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#1 SteveBrown

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Posted 10 July 2004 - 12:52 AM

Acne is a problem I have dealt with, off and on, since I was a teenager. Now that I'm 54, four decades of experience has taught me how to control acne and maintain a clear complexion. I decided to post this so that humankind may benefit from my knowledge and experience. wink.gif

Acne is a bacterial infection that occurs in the pores of the skin. Controlling acne is therefore a matter of changing your skin from a friendly to a hostile environment for p. acnes, the bacteria that causes acne. An acne pimple is the result of the inflammatory defense the immune system presents to an invasion into the pore by p. acnes, and to their proliferation once inside the pore. That defense entails dispatching millions of leukocytes, or white blood cells, to the site of infection, where they actively seek out and destroy bacterial cells. That is our last line of defense, and it nearly always works, because the infection rarely becomes systemic and life-threatening. However, the resulting carnage can give your face the appearance of a battleground, and to avoid that, it is best to use a two-tiered strategy: to deny the bacteria access to the pores, and to make the environment within the pores less favorable for them.

I believe that the mobilization of leukocytes to kill bacteria in the pores is continuous even in non-infected skin, but it occurs below the level of activity at which visible pimples appear. So, if the sum of the number of bacteria that can gain access to the pores via the epidermis, plus the number of new bacteria resulting from reproduction within the pores, is limited to a quantity that is no greater than the number of bacteria that are routinely killed by leukocytes, then pimples will not appear. The leukocytes will be able to maintain a clear complexion, free of visible signs of infection. To achieve that condition, it is necessary both to reduce or eliminate bacteria on the epidermis, and to make the environment within the pores less favorable for their proliferation. The emphasis on this web site appears to be on eliminating bacteria, not only on the epidermis, but also on killing bacteria within the pores by means of the penetrating chemical benzoyl peroxide. However, while I believe that reducing or eliminating the population of bacteria on the epidermis is important to control acne, I believe it is just as important to make the environment within the pores less favorable, and I'll address that aspect first.

Bacteria within the pore require nourishment, and they feed upon the sebum (oil) secreted by the sebaceous gland in the pore. The amount of sebum secreted is regulated by hormones. One of those hormones is insulin. The pancreas secretes insulin in response to sugar entering the bloodstream from the digestive tract. If the amount of sugar exceeds that which you can metabolize right away, insulin is secreted to convert the excess sugar to body fat. Most of that fat is stored in subcutaneous layers, but some of it is secreted as sebum in the pores. Above a critical level of sebum, the bacteria thrive. Below that level, the leukocytes are able to keep the population of bacteria in check. Keeping the secretion of sebum below that level is therefore a matter of preventing the influx of sugar from the digestive tract from exceeding that level at which the pancreas is stimulated to secrete insulin. To do that, it is necessary to avoid eating foods containing large amounts of sugar, especially refined sugar. A banana is ten times better for you than a candy bar, because it has a lower glycemic index, a measure of how fast sugar is released into the bloodstream from the digestive tract. Adequate dietary intake of protein and fats is also important in controlling the rate of the release of sugar into the bloodstream. More information about controlling the insulin response to sugar is available in books and on the web, usually with regard to controlling body weight. However, such regimens are also useful in controlling acne.

Of course, it is also important to reduce or eliminate bacteria on the epidermis, from which they gain access to the pores. The first tactic toward that end is to keep the skin clean, by means of washing with mild soap and clean water. After washing, do not use a towel, but allow the skin to air dry, which normally takes a few minutes, depending on relative humidity. Oral hygene, the brushing of teeth and using mouthwash, is also important, because I believe it is no coincidence that pimples tend to occur on the face and especially around the mouth. Anything that touches the face, such as pillowcases and bedsheets, should be kept clean, as should the hair. I have found it useful to disinfect the screen and cutters of my electric shaver periodically by immersing them in rubbing alcohol, and to wash my face before shaving, as well as after.

Benzoyl peroxide is widely recommended to control and prevent acne, because it is able to penetrate the skin and kill bacteria within the pore. The chemical formula of bp is C14_H10_O4. (Underscores inserted for clarity; subscripts not easily implemented here.) BP reacts with moisture on the skin and within the pore to release H2_O2, which is hydrogen peroxide. It is the hp that actually kills the bacteria. However, hp is a powerful oxidizer, and it is known to be cytotoxic, that is, toxic to all living cells, including your own. In high enough concentration, it may be toxic to leukocytes, which are your body's own defense against invading bacteria. For that reason, I believe benzoyl peroxide should be a treatment of last resort, for stubborn cases of acne.

