Stages of Acne

All of us have in one form or another have encounter acne.  Let’s break it down by stages

Acne at 12 to 20

Acne usually starts at puberty.  The surging and fluctuation of hormones becomes a bane of any teenager’s life.  Types of acne ranges from a few pimples during, before or after the menstrual cycle to deep cystic, angry acne on the forehead, cheeks, jawline, neck and/or on the back and shoulders.  At this stage of acne, most common prescription from your doctor would be to go on the pill or Roaccutane.  The pill is used as a band-aid solution to hormonal acne, painful periods, endometriosis, polycystic ovarian syndrome (PCOS), severe premenstrual syndromes and etc.  This is also a stressful period for young boys with surging testosterone hormones that can affect their confidence and emotional well-being. As age progresses, the severity of it usually starts declining.  However, some will persist until adulthood. 

Acne at 20-35

Those that were blessed with clear skin throughout their teenage years then suddenly, acne starts popping out in adulthood are due to fluctuation of hormones caused by stress, lifestyle and diet.  Another type of acne that I commonly see in the stage is women with PCOS.  This type of acne are a continuation from puberty where menstrual cycles are irregular that had not been diagnosed until later stage into adulthood.  In addition, women at this stage are thinking of coming off the pill for fertility purposes or a decision to address issues of hormonal changes that affected you in your teens such as hormonal acne, irregular cycles, painful periods, severe premenstrual syndrome, endometriosis and etc. Coming off the pill may cause the hormones to fluctuate as there is no longer a controlled mechanism derived from the pill. The body often revert back to where it was before you started on the pill. As mentioned before, the pill is often a band-aid solution.

Acne at 45+

This stage of acne is commonly seen in women that are peri-menopause.  In addition to typical peri-menopause symptoms such as hot flashes, day/night sweats, irregular cycles, weight gain, insomnia etc, acne and dry skin may be present.  This is caused by increase in luteinising hormones which increases androgen levels.  In addition, stress and poor lifestyle choices may be a contribution to late onset acne.

What is common amongst the stages of acne is the fluctuation of hormones.  This fluctuation can be due to the imbalances of hormones during teenage years, gyneacological problems (PCOS, Endometriosis etc), stress, emotional challenges, lifestyle and diet.  In Chinese medicine, we look at the body holistically in terms of Yin and Yang.  Yin provides softness and cools the body down and Yang provides energy and warmth to the body.  This delicate balance can often be displaced due to factors outlined above.  Can Chinese medicine and acupuncture re-balance this?  Absolutely!

Chinese herbal medicine and acupuncture can reduce and manage the symptoms and the root cause of acne .  In essence, acne from Chinese medicine perspective is caused by Heat or Damp Heat.  The source of Heat or Damp Heat can arise from hormonal imbalances, emotional factors, stress, poor diet of spicy, deep fried, greasy foods, sugar and etc. Organs that affects acne are Lungs, Stomach, Large Intestines, Small Intestines and Conception vessels.  To determine what may cause the breakout of acne, a detailed consultation is carried out.  From my clinical experience, each person presented with acne have different diagnosis and treatment.  Therefore, the treatment is tailored towards your constitution and overall state of your body and health.  To find out how I can help you reduce and manage your flare ups, BOOK ONLINE for a consultation to begin your journey in rectifying the root cause of your acne.

Spring Series: Growth and Expansion

Spring is in the air! Daylight feels longer with slightly warmer temperature during the day, flowers are blossoming, and plants that had laid dormant under the soil are sprouting upwards . We are slowly rising from deep hibernation that has rejuvenated and renewed our energy which we begin to gently release it outwardly. The heavy Yin energy (cold, slow and deep) begins to slowly shift and transform into a light Yang energy (warm, growth and light).

In Chinese medicine, spring is the governed by the Liver, belongs to the Wood element, and the flavour that supports the Liver is Sour. Its colour is Green, the climatic element is Wind, and sense organ is the eyes. The energetic organ of the Liver is in charged of the smooth flow of Qi (energy), stores Blood for nourishing Organs, and controls the tendons and sinews in the body.

