Bacterial acne, what causes it and how to manage it.
Important: This blog is about bacterial acne and does not cover fungal acne.
First of all, it is important for you to know that you are not breaking out because of anything that you did or didn't do. Breakout prone skin is going to break out, no matter how perfect your routine or how pristine your diet but every effort matters and paying attention to your lifestyle choices and environment can give you an edge when confronted with this mountain of a challenge
Here is a flow chart to help you visualize what you are about to read.
Acne prone skin is a beast all on its own. Dealing with it can take a toll on an individual both physically and emotionally. The sufferer often gets caught in a vicious cycle of inflammation and symptom mitigation. What actually causes it? Hormones? Genetics? A modern lifestyle? Hopefully, the following information will help clear up the complex nature of this problem so that you can take a more targeted approach to addressing your own issues.
First I need to define the role that hormones and microbiome plays in every individual person.
Hormones:
Hormones control literally every function of your body from your mood to your growth all the way down to the metabolism and differentiation of each individual skin cell. When hormones circulate around the body in abnormal concentrations, cellular metabolism, as a result, also becomes abnormal. This is especially true in our teen and early adult years. Hormones are handing out a lot of demands to every cell in our body all at once which has some specific implications for our keratinocytes. Our skin cells are suddenly asked to process larger quantities of glucose and manufacture more lipids.
This happens for every single person during puberty and other abnormal hormonal phases throughout adulthood.
Microbiome:
Fun fact: The number of microorganisms that live on and in our bodies is believed to equal that of our own cells!
Our skin has a complex and intricate symbiotic relationship with bacteria. There are a couple specific ones in our skin that help to modulate immunity, protect against pathogens, and break down skin oils that they use as energy to undergo mitosis.
The skin of every single person is populated with these bacteria.
So, if everyone has these bacteria populating their skin and everyone goes through puberty then why doesn’t everyone have acne? Could we have inherited a gene that influences this? Is it as a result of being exposed to a modern lifestyle? Is it possible that we inherited an imbalanced biome from birth?
The likely truth is that all of these play a role to some degree, but until we have a better understanding of genetics, epigenetics, and microbiomes, we have to make educated guesses. For now, we have to manage the effects until we discover the cause.
What to do about it.
Level 1 skintervention: marginal symptom mitigation
Reduce inflammatory foods and exposure to hormones, EDCs, and potential irritants.
Avoid
Sugars, carbohydrates, and processed foods are all inflammatory. It makes sense that to help reduce the severity of an inflammatory condition like acne, you would need to try to avoid these things so I'm going to leave it there.
There are some people that say that junk food causes acne because of the grease. While it's unlikely that greasy foods directly influence sebum production, it is possible that another common denominator is the linking factor. Hormone enhanced meats also tend to be present in greasy junk food meals. If you are breaking out, your hormones are already out of whack. Don't add fuel to the fire.
Endocrine disrupting compounds such as BPA, PFAS, and other plasticizers are becoming harder and harder to avoid but the same logic goes here as well.
Stay away from botanicals, and natural soaps. Botanicals are made from the oils that plants create to defend themselves. Using them increases the chance of developing accumulative irritation which leads to inflammation. Natural is not always better. Natural soaps are highly alkaline and disrupt our acid mantle causing our skin to pump out even more sebum as a result. Don't add insult to injury! Learn about fragrances here. Learn why natural soaps are not always better.
Embrace
Steer toward a more plant-based diet packed with leafy greens and antioxidants. Microwave your food in a glass dish instead of plastic. Try a water filter instead of plastic bottled water. Buy a synthetic cleanser like Cera-ve and use fragrance free skincare like illumenase.
Level 1 and 2 skinterventions: Symptom intervention
Adapalene, Benzoyl Peroxide, Clindamycin, Doxycycline, Azelaic Acid, Blue Lights, High frequency, Aestheticians, Clascoterone.
Oral and topical antibiotics are often prescribed for conditions like acne and rosacea. Usually, one will be recommended before the other and this sometimes depends upon the philosophy of the dermatologist. There are pros and cons to each of them so make sure you understand the possible side effects and try not to think of it as a long-term solution.
