Whether you call them zits, spots, or pimples, doctors estimate that acne affects more than 80% of people at some point in their lives.
Today’s post from The Bridge discusses how and why acne forms in human skin, what the common types of acne are and treatments that exist, both from an allopathic (Western medicine) and complementary/alternative (holistic) standpoint.
Acne (Acne vulgaris or common acne) has likely plagued humans for thousands of years. Researchers studying ancient Egyptians and Greeks have found mentions of acne in medical texts of the time. Popular anti-acne and facial scar remedies were found in the boy-King Tutankhamun’s tomb, suggesting that he may have suffered from the condition. The ancient Greek physician Hippocrates, considered by many to be the father of modern medicine, discusses acne in his text De Morbis Vulgaribus. The vocabulary term he used to describe acne implies that the condition comes “with the first growth of the beard”, signifying around the time of puberty.
Throughout recorded history, there have been a number of theories as to why acne occurs.
The 3rd century B.C. poet Theocritus opined that telling lies causes pimples to form on the nose; and in the 4th century A.D. a physician instructed people to wipe their faces with a cloth while watching the skies for a falling star, and consequently, the pimples would fall from the body. In Elizabethan times, people were believed to have been afflicted with acne via witchcraft hexes or spells.
What about nowadays?
Even today, there isn’t always agreement on the exact cause of acne, but almost all experts agree that the condition begins when dead skin cells begin to shed and block pores. The dead skin cells then react with sebum, the natural oil that our skin produces. This eventually is what causes an acne lesion to form.
For many years, scientists believed that skin bacteria (including the most common Proprionibacterium acnes) is what caused acne to form. However, recent studies indicate that while there are “unfriendly” bacteria living on skin that help support the development of acne, there is also a “friendly” strain of the same P. acnes bacterium that actually helps protect skin from forming acne lesions! People who are not prone to acne have been found to have high levels of the “friendly” bacterial strain on their skin. Consequently, the theory that bacteria is the cause of acne has been discarded by many researchers.
Many researchers now believe that oxidative stress causes the formation of acne.
The theory alleges that the skin’s own natural sebum oil oxidizes (reacts with exposure to oxygen) when exposed to air on the skin’s surface, and this begins a cycle of inflammation. This inflammation may be worsened by one’s own genetics or by conditions like polycystic ovarian syndrome (PCOS), stress, diet, gut, or environmental issues.
Regardless of which theory is actually correct, acne causes a great deal of mental stress, to the point where people spend hundreds or thousands of dollars on products and medications designed to help heal their skin.
Types of Acne
- Comedones (blackheads and whiteheads)
When a hair follicle gets clogged with dead skin cells and sebum, this is the beginning of a comedo (“comedones” is the plural of comedo). The illustration below shows what happens in the shaft of the hair follicle when comedones form.
Blackheads are comedones that are “open” at the surface of the skin. I used to think as a teenager that blackheads were caused by trapped dirt in my skin pores. Remember how sebum oxidation was mentioned above as the most likely cause of acne? It is sebum’s chemical reaction with air on the surface of the skin that causes it to turn black. In contrast, whitehead comedones stay “closed” at the surface of the skin. Since the sebum is closed off to air, the comedo doesn’t turn black.
Papules and Pustules
When comedones become increasingly red, irritated or inflamed, they can worsen, progressing to papules or pustules. This indicates a more severe form of acne.
Nodules and Cysts
Nodules and cysts are the most severe forms of acne and form large, painful swellings on the face and/or body. This type of acne can lead to permanent pitting and scarring and often causes great emotional distress.
Many treatments exist for acne, and they are dependent upon contributing factors such as the type of acne, hormonal shifts, and age and skin type. Allopathic (Western) medical treatments for acne include topical treatments such as benzoyl peroxide, which reduces the amount of skin bacteria and is a drying agent; antibiotic gels which reduce bacterial population on the skin, and retinoid creams, which help unclog pores and speed cell turnover.
