A year ago, I didn't know what I know now, but I wish that I had. Certainly six, let alone 3 months ago, I didn't know, nor cared how topicals or certain medications worked. I was just glad that they did. Yet, the more I learned, the more connections I found, and the more questions I needed to have answered. As a result, I realized that not only is it important to know the Why's & How's of acne, but also the mechanisms of successful treatment methods. Since we don't have the FINAL answer in regards to acne, we can learn to work our way backward (treatment to cause) by studying what helps us control, prevent or eliminate our breakouts. So, would everyone agree with me that most definitions of ACNE state that it's a condition of having clogged pores or follicles caused by a combination of the factors below?
Hormones (specifically DHT converted in the sebaceous follicles)
Now, if I left something out please let me know. Otherwise, this would explain why there are a variety of acne treatments on the market. They aim to stop one or more aspects of the above problem either topically or internally. As such, that is why different methods work better for certain people than for others. In truth, it really does depend on what your own genetic factors are when it comes to treating your acne problem.
Now if you read various research articles, other's postings, or saw my post Accutane-Diet post [url="http://www.healthboards.com/ubb/Forum1/HTML/018163.html"]http://www.healthboards.com/ubb/Forum1/HTML/018163.html[/url] then you already know that acne is always hormonal. Whether you are exhibiting an allergic response, have dry skin, or extreme hormonal imbalance, there are still hormones, enzymes, vitamins (cofactors), etc that are responsible for the proper maintainence and health of your skin. If these are disturbed in some way, then a variety of skin problems will result, such as rosacea, eczema, psoriasis, keratosis pilaris, dandruff, pseudofolliculitis (ingrown hairs) etc. So, how many of you have more than ONE type of skin problem (includes hair, nails, and hyperpigmentation)? I certainly do...
This made me realize that while a lot of you feel that sebum is the problem, when you think about those that have the above skin disorders, someone with acne that has DRY skin ,or someone that's extremely oily with no acne, sebum can't possibly be the MAIN culprit, but it can contribute. When you consider that everyone has P.Acnes bacteria on the skin, that particular form of bacteria can't be the culprit either, but it may also contribute. Yet, I absoultely believe that either through their own existence or our bodies trying to attack them, that there are various forms of bacteria that will indeed cause, at the very least, an inflammatory response. Infact, most acne sufferrers are just OVERLY sensitive to the androgens or bacteria they produce and as such, that would explain why most of you do not have a hormonal imbalance, but STILL have acne.
Therefore, that only leaves Hyperkeritinization / reduced Desquamation and Skin Cell Proliferation as the "cause". Why? Well, because of all the dead skin building up due to poor exfoilation was the reason you got the inflammed, clogged oil & bacteria filled pores in the first place. Indeed, these problems right here are the reason why The Regimen and the "Acne Cure" have worked so well for many of us. So as you can see, there's not always a need to use expensive prescriptions. Yet, if you've done enough research on your favorite acne medications or other treatments, you should have found that the more POPULAR and MOST EFFECTIVE do a combination or ALL of the following:
Great, so Antibacterial agents (antibiotics, anti-inflammatories, benzoyl peroxide, tea tree oil) reduce inflammation and Exfoilants (Acids, AHA, BHA, sulfur) encourage healthy skin cell turnover, yet that doesn't help us get to the DEEPER source of our problems. If using the above allows you to control your acne problem then you can stop reading now. Yet, if your acne keeps coming back and you breakout WORSE during certain seasons of the year, then you may want to keep reading.
If you want to go for the ULTIMATE acne treatment, you want to pick the one that is going to prevent DHT in the follicles. Now in case some of you aren't familar, DHT stands for 5-alpha-dihydrotestosterone. This is the most produced and most potent form of male hormone in our bodies and the cause of several hormonal disorders such as, acne, hirsuitism, hair loss, and prostate problems. With the exception of removing your reproductive organs and adrenal glands there is NO way you can ELIMINATE all DHT! So please don't even start to obsess over it ;-) However, there are plenty of ways, hence the arguing and confusion, we can reduce and even "normalize" the levels in our system.