The method I prefer, to sanitize the skin routinely, immediately after washing, is to apply hydrogen peroxide, 3% aqueous solution, available in all drug stores and supermarkets. Being 97% water, it's physical properties are very similar to water, and hp does not penetrate the skin, as benzoyl peroxide does. Instead, it kills bacteria on the surface layer of skin, the epidermis, where it cannot do harm, because the epidermis consists of dead cells. HP 3% solution also has a surface tension similar to water, causing it to form large drops, instead of wetting the skin evenly. So, I have found it useful to mix a surfactant, or wetting agent, in the form of two or three drops of mild liquid detergent, to one bottle of hp. The MSDS (Material Safety Data Sheet) for hydrogen peroxide, 3% aqueous solution, says that contact with the eyes is a serious hazard. If contact occurs, the eyes must be flushed with running water for 15 minutes. So, hp must be applied to the face very carefully. I use a cotton ball to apply it to my nose, and I pour a little into a cupped hand to apply to chin and mouth area, with eyes closed, being careful not to splash.

Those are the methods of dealing with acne that have worked for me. Good nutrition, hygene, kill bacteria on the surface of the skin, and let the leukocytes do their thing down deep. I'm aware that this web site states that the dietary link to acne is a myth, but I am certain from my own experience that excess sugar gives me acne. Normally, I avoid any food containing refined sugar, and my complexion remains clear. Many times, while attending a family birthday party, I got complacent and ate a big slice of cake with lots of frosting, ice cream, plus a few cookies and a glass or two of soda, and every time, I always paid a price in the form of a zit or two that appeared, usually within 24 hours. I know this post has been long, but if the information helps just one person, the effort will have been worthwhile.
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#2 aaa

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Posted 10 July 2004 - 12:00 PM

Thank you for posting.

#3 nomore

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Posted 10 July 2004 - 12:09 PM

nice post.. thanks for the info

#4 Bailey

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Posted 10 July 2004 - 12:27 PM

QUOTE(SteveBrown @ Jul 10 2004, 12:39 AM)
So, I have found it useful to mix a surfactant, or wetting agent, in the form of two or three drops of mild liquid detergent, to one bottle of hp.

Can you exlplain more? What is it called?

Also, what moisturizer do you use?

#5 edenfield

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Posted 10 July 2004 - 12:47 PM

So, I have found it useful to mix a surfactant, or wetting agent, in the form of two or three drops of mild liquid detergent, to one bottle of hp.

he says right there tongue.gif

in the form of two or three drops of mild liquid detergent, to one bottle of hp.

i'm guessing like dawn or something just mild dish soap the brand that's 'safe for your hands'

#6 lib

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Posted 10 July 2004 - 02:29 PM

I thought hydrogen peroxide doesnt' actually kill any bacteria?

#7 SteveBrown

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Posted 10 July 2004 - 02:36 PM

> Can you exlplain more? What is it called?
> Also, what moisturizer do you use?

I use Ivory liquid hand soap, which is available in a pump bottle and refills. It also makes a great, inexpensive shampoo. You can also use any mild liquid dish detergent as a wetting agent. Mix two or three drops with one quart of hydrogen peroxide, 3% solution. Be careful not to get hp into the eyes. In case of contact, flush eyes for 15 minutes with running water. HP solution evaporates from the face after a few minutes, without leaving any residue. I believe it evaporates before it has a chance to penetrate the epidermis, and that makes it safe to use. It has routinely been used as an antiseptic on open wounds, so I'm sure it's safe to use on unbroken skin.

I ordinarily don't use benzoyl peroxide or other acne medication, so I find I don't need to use a moisturizer. For washing, I use Lever 2000 "Moisture Response" soap, which is very mild. I've found that anti-bacterial soaps do not have a noticeably better effect on acne than ordinary soap.

Here is a link to more information about the link between insulin and acne:

http://www.mercola.c.../bread_acne.htm

The article discusses the effect of bread on insulin response, but I believe that whole-grain bread and pasta are OK and much better for you than foods containing added sugar.

#8 SteveBrown

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Posted 10 July 2004 - 02:48 PM

>I thought hydrogen peroxide doesnt' actually kill any bacteria?

It doesn't penetrate down into the pore as benzoyl peroxide does, but hp is very effective at killing bacteria on the surface of the skin. Consequently, hp does not irritate or dry the skin as bp does, and I believe it is safer than bp. My strategy is twofold: eliminate bacteria on the surface, so they can't gain access to the pores; and control your insulin response, so that the environment in your pores is not favorable to the proliferation of bacteria, thus enabling your leukocytes to keep the bacterial population in check.

#9 Bailey

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Posted 10 July 2004 - 03:51 PM

QUOTE(SteveBrown @ Jul 10 2004, 02:23 PM)
I use Ivory liquid hand soap, which is available in a pump bottle and refills. It also makes a great, inexpensive shampoo. You can also use any mild liquid dish detergent as a wetting agent.

You put hand and dish soap on your face???

#10 cynic

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Posted 10 July 2004 - 04:23 PM

SteveBrown,

I'm intrigued about the link between the low-carb diet theory and acne. I've pretty much given up eaten sugar altogether - no fizzy drinks, chocolate, sweets, etc., also.

