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Acne

Category: Illness or disabilities

Type

Involuntary

Introduction and description

Acne is a skin condition marked by skin eruptions, for example, red pimples, blackheads, whiteheads, rashes, and large bumps. It is a common human skin disease, characterized by areas of skin with seborrhea (scaly red skin), comedones (blackheads and whiteheads), papules (pinheads), nodules (large papules), pimples, and possibly scarring.

Acne affects mostly skin with the densest population of sebaceous follicles; these areas include the face, the upper part of the chest, and the back.

Sebum is secreted by the sebaceous gland and is primarily composed of tryglycerides (~41%), wax esters (~26%), squalene (~12%), and free fatty acids (~16%).  Wax esters, like squalene, are unique to sebum and not produced anywhere else in the body.  Sebum has a purpose and that purpose is to waterproof your skin and give it a protective barrier.  Sebum is odourless, but its breakdown by bacteria can produce strong odours.

Some hormones, including androgens such as testosterone and estrogen, as well as progesterone, increase the rate of sebum secretion.  Hormonal activity, such as menstrual cycles and puberty, may contribute to the formation of acne. It is not the cause.   But more sebum can produce its own problems, of which more in a moment.  During puberty, an increase in sex hormones called androgens cause the follicular glands to grow larger and make more sebum. Pregnancy, which also disrupts the hormones can also result in more sebum. The menopause can result in more sebum. Acne during adolescence affects an estimated 70-90% of teenagers. For most people, acne diminishes over time and tends to disappear — or at the very least decreases — by age 25.  But if you continue with hormonal disruption, you will continue to produce more sebum and as a consequence may get acne.

Acne rosacea

 Names, names, names

There are a huge number of different types of acne, but they are all in the end “acneiform eruptions”. It is most generally used when referring to acne vulgaris, but may also refer to 

Acne aestivalis

Acne conglobata

Acne cosmetica

Acne fulminans

Acne keloidalis nuchae

Acne mechanica

Acne medicamentosa (drug-induced acne) (e.g., steroid acne)

Acne miliaris necrotica

Acne necrotica

Acne rosacea

Chloracne

Excoriated acne

Halogen acne

Occupational acne

Oil acne

Pomade acne

Tar acne

Tropical acne

Acne necrotica miliaris, a disease of the scalp

Acne keloidalis nuchae

Causes

The principal causes are as follows.

 

Drugs and pharmaceuticals

Many many drugs and pharmaceuticals are linked to acne, for example anabolic steroids and the androgens testosterone, dihydrotestosterone (DHT) and dehydroepiandrosterone sulfate (DHEAS), as well as insulin-like growth factor 1 (IGF-I). The medications that trigger acne are frequently hormone analogues.  The other major hormonal medications that causes acne are the progestin analogues present in hormonal contraception.

Acne can also be caused by corticosteroids - immunosuppressants and a big big culprit anti-histamines in all its hidden variants - from cough medicines to travel sickness pills.  Anti-histamines and immunosuppressants suppress the immune system.  Bacteria and parasites are the principal cause of acne, as we will see shortly as such by suppressing the immune system bacteria and parasites can flourish.

The eHealthme site collects the Adverse Drug reports submitted by doctors to the FDA and SEDA in the USA.  It then summarises them for ease of use.  We originally provided a direct link to Acne and the pharmaceuticals that can cause it, but the eHealthme website frequently reorganise the site and thus break the links.  Thus in order to find out which pharmaceuticals are implicated in Acne

  • Follow the LINK to the eHealthme website
  • Using the ‘All conditions’ index find the Acne entry
  • Now scroll down until you get to the section marked ‘Drugs that could cause Acne

The list shows you all the drugs implicated in CAUSING Acne as well as the number of people who have made a complaint to their doctor and had their case reported by him.  Note that it is up to the doctor whether he reports or not.

As of October 2016, about 1,250 pharmaceuticals were in this list.

