Acne

ALTERNATIVE DOCTOR, LLC

Acne

Acne is a disorder of the skin's oil glands (sebaceous glands) resulting in plugged pores and outbreaks of lesions (pimples). Acne occurs on the face, neck, back, chest, and shoulders. Nearly 17 million people in the United States, mostly adolescents, have acne, making it the most common skin condition. Although acne is not a serious health threat, severe acne can lead to permanent scarring.

Signs and Symptoms

Acne is accompanied by the following signs and symptoms.

	Lesions (pimples)
	Blackheads
	Whiteheads
	Cysts (pus-filled)
	Nodules (deep, solid)
	Scarring

What Causes It?

Elevated levels of androgen, a steroid hormone, result in increased secretions (sebum) in the sebaceous glands. Acne results from a change in the inner lining of hair follicles that prevents sebum from passing through. The mixture of oil and cells causes bacteria that normally live on the skin to grow in the plugged follicles. When the plugged follicle can no longer hold its contents, it bursts. Pimples develop as a result of the irritation to the skin.

Contrary to popular myth, chocolate, greasy foods, and dirt seem to have little effect on the development and course of acne in most people.

Who's Most At Risk?

People with the following characteristics or conditions are more likely to develop acne.

	Adolescence (severity of acne is greater in males but more persistent in females)
	Genetic predisposition
	Use of greasy/oily cosmetic or hair products containing vegetable or animal fats
	Flat warts
	Inflamed hair follicles
	Dermatitis (skin inflammation)

Treatment Options

Prevention

There are a few preventive measures for acne. These include the following.

	Taking isotretinoin, the only preventive drug for acne
	Using only untreated cotton pillow cases and changing them frequently
	Avoiding oily cosmetics and cleansers

Treatment Plan

Acne cannot be cured but often can be well controlled. The primary goal of a treatment plan is to prevent scarring. Additional goals include reducing the number of painful pimples and minimizing the psychological stress and embarrassment caused by this condition.

Drug Therapies

Your provider may prescribe the following medications.

	Isotretinoin, to reduce excretion of oily substances, decrease inflammation, and fight bacterial infection.
	Tritinoin (Retin-A), to treat blackheads and whiteheads
	Benzoyl peroxide, to dissolve plugs, allow secretions to flow, fight bacterial infection
	Oral antibiotics, usually tetracycline, to fight bacterial infections and reduce fatty acids
	Topical antibiotics
	Oral contraceptives containing estrogen

Surgical and Other Procedures

Procedures include injections to treat painful pimples, dermabrasion to decrease the depth of scars, surgically removing the scars, or a combination approach.

Complementary and Alternative Therapies

A comprehensive treatment plan for acne may include a range of complementary and alternative therapies.

Nutrition

Recommended nutritional foods to support skin health include the following.

	Anti-inflammatory oils, such as cold water fish, nuts, and seeds
	Carotene-rich orange, yellow, and leafy green vegetables
	Water

Avoid allergenic foods such as dairy, caffeine, sugars, alcohol, refined foods, and foods containing iodine. Also, decrease your consumption of animal products.

Potentially beneficial nutrient supplements include vitamin A, vitamin E, and zinc.

Herbs

Herbal remedies may offer relief from symptoms. Take 20 to 30 drops of the following tincture two to three times daily, or drink two two three cups of tea daily of the following herbs. Dose for teas is 1 heaping tsp/cup water steeped for 10 minutes (roots need 20 minutes).

Cleavers (Galium aparine), red clover (Trifolium pratense), calendula (Calendula officinalis), and coneflower (Echinacea purpurea) in equal parts, adding yellow dock (Rumex crispus) and burdock root (Arctium lappa)

Homeopathy

Some of the most common homeopathic remedies include the following. Acute dose is three to five pellets of 12X to 30C every one to four hours until symptoms are relieved.

	Belladonna for inflamed pustular acne
	Calcarea carbonica for severe acne
	Kali bromatum for deep acne with chills and insomnia

Physical Medicine

An external wash may reduce acne symptoms. Use any of the following two times daily.

	Calendula soap or tea (1 tsp herb per cup water)
	Tea tree oil (15 to 20 drops per cup water) for severe acne
	White distilled vinegar (1 tsp per cup) for normalizing skin pH

Acupuncture

Acupuncture can help restore hormonal balance.

Massage

Massage can stimulate circulation and help your body eliminate wastes.

Prognosis/Possible Complications

Acne symptoms usually disappear after adolescence. Avoid squeezing pimples since this can worsen the condition.

Supporting Research

Behrman RE, ed. Nelson Textbook of Pediatrics. 15^th ed. Philadelphia, PA: W.B. Saunders; 1996.

Dambro MR. Griffith's 5-Minute Clinical Consult. 1999 ed. Baltimore, MD: Lippincott Williams & Wilkins, Inc.; 1999.

Fauci AS, Braunwald E, Isselbacher KJ, et al, eds. Harrison's Principles of Internal Medicine. 14^th ed. New York, NY: McGraw-Hill; 1998.

Habif TP. Clinical Dermatology. 3^rd ed. St. Louis, MO: Mosby-Year Book; 1996.

Hoffman D. The New Holistic Herbal. New York, NY: Barnes & Noble Books; 1995: 77, 79.

Lucky AW, Cullen SI, Jarratt MT. Comparative efficacy and safety of two 0.025% tretinoin gel: results from a multicenter double-blind, parallel study. J Am Acad Dermatol. 1998; 38(4): S17–23.

Lucky AW, Biro FM, Simbartl LA. Predictors of severity of acne vulgaris in young adolescent girls: results from of a five-year longitudinal study. J Am Acad Dermatol. 1998; 38(4): S17–23.

Morrison R. Desktop Guide to Keynotes and Confirmatory Symptoms. Albany, Calif: Hahnemann Clinic Publishing; 1993.

Rakel RE, ed. Conn's Current Therapy. 50^th ed. Philadelphia, PA: W.B. Saunders; 1998.

Scalzo R. Naturopathic Handbook of Herbal Formulas. 2^nd ed. Durango, Colo: Kivaki Press; 1994: 66-67.

Whang KK, Lee M. The principal of a three-staged operation in the surgery of acne scars. J Am Acad Dermatol. 1999; 40(1): 95–97.

Werbach M. Nutritional Influences on Illness. New Canaan, Conn: Keats Publishing; 1988: 3-4.

White GM. The evolving role or retinoids in the management of cutaneous conditions. J Am Acad Dermatol. 1998; 39(2).

The publisher does not accept any responsibility for the accuracy of the information or the consequences arising from the application, use, or misuse of any of the information contained herein, including any injury and/or damage to any person or property as a matter of product liability, negligence, or otherwise. No warranty, expressed or implied, is made in regard to the contents of this material. No claims or endorsements are made for any drugs or compounds currently marketed or in investigative use. This material is not intended as a guide to self-medication. The reader is advised to discuss the information provided here with a doctor, pharmacist, nurse, or other authorized healthcare practitioner and to check product information (including package inserts) regarding dosage, precautions, warnings, interactions, and contraindications before administering any drug, herb, or supplement discussed herein.