So the goal here is to inhibit the conversion of DHT in our system. As far I as know, there are around 5 - 6 enzymes that are responsible for the conversion of testosterone into this form of "super" testosterone. Usually a drug hits 1 or 2 of these enzymes, like 5-alpha reductase. Since DHT can effect hair follicles, sebum glands, and other tissues in the body, some drugs work better than others based on Gender, Genetic Factors, and your Target Area. Of course, diet, exercise, and/or supplements can do the same thing and can be equally confusing. ;-)
One of these versatile DHT inhibitor drugs is Spironolactone. I'm sure you've heard women talk about it, but since we use it internally men usually don't get the opportunity to reap the rewards. This drug can and HAS been used by both men and women since it's actually a diuretic, used in the the treatment of heart disease, high blood pressure, and has been used to treat hormonal acne for over 20 years. Now, believe it or not, it has been utilized in a TOPICAL form (5% cream or 2% solution) for just as long.
Unfortunately. while the results seemed rather favorable, you can only purchase this on hairloss websites or make your own solution. Since this drug is suppose to be safe and effective for males (and females), even with body acne, I am perplexed as to why it's not very popular. It's effectiveness was proven for many years with 95% success (30% remission and 65% improved) and here's what was found: [url="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_u ids=2972662&dopt=Abstract"]www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_u ids=29 72662&dopt=Abstract[/url] [url="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_u ids=2150020&dopt=Abstract"]www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_u ids=21 50020&dopt=Abstract[/url]
So like I mentioned above, there is more than one choice when it comes to DHT inhibitors. Since they don't inhibit all the possible enzymes that are used to convert DHT, that's probably why the most severe or sensitive of acne sufferers require a combination or the most "drastic" (i.e. accutane, diet) of methods to achieve clear skin. Below is a list of mainly DIRECT Anti-Androgens and I'm sure you'll recognize a few. ;-)
NATURAL ALTERNATIVES (topical and/or oral):
Zinc (must be used with B6)
Vitamin A (requires other vitamins and minerals)
EFAs Blend (Essential Fatty Acids - Fish Oils, Omega 3-6-9)
To tell the truth, there are actually more of them than these above. These are what somewhat directly do this, but if you were to take other supplements or medications, you would be able to indirectly effect your level of DHT. That's why you hear some of us raving about taking B5, ALA (alpha lipoic acid), Digestive Enzymes, Thyroid meds, Avandia, Prednisone, Birth Control pills, etc. There's definately more than one way to treat hormonal imbalance. The trick is knowing what the imbalance is inside of YOU and then proceeding to treat it properly.
Please remember, unless you grow out of acne, you will ALWAYS have to follow your successful treatment method. Some of these Anti-androgens are more effective than others and depending on your own "blue print", you may need something that is the strongest, the WEAKEST, or a combination of the two, to solve your problems. Some of these are completely safe and "easier" to follow than others. Others produce painful, irritating, or harmful side effects. While others may throw our other vitamins & nutrients out of psync. Fortunately, some of these can be remedied by taking a good multivitamin, fiber supplement, or detoxing to correct any imbalances, but what about the others?
Since they ALL do the same thing, it really is up to you, but don't think that a Pill is MORE powerful than some dietary change, because for some of us it was the other way around. ;-) Through my own ordeals, I've learned that there is a treatment or combination that is the BEST one for you and your body will let you know if you made the right choice. So think about what your skin concerns are and then choose a product or method that is going to help you eliminate this problem. If it's not right, you'll keep breaking out, so keep testing various methods until you find the one (or combination) that helps you the most, better yet, gets you completely clear. =)
[This message has been edited by SweetJade1 (edited 09-02-2003).]
[This message has been edited by SweetJade1 (edited 09-23-2003).]
