopaths) emphasize the importance of good liver function in the treatment of acne and often recommend liver-strengthening herbs and nutrients.

    Just a reminder: If you have a serious medical condition or are taking medication, always talk to your doctor before starting a supplement regimen.

    Vitamin A helps prevent overproduction of sebum, making it a key anti-acne supplement. Try taking high doses (25,000 IU a day) of vitamin A until acne begins to clear up, but for no more than a month. After a month, if treatment is still necessary, reduce dosage to 10,000 IU a day. Women who are pregnant or considering pregnancy should not take more than 5,000 IU of vitamin A daily, and should under no circumstances take Accutane.

    Antioxidants such as vitamin E and selenium are important for protecting the skin from free-radical (oxidative) damage. Some studies indicate that people with acne are deficient in an antioxidant called glutathione peroxidase. Taking vitamin E and selenium, which are sometimes sold in combination for convenience, can correct this.If menstrual cycles trigger acne outbreaks, vitamin B6 can help to regulate levels of certain hormones associated with acne.

    Zinc not only boosts immune function and reduces inflammation; it also helps balance hormone levels. If you take zinc for more than a month, combine it with copper, because long-term zinc use can interfere with copper absorption.

    Essential fatty acids, in combination with the zinc, will help to dilute sebum so that it's less likely to clog pores. Flaxseed oil and borage or evening primrose oil are good sources of essential fatty acids. Some women have a significant premenstrual component to their acne flare-ups. The herbs chasteberry (Vitex) and dong quai can go a long way towards balancing hormone levels. The two herbs are usually combined in PMS Herbal formulas.

    Self-Care Remedies


    Self-Care Remedies Although you can't do much about any tendency you might have to develop acne, you certainly can reduce the frequency and severity of acne flare-ups by keeping your face clean and avoiding known triggers, such as oil-based cosmetics and tight-fitting clothing or sweatbands. Practical suggestions include:

  • Wash your face twice a day, with ordinary soap and water, but don't wash too often or scrub too roughly.

  • Apply an anti-acne cream or lotion. Over-the-counter topical products containing benzoyl peroxide, sulfur, or resorcinol help to control acne by drying the skin and promoting peeling.

  • Consider a product containing tea tree oil at a 10% to 15% strength; it can be an effective alternative to benzoyl peroxide. Wiped on twice a day, this solution is antibacterial and can help to dry out active lesions.

  • Use only "oil-free" cosmetics. They are usually labeled "noncomedogenic" or "nonacnegenic." Be sure to wash off cosmetics with soap and water every night before going to bed. And avoid cosmetics altogether if you have severe acne.

  • Try a daily chamomile tea rinse. Make a strong chamomile tea, allow it to cool, and wipe the liquid over your face each morning. It makes an effective daily rinse because it both tones and cleanses.

  • Avoid tight-fitting nonabsorbent clothes, especially exercise outfits and sweatbands, which tend to trigger acne. If you can't avoid them, at least change out of them as soon as you can.

  • Stay away from "trigger" foods that you feel may set off your outbreaks. Even though there's no proof that food causes acne, it can't hurt to avoid any potential problems. Try eliminating the "junk" fats (called trans fatty acids, like the hydrogenated oils) and replacing them with the "healthy fats" like those found in flaxseed and fish oils.

  • Don't pick at your face. Squeezing and picking pimples and other acne blemishes can increase inflammation and result in permanent scarring.

    When to Call a Doctor


    * If an outbreak of common acne does not respond to self-care measures within three months
    * If you develop cystic acne, with fluid-filled cysts, red or purple inflamed areas and hard nodules under the skin
    * If your skin is persistently red and flushed, even if pimples and other lesions do not develop
    * If acne causes you to feel self-conscious, depressed, or frustrated


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