Take Control Of Your Acne

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Nearly everyone will suffer from spots and pimples at some point in their lives and indeed it is estimated that well over 85 percent of the adult population will develop acne between the ages of 12-25 years. Approximately 25 percent of these sufferers will have some form of scarring, be it mild or severe. But it isn’t just adolescents who suffer from acne as it is thought that one in five adults also suffer from acne. For many acne sufferers, the embarrassment leads to stress and in the worst case scenario, even depression. It is therefore not hard to understand why people spend so much time, effort and money to try and find a solution to acne and with the endless range of over the counter products, they often resort to their doctor for help. Unfortunately, the usual prescription medicines are not without side effects, often attempting to treat the symptoms rather than the causal factors. My hope is that reading this article will give you a better understanding of why people get acne, the current treatments for acne and what can be done to help prevent it.

What is acne?

Acne vulgaris or cystic acne, which is the most common type of acne, is defined as an inflammatory disease of the sebaceous glands and hair follicles, marked by the eruption of pimples or pustules, especially on the face. You have the definition, but what actually causes acne? Anyone who has been through puberty can vouch for spots to be annoying, and often as one spot begins to vanish, another one miraculously appears. Because acne is such a widespread and almost unavoidable concern, there are many theories as to how it starts and naturally there are also a lot of myths.

What causes acne?

The surface of the skin consists of sebaceous glands, which produce an oil-like substance called sebum, connected to a canal called a ‘follicle’. Each follicle contains a fine hair that grows out through the open end of the canal at the skin’s surface. This open end is usually called a ‘pore’. The whole unit of a sebaceous gland, follicle, hair and pore is termed a pilosebaceous unit (PSU). Living on the skin’s surface are numerous species of bacteria including one specific bacterium species called Propionibacterium acnes (P.acnes) which are thought to be the major culprit of acne lesions. The sebaceous glands produce the oily substance called sebum which normally empties onto the skin’s surface.

The main role of sebum is to waterproof the skin and hair and both excessive sebum production and a lack of sebum are undesirable. It is now widely accepted that acne arises as a result of the follicle becoming ‘plugged’, which arises often as a result of inflammation. What actually occurs is that the inflammation causes an increase in cell turnover, which then blocks the follicle preventing the sebum from emptying onto the skin’s surface. The mixture of oil and cells is the ideal ground for the bacteria to thrive inside the blocked follicle. The body then reacts to this blockage by sending white blood cells to destroy the invading bacteria causing inflammation and pain leading to acne lesions. Whilst it is true that P.acnes is not the causal factor of acne, this bacterium does produce by-products, which cause further inflammation of the skin.

The basic acne lesion is called a ‘comedo’, which is an enlarged and plugged follicle. If this remains beneath the skin, then it is termed a ‘closed comedo’ and produces a white bump called a ‘whitehead’. A comedo that opens up and reaches the skin’s surface is called a ‘blackhead’ because it looks black on the skin’s surface. A ‘papule’ is an inflamed lesion that usually appears as a small, pink bump on the skin and may be tender to touch. A ‘pustule’, often referred to as a ‘pimple’, is a pus-filled lesion that may be red at the base whereas a cyst is a deep, painful, pus-filled lesion that can cause scarring.

What causes this inflammation that leads to acne?

The exact cause of acne is still not fully understood, but a sound theory is that there is an increase in the male hormone testosterone, which causes the sebaceous glands to become inflamed leading to excessive cell proliferation as well as excessive sebum production. These two processes then allow the bacteria to thrive, leading to acne. During our teenage years, and even in adulthood, our hormones exert an effect on our skin. Specifically, the increased levels of testosterone during our teenage years causes increased inflammation leading to excessive sebum production. During our adulthood, the increased levels of testosterone may be either associated with simply the over-production of testosterone or it may be that due to the lower levels of the female sex hormones, testosterone becomes dominant in the bloodstream leading to inflammation. Oestrogen is believed to help prevent acne. If you have a hormonal imbalance and your oestrogen levels are low, incidences of acne increase. This is why most women experience the increase in acne with the arrival of the menstrual cycle and for the same reason why doctors will often prescribe birth control pills to treat acne.

Stress plays a major part in inflammation in the body. The adrenal glands are the body’s main stress reducing and energising glands and at times of stress they over-produce cortisol, the stress hormone. Whilst cortisol is required in small amounts for the optimal function of the body, excessive production of this hormone is well known to cause inflammation in the whole body, which includes having an affect on the skin. Additionally, at times of stress, the adrenals over-produce testosterone compounding to the inflammation already caused by the production of cortisol. Several studies show the relationship between stress and acne, and in one particular study, researchers found that the subjects who had the most stress during exams also had the worst acne breakouts suggesting that external stress is a major contributing factor to compromised skin. Whilst many would argue that stress merely aggravates a pre-existing condition such as acne, researchers believe that this new evidence proves otherwise. As part of a holistic approach to prevent acne flare-ups, managing stress effectively is a key to healthy skin.

