The Causes of and Possible Solutions to Acne Vulgaris

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					Title:
The Causes of and Possible Solutions to Acne Vulgaris

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1556

Summary:
Acne is the term for plugged pores (blackheads and whiteheads), pimples,
and even deeper lumps (cysts or nodules) that occur on the face, neck,
chest, back, shoulders and even the upper arms. Acne affects most
teenagers to some extent. However, the disease is not restricted to any
age group; adults in their 20s - even into their 40s - can get acne.
While not a life threatening condition, acne can be upsetting and
disfiguring. When severe, acne can lead to serious and permanent
scarring. Even less severe cases can lead to scarring. Why does acne
happen?


Keywords:
acne treatment, acne, acne solution, spots, blackhead, pimples


Article Body:
Acne is the term for plugged pores (blackheads and whiteheads), pimples,
and even deeper lumps (cysts or nodules) that occur on the face, neck,
chest, back, shoulders and even the upper arms. Acne affects most
teenagers to some extent. However, the disease is not restricted to any
age group; adults in their 20s - even into their 40s - can get acne.
While not a life threatening condition, acne can be upsetting and
disfiguring. When severe, acne can lead to serious and permanent
scarring. Even less severe cases can lead to scarring. Why does acne
happen?

- An inflamed spot occurs due to the release of inflammatory fatty acids
by a particular bacterium known as p.acnes, which causes the body’s
defence systems to respond.
- You would however not get p.acnes colonisation of the hair follicle
duct without a plug forming.
- The plug forms due to an increase in skin cell turnover, increased
keratin deposition narrowing the opening of the hair follicle duct,
combined with increased sebum production, which mixes with the debris to
cause a blockage and a plug to form.
- The increased sebum, keratin and cell turnover would not happen if
linoleic acid levels in the skin had reduced dramatically.
- Linoleic acid levels reduced due to the development of sensitivity to
the hormone DHT.
- DHT is formed from testosterone. The chemical reaction naturally
happens throughout the body and the conversion of testosterone to DHT is
assisted and promoted by the enzyme called 5-alpha reductase. (All
chemical reactions in the body are controlled and accelerated by
enzymes).

<b>Possible solutions to the underlying causes of acne:</b>
1)    Stop hormonal fluctuations. This is impossible although people do
try by taking plant hormones, HRT and royal jelly. But basically it is
best not to mess with our natural hormonal balance.

2)    Use Roaccutane. This will affect the conversion of testosterone to
DHT, but this will occur all over the body and DHT plays a role in a
number of body functions and suppressing it leads to a number of possible
side effects.

3)    Reduce DHT levels in the hair follicle and in sebaceous gland area
only, known as the pilo-sebaceous unit. If it were possible to prevent
testosterone from converting to DHT in the acne area of the skin but not
stopping this conversion elsewhere in the body could reduce skin
sensitisation and the resulting linoleic acid loss, but without affecting
the conversion of testosterone to DHT in other parts of the body. This
would be great in principle if one can alter the conditions in the
pilosebaceous unit for an extended period of time so that DHT levels were
reduced locally during the times in our lives when normal hormone levels
were ‘out of sync’ with a topical preparation could lead to a reduction
in the triggering of the acne process. Two products called tri-ethyl
citrate and ethyl linoleate which are safe and release citric acid and
linoleic acid can change conditions in the skin which slows down the
enzyme 5-alpha reductase and hence testosterone conversion to DHT is
slowed down locally. The testosterone conversion to DHT will still occur
but just somewhere else in the body, meaning other bodily processes are
not affected.

4)     If one could also replenish linoleic acid levels in the skin then
this would lead to a slow down in oil production and skin cell turnover
rates and keratin deposition, preventing the plug forming and the
colonisation by p.acnes.

5)    One could take linoleic acid supplements and foods high in linoleic
acid. However linoleic acid is used by many parts of the body and one
would have to take possibly toxic levels to affect skin levels
significantly enough through oral supplementation alone. Doing this
without going to excess is probably however a good thing and it has been
noticed that the Eskimos (the Inuit) did not suffer from acne until they
were introduced to western diets. However if one can find a way to
supplement skin linoleic acid levels using a topical preparation then
this would also have an impact on the acne process.

6)    Getting linoleic acid into the skin is not easy but you can use
special delivery technology using special molecular structures in creams
such as Oleosomes and involving techniques with fancy names such as
Drysyst technology to help this process. Also if one uses ethyl
linoleate, then skin bacteria will help break this down and release
linoleic acid into the skin (look for products containing ethyl
linoleate.)