It is indeed an impressive list and growing.  In this list are antipsychotics, acne treatments - which have served to make the condition worse [and in some cases left scarring], and here I quote:

Isotretinoin [Accutane] is primarily used as a treatment for severe acne. The most common adverse effects are a transient worsening of acne (lasting 2–3 weeks), dry lips (cheilitis), dry and fragile skin, and an increased susceptibility to sunburn. Uncommon and rare side effects include: muscle aches and pains (myalgias), headaches. Isotretinoin is known to cause birth defects.

Then there are cough medicines like Benadryl that contain anti-histamines, as well as histamine antagonists, again I quote

Loratadineis a second-generation H1 histamine antagonist drug used to treat allergies. Loratadine is marketed under several trade names (e.g., Claritin). In a version named Claritin-D or Clarinase, it is combined with pseudoephedrine, a decongestant and used for colds, as well as allergies.  It has a number of potential side effects of insomnia, anxiety, nervousness and skin conditions.

And here is another pharmaceutical that causes skin problems, although these appear to be the least of your worries, again I quote...

Depo-Provera is a branded progestin-only contraceptive, .... a long acting reversible hormonal contraceptive birth control drug that is injected every 3 months. It is also used for chemical castration.  Depo-Provera can affect menstrual bleeding and can also lead to skin problems.  Its use can result in delayed return of fertility. The average return to fertility is 9 to 10 months after the last injection. Long-term studies of users of Depo-Provera have found .... a slightly increased risk of breast cancer in recent users.  A study of accidental pregnancies among poor women in Thailand found that infants who had been exposed to Depo-Provera during pregnancy had a higher risk of low birth weight and an 80% greater-than-usual chance of dying in the first year of life. Black box warning:  it has long been known that Depo-Provera causes bone loss.

Enough said.

 

 

Stress

 Extreme emotion and stress can itself result in acne. Scientific research indicates that "increased acne severity" is "significantly associated with increased stress levels." The National Institutes of Health (USA) list stress as a factor that "can cause an acne flare." A study of adolescents in Singapore "observed a statistically significant positive correlation … between stress levels and severity of acne."

Stress can cause hormone disruption and in this case  the hormonal imbalance causes sebum to be produce and it is the sebum which is the key to the effects.

BUT high levels of stress result in the compromising of the immune system and by compromising the immune system we lay oursleves open to the  ultimate cause of acne - parasites and bacteria.

 

Bacterial infection 

It has long been recognised that bacteria play a major part in the formation of acne.

Initially, all fingers pointed to Propionibacterium acnes (P. acnes) , but then it was realised that normal pores appear to be generally colonized by P. Acnes.

They may even be 'good bacteria', of which more in a moment.

There are specific clonal sub-strains of P. acnes associated with normal skin health.  Thus to eliminate the bacteria using broad brush antibiotics could remove 'good' as well as 'not so good' bacteria.  So if it was bacterial it had to be other bacteria.

Once this was realised, research homed in on another culprit and this culprit was a parasite.

Parasite infection 

follicle mite tails -demodex-folliculorum

Researchers isolated another bacteria Bacillus oleronius, as the cause of some of the irritation of the skin and then realised that the bacteria was being produced by a parasite -  Demodex folliculorum mite. [Ref  PMID:  24248990]

"patients demonstrated increased Demodex populations on their faces and reduced sebum levels"

In fact it is the Demodex family as a whole we should be looking at.  Demodex folliculorum measures 0.3 to 0.4 mm in length and typically occupies hair follicles. It is also called an "eyelash mite" because it commonly occurs in follicles at the base of eyelashes. Demodex brevis is about half that size (0.15 to 0.2 mm) and typically lives in sebaceous glands adjacent to hair follicles.  For more details there is a marvellous article I have found on these mites which I have included in the Science section - see Skin mites.

The research now appears to point to the fact that the mite likes to feed on sebum.  The more sebum, the more parasites there are and it increases in numbers to match the increase in the sebum.  The by-product of the mite eating the sebum is the bacteria.  In effect, the ultimate cause is a parasite and this parasite lives with us most of the time, munching away on any excess sebum oozing through our pores.

The skin irritation, however, is caused by the bacteria it attracts - without putting too fine a point on it, helping themselves to the parasite's faeces.  So we have a colony of parasites feeding on our excess sebum, pooing liberally as a consequence, and all the poo being munched voraciously by the Bacillus oleronius.

