Hormone imbalances, particularly the excessive production of male hormones (androgens) like testosterone, are usually the main culprit responsible for acne. This is very apparent in growing teens between the ages of 14 to 18, and women with reproductive disorders such as PCOS. Basically androgens directly stimulate the sebaceous oil glands to produce more oil (sebum). This sebum may or may not combine with keratin (dead skin cells) which then block the skin pores, leading to comedones (black and white heads). If this blocked pore becomes infected with bacteria, then an inflammatory lesion like a pustule (zit) will form. Obviously hormone imbalances, being an internal issue, are best treated internally with remedies like herbal medicines but, besides drinking herbal tea, there are a few lifestyle practices that will also greatly help the healing of acne.
Learning how to relax, both body and mind, can greatly improve the severity of acne. This is simply because relaxation helps reduce our response to stress, an often over looked factor that can contribute in a big way to the hormonal imbalances affecting acne. Basically stress stimulates our adrenals to produce cortisone and testosterone, both of which stimulate the oil glands to produce more sebum. Studies have also shown that stress lowers the immune response to healing, thus leading to the acne sores taking longer to clear. Practicing methods to help manage stress, like exercise, meditation, counseling, and acupuncture, are obviously very useful for acne sufferers.
Diet is another area of our lives that we can take charge of and, which may have a good overall effect on our skin. Studies have shown acne lesions may be reduced by following a simple low glycemic index diet. Basically sugar, in any form, will increase insulin levels which then influences androgens, like testosterone, to increase. In Chinese medicine it is thought that the over consumption of sweet foods damages the digestion, which in term leads to the accumulation of dampness, a sticky pathogenic fluid that clogs up the bodily systems and can be discharged onto the skin (A greasy complexion is a result of dampness accumulation in Chinese medicine). It is interesting to note that the herb Shan Zha, or Hawthorn fruit, whose primary action is on improving digestion, is also used to treat the greasy complexion seen in acne sufferers. In laboratory settings Hawthorn has displayed potent sugar lowering abilities, thus stabilizing insulin and indirectly testosterone.
Our physical environment can make a big difference on the health of our skin. Overly humid conditions, such as working in an unventilated commercial kitchen, can clog the skin pores and thus aggravate acne. When I was a teen I had pretty bad acne, a reality due in part to the fact that I worked as a cook in several greasy/ humid kitchens. As soon as I switched my position to that of “server” and got out of the kitchen, I found my skin improved dramatically.
In terms of washing and caring for our skin, it is absolutely essential that people do not pick at their zits, nor should they strongly scrub their face with a face clothe or other abrasive material. This will only aggravate the inflammation already present, spread bacteria, and may even lead to deep and permanent scaring. The best care is to wash the face with warm water and mild soap, once or twice a day, using only your finger tips. Then pat dry the face with a clean towel. Afterwards apply some type of treatment.
Since I am a Doctor of Chinese medicine, I prefer that my patients use the herbal products that I prescribe, such as a variation of the ancient formulation called Dian Dou San, or upside down powder. It contains Rhubarb root and medical grade sulfur and works very well on inflammatory acne lesions, usually drying them up within a day or two. I also like to make up different herbal washes that are applied directly to the skin and left on. But in the end, individually prescribed internal herbal medicine is really the main treatment for acne, as it is for most chronic skin disorders. Taking care of of ones skin from the outside is useful, as in face washing and applying creams and lotions, but the best method is to work from BOTH the inside-out and the outside-in.
Dr Trevor Erikson