read this if you have acne

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:

Treatment	Ingredient
Topical anti-inflammatory, anti-bacterial and comedolytic ingredients	Benzoyl peroxide, Adapalene, Retinoids, Dapsone, Tretinoin, Salicylic acid, Sulfur, Niacinamide, gluconolactone
Systemic	Oral antibiotics
Hormonal	Estrogen containing oral contraceptives
Hyperpigmentation reduction	Azelaic acid, ascorbic acid

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. 

Ayurveda and acne
Given how ancient Ayurveda is, it is quite remarkable how many of the modern acne pathways it covers. Below is a table tha summarizes the Ayurvedic treatment modalities:

Factor	Explanation
Kapha Dosha	Imbalance of Kapha dosha causes sebum issues
Pitta Dosha	Pitta dosha imbalance causes "blood impurities" - this leads to inflammatory acne
Vata Dosha	Vata dosha imbalance causes blackheads and hyperpigmentation at the site of the acne scar
Diet	Certain types of food cause acne - Ayurveda gives practical dietary guidance for acne
Activities	Certain activities such as excessive sun bathing, excess or too little sleep, and fasting can trigger acne
Emotional	Stress, anger, irritation, and behavioral changes cause acne

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