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Acne Frequently Asked Questions by Dr Irene Prantalos (Chinese Medicine)

What is Acne

Acne is an inflammatory skin condition that erupts in various forms which include comedones (blackheads, whiteheads), pustules, papules, cystic and nodules.

It is commonly caused by hormonal changes as seen in teenagers during puberty, at times of stress and can be a symptom of another health condition such as Polycystic Ovarian Syndrome.

Although commonly seen in teenagers, acne can present at any age for a number of reasons.

The causes of acne are varied but the outcome is the altered hormonal state. This can be stress leading to an increase in testosterone, the contraceptive pill disrupting a woman’s balanced hormones, fertility treatment wreaking havoc on hormones, pregnancy causing hormones to fluctuate or the hormonal surge of puberty.

Another trigger is food. Eating a diet rich in greasy, fatty foods will make the skin more greasy and cause the pores to block. When bacteria is trapped in the pores these comedones become acne lesions. Other inflammatory foods that will increase acne eruptions are alcohol, sodas, sports drinks, sugary snacks and foods, take away, pizza, deep fried food and spicy hot food.

It’s always interesting when adults are surprised they are dealing with acne. It’s perceived as an adolescent skin disease and one that should typically end then as well. But the truth is we can have acne present in many times of our life.

A great instigator is stress and a poor diet, while in women there are more triggers such as menstrual cycles, pregnancy, contraceptive pill, and anything that alters the body’s natural hormonal regulation.

As with adolescence, adults need to look at their diet, emotions, gut health, digestive health and hormones to gain further understanding as to what is triggering the acne and how they can effectively combat it.

There may be the need to see a health practitioner for guidance and treatment but looking at what the person afflicted with acne is doing that is contributing to the flare up will only empower the person to make the necessary changes to help the skin heal.

There are many subtypes of acne which include whiteheads, blackheads, papules, pustules, cystic and nodules.

Then we also have the areas where these acne lesions present.

When it is on the forehead it usually represents due to stress, dehydration or the hair covering the forehead.

The cheeks are indicative of inflammation in the body, smoking or perhaps having a pillow that needs to be cleaned.

Finally, the chin region is hormonal and a poor diet such as fatty foods and sugar. Here we will find the cystic acne resides mostly. 

Acne vs Rosacea

There are many similarities when differentiating between Rosacea and Acne.

Similarities:

- Caused by alcohol, spicy food and stress 

- Have redness and acne type lesions on the face

Differences:

- Rosacea tends to have more redness and swelling, while acne will have redness localised to the acne lesion itself.

- Rosacea can present with broken capillaries, while this is not the case for acne

- Rosacea can come and go but acne tends to linger around if left untreated

- Acne can present on the chest, back and other areas of the body, while rosacea only present on the face

The most common place for acne to appear is the face but this is not the only place it can appear. The chest and back are common areas especially in people who have quite severe chronic acne. 

One of the most common concerns of an acne sufferer is the scarring that can occur from having acne lesions on the skin.

The scarring can occur from the injury to the skin from the actual acne lesions as well as physical trauma in trying to extract the blocked pore or pustule that has created the acne lesion.

The biggest issue with acne scarring is that it is forming in the dermal layer where the blood vessels, sweat glands, hair follicles and sebaceous glands reside. Trauma to the deeper layers of the skin causes scarring that isn’t simply resolved with the normal shedding of the skin in the epidermis.

How to treat Acne

Internal Treatment

My opinion has always been that we need to work with the body, not against it. To listen to what the body is showing us with the symptoms is paramount to healing the skin. If instead we suppress its voice and try to get rid of the problem without actually addressing the problem, the acne can get worse and even spread to other areas of the body.

Western Medicine usually approaches acne with antibiotics (low doses given for long periods of time), roaccutane (which has a long list of side effects) and the contraceptive pill (to manage hormonal regulation).

Personally I believe these only relieve the problem for a short period of time, but inadvertently create other issues such as gut dysbiosis, hormonal regulation and mental health issues that can lead to serious consequences.

If in turn we look at it from a natural perspective and address the hormonal imbalance, regulate sebum production to reduce greasiness in the skin and improve gut health; the skin will heal from the inside out and reduce flare ups in intensity and frequency.

Plus there will be less scarring as the damage to the skin will be addressed and by effectively reducing the acne lesions there will be less scarring on the skin.

Chinese herbal medicine provides all these benefits and is natural and plant based. The nutrients needed to heal the skin from the inside out are focused on being anti-inflammatory, anti-bacterial, promoting circulation to promote healing and improving digestion to help with the healthy elimination of toxins to alleviate the toxic load from the skin.

Nutrition

To help the skin rejuvenate, it is essential to eat the foods that contain the nutrients the skin needs to heal. These include Essential Fatty Acids, Vitamins A, B1, B2, B6, C, E, minerals such as iron and zinc. 

Topical

It’s also very important to avoid drying out the skin with harsh cleansers and exfoliators as the skin is delicate and in fact damaged. So it is extremely important to use a topical skin care regimen that supports the delicate skin’s surface with natural and organic ingredients to reduce the congestion and inflammation in the skin.

There is no reason why acne can’t be cured. Looking at what triggers your acne and making those necessary changes will help heal the skin.

