Discussions that mention tretinoin

Acne board

Quote from kkpb7825:

I am not sure if there is a way of testing for this, because it isn't due to very high histamine levels, actually some scientists argue that histadelics don't even have high histamine levels at all. But their cellular receptors (that govern their metabolic rate) are extra senstive (or respond differently) to normal levels of histamine.

I'll simplify it quite a bit. Yes, if you're histadelic you'll be extra sensative to histamine. Acne is a result of to much sebum, clogged pores and bacteria leading to an infection.

See my post on histamine. If my theory is correct, those who are sensative to histamine experience flushing after consuming foods high in histamine. Flushing means dilated blood vesels, which means increased sebum production....and acne as the result.


1) low histamine diet
2) anti-histamines (~20 mg loratadine per day). Loratadine is Claritin.
3) Vitamin B6 -- Helps the ezyme (diamine oxidase) that processes histamine and reduces flush. Be careful with B6 though, as it can affect nervous system.

and in reality the ultimate cause is glands that are too large and need to be reduced in size. So if the above 3 don't work 100%...

4) isotretinoin (accutane)
Firstly..I am sorry to have taken so long to reply, i have been very busy for the last 2 weeks.

but i am very interested in the research done by erica. they seem to back up the theory quite well. My initial perspective was that pharmaceutical h2 antagonists would be inaffective, but these two studies seem to suggest that they may actually be affective, especially the first abstract that you posted.

to answer your questions.
erica..when i was studying pre-clinical medicine i had to do biochemistry and i came across it then. I was intriged by many of the signs and symptoms of histadelia, because i seemed to have them. Also many of the treatments for histadelia are also treatments for acne, histamine increases metabolic rate and increases toxin (reactive oxygen species..ROS) production, on a cellular level, that is why many people who eat a very healthy diet still get acne, because the problem is with food itself.

I then learnt about the effects of histadelia on insulin resistance (there is a direct correlation due to chronically increased carbohydrate metabolism), and on modulating the immune system (as mentioned in the second abstract you posted). The ROS causes increased inflammation, and modulation of receptor sites IN THE NUCLEUS of ketatinocytes and sebocytes in the skin. These receptor sites are called peroxisome proliferator activated receptors (PPARs), these receptors work along side...and this is where things get really interesting....thyroid nuclear receptors(thyroid hormone levels affect acne), retinoic acid receptors(where tretinoin and isotretinoin work), vitamin D and androgen receptors. The interaction of these receptors determines the rate at which keratin is shed and at which sebum is produced.

Both ALA and essential fatty acids act on PPARs, similarly zinc forms a key part of the retinoic acid receptor and without enough zinc vitamin A cannot work to decrease ketatin proliferation.

With regards to the chinese medical connection. I had a long discussion with a chinese doctor, who described the fact that food itself creates the ROS which cause the acne, because acne sufferers have a genetically fast metabolism. I realised that histadelia also is associated with a rapid metabolism and excessive toxin production, since i have most of the signs of histadelia, my theory was that this could be the cause of the super fast metabolism and hence my acne.

your last point is a very good one..ALA probably works in many ways, antioxidant increasing insulin sensitivity, and as a positive modulator of PPARs. But all these positive effects oppose the negative effects of histadelia, have your blood glucose checked randomly, in my case it is always slightly high, not diabetic but high, due to the fast carbohydrate metabolism, chronically raised glucose leads to insulin resistance. But the problem isnt insulin, because injecting insulin has been shown to improve acne. Also complete fasting improves acne, thus the problem is high blood sugar levels, where does the sugar come from and why is it too high if you don't eat a sugary diet?

Now for smites questions..sorry if these answers are not as good as they might be but i am writing this at nearly 2am and am knackered.

1. i have had acne for 9 years, normally mild-moderate (with antibiotics, tretinoin, niacinomide, azeliac acid and various supplements)..it has been very severe three times, (i have been on isotretinoin twice)

2. i have just finished 1 month of toxin-histadelia treatment, and need to replenish supplies tomoro. Although the first two weeks of treatment were so sucessful that i got slack on some of the regime (ie. calcium), i mainly take the chinese herbs, methionine (with other liver support), msm, ALA as well as the usual acne supplements.

