Adolescent Acne

• Introduction
• Research
• TCM Clinical Trials
• Patient Form

Introduction

Being a teenager is difficult today, with the ever-increasing pressure to grow up fast and be physically beautiful. But for many teens, this critical and self-defining time is made even more difficult when they have to look in the mirror every day and see acne.

Acne is the most common skin disease in the world, and affects 85% of teenage boys and 80% of teenage girls. The term acne comes from a corruption of the Greek ??µ? (acne in the sense of a skin eruption) in the writings of Aetius Amidenus. Acne is a skin condition characterized by whiteheads, blackheads, and inflamed red pimples. Acne is also referred to as acne vulgaris, comedones, cystic acne, pimples and zits. Some degree of acne is nearly universal. It can appear on many parts of the body, but is usually most prominent on the face -- which can exacerbate the normal insecurities of the teenage years. Acne peaks between 16 and 19 years of age for most boys and between 14 and 17 for most girls. If ignored or ineffectively treated, acne may persist into adulthood. The physical and emotional scars that are left behind make acne a life-long problem. Acne can lower a teen's self esteem and turn a once outgoing and light-hearted child into a shy, self-conscious or even depressed teenager.

What is it?

Acne is a common, chronic inflammatory disease of the sebaceous glands and hair follicles. The most common form of acne is known as "acne vulgaris", meaning "common acne." The main symptoms of acne are whiteheads, blackheads, papules, pustules and sometimes cysts. Inflamed pimples near the skin's surface are called papules; they are red and raised, and may be quite tender to the touch. The papules may become filled with pus, and are then deemed pustules. If the follicle continues to enlarge rather than rupture, it forms a closed sac, called a cyst, which can be felt as a lump under the skin. Large hard swellings deep within the skin are called nodules. Both nodules and cysts may cause pain and scarring. Inflamed lesions may cause redness, pain, tenderness, itching, or swelling in affected areas. Damage to self-esteem, confidence, personality, and social life are common complaints of acne sufferers, especially teenagers.

Acne is the young person’s curse. Teenagers have to worry about pimples just when they want to look their best. Acne can pop up on the shoulders, back, neck, and face (or in other words the areas of the body where the most sebaceous glands are found). In teenagers, acne is often found on the forehead, nose, and chin. As a person ages, acne tends to appear towards the outer part of the face. Adult women may have acne on their chins and around their mouths. The elderly often develop whiteheads and blackheads on the upper cheeks and skin around the eyes.

Is it Treatable?

The good news for all concerned is most cases of acne respond very well to Traditional Chinese Medicine.

Treatments aims to:

• Heal pimples
• Stop new pimples from forming
• Decrease inflammation
• Prevent scarring
• Reduce the amount of sebum being produced
• Eliminate the embarrassment of having acne

The TCM Approach - Chinese Herbal Medicine

In TCM, the approach to eradicating acne primarily involves herbal medicine. Chinese herbal medicine is composed of several hundreds of substances, mostly plant in origin (roots, seeds, flowers and barks), as well as some minerals. Based on a thorough assessment and diagnosis, the doctor of Traditional Chinese Medicine will prescribe a herbal formula that is customized for the patient. Generally, these customized formulas contain 12-18 ingredients that work synergistically to improve the treatment outcome. The herbal formula may be modified after subsequent visits and according to the patient’s progress. When treating skin problems, a TCM doctor often uses a combination of internal herbal medicines and an externally applied herbal solution. Depending on the doctor, this external formula may be in the form of a paste, cream, wash or alcohol based lotion.

The time it takes to successfully treat acne varies from person to person but the course of treatment usually lasts 10-15 weeks. Results are often noticeable within the first few weeks of treatment and sometimes changes are noticed within the first few days. Unlike various modern medical treatments for acne, there are no harmful side-effects when Chinese herbal medicine is properly prescribed.


Research

• Acne and Milk
• Acne and Stress
• Acne, Antibiotics, and the Common Cold

Acne and Milk

If your teen struggles with acne, you may find the most recent research both interesting and helpful. A study has found that milk might have a negative impact on a teenager's most valued feature, their complexion. The fat, animal protein, sugar, iodine and hormones that are commonly found in milk today irritate the skin, causing acne breakouts.

