What causes acne and how to treat acne

In the Western world, acne is estimated to affect 75-95 % of the adolescent population, 40 – 54 % of individual older than 25 years, and 12 % of women and 3 % of men of middle age.

So what is going on ?

Three steps to a giant size pimple (zit)

Three things need to be going on simultaneously for a pimple eruption to occur.

Factor 1

The sebaceous follicles, which are really just little sacs in the skin that squirt out oil get blocked up. The reason they get blocked up is because something goes wrong with the outer layer.

Factor 2

There are extra male hormones around which increase the production of skin oils (sebum).

Factor 3

Propionoibacterium acnes can’t resist the oil pools. It pops in for a quick dip and soon there is a pool party going on – with hundreds of bacteria splashing about.

Eruptions and ructions

The neighbours complain and call the police to shut down the party. But the bacteria don’t go quietly, so the immune system needs to use force. In the process, things turn red hot and ugly. The end result a huge bright red carbuncle, which is not only horrific to look at but damn sore too.

The pool party is eventually shut down. The force of the intervention leaves lots of little bodies in its wake and so, the pimple changes from a red hot firey mountain, to yellow wasteland, filled with pus.

Banning the pool party

So if you don’t want to look like a spotty ogre – you need to prevent the pool party from happening.

So how would you stop a pool party ?

Keep bacteria out

One strategy would be to make sure no one gets near the pool – this is the thinking behind most scrubbing your face regularly. Keeping everything squeaky clean so the bacteria can’t get near the pool, should limit the number of pool parties that happen.

Sometimes this idea is taken one step further and a little more force is applied. Any one who looks suspicious and might stop by the pool for a swim is exterminated. Swallowing antibiotics or using creams which contain antibiotics, pretty much work this way. The antibiotic kills every bacteria in sight so there no one around, so the pools are absolutely deserted but other body parts may also end up depopulated in the process.

Drain the pool

The second strategy is to drain the pool i.e. remove all the oil. This is the thinking behind most of the products that treat acne on the market today, including the infamous roacutane.

Stop oil production

A final strategy is to stop excess oil production in the first place, by targeting the hormone imbalances. Therapies usually focus on getting the sex hormones balanced, because too much male hormone (androgens), is causing the oil wells to run. Girls can sometimes tame their sex hormones by taking an oral contraceptive pill. Boys options are limited, but fortunately the levels eventually subside.

The food for the pool party

No party is complete without munchies. So is there a relationship between foods and acne ?

Glycemic index, glycemic load : new evidence for a link with acne. J American College Nutrition (2009) 28(4):450S-454S. Bruno Berra, Angela Maria Rizzo

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