Acne Treatment: Women Pinpoint the Trigger

From the occasional pimple during times of stress to the familiar breakouts before menses, acne affects almost all women at some time in their lives.

While acne commonly develops during the preteen and early teen years, it can also arise in young adulthood and persist for years. Studies show women feel more frustrated by acne than men do—adult women even more so than teenage girls. Why? Dealing with a chronic disorder typically associated with puberty can lead to great frustration. But don’t despair if you have acne, effective treatment is available.

How acne happens

Your skin is studded with thousands of oil glands that produce sebum to moisturize and enhance the skin’s ability to act as a protective barrier. Sebum within each gland is carried to the surface through pores. The highest density of oil glands is found on your face, especially at the nose, forehead and mid-cheek areas. The largest oil glands are found on the back and mid-chest. This explains in part why acne appears mostly on the face, chest and back.

But what actually causes acne is still unknown. Researchers suspect hormones play a role in pore blockage and increased oil production. A blockage creates the build-up of oil within the pore to form blemishes such as blackheads and whiteheads. “Zits” appear when acne bacteria multiply within the blocked pore, resulting in inflamed red bumps or pustules. Some of these large sacs of oil may rupture leading to large red lumps (also called nodules).

Unfortunately, you may inherit acne-prone skin—particularly the type susceptible to the more severe, scarring forms of the condition.

Prevention

For some patients acne can be aggravated by:

* Thick, pore-blocking creams
* Clothing, hats, helmets or pads that retain sweat or moisture
* Long hair that brushes the skin on your back, neck, and face
* Hair gels and sprays where they may touch your skin
* Sleeping on damp hair

While diet has not been conclusively shown to be an acne trigger, some women may notice certain foods aggravate their skin. Try excluding these foods for two or three weeks and see if your skin improves.

Treatment

Fortunately, therapy can reduce acne, minimize the risk of scars and improve your skin’s appearance. Treatment begins with discovering your acne triggers and learning what treatments will help you control the condition. Choosing cosmetics appropriate for your skin is important, too.

Acne treatment ranges from cleansers, topical gels and creams for mild acne to antibiotic or hormonal pills for moderate cases. Accutane may be prescribed for severe cases. Acne staining can be treated with exfoliating creams and facials while scarring may require the use of fillers, dermabrasion or laser treatments. Full compliance with a treatment program is the key to success.

About the author:
Jerry K. L. Tan, MD, FRCPC is an Adjunct Professor, Faculty of Medicine, University of Western Ontario, Windsor, Canada. He is also Director, Acne Research and Treatment Centre, Windsor, Canada. Dr. Tan’s area of specialty: acne and rosacea.

Restoring Your Youthful Appearance

Facial rejuvenation is the term used to encompass all forms of restoring a youthful appearance to the face. It includes the broad categories of:

* Injectables (Botox® & fillers) (See BotoxFacts.ca for additional uses of Botox®);
* Resurfacing procedures (laser treatment, microdermabrasion & chemical peels);
* Surgical rejuvenation (brow lifts, eyelid surgery; facelifts, nose jobs, face and chin augmentation, and neck lifts);
* Topical tretinoin and tazarotene which reverse sun damage and enhance collagen production. The normal changes associated with facial aging are the result of both:

* intrinsic (age related fat and bone loss known as atrophy, and skin laxity for example) and
* extrinsic factors (like ultraviolet light / sunlight, chemicals, and smoking).

These factors contribute to biological changes associated with age and create predictable patterns of facial change. An over-simplistic analogy is mimicked by the changes in the helium balloon your child wouldn’t let you throw away. With time there is loss of internal volume (gas in this example) and as a result the covering loses its taught shape, luster, and becomes wrinkled. Moreover, there is a marked change in shape of the entire structure. Naturally, similar changes on your face can be highly distressing especially since many available treatments are being promoted.

Physicians can treat facial aging three ways: through reduction (making the skin “fit”), augmentation (“stretching” the skin back to normal) or a combination of the two.

When it comes to choosing a rejuvenation procedure, the severity of the facial aging must be considered. Here’s a review:

* Wrinkles (individual fine or deep rhytids) are managed well by Botox® or injectable fillers. Although other agents are touted to produce similar results, Botox® is currently unsurpassed in its ability to soften or eliminate wrinkles caused directly by the action of underlying muscles of facial animation. (Botox Facts has more information for you)

* For wrinkles that may not be contributed to directly by facial movement or for depressed scars; superficial or deep fillers (ranging from collagen, hyaluronic acid and poly-L-lactic acid to silicone particles and bone cement and even your own injected fat). These can also be used for wrinkles, scars, and soft tissue augmentation (most commnly lip augmentation).

