72. Detailed Description of Acne Treatment

ACNE AND RELATED DISORDERS

WESTERN MEDICINE THEORY

Acne vulgaris is a chronic disorder of the sebaceous glands, specifically those on the face, chest, and back, where the glands are the largest and densest. Sebum from the glands reaches the surface by emptying into the hair follicle and flowing along the hair shaft, the two skin appendages forming the pilosebaceous unit.

The earliest lesion of acne is the comedo, a plug formed by the impaction of the pilosebaceous duct with rough material and dried sebum. These plugs are visible as closed comedones (whiteheads) and, if the surface is darkened, open comedones (blackheads) are black not due to dirt but to oxidation of melanin and sebum in the plugs. Comedones become inflamed as bacteria, normal residents within the duct gland, proliferate within the obstructed glands and produce erythematous tender papules. As inflammation progresses, these papules may become pustular and, in severe cases, cystic. Cystitis are presumed to be due to abscess formation deep in the dermis. Various manifestations of the disorder are usually present in the same patient.

Acne involves abnormalities within the sebaceous follicles; these specialized follicles are differentiated from other hair follicles by having large sebaceous glands and small vellus hair(a delicate, non-pigmented hair). They are present over the face and upper trunk. Four things must be present for acne to develop:
(a), androgen-stimulated sebum production;
(b) Propionibacterium acnes, an anaerobic diphtheroid that constitutes most of the normal follicular flora and proliferates in response to increased sebum;
(c) altered keratinization and desquamation of the cells lining the follicles;
(d) a host inflammatory response.

ACNE GRADING BY BURTON SCALE

Grade 0 Total absence of lesions
Grade I Subclinical Acne Few comedons visible only in close examination
Grade II Comedonal Acne Comedons with slight inflammation
Grade III Mild Acne inflamed papules with erythema
Grade IV Moderate Acne Many inflamed papules and pustules
Grade V Severe Nodular Acne ? inflamed papules and pustules with several deep nodular lesions
Grade VI Severe Cystic Acne Many nodular cystic lesions with scarring

CHINESE MEDICINE THEORY

Internal Etiology of Acne:

1. Malfunction of the endocrine system.
2. Imbalance of estrogen and androgen.
3. Oily skin.

External Etiology of Acne:

1. Poor hygiene.
2. Diet of hot, spicy, oily, and seafood.
3. Smoking cigarettes and drinking excessive amounts of alcohol.
4. Drug abuse.
5. Oral contraception drug.
6. Deficiency of zinc, magnesium, and other trace minerals.
7. Air and noise pollution
8. Over stress and working, no rest, depression.
9. Menstruation or mal-menstruation.
10. Puberty period.
11. Oral steroids.
12. Constipation.

ACNE TREATMENT

WESTERN MEDICINE TREATMENT

1. Comedonal acne: 1, General hygiene, gently wash face with fingertips 2 times/day using lever 2, Dial, or Almay antibacterial liquid soap. Avoid lotions or cosmetics containing oil. 2, Retin-A 1% gel or 5% cream, a pea-sized amount at bedtime for 8 weeks. If not responding, will increase Retin-A to 2 times/day if tolerated.
2. Inflammatory acne: 1, General hygiene as above. 2, Retin-A as above; benzoyl peroxide gel 25% every AM, or Erythromycin 2% or clindamycin 1% solution or gel 2 times/day for 8 weeks. If not responding, will add oral antibiotics; tetracycline 500mg 2 times/day or erythromycin 333 mg 3 times/day.

Cystic acne or Scarring inflammatory acne: treat as above, if not responding, discontinue all the above, begin Accutane.

There are many side effects. For example, Retin-A causes cutaneous squamous cell carcinomas and papillomas in some female mice and teratogenic effects on some pregnancy rabbits (Physicians? Desk Reference, 2005). Antibiotics will cause an imbalance of bacteria on the face, which will lead to an overgrowth of bacteria insensitive to the specific antibiotic.

CHINESE MEDICINE TREATMENT

1. Explores the internal and external etiologies.
2. The treatment protocol is based on etiologies, i.e. treating the cause of acne with all-natural products and acupuncture.
   1. Deeply cleansing the skin with all-natural products, will prevent all the side effects produced by Western Medicine products. Skin protection products will be used on the skin after deep cleaning.
   2. Acupuncture, using meridian acupuncture, cleans the toxic chemicals precipitated in the skin and organs. We will use body or auricular acupuncture.
   3. Treating the cause of acne with Chinese herbs, which have been used in China for thousands of years and especially for emperors and their wives.
3. Results and evaluation:
   If you have the following conditions, the treatment is effective.
   1. Acne dries out and no new acne grows.
   2. Acne still grows, but the skin is smooth
   3. Acne hidden underneath the skin becomes obvious, but no further development.
   4. Large acne becomes smaller and atrophies.
   5. Oily skin becomes dry and acne is reduced.
   6. Menstruation becomes normal.
   7. Normal bowel movement, no constipation or halitosis.
4. The regular treatment period might take about 3 months.