Several studies have indicated that acne sufferers do not process sugar properly and it is this connection between high blood sugar levels and acne that has led some to call acne ‘skin diabetes’. When we eat carbohydrates, our digestive enzymes break these into individual glucose molecules. When glucose reaches the bloodstream, the pancreas is triggered to release insulin which transports the glucose into individual cells for energy production.

The levels of glucose in the bloodstream can be greatly affected by the type of carbohydrates we eat. Some carbohydrates are broken down into glucose molecules much quicker than others and this can be measured by what we term as Glycemic Load (GL). High GL foods such as sugar-rich foods and simple carbohydrates release glucose quickly, whereas low GL foods such as rice and whole-wheat grain foods release glucose more slowly into the bloodstream. When we eat foods with a high GL, the body reacts to these by producing large quantities of insulin. Constant ingestion of high GL foods results in the cells becoming resistant to insulin. When this occurs, insulin is unable to perform its role of transporting glucose into the cells of the body and hence the body produces ever increasing amounts of insulin to reduce blood glucose levels. The problem with insulin and acne sufferers is that insulin may trigger inflammatory markers due to its effects on hormones and insulin itself can trigger excessive sebum production and increase skin cells, all factors which contribute to increased acne. However, eating complex carbohydrates is not enough to rid you of acne, especially if these are derived from grains.

How does diet affect acne?

Carbohydrates are classified into two groups:

  • Simple carbohydrates are sugar rich foods such as sweets, soft drinks, biscuits and numerous processed foods. It is really vital to reduce the intake of this group of foods and ideally completely eliminate them from your diet.
  • Complex carbohydrates are those found in natural whole foods such as beans, whole-grains, nuts and vegetables. Although more nutritive than simple carbohydrates, you do need to limit these if acne is a problem.

The use of complex carbohydrates from vegetables is more beneficial than from those found in grains because your body handles their digestion differently. The body breaks down complex carbohydrates from vegetables very slowly, having little impact on insulin production, whereas eating carbohydrates from grains raises the insulin levels. As mentioned previously, insulin increases the production of sebum leading to acne and hence it is vital to change your diet accordingly. In a 2007 study published in the American Journal of Clinical Nutrition, young men (between the ages of 15-25) were placed on a low glycemic diet for 12 weeks showing great improvements in their acne as well as insulin sensitivity.

Many people suffer from gluten intolerance. Gluten in wheat and other grains may also be a contributing factor to the symptoms of acne. This is a separate issue from the effects of insulin discussed above. Gluten is in fact also linked to acne rosacea. Since gluten intolerance is so widely spread in the adult population, it makes sense to try and avoid gluten for a couple of months and see if your acne improves. This should not present a problem especially if you are following a grain-free or low-grain diet which minimises the sources of gluten.

Gluten containing foods include anything containing wheat, bulgar wheat, durum wheat, wheat bran, wheat rusk, wheat flour, semolina, couscous, barley , barley flour, rye, spelt and kamut.

Gluten-free foods include corn, corn flour, soya, rice, buckwheat, potatoes, polenta (cornmeal), sago and tapioca but there are also a wide variety of ready-made gluten free products and meals on the market, but do remember that you still have to follow a diet that does not put a burden on the Glycemic Load (GL) to the body.

Is acne genetic?

Doctors, until now, did not believe that acne was genetic or ‘inherited’, but research from several studies is now changing that viewpoint. At the Medical College of Georgia, scientists spent countless hours working with families to find the answer to this link. What they found was that acne did in fact run in families and they found that of 81 percent of the case studies, this was true. Our genetic blueprint does influence the thickness of our skin, oily tendencies of the skin and hormonal responses within our bodies. It seems logical that if we look like our families, have the same birthmarks, freckles and other signs, then why should we not have the same pre-disposition to acne?

Look through your family and if either of your parents had acne, then you may have an increased chance of being a sufferer. But what does this actually mean? Are you then stuck with acne forever? Most definitely not. More than likely, your family or relatives simply did nothing to prevent the acne or scarring. Years ago there were very few products or treatments to help acne, but today we are better informed and we have access to a wide range of products and treatments.

Common myths about acne

There are many myths about acne and acne home remedies. Many still persists in spite of scientific evidence proving them to be false. I have highlighted some of these below:

  • Junk food causes acne: Whilst fried foods, pizzas and many beverages are not the healthiest of foods, there is no direct relationship between these and acne. The same applies to chocolate and this myth may have arisen as a result of the fact many teenagers indulge in these foods and are more prone to acne breakouts. Ideally a balanced and healthy diet in general with occasional use of these junk foods will do no harm to your acne as long as you do not over-indulge in them.
  • Exposing your skin to sun will cure your acne: Exposing the skin to natural sunlight can be of benefit to your acne since both vitamins A & D are produced and may help temporarily, but it will not cure your acne. Over-exposure to radiation from the sun may damage the skin cells and actually worsen the acne due to inflammation of the skin causing excessive sebum production.
  • Poor skin hygiene causes acne: Acne is not caused by poor skin hygiene and in fact vigorous scrubbing of the area can actually worsen acne. Cleansing with a gentle face wash, preferably alcohol free, will help prevent outbreaks and not strip the natural oils within skin.

The real truth is that acne is treatable and you do not have to let acne ‘run its course’. The most effective treatment can vary from person to person and it is simply a case of finding the right treatment for you.

