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Health Conditions

General Description 

Do zits give you fits?  Chances are, yes.  Acne is the most common skin problem affecting to some degree three out of every four teenagers.  And an imperfect complexion is not limited to this age group; many 20 and 30 year olds also suffer with this condition.  The problem is an expensive one, with millions of dollars spent each year on over-the-counter preparations as well as on prescription drugs.  For many, the acne process consists of nothing more than an occa­sional pimple or blemish on the face, back or chest.  A few are less fortunate and develop extensive, persistent eruptions eventuating in permanent pits and scars.  The psychological effects may be devastating.There are several different types of acne lesions. These include comedones (whiteheads and blackheads), papules, pustules, cysts, and scars. Comedones are of two varieties: open and closed. A closed comedone, called a whitehead, arises when a pore becomes clogged with oil and the sebum creates a tiny white covering over the entrance. When the opening remains unobstructed, the oil is oxidized by the air and turns black. This open type of comedone is called a blackhead.

A papule is a solid, elevated lesion of the skin. Papules range in hue from flesh-colored to bright red. Red papules are those pimples still undergoing inflammation.A pustule is a pimple filled with fluid, or pus. This substance is composed of dead cells and bacteria. When a pustule becomes larger and deeper, it is then termed a cyst. Tender, inflamed red pustules and cysts may result in scars, which is why these two types represent the most severe forms of acne.Acne - Cystic

Acne is a skin disease caused by the clogging of pores and an inflammation of the sebaceous glands and hair follicles which are on the face, neck, shoulders, back and chest. These glands produce too much oil, or sebum, become plugged and end up becoming whiteheads, pimples or blackheads. This sebum mixes with dead cells on the surface of the skin clogging the pores and causing blackheads and whiteheads. Bacteria around the hair follicles enter the skin if the whitehead ruptures causing a pimple. Squeezing the pimples can cause pitting and scars on the skin.

While we think acne is just a teenage problem, it is not uncommon for adults. Surprisingly, more adults have acne than teenagers. Acne affects more than 50% of adults between 25 and 49, compared to 25% of teenagers.

One form of acne is caused by a condition known as "skin hypoglycemia" or "skin diabetes." This means that the skin, which is an organ, is intolerant to sugars.

Causes

Acne appears to be the result of a number of factors; there is no single cause. Certainly a major factor is heredity. If one of your parents had acne, you run an increased risk of acquiring this condition.

Another contributing factor to the development of acne is the activity of certain hormones within the body. For many, acne first becomes a problem at puberty. During this period, testosterone, the male sex hormone, is formed not only by the male sex organs, but also in small quantities by the ovaries in young women. Testosterone promotes marked growth of the sebaceous glands and, in susceptible persons, may trigger or worsen acne.

Some women develop one or two pimples each month shortly before their menstrual periods. Others may flare when placed on certain birth control pills. In both cases, the resultant acne is due to changes in the body’s hormone levels. Polycystic ovary syndrome is characterized by irregular periods, excess facial hair, and scalp hair thinning. Abnormal hormone levels in women so afflicted results in persistent acne.

Another factor that contributes to acne is the bacteria that live within the sebaceous glands breaking down the skin’s natural oils into irritating by-products. These bacteria and the substances they produce play a key role in the inflammatory lesions of acne.

An increasing number of American women are developing acne not at puberty or in adolescence but during their twenties. This phenomenon has been attributed in part to the prolonged use of cosmetics. Certain moisturizers, creams, and cover-ups may contribute to pore plugging and consequently lead to comedones and papules.

Emotional upsets and stress also tend to worsen existing acne. Many high school and college students experience marked flare-ups during their exam periods.

Certain factors once thought to play a significant role in the cause and perpetuation of acne are now considered quite unimportant. No evidence exists that lack of regular washing leads to a worsening of acne. By the same token, acne does not appear to be improved by incessant cleansing. Washing two or three times daily is all that is usually needed to remove excess oil and germs on the skin’s surface.

Lingering controversy surrounding acne involves the role of diet. A diet high in fats and oils does not make the skin oilier; greasy skin is not caused by greasy foods. A scientific study conducted years ago was unable to demonstrate that feeding individuals with acne huge quantities of chocolate led to increased pimple formation. However, more recently, a link has been postulated between breakouts and high-glycemic-load diets that are rich in processed carbohydrates. Acne severity decreased in volunteers maintained on low-carbohydrate diets, but these diets also promoted weight loss, which alone may have triggered changes in body hormones that diminished the number of breakouts.Acne - Scar Formation

Speaking of hormones, yes, the role of milk in acne causation is also controversial. Again, a recent study found a positive association between milk intake and acne. Since the majority of milk comes from pregnant cows, a tenable hypothesis holds that hormones in milk have a stimulatory effect on the oil glands of those that drink it.

