How to Get Acne Under Control

The information on this page originates from the Reversion website.

What causes acne?
Acne is a result of an imbalance of two or more factors in skin physiology relating to the sebaceous gland and duct system. When our body physiology is working properly, small amounts of oil (called sebum) are produced in the sebaceous glands in the dermis or deeper part of the skin. These sebaceous glands share a duct or tubule that goes to the skin with a small hair. When either too much oil is produced or blockage of the tubule preventing the escape of oil occurs, the net result is acne.

The most common cause of acne is an increased production of sebaceous material due to hormone imbalance or side effects of stress that cause an overproduction of sebaceous material. With the occurrence of acne, there is usually also a related phenomenon called retention keratosis.

These two big words actually refer to the lining cells of the sebaceous duct not shedding properly and staying in place for a longer period of time. This builds up like rust in a pipe until the duct is closed or blocked. When this happens, it sets events occurring that proceed to inflammation or an irritation underneath the surface of the skin. If one imagines that the sebaceous duct were a small stream that got plugged up, it causes a backup of everything upstream from the direction of flow.

Another factor is the presence of several different types of skin bacteria that normally don't cause problems. However, when trapped beneath the skin, the bacteria begin to react chemically with the sebaceous material causing it to break down into free fatty acids. Free fatty acids are quite irritating to the deeper structure of the skin and result in inflammation.

The first signs are redness, firmness, swelling, tenderness, and heat. On about the second or third day of inflammation, white blood cells increase in the area attempting to digest the bacteria and rid the body of them. This results in the formation of pustules and even more irritation extending sideways beneath the surface of the skin.

Does chocolate cause acne?
Eating chocolate, or for that matter any other foods, does not cause acne. The only way chocolate could cause acne would be perhaps to rub chocolate on the skin until it clogs the pores causing a mechanical blockage of the pore openings. Some studies in the past indicated perhaps that excess amounts of some iodine-containing foods, such as shellfish, can influence the severity of acne. This has been questioned by a number of other recent studies, however. My recommendation is to eat, drink and be merry in moderation of all foods.

Does stress cause acne?
Stress does not cause acne per se. Stress does stimulate our body enzyme and immune systems to cause a stimulation of the oil glands. It has been proven that lowering stress levels certainly can help to decrease oil production, and thus decrease the symptoms of acne.

Do fried foods cause acne?
Fried foods in excess certainly can cause us to gain weight. However, fried foods have not been shown to be related to causing acne. In fact, there aren't any specific foods that cause acne.

Of course, skin health is directly related to a well balanced diet, adequate rest and general personal cleanliness. Many people have told me that a good order of tasty french fries properly cooked seemed to lower their stress level.

What part do hormones play in acne?
Hormones play an indirect but active part in acne. The part they play is related to side effects of the hormones, rather than a direct effect. It's interesting that the male hormones (androgens) have a greater effect on skin oil production (acne) than female hormones. This said, it's important to say that male hormones and female hormones of the ovarian type are very similar in their structural configuration. One of the side effects of female hormones related closely to the ovarian monthly cycle in women is the stimulation of oil gland activity.

It's impossible to change your hormones. However, women do have access to some medications that can actually balance the hormone events in the monthly cycle. One very good product that has been developed as a birth control pill was actually developed to decrease the androgenic side effects of the monthly cycle in women in order to control acne. This product is Orthotricyclen.

Some of the benefits from using OrthoTrycyclen include minimizing cramping and discomfort related to the premenstrual cycle, as well as causing more even transition in the phases of the monthly cycle. Tricyclen minimizes the oil-producing side effects from the female hormone shift.

Why is my acne worse before my period?
Very definite physiological and emotional changes are associated with the changing in levels of progesterone and estrogen which are the two ovarian hormones related to menstrual cycles. With the bouncing and changing concentrations of these two hormones, the side effects also bounce and change much like static in a car radio that's bouncing on a gravel road.

Actually, it is the androgenic side effects of these hormones that create oil gland activity in the skin and thus relate to monthly breakouts. In women that have irregular periods, both in time and flow, and those who may have premenstrual cramps and pain, there is a medication which is useful. It's useful in controlling those symptoms, as well as often has a remarkable effect on calming breakouts even to the point of elimination.

