Our understanding of why acne occurs is still evolving. Although not seen as a 'serious' medical condition, the effects of acne on mental health can be significant and distressing. 

 

We know that many factors affect acne pathogenesis including:

• genetics

• hormones - particularly androgens and insulin

• long term inflammation in the body

• stress

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My patients

People with hormonal conditions e.g. PCOS are particularly prone to acne, caused by high androgen levels, insulin resistance and body inflammation. 

Acne can also occur more frequently during times of hormonal fluctuation/imbalance e.g puberty and peri menopause. During the menstrual cycle the changes in progesterone and oestrogen levels, particularly leading up to a period can produce spots.

I also frequently see acne in anorexia patients and people who over exercise. The combination of under eating, physical exertion and high anxiety affects hormones levels and chronic inflammation.

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Acne Treatment

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Because the cause of acne is multi faceted, so too is the treatment. For successful long term treatment, it is important to look to the underlying source(s) of the issue. While pharmacological (medication/drug treatment) can be very effective, this can be short term, and acne may return at the end of treatment. Here are some important things to consider:

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• What you eat can have a significant effect on hormones, skin structure and inflammation.

  • Inflammatory foods can be specific to each individual e.g. gluten, nuts, dairy; or they can be generally inflammatory for everyone e.g. processed foods, high glycemic index foods, trans fats, high sugars. Many foods are anti-inflammatory e.g. vegetables, fruit, fish and wholegrains.

  • Many of these foods are high in the nutrients that are needed for healthy skin as they are needed to produce collagen, elastin, protect against UV light, and have antimicrobial activity. including vitamin A, C and E; selenium, zinc, copper and silicon. ​​

  • Omega 3 fats found in salmon , mackerel, sardines or supplements of fish/algae oil are beautifully anti inflammatory for the skin, and are also essential for hormone production.

• Stress increases the levels of some of the hormones in the body which promote inflammation. Stress can be psychological and physical. Over exercisers and workaholics are common examples. Reducing stress and anxiety levels can be fundamental part of acne treatment. 

• Topical treatments: Depending on the type of spots, specific skin care products e.g. benzyl peroxide, salicylic acid, tretinoin can be very effective as part of the treatment.

• Oral medication: isotretinoin (Roaccutane) is considered the gold standard of medical treatment for severe acne. Antibiotics or the oral contraceptive pill may also be considered. Although these can be very effective, there are unfortunately potential negative side effects and many people prefer to use these as a last resort.

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