3. My current status, (which i measure by how much benzoyl peroxide and cover cream i need in order to go outside) is...i could happily go out with no Bp or cover cream, which is brilliant for me, but i have slacked in the last week, (not taken supps at regular hours, skipping breakfast, pizza, cookies, pizza etc) so i currently have about 4-5 tiny non-inflammatory white heads, (NB 5 weeks ago i wouldn't have considered them spots worth counting).

4.I have started taking acetyl-L carnitine, because it improves the penetration of ALA into mitochondria to clean it up, at the moment i take 600mg ALA with 400mg Acetyl L carnitine, however i may re-evaluate this
latter dose soon.

5. If you want to get the herbal medicines then i suggest you visit a chinese doctor, they arent things to order on-line without first having your toxic load examined by a chinese doctor (they do this by taking an acne history, palpating your pulses and examining your tongue), because the dose is not fixed and they are powerful treatments. The difference between them and other detox herbs is that they dont just cleanse the liver and the blood, but also the cellular mitochondrion as well as regulating your metabolism. the herbs are written in chinese so i cannot write them, but i will see if i can find out for you.

In the interest of completeness, i will also say that probably the only food group that generally produces the least toxins is green vegetables. I have also noticed that my tolerance to other food groups seems to have changed, i now seem to get tired after eating bread!? i never did before. This may be coincidental. I also use niacinomide gel in the mornings and cetaphil cleanser so that you know.

Lastly because of the posts by erica i will be adding cimetidine to my daily regime at night. Hope thats ok..
good night
It suddenly occured to me that i havent explained what i am taking for my acne based on this new research..

H2-ANTAGONISTS.... this is the most important thing,based on my research it helps to normalise the in-balance in the immune system that is promoted by modern-wester living (and high histamine levels)...PLEASE SEE MY LAST TWO POSTS.


Histamine acts mainly on two receptor sites: H1 (blood vessels, lungs etc) H1 receptors are the ones that cause the symptoms of hayfever and the blushing effect of niacin, as the blood vessels dilate.

H2 receptors act in many other places, including the stomach (where they increase acid secretion and this is what H2 antagonists are sold for (to prevent heart burn). They also act in the skin and on immune cells.

One important immune cell they act on is called the monocyte... they stimulate the monocyte to release a chemical messenger to signal Th2 cells to activate. the chemical also deactivates Th1 cells, this in-balance becomes long term and is also influences by modern lifestyles.

The in-balance causes the delayed type hypersenstivity reaction that is now chronic and is acne-like, or acne.

My next line of research (if anyone wants to join me) is the influence of hormones on the in-balance to the immune system.

Also i am requesting that if anyone tries this treatment that they mention it on this message board, there are other things they should be taking as well. Also i would like to know if this works for anyone else...

But importantly look at the list i mentioned on my post (2 posts ago..with all the evidence) because there are many things that contribute to the in-balance (not just histamine).. they all must be addressed, but once you do i frimly believe that you will see an amazing improvment.

My skin is now clearer (after i week of the H2 antagonist) than it has been since isotretinoin. But finally there are other important points like, dose, timing and other supplements, dietary etc (all based on this theory) that are important, so if anyone wants to know all this then let me know, because i have to ge now..thanks
Erica...the study you are refering to speculates that the effect of cimetidine is due to its possible antiandrogen effects, but more recent research (see my research reply on page 8 of this thread, and sweetjades research on page 7..)...suggests that the effect of H2 antagonists is due to their ability to modulate the immune system.

Even in the study that you found, it mentions that hormone levels aren't actually altered, so perhaps they are so surprised by the effect of the cimetidine on the skin that they say that it must have some sort of androgen altering propertiy...? Because hormone imbalance is the ONLY acceptable current acne-genesis theory?..(this is common in the history of science..experimentors fitting in erronous experimental results with existing paradigms)

Either way, the science is building up, thanks to yourself, sweetjade, freerider and redshoes, the theory now has a tremendous amount of evidence, i am going to re-read all of the important posts in this thread, and summarize them and then re-post it because there is now so much infomation scattered around this thread, it needs to be brought together... i truely believe this could be a paradigm shift in the understanding of acne pathogenesis.

