Acne is a pustular infection of the skin, caused by changes in the sebaceous glands. The most common form of acne is known as acne vulgaris (pimples), which means common acne. Excessive secretion of oils from the glands combine with naturally occurring dead skin cells to block the hair follicles. Oil secretions build up beneath the blocked pore, providing a perfect environment for the skin bacteria Propionibacterium acnes to multiply uncontrolled. In response, the skin inflames, producing the visible lesion. The face, chest, back and upper arms are especially exposed.

The infection is common in puberty as a result of an abnormal response to normal levels of the male hormone testosterone. The response for most people diminishes over time and acne thus tends to disappear, or at least decrease, after one reaches early adulthood. There is, however, no way to predict how long it will take for it to disappear entirely, and some individuals will continue to suffer from acne decades later, into their thirties and forties and even beyond.

Acne affects a large percentage of humans at some stage in life. Aside from scarring its main effects are psychological, such as reduced self-esteem and depression. Acne usually appears during adolescence, when people already tend to be at their most socially-insecure. For this reason acne should be treated if severe.

Causes for acne – Wesern medicine perspective

Exactly why some people get acne and some do not is not fully known. It is known to be partly hereditary. Several factors are known to cause acne:

• Hormonal activity
• Hyperactive sebaceous glands
• Accumulation of dead skin cells
• Bacteria in the pores
• Skin irritation or scratching of any sort
• Anabolic steroids
• Birth control pills, however many women have reported reduced acne while on the pill
• Consumption of heat damaged foods. Proteins exposed to heat are altered in such a way that digestive enzymes are unable to break them down into constituent amino acids. These proteins are processed by lymph glands and excreeted through the skin. Due to the hydophelic nature of protein, subcutaneous water pressure is increased which closes off sebum canals, trapping bacteria. A cyst is the result.

Some of the aggravating factors include: food allergies, other diseases, cortisone therapy, vitamin deficiency, ingestion of halogens (chlorine, fluorine, bromine or iodine), contact with various chemicals (such as tar or chlorinated hydrocarbons) and psychological factors such as stress, worry and depression.

Why do doctors and dermatologists say diet doesn't cause acne?

Doctors and dermatologists say diet doesn't cause acne because they can't sell you a healthy diet. This may sound cynical, but they are under huge pressure from pharmaceutical companies to prescribe antibiotics, topical creams, Dianette, Roaccutane and other treatments. Also, think about this: why is there little research into diet and acne? Again, because there's no money in it. Drug companies fund most research and if the aim is to find a link between acne and diet, there's no drug candidate at the end of it. This is also why, through no fault of their own, doctors and dermatologists always say there is no link between diet and acne — when they were training in their profession there was little documented research to say diet can aggravate acne. Their argument for this is based around the fact that diet doesn't cause acne — you may have acne and eat relatively healthily, while your friend eats fried food, chocolate, pizza etc and stays blemish-free. This is because there are several factors in why certain individuals get acne and others don't. If you are predisposed to get acne, diet can aggravate it.

Treatments – Westen Medicine

There is a myriad of products sold for the treatment of acne, many of them without any scientifically proven effects. However, a combination of treatments can usually prevent acne in all but the most severe cases. Generally there are three types of treatments that have been proven effective:

1. Killing the bacteria that are caused by the blocked follicles. This is done either by the intake of antibiotics like tetracyclines, or by treating the affected areas externally with bactericidal substances like benzoyl peroxide. However, reducing the p.acnes bacteria will not, in itself, do anything to reduce the oil secretion that is the initial cause of the blocked follicles. Therefore, acne will generally reappear quite soon after the end of treatment — days later in the case of topical applications, and weeks later in the case of oral antibiotics.

2. Reducing the secretion of oils from the glands. This is done by a great daily intake of Vitamin A derivates like isotretinoin over a period of a few months. The product is sold by Roche under the names Accutane in USA and Roaccutane in Europe. Isotretinoin has been shown to be very effective in treating severe acne and is effective in up to 80% of the patients. The drug has a much longer effect than anti-bacterial treatments and will often cure acne for good. The treatment requires close medical examination by a dermatologist since the drug has many known side effects. The most common are dry skin and nosebleed. It can also permanently damage the liver and cause depression. The drug also causes birth defects if women become pregnant while taking it.

3. Exfoliating the skin. The topical treatment salicylic acid for example encourages the peeling of the top layer of skin to prevent a build-up of dead skin cells which combine with skin oil to block pores. It also helps to unblock clogged pores.

Popping a pimple or any physical acne treatment should not be attempted by anyone but a qualified dermatologist. Pimple popping irritates skin, can spread the infection deeper into the skin and can cause permanent scarring.

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