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Diet and acne study - Nov 2006
A recent Australian study has linked a low GI (high protein) diet with reduced acne and while the findings are encouraging, dermatologists are reminding people that diet alone will not cure acne.
A low GI load diet includes eating wholegrains and fruit and vegetables, along with a variety of protein rich foods (lean meat, fish and seafood).
The RMIT University study investigated two groups of males aged 15 to 25 years with 20-25 males in each group. The group that undertook the high protein - low GI diet over a 12 week period had reduced acne compared with people on a moderate to high GI diet which is typical of a normal diet.
Member of the All About Acne team, dermatologist Dr Greg Goodman says the study provides important evidence in identifying a link between diet and acne.
"This is a well-designed study that raises the very valid point that diet has been poorly studied in the past," said Dr Goodman. "However, further research is required, particularly to see if this diet has the same effect on females with acne."
"It's important to emphasise that by simply eating well, your acne may improve but it will not be cured. Diet is not an alternative to seeking medical treatment, particularly for people with severe acne, but this study demonstrates it can be a useful addition.
"There are numerous benefits to healthy eating and physical activity, beyond the appearance of skin so it's definitely worth looking after yourself. If you also notice your acne worsens after eating specific foods, stop eating these foods and note what happens.
"The most important thing to remember is that if acne is affecting your enjoyment of life, see your GP. There is a range of safe and effective treatments available to help you," says Dr Goodman.
Adult acne : 2006
Acne doesn't just affect teenagers; sometimes women in their mid-20s, 30s or occasionally in their 40s, can have problems with acne. Most people expect to have grown out of acne by these ages and because it's such a visible condition, it can still affect self-confidence. Even mild acne can have a big impact on women in these age groups.
Adult acne is not the same as acne that affects teenagers - when you are younger your skin is oily and less sensitive, whereas as an adult it is drier and more fragile.
Causes
Poor skin care
Pore clogging skin care products (these can affect men too) can cause adult acne. If you're acne prone, products labeled non-comodegenic or oil free are your best bet, but avoid vitamin E cream or products with sorbolene on your face.
Go for a facial sunscreen with a lower SPF - 12 to 15 rather than 30 - preferably in a gel or spray formulation. Sunscreens containing Mexoryl X and Mexoryl FX are good UV blockers that won't clog pores.
Over the counter products containing salicylic acid, benzoyl peroxide, or an acne wash containing Montaline C40 may be enough to treat mild cases of acne.
If that doesn't work, a doctor can prescribe either a topical retinoid that keeps pores open and prevents inflammation, or a product that combines benzoyl peroxide with an antibiotic.
Severe acne usually improves with the prescription drug isotretinoin (Roaccutane, Oratane).
Hormones
Adult women who have excess body weight can be more prone to acne. Surplus fat can convert the female hormone oestrogen into hormones that behave like male hormones (androgens), promoting acne by increasing production of sebum (natural oil that prevents skin from drying out).
Extra sebum mixed with dead skin cells clog pores, causing white heads or blackheads that turn into pimples if they're inflamed by bacterial infection.
The pill
Some contraceptive pills including high dose progesterone pills, the 'mini' (progestogen only) pill and contraceptive implants can also cause acne by boosting sebum production, while other pills can help improve acne.
Polycystic ovarian syndrome
Acne can also be a symptom of Polycystic Ovarian Syndrome (PCOS), a common, treatable condition affecting up to one in ten women. See your doctor to rule out this as a cause.
Stress
Studies have shown that women who work in competitive environments can overproduce male hormones. High levels of these male hormones can trigger acne outbreaks in adult females.
Many women juggle jobs, friends, family, financial commitments and many other life stresses which make adrenal glands produce more cortisol hormones, which can set off acne.
Also, acne itself can cause stress!
Study finds acne treatment improves depression: 2005
A recent study has found that the treatment of acne with isotretinoin (Roaccutane, Oratane) has a positive, protective effect against depression in teenagers with moderate to severe acne.
The study, recently published in the Archives of Dermatology, included 101 male and female patients between 12 and 19 years old. The control group received a combination of topical and oral antibiotics as well as a topical retinoid. The other group received isotretinoin.
After three to four months, it was found that the use of isotretinoin in patients with moderate to severe acne did not increase symptoms of depression, but improved them. The incidence of suicidal ideation in the isotretinoin group was zero; in the control group it was 1.4 per cent.
Dr John Sullivan, a leading Australian dermatologist and Chair of the Severe Cystic Acne Resource said he hoped this latest evidence-based study would reassure people with severe acne that its effective treatment is associated with a corresponding improvement in mood and well-being.