What would class as 'high carb' food? I've always been a sucker for eating tonnes of bread (though I switched from white to wholemeal after reading about how white bread can trigger acne). Would I include pasta, rice, potatoes etc as 'high carb', and is this an aspect of it you follow/followed yourself?

And if so, what the hell is there left to eat? confused.gif

Thanks for the first post you wrote by the way, very informative.

#11 Scotty_G

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Posted 11 July 2004 - 10:34 AM

Yea you can't have any of that cynic. Those things you listed are all high carbs! There is plenty left to eat though. What you have to start eating more of is poultry and fish! Combine that w/ a lot of vegetables and some fruit for starters.

#12 cynic

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Posted 11 July 2004 - 05:17 PM

Thanks Scotty.

What about the benefits of switching from white to brown (wholemeal) bread? What's your opinion on that?

Also, how much a day of carbs would be, say, 'too much'? Realistically, I can't cut them all out of my diet - I'm a fussy eater at the best of times - but is there some kind of 'limit', perhaps?

#13 cynic

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Posted 11 July 2004 - 05:18 PM

Thanks Scotty.

What about the benefits of switching from white to brown (wholemeal) bread? What's your opinion on that?

Also, how much a day of carbs would be, say, 'too much'? Realistically, I can't cut them all out of my diet - I'm a fussy eater at the best of times - but is there some kind of 'limit', perhaps?

#14 cynic

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Posted 11 July 2004 - 05:19 PM

Apologies, obviously, for the duplicate post. rolleyes.gif

#15 SteveBrown

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Posted 14 July 2004 - 11:01 AM

QUOTE(Bailey @ Jul 10 2004, 02:38 PM)
>You put hand and dish soap on your face???


I was referring to adding a few drops of mild detergent to a quart of hydrogen peroxide, to make it wet the skin, instead of beading into large droplets. For washing my face, I use Lever 2000 "Moisture Response" soap.

#16 SteveBrown

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Posted 14 July 2004 - 12:05 PM

QUOTE(cynic @ Jul 10 2004, 03:10 PM)
SteveBrown,

I'm intrigued about the link between the low-carb diet theory and acne. I've pretty much given up eaten sugar altogether - no fizzy drinks, chocolate, sweets, etc., also.

What would class as 'high carb' food? I've always been a sucker for eating tonnes of bread (though I switched from white to wholemeal after reading about how white bread can trigger acne). Would I include pasta, rice, potatoes etc as 'high carb', and is this an aspect of it you follow/followed yourself?

And if so, what the hell is there left to eat?  confused.gif

Thanks for the first post you wrote by the way, very informative.

The fact of the matter is, we can't live without carbohydrates. Our muscles can burn fats, but the only fuel the brain and nervous system can use is glucose, a simple sugar, conveyed by the bloodstream. To control your insulin response, it is necessary to eat a balanced diet that includes adequate portions of protein, fat, and carbohydrates. The carbohydrates should be whole-grain and natural foods, such as brown rice, whole-grain pasta and bread, oatmeal, vegetables and fruit. Refined sugar, white bread, and white rice should be excluded from the diet, because those carbohydrates have a high glycemic index, a measure of how rapidly they are digested and absorbed into the bloodstream. Too rapid absorption causes a spike in insulin production, which leads to a hormonal shift that increases the activity of the sebaceous glands, which causes acne.

It would be a good idea for anyone afflicted by acne to Google "glycemic index" and do some research. One important thing to know is that eating fruit is better than drinking fruit juice, which is a concentrated source of fruit sugar. Experience has taught me that while fruits are good, they should be eaten in moderation. I lean toward whole grains, broccoli, corn, brown rice, potatoes, and tomatoes as my source of carbohydrates.

A balanced diet means that the carbohydrates should be eaten with adequate protein and fats. When I was a teenager, the literature on acne recommended reducing or eliminating fats from the diet. Some of it still does. That was a misconception, based on the simplistic idea that since acne is caused by overproduction of sebum (oil) in the pores of the skin, that fats in the diet are the cause of the problem. It is now known that both protein and fats in the diet are essential for proper nutrition, and that they help to regulate the insulin response, by slowing the digestion of starches into sugar.

While I have found the topical application of hydrogen peroxide, 3% solution, effective at reducing the population of p. acnes bacteria on the skin, it is a bit strong for frequent use. A solution that works almost as well, but is less harsh, is a solution of sodium hypochlorite, which I make by mixing 1 teaspoon of chlorine bleach into 1 quart of water, with a few drops of mild detergent added to improve wetting of the skin. As with hydrogen peroxide, contact with the eyes must be avoided. Unlike hydrogen peroxide, which evaporates completely, sodium hypochlorite solution leaves a residue after the water evaporates, which is not visible but has a faint chlorine odor. For that reason, I usually use the sodium hypochlorite solution before going to bed, and I use the hydrogen peroxide during the day.