Acne: Eliminating the causes

Many teenagers are affected by acne vulgaris, a common inflammatory skin condition that is marked by pimples, whiteheads, blackheads and cysts. They complain of the embarrassing bumps on their face, chest, neck and back, at an age when appearance, attractiveness and peer acceptance are of paramount importance. On an emotional level, acne can be very difficult.

While teenagers do make up the largest percentage of the acne-afflicted population, they’re not alone in their suffering. Acne strikes adults, too — more than half of all adult women and about a quarter of adult men. And these figures appear to be climbing. Whether one’s acne persists through adolescence into adulthood or strikes suddenly after 30, the condition can have lasting physical and psychological ramifications.

The secret to managing acne is prevention — stopping this condition before it exhibits visual symptoms. One of the best weapons in the fight against acne is knowledge; if you know what causes it, it’s easier to formulate a good plan of attack. There are five primary culprits contributing to this process. Each of these factors may vary dramatically among individuals.

Causes of Acne:

#1: Hormones

For the majority of acne sufferers, the trouble begins at puberty, when the body begins to produce hormones called androgens. During natural development, androgens stimulate the sebaceous glands to enlarge, but in acne sufferers, these glands are overstimulated, sometimes well into adulthood. Women whose skin is affected by PMS, or who are taking birth control pills get acne as a result of an imbalance of hormones. Also, hormonal fluctuations during the menstrual cycle and pregnancy may also be responsible. In today’s fast-paced society, people are overburdened with stressful lifestyles which alter the delicate hormonal balance in their bodies. This is reflected in the health of their skin, as well as in various other symptoms.

#2: Extra Sebum

When the sebaceous gland is stimulated by androgens, it produces extra sebum. In its journey up the follicle toward the surface, this extra 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 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, 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.

What’s The Answer?

Just like the colon and the kidneys, the skin is another means of detoxification, meaning that wastes that remain in the blood are eliminated through the skin. It is important to make sure all the organs involved in eliminating wastes and toxins are functioning optimally, otherwise these toxins will do anything to get out, and their last resort is through the skin. A naturopathic doctor knows exactly how to properly support the elimination pathway of each organ, without harming the body or causing unnecessary side-effects from the mobilized toxins.

Nutrition should focus on whole foods and foods that are the least processed or refined. Eat a well-balanced diet that omits dairy products (due to their high hormone content), foods high in iodine and foods containing trans-fatty acids and saturated fats. Fats from animal products and processed foods interfere with the metabolization of the essential fatty acids and should be avoided. Especially harmful are the trans-fatty acids contained in heat-damaged and hydrogenated fats. Fried foods, shortening, margarine and most commercially prepared foods are full of hydrogenated fats.

Choose instead fresh, raw vegetables at every meal to provide nutrients needed for healthy skin, including beta-carotene which is essential for epithelial tissue maintenance and repair. Foods high in vitamin C (lemons, oranges) aid in resisting the spread of acne infection, and fiber-rich foods help keep the colon clear. Reach for raw, unroasted and unsalted pumpkin or sunflower seeds to provide zinc to your body, which is an important nutrient for skin health. A deficiency in zinc is a cause of acne in some people, especially in adolescents.

Since inflammation is a common cause for acne sufferers, the most potent anti-inflammatory to take is a daily dose of pharmaceutical-grade fish oil, or unrefined, cold-pressed flax seed oil. These oils contain essential fatty acids that also lower the body’s production of sebum, reducing the pore clogging which causes acne. What’s interesting is that a deficiency in the essential fatty acids will trigger increased production of sebum.

The underlying cause of increased sebum production lies internally; and therefore, ensuring all hormones in the body are balanced is vital in preventing acne breakouts. Highly stressful lifestyles can wreak havoc on the balance of hormones. Instill daily stress management activities to offset the effects of increased stress hormones, which when too elevated, ultimately lead to unbalanced sex hormones, especially the hormones called androgens that contribute to acne development. Women going through a transition period such as PMS, pregnancy, post-pregnancy, menopause, etc. can benefit from replenishing what may be lacking and/or supporting the production of certain hormones. A naturopathic doctor can advise on lifestyle habits and possibly supplementation that will not harm her body (or her child’s) to bring her health, and therefore her skin, to its optimal level.

-Camille Nghiem-Phu, BSc, ND, September 2004-

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