Do you, or your loved one, suffer from acne? Do you feel like you've tried everything but nothing seems to work? There's good reason why most acne products don't work. The fundamental issues are:

1. There are multiple factors that cause acne.
2. There is no "broad spectrum" one size fits all acne solution. 
3. Different products address specific causes of acne - if your acne is not caused by the factor that a particular ingredient addresses, it won't work for you. 

​This blog post is meant to be educational and it is my hope that at the end of it, you will be empowered to make appropriate choices towards a solution that works for you. 

What is acne?
Acne is characterized as a chronic inflammatory disease. It presents as closed or open comedones - i.e. whiteheads and blackheads - and inflammatory lesions - i.e. pimples, nodules, pustules. Typically acne is prevalent in young adults with girls being affected at a younger age (average 12 years) than boys (average 15 years). Adults also suffer from acne, typically women, due to hormonal issues. Since acne is characterized as a disease, it is a medical condition.

Causes of acne
There are multiple factors that cause acne. Below are a few well known ones:

• microbial colonization with P. acnes - bacterial infection 
• sebum production - sebum is the term for a complex of oils including triglycerides (fatty acids) and fatty acid breakdown products, wax esters, squalene, cholesterol esters and cholesterol that is produced by the skin. Recent research indicates that certain characteristics of sebum is associated with acne, namely, increased sebum production, alteration of lipid composition and the oxidant/antioxidant ratio characteristic of the skin surface lipids. Diet is linked to these sebum characteristics. 
• complex inflammatory mechanisms - inflammation is the body's immune system's response to an irritant. It involves changes in the blood, such as an increased number of immune system cells.
• neuroendocrine regulatory mechanisms - emotional stress induced acne
• diet - linked to sebum characteristics
• genetic factors - there is some research showing evidence of an "acne gene" 
• hormonal factors - androgens, a group of hormones, are linked to adult acne in women. "Androgens like testosterone stimulate sebaceous gland growth and sebum production. Estrogens have the opposite effect, that is, they inhibit the secretion of androgens, modulate genes involved in the growth of the sebaceous gland and inhibit their function. The activity of the sebaceous gland therefore depends on the estrogen/androgen ratio." 

Current treatment for acne
Modern treatment of acne falls under four categories:

1. Topical - creams, gels, lotions, and washes that are used on the skin and contain drugs and active ingredients that treat acne
2. Systemic - oral or topical antibiotics to treat inflammation
3. Complementary and alternative medicine - topical products or oral supplements that are herbal 
4. Physical - comedone extractions, laser treatments, cryotherapy

By far, the most common treatment is topical - i.e. products applied on the affected area. Below is a table that summarizes modern treatment options:

The current practice for treating acne combines multiple methods and ingredients in the hope that one or more of them will address the patient's particular acne. 
The major drawbacks of such an approach are side effects of using too many products, bacterial resistance to antibiotics rendering them ineffective, and expense involved in buying multiple products. 

Unfortunately, from my study, Ayurveda does not delve much into female hormonal issues in general. So this is a topic that I need to spend more time researching. 

In summary, both modern scientific research and Ayurveda point to multiple factors that cause acne. Therefore the most effective solution is one that is customized to your particular TYPE of acne. While there are many over the counter products for acne, you need to understand the cause of your particular type of acne and the ingredients that are suitable to address it for the products to be effective. The concentration of the active ingredients is also crucial in the efficacy of the products. 

The Ayurvedic approach offers the following benefits:

• To quote from Charaka Samhita, A handbook on Ayurveda edited by Gabriel Van Loon, "[All substances have qualities.] [In reality, all substances will have several qualities.] [By substance, it means food, herbs, weather, music, people, disease symptoms, etc.] [The beauty of this system is that everything in life may be viewed on the same radar screen, as it were, so that cause and effect is easy to see and treatment may be achieved with any substance, so long as it is opposite to the quality of the aggravated substances or pathology. 
• The Ayurvedic approach is inherently a personalized approach - it involves figuring your dosha imbalance, lifestyle, and mental state and thus can be more effective if done correctly. 
• Typically has minimal side effects if done right. 

To learn more, book a consultation with Saroya today!

Sources:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6560440/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3051853/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3780801/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2835906/
https://www.aad.org/member/clinical-quality/guidelines/acne
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6360964/
https://www.jidonline.org/action/showPdf?pii=S0022-202X%2815%2930101-9
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3366450/
https://www.mdpi.com/1420-3049/21/8/1063
https://www.researchgate.net/publication/330243222_Review_on_Yuvanpidika_Vis-A-Vis_Acne_Vulgaris

I am part of a Facebook group of female founders in beauty where someone asked the group to provide inputs on preservatives in cosmetics. Below is what I sent. Please note that there is a lot of misinformation around the use of preservatives. It is true that Saroya as a brand attempts to minimize products that have water and thereby remove the need of preservatives. But that choice is driven by many reasons beyond the need for preservatives. 

Why are preservatives important in cosmetics?
Preservatives are important in cosmetics for pretty much the same reasons they are important in other products, including food. They extend the shelf life of the product by inhibiting the growth of bacteria, mold, fungus, and yeast. Typically all cosmetic products that contain water need a preservative to have a shelf life that extends beyond a few days. 

What preservative(s) do you use in your products? Why?
- My brand focuses on waterless formulations so I do not use preservatives in a lot of my products. For the few products that do contain water like creams and lotions, I use a preservative combination of gluconolactone and phenoxyehanol. Phenoxyethanol is a very easy to use preservative in that it does not impact the stability of cosmetic formulations. It is also effective. However, it is a skin irritant and I am personally allergic to phenoxyethanol. This particular combination works for me as I am able to reduce the concentration of phenoxyethanol to a point where it does not cause a reaction while being effective in doing the job of extending the shelf life. 

What is your opinion on parabens?
I believe parabens have got a bad rap not necessarily backed by science. I personally have never used parabens but as a scientist I believe that a lot of things said about them are taken out of context or are not backed by facts. Some of the reasons that people believe parabens are bad are: 
a) They are endocrine disruptors. Yes, but so are many other things that contain phytoestrogens, including a lot of foods like soy. 
b) They cause cancer - this is really not backed by facts. The reason people believe parabens cause cancer is because there was a paper published that found parabens in breast cancer cells. Somehow this came to mean that parabens was the cause of the cancer. 

Do you use natural preservatives?
Vegetable glycerin is not regarded as a preservative but it can enhance shelf life by binding to water. In that sense, yes, I do use naturally available ingredients as preservatives.