Even Skin Tone: Acne - The Battle is On! - Part 3

Acne can do some pretty funky things to your skin. I developed acne in my mid-twenties and still have outbreaks more than ten years later. I tried some stupid and scary skin-fix remedies in an effort to control breakouts and to control the constant oil slick on my face. Some worked short-term but I believe caused long term damage.

The Problem.

Acne or Acne vulgaris, is an inflammatory skin disease that occur on the face, shoulders, chest and back.

One of the main causes of acne is associated with testosterone/androgen hormones which is produced at puberty and is found in women as in men. Hormones can trigger the sebaceous glands which produce sebum. This is not a bad thing, sebum makes the hair shaft flexible and moisturizes the skin but it also makes the skin more greasy. When the skin has an excess of sebum around a hair follicle or pore it can be come clogged. Propionobacterium (a bacterium bug) that normally lives on your skin can thrive in the blocked pore resulting in an infection that may cause inflammation. The inflammation is what causes redness and swelling of acne. In some severe cases a pore can rupture and cause scarring.

The Anatomy of a Pimple.

Cells that line the follicle are shed too quickly and begin to clump together. Excess sebum sticks to the dead cells and forms a plug, or comedo (also called comedones), that blocks the pore, which is not usually seen. When the follicle begins to bulge and show up as a small whitish bump mostly under the skin, it is called a whitehead. If the comedo opens up, the top surface of the plug darkens, and it is referred to as a blackhead. Pimples are the result of infected blackheads or whiteheads that rupture, releasing sebum, bacteria, dead skin, and white blood cells onto the surrounding tissues.

Some common factors that cause or aggravate acne flare-ups are hereditary, environmental factors, disease, drugs and cosmetics. A common but unfounded myth is lazy personal hygiene causes acne breakouts. What can cause flare-ups is a too-aggressive approach to cleaning your skin in an effort to get rid of the over-production of oil. This can actually cause an over-production of oil and make a bad situation worse.

Acne can be mild, moderate or severe. Mild is usually represented by the occasional whitehead or blackhead and may sometimes include a pimple or two. Moderate acne is characterized by pimples and pustules that pop up on the face. Pimples may also occasionally appear on either the back or chest or both. Severe acne is characterized by many nodules that are usually large and sore and appear on the face as well as the back, chest and other parts of the body. (I got them on my face). Severe acne will most likely leave scars, however if not treated correctly, all forms of acne can leave scars. If you suspect that you have nodular acne, discuss the situation with your dermatologist as soon as possible.

One thing that acne is not; it is not caused by eating french fries, pizza, chocolate, candy and other other greasy foods. This does not mean you can rush out for a grease and sugar cocktail. A healthy diet and lots of water which flushes toxins out of your system, is still a good bet for better skin. Water also helps to regulate body functions in all your organs (skin is the largest organ, the integummentary system) and helps to shed and eliminate dead cells faster.

Lazy personal hygiene is less of a culprit for breakouts than over zealous scrubbing. Aggressive scrubbing with harsh products such as products that contain crushed fruit pits, can create small scratches on the skin, over-stimulate sebaceous glands and at the end of the day, increasing oil production and exacerbating the problem.

While a outbreak can occur anywhere on your face (or other areas for some people), the T-Zone is the most acne prone area of your face. The T-Zone starts from the middle and sides of the forehead and extends down the middle of the nose including a little bit of the sides of the nose and goes down to include the chin.

One of the major reasons acne occurs in the T-Zone is because this area is touched the most, usually with dirty hands. The quick and easy cure for this is to stop doing that! We touch our face usually without realizing it so many times in a day that we are causing dirt to spread on the skin which can result in an acne flare-up.

The Fix.

Vitamins. The best source of course, is in a healthy and balanced diet. If you don't eat right, vitamin supplements are a must. Vitamins A, B Complex, C, and E are the heavyweights that can help control flare-ups. Retinol is a derivative of Vitamin A which is used to reduce sebum production and control acne. Retinol also helps reduce wrinkles.

Vitamin B Complex has anti-inflammatory and humectant properties, metabolizes fats and reduces oil production. B Complex include the vitamins B3, 5, 6, and 12.

Vitamin C has antioxident and anti-inflammatory properties that helps prevent recurrent acne and may help repair acne scarring.

Vitamin E is another antioxident that may also help to heal scar tissue.