That medication is actually a birth control pill designed to give a regular and gradual transition of hormone concentrations of estrogen and progesterone. It does this in a manner that has far fewer androgenic (male hormone) side effects than found in natural ovarian hormones or previously available birth control pills. Ortho Tricyclen is taken as a birth control pill, but actually was designed for the control of acne. Ortho Tricyclen is a prescription drug but may be obtained through your Gynecologist, Family Physician, or Dermatologist.

Who gets acne?
From a medical standpoint, one who gets acne has a combination of factors working in concert. Two or more factors can cause a condition based on the anatomy and physiology of the skin itself to promote an inflammatory response that we call acne.

The factors include:

• Increased oil - either production by the sebaceous glands or added (in makeup etc.)
• Retention Keratosis - skin cells that are not shed properly and plug sebaceous ducts
• Trapped bacteria under the skin's surface - normally present and harmless as they are on the surface.
• By and large, genetics can play a part in acne in that our genetic blueprint does influence thickness of skin, oily tendencies of the skin and basic hormone responses. However, just because one's parent or another family member has acne, does not necessarily mean that you or I will have acne.

It most often occurs in the teenage years, but may appear a few days after birth. This is more often related to increased activity in the hormone processes within the skin. Older persons can develop adult acne, sometimes from different causes. Still basic factors of plugging an oil gland result in the development of an inflammatory process.

Will acne cause scarring?
Any chronic wound or delayed healing process in the skin will cause scarring, whether it be from a surgical wound with complications, an embedded splinter that takes days, weeks or months to work its way out, or an acne pustule that cannot heal.

If I have acne now, can I minimize permanent scarring?
Although you may may already have some permanent scarring present from the past, you should be able to minimize any new scarring. The key things to remember are:

I'm 30 -- why acne now?
It is becoming more and more common for young women who had no problem during teen years to develop acne between age 30-35. There are probably many reasons. One significant reason is related to the use of birth control pills.

Birth control pills utilize two hormone groups that are synthetically made to mimic the ovarian cycle/ovulation processes that are normally at work only during pregnancy. Specifically, birth control pills trick the ovaries into thinking the lady is already pregnant and ovulation does not occur. These synthetic hormones in most birth control pills have strong Androgenic (male hormone) side effects on sebaceous gland production of oil in the skin.

Another possible reason for the 30 year-old onset of acne might relate to hormone adjustments after a pregnancy, nursing a child, or simply experiencing the stressful lifestyle so prevalent today with all the demands and time limits we impose on ourselves.

Men may still have acne symptoms at age 30, but it is unlikely that acne will develop then for the first time. We are all still subjected to stress, and men may skip the gentle cleansing of facial areas after sports, etc., so acne can still be a problem.

When can I expect my acne to go away?
Although acne is not as predictable as the weather, it certainly is as unpredictable as the weather can be. By this I mean acne can seemingly for no reason at all cease and never return. More than likely, if you have acne at this time and you're in an age transition when male or female hormones are still changing randomly and haphazardly, your acne will go away when hormone levels become more consistent.

For instance, during pregnancy, oftentimes acne breakouts become more prominent and suddenly after pregnancy seem to disappear. This again is related to hormonal changes related to normal body physiology.

Most patients that suffer from acne as teenagers can expect acne to certainly become less active in their mid to late 20's as the stresses of life in general become more regulated and less emotionally severe. Do all ethnic groups battle acne?
Persons in every ethnic group may have acne. The genetic component is still in effect. Each parent's family tree will have some effect in a specific persons acne. Significant factors still relate to whether or not the person's skin is oily and the thickness of skin. Other factors such as sun exposure, makeup and skin care products used may influence breakouts as well. Blue eyed, lighter complexion persons usually have thinner and more dry skin as a rule. That group probably has less acne problems than some other groups.

