The following article is a wonderful understanding of acne from both a western medicine perspective and a Chinese medicine perspective. At the Blue Ridge Acupuncture clinic in Asheville, North Carolina, we have been extremely successful at helping both women and men with curing acne naturally. You can call for a free consult to find out more: (828) 254-4405.
By Tai Lahans, DAOM, M.ed., L.Ac.
Acne vulgaris is a very common skin condition of adolescents and young adults. It is characterized by a combination of comedones ( blackheads ), pustules, cysts and scarring of varying severity. It usually occurs on the face, neck, upper back and chest, beginning usually at the ages of 9 – 12 or later and lasting with new outbreaks for months or years, usually subsiding by the age of 20 but it can have flares for years.
Etiologically these factors are important:
Acne involves an over activity of the oil, or sebaceous, glands of the skin. The skin is covered with hair. An individual hair follicle is associated with a sebaceous gland that is connected to the skin by the follicular canal through which the hair shaft passes. The sebaceous gland produces sebum, a mixture of oils and waxes that lubricate the skin and prevent the loss of fluids through perspiration. Sebaceous glands are found in the highest concentrations on the face, and to some extent on the chest, neck, and upper back.
Acne is most common in males. This is because male sex hormones called androgens (an example is testosterone ) stimulate the cells that line the follicular canal to produce keratin as well as cause the sebaceous glands to enlarge and produce more sebum. During puberty there is an increase of androgens in both males and females. The severity and progression of acne is determined by a complex interaction between these hormones, keratin producing cells, sebum and bacteria.
The actual lesions begin when an oil gland opening becomes plugged by excess keratin forming a blackhead ( open ) or whitehead ( closed ) that irritates the skin similarly to a sliver irritating the skin. The bacterium Corynebacterium acnes is allowed to overgrow and release enzymes that break down sebum and promotes inflammation. The irritation takes the form of a pimple or deep painful cysts. These are infections that can destroy tissue which when healed can leave a scar. The flares can occur cyclically in boys as well as girls.
The skin of patients with acne shows greater activity of an enzyme ( 5-alpha-reductase ), which converts testosterone to a more potent form dihydrotestosterone. Also one study found that 50 percent of patients with severe acne had increased blood levels of toxins absorbed from the intestines. This suggests that some food allergies in individuals may contribute to a propensity for acne. Acne-like lesions are also associated with steroidal drugs, diphenylhydantoin, and lithium carbonate. Industrial pollutants like machine oils and coal tar derivatives also contribute to a higher incidence of acne. Some cosmetics, pomades, over-washing and repetitive scrubbing also have been linked to increased acne.
Chocolate and colas exacerbate this condition.
Nuts, especially peanuts that are rancid contain arginines, which exacerbate the condition.
Milk products should be limited because of a high fat content.
Seafoods like shrimp, lobster, oysters, crab may cause an exacerbation.
Any products containing iodized salt, nerve and headache medications, and some cough remedies have been found to exacerbate acne.
Avoid an excess of sweets.
Avoid spicy foods including catsup, chili, smoked meats.
Refined carbohydrates and trans-fatty acids should be eliminated.
Popping pimples can cause more scarring.
Nutritional Supplementation and Vitamins for acne:
Chromium: Many dermatologists have reported that insulin is effective in the treatment of acne. Glucose tolerance in the skin biopsies of acne patients has been shown to be significantly impaired. Some have called acne a form of skin diabetes. High chromium yeast is known to improve glucose tolerance and enhance insulin sensitivity.
Vitamin A: Vitamin A reduces sebum production and hyperkeratosis of the sebaceous follicles. 300,000iu per day of vitamin A has rarely been found to be toxic but should be monitored by a physician.
Zinc: Low levels of zinc increase the conversion of testosterone to its more active form while higher levels of zinc significantly inhibit this reaction. Serum zinc levels in 13 and 14 year old males are lower than in any other age group.
Vitamin E and selenium: Vitamin A is poorly absorbed when not in the presence of vitamin E. Vitamin E levels also help to regulate vitamin A levels in humans. Acne in both men and women improves when supplemented vitamin E plus selenium is used.
Vitamin B6: Women who have an exacerbation of acne during pre-menses respond well to vitamin B6 supplementation. The role of B6 in the normal metabolism of steroid hormones is well known.
