Acne is one of the most common form of skin problem faced by many teenagers and sometimes persist into adulthood for some people. There are countless of commercial and natural products, and prescribed medications and ointments to help counter the growing rate of people facing acne problems. There are varying degrees of acne presentation - from big angry red and painful pimples presenting all over the face right to the neck, chest and at the back of the skin to mild small pinkish bumps that are presented on the chin, jawline, cheeks or forehead. Whatever the presentation is, having acne can be frustrating, embarrassing and it can affect your confidence. I have listed below the different approach and views by Western and Chinese medicine perspective so that you can be informed with which treatment option is best for you.
Western medicine perspective
The most common trigger of acne is due the onset of puberty when the surge of androgen stimulate sebum production and hyperproliferation of keratinocytes. Other triggers are hormonal changes occurring with pregnancy or menstrual cycle; types of cleansers, lotions and clothing used; and high humidity and sweating.
Diagnosis of acne is via examination. Differential diagnosis of acne includes rosacea, corticosteroid-induced acne, perioral dermatitis and acneiform drug eruptions. The severity of acne is graded as mild, moderate or severe based on number and type of lesions.
Treatment for acne:
- Comedones - topical tretinoin
- Mild inflammatory acne - topical antibiotics and/or benzoyl peroxide
- Moderate acne - oral antibiotics
- Severe acne - oral isotretinoin eg. Claravis, Sotret
- Cystic acne - intralesional triamcinolone
Common side effects of topical ointments prescribed for the skin are:
- Mild burning, stinging or tingling sensation
- Mild chapping or slight peeling
- Mild redness, dryness and itching
- Mild sensation of warmth or irritation
In addition, doctors are quick to prescribe oral contraceptive pills (OCP) to teenagers to help control/reduce acne. This seems unnatural as the primary use of the drug is for the prevention of pregnancy. There is also the question of what long term effects does OCP have on women's fertility and emotional stability. There are a few interesting studies and articles in the resource section below on the long term effects of OCP on fertility and the emotional impact it has on women.
Chinese medicine perspective
Acne is caused by an internal imbalance of the body which cause excess Heat and/or Damp that manifest in the face, neck, chest or the back of the skin.
Causes of internal imbalance are often related to:
- Poor diet of spicy, greasy, damp foods such as junk food, excessive chili consumption, and deep fried food
- Stressful lifestyle, lack of exercise
- PMS and other emotional upsets such as anger, irritability and frustration
- Excessive alcohol consumption
Diagnosis often require:
- Questioning the function of the body as a whole
- Accessing the lesions ie. the severeness of the acne, areas where the lesions are presented ie. chin, jawline, forehead, cheeks, neck or back of the body, and other symptoms such as dry, greasy, itchy skin or painful to touch.
- Evaluation of the emotional/state of the mind, lifestyle and diet.
- A comprehensive questioning of women's gynaecology and reproductive systems
In Chinese medicine, both the root cause and presentation (acne) are treated at the same time. There are five differential diagnosis/patterns that can cause acne. Each pattern are presented differently in terms of lesions and overall internal imbalances. Therefore, treatments are individualised based on the presenting signs and symptoms.
Treatments include:
- Acupuncture and herbal medicine to re-balance internal imbalances
- External topical ointment, herbal facial wash or herbal masque to tackle acne on the outside
- Dietary and lifestyle changes to further strengthen the treatment process
There are little to no side effects in treating acne with Chinese medicine. Some common complaints are the herbal medicine can be a little difficult to digest or the taste can sometimes be off putting.
In conclusion, it is important to be aware of which modality will have the biggest benefit in the long term without harming or upsetting the body's natural system. Western medicine treatments for acne is often good for a short term purpose however, I question what these drugs do to the body in the long term and the one-size-fits all approach. Chinese medicine is a natural medicine therefore, progress of treatments does take time. However, the long term benefits of this individualised treatment which targets both the root cause and the lesions are - 1) the presentation of acne is reduced and 2) future flare ups are minimised and can be prevented.
Resources
Balfour, A., 2014. Why Chinese Herbs Are Great For Treating Acne.
McKoy, K., 2013. Acne Vulgaris.
National Institute of Arthritis and Musculoskeletal and Skin Diseases, 2010. Acne.
NPS Medicinewise, 2013. Oral Antibiotics: An Option In Acne But Consider The Risks
Ryan. M., 2016. I Stopped Taking The Pill And Changed My Life.
Grigg-Spall, H., 2016. The Pill Is Linked To Depression - And Doctors Can No Longer Ignore It.
Talukdar, N. et al., 2012. Effect Of Long-term Combined Oral Contraceptive Pill Use On Endometrial Lining.
Farrow, A. et al., 2002. Prolonged Used Of Oral Contraception Before Planned Pregnancy Is Associated With A Decreased Risk Of Delayed Conception.