* When you have wrinkles involving larger areas or if it’s related to sun-damage, the underlying problem commonly lies in the biological changes in the skin itself. Here rejuvenation methods such as laser resurfacing, microdermabrasion, and chemical peels act to restore some of the lost intrinsic biologic properties of the skin and can provide a significant restorative change over these large areas. These treatments use light associated heat, physical sanding, or chemicals, respectively, to remove the surface layers of the skin and hence stimulate a regenerative-like process. Many common skin creams advertised to improve facial wrinkles contain glycolic or other acids used in light chemical peels to help improve the taughtness of your treated skin.

* As the severity of skin aging increases, injection and resurfacing procedures may be combined themselves or with surgical rejuvenation (possibly in a staged fashion).
* Surgical management of more severe forms of facial aging can be through an additive (implants), reductive (excisions or tucks), or combined approach. Modern rhinoplasties (“nosejobs”) are a good example where combined approaches of reduction by excision and

augmentation through cartilage grafting are employed. As these procedures typically address changes in the three-dimensional volume (deep structures) and in the skin (envelope or cover) they obviously provide the greatest extent of rejuvenation and can address the greatest degrees of facial change. That said, they do come with a limited amount of scaring and the possibly some temporary numbness. Often these scars, created in lines of election, are fine and highly acceptable with some rare exceptions.

* Topical tretinoin and tazarotene can improve fine lines and the general appearance of the skin. The down-side is that you need to continue to use these topical treatments in order to maintain its effect. Sometimes, tretinoin and tazarotene can be combined with the procedures listed above to enhance the effects.

Although you may hear more and more about treating aging skin with the procedures and products mentioned above, we all know that the best form of care is through modification of your exposure to the extrinsic “modifiable” risk factors, like sun exposure (See Skin Cancer Guide for more information).

By: Dr Bryce J Cowan BSc MSc MD PhD FRCS(C)

Best Acne Skin Treatments

Acne, often thought to be only a teenager’s skin problem, is actually a condition that can affect adults both male and female, although it generally begins during puberty. Taking a proactive approach to treating acne is very important. How you look after your skin every day, along with the treatment you and your doctor select are key steps in your fight to eliminate pimples, preventing scarring and eliminating your acne.

There are a number of acne medications that can be used to treat your acne including over-the-counter acne products like Panoxyl®, or prescription drugs including topical treatments, Accutane® and hormone therapies.

Hormonal treatments, including oral contraceptives, have long been recognized by dermatologists to be an effective treatment option for women who have acne, no matter how severe.

Have you been told that you shouldn’t eat chocolate because it causes acne? Or how about French fries? Pizza? Wrong! Those are just myths, and while some foods can make acne worse for some people, researchers have found that it does not cause it!

While acne commonly develops during the preteen and early teen years, it can also arise in young adulthood and persist for years. Studies show women feel more frustrated by acne than men do - adult women even more so than teenage girls. Why? Dealing with a chronic disorder typically associated with puberty can lead to great frustration. But don’t despair if you have acne, effective treatment is available.

Acne Myths: Chocolate and Sex Causes Acne!

Have you been told that you shouldn’t eat chocolate because it causes acne? Or how about French fries? Pizza? Wrong! That’s just a myth, and while some foods can make acne worse for some people, researchers have found that it does not cause it!

There is recent work from Australia that suggests that high carbohydrate foods may in some people flare their acne. The theory is that chronic consumption of high carbs stimulates the excessive production of insulin so that eventually more and more insulin is needed to assist glucose into cells. This is called insulin resistance. The higher insulin may drive the ovaries to produce more testosterone which in turn encourages acne. This may be what is happening partly in a condition called polycystic ovary syndrome.

There are a number of myths about the causes of acne and how to treat it. Here are just a few:

1. Acne is caused by sexual activity.

When you reach puberty, your body experiences hormonal changes that lead to the development and maturation of your sexual features. These hormonal changes may also cause you to get acne. Acne is associated with these changes, not with sexual activity.

2. Cosmetics will make acne worse.

While it is true that many creams, oils and greases can aggravate your acne, there are many cosmetic products you can use that do not, including sunscreens, moisturizers and foundations. Those that do not aggravate acne or lead to development of comedones are labelled “non-acnegenic” and “non-comedogenic” respectively. (See more information about cosmetics and acne)

3. Acne is caused by dirty skin.

If you have acne, it does not mean that your skin is dirty. What may look like dirt inside your black heads is actually melanin, the pigment that provides the natural color in your skin. Cleansing and scrubbing your skin excessively will not help your acne. In fact, it may make it worse. Remember that the causes of acne affect oil glands, which are well below the surface of the skin, so you should avoid over washing. This can dry out and irritate your skin, increasing inflammation and aggravating the situation. The best thing to do is to gently wash your face twice a day with a mild soap and then pat dry. (Check out MildCleanser.ca for more hints)

4. There is nothing I can do to treat my acne. It will go away on its own.

This is not true! While your acne may eventually go away on its own, it can leave permanent scars on your skin that could have been prevented if you had treated your acne. These scars can really hurt your self-esteem, too! There are many treatment options available. Talk to your doctor about which ones are right for you.

