by Danne Montague King
When I was a teenager I had the worse case of Acne Vulgaris imaginable. In those days (the 1950′s) there was a popular over-the-counter product called “Clearasil™”, a sort of pinkish beige tinted chalky crème allegedly supposed to dry out Acne and pimples. However, I had other uses for the product. I loathed appearing at school bristling with pustules, so I covered my entire face with this salve, like a make-up base, to cover the offensive ‘Pizza Face’ look. Unfortunately, the product really did dry out the skin and would crack with facial movements; hence I never smiled at all, earning me the title ‘the death mask kid’
It all sounds funny now, but to a teenager suffering from peer groupism, an Acne condition is far from amusing. I recall in 1994 when I was appearing on the Dublin chat show ‘Kenny-Live’ (Ireland’s answer to Oprah Winfrey and Geraldo Rivera), my topic was Acne conditions. The preceding evening, the newspapers headlined the story about a youth who committed suicide because of his severe Acne and lack of money to have it treated. There really is a hopeless unclean feeling when you are an Acne victim. You feel especially vulnerable to the opposite sex in those growing years, positive that every girl (or boy) recoils in disgust when you enter the room.
At 17 years of age I decided to do something about my condition, having run the gamut with my parents who trotted me to every dermatologist in town, with no success (the treatments in those days were archaic, as even in some cases now-a-days). I felt that using Ivory soap twice a day along with astringents was the wrong approach. Being a kitchen chemist in those early years, I knew about acids and alkalies. A medical friend taught me about the pH of the skin and its slightly acid sebaceous oil and I know the bases of all bars of soap contain alkaloids. After all, the first soaps were made from ash and fats. So it occurred to me that the alkaloids in commercial bars of soap, no matter how pure or botanical the oils used in manufacturing were, would turn the acid oil in my skin into pre-deposited fats as well. In other words, it would create tiny plugs of soap or wax in my pores!
Reading up on Native American lore and methods of how the ancients used to clean their bodies, I discovered the powers of natural saponin obtained from certain tree barks. I actually stripped some of these barks from trees, soaked them in water and pounded the inside cellulose into a pulp. I then filtered this pulp into a bottle, added a little powdered ascorbic acid as a preservative and started using this odd smelling concoction to cleanse my face.
I also started whipping up odd masks made of oatmeal, tomatoes, okra and wheat germ. I made a crude crème with sodium alginate, olive oil and again, vitamin C. This seemed to hold water in my skin without being greasy like conventional moisture cremes of the day. I also altered my diet and refused greasy chips, hamburgers and fatty foods. I increased water consumption instead of Coke or Pepsi and went on a workout program two hours a day. I was determined to be as beautiful and as popular as the blemish free boys in school.
As I looked in the mirror over the months of my 17th year, I could see changes happening. As they happened, the stress and fears of being ugly started to vanish, and my confidence soared. When I turned 18, girls straining cashmere sweaters with Jane Mansfield hair-do’s were approaching me in the halls. I was invited to parties, more because of my caustic wit than looks, but I was now unafraid to attend and did not sit in shadowy corners as I had before. I had come into the light at last! The biggest triumph was trying for and getting the romantic lead role in a play at the Queen Elizabeth Theatre in Vancouver, British Columbia, Canada.
Journalists who have interviewed me over the years like to say I got into the skin business because of this situation and they are partially correct. This experience taught me that things can be changed, despite conventional medical opinions, if one only takes the time and effort to find a way. Years later as we learned more and more about the condition of Acne, the changes of my youth suddenly had reason behind them. As a scientist I always want to know why something works, not just that it does.
Acne: The Cause
‘There are as many varieties of Acne as there are stars in the sky’, and it takes specific training to recognize and diagnose each basic category or combination of categories. There have been many articles, which I am sure you have read or will read, that list the ‘types’ of Acne. As a therapist, knowing this list by heart will do you little good unless you take formal training. Sufficient to say it is more important to know the cause first.
Stress is the hands-down number one cause of Acne. There are other contributing factors as well, including picking and squeezing pimples, pressure or friction (head bands, caps etc), lifestyle, birth control pills, cosmetics, climate and diet, but stress is the Big Kahuna!
