Skin Disease: Acne vulgaris. Review of orthodox and alternative medicine approach to the treatment of Acne.


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Acne vulgaris

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Skin Disease: Acne vulgaris

Acne is an androgenically stimulated, inflammatory disorder of the sebaceous glands, resulting in comedones, papules, inflammatory pustules and, occasionally, scarring.

Acne vulgaris is the most common skin disease. It affects nearly 17 million people in the United States. While acne can arise at any age, it usually begins at puberty and worsens during adolescence. Nearly 85% of people develop acne at some time between the ages of 12-25 years. Up to 20% of women develop mild acne. It is also found in some newborns.

Most often, Acne occurs in Teenagers and during 'Middle Age'. These times in everyone's life are also times when one's appearance is very important. The Teenager dreads the Acne spots appearing just before that crucial date and the over 40's feel just the same if they are about to have an important meeting with another person or persons, be it for business or personal reasons.

Below we describe and discuss both western orthodox and traditional (alternative) medical approaches to the treatment and management of Acne.

Skin Disease: Acne vulgaris

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MedlinePlus Medical Encyclopedia: Acne Vulgaris

Alternative names   

Acne vulgaris; Comedones; Cystic acne; Pimples; Zits

Definition   

Acne is a skin condition characterized by whiteheads, blackheads, and inflamed red pimples or "zits."

Causes, incidence, and risk factors   

The condition occurs when tiny holes on the surface of the skin, called pores, become clogged. Each pore is an opening to a canal called a follicle, which contains a hair and an oil gland. Normally, the oil glands help keep the skin lubricated and help remove old skin cells. When glands produce too much oil, the pores can become blocked, accumulating dirt, debris, and bacteria. The blockage is called a plug or comedone.

The top of the plug may be white (whitehead ) or dark (blackhead ). If it ruptures, the material inside, including oil and bacteria, can spread to the surrounding area and cause an inflammatory reaction. If the inflammation is deep in your skin, the pimples may enlarge to form firm, painful cysts.

Acne commonly appears on the face and shoulders, but may also occur on the trunk, arms, legs, and buttocks.

Acne is most common in teenagers, but it can happen at an age, even as an infant. Three out of four teenagers have acne to some extent, probably caused by hormonal changes that stimulate oil production. It may persist into a person's 30's and 40's.

Acne tends to run in families and can be triggered by:

  • Hormonal changes related to menstrual periods, pregnancy, birth control pills, or stress
  • Greasy or oily cosmetic and hair products
  • Certain drugs (such as steroids, testosterone, oestrogen, and phenytoin)
  • High levels of humidity and sweating

Despite the popular belief that chocolate, nuts, and other foods cause acne, this does not seem to be true.


Symptoms   
  • whiteheads
  • blackheads
  • pustules
  • cysts
  • redness around the skin eruptions
  • inflammation around the skin eruptions
  • crusting of skin eruptions
  • scarring of the skin

Signs and tests   

Your doctor can diagnose acne based on the appearance of the skin. Testing is usually not required.


Treatment - Western orthodox medical approach

Take the following self-care steps to lessen the effects of acne:

  • Clean your skin gently with a mild, non-drying skin cleanser such as the Skin Renewal Gel. Remove all dirt or make-up. Wash once or twice a day, including after exercising. However, avoid excessive or repeated skin washing.
  • Shampoo your hair daily, especially if it's oily. Comb or pull your hair back to keep the hair out of your face. Avoid tight headbands.
  • Try not to squeeze, scratch, pick, or rub the pimples. Although it might be tempting to do this, it can lead to scarring and skin infections.
  • Avoid touching your face with your hands or fingers.
  • Avoid greasy cosmetics or creams - choose the correct natural skin care system for your skin type from the extensive natural skin care systems range. Take make-up off at night using one of the Cleansers specific for your skin type.

If these steps do not clear up the blemishes to an acceptable level, try over-the-counter acne medications. These creams and lotions are applied directly to the skin. They may contain benzoyl peroxide, sulphur, resorcinol, or salicylic acid. They work by killing bacteria, drying up the oil, and causing your skin to peel.

If the pimples are still a problem, a dermatologist can prescribe stronger medications and discuss other options with you.

Prescription medicines include:

  • Oral antibiotics (such as minocycline, doxycycline, and tetracycline).
  • Topical antibiotics (applied to the skin), such as clindamycin or erythromycin.
  • Synthetic vitamin A derivatives, called retinoids, for severe acne. These include retinoic acid cream or gel (Retin-A) and isotretinoin pills (Accutane). Pregnant women and sexually active adolescent females should NOT take Accutane, as it causes severe birth defects.
  • Birth control pills can sometimes help clear up acne. (In some cases, though, they may make it worse.)
  • Prescription formulas of benzoyl peroxide, sulphur, resorcinol, salicylic acid.

Your doctor may also suggest chemical skin peeling, removal of scars by dermabrasion, or removal or drainage of cysts.

A small amount of sun exposure may improve acne. However, excessive exposure to sunlight or ultraviolet rays is not recommended because it increases the risk of skin cancer.

