Acne is a Four
By Barbara Strickland, Certified Para-Medical Esthetician
not enough that we are blessed with the whole aging cycle, PMS, wrinkles, lines, graying
hair and arthritis as we grow more mature and wise? Everyone always told you that Acne was
just a complexion problem and that you would outgrow it if you stopped eating so many
french fries, hamburgers, sodas, chocolates and candies!
How can Acne go away when so many of us inherited the gene
that causes acne from our parents and ingest medication, vitamins, homeopathic
remedies, hormones and birth control pills which exacerbate the very problem we are
trying to get rid of?
I'll bet your parents never told you that one
out of three adult women and one out of five adult men have
Adult Cosmetic Acne from their skin care products,
shaving creams, sun blocks,
acne products and self tanning products. Since consumers are taught
from the cradle to purchase by The Three P's: Perfume, Packaging and
Price, the cosmetic companies just change the color, fragrance and
packaging for men so it will appeal to their psyche.
If you have inherited (genetic) acne as well
as cosmetic acne, it simply does not go away as we age. Instead, we reap
the benefits of aging skin and the effect it has had on our acne, giving
us discolored, uneven, bumpy, leathery, red or irritated looking skin.
For most sufferers, Acne is truly a FOUR LETTER
WORD and worst nightmare come true. What could possibly be more exciting
than going into a board meeting, national sales meeting, class reunion or
group therapy session with an uneven, scarred or bumpy face full of ZITS?
I can't think of anything except total memory loss or a huge unpaid bill
from the IRS right in the middle of a PMS cycle!
Acne Statistics and Facts:
- 85% of all U.S. teenagers are affected.
- 25% of these will have permanent scars.
- 20% of all adults have active acne.
- 60 million Americans have active acne.
- 20 million Americans have acne badly enough to cause scars.
- Acne is an Autosomal (dominant characteristic gene)
- Only 11% of acne sufferers seek help.
- Acne is socially taboo.
- The medical establishment or society does not take acne
- Past acne treatment has staggering failure rates
False Myths About Acne
- "Chocolate and greasy foods cause acne."
- "Dirty skin and hair on your forehead cause acne."
- "Sexual frustration and thoughts cause acne."
- "Acne is a teenage disease."
- "Acne scars will disappear with time."
- "I do not have acne...just complexion problems."
- "No treatment works."
- "The right cosmetics will improve my acne."
- "Acne is a manifestation of psychological problems."
In the first part of
this series, we covered the myths, aggravating factors, and genetic predispositions
that cause acne to form. Now
we will cover the Acne cycle—how lesions form, and how to eradicate
There are Two Basic
Kinds of Lesions or Zits: Non-Inflammatory and Inflammatory
kind or combination you get, the lesions or zits you have take 90 days to
form. So there are zits forming right now that you will not see or feel
for about three months, unless they are exacerbated by stress or
lesion starts out as a micro comedo or hard white "millet seed"
under the skin. Normally, a comedo turns into a closed comedone or hard
white bump and then turns into an open comedone or blackhead and falls
out. This process, unless exacerbated by stress, takes about three months.
acne lesions don't give the pizza-face look that inflammatory lesions do,
and from a distance the skin looks relatively clear. Scarring from
extraction may occur if the entire lesion is not removed leaving
discoloration, holes or craters, and/or keloids or raised
scars. Have these lesions removed by a professional.
this case, the hard millet seed turns into a papule (a sore bump commonly
called a pimple), which has no opening. As more inflammation takes place,
pus develops near the surface and turns
into a pustule. If the lesion is very
deep under the skin, it turns into a nodule filled with pus and becomes
about the size of the end of your little finger or larger.
terms of treatment and removal, inflammatory acne is easier to clear as it
responds to medication quicker than non-inflammatory acne. Well, you
might say, all of this is very interesting. How does it concern me and how
do I get rid of it quickly, efficiently, and economically so that I look
a long time, it has been almost impossible for consumers to obtain
accurate, helpful information about acne. Because of the
misinformation pervading the skin care market, the
average individual has spent thousands of dollars and been to at least ten
different treatment centers before they get real help.
