Acne Treatment

Acne affects almost everyone — more than 90% of all adolescents, nearly 50% of all adult women and 25% of all adults. Crossing gender lines as well as national borders, it's one of the most widespread medical conditions in the world. Yet there's still no cure. But there is hope. While acne is not curable, it is treatable. it is the commonest skin disease of the world. Acne is a systemic imbalance that manifests itself in the skin. It cannot be “fixed” by stripping the skin of all oil and killing the bacteria in the pores and follicles. Those steps will help temporarily, but if the source of the imbalance is not being addresses, the body will find another way of communicating (whether that be the flu, digestive troubles, eczema or dermatitis, or something else.)

Western medical philosophy tends to place acneic skin in a certain category based on topical symptoms, then introduce a specific medication to stop those symptoms – never truly looking deeper at what could be causing the skin to weaken, overproduce oil, harvest the growth of bacteria, slow cellular turnover or become inflammed.

You can read how bezoyl Peroxide can age your skin here.

 

Acne Causes:

1: Hormones. For the majority of acne sufferers, the trouble begins at puberty, when the body begins to produce hormones called androgens. These hormones cause the sebaceous glands to enlarge, which is a natural part of the body's development. In acne sufferers, however, the sebaceous glands are overstimulated by androgens, sometimes well into adulthood. Androgens are also responsible for acne flare-ups associated with the menstrual cycle and, on occasion, pregnancy.

2: Extra sebum. When the sebaceous gland is stimulated by androgens, it produces extra sebum. In its journey up the follicle toward the surface, the sebum mixes with common skin bacteria and dead skin cells that have been shed from the lining of the follicle. While this process is normal, the presence of extra sebum in the follicle increases the chances of clogging — and can cause acne.

3: Follicle fallout. Normally, dead cells within the follicle shed gradually and are expelled onto the skin’s surface. But in patients with overactive sebaceous glands — and in nearly everyone during puberty — these cells are shed more rapidly. Mixed with a surplus of sebum, the dead skin cells form a plug in the follicle, preventing the skin from finishing its natural process of renewal.

4: Bacteria. The bacterium Propionibacterium acnes, (P. acnes for short) is a regular resident of all skin types; it’s part of the skin’s natural sebum maintenance system. Once a follicle is plugged, however, P. acnes bacteria multiply rapidly, creating the chemical reaction we know as inflammation in the follicle and surrounding skin.

5: Inflammation. When your body encounters unwanted bacteria, it sends an army of white blood cells to attack the intruders. This process is called chemotaxis; or, simply put, the inflammatory response. This is what causes pimples to become red, swollen and painful. The inflammatory response is different for everyone, but studies have shown that it is especially strong in adult women.

Treatment of acne require proper skin care, proper diet and proper skin cleansing regime. In addition that modern therapy with blue light and acne laser provides faster relief as well as prevention of acne.

Complications of acne

Postinflammatory hyperpigmentation.  This is the darker pigmentation of the skin as a result of acne.

 

Keloid a scars. Raised scars which can grow larger. Occur commonly in chest, shoulders, upper back, back of neck and ear lobes. Commoner in asian skin.

Hypertrophic scars

 

Blue-light therapy. The FDA approved narrow-band, high-intensity blue-light therapy for treating acne. Now widely advertised, this is probably the best-known light therapy for acne treatment. Blue light works by killing the acne-causing bacteria, P. acnes, and is being used to treat inflammatory acne vulgaris that has not responded to other acne therapies. The blue-light products of today do not contain ultraviolet (UV) light, which was a staple of former light therapy used to treat acne. UV light can damage skin and is no longer used to treat acne. Patients receive blue-light therapy in increments. Generally, eight sessions are given over a four-week period, and each session lasts about 15 minutes. Side effects tend to be mild and include temporary pigment changes, swelling of the treated areas, and dryness. In many of the studies performed blue light therapy had been more effective than the traditional treatments.

Pulsed light and heat energy (LHE) therapy. We combine ELOS technology which is combined radiofrequency with IPL at the blue light range. Not only this shrinks sebaceous glands but it rejuvenates the facial skin for long term improvement of the damage done by the acne. This treatment combines pulses of light and heat, which researchers believe target two causes of acne. It is known that LHE destroys P. acnes, the acne-causing bacteria. LHE also may decrease sebum (oily substance) production by shrinking the sebaceous glands. A system that combines pulses of green light and heat has been approved by the FDA for treating mild to moderate acne. Here’s what a recent study showed:

The skin produces hydrogen peroxide to fight each acne infection and this may continue for weeks, until the infection is resolved. Hydrogen peroxide is a free radical which causes skin damage and skin aging. Over a period of time the volume of hydrogen peroxide acts just like continual sun exposure, damaging skin components such as collagen and causing the skin to sag and wrinkle.