Probiotics/prebiotic foods can also help you treat your acne at home and helps to reduce breakouts while taking acne drugs such as Tetracycline, Doxycycline and Clindamycin. Foods such as honey, bananas, onions and artichokes are probiotic and added to your diet while taking antibiotics replaces the helpful bacteria in your system that is depleted while taking antibiotics. Be aware that all antibiotics can cause candida vaginal yeast infections in women. Tetracycline most frequently has this side effect.

Prescribed Medications.

Accutane is one of the best treatments available for acne. Accutane contains retinol which is a vitamin A derivative and is considered one of the most potent treatments for acne. It is also a very effective treatment for severe acne. Some people may experience side effects with Accutane, but the majority who use it report positive results.

Anti-androgens is any substance that inhibits the production of adrogens. Oral contraceptions are anti-androgens and are used as acne treatments effectively reducing oil production and reducing the hormones that enable the formation of comedones (the plug of dead cells and sebum that cause pimples).

OTC Treatments.

Over the counter treatments can be very effective in treating acne. Over the cunter acne medications work as exfoliative agents and dry out pimples. It doesn't make sense to try to list all of the over the counter acne medications here but there are some basics that you should know in order to choose your weapons selectively.

Acne medications that include salicylic acid are good for people with sensitive skin. The amount medication used in these medications are measured percentages and the stronger creams and gels will obviously have stronger concentrations of the active ingredient. Choose products that have the percentage of the active ingredient listed and complementing carrying agents as the first few ingredients on the ingredients list printed on the packaging.

Salicylic acid renews skin and unclogs pores. Salicylic acid is an exfoliative agent that removes the dead cells of the skin and helps the skin to regenerate faster and thus it decreases the blockage of the pores and formation of acne pustules and blisters preventing flare-ups.

Benzol peroxide kills the bacteria that causes acne. It acts as an antiseptic and oxidizing agent, and reduces the number of blocked pores. In 80 years of use, there has been no bacterial resistance to benzoyl peroxide; it is the cornerstone of acne therapy.

Tea tree oil and green tea cream are two herbal products that are claimed to work well in the treatment of acne. Tea tree oil and green tea cream can be found at any store that sells wholistic products.

Even though acne for the most part only lasts until the beginning of adulthood, it tends to leave life long scars - pockmarks and craters. The procedures used to eliminate these scars are numerous. Some were mentioned in Even Skin Tone - Pore Perfection - Part 2 of the Even Skin Tone for the Tone Deaf six-part series that discuss products and procedures that eliminate dark spots (hydraquinoine) and other skin imperfections. Dermabrasion involves abrading the skin resulting in the removal the top layers with a electrical machine. When the skin heals from the procedure it looks smoother and fresher. A chemical peel minimizes the appearance of acne-damaged skin. Laser resurfacing uses high-energy light pulses to burn away damaged skin. Laser resurfacing is also used to minimize wrinkles and fine scars. Another procedure that is used is punch grafting. The dermatologist uses small skin grafts to replace scarred skin. Here is how punch grafting works: a hole is punched in the skin to remove the scar, the hole is then replaced with unscarred skin usually taken from the back of the ear lobe. Punch grafting is usually used to treat deep acne scarring. All of these procedures should be performed by a liscenced dermatologist.

At the end of the day, as in all things, common sense is the best defense. Arm youself with knowledge and don't harsh out your skin with products such as alcohol, and abrasives (microdermabrasion, notwithstanding). Yeah, they'll dry the oil on your skin, but they will also get your glands going into overdrive and you'll end up spending most of your time battling the acne you helped to create by driving your sebaceous glands nuts! Gentle, regular cleansing with products that control oil and kill bacteria should be a basic first step in your skin care regimine. For acne conditions that is more serious than a mild case should be taken to your dermatologist. If any product claims to cure acne, put it back on the shelf. There is no known cure, only treatments--very effective treatments but, treatments only.

Even Skin Tones - Pore Perfection - Part 2

Enlarged pores are a fact of life and a problem for many women. We spend millions a year on products to transform our skin to rival images we see in Glamour, Elle, and Cosmo. Unfortunately, what we see on magazine covers is not reality, its airbrushing. Yet we strive to attain the ‘poreless’ look usually with not a lot of luck. It is what it is: real life. Generally there is not a lot that can be done to permanently reduce the size of our pores. And that’s ok, there is an upside. Our pores are from where our hair grows and makes it shiny. They secret oil to protect the skin surface, they serve as an outlet for sweat to help to regulate our skin temperature. The pores in skin also serve as a waste filtering system that gets rid of toxins in our systems.

