It is estimated that acne vulgaris affects 650 million people globally and is the eighth most common disease in the world. Acne accounts for about one third of skin diseases and is one of the most common reasons for visiting the GP.
The effects of Acne:
The development of acne is influenced by excessive sebum production; over-production of skin cells blocking the sebaceous duct; the release of inflammatory mediators; and the local environment to harbour the growth of propionibacterium acnes. Acne is more than just skin deep; it has major impacts on mental health (including depression) and can be debilitating throughout adult life.
Many of the biomedical treatment options have impacting side effects. Low grade antibiotics which are commonly used as the first line treatment for acne (such as clindamycin, tetracycline and erythromycin), have negative impacts your gut flora and immune health, and has many more side effects on your liver and bowel, and colourchanges to your skin.
From a naturopathic perspective, addressing body system imbalances and root causes is the number one priority. Undeniably acne vulgaris and the more severe cystic acne has multifactorial causes, and the triggers vary from person to person. It’s the perfect storm that causes the outbreak, and the knock-on effect can be debilitating.
“As a degree qualified naturopath, my four years of full time training reminds me that it is about treating the individual and looking at the issue from all angles and making clinical decisions drawn from the evidenced-based and clinical research available.”
Triggers range from dietary, lifestyle & environmental, hormonal, blood sugar problems, effects of stress, gut flora and digestive issues. There have been key areas of research, but with no definitive cure for acne. This highlights the level of sensitivity required for adopting a multi-levelled approach to developing a treatment plan.
The top 7 areas to consider when treating acne:
- DIET: Research has found that a high glycaemic diet, and an excessive intake of dairy may exacerbate acne with a positive correlation between milk, chocolates, sugar and salt. Key nutrients which help boost the skin’s integrity and cellular health include: omega 3 fatty acids, vitamin A and beta-carotene, Vitamin C, Vitamin D, Vitamin E, Zinc, Polyphenols (the antioxidant compounds in foods) found in nuts, fruits, vegetables, cocoa, and green tea.
- LIFESTYLE & ENVIRONMENT: Aggravating factors such as pollutants need to be addressed: topical applications, and lifestyle choices that affect the liver. Seasonal change may also be a trigger for those with acne prone sensitive skin.
- HORMONAL IMBALANCES: Excess androgens present in hormonal conditions such as poly-cystic ovarian syndrome (PCOS) and puberty cause the sebaceous glands to secrete more sebum. By supporting digestion and liver detoxification pathways using dietary compounds, specific herbs and nutrients will assist in balancing the hormones. Currently a clinical trial is underway investigating the link between dysmenorrhoea (painful periods) and acne. Painful periods are an indicator of inflammation and hormonal imbalance.
- BLOOD SUGAR PROBLEMS:Insulin resistance and blood sugar problems with high glycaemic diets and processed foods has been linked to acne. Key nutrients to address the imbalance include chromium, magnesium, alpha-lipoic acid, Epigallocatechin-3-gallate (the main active ingredient in green tea). Dietary changes with low processed, low glycaemic load, and high plant fibre correlates with improved gut flora and blood sugar management.
- STRESS MANAGEMENT:Hormonal cascades triggered by stress may initiate inflammation in sebaceous follicles. Stress management strategies and nervous system supporting herbal medicine which buffer the effects of cortisol, are of paramount importance to address this acne trigger.
- GUT FLORA IMBALANCE & DIGESTION: The gut microbiome is an important mediator of inflammation both locally in the digestive tract and in all body systems including the skin. Current evidence suggests that a plant based diet and probiotics (Lactobacillus acidophilus and bifidobacteria) support the gut-skin axis to reduce inflammation, and oxidative stress, thereby helping with acne, and assisting in the healing of skin. Further, hypochlorhydria (high pH/ low stomach acid) has a positive correlation with acne. This may indicate a zinc deficiency due to its fundamental requirement for correcting stomach acid pH. Hypochlorhydria is a significant risk factor for small intestinal bacterial overgrowth (SIBO) – a major cause of intestinal permeability – “leaky gut” which may further exacerbate the problem of acne.
- GENETIC CONTRIBUTION: The polymorphisms IL-1α, TNF-α and CYP1A1 are implicated.
A naturopathic approach to acne treatment:
Within a naturopathic consultation, in-depth questioning about body systems reviewing the gastrointestinal tract, endocrine, nervous system with analysis of dietary and lifestyle influences, help to highlight the main triggers of acne. Signs and symptoms are explored, and sometimes further investigation is required (e.g. pathology tests). The goal is to adopt a multi-levelled approach to treatment by correcting deficiencies, and mediating the triggers by restoring balance, and ultimately improving the severity of acne and healing of the skin.
Reducing your sugar intake also helps to reduce inflammation in the body – particularly in the blood vessels – and therefore reduces the severity of acne prone skin.
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