Medical Treatment

For most, acne merely represents a temporary embarrassment, while for some the condition constitutes a disfiguring disease. Regardless of the extent of involvement, virtually all cases should significantly improve with proper therapy.

Certain general principles are best followed when dealing with acne. As mentioned, it is advisable to wash the affected areas two or three times daily to remove excess sebum and bacteria from the skin’s surface. (It should be noted that excessive washing only leads to excessive dryness and irritation.) Acne cleansers and soaps often contain surfactants that facilitate oil removal. Cleansers containing benzoyl peroxide and salicylic acid are very effective. Cleansing pads containing the combination of salicylic acid and benzoyl peroxide are available (the prescription product Cleanse and Treat) as are pads containing glycolic acid and salicylic acid (Health911 Gly Sal pads). Defatting solutions known as astringents may aid in the temporary removal of surface film. Abrasive cleansers contain fine granules that are rubbed against the skin to produce a mild “sandpaper” effect. Such preparations will help reduce excess oil but can cause increased peeling and may prove too harsh for some persons; dermatologists discourage their use in the inflammatory types of acne. Nonirritating, noncomedogenic soaps are recommended for those with sensitive skin.

Persons with acne must strenuously avoid picking, scratching, squeezing, or otherwise manipulating their pimple-plagued skin. Unless properly instructed, leave all mechanical manipulations to a skin care specialist. The temptation is certainly great to force out pus-bumps and to pop zits. But such facial trauma, besides coating the bathroom mirror, may transform an ordinary pimple into a permanent scar.

Overzealous use of certain cosmetics may exacerbate acne. Many adolescent and adult women are heavy makeup users. Their day begins with the application of moisturizers, foundation creams, and coloring agents and ends with the smearing on of a night cream. Frequently one witnesses a vicious cycle. A woman with a few scattered pimples may try to camouflage their presence with makeup. This in turn leads to a flare-up of acne and to the subsequent use of an even greater quantity of cover-up. The cycle is broken when the woman is advised to stop using all cosmetics, although actual clearing may be delayed for many months. Fortunately most cosmetics now on the market are noncomedogenic, meaning “non-pore-plugging,” when used in moderation.

Sunlight often plays a beneficial role in acne treatment. Many people experience a considerable improvement in their complexion during the summer months. Of course, one must weigh this benefit against any harmful, long-term effects of ultraviolet radiation. And, as you will soon learn, some acne therapies do not mix with sunlight.

Persons with acne usually try over-the-counter acne preparations as first-line treatment. Active ingredients may include sulfur, resorcinol, benzoyl peroxide, salicylic acid, or alcohol. All promote drying and peeling and help limit bacterial growth.

Those who do not respond to the above measures should consider medical consultation. Dermatologists possess considerable knowledge concerning the nature and course of acne and have at their disposal a number of powerful therapeutic modalities to improve one’s appearance and—of equal importance—to prevent scars. Indeed, a good percentage of persons with acne require medical specialist treatment to prevent physical or psychological scarring.

Benzoyl Peroxide


OurHealth911 - BP 10% Wash with Aloe Vera – Moderate to Severe Acne Treatment Moisturizing Acne wash is a therapeutic combination of Benzoyl Peroxide 10% in a base of Aloe Vera Gel providing a mild lathering cleanser for the treatment of acne. Regular use minimizes oiliness, decreases surface bacteria and helps prevent pimple formation.

 Wash away signs of acne with Health911 - Mosturizing Aloe Vera Acne Wash.  Using daily with its combination of Benzoyl Peroxide and Aloe Vera  Gel will  assist in soothing irritated skin. Effective cleansing and moisturizing action in a soap-free base. Formulation which is pH balanced and oil-free.

The addition of penetrating, acne-fighting ingredient Benzoyl Peroxide 10% fights acne-causing bacteria for a clearer face, enhancing tone and texture and minmizing those ugly zits.

Specially formulated for mild to moderate acne-prone skin.  Contains 10% Benzoyl Peroxide in combination with Aloe Vera Gel.

One of the mainstays of acne therapy is application of benzoyl peroxide. Preparations containing this substance promote facial drying and are antibacterial leading to rapid reduction of inflammatory lesions.

Benzoyl peroxide is formulated in a number of concentrations ranging from 2.5 percent to 10 percent. In general, one should start therapy with the lowest concentration. The major side effects encountered with this product are excessive dryness, irritation, and allergic reactions. As these untoward reactions increase with higher concentrations and several studies have failed to demonstrate significantly improved efficacy with higher dosing, most individuals are best maintained on lower strengths. Individuals with sensitive skin may not be able to tolerate this compound, and it should be noted that benzoyl peroxide will stain clothing.

Certain benzoyl peroxide preparations are advertised as cosmetics and may be purchased over the counter (i.e. Health911 Acne Wash, ProActiv). Other preparations are marketed strictly as drugs and must be obtained by prescription only (examples include Benzac, Brevoxyl, Cleanse & Treat and Triaz). The rationale for this somewhat nonsensical dichotomy rests with the FDA.