What are the pros and cons of Accutane and other prescription drugs?
Prescription drugs may be necessary to control acne in some cases. Accutane is a very serious drug that acts by interfering with the cells that actually produce skin oil. In several studies it has been able to cut oil production by 80%. Unfortunately, because Accutane is taken internally, it affects many other cells in the body. It often will cause mucosal surfaces to become dry, cracked and even to bleed. This includes lips, mouth, eyes, vaginal, and urinary tract linings.

Accutane has caused significant birth defects during pregnancy from taking only one dose! For this reason, the FDA mandates that pregnancy testing be done for any female of childbearing age before starting usage of Accutane and at intervals during usage.

Accutane can also have significant harmful effects on the liver, and liver function tests must be done monthly while taking the drug. These tests, along with visits to the doctor's office and the cost of the drug itself, may cost $400-$1200 for 2-3 months use. Even with all of these negative effects, Accutane is still useful for some patients to control the worst cases of acne and to prevent deep scarring.

Retin-A is chemically akin to Accutane but is used topically on the skin for acne as well to repair sun damage. It does not have the same degree of health concern problems such as birth defects but it still has troublesome side effects such as irritation, itching, redness, and flaking of the skin area where used. It also is by prescription only, but useful with some cases of acne.

Antibiotics taken orally may be of great benefit when taken for 2-3 weeks to control very pustular acne breakouts. They should not be taken continuously for long periods. Topically applied antibiotics such as Cleocin Tea or erythromycin liquids are almost surely to cause a development of resistant bacteria on the skin that will make acne control more difficult.

Prescription drugs have a place in acne treatment for some cases. They are costly, always have side effects, and should be used only when less drastic measures have not been successful in controlling acne.

Fortunately, the Reversion Acne Control System is very effective in controlling the majority of acne problems in nearly all patients and is able to do this in the least costly way.

Are any kind of "masks" helpful to dry the oiliness of the skin?
Charcoal masks have been reported by some to be helpful in decreasing oiliness. Oatmeal masks likewise may be quite helpful. The key is not to attempt to reach a "no oil" state. This will always cause the body to try to produce more oil and a never-ending cycle will occur in the oil production cells.

What is salicylic acid?
Salicylic acid is an organic acid. A form of it was originally discovered by American Indians in the bark and leaves of certain trees. That particular form of salicylic acid was acetyl salicylic acid. It was known and passed down for generations that when that bark was chewed, headaches or other inflammatory processes actually became improved. We know acetyl salicylic acid today as the drug aspirin.

The salicylic acid used for acne treatment is actually a higher concentration than would be found in nature. Its usefulness in acne control is that it promotes exfoliation of the skin surface cells, and in particular the cells lining the sebaceous ducts. Topical application of salicylic acid on a daily basis in low (1-2%) concentration promotes regular, even exfoliation that minimizes the plugging of follicles.

In more concentrated forms (15-20%), salicylic acid acts as a peeling agent. This is normally reserved for application by an aesthetician, nurse or physician in an office setting to unroof blackheads, whiteheads or pustules. This allows a more rapid removal of the foreign material so that scarring does not occur. Jessner's Peel is a solution of three different peeling agents including 14% Salicylic Acid. Jessner peels greatly enhance the clearing up of acne lesions.

What does "non-comedogenic" mean?
Actually, to describe what non-comedogenic means would require an explanation of what comedogenic means. A comedone is a plugged sebaceous follicle with sebaceous material, epithelial cell debris like a small logjam that prevents this material from getting to the external surface of the skin and being removed.

Non-comedogenic refers to substances that, when put on the skin, have minimal or no effect in plugging the oil glands. Look for this label description on products such as makeup, foundation, and moisturizers. This nearly always relates to a very low oil content in these products and the formulation of them allow very easy removal with gentle cleansing.

If I stop using acne medication, will the acne return?
The factors in life that predispose one to breakouts and acne probably will remain essentially unchanged. If an acne medication has been successful in controlling breakouts and then is no longer used, the acne certainly won't instantly return. However, over time the factors and conditions may become optimum again for acne breakouts. Unless other changes occur in life some of those skin condition factors may cause acne to return.

