Acne: causes and treatments May 26, 2016 09:15
Suffering from the dreaded acne? Welcome to the club. You might have tried lots of things and nothing worked... Or you’ve just noticed the first spots and are looking for a way to prevent more coming up.
Acne is an inflammatory disorder of the skin, caused by a combination of factors:
- First of all, the glands (sebaceous follicles) on the skin of the face, neck, chest and back produce too much sebum. This is because these glands are oversensitive to hormones called androgens.
- Second, the shedding (desquamation) of the cells of the skin is abnormal: the dead skins are less loosely organized. These densely packed dead cells together with excess sebum cause a blockage of a hair follicle, or a microcomedone.
- The blockage provides a very comfortable environment for the bacterium called Propionibacterium acnes (let’s call it acnes).
- Finally, acnes releases various substances that cause inflammation, such as cytokines and chemokines, as well as reactive oxygen species. It is this inflammation that produces the final result: the spot (acne lesion). The severity of your acne depends on how your body responds to these inflammatory substances.
We all know that acne is the curse of teenagers, but actually around 5-10% of adults are plagued by it throughout their lives. If you’re a woman in your 20s, 30s and 40s and you have acne, you might have noticed that the flare ups correspond to the stages of your menstrual cycle (your skin is smoother right after the period and spots start coming back after ovulation). At least you get a break from acne rather than suffering from the entire time!
Treatment of acne can target each of the four factors that contribute to this tiresome skin disease. First of all: do not use harsh face washing products. Acne is not caused by dirt and such methods will just irritate your skin and might exacerbate the problem. The overproduction of sebum can be treated with isotretinoids and oral contraceptives. So for some of us the pill might be all we need. The abnormal shedding of the dead skin can be corrected with topical retinoids prescribed by dermatologists and by salicylic acid. The P. acnes can be killed with antibiotics and antimicrobials.
And here is the thing: if your acne is in very early stages of development, it is a good idea to see a dermatologist, because disrupting the process of blocking the follicles might prevent the colonisation of your skin by P.acnes.
Often one or a combination of several methods of treating acne cures the problem. What about those of us, however, whose skin reacts to benzacne and retinoids with irritation and unbearable dryness, and spots are still present at the age that we should not really take the pill anymore?
Researchers have looked into natural treatments for acne. These methods can be tested in different ways: in clinical studies people are randomly allocated to different treatment groups, so that those treatments can be compared. This is the best way of testing medicines because sometimes our symptoms improve on their own or simply because we think that we are receiving treatment, even if it’s just a sugar pill (the ‘placebo effect’).
The most researched herbal remedy for acne seems to be the tea tree oil. It is extracted from the Australian plant called Melaleuca alternifolia (from myrtle family; not to confuse with the tea bush called Camellia, which provides us with the drinking beverage). This natural oil has been tested in several clinical studies, The clinical trials show that tea tree oil is better than placebo and has similar effects to some of the conventional treatments, such as 5% benzoyl peroxide and 2% erythromycin (Hammer, 2015). Overall, if we apply the oil at concentration of at least 5% for at least 4 weeks, it reduces outbreaks of mild to moderate acne by 23.7 to 62.1%. This improvement could be due to antimicrobial and anti-inflammatory effects of the terpinen-4-ol, one of the main ingredients of the tea tree oil. It kills P.acnes, however be careful if you want to use it in high concentrations (more than 5%), because it might cause irritation of the skin and sometimes allergies. Some people find that handmade soaps with tea tree oil make their skin smoother or even spot-free.
A promising botanical substance in the fight against acne is extract from green tea. It works on as many as three out of four factors that cause the spots: reduces the production of sebum, calms down inflammation and kills P.acnes (Fisk et al., 2014). In twenty patients who used lotion with green tea extract twice a day for six weeks, the number of acne lesions diminished by, on average, 58% (Elsaie et al., 2009). In another study a similar result was achieved with the regular black tea (Sharquie et al., 2006). The scientists simmered leaves of the black tea on low heat until some of the water evaporated and then mixed 75ml tea with 25ml ethanol. Why not try washing your face with cotton wool soaked in freshly brewed green tea?
German scientists conducted an interesting study on jojoba oil and clay mask. Rather than comparing groups of patients who used different treatments, they asked their participants to use the mask 2-3 times per week for 6 weeks and keep a ‘spot diary’, where they wrote down the number of acne lesions. On average their skin cleared by 54%. The reason for this improvement could be the absorbent properties of clay: apparently it ‘draws’ the products of metabolism out of the skin, as well as the toxins produces by bacteria, and binds them. Clay also absorbs excess sebum and improves circulation of blood, which carries nourishment to the skin cells. On the other hand, jojoba oil has antibacterial and anti-inflammatory properties. Bear in mind that this study was financed by the company that produced the clay mask.
The main advantage of plant extract in the fight against acne is their wide spectrum of action: not only do they kill the bacterium causing the spots, but at the same time reduce inflammation. They are usually gentler than the traditional methods, and could be more suitable for people with sensitive, atopic skin, which reacts with dryness to the very tap water, not mentioning benzacne. Botanical treatments can also serve as adjunct treatments: thanks to them it might be possible to reduce the dose of the medicines that irritate the skin. Remember however, that if you acne is not responding to your current methods and causes you problems, you need to go to a dermatologist.
Jadwiga Nazimek ©
Disclaimer: this article is for informational purposes only. Always use herbal products according to the instructions of the producer or a therapist.
Elsaie, M. L., M. F. Abdelhamid, L. T. Elsaaiee, and H. M. Emam, 2009, The efficacy of topical 2% green tea lotion in mild-to-moderate acne vulgaris: J Drugs Dermatol, v. 8, p. 358-64.
Fisk, W. A., H. A. Lev-Tov, and R. K. Sivamani, 2014, Botanical and phytochemical therapy of acne: a systematic review: Phytother Res, v. 28, p. 1137-52.
Gavini, E., V. Sanna, R. Sharma, C. Juliano, M. Usai, M. Marchetti, J. Karlsen, and P. Giunchedi, 2005, Solid lipid microparticles (SLM) containing juniper oil as anti-acne topical carriers: preliminary studies: Pharm Dev Technol, v. 10, p. 479-87.
Hammer, K. A., 2015, Treatment of acne with tea tree oil (melaleuca) products: a review of efficacy, tolerability and potential modes of action: Int J Antimicrob Agents, v. 45, p. 106-10.
Meier, L., R. Stange, A. Michalsen, and B. Uehleke, 2012, Clay jojoba oil facial mask for lesioned skin and mild acne--results of a prospective, observational pilot study: Forsch Komplementmed, v. 19, p. 75-9.
Sharma, M., R. Schoop, A. Suter, and J. B. Hudson, 2011, The potential use of Echinacea in acne: control of Propionibacterium acnes growth and inflammation: Phytother Res, v. 25, p. 517-21.
Sharquie, K. E., I. A. Al-Turfi, and W. M. Al-Shimary, 2006, Treatment of acne vulgaris with 2% topical tea lotion: Saudi Med J, v. 27, p. 83-5.