 Benzoyl peroxide is a potent oxidizing agent that kills germs on contact. Unlike with antibiotics, bacteria do not develop resistance to this agent.

Sulfur

Sulfur-containing compounds have been used to treat acne since the 1800s. Sulfur has anti-inflammatory activity, and many formulations have a distinctive odor. As with benzoyl peroxide, some sulfur-based products are available over the counter while others require a prescription (Avar, Klaron, Plexion, Rosanil, Rosula, and Sulfacet-R. Nuox gel is a prescription medication that combines benzoyl peroxide and sulfur).

Retinoids

Another modality commonly used to treat acne consists of the topical application of vitamin A derivatives called retinoids (examples include Atralin, Avita, Differin, Retin-A, Tazorac, and Tretin-X). These substances possess comedolytic properties;    they dislodge dried sebum and help keep the pores open. There is increasing evidence that retinoids may also exert a direct anti-inflammatory effect upon the follicle. The major downside of such therapy is undue irritation.

Most vitamin A derivatives utilized as acne therapy require a doctor’s prescription. Undesirable side effects include facial redness, peeling, and burning. These reactions frequently diminish with repeated use.

Skin treated with retinoids may become very sensitive to sunlight and easily sunburned. For this reason, excess sun exposure should be minimized. In fact, at least in the summer months, prescription retinoids are best applied only at night and thoroughly washed off in the morning.

Antibiotics

Topical antibiotics are commonly used to treat acne. Clindamycin and erythromycin are formulated in solution, gel, and pledget formulations (including Cleocin-T, Clindets, Evoclin, Erygel, and Erycette). Azelaic acid (Azelex, Finacea) is an antibacterial cream derived from wheat. Newly released is topical dapsone gel (Aczone); interestingly, the oral form is used to treat leprosy.

An antibiotic may be combined with benzoyl peroxide in a gel form (Benzamycin, Benzaclin, and Duac). Combination therapy is thought to decrease the potential for bacterial resistance. Recently a combined form of retinoic acid and clindamycin has been released (Ziana) as well as a combination featuring adapalene and benzoyl peroxide (Epiduo).

Oral antibiotics are the mainstay of therapy for moderate to severe acne. As a general rule, antibiotic treatment for this condition begins with tetracycline or a tetracycline derivative. Oral tetracycline has been used to treat acne for decades. The drug is remarkably safe; people have been on tetracycline for years without any serious long-term effects. As far back as 1975, the American Academy of Dermatology reported on the safety and efficacy of chronic antibiotic therapy for acne. After studying thousands of patients, the Academy concluded that tetracycline is effective in the control of this disorder and that usage over long periods of time is indeed safe. Today the conclusions of their report are still widely accepted by the medical community. A 2004 study published in the Journal of the American Medical Association suggested a link between chronic antibiotic use and breast cancer. Another similar study published one year later found no such link. Still, the lowest dose of an antibiotic necessary to control acne is the wisest course of action, with discontinuation recommended once adequate control is achieved.

Tetracycline should not be taken with meals, milk, or vitamin-mineral combinations because these substances bind the drug in the stomach and lessen its acne-fighting abilities. For this reason tetracycline is best taken on an empty stomach no sooner than thirty minutes before or one hour after a meal. Tetracycline may lead to mild stomach upset and heartburn. Some women on this medication may acquire vaginal yeast infections. Tetracycline must never be taken by pregnant women for the drug can enter the womb and stain the child’s teeth yellow, nor should it be given to nursing women and children under the age of eight.

Erythromycin may also be used as a first-line acne therapy as it possesses antibacterial and anti-inflammatory activity. Manufactured in liquid, tablet and capsule form, the antibiotic is moderately priced. Occasionally erythromycin may produce gastric upset, but as with tetracycline, long-term usage has proved extraordinarily safe.

A drawback to using tetracycline and erythromycin has been the emergence of resistant strains of the germs that cause acne. This, coupled with an inconvenient dosing regimen, has led to the popularity of tetracycline derivatives as first-line therapies. Although more expensive than tetracycline, these compounds have better efficacy and can be taken with meals. Like tetracycline, these agents are quite safe but should be avoided by pregnant women. Doxycycline (Adoxa, Doryx, Monodox, Oracea) and minocycline (Minocin, Solodyn) are widely prescribed. Minocycline in high doses may produce nausea and dizziness and has recently been linked to transient blood chemistry abnormalities. Minocycline may rarely cause abnormal skin pigmentation, and doxycycline may uncommonly cause sun photosensitivity.

