A common inflammatory pilosebaceous disease characterized by comedones, papules, pustules, inflamed nodules, superficial pus-filled cysts, and, in extreme cases, canalizing and deep. inflamed, sometimes purulent, sacs.
A common problem that is a potentially disfiguring skin disease. Unfortunately it often affects those in an emotionally vulnerable stage of life–adolescence. It involves the sebaceous glands in the skin which secrete lubrication (sebum)for the hair follicles (pilosebaceous follicles) and surrounding skin. These are located in greatest concentrations on the face, back, shoulders, and chest. Acne lesions are commonly of these types:
- Blackheads, glands plugged with excessive material which discolors on exposure to air.
- Whiteheads, small collections of pus within glands.
- Nodules or papules, are the red and inflamed areas of more extensive infection.
There are a complex of causes that underlie acne. Unfortunately it is rarely as simply as blaming fats, chocolate and sugar! Important predisposing factors include:
- Genetic predisposition. Statistics suggest that the strongest single factor seems to be family history. It is concluded that this means a genetic basis, however it might be argued that is it generations of inappropriate nutrition!
- Hormonal changes in adolescence: Stimulation of the sebaceous glands seems to occur with the production of androgens (the masculinizing hormone found in both sexes) at puberty. Acne patients seem to produce normal amounts of androgen, but their skin is unusually sensitive to it. production.
- Skin flora
- External irritants
- Nutrition
One explanation for the physiological processes behind the characteristic skin eruption, suggests this sequence of events:
Stimulation by the androgens (male sex hormones)
- this causes an increase in the amount and thickness of oil secretion
- thus more lipid in the follicles
- this change in skin ecology promotes bacterial growth, especiallyPropionibacterium acnes
- resulting obstruction of sebaceous glands by comedones (blackheads& whiteheads)
- any consequent disruption of follicular epithelium allows discharge into the dermis
- an inflammatory reaction develops
- pathological changes ensue in this sequence: papules Û pustulesÛ nodules Û cysts
Actions indicated for the processes behind this disease :
Alteratives
are the core of any treatment. Hepatic alteratives are especially helpful. Hormonal Normalizers are indicated because of the androgen involvement. However, it is not always a straightforward matter to impact these hormones in an appropriate way. There is no specific herb that has a Vitexlike effect for the androgens. Occasionally, Vitex itself can have a beneficial effect in adolescent girls.
Anti-microbials will help the body deal with secondary infection. They may be used both internally and topically.
Lymphatic Tonics support lymphatic drainage from the skin and underlying tissues.
Hepatics will prove vital, partly for the generalized benefit that their toning of the liver imparts, but also because of a specific role in detoxification.
Diuretics are important in ensuring adequate elimination through the kidneys.
Anti-Inflammatory remedies used topically within the context of daily hygiene can be helpful.
Astringents will, when used topically, similarly help in cleansing and avoid secondary infection.
System support :
Applying the basic principles our model works with the endocrine system should be given tonic support. This is the ideal, but such general endocrine toning is not a simple thing. Toning work is focused through liver alteratives. The immune system must be helped if there has been long-term antibiotic use.
Specific Remedies :
There are no definite specifics here, other than the hepatic alteratives.
One possible prescription :
Iris versicolor
Arctium lappa
Echinacea spp.
Galium aparine equal parts to 5ml of tincture, three times a day
Urtica dioica an infusion drunk 2 or 3 times a day.
Calendula officinalis applied topically as a wash,
infusion mixed with distilled Witch Hazel
Broader Context of Treatment :
Of course, there are a number of non-herbal issues to address, ranging from diet and hygiene to dealing with a whole complex of emotions. It is often important to explain the nature of the problem as well as the treatment you propose. In adolescents’ especially there is a need to address unspoken feelings such as fear and guilt. Ensure they understand that:
- Acne is not caused by dirt and cannot be washed away; it is an imbalance(hormonal or chemical) that causes the oil in the skin to form blackheads.
- Acne is not related to sexual activity.
Personal hygiene is important but obsession with it can aggravate the problem. It may be helpful to go through some specifics with the patient, such as:
- Keep hands away from the face, avoiding friction of the skin. Some specifics are:
- don’t prop your hands against your face
- don’t `scrub’ the face when washing
- don’t rub the face
- avoid pressure from tight collars or helmets
- avoid perspiration around the face as much as possible.
- Do not squeeze pimples or blackheads, as squeezing the skin makes the acne worse. The blackhead may be pushed deeper into the skin, possibly cause he follicle to rupture.
- Keep the hair off the face and wash the hair daily if needed.
- Avoid cosmetics that contain synthetics chemicals.
Ideas about nutrition do’s and don’t’s abound. Some generalizations are clear, such as avoiding refined food, red meat and high-fat or carbohydrate rich foods. A diet rich in green leafy vegetables & fruit is indicated. The Textbook of Natural Medicine recommends the following supplements:
Vitamin A 100,000 IU/day for 3 months
Vitamin E 400 IU/day
Vitamin C 1000 mg/day
Zinc 50 mg/day as picolinate
Selenium 200 ug/day
Brewer’s Yeast 1 tablespoon twice a day
It is essential to deal with the repercussions of long term antibiotic therapy, if this therapy has been used. Please refer to the section on immunity and infection.