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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 [b]not only is it important to know the Why's & How's of acne, but also the mechanisms of successful treatment methods[/b]. 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?

[b]Bacteria[/b] ([i]P. Acnes [/i]or some other)

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

[b]Skin cell proliferation[/b] (overgrowth of skin cells)

[b]Hyperkertinization[/b] (build up of skin cells)

Poor [b]Desquamation[/b] (skin cell shedding, exfoilation)

[b]Inflammation[/b] (immune response, irritation)

[b]Hormones[/b] (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. [b]They aim to stop one or more aspects of the above problem either topically or internally[/b]. As such, that is why different methods work better for certain people than for others. In truth, it really does [b]depend[/b] on what [b]your own genetic factors [/b]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 [b]acne is always hormonal[/b]. 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 [b]more[/b] 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 [b]extremely[/b] 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, [b]most acne sufferrers are just OVERLY sensitive to the androgens or bacteria they produce[/b] and as such, that would explain why most of you do not have a hormonal imbalance, but STILL have acne.

Therefore, that only leaves[b] Hyperkeritinization / reduced Desquamation [/b]and [b]Skin Cell Proliferation[/b] as the "cause". Why? Well, because of all [b]the dead skin building up due to poor exfoilation was the reason you got the inflammed, clogged oil & bacteria filled pores[/b] in the first place. Indeed, these problems right here are the reason why [b]The Regimen [/b]and the "[b]Acne Cure"[/b] 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 [b]combination[/b] or ALL of the following:

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

[b]Decrease or absorb sebum [/b]---which could prevent hyperkeritinization and inflammation

[b]Exfoliate[/b] --- prevents hyperkeritinization, encourages desqaumation, dissovles sebum oil, reduces inflammation

[b]Kill bacteria[/b]--- which prevents inflammation

[b]Reduce or prevent Inflammation[/b]

Great, so [b]Antibacterial agents [/b](antibiotics, anti-inflammatories, benzoyl peroxide, tea tree oil) reduce inflammation and [b]Exfoilants[/b] (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 [b]keeps coming back[/b] and you breakout WORSE during certain seasons of the year, then you may want to keep reading.

[b]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[/b]. Now in case some of you aren't familar, DHT stands for [b]5-alpha-dihydrotestosterone[/b]. This is the [b]most produced [/b]and [b]most potent[/b] 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 [b]there is NO way you can ELIMINATE all DHT[/b]! 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 [b]inhibit the conversion of DHT[/b] 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 [b]same[/b] thing and can be equally confusing. ;-)

One of these versatile DHT inhibitor drugs is [b]Spironolactone[/b]. 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 [b]HAS [/b]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_uids=2972662&dopt=Abstract"]www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=29 72662&dopt=Abstract[/url] [url="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2150020&dopt=Abstract"]www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=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. ;-)


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

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


[b]NATURAL ALTERNATIVES[/b] (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 [b]B5[/b], ALA (alpha lipoic acid), [b]Digestive Enzymes[/b], Thyroid meds, Avandia, Prednisone, [b]Birth Control pills[/b], 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 [b]grow out of acne[/b], you will [b]ALWAYS [/b]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, [b]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.[/b] ;-) 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 [b]right[/b], 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).]

[This message has been edited by SweetJade1 (edited 09-23-2003).]
I follow the glycemic index..more then not. It is easily found in a search engine. Very comparible to "diabetic" diet following to keep insulin levels more stable and the body reacts to that by running more smoothly. When I say "diet" I don't mean it in any other terminolgy but your daily intakes, no special diet, just learning to regulate your body and your insulin levels. It isn't so much "low carb" but "good carbs" and rice is of course fine...although brown rices would be a better choice then white, but I am not against any certain foods or ways of eating. I am merely suggesting altering a few things to see if it helps. I have a BS in exercise science and nutrition and left school like most in my field..anti atkins, follow the RDA, etc., but as the years pass and I listen, watch and train others my mind is more open. Like I said earlier I use myself as a guinea pig and have found the glycemic index to be most helpful.
Anyway..canteloupe is a good fruit to help with skin, tomatoes are also good (even though high in carbs), green peppers, red peppers, onions..also great. I stay away from yellow veggies and starches..
One other thing of interest maybe I have found in my studies..the good ole USA is one of the only countries injecting their foods with steroids..most countries will not even allow our meats to be imported because of this...I am a strong believer that these additions to our meats is also having negative effects on acne, since the US ranks higher with acne issues then any other country..could be the higher carb diets as well...but something to think about...
I don't say to stay away from any food...but just see if balancing your insulin won't help cure your issues..and everyone processes and uses food differently so there is not "set" way to do it..thus self experiment to see what works for you.
a typical day for me is as follows:
breakfast (hate it, but do it): 4oz cran or orange juice and whey protein powder..and of course coffee..lol..
lunch a salad with chicken, or teriyaki on rice with veggies..once in awhile a 1/2 sandwich or a small burger...
dinner..fish, chicken, or steak and veggies..and thai food sometimes.
I use olive oil to cook most my meats.
I stop drinking coffee by lunch and switch to water for the rest of the day, but may have a diet soda with dinner..
a lot of meds, topicals etc. are robbing your skin of the natural oils it is producing..by limiting the oil/fats in your diet as well the body ends up producing more and it is a cycle...often many acne prone people aren't getting enough oils and fats to help their body function.
coffee is a known stimuli that increases many negative responses and is a "horrible" thing to have when you have acne, but I am addicted...lol so I compensate by drinking extra water and ensuring balance in my insulin levels to help level out the bad with good...
just like beer...okay want a couple beers then with your beer have a good protein and veggie dinner...have no other carbs or starches..it is a trade off...
if you study the index and learn how it works you will find what works for you...no special cure or plan, it is your own thing you incorporate into your lifestyle...
insulin levels is what rules your hormone production...period.
stress, fight or flight responses also release andrenalines that will affect levels also, thus why "relaxation" is also key...exercise is a big helper in that so you are probably great there, but I still think a good "oxygenating" 5 minute breathing exercise would help too..
I do not claim to know it all, but after all my years studying the human body and actually experimenting on myself I do know that it is easily found how the body works or what does this or that, but truley you will find your answer in insulin balancing...and that is accomplished through diet...and no most don't get all of their daily minerals and vitamins in a good diet thus why a multi is a good idea...
I take a multi every monring..I also take 500mg of flax seed oil...having enough oils and fats will help your body stop overproducing...also why a good moisturizer after cleansing instead of drying ointments will help keep acne away...
oh and soaps..very important...dove is great...acne bars simply dry your skin and then more oils(sebum) is produced...try wahing with dove, using aveeno moisturizers (the oatmeal is naturally calming to the skin), and a warm shower not hot...
and again..everyone is different...but if you study other countries nutrition, older times before all the additives(which btw many are allergic to)...you might find something that works for you.
peace





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