Nothing’s more exasperating than conspicuous breakouts. We all get them, and we all spend a lot of effort trying to avoid them. Read on, and you’ll discover that dealing with acne can be quite a bit easier if we learn to understand it.
A daily diet of topical antibiotics and antimicrobials to combat acne may work for a time, but the ultimate effect may be to disrupt skin microbiome balance. It’s now common knowledge that prolonged use of antibiotics kills off beneficial bacteria found in the gut microbiome, tipping the balance in favor of over-colonization by disease-causing pathogens. Similar to the gut’s microbial disruption-disease cycle, skin microbial dysbiosis can lead to skin problems ranging from redness, irritation, rosacea, rashes, eczema, resurgence of acne and adult acne to photosensitization.
Over-production of sebum draws another actor onto the acne stage—the microbe Propionibacterium acnes. P. acnes lives in the sebaceous glands and hydrolyses sebum into free fatty acids and propionic acid (hence its name), thus assisting greatly in maintaining proper skin barrier function. A commensal microbe that inhabits all skin, healthy and acneic alike, it only starts to become problematic when pores become clogged with excess sebum and dead skin cells. To add more complexity to the picture, new research reveals that there are some strains of P. acnes found in acneic skin not found in healthy skin, leading scientists to believe that not all species of P. acnes create acne, just some strains.
Despite our understanding of P. acnes as a commensal bacterium that may or may not become pathogenic depending on the species’ strain, acne sufferers still reach for the mainstay of popular treatments —benzoyl peroxide—killer of all P. acnes.
Today’s focus is benzoyl peroxide—the number-one bully of our microbe friends.
Benzoyl peroxide (BP) is a powerful antimicrobial that is banned in the European Union in all over-the-counter skin care products. While BP is still approved for use in the U.S., the FDA has issued warnings about it: “The use of certain acne products containing the active ingredients benzoyl peroxide or salicylic acid can cause rare but serious and potentially life-threatening allergic reactions or severe irritation.”
In addition to issuing warnings, the FDA has switched benzoyl peroxide from a Category 1 substance to it’s current status, Category 3, which means the safety is unknown.
Not only a serious allergy risk for a rare group of people, BP also presents other problems for everyone who uses it.
BP accelerates aging:
Strong bleaching agent/photosensitizer:
Promotes tumor growth:
by TJ Slaga, AJ Klein-Szanto, LL Triplett, LP Yotti, KE Trosko Science 28 August 1981: 1023-1025. [DOI:10.1126/science.6791284]
Some people find that BP works for a time to clear their acne, then simply stops working. Why it stops has not been determined, but my take on it is that repeated applications of a strong antimicrobial may have a similar effect as taking repeated courses of antibiotics. The gut microbiome is disrupted and the pathogens kept in check by helper microbes begin to take over, resulting in gastrointestinal and bowel disorders of all types. Repeatedly killing off P. acnes, the microbe that helps maintain proper skin barrier function, can result in problems down the road. Most people using BP, regardless of how effectual or problematic it’s been, would welcome a substitute. Fortunately many natural alternatives do exist.
Microbial balance in the gut is a new frontier, and skin microbiotic balance is even newer. Scientists are studying how beneficial bacteria applied topically to the skin can work to interfere with the development of acne.
Topical probiotics can benefit the skin in a number of different ways:
Pantothenic acid 750 mg and 250 mg l-carnitine 3x a day
Niacinamide 500 mg 1x a day
Probiotics—in capsules, powder or in probiotic foods like yoghurt, kimchee or sauerkraut
1) Cleanse 2x a day with cleansers containing some or all of the following ingredients:
Not recommended: Scrubs contain sharp particles that can cause microscopic tears in the skin and invite invasion from unfriendly microbes like Stapylococcus aureus and Streptococcus pyogenes.
* Do be aware that the FDA has issued a warning about rare but serious allergic reactions occurring with salicylic acid (as well as benzoyl peroxide). If you develop extreme redness or a rash from an SA or BP product, discontinue use immediately.
2) Mist 2x a day with green tea (reduces sebum production), probiotics. (Treatment Mist)
3) Use serums containing vitamin B3 and B5. 1x a day, at night. (Treatment Serum)
4) Follow with an oil blend composed of antioxidants, omega-3 and omega-6 EFAs and tea tree oil. Studies show that tea tree oil helps control P. acnes populations just as well as benzoyl peroxide, but without side effects. (Treatment Oil) 1 or 2x a day, morning and night.
5) As a final step, you may apply a thin layer of yoghurt containing live strains of lactobacillus and/or bifidobacterium species. Stonyfield has an exclusive six live active culture blend of probiotics, which include Streptococcus thermophilus, Lactobacillus bulgaricus, Lactobacillus acidophilus, Bifidus, Lactobacillus casei and Lactobacillus. 1x a day, at night
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