Acne Fighting Manual: Scientific Analysis of Acne Causes and Countermeasures

Author: Dr. Guo Xinwei, attending physician at Beijing Longfu Hospital

Reviewer: Sun Liyun, Chief Physician, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University

1. How does acne occur?

What we usually call "red pimples" are generally called "acne" or "folliculitis" in Western medicine, and "furuncle disease" in traditional Chinese medicine. Today we will talk about one of the "red pimples" - acne, which is actually a chronic inflammatory skin disease involving the hair follicles and sebaceous glands. It mainly occurs in adolescents and often naturally alleviates or heals after puberty. Its clinical manifestations are characterized by polymorphic skin lesions such as acne (whiteheads or blackheads), papules, pustules, nodules, etc. that occur on the face. Some people even get acne on the chest, back or buttocks.

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So how does acne form?

Let's take acne on the face as an example. Did you know that the sebaceous glands on our face are constantly secreting sebum, and the pores are constantly excreting this sebum. If the secretion and excretion of sebum are balanced, the skin will be smooth. Once the secretion and excretion are unbalanced, sebum will accumulate in the pores, causing the sebaceous gland ducts and pores to be blocked, which will lead to inflammation of the hair follicles and sebaceous glands. This is how most of the acne on our faces is formed!

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Then everyone must be curious: "Why is the secretion and excretion of sebum unbalanced?"

For boys and girls in adolescence, the main reason for the imbalance of sebum secretion and excretion is the increase in androgen secretion during adolescence. This hormone can promote the growth of sebaceous gland cells and enhance the sebum secretion of sebaceous glands. Therefore, the increase in sebum is a normal physiological development process.

After puberty, there are two main reasons for the imbalance of sebum secretion and excretion. On the one hand, people with oily skin have strong sebum secretion, which is easy to clog hair follicles. On the other hand, there are some parasites on human skin. Generally, they will not cause disease, but when the sebum secretion of the skin increases, these parasites such as Propionibacterium acnes, Pityrosporum ovale, Staphylococcus albus, etc. will release lipase that dissolves sebum and converts fat into free fatty acids. These acidic products will further cause inflammation in and around the hair follicles, causing acne skin lesions.

2. What should people who are prone to acne pay attention to in their daily diet?

For people who are prone to acne, they need to pay special attention to their daily diet.

(1) Eat less fried foods and sweets.

(2) Eat less spicy food.

(3) Try not to eat cold foods.

(4) Be cautious when using health supplements advertised on the Internet that claim to have acne-removing effects.

(5) People without contraindications are advised to eat some soy products, such as soy milk, tofu, etc., to antagonize androgen and reduce sebum secretion.

(6) Eating more whole grains rich in vitamin B and dietary fiber, such as corn, coix seed, purple sweet potato, etc., can not only inhibit sebum secretion but also improve constipation.

(7) Eat more fresh vegetables and fruits that are rich in vitamin C and low in sugar. Some of these fruits have anti-inflammatory and whitening effects, such as dark leafy vegetables, tomatoes, kiwis, pomegranates, passion fruit, blueberries, strawberries, grapefruits, etc.

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3. How do people who are prone to acne take care of themselves on a daily basis?

For people who are prone to acne, daily care is also very important.

(1) Washing your face: For those who are prone to acne, try to wash your face with warm water in the morning and evening, because cold water will close the pores. In addition, you should choose a suitable cleanser or baby soap that can effectively clean the skin. Do not use a towel to scrub excessively to avoid pore inflammation. The best way is to wash gently with both hands, and only wash twice a day.

(2) Moisturizing skin care: For people who are prone to acne, choose clear lotions and lotions, and use less essences and oils. The simpler the better. Choose mild masks that avoid those containing irritating ingredients. In the early stages of acne when redness is the main symptom, choose masks containing anti-inflammatory ingredients such as salicylic acid or tea tree oil. In the later stages of acne when it subsides and pigmentation occurs, choose masks containing hyaluronic acid or collagen to promote repair and improve pigmentation. Masks can be used about twice a week.

(3) Do not over-cleanse the skin: Pores are often not clogged by dirt on the surface of the skin. The clogged hair follicles and sebaceous glands deep in the skin are the cause of acne. Excessive cleaning will not only fail to prevent acne, but will damage the skin barrier, causing the skin's resistance to decrease, making it easier for bacteria to invade the deeper layers of the skin. At the same time, the skin will produce more oil to compensate for the oil and moisture that has been taken away, which will lead to acne outbreaks.

(4) Do not pick or squeeze pimples: Picking or squeezing pimples can damage skin tissue and cause the skin to lose elasticity. On the other hand, if your hands are not clean and you directly pick or squeeze pimples, it is likely to cause infection, especially when the pimples grow in the danger triangle area. If you are not careful, it may even lead to intracranial infection.

(5) Pay attention to sun protection: While treating acne, it is very important to protect the existing skin condition. Some people have found that the skin will peel after sun exposure. Acne may seem to improve in the short term, but in the long run, sun exposure will only aggravate acne. However, sun exposure is not without benefits. Appropriate sun exposure can promote the synthesis of vitamin D. It should be noted that for people who are prone to acne, sun exposure should be limited to the parts prone to acne.

(6) Avoid staying up late: For people who are prone to acne, it is recommended to go to bed before 11pm. From the perspective of traditional Chinese medicine, a regular work and rest schedule reflects the balance of yin and yang in the human body. The balance of yin and yang during the day and night corresponds to the balance of yin and yang in the human body's fire and water. The Yellow Emperor's Classic of Internal Medicine states: "When yang qi is exhausted and yin qi is strong, the eyes are closed; when yin qi is exhausted and yang qi is strong, the eyes are awake." "Defense qi moves in yang during the day and in yin at midnight. Yin governs the night and night governs sleep." "Staying alert during the day and awake at night" is the result of the human body adapting to the time of nature and the harmony of the nutrient and defensive qi [1]. In short, having a regular work and rest schedule and not staying up late will help the human body adapt to the time of nature, promote the balance of yin and yang in the human body, and the harmony of the nutrient and defensive qi, which will naturally help prevent and treat acne.

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(7) Appropriate exercise: Exercise at least three times a week, and exercise for more than 30 minutes each time to promote the body's metabolism, accelerate blood circulation, promote the excretion of sebum, and consume fat, making the skin more elastic and improving acne-prone skin. It is important to remind you that you should clean your skin in time after exercise to prevent oil, dirt, bacteria, etc. from clogging the hair follicles.

Acne may be a problem for most people, especially when it appears on the face. After puberty, if acne does not subside or pimples still appear frequently, you can seek help from a professional dermatologist. The doctor will prescribe oral or topical medications (such as topical antibacterial and anti-inflammatory drugs, Chinese medicine for internal heat-clearing, fire-purging, or dehumidification and detoxification, etc.) to regulate the body constitution, reduce sebum secretion, and promote the excretion of sebum through the pores. In addition, we should also analyze whether there is an unreasonable diet structure or irregular work and rest. If so, we should adjust it in time. Let us deal with acne calmly and fight "acne" scientifically!

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References:

[1] Li Zirong, Wu Yufei, Wang Miaoran, et al. Application of circadian rhythm in the treatment of insomnia based on the daily rhythm theory of "daytime concentration and nighttime sleep" [J/OL]. Global Chinese Medicine, 1-5 [2024-08-12]. http://kns.cnki.net/kcms/detail/11.5652.R.20240809.1726.078.html.