Acne hurting your confidence?

April 10, 2019

The psychosocial impact of acne is well-known and is severe enough to be the subject of several major studies in prominent journals. Acne is THE most common skin condition in the US affecting approximately 50 million Americans each year.  Depression, anxiety and lack of self-confidence due to facial acne  leads to time-off from school and work and the costs associated with this loss of productivity has been estimated to be as high as $400million (Statistics 2013)!! If that number is not staggering enough on its own,  the total cost of acne treatments combined with the cost of lost productivity were approximated to be $1.2 billion!

Numbers aside, in my practice I have personally witnessed and documented the social difficulties experienced by patients suffering from varying degrees of acne. Besides the physical discomfort, the negative impact of persistent acne on a patient's overall well-being varies based on many factors including their perception and understanding of the disease, underlying self-esteem issues and extent of support from family and friends. In this era of social media, the age group of 10-20 years olds are affected the most. So while counseling and use of psychotherapy and can help with many of these self-esteem & confidence factors, it still remains important for the patient (in their own words) - to 'get rid of the acne'! Almost all these patients usually have been through some combination of the following conventional treatments for acne:

  • Topical / oral high dose vitamin A
  • Topical/oral antibiotic
  • Topical salicylic or azelaic aid
  • Topical/ oral steroids
  • Oral contraceptives
  • Oral anti-androgen

Though some or all of these treatments can be effective in suppressing new eruptions, upon termination of the treatment,  the acne returns and sometimes at an intensity worse than prior to the treatment!

So what else can be done?
Most acne sufferers already know that acne is not just 'skin-deep' and there is more to it's story - i,e. cause and recurrence.There are many naturopathic herbal remedies that can help with acne  symptoms, but I have observed for  a long time now  that there is one thing that seems to be the underlying root cause for the presence and persistence of acne vulgaris. The one thing that can be linked to all of the factors  often listed as its cause such as:

  • Excessive sebum production & faulty keratinization leading to clogged pores
  • Presence of the bacteria  Propionibacterium acnes or P.acnes
  • Excessive inflammation in the skin​
  • Insulin-resistance

What is that one thing?

If you follow my blog, it is likely that you have guessed the answer. It is in fact the state of your gut!

The gastrointestinal tract, the source of your nutrients also harbors a large percentage of your immune cells and major immune modulators - your intestinal flora of bacteria, archae and viruses. This microflora (also known as the microbiome) can change based on a person's diet, environmental factors, disease states, toxin exposure and yes, hormonal changes. The influence of the microbiome on our hormones  and vice-versa is a major field of study in the scientific world right now and even though its implications are yet to be fully understood, current studies have sufficient data to define what a  healthy microbiome constitutes and it's potential impact of an unhealthy one on various systems of your body.

In 2017, an interesting study by Clarke et al. was published in the International Journal of Molecular Sciences. It summarized how plant-based herbal supplements can influence the microbiome, which in turn influences the levels of inflammation and androgen production leading to a targeted impact on the skin.  Following a diet that includes low-glycemic foods and lots of fiber rich plant-based foods does not just influence blood glucose levels, but also shifts the microbial balance in favor of lower inflammation and therefore, lower permeability of the gut. With a gut lining that is very selective about what is being absorbed into your bloodstream and then being transported to various organs including the skin, the rate of new lesions goes down significantly. Plus, older lesions and scars heal much more rapidly with the use of appropriate non-toxic cleansers and healing agents, when the gut microbiome is truly balanced- that is, topical treatments are more effective when combined with the treatment of the underlying cause.

The diagram below from the study mentioned above, provides an insight into the interconnected process :


Diagram credit:Ashley K. Clark 1, Kelly N. Haas 2 and Raja K. Sivamani 2,3,* Edible Plants and Their Influence on the Gut Microbiome and Acne. Int. J. Mol. Sci. 2017, 18, 1070

How do you know what needs correction/balancing in the gut and specifically the microbiome?
This is where the power of naturopathic medicine comes in. A thorough evaluation of a person's diet, bowel habits, all factors affecting the acne, i,e. cyclic changes, stress levels, travel etc  combined with comprehensive testing can help determine the most appropriate dietary and lifestyle changes and list of herbal supplements that can help resolve the occurrence and recurrence of acne lesions.  Time and again, I have seen this as a successful approach to treating acne in my practice; as the skin clears, patients report that their confidence and productivity at work/school/social settings increases dramatically.  

If you feel that you or a friend need help with acne, please be sure to share this blog's link. As I always say, whether you are curious or concerned, come in for a 20-minute conversation to figure out if naturopathic medicine is right for you.

Go ahead, aim for that healthy, glowing skin!

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