Having stubborn acne, how to get rid of spots?

What is acne? What causes acne? Acne is a disorder that occurs in the hair follicles in the face, chest and back. This is known as black heads, white heads, pimples, pustules and cysts on the skin. It is a common condition in teenagers and younger adults. Acnes can be on and off for a few years and disappear by mid 20s. Acne can have a big impact on psychological well-being.

Acne is thought triggered by hormone imbalance. Too much androgen secretion is the major trigger. Changing of hormone levels makes glands in the skin produce excessive amounts of an oily substance- sebum. Increased male hormone stimulates the oil gland attached to the hair follicles-small holes in the skin. Increased male hormone alters the oil production which causes the follicular pores clogged and hair follicles enlarged. Bacteria can access to the deeper layers of the skin through these follicles causing inflammation. Inflammation closed to the skin surface causing a pustule; inflammation in deeper layer leads to pimple and a cyst. And sometimes scar can form from abnormal wound healing following inflammatory damage. White head is caused by oil clogging to the skin surface while black head is caused by oxidized oil or accumulated melanin pigment. The factors that don’t cause acne include heredity, food, dirt, or stress.

Acne vulgaris (acne) is a chronic condition that begins in adolescence and can last over 10 years. Globally, acne vulgaris affects 85% of individuals aged 12 to 25 years. The condition affects 80% of people in the United States at some point in their lives. 25% of women over 30 are still experiencing acne. Acne is characterized by inflamed and noninflamed comedones, oily skin, and cysts.

From Traditional Chinese Medicine point of view, there are several factors causing acne: heat and damp is accumulated in lung and stomach meridians causing skin blockage. Spleen dysfunction makes food transportation, digestion and transformation abnormal and produces more heat. This also makes obstruction in the skin.

Acne has great impact on quality of life

Acne is a very common disease in adolescents. Acne has great impact on quality of life. A study involved in 600 high school students investigated this aspect. There were 303 girls and 260 boys aged between 13 and 19. 83% of them was self reported acne. 40% was mild, 36% was moderate and 6.5% severe. This was correlated with dermatologist’s assessment. Acne was more prevalent and severe in boys than girls. There was a direct link between subjective, severety of acne and symptoms of anxiety, depression and lower self-esteem.

Stress makes acne worse

Psychological stress has also been identified amongst factors that worsen acne. Recently a study involved in 160 students was carried out to investigate the association between acne severity and stress levels as well as the mechanism for this. They demonstrated a statistically significant positive correlation between increased self-reported stress and increased severity of acne; there was no correlation between increased stress and sebum levels. They explained that increased acne severity may result not from increased sebum secretion and excretion but from changes in neuropeptide secretion and sebum lipid composition. Other studies have shown that stress may affect the production of inflammatory mediators and specific lipids involved in inflammation by the sebaceous glands rather than the quantity of sebum.

Acne nodules, cysts and acne scarring

Acne nodules and cysts are the most severe type of acne. Nodules are large hard lumps that build up beneath the surface of the skin and can be painful and cysts are large pus-filled lumps. The nodules and cysts and surroundings are inflamed and become red. The nodules and cysts are very destructive to the skin and deep tissues and carry the greatest risk of causing permanent scarring. They can be there for long time and are difficulty to treat which is very upsetting and depressing. Acne scarring can sometimes develop as a complication of acne. Any type of acne spot can lead to scarring, but it's more common when the most serious types of spots (nodules and cysts) burst and damage nearby skin.

When you have pimples on the face, you want to pop them to make them go. But popping a pimple is not a good idea. It causes a disruption in the skin, it increases the chance of infection, worsening inflammation and even scarring, especially repetitively picking/scratching at acne pimples could lead to not only infection but scarring and possibly permanent change in pigment. If you have painful cystic acne, avoid popping it at all costs. Squeezing the contents of acne cysts through their small opening creates pressure, this pressure can rupture the cyst inside, creating a severe inflammatory reaction and possible infection that will likely require drainage and taking oral antibiotics.

Acupuncture reduces inflammation and is used to treat acne effectively. Acupuncture can effectively treat acne nodules and cysts and reduce acne scarring formation and make the skin smooth. Have you tried acupuncture?

There was a study using acupuncture to treat acne. In this study the criteria of participant selection is that they (older than 13 year old) had more than 10 papules and less than 10 nodules on the face and had acne for more than 3 months (chronic stage). They did not use retinoids, antibodies or herbal medicine for acne before. They did not have chemical peeling, intense pulsed light or laser treatment within the past month. After 6 week treatments, there was a significant reduction in the inflammatory acne lesion counts. They suggested that acupuncture treatment of moderate acne vulgaris was associated with reduction of inflammatory lesions and improvement of the quality of life. The significant effects can be obtained in 6 weeks.

There were many case reports that acupuncture can treat acne. For example, Son BK et al studied the effect of acupuncture on acne. They found that 12 sessions of acupuncture over 6 weeks reduced inflammatory lesion counts and quality of life in patients with acne. Recently Li B et al studied the current situation in research to evaluate the therapeutic effect and safety for clinical randomized and controlled trials of treatment of acne with acupuncture and moxibustion in China. They analysed 17 papers involving 1613 cases with acne and they found that acupuncture and moxibustion is safe and effective for treatment of acne and it is possibly better than routine western medicine.

Here is an example of a case. Lily is 30 year old. She had acne on her face on and off for 6 months. There are many newly formed pimples, cysts and some of them are infected by bacteria forming pustules. Scars can be seen on her face. She also had mouth odour and constipation. She heard from a friend that acupuncture may help her and wanted to try acupuncture. After a course of acupuncture, the acne symptoms were improved significantly. Also mouth odour was improved and there was no constipation at all. After 3 courses of treatment, acne was cured. 

Study has shown that acne patients used antibiotics too long

Acne is not a life threatening condition, however it affects patients quality of life so much. The spots take their happiness away. Women cannot go out without covering the spots up first. They often use over-the-counter creams, prescription gels, and finally: oral antibiotics. Antibiotics was used too long and increased the antibiotic resistance makes antibiotics loss their effects. A research study at a dermatology practice in an academic medical center has shown that the average duration of antibiotic use was 331.3 days. In all, 21 patients (15.3%) were prescribed antibiotics for 3 months or less, 88 patients (64.2%) for 6 months or more, and 46 patients (33.6%) for 1 year or longer. Patients treated only at the study site had a mean duration of antibiotic treatment of 283.1 days whereas patients who also received antibiotics from another institution had a mean duration of 380.2 days.

Acupuncture has better effect for treating acne than oxycycline

A study has compared the efficacy differences between acupuncture and oxycycline tablets for the treatment of moderate to severe acne vulgaris. Sixty cases of moderate to severe acne vulgaris were involved in this study and they were divided into acupuncture group and medication group with oxycycline treatment). The treatment duration was 20 days. The fading time of skin damage, including papule, pustule, nodule and cyst in the two groups was recorded and clinical efficacy was compared. After the treatment, two-month follow-up was performed to observe the recurrence rate in the two groups. The results have shown that the curative rate was 69.0% (20/29) in the acupuncture group, which was significantly higher than 40.0% (12/30) in the medication group. The fading time of each type of skin damage in the acupuncture group was shorter than that in the medication group. Recurrence rate was similar between two groups.

References

Li B et al Zhongguo Zhen Jiu (2009) 29:247-51

Son BK et al Acupunct Med (2010) 28:126-9

Gong and Qian J Tradit Chin Med )2007) 27:255-7