Additionally, the healing process of acne infections involves thousands and thousands of chemical processes. These chemical processes produce more free radicals as a natural by-product and add to the volume of free radical damage (aging).

The skin has a supply of antioxidants that reduce the volume of free radicals and their damage. It is believed that moderate to severe acne literally depletes the skin's level of antioxidants, leaving it nearly defenseless against free radicals that are created by normal skin functions.

By combining the blue light therapy with the Syneron acne laser we can obtain better results for resistant acne.

Patient above obtained eight treatments of blue light therapy over a period of four weeks. It is recommended that patients who receive a good result maintain the once a month treatments for a year and then once in two month treatments for two years.

Above patient obtained twice a week blue light therapy together with acne laser treatment.

This patient was treated with blue light therapy twice a week for four weeks. Significant clearing of his acne noted.

Above patient receeived acne laser treatments as well as blue light therapy.

This patient on the left was treated with blue light treatments and then with laser and dermapen treatments.  In addition to that she was placed on a special diet plan and antioxidant plan.

General recommendations are

Take baths in lukewarm water. Limit bathing to 15 minutes a day. Use gentle cleansers or small amount of baby soap to avoid dry flaking skin. Pat dry after bathing to retain moisture of the skin. Apply moisturing cream. Avoid going in the sun.

 

Acne Differential Diagnosis
Neonatal Folliculitis
Eosinophilic Pustular folliculitis
Miliaria
Erythema toxicum neonatorum
Exposure to maternal meds (Corticosteroids, Lithium, Phenytoin)
Infantile Hyperandrogenic State
Perioral Dermatitis
Miliaria
Milia
Acne venenata or pomade acne
Corticosteroid induced acne
Chloracne
Prepubertal Angiofibromas or Adenoma Sebacum
Keratosis Pilari
Milia
Flat warts
Molluscum Contagiosum
Perioral Dermatitis
Syringomas
Acne venenata or pomade acne
Corticosteroid induced acne

Although western medicine has totally neglected and ignored the aspect of wrong foods causing acne. Wrong diet results in hormonal problems. I strongly recommend a vegan diet for acne which means taking only plant based whole food.  Weight Loss Guidelines.html In additon to that all these foods should be avoided.
 

a.  Coffee and other caffeinated drinks

b.  All forms of sugar

c.  MSG containing foods Ajinomoto

d.  Bananas

e.  Seafood containing iodine (Shrimp, Lobster etc)

f.  Margarines

g.  Animal Lard

h.  If possible all forms of Animal Proteins

i.  White potatoes

j.  Vinegar

k.  White Starch

l.  Yeast

m.  Smoked cheeses, Blue Cheeze

n.  Wine Specially Dark Wines.

o.  Mushrooms,

p.  High amounts of nuts containing fat such as cashews, almonds

q.  Fried foods.

r.  Try to eat raw vegetables for breakfast


If you have hormone related acne please read this page.

Acne causes pigmentations which are best treated with laser and creams.

Above is a very happy Sri Lankan patient who got rid of most of her skin pigmentations after three treatments of IPL and RF with CO2 resurfacing and three months of day cream and night cream use. She also got very fare with the treatments.

 

In addition to taking out pigmentation from the skin fraxel resurfacing can be used to treat acne scars. The above results took six fraxel treatments done once a month. The depth of the fraxel laser is usually increased gradually.

Here the acne scars have improved and the patient also got a lighter skin and facial skin tightness following her laser treatments.

When scars are severe and patient shows signs of ageing due to acne damage it is best to perform a fat graft to fill the acne scars from below. Fat grafting provides much needed stem cells from body areas such as abdomen, back, under arm or thighs to be layered in the facial skin. Above patient had severe acne scars and has completely reversed aging and looks much younger following three fat grafts. Her skin color improvement is due to laser creams and glutathione injections.

