posted 09-02-2003 01:37 PM            

Bacteria (P. Acnes or some other)

Excess Sebum (protective barrier & carrier of dirt, protien, blood cells, bacteria, androgens)

Skin cell proliferation (overgrowth of skin cells)

Hyperkertinization (build up of skin cells)

Poor Desquamation (skin cell shedding, exfoilation)

Inflammation (immune response, irritation)

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 http://www.healthboards.com/ubb/Forum1/HTML/018163.html 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:

Prevent DHT conversion--which enoucrages desquamtion, prevents hyperkeritinization, skin cell proliferation, EXCESS sebum production, and inflammation.

Decrease or absorb sebum ---which could prevent hyperkeritinization and inflammation

Exfoliate --- prevents hyperkeritinization, encourages desqaumation, dissovles sebum oil, reduces inflammation

Kill bacteria--- which prevents inflammation

Reduce or prevent Inflammation

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: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=29 72662&dopt=Abstract www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=21 50020&dopt=Abstract

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. ;-)

TOPICAL:
Finasteride (Proscar, Propecia)
Aldactone (Spironolactone)
Flutamide (Eulexin)
Cypertone Acetate (Cyprostat)
Azelex (Azeliac Acid)
Retiniods-
RetinA (Tretinoin...13-cis retinoic acid)
Tazorac (Tazoratene)
Differin (Adapalene, retinoid mimicker)
Vitamin A (Retinol)

ORAL
Finasteride (Proscar, Propecia)
Aldactone (Spironolactone)
Avodart (Dutasteride)
Flutamide (Eulexin, Drogenil)
Diane 35 - (contains cyproterone acetate)
Accutane (Isotretinoin...13-cis retinoic acid)

NATURAL ALTERNATIVES (topical and/or oral):
Controlled Diet
Zinc (must be used with B6)
Saw Palmetto
Nettle
Beta SitoSterol
Vitamin A (requires other vitamins and minerals)
EFAs Blend (Essential Fatty Acids - Fish Oils, Omega 3-6-9)
EMU Oil

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. =)

Good luck

[This message has been edited by SweetJade1 (edited 09-02-2003).]

posted 09-02-2003 07:55 PM            

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

posted 09-02-2003 11:21 PM            

Re: Spiro

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?

posted 09-03-2003 12:50 AM            

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. ;-)

posted 09-03-2003 08:09 PM            

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

R

posted 09-04-2003 08:43 PM            

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.

Bye for now =)

posted 09-04-2003 09:39 PM            

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..

posted 09-05-2003 04:01 PM            

Therefore, DIET is covered, because it does act as a control/preventative method for our hormones. However, THANK YOU for mentioning more specifics about it. I try not to favor any particular solution because I know that while topicals and most oral drugs failed me and a Gluten-Free Diet didn't, I know that for others, oral medications did the trick.

I prefer the most natural methods IF possible to cure myself and most definately there's something special about probiotics if you've been overdosing on Antibiotics (ALL of us) and an anti-yeast diet are a good way to go. While some feel that they cleared because they got rid of the candida in their system, I still wonder if it may not ALSO be due to the fact that they just lowered a HUGE amount of sugar entering their system, thus lowering their androgen production and DHT conversion. Well as long as it works for us right? ;-)

posted 09-05-2003 09:36 PM            

Big,
I have not forgotten about you, just answering posts that don't require links, etc. About your diet though, we all thought we ate "healthy" in terms of carbohydrates, even when we eliminated the junk food. However, most of us realized that sugar is in EVERYTHING, yes even some proteins, and as such one food item COULD be problematic for you, or in general it could just be that you need some form of a Low Carb Diet. If interested, mind posting what you usually eat for us?

posted 09-05-2003 10:31 PM            

I will have to dig deeper, but just from that list above Testosterone would be the obvious culprit. Granted, Cortisol, Norepinerphrine and Epinephrine could also be causing your woes, but it would also be due to ADDITIONAL production of Testosterone by the Adrenal Gland in order to produce those hormones (more about that later). I do know that for females Prolactin levels are vital to hormonal balance, if it is too high, they can experience menstrual irregularites, acne, etc. However, I don't know offhand how that would apply to you, other than to say that it also INCREASES your testosterone levels. ;-)

So from what I've mentioned above here's what I'm thinking:

1. You make TOO much testosterone during sex, unlike other males (that also make lots during sex). Same treatments apply as mentioned above.