Contraceptives

Although some oral contraceptives may actually aggravate acne, others may reduce oil production and promote acne clearing. Women with persistent acne who do not respond to more traditional therapies may be candidates for such hormonal manipulation. Certain birth control pills (Ortho Tri-Cyclen, Estrostep, Yasmin, and Yaz) have even been approved as a treatment for acne. The drug spironolactone helps counteract the male hormone and may also prove useful for women with moderately severe breakouts.

Isotretinoin

In 1982 a powerful medication for the treatment of severe acne was released in the United States. Called isotretinoin, this “miracle” drug will actually “cure” selected cases of acne. Trade names include Amnesteem, Claravis, and Sotret. The flagship product, Accutane, was voluntarily withdrawn from the market in July, 2009. The manufacturer cited business reasons with no relation to safety and efficacy.

Isotretinoin is a derivative of vitamin A and is available in capsule form. The medicine is taken for a five- to six-month period. Within three weeks of commencing the medication, varying degrees of skin dryness invariably occur and may be accompanied by dry eyes, cracked lips, and nosebleeds. These annoying side effects may last for the duration of therapy. Isotretinoin may also raise the level of circulating fats, and for this reason periodic blood tests are mandatory.

For those with cystic acne, the results of isotretinoin therapy are well worth any transient aggravation. The disfiguring cysts resolve, and for the majority of people undergoing the treatment, new cysts rarely appear. Some 80 percent of such patients achieve long-lasting remission. By preventing deep cysts, isotretinoin abruptly halts the dreaded sequelae (scarring) of acne. Some individuals with chronic, less severe, forms of acne may benefit as well.

Controversy exists regarding the association of isotretinoin with mood changes, depression and colitis; direct links, if they do occur, are certainly rare. This drug must never be taken by pregnant women because of the high incidence of birth defects. Women of childbearing age must practice strict birth control. Isotretinoin should only be administered under a dermatologist’s care. Indeed, persons taking this drug must be registered in a central government-mandated database called I-Pledge.

Other Treatments

What about the physical methods used to treat acne? Again, please remember not to pop pimples or further manipulate acne lesions unless properly instructed by a dermatologist. Extraction of open comedones (blackheads) can be accomplished under proper supervision by use of a comedone extractor. This instrument features an open loop that is placed over the blackened pore, allowing the contents to be expressed when firm pressure is applied. Comedone expression has minimal influence on the course of acne. The widened pore will reaccumulate its blackened contents within a month’s time; however, many persons obtain cosmetic and psychological benefit from this procedure and welcome the removal of these unsightly black dots.

Most recently, lasers, IPL (intense pulsed light), blue and red light sources, and even a topically applied solution activated by light have been employed as acne therapies. Such interventions, of varying costs, may lessen the need for oral antibiotics. The verdict is still out as to the overall effectiveness of these physical modalities, which are somewhat expensive and generally not covered by health insurance.

Persons who develop large, disfiguring cysts benefit from the injection of a steroid solution (Kenalog) directly into each cyst. This medicine often dramatically reduces the size of a lesion within twenty-four hours and may prevent subsequent scarring.

Scarring

What can be done for those already scarred by acne? Dermatologists and plastic surgeons possess several tools for the correction of scarring, including dermal filler implants (such as Cosmoderm, Juvederm, Radiesse, Zyderm), dermabrasion (mechanical sanding), and lasers. Which procedure(s) to use depends on a number of factors, including the extent and depth of scarring. Shallow, concave, pliable scars respond immediately to dermal filler injection. More superficial scars may respond to multiple laser sessions. Good results are being reported with fractional laser photothermolysis. Consult with a dermatologist who is knowledgeable in all facets of scar correction. Keep in mind that although 100 percent correction is unlikely, some degree of improvement may be achieved. Often the changes are dramatic.

Summary

The immediate goal of acne therapy is to clear up existing pimples and blemishes and prevent new ones from appearing. You may have such mild acne that daily washing coupled with an over-the-counter benzoyl peroxide or salicylic acid preparation is all that will be needed to control the disorder. However, if these measures fail, an appointment with the dermatologist would be prudent. The skin care specialist has at his disposal a variety of beneficial treatments for acne. Two or more different medications are commonly employed at the same time. One must bear in mind that such regimens rarely produce instant results; acne does not clear up overnight. Be patient! You should always give a new regimen a minimum of three to four weeks for visible results to occur.

Acne is a cosmetically disfiguring problem. If left untreated, the condition may lead to immense physical and emotional scarring. Today acne is certainly controllable, and select cases may even be cured.

Poor hygiene, diet, stress, heredity and hormone imbalances often are causes of acne.

 Dietary

• Food allergies, especially in adults over 25, are the cause of some of the worst cases.

• In general, bad digestion, often caused by too little hydrochloric acid in the stomach, leads to the inability to absorb important nutrients and is a major cause of acne.

• As with any wellness program, we suggest drinking six to eight glasses of water daily. This will aid your body systems in functioning properly, especially your skin (your largest organ) for acne suffers.


