Better Acne Treatment Inside and Out
Most people have experienced acne. For some it is merely an occasional nuisance
while others find it to be a
seriously embarrassing and frustrating issue that seems to defy all logical treatment. And for a few it can leave emotional scars
that are more than just skin deep. Successful
acne treatment requires getting to the root cause of the acne and fixing it at
the source. We need to address issues
with skin turnover, bacteria and fungal infections, inflammation in the body
and hormone imbalances. And yes… diet,
stress, and sleep also play a role.
Acne is the
result of clogging of the skin’s oil glands, with or without inflammation and
infection. We know that acne is caused
by hormones and bacteria. The oil glands
secrete a waxy oil called sebum,
and become whiteheads (closed
and plugged oil glands), blackheads
(open and plugged oil glands), and pustules
(red and inflamed, often infected). At a
basic level the simplest form of acne is when the oil glands are plugged by the
normal outer layer of dead skin, called keratin.
Good skin care
involves twice daily washing, moisturizing, and sun protection. We recommend cleansers that gently and effectively rejuvenate the skin by
dissolving surface oil, bacteria and impurities without harmful over drying,
leaving your skin feeling fresh and clean.
A good moisturizer should
be oil free and provide nutrients that encourage healthy skin. By combining a sunscreen with moisturizer it makes for a very simple step in
your daily regimen. We recommend the ABI
product line for basic skin care with outstanding results.
When it comes to
make-up, avoid heavy pore-clogging, high-fragrance foundations such as Revlon,
Loreal, Maybelline, Mary Kay, Lancome, Elizabeth Arden, etc. We suggest mineral make-up which does not
clog pores. Our favorite brand is
YoungBlood, which is full of nutrients and antioxidants, even including
sunscreen.
Control of acne
requires an effective and convenient way to control sebum production and gently
exfoliate dead skin cells. This can be
done with daily topical treatments, such as glycolic and salicylic acid topicals,
retinoids, and fruit peels.
Microdermabrasion can be very helpful in preventing keratin build up but
can worsen acne during a flare up.
A crucial part of
successful acne treatment is to understand the role of infection. P.
Acnes is a common bacteria that inhabits oil glands, causing a worsening
of the size and inflammation of plugged glands.
Once acne moves beyond whiteheads or blackheads into pustules or boils then
additional treatment is indicated. For
milder cases, prescription topical antibiotics often work well. For more intensive infections systemic
antibiotics are helpful. The Blu-U light
therapy effectively kills the P. Acnes
bacteria. Adding the
photosensitizing agent Levulan to the Blu-U is great for the most resistant
cases.
For many people acne
is a sign of underlying inflammation or problems with the immune system as a
whole. Everything from diet, stress, poor
sleep, infections and allergies might be playing a role in acne due to
inflammation.
Certain foods
cause acne due to the effects on various hormones in the body that deal with
inflammation. High sugar and high
glycemic diets will cause spikes in insulin and with it our stress hormone
cortisol will rise. Cortisol will
directly stimulate the sebum glands and cause acne. Too much saturated fat in the diet will cause
inflammation and high cortisol. Stress
and lack of sleep will both cause high cortisol, and again, this can lead to
more acne.
Sneaky underlying
infections in the gut or bloodstream, such as the yeast Candida, can cause inflammation and acne. Interestingly, the “good” bacteria in the
body, especially in the gut, play a big role in keeping the immune system
strong and helping to keep “bad” microbes and inflammation under control. When the immune system is weakened it allows
the otherwise harmless microbes to take over - and this can happen in the skin. The beneficial bacteria in the gut also play
a role in removing toxins and excess hormones from the body, both of which may
help acne. We often treat for infections
such as Candida and include a probiotic (our body’s beneficial bacteria) supplement
as part of our acne treatment plan.
Believe or not,
delayed food allergies can cause acne due to the resulting inflammation and
increased cortisol hormone production.
We see numerous cases where acne just disappears as patients eliminate
certain foods they are allergic to such as gluten or dairy products.
The skin is often
a tell-tale sign of an underlying hormone imbalance. Similar to cortisol, the androgens or “male hormones” such as
DHEA, Testosterone, and its byproduct DHT, all increase oil production in the
skin and stimulate hair growth. When the
androgens are in excess relative to the “female hormones” such as estrogen and
progesterone then the skin can become oily, hairy, or both.
Pre-menopausal
women commonly have estrogen dominant cycles due to a lack of sufficient
progesterone, causing pre-menstrual breakouts.
During and after menopause many women experience a flare up of acne not
seen since their teens or at all due to the falling levels of estrogen and
progesterone. Other hormone conditions
such as low thyroid and polycystic ovarian syndrome can affect the skin. A hormone analysis is a very important step
in acne treatment and correction of hormone imbalances will improve skin and
overall health. In some cases we
prescribe medications that block hormone receptors in the skin.
Our acne
treatment protocol typically involves treating the skin directly while
evaluating the whole person beneath.
Certainly proper skin care and aesthetic procedures will do wonders for
reducing acne and improving skin health but we also help with lifestyle issues
such as dietary changes, stress management, and improving sleep – all of which
can build the immune system and reduce acne promoting inflammation.
An integrated
medical-aesthetic approach looking for underlying causes is often the “cure”
for difficult to treat acne. We’ve seen
many cases where years of acne frustration ended simply and quickly with proper
treatment of immune system or hormone imbalances. For better acne treatment, consider an
approach that works inside and out!
Free
seminars
The ACNE
Cure: Functional Medicine &
Aesthetic Skin Care
Monday,
October 15th at 6pm, at the IMC
BioIdentical
Hormone Replacement for WOMEN
Monday,
October 29th at 6pm, at the IMC
Bio
Scott Rollins, MD, is Board Certified with the American
Board of Family Practice and the American Board of Anti-Aging and Regenerative
Medicine. He specializes in Bioidentical Hormone Replacement, thyroid and
adrenal disorders, fibromyalgia and other complex medical conditions. He is founder and medical director of the
Integrative Medicine Center of Western Colorado (www.imcwc.com). Call (970) 245-6911 for an appointment or
more information.
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