The treatment of acne by conventional drugs

Dermatologists may prescribe medications in combination with over-the-counter products, and/or may also diagnose additional skin problems such as ingrown hairs or other types of skin irritation that may be contributing to breakouts on the face, back or shoulders. Treatments include:

Oral Antibiotics: Oral antibiotics often include different types of tetracyclines. They are widely promoted and often prescribed for long term use. Their function is to kill the bacteria that live on the skin’s surface and in the pores, but they are not without side effects. As a pharmacist, I am not keen on the use of antibiotics for several reasons. Antibiotics destroy all the beneficial bacteria within the gut, which have a varied and critical role in breaking down foods. Beneficial bacteria provides vital B vitamins to the body, they keep yeasts and other fungi in check to ensure that these do not proliferate, but crucially beneficial bacteria are involved in the production of immune enhancing compounds. Over 80% of one’s own immunity is derived from the gut and there is a very strong link between antibiotic use and vaginal candidiasis. Antibiotic resistance is a serious and growing problem.

Topical Antibiotics and Other Treatments: Topical treatments are often the first thing that a dermatologist will prescribe and include a range of treatments including topical antibiotic creams, tretinoin compounds (all derived from vitamin A) and keratolytics such as salicylic acid and sulphur based creams.

Topical antibiotic creams usually containing erythromycin or clindamycin are effective against the P. acnes, the bacteria that live on the skin’s surface. They are often used in combination with other drugs, such as retinoids, where the retinoids would be used to clear the pores of excess cells allowing allowing the topical antibiotics to have an easier path to kill the bacteria within the pores. Benzoyl peroxide was considered the gold standard as a topical in the treatment of acne and works as an effective antibacterial agent that kills the bacteria that reside on the skin and within the follicles. Topical antibiotics are not without side effects with some users experiencing burning or stinging on contact with skin.

Keratolytics such as salicylic acid, resorcinol and sulphur encourage the ‘sloughing’ of skin cells, thus helping to prevent the blockage of the follicles. They also usually help to breakdown blackheads and whiteheads but are not without side effects which include peeling, sensitivity to cold and sometimes pigment changes in the treated areas.

Topical retinoids including tretinoin work to increase the regeneration of new cells and ‘sloughing’ of old cells and their side effects can include photosensitivity, peeling and itchy skin. I am not averse to the use of topical treatments in the control of acne as long as the user is aware of the side effects.

Accutane: Also known as Isotretinoin, Accutane is a derivative of vitamin A that is taken orally by those with severe acne, especially those with cystic painful acne, where all other options have failed. Generally given over a period of 16-25 weeks, Accutane works to reduce the size of the sebaceous glands by up to 60%. This decreases the amount of oil or sebum by almost 80%. A more controlled production of oil reduces the likelihood of infections and acne breakouts and this in turn helps to reduce the numbers of acne causing bacteria. Accutane also works to slow down the production of new cells in the pores and Accutane also has potent anti-inflammatory properties which helps to lessen the swelling and the irritation caused by acne.

Accutane is a systemic medication meaning that it impacts multiple parts of the body. It causes widespread side effects, which are well documented. From a personal viewpoint, I would recommend exploring other forms of treatment first.

Natural cures for acne

If you have been informed that the only cure for your acne is continual use of over-the-counter or prescription medications, please don’t give up. There isn’t a pill or cream that can help you get rid of acne for life. The root cause of acne generally stems from poor health decisions or exposure to harmful environmental elements and in order for a treatment regime to be effective it has to go beyond a topical or oral remedy in my opinion.

The skin is a reflection of your health. If your skin is prone to frequent breakouts, it is a sign that internally you need to address what is going on. It can also be a signal that your defence against elements, which cause skin conditions, is weak. This means that your health could be the key to helping keep acne at bay.

In my opinion, the most effective treatment for acne is one that is natural, free of any drugs and holistic in the way it treats the acne. A natural regimen should help to clean up the body from the inside out and, coupled with a healthy diet and lifestyle, should return the body to a cleaner state helping the healing processes.

Can burdock help acne?

The use of Burdock (Arctium Lappa) for acne is one of the lesser known, but highly effective herbal remedies for acne. The origin of the name is thought to be from the Greek arktos, or bear, referring to it’s rough texture, and lappa, meaning to ‘to take hold of’. The use of Burdock for skin conditions has a long history dating back to ancient times.

Culpepper, the herbalist and physician from the 1600’s gives some of the following use for Burdock:

‘The Burdock leaves are cooling and moderately drying, whereby good for old ulcers and sores…. The leaves applied to the places troubled with the shrinking in the sinews or arteries give much ease: a juice of the leaves or rather the roots themselves given to drink with old wine, doth wonderfully help the biting of any serpents – the root beaten with a little salt and laid on the place suddenly easeth the pain thereof, and helpeth those that are bit by a mad dog’.

In Japan and parts of Eastern Asia, the roots of Burdock are known as ‘gobo’ and are readily available in the markets and grocery stores.