What is perhaps of added interest is that our good bacteria, do a sterling job at attempting to fight the bad bacteria and the parasites.  By using anti-biotics, for example, which appears to be the medical professions answer to everything, we may actually kill off the one thing that is helping us and prolong the agony.

The precise contribution of the commensal bacterium Propionibacterium acnes (P. acnes) in the response associated with acne vulgaris remains controversial. ...Qin et al. showed that P. acnes induces robust IL-1β secretion in monocytic cells by triggering the activation of the NLRP3 inflammasome. In vivo, the encounter of P. acnes and macrophages in the peri-follicular dermis could locally result in the release of substantial amounts of IL-1β .

In other words they are the means by which the immune system fights the invaders, the 'good' bacteria [condemned by scientists] and the immune system co-operate to repel the parasite and the 'bad bacteria'.

Toxins

Toxins are implicated in some of the types of acne, but I think we should be clearer about the classifications of skin diseases here.  Acne is caused by parasites, whereas I think dermatitis is caused by toxins, which act differently as an irritant.  The symptoms can be similar, but exposure of the skin to toxic chemicals, requires a different treatment - removal from the toxins - than does acne. For some people, perfumes, soap powders, detergents, deodorants, cosmestics and other household and industrial chemicals are toxic. 

Treatment

There are two types of treatment used for acne

Symptom based treatment

The method used by western medicine is based on the symptoms. Antibiotics are used, along with various other pharmaceuticals designed to kill off the bacteria "although In vitro, resistance of P. acnes to commonly used antibiotics has been increasing".

As we have seen, the pharmaceuticals have their own somewhat unpleasant side-effects.  The use of antibiotics is also dangerous leaving us open to the destruction of the intestinal flora and the possibility of food allergies or allergies to other things. 

As a purely anecdotal piece of non evidence, my sister-in-law started with acne rosacea, was given antibiotics, which only produced a result after 9 months [!] after the original stress had gone which caused it, and is now allergic to all insect stings in that she has to carry ephedrine because they can induce anaphylactic shock.

So much for symptom based medicine.

Cause based treatments

Go for vegetables - no fatty or sugary food - however tempting!!

Find the cause.  Is it the pharmaceuticals?  If so stop the pharmaceuticals.

Is it stress?  If so help yourself by using the suppression activities I have on the site.

All contribute and help.

Is it the parasites?  Get yourself checked using swabs.  If your skin is very greasy this may be a clue!

A high glycemic load diet is associated with worsening acne, but does not cause it. It is possible that a fatty diet simply results in more exuded fat – more sebum.  Thus there is every reason to adjust your diet to exclude too much fat [you need some] and to increase your intake of fuit and vegetables.  See Eating for health.  But balance is key, the aim is to not be nutritionally deprived!!

See also  Healing yourself for the options,  as well as the observations under the healing section below, where there are suggestions on other options that have worked.

The hormones must be rebalanced, which is one set of treatments and here the stress busting suppression activities should help [NO PHARMS!] and then the extra set of treatments aims to reduce the parasites where need be - naturally.  The objective is not to kill them all off - they are useful - but not in the numbers we might be supporting if we have acne!

Stop using make-up if you get an infestation

People with oily skin, or those who use cosmetics heavily and don't wash thoroughly, reportedly have the heaviest infestations. They are transferred by facial contact and are apparently more common in adults than in children. In some people, high mite populations can cause demodicosis and blepharitis, possibly due to a suppressed immune system, as such boosting the immune system is important. All these conditions are characterized by itching and inflammation of the skin and eyelids. High densities of Demodex have been found in people with the skin disorder rosacea

 

How it works

Why do people get hallucinations or other experiences with acne?  Acne does not of itself give you hallucinations or visions or out of body or near death experiences,  but the antibiotics and anti-acne pharmaceuticals used by physicians  to suppress the symptoms of acne do.  So the real cause of the experiences is the pharmaceuticals doctors have given you to supposedly 'treat' the condition.

Most of the healing observations seem to be based on boosting the immune system, although there are some methods of healing related to the gentle removal of the parasites.

 

 

 

Related observations