Study 1: Dr. Jerome K. Fisher conducted a clinical study of 1088 teenage patients over 10 years and reported to the American Dermatological Association that milk was a primary contributor to some patient’s acne. Dr. Fisher found that a reduction in milk consumption directly co-related with reduced acne. Dr. Fisher noted that the high volume of hormones produced naturally in the milk of pregnant cows breaks down into androgen. When consumed by humans, this hormone stimulates the production of sebum, the waxy substance secreted by the sebaceous glands which clogs pores and creates acne when the pores become infected.

Study 2: Iodine in milk may be a primary cause of acne in teenagers says Dr. Harvey Arbesman, a dermatologist at the University at Buffalo. Arbesman’s theory was published in the December issue of the Journal of the American Academy of Dermatology. Arbesman asserts it “has been well-established since the 1960s that iodine intake can exacerbate acne.” Arbesman adds that various studies have shown there is still a significant level of iodine in milk in several countries, including the U.S., Britain, Denmark, Norway and Italy." Iodine ends up in milk through various routes, such as when farmers give their cows iodine-fortified feed to prevent infection or use sanitizing iodine solutions on their cows' udders and milking equipment. As well, today’s dairy cows are spending less time in the pasture, as a result, they are consuming more supplemented feeds. Milk containing excessive amounts of iodine can irritate pores and bring on acne flare-ups. According to James E. Fulton JR, MD, head of the Acne Research Institute in Newport Beach, California, ‘In some who are acne-prone, I'd say 1000 micrograms or one milligram of iodine a day could be a problem.’ A 1997 survey carried out by the Ministry of Agriculture Fisheries and Food's Joint Food Safety and Standards Group on the nutrient content of milk showed iodine levels in British milk to be as high as 480 micrograms per litre.

Acne and Stress

Acne is the number one reason people visit dermatologists. We know that acne can cause stress during the already turbulent teenage years. Many teens, their parents, and (to a lesser degree) members of the medical community believe that stress can trigger and worsen acne outbreaks – but there was an absence of concrete studies to suggest this to be true.

Researchers at Stanford University took it upon themselves to conduct a study proving that stress and acne are unrelated. However, much to their surprise, researchers found that stress, in fact DOES worsens acne. College students were followed closely, and when exam time rolled around, acne worsened. The more stress reported by the students, the worse the acne. Perhaps this worsening could have been caused by changes in diet or sleep during the exam period, rather than the stress itself? Even after taking these factors into account, the stress/acne relationship was consistent. The study, published in the July 2003 Archives of Dermatology suggests that changing hormones and neuroactive substances during stress may be what stirs up acne. If this is so, relaxation and stress reduction techniques thereby reducing stress chemicals could prove to be powerful ways to treat acne, even if only practiced for a few minutes a day.

Acne, Antibiotics, and the Common Cold

Antibiotic users beware. A study in the September 2005 Archives of Dermatology found that people using either oral OR topical antibiotics to treat their acne are more than twice as likely to experience ‘the common cold.’ This extensive study, analyzed over 100,000 people with acne over a fifteen year time span. Seventy-five percent of the participants were treated with commonly prescribed antibiotics such as topical erythromycin or clindamycin and/or oral minocycline, doxycycline, or tetracycline. Astoundingly, those who consumed any antibiotics for at least 6 weeks more than doubled their chance of catching colds throughout the subsequent year. In addition to taking care of harmful bacteria, antibiotics also attack the beneficial bacteria that are a critical component of our body’s defense system, resulting in the increased frequency of viral infections. Moreover, the odds of being a carrier of resistant Group A Strep are higher in people treated with oral or topical antibiotics. It is interesting that topical antibiotics, when applied to the skin of the face had the same effect as their oral counterparts. Research has shown that topical antibiotics can change the characteristics of healthy skin bacteria even in areas far from the site of application. Topical antibiotics can also alter the bacteria in the nose passages, as well as the skin bacteria of people who come in contact with the primary user.


TCM Clinical Trials

Study 1

Dr. Zhouxin Zhong treated 58 patients suffering from acne with the Chinese herbal formula Qing Fei Yi Rou Tang with good success. Findings were reported in the medical journal, New Journal of Chinese Medicine (April/2001). The patients were between 16 and 38 years old. The herbal formula was modified based on the type of lesions present and on the constitution of the patient. The course of treatment ranged from 2-6 months Using the above formula, 46 cases were clinically cured (i.e disappearance of all acne lesions and no reoccurence) and 10 cases showed improvement (reduction in all lesions, but mild reoccurrence on stopping treatment). Two cases showed no improvement.


Patient Form

This printable handout is to inform current patients how they can assist in the healing process by offering helpful tips and suggestions.