So how does Burdock work: Herbalists worldwide have used Burdock to treat skin diseases such as abscesses, acne, carbuncles, psoriasis and eczema. Burdock is used to improve liver function in order to remove toxins and purify the bloodstream. This dramatically helps to relieve acne because sebum production is greatly enhanced when the blood is filled with toxins and hormonal waste by-products. One of the most common causes of acne is a congested and sluggish liver arising as a result of hormonal metabolites and/or a poor diet. When the liver is unable to cope sufficiently with these toxins, they pass into the bloodstream causing inflammation of the sebaceous glands which eventually results in acne. In addition Burdock displays powerful diuretic properties increasing fluid output by the kidneys. This helps to filter out the impurities from the bloodstream.

Burdock also displays powerful antimicrobial properties helping to eradicate a wide range of bacteria and fungi from the body. It is theorised that this property helps to control acne because the bacteria that live in the follicles cannot thrive and additionally the bacteria that live in the body produce toxins as by-products and reducing their numbers greatly improves skin health.

Finally, Burdock is nutritionally rich and especially in vitamin C making it useful for many inflammatory skin conditions including boils, ulcers and scaly skin disorders. Vitamin C is important to the health of all of the body’s connective tissues primarily through its role in collagen synthesis, free radical scavenging, detoxification and inhibition of inflammatory processes.

Anecdotal evidence points to the success of users with acne using Burdock by way of supplementation.

How does vitamin A help acne?

Vitamin A is an important antioxidant vitamin involved in numerous processes carried out within the body. Vitamin A plays an important role in treating and reducing acne. vitamin A is called retinol. In mild doses, it dries the skin and peels it. This side effect has been used to prepare derivatives of vitamin A called retinoids. Vitamin A works to control acne in several ways:

  • As mentioned above, vitamin A in mild doses dries out sebum production. With less sebum in the pores, the chances of the pores becoming clogged are reduced, ultimately decreasing the chance of acne breakouts.
  • Vitamin A encourages the production of fresh healthy cell production and this encourages the proper shedding of dead skin cells. When dead skin cells are not eliminated effectively, they are liable to clog the pores and encourage bacterial growth both of which contribute to acne.
  • The manufacture of healthy outer cell layers also form a ‘barrier’ to toxins from the bloodstream inflaming the sebum producing glands with a subsequent possible decrease in acne breakouts.
  • Vitamin A deficiency in the body can induce inflammation and escalate existing inflammatory conditions such as acne. Having sufficient vitamin A in the body is liable to reduce the effects of inflammation caused by acne.

Vitamin A also plays a key role in improving or maintaining healthy vision, enhanced immunity against bacteria and viruses as well as helping to promote healthy bones. However, despite the effectiveness of vitamin A against acne, excessive intake of vitamin A can have side effects such as liver damage, birth defects, nerve damage as well as nausea and hence use the correct dosage on your supplement. Food sources of vitamin A include beef and chicken liver, fortified milk, cheese and eggs.

Other natural remedies for acne

There are many other natural herbs and nutrients that are of benefit in the treatment of acne but in my opinion the use of Burdock and Vitamin A is the key to managing acne both in the treatment and prevention of acne. I will however highlight briefly some of these other remedies for the sake of clarity:

Vitamin D: With years of research, scientists have been able to find and form a relationship between vitamin D and acne. Most acne sufferers would vouch to the fact that they have a healthier complexion during the summer months and less so during the winter. This is because exposure to the sun triggers the formation of vitamin D in the body. Vitamin D’s primary role in acne appears to be in the building up of immunity, which then fights bacterial infections such as acne with the result of giving you a clear complexion. Exposing large areas of your skin to sunlight is the best way to optimise vitamin D production and as a rule of thumb you should expose your skin until it just barely begin to turn pink. If however you live in an area with either little sunshine or the latitude in which you live means that you would have to expose your skin to hours, then vitamin D supplementation is the next best thing.

Dandelion: One of the most abundant plants on the planet, Dandelion offers numerous medicinal properties. Dandelion has long been used to help a congested liver, enhance kidney function due to its diuretic properties, for digestive disorders, aid gall bladder function and for a variety of skin disorders including acne. Dandelion also is nutritionally rich containing vitamins A, B, C and D together with iron, potassium and zinc. Its benefits in controlling acne may be due to its role in cleansing the liver and hence preventing toxins from entering the bloodstream as well as its diuretic properties to help with the elimination of toxins.

Zinc: Zinc is a mineral best known for its immune enhancing properties. With specific reference to skin health, zinc influences protein synthesis and related biological processes which encourages skin tissue regeneration. Several studies indicate that zinc is as effective as some antibiotics in acne therapy. It is likely that zinc’s benefits in acne are not only due to tissue regeneration and healing but also due to its influence on hormones, retinal-binding protein and its ability to enhance the manufacture of anti-inflammatory compounds within the body. However, poorly absorbed forms of zinc have little or no influence on acne when compared to the better forms such as zinc citrate. It should also be noted that long term use of zinc is liable to interfere with copper utilisation as well as iron absorption. When taken on an empty stomach, even moderate doses of zinc can cause nausea.

