Acne is a chronic and inflammatory skin condition that affects most people at some point during their life. If not treated in time, acne may cause permanent skin damage through skin thickening and irreversible dilatation of blood vessels as well as formation of cysts.
Acne involves the skin sites where the hair originates; hair follicles, and the sebaceous glands. Acne typically appears on the face, neck, upper chest, back and the shoulders.
Due to its effect on the external appearance, acne can also cause psycho-social problems such as: decreased self-esteem/self-confidence; problems with body image; embarrassment leading to social withdrawal; depression, anxiety and anger; preoccupation with the acne; confusion/frustration with treatment; limitations in lifestyle and difficulties with family members.
It is important to seek treatment, and should not be dismissed as something purely cosmetic or trivial.
Causes of acne
The increased production of the hormone androgen in puberty triggers a higher production of sebum by the sebaceous glands in the skin. The sebum is a natural subtract for bacterial growth, and allows the bacteria to increase dramatically in numbers, especially Propionibacterium acnes (P.acnes). The sebum is transformed by P. acnes into both free fatty acids, and other chemicals that produce the inflammation process.
The combination of increased androgen and pro-inflammatory chemicals causes a higher cohesion of the epidermal cells in the pore areas. This action forms what are commonly known as pimples – the characteristic lesions of acne.
There are closed and open pimples: a closed pimple is a closed pore with a tiny plug. An open pimple, also known as a blackhead, is also a closed pore with a larger follicular plug. Blackheads are not dirty. The dark colour is due to increased skin pigment and the sebum contacting the oxygen present in the air. The plugged pore can become swollen and inflamed, resulting in a pimple of minor or major proportions. The leakage of the follicles, in the surrounding skin, produces more inflammation, and creates other lesions of acne, such as cysts, pustules, and abscesses. Cysts are hard and deep closed pimples which can lead to scarring (acne scars).
Problems can include minor pain, itching, or mild soreness, and sometimes even pain in the joints.
Symptoms usually starts before puberty, or at the onset of puberty, but it can also begin in adulthood or even in elderly people. 40 per cent to 54 per cent of men and women older than 25 years have some degree of facial acne which can persist into the middle age. At the age of 18, it is more frequent in men than women. Beyond the age of 23 it is more common in women. The severe inflammatory form of acne is more often found in men.
Western medical view
Acne is a form of infection/inflammation, therefore antibiotics are used as the main treatment in Western medicine, which can be effective in short term. However, it often recurs after treatments stop and many are reluctant to stay on antibiotics long term for fear of their side effects. The cause of acne is unknown in Western medicine. Tests for hormonal imbalances can be carried out as part of the diagnosis. Skin biopsy is also used to differentiate from other possible diseases.
Chinese medical view
Acupuncture has been shown to have a therapeutic effect on acne vulgaris according to the World Health Organisation*. Treatments in Chinese Medicine include acupuncture and Chinese herbs.
According to Chinese Medicine theory any skin disorder is primarily the result of an imbalance within the body, particularly the internal organs. This imbalance can cause reactions in the skin to external pathogens. In CM theory, acne is associated with the Lungs, Stomach , Intestines and Blood and is caused by one of the following: heat in the lungs; blood stasis, damp or heat in the stomach and intestines.
After examination, the Chinese Medical doctor will prescribe Chinese herbal medicine as well as Chinese herbal lotions to complement the herbs. In cases where the patient does not respond to herbs, other therapies such as ear/body acupuncture can be used as natural treatments.
The length of treatment depends on the extent and the duration of the symptoms. The minimum course is normally 4 weeks although in some cases treatment can last a lot longer.
To stop or prevent acne, factors that you should take into consideration are:
- Unbalanced diet
- Irregular eating
- Over-consumption of spicy and oily food
- Over-consumption of alcohol.
Other factors which can contribute include stress/anxiety, chronic constipation and hormonal imbalances (acne rosacea is often seen in menopausal women).
In female patients, severity of symptoms may relate to menstrual cycles. In general you should avoid spicy, greasy and sweet food, eat plenty of vegetables and fruit, and ensure regular bowel movements.
Early treatment can prevent complications such as scarring. Long periods of exposure to the sun can aggravate your skin. Do not abandon treatment before the doctor indicates it is safe to do so.
For personalised advice on diet and lifestyle to stop or prevent acne, please ask the doctor during your consultation.
Please be reminded that we offer free online health advice.
+ *Clinical trials
Li HQ et al. [Acupuncture treatment in 42 cases of acne vulgaris.] Chinese Acupuncture and Moxibustion, 1998, 18(3):166)
Wang J et al. [Auriculo-acupuncture treatment of 32 cases of facial acne vulgaris.] Shanghai Journal of Acupuncture and Moxibustion, 1997, 16(3):25) [in Chinese].