The Chinese Medicine Approach to Acne
Many conditions that manifest in the superficial or exterior aspect of the body – for example the skin – are not only exterior conditions caused by things impacting from the outside but are also conditions that have a relationship to the internal organs and their dysfunction. A good example is the relationship of a deficient immune system ( internal ) to an increase in colds and flus ( external or superficial illness ). Chinese medicine, in particular, views this relationship as an important causative factor in medicine and acts to treat both the external condition and the underlying internal imbalance or issue in an effort to resolve the external condition.
Many skin conditions are considered internal/external conditions even in conventional medicine. Acne, as we just have read, is one such skin condition. And it has been only recently that the internal treatment of acne has been addressed by conventional medicine. However, the side effects of the main medications are fairly severe placing young people who are greatly concerned with their external appearance to weigh this against damage to internal organs and processes.
Chinese medicine seeks to resolve the condition of acne by resolving the internal imbalances while treating the external result of that imbalance simultaneously. It seeks to rebalance the system rather than suppress the symptom. This requires personal engagement by the patient with their own health outcomes especially as it relates to diet. And this is sometimes a hard thing for an adolescent since they have the highest caloric requirements of any group of humans, and also may not see the connection between what they put in their mouths and what happens with their skin.
The organs involved in acne vulgaris include the lungs (skin), liver (gallbladder), and stomach. The lungs include the skin in Chinese medicine because the skin acts as a temperature regulatory and venting system for internal heat through the pores. The body, of course, should be warm or we would not be of this world. However, certain internal conditions can cause a level of internal warmth, or heat, that is not conducive to health. Hyperthermia ( heat stroke ) is the most obvious example. However, inflammation within the body also causes low-level heat. The lungs act as a ventilation system for this heat. The causes of inflammation are many but some are hormonal imbalances, trauma, digestive dysfunction, cancers, chronic diseases, and so on.
1) Excessive consumption of a diet that is high in refined carbohydrates, sugar, and fats, 2) the use of certain pharmaceutical drugs, and 3) the confluence of puberty may cause heat to accumulate and injure the organs, producing inflammation and sometimes even poisons internally. The liver and lungs in Chinese medicine have an intimate relationship. When the liver function is overheated this heat can be vented through the lungs via the skin. It is not atypical for adolescents, who are passing through the eye of the needle into adulthood as they acquire an adult body, to run hot and have hormonal imbalances that register as heat in the liver. This heat is vented through the lungs. At the same time, the intense need for calories in a young adult can lead the individual to eat anything and everything in sight. This includes many foods that are ultimately feeding this cycle of liver ( or gallbladder ) heat. Concurrently it can cause heat in the stomach and an intestinal disharmony that alters the natural fauna and flora balance of the colon. In fact, anaerobic bacteria multiply in a colon swamped with fats and bile acids, sugar, and no roughage from a poor diet. Add to this a lack of vegetables and fruit and there is a good opportunity for the body to find a means of discharge, especially in a young person through the skin since the lungs and large intestine are considered coupled organs with a special energetic and physical relationship.
It turns out that the stomach, lung, and gallbladder meridians all traverse the face. And activity related to the functioning of these organs can express in the skin of the face either through healthy or unhappy skin especially of the face.
Interior heat manifests first mainly in the stomach and lungs. If lifestyle issues are present, especially regarding diet, then the gallbladder may become involved, as well. In this case, the relevant hormonal issues manifest as a latent liver heat pattern that rises and falls according to hormonal cycles and other stressors. The liver helps to regulate reproductive hormones. In young women, the pre- menses time frame is a contributing factor. The liver/gallbladder axis is involved hormonally, and other excess and deficiency patterns may be exacerbated by pre-menses, especially in relation to certain food cravings.
Although patterns of acne are best diagnosed by a practitioner, the following traditional herbal preparations are most commonly used to address chronic acne.
When the stomach/lung manifestation is the more pronounced pattern then use:
Lian Qiao jie du pian. This is Forsythia Clear the Poison Pills.
When the gallbladder/lung presentation is more pronounced the use:
Niu Huang jie du pian. This is Gallstone Clear the Toxin Pills.
The patient must be advised and follow through on dietary and other lifestyle changes. These lifestyle changes should be curative at this age. Otherwise, herbal medicine will be necessary and sometimes in severe cases, pharmaceutical drugs may play a role in treatment for severe and scarring acne.
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