Above shows the latest treatment for deep acne scars where we use dermapen treatment. After six treatments much improvement is seen with acne scars. For better results we combined the treatment with laser photofacial treatments with IPL, RF and co2 resurfacing laser.
The consensus in the dermatological community is that acne is largely a genetic disorder and that diet has little to no effect on the development of the condition. A literature search shows that the irrefutable beliefs held by dermatologists are based on a collection of studies that are inconclusive at best. The pathology of acne is well understood. Unsurprisingly though, the medical establishment is unaware of (or dismissive towards) the power of natural methods and diet to prevent, modify, and cure the condition. Instead, they choose to focus on using drugs that down regulate, inhibit, or kill rather than work with and restore balance back to the body.

Acne is a disorder of EXCESSIVE GROWTH and INFLAMMATION, which is driven by hormonal changes.

1. The formation of acne begins in the hair follicle, with over proliferation and adhesion of epidermal cells called keratinocytes (dead surface skin cells). This process is driven by a growth factor (EGF) and a cytokine (IL-1).

2. An over active sebaceous gland empties sebum into the follicle, which mixes with the dead skin cells. This sticky mass inhibits normal skin exfoliation and creates a clogged pore (microcomedone).
3. Impaction and bacterial infiltration creates oxidative stress and the follicle eventually bursts, releasing its contents. Inflammation ensues and becomes visible in and around the clog. The lesion is now called a papule, pustule, or cyst.

Insulin influences every step in the formation of acne directly and indirectly.

1. First, insulin frees up IGF-1 and EGF, which are incredible promoters of growth. IGF-1 acts on and stimulates keratinocyte proliferation. It also decreases IGFBP-3, which regulates IGF-1, and acts on RXR to normalize cell growth. High insulin levels are also linked to chronic inflammation, triggering the release of IL-1 that starts the whole process.
2. Insulin increases sebum production in two ways: by stimulating androgen release in the testes and ovaries and by decreasing SHBG, which normally binds sex hormones in the bloodstream, regulating its availability to cells.
3. Insulin worsens acne by diverting essential fatty acid (EFA) derived eicosanoid production towards inflammation.

Recommendations

1. Diet
- Choose low-glycemic load , anti-inflammatory foods, which provoke less insulin, growth factor release, androgen production, and inflammation. These changes normalize follicular cell proliferation and reduce sebum.
- Avoid inflammatory foods like trans-fats, refined vegetable oils, grain-fed meats, and refined carbohydrates. Coconut oil is the best oil for your skin.

2. Lifestyle
- Increase quality and quantity of sleep. Inadequate sleep increases inflammation, stress, weight gain, and cortisol production. Cortisol may contribute to acne flare-ups by elevating blood sugar and stimulating the sebaceous glands, much like the androgens.
- Negative emotions and stress are linked to increased production of inflammatory cytokines. Stress also increases the production of cortisol.
- Chronic stress depresses the adrenal glands over time and leads to hypothyroidism. Hypothyroidism decreases SHBG, freeing up the androgens that increase sebum.

3. Supplements
- Vitamin D3: Regulates proper skin cell formation and modulates the inflammatory response.
Vitamin B12 is essential for proper immune function. Most of us dont get enough of this and everybody needs a little supplementation. It is best taken as methylcobaltamine injections which work better.  ( Sri lanka only has cyanocobaltamine)
It is a well known fact that with the repeated farming we are all taking in less magnesium than we need for proper health. About 200mg of magnesium should be taken daily as a supplement.

- Methylsulfonylmethane
- N-acetyl cysteine: precursor to glutathione; prevents oxidative damage and inflammation and enhances Vitamins C and E.
For better results consider glutathione intravenous injections for detoxification of your body.
Acne may have a genetic component, but as with most other diseases, the expression and severity of acne is influenced by lifestyle factors that are well within our control. Until dermatologists recognize the potential for natural, holistic solutions to modify the hormonal and inflammatory changes that cause acne, long-term success with conventional therapies will be elusive.

Sources:
1."Implications for the Role of Diet in Acne" (Seminars in Cutaneous Medicine and Surgery, 2005).
2."Dietary Implications for the Development of Acne: A Shifting Paradigm" (US Dermatology Review, 2006).
3."Acne Vulgaris" (Archives of Dermatology, 2002).
4."Vitamin D analogs: mechanism of action and therapeutic potential" (Nagpal S, Boehm MF).
5."Noncalcemic actions of vitamin d receptor ligands" (Nagpal S, Rathnchalam R).
6."The vitamin D pathway: a new target for control of the skin's immune response?" (Experimental Dermatology, June 2008).
7."Oxidative Stress in the Pathogenesis of Skin Disease" (Journal of Investigative Dermatology, 2006).