7)    One could normalise cell turnover to reduce skin thickening and
also reduce keratin increases in skin cells. This would help to prevent
blocking of the pilo-sebaceous duct. Retinol A based creams have been
shown to normalise skin cell turnover rates. However a potential side
effect of retinol products is increased sensitivity to UV and maybe
increased skin cancer risk. So users of retinol based products are
advised strongly to use a high SPF sunscreen while using retinol based
products. There is a chemical called triethyl citrate which also
normalises keratin deposition and skin cell turnover rates and without
causing photo-sensitivity (please search for products containing triethyl
citrate).

8)    Reduce oil levels on the skin. This is normally done by using
detergents to keep surface oil levels down. Doing this on its own just
leads to more oil production and one gets into a downward spiral with a
‘negative feedback loop’ leading to further increase (up regulation) of
sebum (oil) production. However oil control is important and using mild
detergents can help in controlling the acne process. Using a combination
of triethyl citrate and ethyl linoleate has been shown in a clinical
trial published in the British Journal of Dermatology at the end of 2007
which showed sebum production rates reduced by up to 68% with an average
of 55%.

9)    Use exfoliants and detergents to help unblock ducts by dissolving
and removing plugs and keeping skin debris levels down and also reducing
skin thickening. This is effective and can help but if the skin is
inflamed and sore then exfoliants can, make the skin more sensitive and
sore. It maybe better to use chemical exfoliants rather than irritating
physical skin exfoliants. Better still use those which have shown to
affect sebum production rates such as Salicylic acid and Pyruvic acid
which are both hydroxy acids (also known as fruit acids). These are the
only two who have shown a sebo-static effect which means temporarily
slowing oil production. Another common chemical exfoliant used is
glycolic acid but this has not shown to have a sebo-static effect. Also
salicylic acid has shown to help with skin thickening by loosening skin
cells. See products containing Salicylic acid and Pyruvic acid).

10)   Even products with fruit acids may irritate some skins, and some
acne sufferers such as younger skins can be very sensitive and actually
don’t have excessive skin thickening. One could use a gentle non
irritating cleansing agent containing products such as silicone and
glucose based cleansers which are very skin friendly, and also contain
triethyl citrate which will normalise skin thickening by addressing over
active skin cell turnover, thereby addressing skin thickening from within
the skin.

11)   Control p.acnes levels. Keeping hair follicle ducts open and oxygen
rich is one way but blockages can still happen. So if you are going to
control p.acnes than ideally do this without attacking skin staphylococci
as discussed earlier due to MRSA development risks. One can use
antibiotics to do this and they may be indicated in pustular scarring
acne but for most we know that p.acnes releases enzymes to break down the
plug to release nutritious fatty acids which also can cause an
inflammatory response from the body. If you change conditions in the
pilosebaceous unit so these enzymes don’t work as well you can slow down
this process and reduce the amount of food and consequently reduce the
growth of p.acnes without attacking good skin bacteria (staphs) (see an
example of how this ca be achieved)
12)   Reduce inflammation. Using products to control bacteria will reduce
inflammation but also anti-inflammatory’s used to reduce inflammation.
Stopping the release of the inflammatory fatty acids is another way, but
also mopping up the inflammatory free radicals produced is an additional
way of controlling inflammation. Antioxidants are useful in this regard
and the best antioxidants are probably skin soluble version of vitamin C
such as ascorbic acid and others such as Ascorbyl Palmitate and
especially Ascorbyl tetra-isopalmitate (see an example of a product
containing these).

<b>In Summary</b>

If you have a product range which alters conditions to slow DHT
production locally, increase linoleic acid levels in the skin, that
normalise skin cell turnover, keratin deposits and sebum production while
also having mild sebo static chemical exfoliants or silicone and glucose
based cleansers. If this product also had, staph friendly antibacterials
to control p.acnes, feeding and development combined with antioxidants to
help control the inflammatory process, then you would have a highly
effective product range which could be obtained with or without
prescription and is supported by eminent dermatologists across the world,
including the top dermatologist on acne in the UK who has had his
independent trail published din the most respected dermatology journal in
the world, then you would be onto a winner. If this product was
incredibly reasonably priced you would think it would dominate the
treatment options of acne.

				
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