They might also recommend that you begin using Adapalene gel at night. Be patient with this topical as it may take up to a year for you to see results. Adapalene gel may also be recommended early on as a preventative measure for those just beginning to break out. Stick with it. While it may not prevent all of your teen hormone induced acne, it certainly will help, and it is now available otc!
Find a good aesthetician who understands your skin-type and utilizes certain spa equipment like high frequency, pore extraction devices, blue light, or galvanic.
Ask your derm about products that contain Azelaic acid, a newcomer to the scene. Concentrations in the 13%-20% range, available as a prescription, are showing promise with conditions such as acne and rosacea.
Much newer to the scene, we have androgen receptor inhibitors. Approved by the FDA in 2121, Clascoterone is a topical drug that helps to locally inhibit the binding of androgens to receptors found in the tissues upon which the drug is applied. The drug's ability to block androgens from binding with AR's is considered by dermatologists to be the holy grail for treating Acne Vulgaris. This is because the root cause of AV is the inflammation that occurs as a result of this hormonal binding. The drug is also showing promise in the realm of androgenic alopecia. More studies need to be done to determine side effects, but the localized action of the drug gives it a promising outlook in that department.
Think about getting a blue led device for your home. Bacteria do not thrive well in the presence of blue or UV light. I do NOT recommend using a tanning bed or excessively basking in the sun, but a blue light device can help you without DNA damage.
If you are doing all of this and you still can’t get your breakouts under control then employ…
Level 1, 2, and 3 skinterventions: Advanced correction
Isotretinoin
Once you have exhausted other forms of treatment your doctor may recommend a cycle of isotretinoin commonly branded (Accutane). This stuff works wonders for most but like most powerful drugs, it carries the risk of some pretty crazy side effects, Familiarize yourself with them thoroughly.
Level 1, 2, 3, and 4!?!? When all else fails throw the kitchen sink at it!
Advanced therapies.
My Story:
I'm telling you this story because I want you to know that I know what it's like to deal with this condition in its worst form. I am not attempting to sway you in one direction or another and I am most certainly NOT providing you with medical advice. I’m telling you this story because I want you to know that it's OK to seek out solutions for yourself and employ outside-the-box thinking because sometimes that's what it takes.
My personal experience with Accutane was interesting. I experienced mostly clear skin while taking the drug. I also experienced an unhealthy amount of rage most of the time and lips so dry they felt as though they would just fall off. Once I finished the cycle I began breaking out again within 3 months, so I did a second cycle. 3 months after finishing my second cycle, I began breaking out again, this time with painful subcutaneous cysts.
I was 24 years old at the time.
I started doing a lot of research, consulting aesthetic professionals, and really digging in on discovering my personal missing link. I came across a peer reviewed study about vitamin B therapies. Specifically, Pyridoxine (B6), Pantothenic acid (B5), and Niacinamide (a form of B3). They were suggesting that therapeutic intravenous and oral dosages of these vitamins may reduce inflammation and help to normalize cellular metabolism. As someone with nothing to lose at this point, I decided to give it a go. I couldn't afford to do all of the intravenous sessions(I think I made 2 out of the recommended 4) but I stuck with the oral regimen and in less than 3 months my skin finally cleared up, once and for all. The only side effect was some very chartreuse pee.
You may reach out to me with questions about this blog, however, I will not disclose any dosing information as it could be seen as medical advice. It is much easier to find information about advanced therapies nowadays considering the fact that I did all my research before smartphones existed. Can you say, "Dewey decimal?"
Tackling acne effectively requires an understanding of its complex triggers, including hormones, microbiomes, and lifestyle factors. Employing several strategies, from dietary adjustments to clinical interventions, may help to manage or potentially reduce the symptoms of this condition. Remain diligent and know that you are not the only one suffering from this condition.
Reach out at any time. illumeninfo@illumenase.com
Please enjoy a quality day,
MBM