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 • Although many traditional medical practitioners may not agree, the excess of milk, sugar, white flour and other refined, processed food, as well as nuts and high-fat meats, such as pork, may be contributing factors to acne.

• A diet high in high glycemic carbs and refined sugar creates a blood sugar boost that sets off a series of hormonal changes known to cause acne. Reported in the Archives of Dermatology.

• Iodine-rich foods, such as liver, cheese, iodized salt, kelp products, clams, crabs and other shellfish have been associated with acne, and should be avoided. Iodine is also used in commercial breads and in processing milk. Consider switching to alternate products. If you use a lot of iodized salt, switch to balanced sea salt which you can find at gourmet or health food stores, or purchase from the Grain and Salt Society, 800-867-7258 or visit their website http://www.celtic-seasalt.com. Don't be fooled by products sold in grocery stores that are labeled "seasalt."

• Avoid all foods containing trans-fatty acids, such as milk, milk products, cookies, chips, margarine, chocolate, shortening and hydrogenated oils.

• Other causes are deficiencies in zinc, vitamin A, and essential fatty acids such as linoleic.

• Poor digestion should be addressed by a good diet and digestive supplements (not antacids!).

Cleanliness

It goes without saying that keeping the skin clean and bacteria-free is of major importance. Here are some tips.

• Keep your bed linens clean, as dead skin, oil, cosmetics, hair preparations and dirt on the linen will be picked up by your skin while you sleep and help clog pores.

• Wash your skin gently twice daily with an antibacterial soap or cleanser containing salicylic acid, not regular soap, as it is alkaline and will promote bacterial growth. Don't scrub too hard, as this will irritate your skin further.

• Products containing benzoyl peroxide are also very beneficial topical cleansing agents. However, if you are using products containing benzoyl peroxide, make extra efforts to screen yourself from the sun.

• A soap with aloe vera is good, too, as aloe is a natural wound healer.

• Allergies to cosmetics may be a cause, too, so if your acne started after using new cosmetics, eliminate them for a week to see if the acne clears up.

• Keep your hands away from your face or other affected areas. They contain oils and bacteria that promote acne. Wash your hands frequently.

• Take a steam shower or boil some water on the stove and put your head over the vapors for a few minutes. This will open up the pores and they can be cleaned out more easily. The blackheads can be squeezed out more easily, but do not squeeze the whiteheads, as this is an infected area and can cause other problems. Another similar method is to put a very warm washcloth on the affected area several times a day, This will open the pores and help cleanse the skin.

• Avoid greasy creams and cosmetics, especially ones that contain oils and dyes, and avoid medications that contain bromides or iodides.

Hormones

Natural hormonal changes for both males and females are some of the primary causes of acne. These changes usually start at puberty and end in early adulthood. The increased androgen males experience at the beginning of puberty causes the sebaceous (oil) glands to enlarge and produce increased amounts of sebum (oil and waxes) which pass through the hair follicles to the skin. When the pores clog, acne occurs. Women, however, often get a mild case of acne beginning a week before their menstrual period begins, even in adulthood.

Birth control pills also can cause acne. Try another brand or another method.

Scalp acne

Some people get pimples on the scalp that may take a few weeks to clear up. This type of pimple is known as acne necrotica miliaris, and seems to flourish during times of high stress or when the scalp is oilier than normal. The latter may occur if you haven't shampooed as often as usual or are using hair-care products with a lot of oil. To speed healing, shampoo frequently and apply an acne remedy with benzoyl peroxide. If the acne itches, use an anti-itch product with cortisone or wash your hair several times with a coal-tar shampoo.

Other causes

Other factors are: stress, seasonal changes, drug toxicity (usually from steroids) and sun exposure, as well as caffeinated drinks and certain spices.

Alternative Treatments

An effective prevention and treatment program has five steps:

1. Begin with a cleansing diet to help your system detoxify. Impurities that cannot be eliminated through the kidneys and bowels fast enough may erupt through the skin. This program is not recommended for anyone under 17 years of age.

2. Clean your skin daily as recommended above. This will keep the pores open and your skin free of bacteria. Discourage new blemishes by using a benzoyl peroxide lotion or tea tree oil, a natural antiseptic mentioned below. Benzoyl peroxide may irritate the skin, so it is best to leave it on for only two hours, then wash off.

3.Check to see if you are allergic to certain foods, cosmetics, or other products applied to your face, such as sunscreens. Did the outbreak of acne begin after you started eating a new diet or using a new product? If so, eliminate the new foods from the diet and begin using hypoallergenic cosmetics, vitamins and other products. Common allergens are chocolate, milk, refined carbohydrates (sweets) and soft drinks. Your doctor may want to test for allergies, and a blood test is more effective than a skin scratch one to help detect these allergies.

4. Make sure you eat a low-fat, high-fiber diet.

5. Start taking supplements that promote healthy skin.

By following this regimen, you should see positive results within three months.

