Problematic Skin

Problematic skin and acne is a condition that is generally associated with adolescence and affects between 80% and 90% of teenagers. Although in most people the disease clears up before the age of 25, in others it can persist into the forties and later.

The condition appears a areas of scaly red skin (known as seborrhoea), blackheads and whiteheads (comedones), pinheads (papules), cysts or boils, pimples, and scarring. It can be a very distressing condition that results in low levels of self esteem, depression and even suicide.

Problematic skin and acne are caused by an increase in the rate of production of male hormones such as testosterone, which occurs during puberty in both young men and young women, and growth hormones (insulin-like growth factor 1) which are also at peak levels during early adolescence. There is also a connection between the menstrual cycle and the condition.

The changes to the skin happen in the skin structures that include a hair follicle and its sebaceous (oil) gland and it generally occurs on the face, the upper chest and the back as these are the areas of skin that have the higher densities of oil glands. Boils can also occur on the buttocks, groin, and armpits which also have a high concentration of oil glands. The hair follicles become blocked and infected by bacteria.

There are many ways of dealing with the condition. Diet is thought to be an important, and in particular sufferers should reduce their intake of sugar and other simple carbohydrates. There are also a number of medications which can be of considerable help. These are designed to reduce skin shedding and oil production to prevent the hair follicles blocking; killing the bacteria; reducing inflammation; and changing the hormonal balance.

Typical treatments are benzoyl peroxide, antibiotics, salicylic acid, and anti-inflammatory drugs and creams. In females combined oral contraceptives can considerably improve the condition.

Numerous studies have demonstrated that topical vitamin A is also beneficial. For instance, in his paper “Topical Vitamin A Acid in Acne Vulgaris”, Albert M. Kligman, MD. PhD and his co-authors showed that “Vitamin A acid increased the rate of production of loose horny cells in the follicular canal, thus preventing formation of comedones and unseating existing ones”, in other words vitamin A applied as a cream gets rid of existing blackheads and whiteheads, and prevents new ones from forming. However, it is important that the treatment is maintained.

Ref: Albert M. Kligman, MD. PhD; James E. Fulton Jr., MD; Gerd Plewig, MD, Topical Vitamin A Acid in Acne Vulgaris, Arch Dermatol, 1969, 99(4), pp 469-476.

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