According to the Stedman’s medical dictionary Acne is defined as an “Inflammatory disease of sebaceous follicles marked by papules and pustules. Typically begins during puberty, affecting mainly the chest, back, shoulders and face”
What does this mean?
This simply means that due to occlusion or “plugging” of the hair follicle due to a collection of oil and dead skin tissue inflammation is caused leading to redness and swelling, resulting in pimples or bumps filled with pus. This creates a breeding ground for bacteria resulting in bacterial infection. This aggravates the severity if acne. The full medical term for acne is known as Acne Vulgaris
Skin anatomy 101
The skin or intugumentary system is the largest organ of the body and the body’s first line of defence. It acts as a barrier and thus protects the body from external factors and invasion, while keeping the internal system intact. Other functions of the skin include: excretion of salt, water and other organic waste products; thermoregulation; vitamin D production; nutrient storage; and detection of stimuli such as touch, pressure, pain and temperature.
The skin is composed of three main layers namely the epidermis, dermis and subcutaneous tissue (Fat layer) as illustrated in the figure below
The main structures in involved in Acne is the sebaceous gland (oil gland), hair follicle which houses the hair and in which the oil is transported to the outside of the skin and the epidermis from where the dead skin cells comes from.
Who suffers from Acne most commonly?
Acne is most common among teenagers in their puberty years, with a reported prevalence of 70 to 87 percent. These days we see an increase number of younger children suffering from acne.
Although both men and women are affected by acne, chances are that young men will suffer from acne much longer than women would. This can be attributed to the much higher levels of testosterone in men.
Well the bad news is there is no clear cut answer to this question. As mentioned above the start of acne is due to the blocking of the pores. This is increased in puberty years due to the increase in androgens (type of hormones) which leads to an increase in oil production as well as an increase in skin turn over (the rate at which dead skin cells are replaced) resulting in pores being blocked faster.
Hormonal changes during pregnancy might trigger the development of acne or it might lead to the reoccurrence there of.
There are studies that shows that acne might have a genetic component to it, i.e. if mom or dad had it you might have it.
Greasy cosmetics may cause acne in some susceptible people or it may just aggravate it. Some hair products are extremely greasy which might have the same clogging effect.
As we all know a High GI diet and dairy is also liked to the development or aggravation of acne. The good news is that there is now scientific proof as published in the Journal of the Academy of Nutrition and Dietetics
Anxiety and stress. Long standing chronic stress causes a change in some hormones like cortisol and adrenalin. These hormones influence the rate of oil production and pro-inflammatory cells leading to the onset or aggravation of acne.
Climate changes especially, hot humid climate leads to an increase in perspiration which leads to oily and sticky skin, resulting in an increase in clogging
There are a few different types of acne
· Whiteheads – they remain under the skin, and are usually very small
· Blackheads – or comedones are small black and clearly visible
· Papules - These are small pink bumps on top of the skin
· Pustules – these are the ones that are filled with pus and appear yellow
· Nodules – These are the large, solid and painful ones and run deep into the skin
· Cysts – These can lead to scar formation. They are large, panful and filled with pus
How to treat your acne
Acne is not dangerous but may occasionally cause scarring and have an emotional or psychological impact. However squeezing or “popping a zit” is a bad idea. By squeezing a papule underlying tissues are damaged and the infected pus may spread causing aggravation of infection and scarring.
Depending on the severity of your acne, doctors will adjust their treatment protocol.
Common topical treatments involve ingredients that will try and limit inflammation, kill bacteria, increase dead cell removal and oils production suppressants etc.
Antibiotics are often give to prevent bacterial overgrowth however in most cases as soon as the antibiotics’ effects wear off the acne returns.
Retinoids containing medication is often given. This however may have LONG TERM side effects and can become toxic.
Oral contraceptives are often given to females as this supress overactive glands, however one should consider the hormonal effect these medications cause.
Homeopathic and natural treatments for acne
A visit to your Homeopath will result in proper and more effective treatment, especially if your problem is hormonal related.
Some OTC (over the counter) products include:
· Tissue salts
- Ferrum phos (4) which will aid in inflammation of the skin and calm the redness
- Silicae (12) this will aid in the expelling of the acne pustule, at first this might seem like it is aggravating the acne but be calm as this will start clearing.
· Acne plus ointment from Natura. This may be used with calendula cream which will aid in the inflammation and infection if pustules.
· Organo 1 (Natura) – Homeopathic medicine assisting in immune system function and aiding in the prevention of spreading of infection. It has a marked function on suppuration, thus the pus forming infections such as acne.
· Feminon (Natura) – This might assist in the regulation of female hormones which might be beneficial for premenstrual acne
· Omega 3 – Essential Fatty Acids plays an important role in hormonal regulation and production. Omega 3 is an extremely important supplement as it regulates and decrease inflammation. It is common that people ingest too many Omega 6 which might lead to an inflammatory response. People on blood thinning medication should consult a practitioner before taking omega supplements.
· Zinc – Zinc deficiency is a common problem in especially teenagers. Zinc is known for skin health due to the inhibition of enzymes leading to testosterone conversion leading to increase in oil production and abnormal follicular growth. Please be careful not to overdose on zinc as it is a metal and there are chances of toxicity in high doses. Something like zinc picolinate can be used in doses of 15-30mg a day.
· Selenium – is an immune boosting mineral with an effect on glutahion. This leads to decrease inflammation. Once again one should be careful not to overdose on selenium due to toxicity levels.
· Wash your skin after sweating with lukewarm water as sweating may lead to aggravation on acne
· Stay clear of alcohol containing skin products. This might aggravate inflammation and dry up your skin.
· DO NOT PICK, POP or SQUEEZE you skin. This just causes more damage to your skin and will take much longer to heal. Let nature take its course and let it heal by itself. This will minimize scarring and spread. In other words HANDS OFF FACE.
· Consult your health care professional for treatment should your acne be “bad”.
-- By Dr. M Swanepoel
Boon, NA. (editor). (2006). Davidson’s Principles & Practice of Medicine. Edinburgh: Churchill Livingston. Pp1299-1300
Martini, F. (2004). Fundamentals of Anatomy & Physiology. USA: Benjamin Cummings. Pp 154-179
Mark, H (editor). (2006). The Merck Manual of Diagnosis and Therapy. New Jersy: Merc Research Laboratories. Pp941-946
Lukens, R (Editor). (2005). Stedman’s Medical Dictionary of the Health Professions and Nursing.cott Williams & Wilkens.P15
Which one is your child?