The reason i think this is because, before a new theory takes hold, the people with the illness notice that they have many things in common, (i.e the signs of histadelia..that have been posted early in this thread and that redshoes has added to) and scientists begin to notice seemingly unrelated associations with acne, such as zinc deficiency, refined carbohydrates, candiasis, stress and toxin overload, and of course HISTADELIA.....the problem is that all current theories (the paradigm) about acne-genesis dont explain why all of these things separately can cause acne....

But this new theory Shows the missing link, ALL OF THESE THINGS CAUSE AN IMBALANCE IN the immune system.....urika.....

We need to do more research however...

1).The relationship of this theory to hormonal imbalance..ie is a hormonal imbalance a cause, or an effect of the immune imbalance...?

2). How the above factors can cause the immune imbalance

3).How immune imbalance affects other known areas of acne-genesis, such as PPARs, Insulin resistance..what is the relationship?

4). the cause of histadelia...we know that histadelia is a main contibutor to Th2:th1 imbalance, but what else can be done?

5). Other possible therapies ?

Also in responce to the post by 'freerider' who said:

Perilla Seed Extract has been used for immune system balancing. Maybe it will have a positive effect on acne. Here's a list I found of what perilla seed extract supposedly does:
Suppress T helper Th2-type cytokine production, particularly interleukins 4, 5, 6, and 10 reducing inflammation
Encourage Th1-type cytokines reducing the allergic response
• Suppress IgE production reducing the immediate allergic response
Inhibit the overproduction of TNF-alpha reducing inflammation and allergies
Inhibit histamine release from mast cells responsible for allergic symptoms – a natural anti-histamine effect.
• Inhibit the breakdown of arachidonic acid into inflammatory leukotrienes

I have since ordered perilla seed, and will try it out, see it is any good, (though when i ordered it i actually had some acne, so now it will be hard to tell if its working, not that im complaining!)

BUT another interesting piece of research is that if perilla seed rebalances Th2:Th1, then this decreases inflammatory leuckotriene production, this could provide the link with PPARs....

Obviously i dont wish to bore you to death... but a while ago a study was published showing that a drug called ZILEUTON, (which is a LOX-5 antagonist).........

Zileuton, an oral 5-lipoxygenase inhibitor, directly reduces sebum production.

Zouboulis ChC, Saborowski A, Boschnakow A.

Department of Dermatology, Charite University Medicine Berlin, Campus Benjamin Franklin, Berlin, Germany. [email protected]

BACKGROUND: Zileuton, a 5-lipoxygenase inhibitor, reduces the number of inflammatory lesions in moderate acne and inhibits the synthesis of sebaceous lipids. OBJECTIVE: To detect whether zileuton directly reduces sebum synthesis. METHODS: A 40-year-old female with mild disseminated sebaceous gland hyperplasia and seborrhea was treated with zileuton 4 x 600 mg/day over 2 weeks, was followed-up for 6 weeks after discontinuation of zileuton and was re-treated with low-dose isotretinoin 10 mg/2nd day over 5 weeks. Casual skin surface lipids and sebum synthesis were determined. RESULTS: Under treatment with zileuton increased casual skin surface lipids were normalized and synthesis of facial sebum was decreased. Six weeks after discontinuation of treatment casual skin surface lipids were increased again and synthesis of sebum returned to baseline. Subsequent low-dose isotretinoin treatment led to similar changes of casual skin surface lipids and sebum synthesis with zileuton already after 2 weeks. CONCLUSION: Zileuton directly inhibits sebum synthesis in a transient manner with a potency similar to low-dose isotretinoin at least in our patient.

This study is afollow up to a previous study showing the same thing...i have researched this and found that...the normal products of LOX-5 act on PPARs in the skin (sebocytes and keratinocytes) to increase the production of sebum and keratin...thus causing acne...The research by freerider suggests that Th2:Th1 imbalance causes increased production of the LOX-5 metabolites (ie increased activity of LOX-5).. so instead of giving Zileuton to inhibit LOX-5, which works...we can simply try to re-address the immune imbalance (an imbalance that is favored by modern western living)...ie with H2 antagonists and perilla seed (maybe?) The task now is what else can re-set the balance?

One last point that redshoes brought up is that histadelics, are low-methylators. This is a fascinating development, because methylation is such a vital process in the body, and may infact be the cause of the high levels of histamine (because histamine is de-activated by methylation)....What are the other efects of low-methylation? This is an urgent question that needs addressing?