Acne is extremely common and most of us will have been affected at some point, generally starting at puberty and sometimes continuing into adult life.
The 3 main causes are genetics, diet and hormones.
Increased levels of dihydrotestosterone cause a series of effects leading to blocked follicles, overgrowth of bacteria and yeasts in the follicle and overproduction of oils in our sebaceous glands. The bacteria and yeast can feed off triglycerides formed from the sebum.
When the plugged follicles start to leak their contents into the surrounding tissue an immune reaction occurs and the lesions become inflamed.
Once acne has reached the inflammatory stage it will require:
- Reversal of the hormonal changes
- Reversal of the follicular plugging
- Elimination of the bacteria and yeast
- Reversal of the inflammation
To achieve this, we need a combination of therapies and patience whilst waiting for the reversal of the acne to take effect. This may take 1-2 months for mild acne, 2-4 months for moderate acne and 4-6 months for severe acne.
Diet has a large effect on the hormonal changes triggering acne and all cases should consider cutting out dairy and processed foods; in effect, I’m recommending a Paleo style diet until your acne has cleared. After that continue to avoid processed foods and add a bit of dairy as tolerated. If your acne recurs it means you need to cut out dairy again.
Just cutting out dairy and sugary, processed foods can lead to an 80% improvement in acne in many cases.
Sticking to an ideal body weight is important and best achieved by following a low-carbohydrate, low processed-food diet as suggested above.
If you smoke, STOP! Adult acne has been linked to smoking – and it’s a disgusting habit…
Cleansers and avoiding greasy creams will help unblock pores and this can be helped by using a suitable skin care regime and by treatments such as chemical peels – see Allison, our skin nurse if you are interested in these treatments.
Blocked pores/blackheads can also be cleared by extractions and medical creams.
For mild acne, an over-the-counter cleanser and improved diet may be all that is needed but for moderate and severe cases you should make an appointment to discuss your options since scarring needs to be avoided and early treatment is vital.
Oral and topical antibiotics are widely prescribed mainly for their anti-inflammatory effects and Roaccutane – an oral retinoid – is often prescribed for severe cases referred to dermatologists.
Dr Simpson prefers to avoid these medications and concentrate on diet, lifestyle and topical therapies.
The most effective of these is a relatively new treatment called Photodynamic Therapy (PDT) which uses a topically applied naturally-occurring substance applied to the skin which when activated with intense LED light causes shrinkage of the oil glands and reduction of the bacteria. Long term results similar to Roaccutane but without any systemic side effects can be achieved with as few as 1-3 treatments spaced 3-4 weeks apart.
If you need further information, book in for a consultation at Peregian Springs.