Acne Facts and Myths and Acne in the Adult Woman

Acne Facts and Myths
Myth: Acne is caused by dietary factors

What is Acne…Really?
    Acne is Genetic
    The Breakdown, The First Steps to Scars

Secrets of a Clear Complexion
    Soap
    Diet
    Rest and Stress
    Cosmetics
    Don't Be a Picker

Treatment Breakthroughs
    Vitamin A Conditioning Lotions
    Fruit Acid Skin Care Products

Acne Facts and Myths

Myth: Acne is caused by dietary factors
Fact: The only dietary ingredient that can aggravate acne, is an excessive intake of iodine, which causes acne impactions to flare up. top of page

Myth: Acne is caused by dirty skin, and wouldn't happen if you washed your face more often.
Fact: Acne comes up from below and is not related to dirty skin, nor can impactions be cleansed away by washing your face. One product that does help fight the acne bacteria is Vivant's BP Cleanser, a stabilized Benzoyl Peroxide Cleanser, which defuses down into the pore, killing the bacteria and irritating the pore so that the bacteria can no longer stick. top of page

Myth: I am too old for Acne
Fact: Stress and Hormones can cause flare-ups at most any age.
Stress causes existing comedones and impactions to break down, become inflamed and develop red nodules and pustules. Chronic Stress can increase hormone levels causeing more oil to be produced, and in predisposed individuals more cells become impacted and inflamed, especially in the chin area. the increase in adult female acne is in direct correlation with more women entering the work force, juggling work and home responsiblities. top of page

What is Acne…Really?

Acne is a devastating disease of teenagers and young adults. Some persons may not be troubled at all - until perhaps their mid-twenties. More or less 80% of teenagers have some pimples, and 20% develop severe scars that may permanently change their whole lives. The "usual treatment" is no longer the best treatment for these acne suffers.
An explanation of how acne develops will illustrate what it is. Acne begins in the follicles.

At puberty an increase in circulating male hormone is taken up in the oil glands of the face. More oil (Sebum) is produced. About fifty percent of this sebum is triglyceride or ordinary fat, which nourishes the bacteria Corynebacterium acnes (C. acnes) which can be found in the follicles shortly after a person is born. These bacteria multiply greatly at puberty. top of page

  Acne is Genetic

C. acnes-a living organism-produces an enzyme which it uses to split triglycerides into the fatty acids and glycerol. Glycerol nourishes the bacteria while fatty acids remain as by products. Although these fatty acids are aggravating factors, the severity of acne is not directly related to the numbers of bacteria present in the skin on the extent of triglyceride breakdown. Increased sebum production and increased triglyceride breakdown occur in every person at puberty. However, the pores of each person react differently to these irritating fatty acids. This reaction is genetically inclined. Some individuals react violently, developing acne, other don't react at all.

    The first step towards acne is the retention in the follicle wall of cells which are normally shed and washed away. During the acne process, cells proliferate at an increased rate near the opening of the sebaceous ducts. This retention of newly formed cells - medically referred to as retention hyperkeratosis - is the important event in the acne process. Interestingly, predisposition to this retention is inherited. In Short, acne is genetic. The increase in oil at puberty, along with more C. acnes and more fatty acids is important, but the unique factor is the sticking or sludging up of dead cells in the pores in certain families. If both parents had severe acne, you too, will probably have significant acne. If nobody in your family has had acne, chances are your case will be mild. Exceptions occur, but they are rare. top of page
  The Comedo
Whiteheads and Blackheads
   Several thousand cells may sludge up the follicular canal, building up a closed comedo, known sometimes as a whitehead. The opening of the whitehead gradually enlarges, becoming a blackhead.
    In some, the face remains studded with numerous closed comedones (whiteheads) that never open. On the other hand, the lining of comedo, or sac, may break down. top of page
  The Breakdown
First steps to scars
   White bloods cells, the body's police-scavengers which attempt to engulf and destroy harmful intruders (such as bacteria), stream into the trouble spot and dissolve the follicle lining. The sea of inflammation finally erupts at the surface as a pustule. The result may be a permanent scar.
    As with all human diseases, the pathological process may differ from individual to individual. Some patients, for example, have predominantly superficial open and closed comedones; others develop large inflamed acne lesions, such as cysts. These types of reaction patterns also run in families. Some families have predominantly whiteheads; other, less fortunate, are cysts. top of page

SECRETS TO A CLEAR COMPLEXION
  Soap

Most soaps only clean the surface of the skin but, as you know by now, the acne process develops about two millimeters below the surface- beyond the reach of most soaps.

The exception is benzoyl peroxide cleansers. Benzoyl peroxide penetrates in the pores and kills the C. acnes bacteria.