Expectations (prognosis)   

Acne usually subsides after adolescence, but may last into middle age. The condition generally responds well to treatment after a few weeks, but may flare up from time to time. Scarring may occur if severe acne is not treated. Some people, especially teenagers, can become significantly depressed if acne is not treated.

Complications   

Possible complications include:

  • cysts
  • permanent facial scars
  • changes in skin colour
  • damage to self-esteem, confidence, personality, and social life
  • side effects of Accutane (including liver damage and birth defects in an unborn baby)
  • side effects of other medications


Alternative Medical Perception and Treatment Approach to Acne

As described above, Acne is a common problem that is a potentially disfiguring skin disease. It can occur at any age and is often seen in teenagers. Acne involves the sebaceous glands in the skin, which secrete lubrication (sebum) for the hair follicles (pilosebaceous follicles) and surrounding skin.
Important predisposing factors include:
  • Genetic predisposition. Statistics suggest that the strongest single factor seems to be family history. It is concluded that this means a genetic basis, however it might be argued that is it generations of inappropriate nutrition!
  • Hormonal changes in adolescence: Stimulation of the sebaceous glands seems to occur with the production of androgens (the masculinizing hormone found in both sexes) at puberty. Acne patients seem to produce normal amounts of androgen, but their skin is unusually sensitive to it.
  • Skin flora/mico-flora
  • External irritants such as soaps, air pollution, chemicals etc.
  • Diet


One explanation for the physiological processes behind the characteristic skin eruption, suggests this sequence of events:


Stimulation by the androgens (male sex hormones)

  • this causes an increase in the amount and thickness of oil secretion
  • thus more lipid in the follicles
  • this change in skin ecology promotes bacterial growth, especially Propionibacterium acnes
  • resulting obstruction of sebaceous glands by comedones (blackheads& whiteheads)
  • any consequent disruption of follicular epithelium allows discharge into the dermis
  • an inflammatory reaction develops
  • pathological changes ensue in this sequence: papules > pustules > nodules > cysts

 

Actions indicated for the processes behind this disease :

  • Alteratives are the core of any treatment. Hepatic alteratives are especially helpful.
  • Hormonal Normalizers are indicated because of the androgen involvement. However, it is not always a straightforward matter to impact these hormones in an appropriate way. There is no specific herb that has a Vitex like effect for the androgens. Occasionally, Vitex itself can have a beneficial effect in adolescent girls.
  • Anti-microbials will help the body deal with secondary infection. They may be used both internally and topically.
  • Lymphatic Tonics support lymphatic drainage from the skin and underlying tissues.
  • Hepatics will prove vital, partly for the generalized benefit that their toning of the liver imparts, but also because of a specific role in detoxification.
  • Diuretics are important in ensuring adequate elimination through the kidneys.
  • Anti-Inflammatory remedies used topically within the context of daily hygiene can be helpful.
  • Astringents will, when used topically, similarly help in cleansing and avoid secondary infection.
  • System support :
  • Applying the basic principles our model works with the endocrine system should be given tonic support. This is the ideal, but such general endocrine toning is not a simple thing. Toning work is focused through liver alteratives. The immune system must be helped if there has been long-term antibiotic use.


Specific Remedies :
There are no definite specifics here, other than the hepatic alteratives.

The Wildcrafted Altrative Compound is a very good first step in treating Acne, however, this is a complex problem and may require other herbs and treatment approaches.

Prevention

There are no sure ways to prevent acne, however, the following steps may help to prevent flare-ups:

  • Gentle washing of affected areas once or twice every day.
  • Avoid abrasive cleansers.
  • Use noncomedogenic makeup and moisturizers.
  • Shampoo often and wear hair off face.
  • Eat a well-balanced diet, avoiding foods that trigger flare-ups.
  • Unless told otherwise, give dry pimples a limited amount of sun exposure.
  • Do not pick or squeeze blemishes.
  • Reduce stress.

Broader Context of Treatment:
There are a number of non-herbal issues which need to be addressed. These range from diet and hygiene to a wide range of complex emotions. It is important to explain the nature and problems of Acne as well as the proposed treatment(s) and their purpose. Adolescent teenagers especially need to address emotional issues including fear and guilt.

  • Acne is not caused by dirt and cannot be washed away; it is an imbalance (hormonal or chemical) that causes the oil in the skin to form blackheads.
  • Acne is not related to sexual activity.
Personal hygiene is important but obsession with it can aggravate the problem. The following may provide a basic guideline:
  • Keep hands away from the face, avoiding friction of the skin, including:
  • don't prop your hands against your face
  • don't `scrub' the face when washing
  • don't rub the face
  • avoid pressure from tight collars or helmets
  • avoid perspiration around the face as much as possible.
  • Do not squeeze pimples or blackheads, as squeezing the skin makes the acne worse. The blackhead may be pushed deeper into the skin, possibly cause he follicle to rupture.
  • Keep the hair off the face and wash the hair daily if needed.
  • Avoid cosmetics that contain synthetics chemicals.

The Merck Manual of Medical Information
Home Edition


Merck manual

This medical reference is highly regarded throughout the medical profession and we highly recommend this book to anyone interested in obtaining high quality information on diseases.

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