by DR JOHN BRIFFA, Daily Mail
Acne often causes considerable distress to sufferers, and while it is most common around puberty, it can affect adults, women in particular, well into their 20s and 30s.
One mainstay medical treatment is antibiotics. However, Swedish research presented at an American conference last week suggests the bacterium associated with many cases is becoming increasingly resistant to these drugs.
There is real concern that over-use of antibiotics may lead to problems with untreatable acne in the future.
New research also shows that a significant proportion of women with acne have relatively high levels of male hormones, such as testosterone in their systems.
Could it be that treating acne with antibiotics is failing to get to the root of the problem, and may, in fact, be storing up problems for later on?
Acne is caused by blockages in the glands responsible for making a waterproofing agent called sebum. It tends to be more common around puberty and adolescence, when the production of male hormones may increase the secretion of sebum.
Last week's research, published in the medical journal Fertility And Sterility, found that almost two-thirds of women with acne had raised levels of at least one type of male hormone.
This most recent study suggests elevated levels of androgens are a far more common factor in female acne than previously thought.
High levels of androgens in women are often, but not always, associated with a condition known as polycystic ovarian syndrome (PCOS) - multiple cysts in one or both ovaries.
Other common symptoms of this condition include breast pain, menstrual irregularities, and excess facial and/or body hair. Women who suffer from acne and also exhibit one or more of these other symptoms should consult their doctor so relevant investigations for PCOS may be performed if appropriate.
If PCOS is diagnosed, then treatment directed specifically at this condition could be most effective in the long term.
One of the most widely used conventional treatments for PCOS is cyproterone acetate, an important ingredient of the contraceptive Pill Dianette.
Cyproterone acetate may help PCOS by blocking the effects of androgens in the body. However, more natural approaches do exist.
While it is not known what causes PCOS, there is some evidence that the higher than normal levels of androgens generally found in sufferers is worsened by increased levels of another hormone - insulin.
Insulin is released in response to carbohydrate foods (sugars and starches), and it makes sense to limit those foodstuffs which give rise to the highest insulin levels. These include sugary foods, white bread, pasta, white rice and potatoes.
Foods that may help stabilise insulin secretion include, meat, fish, eggs, brown rice, beans, pulses, nuts, seeds, green vegetables and fruits other than grapes and bananas. The symptoms of PCOS and/or raised levels of androgens can often also be helped with a herbal approach.
The main androgen is testosterone. In the body this can be converted into a more active form of the hormone called dihydrotestosterone.
The herb saw palmetto slows down the conversion of testosterone into dihydrotestosterone, and may therefore help to control acne in women with high levels of testosterone in their systems. Available from health food stores, the standard dose is 320mg of standardised extract per day.
More information about PCOS and its treatment can be obtained by writing to the self-help organisation Verity at 52-54 Featherstone Street, London EC1Y 8RT.
In addition, other approaches may be effective in treating acne. In natural medicine, it is often viewed as a problem relating to toxicity within the body. As a result, it can help sufferers to eat as 'clean' a diet as possible.
Try to avoid fatty foods and those laced with artificial colourings, flavourings, preservatives and sweeteners. Drink about two litres of filtered or still mineral water a day to help keep the body free from toxins.
Certain nutrients may also be useful. Some women find their acne can flare up before a period. This sort of acne - known as pre-menstrual acne - is often helped by taking 50mg of vitamin B6 each day.
One study published in the British Journal Of Dermatology found that zinc therapy worked as well as antibiotic medication. Patients should take 30mg, three times a day for three to four months, after which the dose can be reduced to once or twice daily. It generally takes 12 weeks before results are seen and because this can induce copper deficiency, I recommend that 1mg of copper be taken for every 15mg of zinc.
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