Causes of Acne

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There are various factors which differentiate acne from ordinary spots. The fact that more boys than girls suffer from acne and that people with no male hormones (eunuchs) do not suffer at all gives us some insight into its causes. The amount of the male hormone testosterone in the body increases at puberty (in girls too, although not as much as in boys). This triggers the production of sebum and keratin. Remember that keratin is the main constituent of the epidermis; and an excess of keratin can block pores, as can an excess of sebum. It has now been found that it is not just the increase in testosterone - which happens to all teenagers - but excess conversion to an even more powerful version of the hormone called DHT (dihydrotestosterone) which may bring on acne!

With the increase in keratin, a blockage forms, this in turn creates a build-up of sebum behind it and shows up as a blackhead. As the pore becomes blocked, it provides an ideal breeding ground for the bacteria Proprionibacterium acnes which normally live harmlessly on the surface of our skin. P. acnes' ideal party environment is one with no air and plenty of sebum to feed off - so it is easy to see how they have a field day and create an infection in the skin, causing the inflammation and soreness of a spot. If this inflammation gets out of hand, it can spread through to deeper tissues. And, if it does not break through to the surface, it causes a cyst under the skin. It is also important to note that acne-like spots can be caused by exposure to industrial materials such as mineral oil and coal tar derivatives, sensitivity to certain cosmetics and certain drugs including steroids. So if you are getting spots which seem to be acne, you should first check that they are not being caused by a. chemical you are exposed to.

The effect of our hormones on our skin is, obviously, beyond our control. There are, however, other factors over which we can have some influence. The difficulty lies in the fact that there are many factors which must be considered. The link between diet and acne, for example, remains very controversial - some swearing that avoiding chocolate helps, and others finding no relief from giving it up. The best advice is to ensure an all-round healthy diet which includes plenty of fresh vegetables and fruits, wholegrain, some protein (in the form of fish, lean meat, Soya products and beans or lentils), and little or no sugary, processed and fatty foods. There are a couple of very important things to take into consideration, and one is sugar.

The sugar connection

While many people say that giving up chocolate doesn't cure acne, most of us - not just acne sufferers - find we feel better all round when we give up sugary foods and drinks. The connection between sugar and acne is demonstrated by clinical studies which have shown that people who have acne do not process sugar well in their bodies. Insulin is the hormone which helps shift sugar (glucose) oat of the bloodstream and into cells where it is used to make energy. People with diabetes either do not produce glucose or do not respond to it, and acne has actually been described by two scientists as skin diabetes.2 In other words, some people with acne do not transfer sugar into their cells properly.3 In order to avoid this, it is important to cut out all sugary foods and drinks, including sweets, chocolate, fizzy drinks, biscuits, cakes, desserts and any added sugar (such as in tea or on cereal). To improve the way the body processes glucose, take 200mcg of the mineral chromium twice daily.

The gut connection

Acne is no exception to this rule, I'm afraid. In fact naturopathic doctors earlier this century considered acne to be a result of a buildup of toxins in the colon. One study showed that half the people with severe acne had higher than normal levels of bowel toxins in their bloodstreams. 4 This usually happens when the bowels are not emptied regularly because of a sluggish digestive system and constipation, which can be caused by a diet low in fiber and fresh foods and high in refined, sugary, fatty foods (e.g. toast with jam for breakfast, a cheese sandwich for lunch, then pizza for supper). Even if a person does not feel constipated, unless they are emptying their bowels properly at least once a day, a build-up of toxic material inside the intestines is likely. We need to get rid of this stuff; otherwise toxins can be reabsorbed back into the body. Think of a sewer system which has nowhere to flow to, with all the build-up and leakage that would ensue. Another problem for acne sufferers is that they are often prescribed antibiotics to calm their inflamed spots. Although this usually does the trick-by reducing the inflammatory effect of the bacteria in the spots, the antibiotics also kill all the important 'friendly bacteria' in the digestive system. This sets the scene for an overgrowth of so-called 'unfriendly bacteria' and other organisms which can release toxins into the body and create all sorts of havoc, including skin problems. Another factor to consider is sensitivity to dairy products: Cut all milk products out of your diet for at least four weeks and see if that makes any difference.

Stresses and strains

Adult acne, in people who have never suffered from it before, is becoming increasingly common. For many it just appears to come out of the blue, while others get it in their teens and never seem to 'grow out of it'. Nobody knows why so many more people are getting acne later in life but it has been linked to stress. We know that stress interferes with the body's usual hormonal balance. So if you are or have recently been under a lot of pressure, and you are suffering from acne, it is crucial to get the stress sorted out before you can expect to see much improvement. Take gentle exercise such as swimming, walking, Yoga or t'ai chi and, if you feel the need, find someone you can talk to about how you are feeling. Another reason why this is so important is that, if you are feeling very self-conscious about the state of your skin, you are likely to get caught in the vicious circle of stress. This will make your skin worse which in turn will make you feel worse and more stressed out.