If you have a persistent case of acne that doesn't seem to go away after trying several remedies, Chinese medicine has shown positive results in difficult cases.

Caution! It is very tempting to pop whiteheads, blackheads and pimples. Whiteheads are clogged pores below the epidermis (outer layer of skin) and should not be squeezed. By following the program outlined above, the whiteheads will disappear in a few weeks. Blackheads are clogged pores on the surface, and also should not be scrubbed or squeezed, but removed with an extractor that you can buy at a pharmacy. Pimples may be squeezed when they are infected and have yellow pus if the proper procedures are followed. Apply a warm compress to the area for a few minutes to open the pores, then squeeze with a clean tissue until all the pus runs out. This will allow the pimple to heal properly. Using fingernails will promote scarring and may be covered with bacteria that will enter the area and cause inflammation.

Wellness Programs

Dietary Changes

Although topical treatments may produce quick results, they often have side effects, may dry out the skin, and don't address the root causes of acne. So, for a long-term strategy, it is better to treat acne from the inside out through dietary changes.

Since diet plays such a large part in acne problems, the first step to alleviate the problem is to make the necessary dietary changes. Without doing this, your chances of improvement are greatly reduced.

• A high-fiber diet of whole grain breads and cereals, bran, legumes (beans, lentils and split peas) and lots of fruits and vegetables is a good way to minimize eating the wrong foods. Often skin problems are rapidly improved when more fiber is added to the diet.

• Reduce your consumption of junk food and limit your total fat intake to no more than 20% of calories. Cut out hydrogenated oils.

• Eliminate sugars. Skin glucose tolerance is significantly impaired in acne patients.

• Eliminate refined carbohydrates.

• Reduce (or eliminate) milk consumption. The hormones contained in milk can aggravate acne.

• Avoid chocolate, tea, and coffee.

• Avoid foods containing trans fatty acids, as noted above under "Dietary Causes."

• Avoid fried foods.

• Eliminate sodas and artificial sweeteners.

• Eat foods with zinc to get enough to satisfy the remedy listed below. Foods containing zinc include oysters, herring, wheat germ, sesame seeds, liver, soybeans, sunflower seeds, egg yolk and lamb.

Supplements

Acidophilus Take acidophilus either in capsule or liquid form 2-3 times a day.

Brewer's yeast tablets taken after every meal has worked for some people. It contains chromium which is an essential mineral involved in the processing of sugar. Take 2 teaspoons of brewer's yeast daily.

Chromium (GTF or glucose tolerance factor) will aid in glucose tolerance. This will be especially beneficial for those with sugars-induced acne. Take 400 mcg of chromium. ChromMate is very bioavailable.

Essential fatty acids (EFAs) are composed of linoleic and linolenic fatty acids and should be taken to help reduce or eliminate inflammation. Individuals with acne are often deficient in these important nutrients. The omega 6 fatty acids are found in evening primrose oil (take 500 mg three times daily), black currant seed oil, and borage seed oil. A tablespoon of fish oil daily will be helpful. Pure cold-pressed flaxseed oil is a good source of omega-3 fatty acids.

Selenium helps boost the potency of vitamin E when the two are taken together. Take 200-400 mcg. per day. People with severe cases of acne have been found to be deficient in selenium. A multi-vitamin with all the antioxidants should have sufficient selenium.

Vitamin A will help reduce sebum production and is important in maintaining healthy skin. Take 10-15,000 I.U. (not beta carotene) and 400 I.U. of vitamin D daily. For severe cases of acne you may need to increase the intake to 25,000 I.U., but do this only with medical supervision as it may cause side effects.

Vitamin B-complex Take a B-complex supplement daily.

Folic acid (a B vitamin) 10 mg daily, especially if your acne erupts at the outset of your menstrual cycle. Take along with B-6.

Vitamin B5 (pantothenic acid) has been used successfully in China. Dosage is 10 grams daily (divided into 2.5 grams doses) plus a cream containing 20% pantothenic acid by weight, applied four to six times daily. After 2-3 days there was a dramatic decrease in the amount of oil secretion, and the acne was brought under control in a few weeks' time. Severe cases needed 15-20 grams of pantothenic acid daily, and the time needed was up to six months.

Vitamin B6 will help restore normal hormone balance, especially testosterone and estrogen, which contribute to flareups. Take 50 mg three times per day. Women should start a week before menstruation and continue for a week afterward, as a minimum; daily would be preferable.

Vitamin C helps promote healing and cellular repair, enhances the immune system, and is beneficial for skin health in general. Start with 500 mg daily and increase to 1-3,000 mg or to bowel tolerance over a week or two.

Vitamin E boosts the effectiveness of certain enzymes (glutathione peroxidase) needed for good skin health and enhances the absorption of vitamin A. Take 400 IU per day. It is more effective when taken with selenium.