"Depression remains a key medical issue for young people with approximately 20 per cent experiencing depression by the time they reach adulthood," he added.
Dr Sullivan highlighted the importance of regularly monitoring for depression in all patients with acne, particularly for the more severe forms, irrespective of therapy being used.
"Family and friends can also be on the lookout for depressive symptoms in people with acne and should encourage the person to see a medical professional if they are concerned," said Dr Sullivan.
Arch Dermatol 2005;141:557-560. May 2005 © 2005 American Medical Association. Isotretinoin Therapy and Mood Changes in Adolescents With Moderate to Severe Acne, Christina Y. Chia, MD; Whitney Lane, MD; John Chibnall, PhD; Angel Allen, MD; Ealine Siegfried, MD
National Health and Medical Research Council. Depression in Young People: Clinical Practice Guidelines. Canberra: Australian Government Publishing Service, 1997.
Lasers and lights - new treatments for acne: 2004
Lasers and other light treatments (photo therapies) are increasingly being used to treat skin problems including acne and scars due to acne.
Now both therapies are proving to have some benefits in treating active acne. They appear to work by reducing Propionibacterium acnes, the bacteria that cause the inflammation in acne.
Both lasers and blue light phototherapy may prove to be most effective used in combination with medications or other treatments, especially as bacteria are only one part of the acne problem.
While it is encouraging to have additional treatment options available for acne, it is important to note that the medical evidence so far suggests lasers and light therapy will be of most use in mild to moderate acne. There is no evidence that either treatment alone will improve severe cystic acne.
Lasers
Lasers are already used to improve acne scars, birthmarks, wrinkles and sun damage. Lasers work by selectively targeting different components of the skin such as abnormally dilated capillaries in sun damaged skin or vascular birthmarks, or collagen in sun damaged skin.
According to a small UK study published last year in the medical journal The Lancet (2003; 362:1347-52), a single treatment with a pulsed-dye laser on mild to moderate acne reduced lesions on the face by about half.
The improvement was evident two weeks after treatment and maintained for three months, the study said.
Most people receiving the laser treatment had few side effects although two dark-skinned participants experienced some pain during the treatment.
A commentary on the study, also published in The Lancet, suggested that the 50 per cent improvement in acne might not be enough to satisfy people who want to be acne-free.
Another study published in the Journal of the American Medical Association (JAMA. 2004;291:2834-2839) using a pulsed day laser on 40 people with facial acne found the laser had little impact on their acne. The authors have called for further research into the use of pulsed dye laser before it can be recommended as an acne treatment.
Blue light therapy: 2004
Narrow band blue-light phototherapy is well known as a method of reducing jaundice in newborn babies. Now, research is showing it may also have a role in the milder forms of acne.
The blue light is an intense pulsed light source, which means it uses a broad band of wavelengths rather than a single wavelength, as a laser does. A typical treatment requires two sessions per week over a four-week period.
No good controlled studies have been performed to confirm whether or not this treatment is effective and to what degree it improves acne.
As with all treatments, there are side effects, with photosensitivity being a potential issue for some people.
One new combination treatment currently being investigated is the use of phototherapy with a radio frequency device that blasts a current deeper into the skin.
For people with severe acne, safe and effective treatments are widely available. Speak to your doctor about which option is the most effective for you
Virus cure for acne too premature: 2004
Media reports in late April 2004 that a bacteria-destroying virus found naturally on the skin will be the new cure for acne are very premature with human trials yet to be conducted.
UK researchers are investigating the virus, known as a bacteriophage, for its potential to kill off the Propionibacterium acnes, one of the three main causes of acne.
Research is only at a very early stage, making it premature to speculate on whether the virus will translate into an effective treatment for acne. Reports indicate that clinical trials are planned. These trials take several years to assess the effectiveness and safety of the treatment in humans.
Dermatologist and chair of the Severe Cystic Acne Resource, Dr John Sullivan, said claims that any new treatment would be free of side effects were highly unlikely as all medications have some side effects.
"The bacteriophage may occur naturally on the skin but that doesn't guarantee there won't be harmful effects from any product that is subsequently developed. So called 'natural' therapies still have side effects," he said.
Dr Sullivan said the good news for people with acne is that there is a range of effective treatments already available for all types of acne, including the more severe forms, which are the most devastating.
"It is important that people with acne do not waste their time waiting for a miracle cure when current treatments have been extensively tested and proven to work. If acne is interfering with enjoyment of life, it is definitely time to see your doctor and find out which treatment is most suitable for you," he added.
Dr Sullivan said all medications had the potential for side effects however most could be easily managed with the right advice.
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