Acne - usually needs a combined approach - don't give up!
From DoctorMyhill
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Acne vulgaris is the common form of acne, it is driven by male sex hormones (present in both sexes from the menarche onwards). In the early stages there is excess keratin which blocks the cysts at the base of hairs, later these become inflammed and infected. This is a real pig of a problem and again one which does not always yield to the environmental approach. Having said that, acne is rate in people eating primitive diets. There is no one "correct" line of attack, but I would tackle acne in the following way:
Treatment of acne
- The general approach to maintaining and restoring good health
- Nutritional supplements over and above Nutritional Supplements - what everybody should be taking all the time even if nothing is wrong. The following help the immune system fight infection and allow skin to heal more quickly:
- Zinc 30mg daily.
- Vitamin A in high doses eg 100,000 iu daily. Vitamin A can cause damage to the unborn foetus in early pregnancy and all patients of child-bearing age need to be aware and reminded regularly.
- Pantothenic acid (vitamin B5). There are many studies demonstrating benefit. High doses of up to 10gms daily need to be used (the highest strength I can find is 500mg: so maybe 20 tabs a day). B5 is extremely safe with no known side effects and no toxicity.
- Azelaic acid 20% cream has been shown to be very effective but I can't find a source of this!
- Sunshine and UV light. Sunshine is an excellent treatment and very helpful for the drying up of the skin. I usually recommend patients to get themselves a UV light.
- Creams and lotions. I prescribe a combination of two products to treat acne:-
- Zinneryt: a mix of zinc and erythromycin to reduce bacterial contamination and improve healing.
- Retin A: a topical vitamin A cream which dries the skin and reduces sebum formation.
Both products need to be used to prevent acne. They will not get rid of a mature spot.
- Antibiotics: again these undoubtedly work, but one risks unbalancing the gut flora, antibiotic resistance and, I suspect, contribute to the general erosion of the immune system.
- Colchicine 1mg daily has also been reported as being highly effective but I have no experience of using it.
- If all the above fails and the patient is desperate, then referral to a dermatologist to consider high dose synthetic Vitamin A. This works really well but there are risks: I have one patient whose chronic fatigue was triggered by Roaccutane, but two patients with CFS whose acne is much improved with it.
- Finally do not be tempted to use the androgen based Pills such as Dianette. For reasons why see Contraceptive Pill and HRT - don't take them
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