Blame genes and hormones for acne

Blame genes and hormones for acne. While diet plays a part in the production of acne, stressing about eating certain foods is a bigger cause. So either give up chocolate or don't, but don't worry about it. Dreamstime stock photo

We've all had that moment when we woke up on an important day, such as picture day or the prom, and found an uninvited friend or two residing on our faces.

In high school, getting pimples is an awkward right of passage and while they're unwelcome, for many it's a passing thing. Unfortunately for others, their acne-fighting days are not segregated to their teenage years, and that, along with battling the signs of aging, equals a lifelong quest for beautiful, clear skin.

The obvious answer to why great skin is important is it makes us feel confident, said dermatologist Dr. Sandy Skotnicki, owner and medical director of Bay Dermatology Centre in Toronto.

"I have a lot of patients who are older ladies who always look so well put together and they have beautiful skin," Skotnicki said. "They may not be a size 6 or what you see in a magazine, but they're really beautiful because they're confident."

Alternatively, she said you can be the skinniest person in the world, but if you have pimples and other skin problems, you may lack confidence.

"Unfortunately, we live in a very critical society where people stare...and say and think all kinds of nasty things," she said, adding in a world where perception is reality, acne causes all kinds of stereotypes like being unhealthy or unclean.

Add to that, if your face is red, bumpy and full of acne, it's not only painful and frustrating, but for many it's embarrassing. Our face is what we show to the world and we can't hide it.

So what exactly is acne?

Skotnicki said acne is an inflammatory condition of the skin caused when the pilosebaceous unit, which is a hair follicle with an oil gland attached to it, becomes clogged. When they don't clear out properly, the pimple forms.

There are many types of pimples, Skotnicki said, but the basic ones are papules, the big, red painful ones; pustules; comedones, commonly known as a blackheads and whiteheads; and cysts, acne that is deep within the skin.

But while some get the odd pimple, others seem to be in a constant battle. The answer to why that is, Skotnicki said, is in your family tree.

"For the majority of people who get acne it's genetic. You either have the gene for it or you don't," she said. "It's just like you have the gene for male-pattern baldness or you don't. It doesn't matter how good you are to your hair or how many times you wash your face."

Acne, she explained, initially gets turned on in puberty because of hormone production and when hormones get out of kilter, you'll get acne.

This is why the topical treatments people use often don't work because they are geared to preventing clogged pores or decreasing inflammation, but don't address the underlying problem, which is hormones.

In addition to hormones, there are many other theories people have about how they get pimples, like eating items such as chocolate or fatty foods.

Skotnicki said if you asked dermatologists 10 years ago if diet has something to do with acne, they would have said no, but now they would say there is some association between diet and acne.

There is a lot of literature out there, and Skotnicki said while she's not an expert, she will talk about diet to her clients and refer people to literature.

But basically, it's not just about stopping eating chocolate or fatty foods, but overall consuming healthy food.

"Eating lots of greens, don't eat processed foods, eat lots of fish and grains. It's a common sense thing and the problem in North America is that we eat a lot of crappy foods," she said.

There have also been studies about dairy products, such as milk, and how that contributes to acne. Skotnicki said cows are often fed hormones to produce more milk. When we ingest those hormones, it messes with our own, she said.

Stress will also aggravate acne by elevating several stress hormones, like cortisol, in your body. Skotnicki said she has her own theory about stress and food and its connection to acne.

"My theory is when people think they're going to get acne from something they've eaten and they stress about it, it's the stress that causes the pimple...not the food," she said.

Classifications

The severity of acne is classified as stages 1 to 3.

One would be a few blackheads, for example, maybe a few papules, which Skotnicki said she would treat topically with Vitamin A cream or a topical antibiotic with benzoyl peroxide, and would suggest skin care regimes and diet changes.

Stages 2 to 3 acne is more severe and sufferers need to get help. Skotnicki may suggest oral therapies like birth control pills or antibiotics.

For those who have scarring acne, she suggests a more aggressive treatment from the beginning because those people would have to live with the scars long after the acne is gone.

While fighting acne can be a frustrating battle, Skotnicki said people don't have to suffer alone.

If people have persistent or scarring acne, Skotnicki suggested they seek help from their doctor or a dermatologist, and get treatment that's tailored for them.