Teenage and Adult Acne: Cause and Cure
Article by Daniel Levy, MD
Bellevue Dermatologic Surgeon
Acne is a universal skin issue which affects up to 95% of the adolescent population. In men and women older than 25, about 50% have some degree of facial acne.
The formation of acne results from a classic interplay between “nature and nurture.” Acne lesions are caused by a blockage of the duct leading to the skin surface from oil glands. This blockage occurs mainly because of natural sex hormones called androgens which are present in both men and women. Androgens regulate the activity of oil glands and the cells lining the ducts in the pores on the face, upper back, and chest.
Because acne is due to sex hormones and growth hormones, it typically begins in girls from 9 to 11, and in boys from 11 to 13, and ceases when growth hormone levels fade at 18 to 22. An increasing and significant percentage of women have post-adolescent acne due to long-term stress or other hormonal factors.
Nutrition also plays a role. Studies have shown that foods with high glycemic indices can stimulate acne. This occurs because these foods cause sharp spikes in insulin levels, and insulin activates the androgen receptor. Just as elevated insulin levels lead to coronary artery blockage, so too in the skin, insulin and IGF-1 (insulin-like growth factor 1) stimulate the androgen receptor and cause blockage of skin pores.
Milk is nature’s perfect food for the creation of acne. In general dairy products boost both insulin and IGF-1 and are also rich in hormones made by the pregnant cows that produce milk; so dairy is a double threat.
With this in mind, the prime strategy in treatment and prevention of acne is to control anything that stimulates the skin’s androgen receptors and oil, or sebum, production. Effective use of a zero dairy, low glycemic load diet, hormone control, and Vitamin-A based topical therapy will control the vast majority of acne cases.
The following table summarizes topical, injectable and light-based options for the prevention and treatment of acne.
Skinmedica facial cleanser: Removal of oil and dead skin cells
Skinmedica AHA/BHA cream: Exfoliation with alpha and beta hydroxyl acids
Tretin-x Kit (Tretinoin 0.025% cream): Vitamin-A based topicals are the ultimate pore refiners; Normalize pore lining, reduces oil gland size and activity
Vitalize peel: This chemical peel is a clogged-pore buster and leaves texture silky smooth
Acne Facial: Microdermabrasion and direct extraction of clogged pores
Personalized massage: Reducing stress lowers cortisol production, an androgen-receptor activator
Kenalog: A long known secret of Hollywood celebrities, this precise injection of a dilute solution eliminates a cystic acne lesion within one day
Omnilux blue light: This series of weekly 15 minute light treatments is safe, effective, non-invasive and rejuvenating
Photodynamic therapy: Reduces oil production and pore size