2. You happen to be overly sensitive to the "normal" amount of testosterone in your system. This is actually the cause for most people's acne, and you can use androgen/dht inhibitors/balancers such as Diet, Supplements or medications to help you.

3. Most acne sufferers are lacking some sort of enzyme and perhaps you are lacking an enzyme neccessary in the production of Cortisol. In your case it would be called Non-Classical Congenital Adrenal Hyperplasia or Late-Onset Congenital Adrenal Hyperplasia. What this means is that you body is TRYING to produce cortisol, but is unable to so it trys even HARDER and as a result other steriod hormones that the the Adrenal Gland produces are OVERPRODUCED. IF this is your problem, in your case, it may not show itself until periods of GREAT stress...

4. You may be lacking aromatase enzymes. Males and females have enzymes that convert various steriod hormones into OTHER steroid hormones as the body sees fit (great huh?). There are enzymes that convert Testosterone into DHT (super testosterone), Progesterone into Female hormones (Estrogens) or one of the Male Hormones (Androgens), and there's Aromatase that converts Testosterone into Estrodial (estrogen). If this is your problem, then you just need to alter your diet or if you like to use supplements, buy those that will aromatize more testosterone for you.

Now if the last one is your problem, at the moment I don't know of any aromatizing herbs or supplements. I'm familiar with DHT inhibitors that also just happen to be Aromatase inhibitors. LOL, do not ask me why or how, but for some reason despite the fact that these Anti-androgens WORK, some of them also stop what testosterone you are still producing from turning into estrogen. So MAYBE that is why, so that your system doesn't loose too much testosterone.

Then again, if that's so, they why is it that some males talk of getty puffy chests, he he a side effect that I NEVER got on BC or Spironolactone? ;-) Of course that would explain why some men lost desire, because they lack a certain amount of Testostrone neccessary for the ability, and the same applies for why women lack desire as well.

So that's all for now, I'll try and look up things that aromatize, but I'm guessing it's not too different from what's already been mentioned on this board. I tell you, having a Balanced diet or taking supplements that contain the vital nutrients neccessary (doesn't a good diet) is really the ANSWER to so many health/hormonal problems. I just keep running into the same multi-faceted supplements and diets for sooo many "cures"

Night

posted 09-05-2003 10:39 PM            

thanx for all that
R

Don't worry about me losing my drive sweetjade, maybe your explaination is why its so high...lol....So if it can keep my acne under control i am sure i will still function just fine thanx again.
[This message has been edited by Big_Wreck (edited 09-05-2003).]

posted 09-07-2003 10:09 PM            

I believe that acne can be due to a combination of Environmental(dioxin & other pesticides, toxins, dirty telephones, etc), External (bad skincare, haircare, etc), and/or Internal factors. For me personally, my formula was Environmental-5%, External-15%, and Internal-80%. Since this is already so long, I'll just go over one way you could go about discovering if yours is mainly internal:

1. If your problems persist, your BEST bet is to go to a doctor.
a. Think about what your symptoms are. Think about any other problems that you have (vision, dental, stomach, energy, wieght, headaches, muscular, etc), for sometimes these symptoms may be related to a specific disorder. Also look back on your famiy's history and see if they can recall any problems or specifc disorders. Do they have anything similar to what you have?

b. If you have some idea as to what the problem is than seeing a specialist, such as an Endocrinologist, Gastroenterologist, Allergist, or Naturopath would be to your advantage.