Yes there are skin types that are prone to being more oily and gut health that is more reactive to greasy, fatty foods but that doesn’t mean it can’t be addressed. The body is in a constant state of rejuvenation, and given the right tools to heal and be healthy will lead to healthier looking skin.

As with many skin health issues, acne requires a multifaceted approach when addressing the lesions.

These include:

- Eating a healthy diet rich in green leafy veggies and detoxifying veggies such as beetroot.

- Avoiding greasy, fatty foods and foods high in sugar. Also avoiding caffeinated drinks and alcohol as that will increase inflammation in the skin.

- Eating foods high in Essential Fatty Acids, Vitamins A, B1, B2, B6, C, E, minerals such as iron and zinc. If that can’t be the case then look into supplementation of these vitamins and minerals.

- Managing stress levels and reducing overwhelm and angst. This can be achieved by nurturing your adrenals with adaptogens. Meditating daily and embarking in journal writing that include positive visualisations and affirmations. Don’t forget to read a positive, uplifting book to help you put life into perspective and give you the tools to deal with life’s challenges.

- Drinking 2-3 litres of filtered water per day.

- Having a topical skin care regimen that gives your skin the nutrients it needs to regulate sebum production, exfoliates the dead cells from the surface of the skin, promotes the skin’s natural healing process, neutralises bacteria and deeply cleanses the skin to reduce comedone formation. 

Scarring occurs in the dermal layer and for this reason I recommend the following 3 tips to encourage the rejuvenation of the skin barrier while addressing the acne lesions on the skin.

1. Get rid of the inflammation in the skin. The inflammation in the skin will damage the tissue both localised to the acne lesion and its surrounding tissue as well.

2. Keep the skin clean and maintain it so that new acne lesions don’t form. Keeping the pores clean will help minimise the formulation of comedones and help balance the skin’s pH so to prevent the overproduction of sebum from the sebaceous glands.

3. Use cosmeceutical skincare products to provide the skin with ingredients that penetrate the epidermis to the dermis. It is here we are encouraging the delivery of key ingredients to encourage the rejuvenation of the skin from the base of the epidermis to the top. Ingredients include green tea, salicylic acid, lactic acid, hyaluronic acid, papaya extract, sea buckthorn, extract.

The flawless range is formulated to encompass all these key factors to address the acne lesions as well as preventing the formation of scarring and also encouraging the healthy rejuvenation of the skin to address the presence of any scarring on the surface of the skin.

One key product in the range is the Acne Prevention Moisturising Lotion. This is key as many acne sufferers avoid hydrating the skin. This leads to the release of sebum by the sebaceous glands and in turn blocks the pores, giving rise to new acne.

By keeping the skin hydrated we can minimise acne breakouts and rejuvenate the damaged skin barrier that results from acne.

The cosmeceuticals in the product (salicylic acid, lactic acid, seabuckthorn, papaya extract and herbal extracts) not only are delivering key benefits to the skin but working on rejuvenating the skin barrier to improve the texture and tone of the skin.

The food we eat has a direct impact on the health of our skin.

The dermal layer contains blood vessels. Everything we eat enters the bloodstream from the small intestine and gets delivered throughout the entire body through the vascular system (blood vessels).

The food we eat is broken down to nutrients and are circulated in the blood.  Some foods increase inflammation in the body and when we are prone to specific health issues, the inflammation fires up this disease and makes the symptoms associated with this disease worse. 


Anyone struggling to manage their acne effectively, I would encourage you to remove all inflammatory food from your diet.

These include sugar, dairy, gluten, red meat and alcohol.

As I mentioned, the blood delivers everything to the skin, including hormones. If hormones are affected by stress, the food we eat, the lack of sleep we have, the emotions we have and so on; these effects will be displayed on your skin.

So keep in mind what you notice impacts your acne and try to either manage it or avoid it. Sometimes stress can not be avoided but our reaction to stress is up to us. Incorporate exercise and meditation in your day to help with minimising the effects of stress on your skin.

Here are my top tips for managing future acne breakouts:

1. Nutrition

Avoid inflammatory food, alcohol and spicy hot foods.

Enjoy loads of green leafy vegetables and detoxifying vegetables such as beetroot and broccoli.

Make sure you drink 2-3 litres of water per day and steer away from caffeinated beverages and sugary drinks.

2. Lifestyle

Avoid late nights, occasionally is fine if you have gone out for a night out, but not a regular occurrence.

Stay away from electronic devices late at night as this can often lead to a poor night's sleep.

Frequent exercise - this will help regulate insulin resistance to reduce inflammation in the body and help blood circulation to encourage the skin’s natural ability to heal.

Plus getting fresh air on your skin is amazing and I would encourage meditating while sitting outside and enjoying the beauty of nature.

Smoking and other toxic vices is obviously going to create poor health.

In fact, smoking will create more damage to the skin barrier and even make the skin leach out toxins from the smoking through the pores. If you are trying to cleanse the pores, smoking will not help your cause.

3. Skincare routine

This should form your daily ritual and is as important as eating a highly nutritious diet.

The above tips help the body from the inside, while the skincare routine is helping the dermis and epidermis function optimally.

By cleansing the skin, hydrating and delivering key ingredients that help with neutralising bacteria, rejuvenating the skin’s surface and reducing inflammation, you can keep your skin looking and feeling amazing without the constant worry of an acne flare up happening.