Genetics play a large part in determining your skin texture. Thick, oily skin is typically characterized by larger pores more so than skin that is dry. There are scads of products on the market to improve the appearance of large pores, refining them and making them look smaller. Some of these products actually do provide a temporary fix, some just make other people richer.

The Problem

Over-active sebaceous glands. Oil is a good thing and a not so good thing. The good thing is that it does protect and lubricate our skin. When produced in reasonable, manageable amounts it helps to give a healthy glow to skin. The not so good thing is our sebaceous glands can be over stimulated and create excess oil that we have to ‘mop’ up. Pores can become clogged with dead skin cells that are not properly exfoliated , the dead cells stick and collect on the skin and becomes an all-you-can-eat buffet for bacteria. The bacteria sit and eat and causes irritation that leads to pus and redness, which usually then lead to pimples. It just becomes a real mess.
Sun exposure (again) can cause enlarged pores. UV rays break down collagen which weakens the tissues that surrounds the pores and ultimately and permanently enlarges them. This makes the case for using sunscreen on a regular basis if the previous post on hyperpigmentation doesn’t.

Digging and picking creates way more problems than it solves. Blackheads and white heads are collections of dead skin cells. To try to squeeze or pick them out of the skin/pore only increases the likelihood that you will only increase (permanently) the size of the clogged pore.

Lackadaisical skin care. It’s a lot of work; looking good. When oily, blackhead-prone skin is paired with inconsistent skin care, the battle waged will be never-ending and brutal. Dead skin cells can gather around the edges of the pores making them look larger than they really are. Overzealous, random cleanings does more harm than good. Skin care should be consistent and approached with a gentle hand. Taking a hand sander to your skin is not going to help. Gentle, consistent exfoliation will.

The Fix

AHAs and BHAs. Glycolic acid (hydroxyacetic acid) will help to reduce oil on the skin. Glycolic acid is a fruit acid or alpha hydroxy acid. Other alpha hydroxy acids include citric, lactic, malic acids. Over-the-counter preparations contain about 10% glycolic or other fruit acid. Dermatological procedures and preparations will contain from 20% in topical preparations up to 80%. These higher concentrations are generally used in chemical peel procedures. Over time, over-the-counter preparations can result in minimal improvement in the overall texture of the skin, but peels performed by an aesthetician or dermatologist will net greater overall results. A professionally performed procedure will not only rid the skin of the lipids that bind the dead cells together giving the appearance of larger pores, it will also correct hyperpigmentation, acne scarring and reduce fine lines and wrinkles.
BHA is the all-too-common salicylic acid. It is derived from the winter bark and sweet birch bark tree and has been used by dermatologists in treating acne for years.

The cause for sunscreen can never be preached too loudly or too often. UV ray damage causes a host of problems some minor some major. Of your reason for UV protection is only superficial, the bonus is you’re also guarding yourself against more serious conditions such as basal and squamous cell carcinoma. The lowest SPF rating you should use is 15. Many dermatologists and aestheticians recommend 30 SPF. At the very least, UV protection will help to guard against the breakdown of collagen that plumps up the skin, thus minimizing the appearance of large pores.

Blackhead extractors can and should be used if you cannot overcome the urge to pick them out. Blackheads are plugs of dead skin cells and oil clogging the pores. Picking at them will make it worse, I promise! But if you must, you should first steam your skin to loosen the oil and/or use a warm wash cloth to compress the area. Encircle the blackhead in the loop of the extractor and press until the clog dislodges. Do not apply too much pressure. If the clog cannot be dislodged, see your dermatologist. Too much force can cause irritation and scarring.

Consistent, common sense skin care is probably the easiest, and hardest habit to develop. Cleansing the skin twice a day goes a long way to ensure skin that is clearer and fresher looking. Exfoliating the skin regularly helps to slough away dead skin cells revealing fresh skin, keeps your pores unclogged which lessens the occurrence of blackheads and enlarged pores. Exfoliating cleansers include products that are granulated to aid in the exfoliation of the skin. Some work better than others. Natural products such as apricot may have jagged edges that can cause irritation. A washcloth is an ideal aid in exfoliating the skin. An oil-free cleanser is a must, a good toner is another product that should be used regularly as it can assist in the lifting of dead skin cells and to help close freshly cleaned pores.