Most Important Points to Remember for Treating Acne:
you would like our suggestions and recommendations for Clearing your Acne
please order the Try Me Pack of your choice, fill out our
and send it to us. Filling
out a profile will insure that you’ve ordered the correct products for
your particular skin conditions, as well as enable us to start you on the
path to flawless skin much more quickly! Acne will always be
a four-letter word unless you make an educated and informed decision to
clear it up.
of time the professional has been treating and clearing acne.
there a product guarantee?
the products non-comedogenic (do
not cause additional acne)?
the professional recommended by a physician to treat acne?
the professional complete a thorough inventory of your medications,
both prescription and over-the-counter and explain possible side
effects to you?
they clear your Acne in 90 days or less?
they explain how to lighten or stop discoloration, reduce the effects
of scarring and be able to suggest medical help to reduce deep
scarring if necessary?
The Four Grades
Consists predominantly of whiteheads (closed comedones) and
blackheads (open comedones). There is an occasional inflammatory lesion, however there are
at least 25 lesions on one side of the face at any given time.
Maturation Arrest Acne is the most difficult to treat and
evaluate. The face becomes STUDDED with many whiteheads (closed comedones) and from a
distance looks clear. Up close the skin feels and looks rough. The lesion count reveals
50-100 whiteheads on only one side of the face with an occasional inflammatory lesion.
In addition to mixture of whiteheads (closed comedones) and
blackheads (open comedones) there are a constant number of inflammatory lesions (7-10,)
pustules, and papules at any one time on one side of the face. Grade Three Acne is painful
because of the swelling, size, and duration of the lesions.
Cystic acne contains all of the above lesions plus nodules
and cysts. It is very painful both physically and emotionally with severe inflammation
that is very red or purplish in color and is commonly called "Pizza Face" Acne.
Grade Four responds very quickly to treatment because all of the lesions are on the
The Two Basic Causes of Acne
1. Acne is Inherited
The gene which gives one acne is
autosomal, or a dominant characteristic gene. If a brown and blue eyed couple had a
child, the baby would have brown eyes because brown is the dominant characteristic or
autosomal gene. If you want to blame someone for your acne, blame your parents
because they gave it to you. You did not get it from eating too many fast food hamburgers
with french fries, drinking too many sodas, eating chocolate, thinking about sex, having
sex, or not washing your face.
Cosmetics are the second largest
contributing factor for adult women and men who suffer from acne. 99% of the over
the counter items you buy to cleanse your hair, wash your face, apply powder or
foundation with, use to reduce lines and wrinkles, shave or use sunblock and self tanners
are comedogenic or acne causing. Comedogenic (ko-mea-de-oh-gen-ic) ingredients have
the ability to form the small open and closed lesions generically called blackheads
and whiteheads, which look like small bumps under or on top of our skin. These
lesions are non-inflammatory, not the "Big
Mothers" one sees in inflammatory acne where it looks like
your nose has been moved to the side of your cheek just in time for your new portrait!
If your blush is comedogenic, you
will have these lesions in the blush area. Your lipstick or lip liner would cause lesions
to occur around the lips. Foundation, powder, sunblock, moisturizers, acne products, and
skin care products would effect your whole face. If Comedogenic Ingredients are in all of
your products, then lesions and zits will appear everywhere. My favorites are Isopropyl
Myristate and Sodium Lauryl Sulfate, which are the main ingredients in toilet
and drain uncloggers!! They are the main or first ingredients in almost all skin care
products because of their ability to make clogs disappear and make your products feel
smooth and silky.
They also give you cosmetic acne. Many companies label their products
as "non-comedogenic" and still include bad ingredients in their
products. Since most acne sufferers have oily areas on their skin, many companies label
their products as water based or oil free and use Acetylated or Ethoxylated
Lanolin. Because these oils are synthetic and do not come from animals or plants it is
legal to use the term "oil free" on the label. However, synthetic oils still
make you oily and they cause acne.
For more information on this topic,
please read the articles,
Become An Acne Detective, which contains a list of Comedogenic
I Bought Everything They Told Me To and I Still Have Zits, which teaches
you how to test your products for oil.
In the first part of this article,
we uncovered the myths about acne and discussed two major causes: heredity and cosmetic or
comedogenic ingredients. Now we will look at additional factors, which can aggravate or
exacerbate Acne: Stress, Heat and Humidity and Medications.