Probiotics: Probiotics are involved in the last stage of digestion, after the stomach digestive enzymes have broken down food. Through their ability to break down foods more efficiently and thus preventing the stagnation of foods, they prevent the build-up of toxins in the gut which would otherwise pass through in the bloodstream causing inflammation which leads to acne. These beneficial bacteria also provide vital immune enhancing compounds and since optimal immunity is linked to healthy skin, their use is justified in the treatment of acne and especially if you have already taken antibiotics for acne.

Vitamins and herbs for acne control are one of the most natural ways to approach the battle against acne and are often without side effects. They will allow you a greater sense of control over your complexion and a tool you can use for lifetime. However, to help prevent acne permanently you have to address other factors such as diet and lifestyle as well.

Beware of skincare for acne

There are countless numbers of skincare products that promise to help you in the treatment of your acne, and often promise to help you within a short period of time. The truth is that no cream or lotion will help to cure your acne completely. The best that these products can offer is to treat your acne temporarily until your next breakout. This is because most of these skincare products simply treat the symptoms of acne which include inflammation, rather than treating the causal factors of acne which is actually an internal problem. This is not to say that I do not agree with the use of a safe and effective skincare regime, and more on that later.

What you put on your skin is as important as what you eat. Your skin is a semi-permeable membrane and anything that you apply topically is readily absorbed through the skin into the bloodstream. Many of the skincare products available for acne are in fact harsh or toxic chemicals that can cause more problems than they solve. These chemicals can seriously inflame an outbreak or even prevent one from healing. Many of these skincare products often contain potentially harmful ingredients and their inclusion is not of an essential nature.

There are a few ingredients which you should not use of your skin, no matter what your skin type and even if you do not suffer from acne. These are alcohol, mineral oil and fragrances. Alcohols, labelled as ethanol, ethyl, methanol, benzyl, isopropyl and SD alcohol are all drying on the skin. These may strip away the skin’s natural acid mantle, which could leave you wide open to bacterial infection, including acne and blemishes. There are however two alcohols, named stearyl and cetearly that are not detrimental at all to the acid mantle and hence you should not avoid skincare products containing these. Mineral oil such as liquid paraffin, petrolatum and paraffin wax can be comedogenic, which means that they can clog the pores encouraging the formation of new acne lesions. Finally do try to avoid fragrances in skincare products. They may make your skin smell better but many of these will affect skin health. There are many conventional brands that claim to be ‘green’ or ‘fragrance free’, but they actually contain phthalate fragrances to neutralise the smell of the petroleum base. Phthalates can disturb hormone levels in the body, which can lead to acne, and equally worse is that they are linked to weight gain.

I recommend the use of as natural a skincare product that you can afford and there are many ‘natural’ or ‘organic’ brands, but again beware because many of these hide the chemical ingredients using confusing and more natural names and a lot of these are not as ‘natural’ as they would have you believe. You will have to educate yourself in reading the label ingredients. Once you have found your ideal skincare product, which is relatively chemical free, then:

You should spend at least five minutes every day to cleanse your face of the impurities that collect during the day and clog your pores. Choose a mild cleanser that promises to clean without drying, and wash with luke-warm water, not hot. Keep oily skin very clean so that the pores do not get blocked up and cause breakouts, but try not to cleanse too harshly or too often as that may lead to a dry, taut skin and the body will then react to this and produce more oils. Do not scrub the skin vigorously as this may irritate the skin and cause more acne breakouts.

I do not normally recommend the use of astringent lotions following a cleansing routine since these often strip the skin of its natural oils resulting actually in greater oil production and further acne breakouts. However, if you do have a very oily skin then aim to use an astringent lotion that is alcohol free to remove any excess oil between your cleansing routine.

Skin, even oily skin, still requires moisture so aim to use a non-comedogenic (non pore-clogging) moisturiser to keep your skin hydrated and balanced. The use of a quality non-comedogenic moisturiser in combination with a gentle cleansing routine and appropriate supplementation can help the skin stay balanced and healthy.

The use of a clay or mud mask once or twice a week is another good way to cleanse your skin and combat the oil production. A good deep cleansing mask can help pull dirt out of the pores, dry up excessive oils and help get rid of dead skin cells gently. Look for a mask that contains kaolin or bentonite clay, preferably with plant oils that will help nourish the skin without clogging the pores.

Exfoliation is often recommended for sloughing off the cells that can clog the pores. Be careful, since many exfoliants could potentially do more harm than good. They often contain salts and abrasive compounds which can cause microscopic tears that could lead to inflammation.

There is a great debate over whether one should use chemical based skin care or natural skin care. There has always been hesitation to the use of natural ingredients because many perceive these to ineffective or not strong enough to achieve the results that they desire. Nothing could be further from the truth. Chemical ingredients in acne-prone skincare can lead to the drying of acne lesions rapidly, but may also encourage premature ageing and inflammation. There is now a growing trend for natural skincare products in the treatment and management of acne. Be consistent with your skincare as it can take several weeks to achieve a healthy complexion.

