Definition

The scourge of adolescence, acne, technically known as ‘Acne vulgaris’, is an inflammatory disease of the skin usually affecting those areas with the largest sebaceous glands (nose, central forehead, middle cheeks & chin, back, and trunk). Acne is generally self-limiting, and  characterised by black heads, whiteheads, pustules and in more severe cases, cysts and nodules. The condition is generally more severe and common in males, but more persistent in females. Acne occurs mostly occurs during adolescence (an estimated 85% of those between 15-24 years of age are affected to some degree), and typically resolves by age 30.

Rising ‘male hormones’ (like testosterone) seen in adolescence and women with polycystic ovaries (PCOS), induces insulin resistance and influences the amount of sebum produced by sebaceous glands. In turn, this causes blockage of hair follicles, leading to the formation of small cysts as well as proliferation of a bacteria called Cutibacterium acnes (for the geeks this was previously called Propionibacterium acnes).

 Risk factors

There are several risk factors involved in developing acne, and there is much recent research how the gut microbiome impacts our skin and hormonal health.

  • Gut dysbiosis – inflammation triggers excessive sebum formation which causes an overgrowth of the usually beneficial bacteria (Cutibacterium acnes) that overgrows in response to inflammatory environment.
  • Diet: A high GI diet (that is too much sugar and processed carbohydrates) leads to elevated serum insulin. This leads to skin cell proliferation and increased sebum production, both risk factors for acne.
  • Fluctuating hormones associated with adolescence, menstruation (acne tends to flare 2 to 7 days pre-menstruation), or pregnancy.
  • Low zinc
  • Genetic predisposition – acne can run in families
  • Certain medications—corticosteroids used topically or in high oral doses; anabolic steroids; oral contraceptives; lithium, isoniazid, phenytoin and phenobarbitone may also cause eruptions. High iodine (from kelp, for example) may also lead to or exacerbate acne.
  • Topical cosmetic or hair products containing vegetable or animal fats may further block skin.
  • Environmental irritants such as wood preservatives, sealing compounds, and other pollutants
  • Friction and sweating—for example, from headbands, backpacks, bicycle helmets, or tight collars, can initiate or aggravate inflammatory acne lesions. Squeezing and picking lesions can worsen acne.

Treatment: Natural Options

  • There are certain Probiotics – specifically a combination of Lactobacillus salivarus; L. casei and Bifidobacterium breve (in a Practitioner only product) that relieves acne symptoms, skin redness and helps healthy skin flora.
  • A diet high in soluble fibre, antioxidants, phytonutrients from fruit and vegetables, essential fatty acids from nuts and fish, plus copious fluid is generally recommended, along with reductions in sugar, white flour, refined and processed oils, sources of trans fatty acids and dairy products. Identifying and avoiding foods you are sensitive to can also assist.
  • Assess levels and supplements as needed with Zinc, Vitamin A, D, E and Omega-3 fatty acids
  • Screen for histamine intolerance – often associated with gut symptoms, hives, eczema, and rosacea. A low histamine diet is best discussed and supervised by a health practitioner
  • Lactoferrin (colostrum) is antimicrobial, anti-inflammatory, binds harmful bacterial products called LPS (lipopolysaccharides) and an immune balancer. One study showed that after 8 weeks of supplementation there was a 95% improvement in blemishes + redness
  • Manage stress – see https://www.holistichealth.com.au/addressing-the-5-essential-pillars-of-health/
  • Herbs tailored to the individual in liquid or combinations with nutrients
  • A good cleansing routine – avoid harsh cleansers that strip oil; moisturise (oil-free is not necessary) + red clay mask if inflamed + essential oil mix
  • Avoid touching the face (I know it’s hard) + using cotton or silk pillowcases

Medications:

A recent review of studies showed the 3 tops treatment choices for GPs: https://www.ausdoc.com.au/news/what-are-the-top-three-treatments-for-acne/ 

If you know someone who would like to address their skin health without medication, book in for a complimentary 15 minutes health discovery chat with Doreen Schwegler:https://holistic-health-pty-ltd.au1.cliniko.com/bookings

Doreen is a Medical Scientist and Naturopath with over 33 years of experience. She works online and face-to-face in Mosman (Sydney) and Melbourne.