PART FOUR - AGGRAVATING FACTORS
Did you ever feel like you were trying to push a very large boulder
up a very steep hill? We all have stress in our lives, whether large or small, which
effect how we feel, look, and respond to life including, but not limited to Acne.
Unfortunately, stress exacerbates any disease or illness and Acne is no exception. When
stress occurs, the adrenal gland (which produces adrenaline) stimulates the pituitary
(hormone gland) to make extra Progesterone to help cope with the stress, and ten days
later additional Breakouts occur keeping the "ZIT CYCLE" in full swing. The bad
news is that stress may cause a small non-inflammatory lesion such as a whitehead or blackhead
to turn into a mature nodule ("Big Mother")
in less than 24 hours. When dealing with stress and acne, it is important to remember that
it is the manner with which we handle stress that effects our acne.
The Stress Effect
Men: Although they are not
immune to stress, and do have "flare ups", men are more fortunate. When men go
through puberty they start creating large amounts of Testosterone and continue to create
it throughout their lives at high levels keeping their sebaceous (oil) glands at maximum
stimulation. Men produce most of their male hormones in the testes and only a small amount
in the adrenal gland. Men do not have monthly hormone fluctuations causing their hormone
levels to go up and down, therefore, extra surges of hormone production in men have less
effect on their Acne.
Women: The stress effect is
very important during a females 28-day menstrual cycle. On the 15th day of a normal
cycle the body produces Estrogen to promote ovulation. On the 18th day her body produces
Progesterone or Androgen to stop ovulation. It takes about 10 days for Progesterone to
travel through the blood steam into the skin. This unfortunately brings her to the the
start of her menstruation, which is when most women flare up! This "flare up" of
Acne produces our friend MORE STRESS and the whole cycle begins again.
What You Can Do
When the bodys resistance is
lowered through stress the immediate stress-acne effect is seen. The interruption of
healing caused by the stress hurts the acne sufferers weakest link, the hair follicle or
pore. New lesions start to form, healing lesions start to break down again, blackheads and
whiteheads turn into Big Mothers overnight, and the skin becomes more oily or unhealthy
Handling stress may include
medication, walking, exercise, shopping, resting or quiet time, yoga, reading, or any
activity which promotes relaxation and calm. Whatever allows you to Control Your Stress
instead of letting your stress control you is the important factor.
HEAT AND HUMIDITY
False: Hot water opens pores
and Cold water closes pores.
(How many times did your mother tell you that one?)
True: Pores have no muscles
and do not open and close.
Behind every old wife's tale is a
grain of truth.
Heat and humidity (St. Louis has the second highest rating in
the U.S.) causes acne flare-ups because the skin "swells" from the
cardiovascular system kicking in. When you get hot or exercise, two things happen at once.
Your skin swells from the freshly oxygenated blood sent to the surface to feed the muscles
that are "working" and then you start to perspire producing acids and salts to
"cool" the body off. This combination of swelling skin with acids and salts
irritates and dries the skin and can cause ZITS to get worse and become larger. (In
Vietnam, many soldiers had acne flare-ups on their entire bodies because of the heat and
Individuals who have a phone pressed
up against their face all day long (Telephone Acne), get acne on the chin and sides of the
face. If you wear sports glasses, helmets, hats, or headbands while doing physical
activities you will get zits around the eyes, hairline, or forehead. Physicians, nurses,
and dental technicians who wear face masks get more lesions around their mouths, chins,
and lower cheeks. Heat, humidity, exercise, and perspiration can cause dryness and
irritation in the very areas that have acne. It is very important to use a Cool It Bag when doing any sport or when exposed to heat
Truth: Cold or ice causes
the skin to compact or get "thinner."
When you ICE lesions or areas, which are covered with Zits,
these areas shrink slightly in size. This allows products like
12% and 20% Smoothing Cream,
20% Smoothing Gel,
Emulsion with Kojic Acid, Retin A, Renova, and Avita to work more
quickly to minimize or eradicate these lesions.
Ice your face with an
ice cube for one minute before applying your products. A Physician would have you do
this for a sprain, burn, or bruise to reduce swelling and irritation. Keep these Acne
Fighting Products in the refrigerator because they also work more quickly when cold.