Don’t sleep in your makeup. Cleanse your skin completely of makeup before you go to bed. Cells regenerate while you sleep. Your pillow also helps to exfoliate your skin (how about that!). Going to bed with a clean face gives your skin a fighting chance at keeping your pore size to its minimum diameter.

Hydration. A recent study suggests that drinking water does not aid in the overall health of your skin. I doubt the validity of the study and will only say that when in doubt, the worst H2O can do is quench your thirst. My own common sense suggests that since a majority of the fluids in our bodies is composed of water it has to have some positive properties that include helping to flush or cleanse and regulate the integumentary system (the skin).

For more detailed reading on this and other common skin conditions, go to http://www.dermadoctor.com/pages/newsletter90.asp

Even Skin Tone for the Tone Deaf

Because beautiful skin is so fundamental to creating the perfect canvas for your look, finding a good skin care system or program that works well for you warrants some time and attention. This is a 6-part series that will include common skin problems and some common, some not-so common and, some cutting-edge solutions that will give you your best skin yet.

Discovering your best looking skin is not as difficult as you might think. Beautiful skin or your best skin is not a one size fits all. But your skin can look its best with some objective expert information, a little discipline and products or procedures that work for you. A good skin care regime is your second step to your best complexion. The first step is knowledge. Before putting together a good skin care regime, you should first know what you’re working with. Specifically, there is no other skin like yours and so you should treat it as such. But, there are common skin types and common skin problems.

Hyperpigmentation and Excess Sun Exposure

The Problem

One culprit of uneven skin tone is hyperpigmentation or a mass of clusters of melanin in skin creating an uneven appearance. Age spots, melasma, and freckles (which are inherited) are examples of hyperpigmentation. UV rays can cause excess melanin to form deposits in the skin resulting in hyperpigmentation. Darkened skin patches can become darker or more pronounced when skin is exposed to the sun. This happens because melanin absorbs the energy of the sun's harmful UV rays in order to protect the skin from overexposure. The usual result of this process is tanning, which tends to darken areas that are already hyperpigmented.

The first and most important rule of thumb is to protect your skin against UV rays. Sun overexposure is a leading cause of skin damage. UV rays can damage all skin tones and skin types. If you think you’re safe because you have dark skin, think again. Dark skin is not your get out of jail free card. UV rays penetrate the skin (all races, all skin tones) and causes free radicals that damage skin cells and cause skin to repair itself more slowly which leads to premature aging.
You can’t shun the sun and become a vampire because you need the sun for your body to manufacture vitamin D which is actually a hormone that that regulates and helps to absorb calcium and phosphorus, but that is a whole other story. Bottom line is you still need the sun, but over exposure can cause potentially serious health problems such as skin cancer. The happy or satisfactory medium – broad-spectrum sun screen.

If you already have superficial damage changing your habits may help to offset the damages of sun exposure. Whatever your skin type, a regularly applied broad-spectrum sunscreen is good protection against blotchy, blemished skin and photo-aging. The recommendation is 15 SPF. Some dermatologists recommend at least 30 SPF.

The Fix

Hydroquinone

There’s more than one cause of skin discoloration. Fortunately, bleaching remains the same regardless of source of the darkness. There are products and procedures on the market that can reverse the effects of damaging UV rays. Topical solutions such as fade creams with hydroquinone work well and are inexpensive. DERMAdoctor.com has articles that provide detail on bleaching or fade creams with hydroquinone and a wide variety of other bleaching solutions that may work for your skin.

Trichloro Acetic Acid
Can erase superficial discoloration and fine lines. Trichloro acetic acid is the most common chemical peel . TCA peels provide an intermediate solution that can last from six months to two years. It is a chemical so it will burn. Your dermatologist will apply iced saline and burns for two to ten minutes. It takes 15 to 60 minutes for the dermatologist to perform the procedure. Chemical peels cannot correct deep sun damage. For more detailed information on chemical peels go to http://www.infoplasticsurgery.com/facial/peels/TCApeels.html

Microdermabrasion
Microdermabrasion uses mechanical abrasion from jets of zinc oxide or aluminum oxide crystals, fine organic particles, or a roughened surface. Particles and removed material are vacuumed off through the wand through which the abrasive particles come. It is also effective in removing sun-damaged skin and dark spots on the skin and scars left from moderate to severe acne. The procedure is not very painful and requires no anaesthetic.