I would love to hear what kind of acne you have and what you or the doctors feels is the cause. There are soo many different types of acne, and some may not even be defined as acne but are really some other skin disorder. That's definately an area for a dermatologist, but I can't imagine why anyone would downplay your problem. Yet, what I do know is that whatever is causing our problems, it's different and like I've mentioned in various other posts, it's usually due to one or more enzyme defects, which are related to various Hormonal Disorders. Have they suggested any such disorders in your case? Of those hormonal disorders that I'm familar with, I've mentioned majority of their treatments above and in other posts.
It could also be due to external factors such as pollution, allergic rx (external and internal), pore-clogging ingredients, etc. Now, as for my own skin, diet played the BIGGEST role. I do still take Spiro, but nothing else, and am wondering if I even need the spiro to control my acne (it does help with my mild hirsutism), as it wasn't good enough in combo with other medications.
I've come across people that didn't realize that it was something they were or weren't doing that was causing their problems. I certainly don't claim to be an expert, for I am ALWAYS learning everyday, but I am interested in hearing more about your problem. Is it something that was passed down to you? Have you been tested for allergies or Intolerances (chemical, bacterial, etc)? Even if I don't know, it wouldn't stop me from doing whatever research I could about it, even if I can't find something even close to an answer, I'd still try. =)
I wish you the best of luck
[This message has been edited by SweetJade1 (edited 09-02-2003).]
i stopped masturbating and it stopped the conversion of testosterone to dht in my body. i'm positive because i'm not loosing any hair and i don't have any pimples anymore. before i would wake up and my pillow would have at least 6 or 7 hairs on it. i also had mild acne.
"This drug can and HAS been used by both men and women since it's actually a diuretic, used in the the treatment of heart disease, high blood pressure, and has been used to treat hormonal acne for over 20 years."
Can you please expand on this. Do think internally this could also help a males acne situation? Why would you say its used currently for females to fight acne and not males? and also the possible side effects or dangers it may have? how long can you use this medication? and lastly what effects you think it would have on a male?
100% Absolutely! Unfortunately, from what I've heard on this board, men don't get prescribed this for the treatment of acne, despite studies that were used involving it's usage for that: [url="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_u ids=1386614&dopt=Abstract"]http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_u ids=1386614&dopt=Abstract[/url] [url="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_u ids=6235834&dopt=Abstract"]http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_u ids=6235834&dopt=Abstract[/url] [url="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_u ids=2462132&dopt=Abstract"]http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_u ids=2462132&dopt=Abstract[/url]
There's various anti-androgens and other medications that I've posted that aren't just for female hormonal disorders, but also for men's. It's just that men are a bit tricky to treat because doctor don't want to cut off their "maleness" and as such, their concerns about acne aren't taken seriously. That's why I always urge everyone, male or female, to see a specialist and to get a 2nd or 3rd opinion even. Perhaps one day they will luck out and find that it's not just that they happen to be "overly" sensitive, but that they are indeed producing too much male hormones (I wonder if that's what could cause early prostate problems).
I can't be 100% certain, but I thought I read about someone that was taking Spiro without any side effects. Otherwise, men resolve to trying Saw Palmetto, or other Prostate controlling herbs & supplements (most are used to "cure" acne). Depending on the dosage they either see results or not. Those that see results, either experience side effects, or don't ;-)
Considering that the usual dose for Heart problems is 200 - 800mg vs. the 50mg - 200mg used for acne, the likelyhood of experiencing side effects on such a dosage seems less of a risk to me, but of course everyone is different. I've never experienced side effects, but for men, the side effects that I've heard about are lack of drive and breast tenderness, BOTH of which go away, upon stopping. Therefore, if you are interested, and you are beyond puberty, then you might want to give it a shot.
