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Acne
Back to Skin Health
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Acne is the most common of all skin problems. It is a disorder of the philosebaceous follicles found in the face and upper trunk. Characterised by pustules, blackheads, whiteheads and cysts, the severity of an acne outbreak is determined by a complex interaction between bacteria, sebum, keratinisation and hormones.
Causes
A number of factors that may to contribute towards acne:
- While any hormonal excess can promote acne, the male hormones (which are present in males and in a smaller amount in females) are particularly involved. This is why acne is more common in males, typically at the onset of puberty. Hormonal changes later in life such as premenstrual, premenopausal or PCOS (polycystic ovarian syndrome) may also trigger an episode.
- Excess conversion of a powerful form of the male hormone testosterone called DHT is believed to be the main cause. Increases in DHT stimulate the cells in the hair follicle to produce more keratin and for oil glands to enlarge and produce more oil (sebum). Increases in keratin cause blockages which then generate a build up of the sebum behind it. This blockage creates an ideal breeding ground for bacteria which go on to create infection in the skin, causing inflammation and soreness. If the spot does not break through to the surface of the skin, the inflammation can spread to the deeper tissues which can cause a cyst.
- Acne like lesions can also be caused by cosmetics, steroid medications, over washing or rubbing and exposure to industrial pollutants such as cold tar derivatives, mineral oils and chlorinated hydrocarbons.
Nutritional factors to consider are:
- A diet which manages sugars/carbohydrates - a high carbohydrate diet is associated with higher levels of the 5-alpha-reduction enzyme which is the enzyme that converts testosterone to the more potent DHT1. Studies have also shown that many people with acne do not handle the processing of sugar well, with skin biopsies showing impaired skin glucose tolerance2. A low glycaemic approach to the diet has been shown to reduce acne count3
- Vitamins A,C,E, B6 and B54 5
- Selenium and zinc6 7
- Toxins removal. One study showed that 50% of acne patients had increased circulating levels of bowel toxins in their blood. A nutritional strategy to support detoxification and bowel health may be beneficial8
- Thyroid problems and excessive intake of certain vitamins may also lead to spots/acne9
Possible laboratory tests
- Comprehensive digestive stool analysis
- Liver detoxification profile
- Food intolerance including gluten
- Serum vitamin A and zinc