The good news is that those medications that had worked well in controlling acne should work well again if acne returns.

If we look at what is causing the acne inflammatory process and its relation to a clogged duct or a clogged pore, we get a picture of events trying to occur that can't occur.

By this I mean that if acne persists for several weeks as a pustule or infected area that cannot heal because of fluid being trapped under the skin, the probability of scarring increases. It is for this reason that dermatologists actually extract comedones or sebaceous plugs in follicles. This is done in order to open the outlet for debris to exit the skin. In cases of deep acne cysts, actually incising and draining may be necessary to minimize future scarring.

Certainly controlling acne in its early stages to prevent the formation of fluid-filled pockets is the best way to prevent permanent scarring from acne.

Is acne contagious?
Acne is a skin condition and certainly is not contagious to your friends or family or any other person. However, if you pick or squeeze an acne lesion with your fingernails and then scratch another area, you can contaminate a non-infected sebaceous duct with bacteria-infected material and cause a new lesion to arise. Using the general principles of washing both hands and face on a regular basis and not picking at acne lesions will decrease the likelihood of new acne lesions developing.

Does touching my face make acne worse?
The act of touching one's face during breakouts does not make acne worse, especially if hands are clean. In fact, touching your face with warm water and a gentle cleanser actually improves acne and the overall health of skin. Squeezing or picking at acne lesions definitely will make them worse, larger, more difficult to eliminate, and much much more likely to leave permanent scarring.

Can using a dirty washcloth cause acne?
Using a dirty washcloth should not cause one to have acne if it is not already present. However, if one has acne and then repeatedly uses the same unclean washcloth for washing, it very likely may cause the spreading of new breakouts or the worsening of those present.

These conditions make an ideal culture medium for bacteria from the skin which remain in the washcloth to multiply overnight. The next time the dirty cloth gets used we are re-infecting our acne breakouts! Will sun exposure help acne?
Small amounts of sunlight exposure to skin certainly is healthy. Sunlight is necessary for certain vitamins to function, such as Vitamin D. If any aspect of the spectrum of sunrays has a helpful nature to acne, it would be bands close to the ultraviolet spectrum of light. For this reason, dermatologists have tried in the past to improve acne using sun lamps for the ultraviolet exposure. One problem with the exposure of the skin to ultraviolet light, however, is that ultraviolet light causes a damaging effect to the skin itself. For this reason, ultraviolet light therapy for acne has not been as popular in recent years as it was some years ago. Another negative effect of sunlight on the skin is that sunlight itself can cause an increased production of skin oils which may actually make acne worse.Does acne occur anywhere else besides the face?
Because acne is not a disease but a condition that exists in sebaceous glands, it is possible for it to occur anywhere on the body surface that has sebaceous glands. Obviously, there are some areas void of these oil glands, such as the palms, the soles of the feet and, interestingly enough, eyelid skin. These areas have sweat glands, but they are eccrine or water glands rather than sebaceous or oil glands. Acne mechanica is a condition that occurs with athletes especially, such as football players in the hot summer months that wear shoulder pads or clothing that rubs continually on skin that is exposed to dust, perspiration, etc. Traditional acne does commonly occur on the chest, the back, arms and legs.

In a case study of 400 high school students over a 12-week period, 100% of all participants reported varying degrees of success using Reversion.. Most improvements began within a 2-week period of continued use. Step l . Reversion Antimicrobial Wash rids the skin surface of 99.9% of all bacteria for up to 12 hours, lowering the chance of infection to ever occur. Nothing on the market removes dirt and oily deposits on skin better than Reversion Antimicrobial Wash. Step 2 . Reversion Acne Medication exfoliates skin cells and oily sebaceous debris from the oil glands to unclog pores. Other acne treatments often address only one aspect of treating acne. When only part of the problem is treated (even if by expensive medicine) the results are very poor. Medications like AccutaneT, Retin-AT, RenovaT and antibiotics require a visit to the doctor and a prescription from the pharmacy, which is costly and time consuming. Although these may be useful at times with severe cases of acne, Reversion benefits all patients with acne -- simply, easily and inexpensively.