I can't remember how each of the herbs work, but for Spironolactone, it just binds to the androgen receptors preventing Androgen from binding. So it doesn't stop your body from producing Androgen, it only stops the effects of it. In the process, it also stops it from being converted into DHT. In terms of my acne, it wasn't effective enough for me, but it's been very effective for other women. As long as your liver is doing good (check it every 3 - 4 months), you can stay on it forever, but if you find that Spiro works, you may want to switch to an herbal alternative (eventually I will try that). Saw Palmetto has been found to be more effective than Finesteride, but Finesteride is a terrible anti-androgen for a woman, although it works for males.
Other side effects with Spiro will be the need to urinate frequently, feeling thirsty, and feeling tired. Actually these side effects I did experience while on 200mg (3 years), but when I dropped to 150mg (2 years) they subsided. Otherwise, I've not had problems with this drug. Men should expect to feel the same and possibly a lack in sex drive, but if that occurs, just lower the dosage. If that doesn't work, then you can always try it topically. It doesn't cross over transdermally like Cyproterone, and as such it won't affect any body parts you don't want affected. ;-)
SweetJade thanx for all the information. You definately have me intrigued and i have been intrigued about this "Spiro" from reading some of the other postings I have read. I have very little doubt that my acne is hormonal, just from my experiences and from what i have read of others.
I am currently taking accutane which I have taken once before when I was 17. i am actually taking it humorously as i have little hope that i will gain long term benefits from it. I am on my third month and actually since my first week, my chin area is basically the only place that has had any breakouts, very little anywhere else. Unfortunately they are relentless and painful and cystic. And on my third month still relentless....but everywhere else i have been clear since week 1 for the most part. My goal now is to make a transition to something after accutane. I am still very happy with my accutane as its help heal my skin alot and that was my goal. Luckily my scarring from acne over the years is only noticeable by myself and acne does not leave marks, i heal very well thankfully.
i would love to see doctors, but my energy level of dealing with their ignorance is drained. They consider me as having nothing. But like I said, one day i can be completely clear and 2 days later breakout like crazy, its like a yo-yo back and forth. and very persistent. I also heal as quickly as i breakout sometimes, but sometimes take forever to clear up.....i have no trends or regularities at all. Topicals are helpful to a cetain degree, but not the kind of control I need.
I am considering B5 as a method and maybe even spiro, accutane doesn't give me much for side effects so i am sure i could handle it well. I have Saw Palmetto on my shelf. I have heard good and bad from that herb, so not sure what to think. Who knows the dosages and length of time the people with negative results had used it. But if i did decide to take spiro i will just find a way to use it without a doctors care, i feel very comfortable doing that.
Thanx for you help and i am sure yur posts will continue to give me more ideas
SweetJade, 1 more question recommendations on taking Saw palmetto, IE Dosages and type? I may try taking this for my last month of my accutane usage to see if I notice any results beyond what i feel accutane is causing.
Mind if I ask how old you are? Just curious to see how long you've had acne and if it appears to be going away some over the years. Although since you're on accutane your answers would be a bit skewed. Say, is this something that your family has also experienced and do they still have acne now???
As for your questions um, whether you take Saw Palmetto alone or in some sort of Prostate Formula, you shouldn't exceed beyond 600mg. The avg dosage for men happens to be 150mg - 300mg daily though and you want to look for 85% - 95% sterols (read my DHT suggestions again) In fact there is a guy on this board that is taking 600mg (I think) and experienced no side effects and I believe said he was clear. Try doing a search for Saw Palmetto on this board.
It's interesting though because as a woman, I have taken 1800mg daily of this stuff ALONG with BC & Spiro or Avandia & Spiro and NONE of them ever cleared me or got me to 99% clarity they way dietary changes have ;-) So we indeed are all VERY different, but all these treatments, natural or prescription, work in some manner to stop the production or harmful effects of Androgen/DHT in our system.
I am 26 now, to be honest my acne has changed somewhat, but not really improved. All that has improved in my opinion is my own ability to control it. Trust me don't be fooled by my accutane usage, I mearly am using it to start from a fresh slate, i am not really expecting long term improvements from that alone. Family wise i am the only unfortunate one who has suffered acne even close to this extent, some of my fathers side has the odd breakout, but no one compares to me. I will say they do have somewhat oily skin though. So i feel genetically my oil production is probably higher based on that, although i don't seem to have noticeably oily skin. I did as a teen though.