Some benzoyl peroxide cleansers use polyethylene granules to increase the deep cleansing action. This type of cleaner is recommended and should be used twice daily. It is also effective as a shampoo for oily scalp or as a total body deodorant soap. top of page

Diet

Dietary factors do not appear as important as previously believed. There is no concrete evidence that chocolate, for example, always makes acne worse. The one exception is excessive iodides (or iodine). Iodides are excreted through the oil glands and they irritate the lining of the skin pore, flaring up acne. Avoid multivitamins that contain iodides and also certain seafood such as kelp which are high in this mineral. A "junk" food diet high in sugar and caffeine may produce stress and flare up acne. Three meals a day consisting of well-balanced diet of fresh fruits and vegetables, fish and poultry are best for general good health. top of page

Rest and Stress

Adequate rest is an important factor in combating acne. Unfortunately, the modern economics of getting an education often dictate that an individual be a full-time student as well as maintain a full-time job. Under these conditions and without adequate sleep (eight to nine hours a night), acne frequently flares up and is very difficult to treat successfully. Severe stress during school exams or trying personal problems may cause acne flare ups.

For best complexion, study every day and do not cram for exams. Avoid late night television and sleep eight hours every night. top of page

Cosmetics

Many cosmetics contain derivatives of fatty acids which are actually more potent producers of acne than the fatty acids themselves. Consequently, many women develop acne cosmetica, a condition usually characterized by many open and closed comedones. The use of cosmetics over acne is unwise, unless specially-formulated cosmetics are selected. For more details read the Acne Research Institute's pamphlet; Let's Talk Cosmetics. top of page

Don't Be A Picker

After initiation of acne treatment program, comedones tend to move closer to the surface of the skin and can be easily extracted. The patient can gently extract the mature lesions but DON'T PICK! You may drive the lesion deeper or cause a skin infection. Use ice compress instead of your fingernail. top of page

Active Cooperation Heals

Strange as it may sound, without the patient's help in actively carrying out his or her own course of treatment for his or her own acne, no program can hope to guarantee successful treatment. Be a good patient, read all the instructions closely. top of page

Treatment Breakthroughs

Whatever the severity, the way to control acne is to interfere with retention of newly formed cells in the skin pore. That means stopping the skin cells from sludging up or sticking in the first place. Over the years traditional drying lotions irritated and peeled the surface skin but often did little to cause peeling down inside the pore.

Oral antibiotics such as tetracycline became popular acne treatments in the 1960's and '70's. Their purpose was to kill the bacteria, C. acnes, in the pores. When you flush the whole body with tetracycline, a small portion does end up in the pores and kills some bacteria. But killing a fraction of the bacteria is not enough to help most patients. top of page

Vitamin A Conditioning Lotions

In 1969, Dr. Fulton and Dr. Kligman co-developed Retin A®. The vitamin A solution was a breakthrough in the topical treatment of acne. With daily application, new skin cells formed rapidly in the pores of the skin. These pushed out old acne impactions and the acne improved. However, there was excessive skin peeling and sun sensitivity in some cases.

A newer product, Derm-A-Gel®, uses a milder formulation of vitamin A. The peeling is not so troublesome and the sun sensitivity is not so great. Within three to four weeks of use the complexion begins to improve. top of page

  Fruit Acid Skin Care Products
    While Dr. Fulton and Dr. Kligman were developing vitamin A conditioning lotion, Dr. Van Scott was developing alpha hydroxy acids (fruit acids). The two most popular, glycolic acid and lactic acid, are useful additions to your skin care program. When used daily these acids speed up the removal of dead skin cells, leaving a smoother complexion. Exfol-A® lotion contains both the vitamin A and alpha hydroxy acid conditioners and is often use for the more severe complexion problems. top of page

ACNE IN ADULT WOMEN
Aggravating Factors            Occurrence

Family History	111/150 (74%)
Incidence of Teenage Acne	106/150 (70%)
Stress	113/150 (75%)
Menstrual cycle	72/106 (68%)
Excoriations	80/150 (53%)
Pregancy	19/55 (35%)
Oral Conteceptives	24/84 (29%)
Cosmetics	31/150 (21%)
Drugs	3/150 ( 2%)
Sunlight	2/150 (1.3%)
Diet	1/150 (0.7%)
Climate	0/150 ( 0%)
Season	0/150 ( 0%)

Of the 55 patients who had experienced pregnancy 19 reported an acne flare up during that period.
Of the 84 patients using oral contraceptives, 24 reported an acne flare up during use.

...Until recently acne was predominately a problem of teenage and young male adults...however this pattern seems to be changing. We are confronted with an apparent increase in the the incidence of acne in adult women, many of whom have continued to have mild to moderate acne conditions well into their 20's, 30's and even 40's. So in the summer of 1998 we conducted a study to explore the possible causes of this phenomenon.

If you would like to receive a complete copy of the results of this study Please e-mail us with your name, business name and address. customercare@vivantskincare.com.