Medications also causes many acne flare-ups
and can give acne to individuals that do not already have it. Many medications such as
Progesterone (Androgen) dominant birth control pills and hormones, given to women for
menopause as well as birth control, cause acne to worsen and appear in individuals who did
not have it before starting the medication. This can happen within a matter of weeks.
Progesterone (Androgen dominant)
birth control pills are preferred by physicians because there are fewer side effects in
terms of your health associated with them, cardiovascular problems such as blood clotting
and migraine headache. For Acne prone women these pills result in Acne flare-ups by
stimulating greater production of sebum (oil,) consequently the skin becomes oilier and in
a few weeks Acne Lesions start to appear.
Estrogen dominant birth control
pills give extra Estrogen to your system and Acne Lesions start to clear. The synthetic
Estrogen in the medication leads the pituitary message center to shut down all the
hormones normally produced in the ovaries. Since about one-half of a womans
Testosterone is produced in her ovaries, the Estrogen pill lowers her Testosterone, which
means less sebum (oil) is produced and Acne abates.
For many women, menopause means a
reduction in Estrogen. Estrogen is the hormone that keeps our skin youthful looking, soft,
and supple. Progesterone now becomes the dominant hormone. Many women are prescribed
Estrogen and Progesterone together for menopause and the additional Progesterone can cause
an Acne problem. Too much Progesterone promotes excessive hair growth (hirsutism), acne,
oily skin, and weight gain.
Pregnancy, while not a drug or
medication, can have a very strong effect on your Acne. Many women experience
"flare-ups" during the first trimester (first through third month of pregnancy)
because her body contains extra Progesterone during this time. The good news is that
during the second and third trimester (fourth through ninth month of pregnancy) and the
first three months after the baby is born, your body is flooded with Estrogen. Your skin
should be beautiful because the Estrogen keeps sebum production at a minimum and your Acne
is held at bay!
- Have your blood tested and ask to be
checked for hormone levels to determine if you have too much Progesterone or Androgen in
your body if you are female. This test will let you know if the Acne
"decorating" your face is because of a hormone imbalance caused by your own
body, the birth control pills or hormones you are taking, or Genetic (Inherited) Acne.
Very Oily Skin, Hyper Pigmentation, Rash, Excessive Hair Growth, Acne Lesions, etc. may be
hallmarks of too much Progesterone.
- Research any medication you are
taking in a Nursing Drug Handbook, PDR (Physicians Desk Reference) or on the Internet to
find out if the side effects (listed under Contra Indications - Skin,) are Acne, Oily
Skin, Hyper Pigmentation, Rash, or Excessive Hair Growth.
- Keep a record of the dates you
started taking medications, whether for Acne or another condition and see what the
progress of your Acne has been since starting the medication. Is your Acne better, worse,
or the same? Was this medication supposed to help clear your Acne? If you have been on it
longer than one or two months and there is NO IMPROVEMENT or your Acne HAS BECOME WORSE,
then consider discontinuing the medication.
- Research your Birth Control Pills and
Hormone Replacement Pills to find out if they are Progesterone or Androgen dominant and
why your physician prescribed this particular pill for you. There are new birth control
pills on the market, which are made for Acne Sufferers and will not induce or make your
Acne worse. The new Tri-Phasils like Tri-Cyclene are effective. Many physicians prefer
Progesterone dominant pills because the side effects on the body are lower than Estrogen
dominant birth control pills. However, for Acne Sufferers they make your Acne worse and
will not help you to clear it up at all.
Additional Medications Which
used for arthritis, chronic allergies, kidney ailments and psoriasis
Danazol or Danocrine: used to treat
endometriosis and fibro-cystic disease
Dilantin: used for Epilepsy
Lithium: used as a Bi-Polar
In addition, many of the
over-the-counter topical acne medications contain Comedogenic (acne-causing) ingredients,
which will worsen existing Acne or give Cosmetic Acne to those who do not already have it.
Learn to Become an Acne Detective. Check with your physician, look in a
Nursing Drug Handbook or PDR, (Physicians Desk Reference) for any medications you may be
taking to make sure that they are not causing problems for your Acne.
Strickland 1998-2006. This information is published and may not be reprinted.