Zinc, an essential mineral, is more effective than antibiotics for wound healing, inflammation control, tissue regeneration and healthy skin in general. To see results you may have to take zinc for one to two months, and it should greatly reduce the recurrence of acne once the body chemistry is in balance. Zinc may be used topically or take 50 mg with each meal. Zinc picolinate is readily absorbed. If you don't see any results after a month or so, increase the level to 100 or even 150 mg with each meal. You should have very positive results within three months. Many teenage diets are high in the junk food category, which is very low in zinc. In addition to zinc, take 1 mg of copper for every 15 mg of zinc. Consult your physician before taking more than 15 mg of zinc per day for an extended period of time, as it may interfere with the absorption of copper. Caution: if you have not seen results with high doses of zinc, reduce the amount to 15-30 mg/da, along with the appropriate amount of copper, and concentrate on other remedies.

Remedies

Folk

Aloe Use aloe vera juice or gel to counteract infection and promote healing. Use the ointment on pimples and sores. For acne scars, using aloe vera juice morning and night for as long as necessary (perhaps six months or longer) will help reduce the scars and improve skin complexion and color. It is drying, so if you have dry skin, use an aloe-based moisturizer. The pulp of the aloe vera plant is an excellent skin cleanser. Break off a portion and rub the pulp directly on the skin.

Apple Cider Vinegar/lemon juice Clean your skin and apply either lemon juice or apple cider vinegar with a cotton ball. The acid in these kitchen remedies helps flush out the pores and keeps the skin looking beautiful. Vinegar acts as an astringent and helps remove excess oil, kills bacteria, and normalizes the skin's pH. This remedy should work quickly.

• Another method using apple cider vinegar is to "steam clean" the face by putting it over a pan of boiling water with a towel over your head to trap the steam. This will loosen the dirt and oil. Then apply the vinegar with a cotton ball to remove the dirt and oil buildup. Repeat twice, then dab more vinegar on the pores to close them. Use this method once a week.

Basil For acne that hasn't responded to other remedies, brew 2-3 teaspoons of dried basil leaves in 1 cup of boiling water for 20 minutes; let cool; apply to affected area with a cotton ball.

Beans Make a tea by boiling a handful of green beans in a quart of water for 10 minutes; add 3 tablespoons of dried chamomile flowers to the tea, cover and steep until cool; strain and bottle. Use as a face wash at least three times daily.

Carrot Juice The essential oils in carrot juice will aid digestion and help stop acne.

Charcoal To aid digestion, take 3 tablets of activated charcoal three times daily.

Colloidal Silver Cleanse the skin morning and night with colloidal silver. You should start to see improvements within a week. Colloidal silver is a natural antibiotic that has safely been used for a century.

Cucumber Liquify a peeled cucumber in a blender and apply the juice to the acne. Another variation of this remedy is to drink four or five cups of cucumber juice daily for a week. This is said to purify the blood and lymphatic system, resulting in a clearer skin.

Egg whites Clean your skin thoroughly and apply egg white with a cotton swab. Let it sit for several hours or overnight. The egg white is an astringent.

Fels-Naptha The use of Fels-Naptha soap has been reported with good results for those with oily skins. It contains mineral spirits and other ingredients that work well on skin problems.

Garlic Rub your acne with raw garlic several times a day.

Grapefruit Seed Extract This extract is a powerful all-around antimicrobial product and is an excellent disinfectant. Make a solution of 4-40 drops in four ounces of water and apply to the affected areas with a cotton ball two or three times a day.

Lemon juice Apply fresh lemon juice to the affected area with a cotton ball or Q-tip before bed. Wash off in the morning.

Molasses Take 2 teaspoons of molasses with one teaspoon of sulphur once or twice daily to cleanse the blood. Skin eruptions may increase initially, but they are an indication that the blood is being cleansed.

Molkosan, a product derived from concentrated whey, the bi-product of cheese manufacture, has been used effectively against many forms of skin problems, especially acne. Add a teaspoon or tablespoon to a glass of water and take with meals. It aids in digestion and regulates metabolism. Soak an absorbant cotton pad or cloth in Molkosan and attach it to the affected areas and leave on overnight. Molkosan is an excellent antiseptic.

Neem Oil Neem (Azadirachta indica) is valued in Ayurvedic medicine for its varied healing properties due to its anti-bacterial, anti-fungal, and anti-viral capabilities. A cousin of mahogany, neem is a tropical evergreen tree native to India and Myanmar. Over 60 medicinal uses have been documented for neem so far - such as acne, eczema, psoriasis, cold sores, dandruff, athlete's foot, ulcers, ringworm, and gingivitis, to name a few. For acne, apply a 2% neem oil-based cream to the affected area and take 2 neem leaf capsules daily to speed the healing. Neem oil may also be used by mixing 1 tablespoon of neem oil with 1/2 cup of a carrier oil such as almond or olive, and applying to the affected area with a Q-tip or cotton ball. If you have sensitive skin or if irritation occurs, dilute the neem with more of the carrier oil.