In an ideal situation, we would have rested and built our energy through winter months to transition into spring. However, life, emotions, illness and work often challenge our intentions, making us feel that there is not much reserve to spring into the coming season. As much as there is growth and expansion in spring, there can also be volatility and sudden movements in the transformation, especially when we are depleted and deficient in Qi. For example, when the Liver is not nourished and anchored, external Wind can stir emotions such as anger, irritability and annoyance outwardly (Liver Qi Stagnation). Internal Wind generated due emotional outburst sending Heat to rise up to the head causing headaches, migraines or sudden outbreak of acne. In addition, we may feel a sense of overall tightness, sluggishness and stagnant energy in the body due to sinews and tendons that are either not nourished by Liver Blood or caused by Liver Qi Stagnation. Here are a few handy tips to help the Liver and body to move forward into spring:

• Squeeze of lemon juice or apple cider vinegar with warm water in the morning before breakfast to get that Liver Qi moving and to kick start the day

• Move, move, move! After long months of winter hibernation and lack of outdoor activities, spring is the best time to go out for walks or to get back into yoga, Pilates or gym. When we move, we stimulate Qi to flow to the body and sending endorphins to the brain therefore, making us feel less lethargic, moody and snappy

• Switch from heavy winter diet such as curries and lamb stews to lighter meals such as sauteed or quick stir fry fresh green vegetables

• Use dry brushing to stimulate Qi and Blood flow under the skin. Starting from the leg, using long gentle strokes, move the brush upwards towards the Heart. This helps to exfoliate the skin, support lymphatic drainage and reduces the appearance of cellulite

• For those that have a roller jade or facial gua sha tool handy, you can use it to help stimulate Qi flow to the face, and lymphatic drainage. This is especially useful for hay fever sufferers or problems with the sinuses

I hope this short list can assist you in transitioning into spring a little easier. However, if you need extra help, we are here to assist you. Simply BOOK ONLINE for either a FREE 15 minutes consult to discuss your concerns or a treatment.

Women's Health Series - PMS Menstrual Island

Does this island sound familiar?  I found this illustration rather amusing but yet it is something that is not funny either.  Countless of women that I know of, both friends and clients that I have treated can relate to Menstrual Island.   

In Chinese medicine, Menstrual Island is a sign that our body is not functioning the way it should and there are some elements of stagnation and imbalance in the system.  Where there is pain, there is stagnation;  where there is acne, there is heat in the Stomach and imbalance of the hormones and where there is bloating there is rebellious of the Stomach Qi.  There is also one experience that almost every women (or men) have encountered is premenstrual syndrome (PMS).  Irritability, moods swings, tearful, headaches, breast tenderness, misery and depression point towards what we call Liver Qi stagnation in Chinese medicine.  

The Liver governs every aspect of Qi.  It tells it where to move, which direction to go and stores the ethereal soul.  I like to think of the Liver as the General Manager of the body.  It manages each organs in terms of their function and movement.  When the General manager gets too stressed out, the rest of the system will begin to feel overwhelmed and does whatever it wants without any direction or aim.  Therefore, to avoid the Liver getting all worked-up, and to ensure minimal trips to Menstrual Island try to avoid:

• A sedentary lifestyle - find ways to move eg. walk to work, take the stairs, do some form of exercise for 30 minutes
• Constant stress from working, family life, studying and etc - try to aim for a balance lifestyle by doing some meditation or yoga, time-out for some 'me' time, time management to overcome stress
• Poor diet consisting of spicy, fatty, processed, deep fried foods & take-aways - incorporate a daily dose of fresh vegetables and fruit into your diet, cut down on sugar (a little dark chocolate is ok if you need something sweet), prepare your own meals so you know what goes into it, and aim for simple meals with high nutrition and flavours

However, if symptoms persist or are getting out of control, Chinese medicine is great at sorting it out, even my gynecologist recommends and acknowledged that Chinese medicine has better outcomes than western medicine can do to help relief these symptoms.  So stop putting up with the misery, cramps, crankiness and bloating every month.  Give your body and yourself some kindness and relief from it today.

Want to learn more on how Acupuncture and Chinese medicine can help to ease your PMS symptoms?

Come in either for a FREE 15 MINS COMPLIMENTARY CHAT or BOOK ONLINE with Dr Jacqueline for a treatment today.  Dr Jacqueline has a keen focus is in Women's Health and Gyneacology and have years of experience in treating problems affecting women during their menstrual cycle.  Whether to reduce the signs and symptoms of PMS, regulating irregular menstrual cycle for future pregnancy plans or painful periods, Dr Jacqueline will design an individualised treatment based on your diagnosis, targeting not only your symptoms but also the root cause of your symptoms.

Resources

Image used with permission from  Gemma Correl 

Acne - Western Medicine vs Chinese Medicine

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.

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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

How Various Drugs Work In Treating Acne

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.

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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.