5. Only teenagers get acne.

Wrong again! You can get acne at any age. Even babies can get it, and about 25% of all people between the ages 25-44 have acne. Many adult women have acne because of the constant fluctuation of their hormones during each menstrual cycle. Some medications, like birth control pills, as well as being pregnant can also contribute to adult acne.

6. Picking or squeezing a pimple is the best way to get rid of it quickly.

Squeezing or picking can damage the cells under your skin and cause the pimple to be inflamed or leave a permanent scar. As tempting as it is, you will be better off in the long run to leave them alone and let them heal on their own.

7. Sunlight will improve acne.

While it is true that sun exposure will dry out your existing pimples, it will not prevent new ones from forming. For some people, the sun can actually make their acne worse, and some of the common acne medications, like tetracycline and the retinoids can make your skin supersensitive to the sun leading to serious sunburns. When you’re in the sun, it is always wise to use a sunscreen with an SPF of 15 or higher to protect your skin.

8. Acne is caused by stress.

While the ordinary stresses from every-day living do not affect acne, some drugs that are used to treat people with severe stress can cause acne as a side-effect. If you think you may have acne because of a drug that has been prescribed for stress or depression, you should talk to your doctor about it.

9. Some foods can cause acne.

In large clinical research studies, no clear associations have been made between foods and acne. However, some foods can make acne worse for some people. If you suspect that a certain food type is making your acne worse, you can determine if it affects it by avoiding that product for 2-4 weeks. If your acne improves over that time period, then it’s possible that you were right! After a break of a few weeks, you can try eating the suspect food again to see whether you get another flare of your acne. Just remember that a healthy, well-balanced diet is the best choice, and foods like chocolate and French fries should be eaten in moderation. So chocolate lovers, you can still enjoy chocolate now and then without worrying about getting more zits!

About the author:
Richard Thomas, MD, FRCPC is Assistant Clinical Professor of Dermatology, Department of Dermatology and Skin Science, University of British Columbia, Vancouver, Canada.

Natural Approaches to Acne

Acne occurs when the oil (or sebaceous) glands under hair follicles, often on your face, neck, chest, or back, get plugged up, inflamed, or infected. Frequently the glands simply secrete too much of a thick waxy lubricant called sebum that keeps your skin healthy. This blocks the pores and creates a perfect breeding ground for bacteria. Follicles then get red and inflamed.

Hormone imbalances can play a role as well. Sebum increases with the overproduction of testosterone and other androgens in teenage boys, for instance, or with women;s hormonal fluctuations, such as those associated with the menstrual cycle, pregnancy, and menopause. In mild cases of acne, whiteheads and blackheads appear, and maybe some raised red blemishes. In more severe cases, pus-filled cysts and deep nodules form around the inflamed follicles, causing unsightly bumps, tenderness, and often pain.

Natural Approaches to Acne
A couple of herbal products are useful for drying up acne. Topically applied tea tree oil is a natural alternative to benzoyl peroxide. Tea tree oil is fungicidal, antiseptic, expectorant, anti-infectious, anti-inflammatory, parasiticide, and antiviral. Wipe on a 10% to 15% strength solution twice a day.

The herb chamomile also has long been used for easing skin inflammations. Make a strong chamomile tea, and wipe the cooled liquid over your face each morning. This effective daily rinse tones and cleanses.

The holistic understanding of acne is generally the result of hormonal imbalance or toxicity of the bowel or blood. Use cleansing herbs like burdock root, yellow dock root, or echinacea root to help cleanse your blood and remove toxic waste products from your liver. Use bowel-cleansing herbs like yellow dock root and psyllium seed for a week, and repeat once a month for several months, especially if you have trouble with boils, acne, and other skin problems. Take evening primrose capsules. And apply tea tree oil solution externally.

Here’s a helpful tea recipe:

1 tablespoon Oregon grape root

1 tablespoon yellow dock root

1 tablespoon burdock root

1 tablespoon red clover flowers

2 cups water

Put all herbs in water and simmer 30 minutes. Drink one cup of the tea, 2 to 3 times daily.