Systemic (internal) anti-acne agents include antibiotic pills, hormones like the birth control pill for women who have hormonally-mediated acne, and Isotretinoin (Accutane), a powerful medication used only in the most persistent cases of nodular or cystic acne, as it carries the risk of significant side effects.
Other allopathic methods of acne treatment involving neither topical nor internal methods include lasers and other light therapies, chemical peels, and incision and drainage of large cysts by the dermatologist.
Complementary/Alternative/Holistic Treatment Methods
Although medical science has disproven the old adage that greasy fried foods and chocolate worsen acne, eating a healthy diet full of vegetables, fruits, nuts/seeds, and protein supports all body processes, including promoting healthy skin. Some researchers tout the benefits of fish oil, especially fermented cod liver oil, in reducing the appearance of acne. Also, carefully choosing your diet to limit foods believed to cause gut or immune issues, such as gluten-rich foods or dairy, may be helpful. Proper hydration with water is also important.
Although definitive studies have yet to be published supporting this treatment, honey (especially manuka honey) has been shown to positively affect the appearance of skin breakouts. It’s theorized that the honey reduces the amount of destructive “free radicals” (oxidizing substances) on the skin.
An increasingly popular method of controlling acne is the oil cleansing method. Simply put, the skin’s natural sebum (oil) is secreted to help protect skin, keeping it smooth and supple. If sebum is continuously stripped away by harsh skin cleansers or topical medication like benzoyl peroxide, the body says “Uh oh! There’s not enough sebum going to the skin–I have to make MORE!” This leads to a vicious cycle of more sebum production, which can lead to more acne. The oil cleansing method may seem like exactly the wrong thing to do–“I have oily skin and you want me to put *more* oil on it??” but many people find that it balances the production of sebum, thereby leading to clearer skin.
How to do the oil cleansing method: take a room temperature carrier oil and massage a teaspoon or two thoroughly into your skin. Then take a very warm wet washcloth to remove the oil, pat dry, and voilà, you’re done!
You might ask “But which carrier oil should I use?”
The answer is somewhat dependent upon your skin type.
- Almond, sweet (all skin types, especially oily)
- Apricot Kernel (dry, mature, or “normal” skin types)
- Argan (all types, but especially mature skin)
- Avocado (mature and very dry skin)
- Camellia Seed (mature skin)
- Evening Primrose (dry, mature, or hormonal skin)
- Grapeseed (all skin types, but especially oily)
- Hazelnut (oily/acne prone skin)
- Jojoba (since jojoba is a plant wax that closely mimics the structure of skin’s own sebum, it’s ideal for many skin types)
- Sunflower Seed (all skin types)
The above is not an all-inclusive list; note that fractionated coconut oil doesn’t make the list as it tends to be comedogenic (clogs pores). The list also doesn’t take into account individual skin type; for instance, jojoba is supposed to be non-comedogenic, but I break out when I use it. Conversely, rose hip seed oil is known to be comedogenic, but I can use it without breaking out. So, sometimes a little trial and error testing is called for. For more information on the oil cleansing method, see Christina’s blog post.
There are a number of essential oils that are helpful in promoting or maintaining clear, smooth skin. These include:
Keep in mind that this list is not all-inclusive.
Proper dilution of essential oils for topical use on the skin is imperative; we recommend no stronger than a 1% dilution for use on the face. Caution is necessary to avoid sun exposure when using an oil that has phototoxic properties such as bergamot.
Making positive changes to your diet, reducing stress in your life, and finding a cleansing method that works for you may all help improve the vibrant, healthy look of your skin!
We want you to learn as much as you want about essential oils and how to use them safely. If you have any questions, comments or other concerns you are welcome to email us at [email protected] or come join us on Facebook at Safe Essential Oil Recipes!
 Grant RNR, MD. The History of Acne. Proc R Soc Med, Vol. 44 (8); 1951
 Puusa, S. Acne Einstein website, www.acneeinstein.com
 WebMD. Acne Visual Dictionary. www.webmd.com
 American Academy of Dermatology website. Isotretinoin. https://www.aad.org/dermatology-a-to-z/diseases-and-treatments/i—l/isotretinoin