This is how it works. There is a gland at the top of the head called the Hypothalamus. Think of it as sort of a radio antenna that receives all signals of stress confronting the human body. The signal is relayed from this gland to the Pituitary (the master gland) located further down at the base of the skull. The Pituitary gland, receiving this message of stress, picks up his telephone and repeats the message to Mr. and Mrs. Adrenal Glands, who in their excitement, wake up Tommy Testosterone. Now Tommy, although a male hormone, also has relatives living in all female bodies. All the Testosterone folks get together and shout at the Hair Follicle Family to not only increase the hair population but to pump more sebaceous oil onto the skin. This aggressive relay of messages is all due to stress, which falls in to several categories.
Subliminal stress (Adult Acne).
Client does not know why they are stressed, but it subconsciously exists and requires psychiatric assistance as well as treatment of the skin. Hormonal stress (passive). Women go through several hormonal changes in their lifetime. They can break out in Acne during any one of these times, or all of them. Many women, for instance, have peaches and crème complexion until they have their first baby “then Pizza Face Time!” Older ladies after going through menopause may suddenly develop acne after a lifetime of perfect skin. Men will have some hormonal changes as well, but usually just during puberty. Keep in mind that in some cases there may be a deeply hidden pathological reason for severe hormonal changes, which require the services of a competent endocrinologist before advanced skin treatment is undergone.
Job Related Stress.
This type of stress can create serious trauma to the adrenal glands. It can be caused by too great of a workload, feelings of inadequacy for the position held, conflicts with staff and management, and threats of layoffs or firing. Sexual dysfunction. The stress of incompetency, “not being good enough” or actual rejection. Marital or family stress. The feeling of hopelessness, being trapped, misunderstood and unworthy. This is similar in many ways to sexual dysfunction.
Stress or trauma caused from the positive charged electromagnetic waves coming off a computer for as much as eight hours a day. This condition usually results in rosacea like symptoms. Teenage peer pressure. Perhaps the worst stress of all as it occurs during the learning years and can set psychological patterns that may reappear later in life.
When appropriate Acne treatment is applied, the client suffering from any or all the above stress patterns can actually see a change. As the Acne condition improves, there is an immediate alleviation of stress, which accelerates with each progressive change for the better. This was the phenomenon I experienced as a kid. I now know that besides the positive mental influence, there is a body chemistry action behind it as well. When stress is removed, the glandular systems quiet down and return to normal, thus assisting the therapist with an internal aid while he/she performs the topical treatments.
There are many articles about Acne and recommended treatments. Some of them contain cut-away skin section drawings depicting the various types of Acne, which to me suggests the therapist must have X-ray eyes in order to identity a certain condition. Other articles include long lists of cosmetic ingredients we must avoid like the plague. I read one such article recently written by an American aesthetician that divided ‘bad’ ingredients into three categories: bad, not so bad and mildly bad. Several ingredients (I think lanolin was one) were listed in two and three categories, which is very confusing to therapists.
Actually whether an ingredient is bad depends on two things: pH of ingredient (too alkaline being ‘bad’) and the viscosity or molecular structure of the ingredient, which determines whether or not it is fractionated enough to be water soluble and work WITH the skin secretions rather than trying to replace them. There are thousands of little openings in the skin with secretive functions. Anything heavier than these secretions is too heavy and will plug or clog the pores. Mineral oil is an outstanding example of a ‘bad’ ingredient, but we have one petrolatum formula that when applied to a hardened cystic-type pustule, will actually hydrolyze away the infection inside the pustule within 24 hours. This application works on the principle of creating pseudo-heat within the pustule, plus the power of a very effective bacticept that destroys gran positive/negative bacteria.
So it really is a matter of opinion and experience regarding good and bad ingredients. The important thing is that the skin must be decongested first, the acid mantle restored to normal, and the flow of sebaceous oil regulated. Basically we are talking about remove and restore.
The macrophagic action of enzymes and the fact that they are nature’s biological catalysts for all the skin’s interactions make enzyme treatments possibly the most superior dead skin cell removal system for acne skins.