Oatmeal As for measles and other skin irritations, people have used oatmeal to conquer acne. Apply some cooled, cooked oatmeal to the whole face for fifteen minutes, then wash off. Oatmeal is an astringent and seems to draw oil and impurities out of the skin, keeping it clean and blemish-free. This method may take a week or two, but should have good results.

Oil of Oregano Put a few drops in a glass of water and dab on the acne using a cotton ball. Oil of oregano is a very strong disinfectant, so if you start to get redness on your skin, stop using it for a few days then use a more diluted solution.

Sugar Wash your face and make a poultice of white sugar with a small amount of water; dab on the affected area. Sugar has an antibacterial effect.

Sun Ultraviolet radiation from the sun or a sunlamp will help kill bacteria on the skin and dry up excess oil.

Witch Hazel In the morning wash your face with a gentle cleanser. If you have oily skin, rub a cottonball saturated with witch hazel over your entire face. It is an astringent and will help dry the skin and shrink the pimples. Next, spread a thin coat of a 2% salicylic acid product (found in drugstores) over your whole face. Its deep penetrating action will help unclog oil-clogged pores. Repeat the cleansing and witch hazel steps, then dab 2.5% benzoyl peroxide over the entire face to kill bacteria.

Herbal

Amaranth Make a tea from amaranth seeds and use as a face wash. To make the tea bring 3 cups of water to a rolling boil, add 2 teaspoons of seeds, cover and simmer for five minutes; remove from heat and add 1 teaspoon of leaves (if available) and steep for 30 minutes.

Basil To treat affected area, obtain a basil-based oil from your health food store and apply it as directed. Another way is to get the actual herb and make an infusion. To make an infusion, put two to four teaspoons of dried basil leaves in a cup of boiling water, steep for 10 to 20 minutes, cool, and apply to the acne.

Burdock The herb burdock (Arctium lappa), is effective in treating acne and is the most important herb for treating all forms of chronic skin problems. To make the tea, bring 1 quart of water to a boil, reduce to simmer, add 4 teaspoons of cut, dried root; cover and let simmer for 7 minutes, then remove from heat and let steep for 2 more hours. Use as a skin wash.

Calendula can be made into tinctures, lotions and creams. Look for products containing this herb. Make a tea of calendula and wash your face.

Oregon grape (Mahonia aquifolium) It has antibiotic properties and helps stimulate the immune system. Take one of the following three times daily: tea from dried root (2-4 grams); tincture (6-12 ml or 1.5-3 teaspoon); fluid extract (1-2 ml or 0.25-0.5 teaspoon); solid powder of 8-12% alkaloid content (250-500 mg.).

Tea There are several other herbs that can be made into a tea and taken internally or used as a wash. Besides aloe and burdock, calendula, chickweed, dandelion, red clover, white oak bark, yellow dock, cayenne, echinacea, ginseng, redmond clay, sarsaparilla, and valarian may be used.

Tea Tree Oil derived from the leaves of the native Australian Melaleuca alternifolia tree contains antiseptic compounds that are a very effective skin disinfectant. Depending on severity, use 5-15% solutions twice daily. It is as effective as 5% benzoyl peroxide and is less drying, although it may take a little longer to work.

Homeopathic

Natrum muriaticum (table salt, sodium chloride) 6x, 12x or 30x.

General Description
Do zits give you fits?  Chances are, yes.  Acne is the most common skin problem affecting to some degree three out of every four teenagers.  And an imperfect complexion is not limited to this age group; many 20 and 30 year olds also suffer with this condition.  The problem is an expensive one, with millions of dollars spent each year on over-the-counter preparations as well as on prescription drugs.  For many, the acne process consists of nothing more than an occa­sional pimple or blemish on the face, back or chest.  A few are less fortunate and develop extensive, persistent eruptions eventuating in permanent pits and scars.  The psychological effects may be devastating.

There are several different types of acne lesions. These include comedones (whiteheads and blackheads), papules, pustules, cysts, and scars. Comedones are of two varieties: open and closed. A closed comedone, called a whitehead, arises when a pore becomes clogged with oil and the sebum creates a tiny white covering over the entrance. When the opening remains unobstructed, the oil is oxidized by the air and turns black. This open type of comedone is called a blackhead.

A papule is a solid, elevated lesion of the skin. Papules range in hue from flesh-colored to bright red. Red papules are those pimples still undergoing inflammation.A pustule is a pimple filled with fluid, or pus. This substance is composed of dead cells and bacteria. When a pustule becomes larger and deeper, it is then termed a cyst. Tender, inflamed red pustules and cysts may result in scars, which is why these two types represent the most severe forms of acne.

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