2. You need to find out if you have an allergy, intolerance, a hormonal imbalance, or some nutrient defiency by having the appropriate tests run. Sometimes the tiniest thing really can make that much of a difference.

3. Based on those results you'll be prescribed maybe Accutane, Birth Control, an Anti-Androgen, or some other specific drug. Or maybe you'll be advised to take a certain vitamin or to change your diet.

4. There's usually more than one way to treat a problem, so if the above fails, you should try a different doctor, formulation or technique.
a. Many vitamins and supplements "cure" acne, but which ones are right one for you?

b. The same should be asked of herbs. These have medicinal properties and as such, you should pick an herb that will do what you need it to do, based on your [u]specific[/u] internal problem. In other words, find an herb that has the same suggested use as the prescription drug your doctor put you on and see if it will help or if you can replace the drug with it. For example, Spironolactone's equivalent would be Saw Palmetto or BetaSitosterol.

c. Diet (headache anyone?) There are between 30 - 50 special diets out there and if we included our own unique diets, the list would be even longer. NOT all of these are designed to cure acne, but SOME of them have proven to be far more successful than anything else! Once again this is very much so depends on how YOUR body works, what it needs, and what your specific internal problem is. The most successful diets that I'm aware of are:

Non-Processed/Refined Diet-- General Health, Insulin-Hormonal Imbalance

Organic/Whole Foods Diet--General Health, Allergies, Intolerances, Toxin/Chemical/Hormone Sensitivities

Vegetarian/Vegan Diet--General Health, Intolerances, Toxin/Chemical/Hormone Sensitivities

Low Fat Diet- General Health, Toxin/Chemical/Hormone Sensitivities

Low Carbohydrate/Sugar Diet--General Health, Allergies, Intolerance, Autoimmune Disease, Insulin-Hormonal imbalance

Mucous Free Diet-- Intolerance, Autoimmune Disease, Insulin-Hormonal imbalance

Gluten-Free Diet--Allergies, Intolerance, Autoimmune Disease, Neurological problems, Insulin-Hormonal imbalance

No Grain Diet-- Allergies, Intolerance, Autoimmune Disease, Neurological problems, Insulin-Hormonal imbalance

Paleolithic Diet--General Health, Allergies, Intolerance, Autoimmune Disease, Insulin-Hormonal imbalance, Neurological Problems, Toxin/Chemical/Hormone Sensitivities

"Evil" Lectin Free Diet--Intolerance, Autoimmune Disease, Neurological problems, Insulin-Hormonal imbalance

Elimination Diet--(Ex: Wheat, Diary, Iodine, Spicy Foods, MSG, Pork, etc) Allergies, Intolerance, Autoimmune Disease, Toxin/Chemical/Hormone Sensitivities

These are just generalized catagories, but there are PLENTY of books or websites, that use the above in some sort of dietary program, such as the Specific Carbohydrate Diet (SCD). You just have to figure out which applies to you and what program fits your lifestyle and is the MOST effective for you. Yes, sometimes that does requres a bit of "trial and error", so just because one diet didn't work for you, it doesn't mean that NONE of them will.

5. Are there any specific foods or drinks you find that you consume the most?
6. Are you drinking enough water to flush toxins, hydrate, increase energy?
7. Are you getting enough sleep to decrease stress, balance hormones, improve healing?
8. Are you exercising to improve circulation, decrease stress, regulate hormones, etc?

9. Have you tried other alternative methods such as
a. Therapy--Counseling, EFT, Hypnotherapy
b. Detoxing--Colon Cleanses, Fasting, Parasite Cleanses, etc
c. Eastern Medicine-- Accupuncture, Ayurveda, etc

I personally didn't really go through the method like that, but it resembles what I learned and experimented with during the past 10 years. Personally, so far Soda, Cherries, and Gluten Grains (or all grains) break me out.