Several types of glycolic acid can actually irritate and ultimately re-inflame Acne skins due to the ‘stripping’ action of skin fluids (alpha hydroxy acids (AHAs) work off these fluids). However a well blended, multiple alpha hydroxy formula in a low strength makes a wonderful removal system if applied to the skin as an ‘occlusion’ masque under strips of cling film (Glad Wrap). This approach really breaks up those annoying hard-to-get-out milia and allows the therapist to perform extractions with minimal scar causing pressure. AHAs are NOT for home use on acne clients despite the current popularity of AHA products.
Playing Piano on the pH Scale.
This is my descriptive way of naming treatments that rapidly change the pH of the skin to very low (acid) or very high (alkaline). These types of treatments are like fighting fire with fire and can be very effective when used in conjunction with enzyme treatments. An acid formula will ‘harden’ the dead and dying corneum very quickly and the brittle cells then sort of “pop off”. An alkaline solution will ‘soften’ the corneum and any keratinized proteins on the skin as well as hair. This is very good for folliculitis conditions. Both styles of therapy must be carefully monitored, require advanced training, and of course, the client’s normal pH must be restored at the conclusion of these types of treatment each time they are performed.
This is the latest in our treatment repertoire although benzoyl peroxide lotions and ointments have been around a long time, even sold over-the-counter in many countries. I was a little reluctant to start working with benzoyl peroxide, mainly because everybody else in the United States was selling Acne ranges that depended on this ingredient yet we were getting wonderful results without benzoyl peroxide products. However, the speed of getting Acne conditions under control is sometimes a very necessary factor in removing stress from the client to obtain maximum healing.
Benzoyl peroxide products have to be in a gel base or water soluble gel/crème base to be really effective. Peroxide releases powerful oxygen into the skin, which kills bacteria. The benzoyl part of the molecule pulls the peroxide down into the pore or follicle where the Corynebacterium (C acnes) are located, killing them off very quickly.
The daily progressive care by the client at home is vital and home prescriptives are usually modified versions of the professional treatments. Diet is essential and although chocolate and greasy foods are not the primary cause of Acne, they do add to the situation. Many Acne sufferers also suffer from candida and have very alkaline systems. Certain vitamins and supplements should be recommended as well (vitamin C, zinc, etc) but again, advanced training is essential in order for the therapist to property prescribe the correct supplements and dosages.
The ethnic arena is another market for Acne treatments but is approached somewhat differently due to the various biochemical differences in black, Asian, Hispanic, or Aborigine skins. In addition, hyperpigmentation usually accompanies acne situations in ethnic skin due to the plethora of melanocyte activity, which reaches the peripheral epithelium cells and even down the side of hair follicles. Melanin is a defense mechanism and is easily aroused in ethnic skin when the client squeezes or pinches pimples. Pigmentation treatments, such as the Melanoplex system developed in the United States, needs to be performed on ethnic clients along with the aforementioned Acne treatments.
There are many approaches to Acne treatment, and of course some physicians feel that drug treatment is the only cure while cosmetic treatment only cleans the skin. My experience has been that the cells of the skin respond to the chemistry that they recognize, indeed the very chemistry they are made of.
If a cell is receiving positive electromagnetic charges from the brain, the sodium surrounding the cell (also a positive ion) will be pulled into the cell itself and vital potassium inside the cell (negative ion) will be pulled out. The cell then goes into trauma and inflammation starts running amok. Infection enters the picture and the trauma spreads. You then have a diseased cell.
On the other hand, if the electromagnetic charge from the brain is changed to a negative charge, the cell becomes re-polarized, trauma disappears and the cell starts functioning normally. This is just a small example of simple body physics, and in fact we have been using electromagnetic machines for years to assist in reversing acne. The chemistry is already in the body waiting to be used , we just have to imitate that chemistry and work with it.
Many teenagers have superficial Acne scars that appear purplish or red. This is a good age to undergo scar revision while the skin is in the growing mode. Unlike ‘ice pick scars’ that require more intense methods of skinÂ planing such as dermabrasion, laser treatment, or the Mon’s Tissue Transplant method, teenage acne scars are often removed easily with enzyme treatments. This type of treatment allows the newer, underlying skin cells to rebuild the surface appearance. Again, advanced training is required and these types of treatment may take from six weeks to as long as eight months to show significant results. There will, however always be results.