Friday, 14 Dec 2018

Plague of puberty: what really against acne help


Plague of puberty: what really helps against acne

A woman examines her acne in a clinic.

Photo: Science Photo Library / imago / Science Photo Library

A woman examines her acne in a clinic.

Acne is a real torture for many people. For physicians, there are clear triggers of skin disease – and also antidotes.

Just recently, an action by the artist Peter DeVito has made it to Internet ethics: In his photo series “Acne is Normal” shows the American artist people who suffer from the skin disease – unretouched. Yes, he even puts the focus on the supposed blemish. His Instagram account is now followed by nearly 50 million people , His posts are allegedly criticized and commented a thousand times, many users thank him for bringing the topic to the public in this way. DeVito has had acne for years.

Pimples on the face, on the shoulders and on the chest – and especially in puberty, when the self-confidence often goes to zero anyway. Acne can be a curse and the number of teenagers affected is increasing. “Acne is much more common than it was 20 years ago,” says Thomas Dirschka, Special Delegate of the German Dermatologists Association. “About 85 percent of all adolescents at least develop a mild form.”

Acne is favored by sugar and flour

In adolescence, which today often begins at the age of eight or nine, the sebaceous glands increase production of sebum under the influence of insulin growth factor (IGF) and certain sex hormones – the androgens. This normally penetrates to the outside. In acne, horny material, which is also formed by stimulated cells, blocks the pores. Blackheads develop that can ignite. Boys are more likely to be affected than girls, and there are familial clusters when both parents were affected as children themselves.

On the Pacific Islands, however, acne scarcely occur, says the Magdeburg dermatologist Harald Gollnick. The skin disease is a civilization disease, such as hypertension or diabetes, adds the Berlin dermatologist Yael Adler. It occurs especially in countries with a western diet style heaped up. “The foods we consume stimulate the sebaceous glands more than unprocessed Stone Age foods, as natural plant-based food.”

Sugar, milk and white flour are therefore so-called insulinotropic foods: They release the growth factor IGF, which stimulates the sebaceous glands via a cascade of signals and makes them larger. And carbohydrate-rich fast food, milk and dairy products, as well as sugary chocolate or muesli bars are very much liked by young people.

Fast food worsens acne

This often starts at breakfast – with sugared cereal in milk, explains Gollnick. “We live in protein excess, many consume half a liter of milk a day.” A study in South Korea has shown that participants’ acne worsened when fed fast food. In a second group, which received vegetable-based traditional dishes of the country, however, the symptoms improved or remained unchanged.

Several other factors are discussed, as the Berlin doctor Adler explains: an influence of environmental toxins and certain medicines, for example, or of cosmetics ingredients and hormones in drinking water. “The study situation is so far not particularly rich.” It is clear that smoking can aggravate skin diseases. “There are many toxins in the smoke, blood flow is shut down, healing is delayed, and inflammation is favored.” Marijuana is also known to increase acne.

A relatively new phenomenon is late-onset acne in women over the age of 25, which can last for years. “The pill seems to play a role, but the exact connections are still unclear,” says Dirschka.

About 40 percent of those affected have a form of acne requiring treatment, says Gollnick, President of the World Forum on Acne. Effective, low-side-effect drugs have been around for a long time – only many young people shied away from going to the doctor. This can have consequences: “The later the therapy starts, the sooner it has a severe course and the higher the risk of scarring.”

The disease still means a stigma, says Adler. “People with acne are very ashamed of their visible skin changes.” Especially in puberty, it is a problem not to find yourself beautiful. In addition, there are often bad reactions. “Acne serves an archaic reflex in humans: there is a disease, because it is better to refrain.” There is no risk of infection and no connection with uncleanliness.

Research is working on new medicines

“Many teenagers do not know that at all and are always trying out new face washes and cleaning agents,” says Adler. Even special brushes or pore unloaders would be sold – but none of it makes sense. “The aggressive cleansing of the facial skin is the most common mistake in acne.” In many cases, the problem gets worse.

With the right medication, acne can get under control within a month, according to Gollnick. Often, so-called retinoids are combined with an antibacterial preparation. The interest of the pharmaceutical companies was awakened. “In the next one and a half to two years, new drugs will come on the market,” says the doctor from Magdeburg.

Work is going on, for example, on gels and emulsions whose active ingredients get better into the skin and intervene in the metabolism of fat and androgen.

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