I know for an absolute fact that my acne is extremely effected by my level of sexual activity. As much as any one wants to deny, argue, disprove, or laugh at the fact, its true. I discovered this when i was about 17. I didn't even want to believe it myself. But I experimented hundreds of times. And the difference is so noticeable, its undeniable. i would say without a doubt 85%-90% is effected by this alone or shall we say the effects it has on my body. I would be happy to bet that the effect of whatever is causing this, is causing 100% of my acne though.
In my late teens I actually refrained from any sex for about 4 months straight. I cant remember having any acne during this time, almost zero. before that If i did have sex, the breakout would happen 24 hours later about. and for me to be clear again, i would have to avoid any sex for at least 1 week. If I had more, more breakouts and they would not stop until i stopped being sexually active. i am not trying to turn this into a sex chat...lol.....i am just trying to explain BRIEFLY the kind of experimenting i have done on my self to PROVE without any doubt whatsoever that its my main cause. In my early 20's i gave this up, its unacceptable to live life this way, so i started experimenting with tons of topicals that would keep me clear and allow me to have a sex life without acne. before i gave up refraining I would only have maybe an acne wash or a benzoyl peroxide cream and thats it. its all i neeeded since i forced myself to avoid sex as much as possible, i had very few breakouts. But i finally stopped that lifestyle....its not natural. So the battle has been on the last 3-4 years to find something to combat this, obviously no topical can help my problem. So the million Dollar question is why does this happen to me and what can i take to stop the effects.....And no i am not gonna avoid sex forever to stop acne..
I am hoping to get a more detailed answer then that. i am taking B6 and zinc right now. Everyone has sex, what i want to know is why this happens to certain people and not to others...hopefully sweetjade might have a more detailed answer to this question. I want to find out whats actually wrong with me.
[This message has been edited by Big_Wreck (edited 09-04-2003).]
I see absolutely ZERO wrong with your post nor your concerns. I've come across plenty of men that have wondered this very same thing. They believe that replensihing their system with Zinc is the answer and I Know it works for some of them. Now, outside of saying Androgens and other hormones, I can't tell you Specifically what those are. So for now, my answer is...I don't know, but I will look into what happens to the Male body when sex is involved (have a few ideas) and get back to you ASAP.
I just have to add some more food for thought on this subject..although all info was good...
yeast and sugars were not mentioned..many people with a higher carb diet and not enough veggies & fruits will often produce higher levels of yeast..beer drinking men with poor diets have been found to rank higher in this area..and often sex will produce more bacteria, yeast coming to the pours as you are "exercising" and that is a way for your body to bring toxins to skin level to release them...water is also a huge factor..even if you drink enough your city or well may have too many additives for your particular body to handle without treating it as a toxin...
Meds & topicals etc. may block and hamper production of some things, but none the less, are imbalancing other areas of your body.
Exercise, relaxation and destressing, a good diet and good water will clear the skin...guaranteed. There are lots of books out there about meditating and relaxiation that can help you learn how to oxygenate your body better so it functions better...
most due lack some vitamins and minerals, and definately almost all are in need of a good multiple, but having conquered this battle of acne (I am 33 and only got bad acne after going off the pill) I can guarantee for everyone balancing your body will cure it. sounds simple enough, the only trick is to find a balanced diet that suits your lifestyle and a good soap and detergent you aren't allergic to.
dermatologists, most docs are trained to use a drug or ointment...they have great knowledge, but I have found in my studies as well as myself as a guinea pig, that nutrition is really the only factor unless some genetic disorder.
start by seeing a nutritionist and have your blood work done and see what you find...
just some thoughts to help those that wish to be free of pills...because it is possible...and balancing not blocking is where your answers are.
good luck to all of you.