Acne is the most common of all skin problems. Adult acne can be a condition with many contributing factors and as such may require an integrated approach. Acne is not caused by poor hygiene or oily skin, but both can make the problem much harder to control.
People often try to treat acne by "de-oiling" and "drying" the skin with products that include harsh soaps, strong scrubs and mass-market medicated (drying) cosmetics. This approach to acne can cause intense drying of the skin, and provides only short-term benefits. While drying out blemishes can make skin appear satisfactory for a few weeks, over-drying can cause oil glands to compensate by working harder, resulting in clogged pores and more "breakouts" 3 to 4 weeks later. This often causes the user to resort back to drying products, which are causing the problem. In addition, treating adult acne harshly can create problems such as redness or broken capillaries.
Optimal nutrient status should be maintained. Information on conventional treatments is widely available, but be advised that prolonged use of antibiotics has the potential for causing candida overgrowth and for disturbing normal colonic flora. Probiotic replacement at the end of an antibiotic cycle is recommended.
Many over-the-counter products contain high levels of glycolic acid, which is a member of the alpha-hydroxy acid family. Glycolic acid used topically can effectively promote skin cells to shed more quickly and has been proven to be very effective in the treatment of acne.
124 patients with mild to moderate acne in a single-blind randomized trial were given either a 5% gel of tea-tree oil or 5% benzoyl peroxide lotion. Both treatments resulted in significant improvement of noninflamed and inflamed lesions after three months, with tea tree oil causing more severe facial redness and benzoyl peroxide being more effective in noninflamed lesions. There were fewer unwanted side-effects in the tea tree oil group – 44% versus 79%. It was concluded that tea tree oil may be a valuable alternative to some traditional treatments of acne. [Lancet, December 8, 1990; p.1438, Medical Journal of Australia, 1990;153: pp.455-458]
We believe that this 5% solution is probably not strong enough for moderate to severe acne. Stronger solutions (up to 15%) should provide even better results.
Boric acid's anti-bacterial properties make it useful as an acne treatment, either in the form of an ointment or simply diluted with water.
Bentonite masks may be helpful in drawing out toxins. These masks are usually left in place for 10 to 15 minutes, removed by rinsing or gentle rubbing with a soft wash cloth and applied three times per week.
Dr. Jerome K. Fisher conducted a clinical study of 1,088 teenage patients over 10 years and reported to the American Dermatological Association that milk was a principal contributor to some patients' acne. Dr. Fisher found that their acne tapered off as their milk consumption was reduced.
Dr. Fisher noted that dairy products often contain large amounts of butterfat and milk sugar, both of which, he believed, aggravate acne. He also suspected that the hormones produced naturally in the milk of pregnant cows may break down into androgen when consumed, which stimulates the production of sebum, the waxy substance secreted by the sebaceous glands that clogs pores and creates acne when the pores become infected.
Milk may also contain excessive amounts of iodine, which can irritate pores, bringing on acne flare-ups. Iodine gets into the milk through the use of contaminated milking equipment and medication given to the cows.
High-chromium yeast is known to improve glucose tolerance and enhance insulin sensitivity [Diabetes 1980:29, pp.919-25]. Although there is no difference in blood glucose tolerance tests between patients with and without acne, skin biopsies revealed that the acne patients' skin glucose tolerance is significantly impaired. Based on this it would be appropriate to describe acne as "skin diabetes" [Can Med Assoc J 1959:80, pp.629-32]. High-chromium yeast has been reported in an uncontrolled study to induce rapid improvement in patients with acne [Med Hypoth 1984:14, pp.307-10].
Fasting clears the skin and whitens the eyes. It is a common experience to see skin eruptions clear while fasting.
Zinc is important in the treatment of acne. It is involved in local hormone activation, retinol binding protein formation, wound healing, immune system activity, and tissue regeneration. There have been inconsistencies in the results from studies using zinc as a treatment, but this may have been due to different forms of zinc having been used. If zinc insufficiency is suspected, use the more absorbable forms. Treatment may require up to 3 months of supplementation before good results are seen. Success or failure of zinc treatment of acne depends on whether a zinc deficiency is present. [Z Hautkr 1987:62(14): pp.1064, 1069-71, 1075]
According to James E. Fulton Jr., M.D., head of the Acne Research Institute in Newport Beach, California, "In some who are acne-prone, ... one milligram of iodine a day could be a problem." Foods high in iodine should be eliminated on a trial basis.
Vitamin E regulates retinol levels in humans. Male acne patients have significantly decreased levels of erythrocyte glutathione peroxidase, which normalizes with vitamin E and selenium treatment. The acne of both men and women improves with these treatments, probably by reducing the development of lipid peroxides.
Though harder to find, a topically-applied 4% solution of niacinamide compared very favorably to Clindamycin in one trial. Oral niacinamide is unlikely to be of benefit.
Vitamin A has been shown to be effective in treating acne when used at very high doses (300,000 to 400,000IU per day) for many months, but caution must be advised because vitamin A toxicity can result. The toxicity potential means that this therapy must be monitored closely, conducted with a water-soluble form of vitamin A and probably be used in lower doses (100,000 to 200,000IU) along with other therapies, not as a single treatment.
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