During a breakout, eat mainly fresh fruits and vegetables, and add a six-ounce glass of cleansing vegetable juice with equal parts of cucumber, carrot, and celery, with a little parsley. Identify and drastically reduce all forms of refined sugar and fried foods in your diet – this includes honey.

Alternate hot and cold compresses over pimples once or twice a day to open the pores, cleanse them, and increase circulation to remove wastes.

Sometimes the skin will show reactions to external factors, such as bacteria, that have led to internal processes, which reflect on the skin instead of manifesting internally. While symptoms on the skin should be attended to, the real problem lies in the weakened defense system, which should be toned and strengthened so that the body will rid itself of infection.

The general guidelines for the treatment of infections also hold true for acne. And if antibiotics have been used recently, at least 1 g of vitamin C should be taken daily.

Chamomile Eases Inflammation and Acne

Chamomile (or Camomile) is a common name for several daisy-like plants. The Greeks named them “earth-apple-on the ground” for their apple-like scent. There are several varieties of Chamomile - each one used for slightly different purposes or intensities of properties. German or blue chamomile and Roman (English) chamomile, or the “garden” chamomile are the most commonly used.

These two types of chamomile are used for health conditions and are most commonly found in skin care or beauty products. While the two kinds are thought to have similar effects on the body, the German variety is more commonly used in the United States. Chamomile, is one of the oldest of all herbs, dating back to ancient Egyptians. It’s both a pretty flower and an ancient healer. Chamomile has been widely used for children and adults for thousands of years for a variety of health conditions.

What It Is Used For

Chamomile is an essential addition to the herbal first aid kit. It is a useful herb in many situations. It can relieve anxiety and calm someone down in the event of stress. It can also relieve gastrointestinal upset - after a big meal, or when stress doesn’t mix well with your meal. Chamomile is even an excellent herb to use as compresses for eye problems. Warm two tea bags with chamomile flowers to ease itchy eyes, especially when traveling to different part of the country and you are not immune to the allergens in that area. It is also used topically for skin conditions and for mouth ulcers resulting from cancer treatment.

How It Is Used

The flowering tops of the chamomile plant are used to make teas, liquid extracts, capsules, or tablets.  The herb can also be applied to the skin as a cream or an ointment, or used as a mouth rinse.

Chamomile in Skin Care Products

This versatile herb is also recognized as a natural healing treatment that helps rejuvenate the skin. There are many wonderful natural facial treatments on the market today that incorporate Chamomile as a key ingredient.

To make a quick and easy tea facial, simply apply a paste made from one teaspoon of fine cornmeal mixed with cooled tea to the face, let dry, then gently rub off. This very gentle skin tonic is ideal to replenish and enrich dry or sensitive skin. Its bactericidal, anti-itching, and antiseptic properties help to refresh the skin and reduce swelling. Making paste with extra-strong brew and using it as an external wash or part of a hot compress can also help soothe burns, skin rashes, and sores.

Chamomile has excellent anti-inflammatory properties. Chamomile contains an anti-inflammatory compound called alpha bisabolol, which helps to soothe itchy, red skin. For this reason, Chamomile along with some other herbs and natural treatments has shown promise as skin treatments for eczema.

According to family physician Dr. Kristie Leong, “Chamomile has been used throughout history to treat various skin conditions and some studies have shown it works as effectively as low dose steroid creams without the side effects. Chamomile oil can be purchased at some health food stores. It needs to be diluted with a carrier oil such as almond oil or jojoba and can then be applied as a skin treatment for eczema. Bathing in warm water containing chamomile flowers may also help to soothe inflammation and itching. Simply make a bath bag using chamomile flowers and float it in a tub of warm bath water.”

For easing skin inflammations and acne, make a strong chamomile tea, and wipe the cooled liquid over your face each morning. This effective daily rinse tones and cleanses.

Essential Oil Usage

Both Roman and German chamomile have excellent calming properties, but Roman chamomile is more effective for irritation, impatience and feeling disagreeable, and has great value in treating PMS and other menstrual and menopausal problems, while German chamomile is superbly effective on the skin, not only to sooth and calm, but to heal and for tissue regeneration.

Side Effects and Cautions

* There are reports of rare allergic reactions in people who have eaten or come into contact with chamomile products. Reactions include skin rashes, throat swelling, shortness of breath, and anaphylaxis (a life-threatening allergic reaction).

* People are more likely to experience allergic reactions to chamomile if they are allergic to related plants in the daisy family, which includes ragweed, chrysanthemums, marigolds, and daisies.

* Tell your health care providers about any complementary and alternative practices you use. Give them a full picture of what you do to manage your health. This helps to ensure coordinated and safe care.