How to treat acne scars

Acne can leave scars, which can be psychologically devastating. Even the mildest form of acne can leave some scarring and often severe acne leaves scars that are much more visible and difficult to get rid of. The good news is that you can treat and even prevent these scars from forming properly with a good cleansing regime and also by avoiding the picking of acne spots. The four main types of scars include:

  • Ice pick scars, which are usually small with a jagged edge and are one of the most common types of scar tissue. They are usually the easiest to treat.
  • Boxcar scars, which usually affect the temples and cheeks. They are angular scars very similar to those caused by Chickenpox.
  • Thickened scars or hypertrophic scars are associated with some of the severe types of acne.
  • Rolling scars give the skin the appearance of a wave-like look.

It is important to note that natural acne treatments are often the best solution for treating acne scars, especially for those with sensitive skin.

Many people report positive benefits with the use of honey. Honey, especially Manuka honey has antimicrobial properties helping to counter the acne-causing bacteria that live on the skin’s surface. After cleansing your skin with a mild cleanser, apply some Manuka honey to the affected part of skin. Wait for ten or fifteen minutes and then rinse with water.

Numerous home-made concoctions exist online for the treatment of acne scars and one of my favourite home-made remedy is the use of an oatmeal cleanser. Mix some oatmeal powder with rose water, make a paste and apply to the affected areas. Leave for approximately fifteen minutes and rinse the residue with cold water. Oatmeal deep cleanses the pores, is hydrating and does help to minimise the appearance of acne scars for many people. Oatmeal is very soothing to the skin and can loosen dead skin cells as well as discoloured scars left behind after the acne has cleared.

There are some really good ready-made creams, gels and lotions that work effectively to minimise the appearance of scar tissue with some also containing peptides to encourage fresh healthy cell production. Examples include Heal Gel, created by five leading British plastic and cosmetic surgeons, containing silicones, peptides and a soothing anti-inflammatory group of substances. There are many reports on the effectiveness of Heal Gel even for severe and old scar tissue.

Another natural acne scar removal product that is gaining popularity with consumers and doctors is Tamanu Oil. This oil, derived from a plant grown extensively in French Polynesia, is a wonderful skin healing agent because it encourages tissue formation and skin regeneration. In one particular study, carried out for one year, six volunteers were only allowed to use Tamanu Oil and no other moisturiser on the scar affected region. The results were impressive. Within a six week period, there was a significant improvement in the appearance of scar tissue and by week nine there was a reduction in both scar length and width.

In the past, treating acne scars has always been a slow and difficult to treat process. Getting rid of acne scars is no longer impossible. It has become a reality with immediate and visible results. Some of these methods include:

Dermabrasion: This is a surgical procedure carried out by a plastic surgeon with the skin frozen by an anaesthetic. A diamond tip device is then used to “sand” the surface of skin removing the surface layers of skin where acne scars reside helping to replace it with new layers of skin from below. Dermabrasion does have several drawbacks and these include the cost of the procedure, the risks and complications of anaesthetics, the downtime for the healing of the skin, pigmentation problems and possible risks of infection of the skin.

Microdermabasion: This is a non-surgical deep exfoliation procedure, which is offered at many dermatologists, spas and beauty salons. Usually a machine discharges very fine aluminium oxide crystals onto the skin. These crystals are then literally vacuumed away resulting in the improved appearance of fine surface scars. For noticeable results, microdermabrasion has to be performed repeatedly over a period of time. The down side is that this procedure is not suitable for deep acne scars but it is less costly, does not require anaesthetics, does not affect the pigment of skin and carries a much lower risk of infection of the skin.

Dermal fillers: This procedure is used to treat depressed scars. Using varying types of fillers, the base of the scar tissue is raised so that it evens up with the rest of the skin. Dermal fillers are used nowadays extensively to smooth out lines and wrinkles and remain in the skin for approximately six months. Ideally, the filler would be safe, inexpensive, hypoallergenic and feel natural under the skin. Generally, human-based fillers are used since they reduce the risk of allergic reactions and usually do not require skin testing prior to injecting.

Laser skin resurfacing: Laser skin resurfacing uses a beam of energy to remove the top few layers of skin, taking away the damaged skin so that healthy new skin can replace it. There are several advantages with this procedure over other types of superficial scar treatments. The procedure is quick and can often be performed at the dermatologist’s office, causes less bleeding and bruising when compared to dermabrasion and chemical peels and generally requires only local anaesthesia. It is claimed that lasers have a much greater precision in the number of layers removed especially as one can observe the effects on acne scars as the treatment progresses. Laser skin resurfacing may not be the best form of treatment for everyone. Laser skin resurfacing is recommended for people with fair complexions whose skin does not have a tendency to rashes. Darker skin tones often experience pigmentation problems. Patients report weeping of the skin for a few days after the procedure which is very common and an expected reaction as collagen forms to rebuild the skin layers. Skin frequently crusts and needs to be kept moist to protect the recovery of new skin underneath. New skin should cover the area treated often within a month and inflammation greatly reduced. Having said this, there is much controversy about using laser treatments, so you need to make an informed choice before undertaking this form of treatment.

Chemical peels: Chemical peels are often the first choice of treatment for acne scars as these treatments appears to be very effective at treating acne and acne scars with very little complications. A chemical peel removes the top layer of skin revealing fresh unaffected skin exposed. Two of the mildest form of chemical peels involve the use of alpha hydroxy acids (AHAs) and beta hydroxy acids (BHAs). Although it is normal for people to experience some redness and irritation, these milder peels do not require much recovery time and can be repeated every six to eight weeks.

A type of chemical peel called the TCA peel is probably the most popular of chemical peels. Most of the milder peels help to control acne but have little impact on the scar tissue itself. TCA, which stands for trichloroacetic acid, does a great job of not only controlling acne, but also helps to minimise the appearance of the troublesome marks left behind from years of acne outbreaks. The application of TCA is very safe, and can be used on a variety of acne scar types and skin explaining its popularity. The treatment usually takes between ten and twenty minutes. A neutraliser is then applied and you are left with sunburned- looking skin for a few days before the peeling process begins leaving you with a vastly improved skin.

Most of the procedures and treatments mentioned above work very effectively for acne scars. Choosing the correct treatment or procedure is a personal choice. Whilst most of these procedures are not painful, expect to go through a recovery period during which skin will be sensitive and need some attention. Always consult a dermatologist and always get a second opinion.

How to take control of your acne

The look of your skin is a direct reflection of your overall health. Taking simple but essential measures will reap rewards not just in the look of your skin, but also in your overall confidence. I have written about this above, but in summary, please note the following:

Grains and sugars: Elimination, whilst difficult, even for a few weeks will most likely result in a major improvement in the look of your skin.

Water: Drink plenty of water. Hydrating your body will help with the elimination of waste, improve skin tone and facilitate regeneration of cells.

Sleep: A good night’s sleep will help to reduce stress levels and lead to a clearer skin. Your body’s healing processes on the whole take place at night and that includes your skin.

Exercise: Exercise encourages circulation and helps support the greater excretion of toxins through the pores.

Balance of bacteria: This is especially important if you have been using antibiotics since these destroy the beneficial bacteria within the gut that are involved in the breakdown of foods, removal of toxins within the gut as well as enhancing the digestive process. There are many probiotic supplements on the market so ensure that you use a high quality probiotic supplement.

To conclude, I am an advocate of using natural supplements to treat a variety of concerns, especially for acne, since these do not generally cause any side effects. Acne arises from within the body so it make sense to treat the problems within the body. This includes looking at your diet because even though science tells us that diet has no correlation with reference to acne, it is nevertheless vital to avoid grains and simple carbohydrate rich foods for all the reasons mentioned within this article. Acne is controllable and changing your lifestyle and diet will have a major impact on your skin especially when taken alongside some of the supplements mentioned.

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This content is not intended to replace conventional medical treatment. Any suggestions made and all herbs listed are not intended to diagnose, treat, cure or prevent any disease, condition or symptom. Personal directions and use should be provided by a clinical herbalist or other qualified healthcare practitioner.

Shabir Daya | , , , , , , , , , , , , , , , , ,
  • Sarah Feakins

    Hi, I’m considering taking a Vitamin A supplement for my skin. I am already taking Alive Multivitamin supplement. Is there enough vitamin A within this multivitamin for this purpose, or should I consider taking in addition to? Thanks, Sarah

  • http://www.victoriahealth.com/ Victoria Health

    Dear Sarah, For acne and spots, you need anywhere between 5000iu and 7500iu of vitamin A per day. Taking a separate vitamin A supplement should be fine. Shabir

  • Unica L

    Do you have recommendations for addressing cystic acne around the chin? I’m 40 years old and I’ve been having cystic acne issues since 16!

  • http://www.victoriahealth.com/ Victoria Health

    Hi Unica, I have two recommendations for the control of cystic acne and have had very favourable feedback. The first is the use of iS Clinical’s Active Serum, a serum designed to counter the symptoms of ageing however Active Serum contains antibacterials, antioxidants and encourages micro-exfoliation as well as unclogging pores. The second recommendation is to use a supplement internally to cleanse the bloodstream of compounds that cause inflammation of skin – the supplement is Viridian Nutrition’s Clear Skin Complex. This inside outside approach is logical and works! Shabir

  • sham3a uae

    I’m wondering which product do you have that contains Benzoyl Peroxide , I’m suffering from whiteheads and blackheads.

  • http://www.victoriahealth.com/ Victoria Health

    Hi, Benzoyl peroxide is generally a pharmacy only item. You might wish to consider the use of Salicyclic acid by The Ordinary to deep clean pores. Best wishes Shabir

  • MrsC

    After about 30 years of acne and rosacea, my skin has improved beyond measure with The Ordinary Azelaic Acid 10% Suspension. Bought at VH but it’s been out of stock for months now. Hoping it’s back soon?

  • http://www.victoriahealth.com/ Victoria Health

    Hi Janie, So glad to hear about azelaic acid’s benefits for your skin. We hope to have it soon so please bear with us.

  • http://www.victoriahealth.com/ Victoria Health

    Dear Kay, I would recommend using The Ordinary’s Natural Moisturizing Factors which is provides surface hydration and is non-comedogenic.
    Best wishes,
    Shabir

  • http://www.victoriahealth.com/ Victoria Health

    Dear Stephanie, i am glad that you have found the newsletters fascinating. According to the principles of TCM, many skin conditions improve dramatically by cleansing the liver since the liver is the organ that processes toxins which can inflame skin.
    Best wishes,
    Shabir

  • Stephanie Wilcockson

    Hello Shabir- thank you so much for replying to my distress call. My son in law now feels he can do something and a liver test is a very good start after feeling that there was nothing he can do about vitiligo. Thank you for your time and generosity. Stephanie ????????

  • http://www.victoriahealth.com/ Victoria Health

    Hi Stephanie, I think we may have got our wires crossed; a liver cleanse would be a good idea using a milk thistle supplement.
    Best wishes,
    Shabir

  • Stephanie Wilcockson

    Hello Shabir- yes it does look as if I got my wires crossed but what I did not add was that my son in law had hepatitis recently. So thank you so much for making the connection and getting this ball rolling – the skin specialist did not pick this up. I will give them the milk thistle info. and let you know how this pans out. Thank you again for your knowledge and time. Stephanie ????????

  • http://www.victoriahealth.com/ Victoria Health

    You are welcome Stephanie and please keep me posted if you can.
    Best wishes,
    Shabir

  • Stephanie Wilcockson

    Thankyou. Stephanie ????????

  • ShónaM

    Hi, Shabir,
    Thank you for this article, it is very informative for me. I discovered you on Trinny Woodall’s channel and you were excellent, thank you. I developed severe acne a month ago for the first time (I’m 37). It’s on my jawline and chin. I feel my skincare and diet are good so I was wondering what do you think of DIM supplements? I have been looking at the Skin Accumax product. If my acne is caused by an oestrogen imbalance is DIM essential as well as Burdock and Vitamin A for example?
    Kind regards,
    Shóna.

  • http://www.victoriahealth.com/ Victoria Health

    Hi Shona, I am glad that you found the session with Trinny useful. DIM supplements work to modify the way oestrogen is metabolised – there are basically two pathways one of which is known to be inflammatory in nature. DIM is fine to take as part of a regimen of other nutrients and my recommendations would be to consider the use of Clear Skin Complex by Viridian Nutrition which contains burdock, probiotics, zinc and other compounds to cleanse and purify the bloodstream of toxins that may cause inflammation leading to excess sebum production. You may also wish to consider the use of Thyme-Out – a spray of thyme tincture which we have just released which helps to calm inflammation and has the ability to eradicate the acne-causing bacteria. Studies carried out by a university in the UK proved this to be more effective than traditional acne topical products.
    Best wishes,
    Shabir

  • ShónaM

    Shabir,
    Thank you so much for getting back to me so quickly. I am going with your recommendations and have fallen very happily into a VH shopping whirl – I’m excited to tackle this at source.
    All the best,
    Shóna.

  • http://www.victoriahealth.com/ Victoria Health

    You are welcome Shona and please keep me informed.
    Best wishes,
    Shabir

  • http://www.victoriahealth.com/ Victoria Health

    Hi Karolina, Accutane has a long list of possible side effects some of which may be attributable to the dryness that accompanies its usage. I would recommend that you use a good liver cleanser and an Omega 7 supplement in addition to your current regimen. I am assuming that you are addressing any dryness topically with some serums but if you are not then please consider the use of Garden of Wisdom’s 100% Pure Squalane Oil which is excellent to restore lost lipids in skin, prevent dehydration and calm down inflamed skin. Squalane is non-comedogenic so this will not clog pores. Please see links below to the products mentioned.
    https://www.victoriahealth.com/product/European-Milk-Thistle/9682
    https://www.victoriahealth.com/product/Omega-7-Sea-Buckthorn-Oil/1080
    https://www.victoriahealth.com/product/100-Pure-Squalane-Oil/12851

    As far as probiotics are concerned, please introduce the broad spectrum probiotic Mega Probiotic ND by Food Science of Vermont, take one capsule twice a day with meals.
    Best wishes,
    Shabir

  • Karolina

    Shabir, you are a lifesaver!
    Thank you so much for taking your time to reply.
    Luckily I haven’t experienced any dryness just yet (maybe little dryness in my eyes in the morning when I wake up).
    I already have squalane oil from The Ordinary, so I will use it up and then get the one you recommended.
    I just have one more favour to ask, with so many pills I’m starting to get confused as to how many, when (before/after meals) and what time of day I should be taking all of them. Could you advise please?
    My best,
    Karolina

  • http://www.victoriahealth.com/ Victoria Health

    Hi Karolina, thank you for your kind response. Power of Krill, Bamboo Extract and Daily Immunity can all be taken with or without food. I would recommend taking these with or immediately after some food because this allows for greater absorption and utilisation because of the digestive enzymes that are released when you eat food.
    Best wishes,
    Shabir

  • Karolina

    Thank you!
    And how about European Milk Thistle?
    Karolina

  • http://www.victoriahealth.com/ Victoria Health

    Hi Karolina, please take the European Milk Thistle with food too.
    Best wishes,
    Shabir

  • Karolina

    Again, Thank you Shabir!

    Best wishes
    Karolina

  • http://www.victoriahealth.com/ Victoria Health

    You are very welcome Karolina.