Acne occurs when the oil glands under the skin, scientifically known as sebaceous glands, become clogged with sebum, an oily substance. This process is known as inflammation, and it is often genetically determined. Hence, if you have a family history of acne, you are at high risk.
A normal amount of sebum usually keeps the skin healthy. Your oil glands become active once you reach adolescence due to hormones and this is when acne usually starts. When clogged, bacteria grows in the glands. This leads to swelling, bumps and visible blackheads and whiteheads on the skin’s surface.
Acne can still affect adults. In fact, many adult females suffer from acne breakouts around the chin, especially during certain times of their menstrual cycle. This should be differentiated from other conditions such as perioral dermatitis, which may look similar but is treated differently.
Under proper dermatologist care, acne can be fully treated with the correct medications, creams and light treatments. For patients who prefer not to be on oral medications, some forms of laser therapies are safe and effective acne treatment methods too. Blue light, a type of light therapy is designed to treat acne when it is active by killing Propionebacterium Acnes on the skin, which causes acne inflammation. Non ablative and ablative resurfacing lasers can treat subsequent acne scarring after it subsides.
In addition to treatment, prevention against future acne breakouts are also crucial. Diet and proper skincare are also important factors in contributing to one’s acne condition. Therefore, holistic counselling with specific advice about how to manage your condition is important.
For mild to moderate acne, you may consider over the counter dermatologist formulated cosmeceuticals such as the Anti-Acne Bundle here.
2. Use hair regrowth products
Originally prescribed only in my dermatologist practice, the Copper Peptide Hair Regrowth Serum uniquely contains Copper tripeptide, a novel molecule that stimulates hair growth. Clinically proven to have similar efficacy to that of 5% minoxidil, stimulating growth without irritation side effects or toxicity. Studies show collagen production is increased, strengthening existing hair and thickening the hair shaft.
In conjunction with the hair serum, one can consider cosmetic camouflage for a quick fix. I often recommend the Kerabuilt Follicle Hair Fibres, integrated with Biomimetic Hair Technology for natural-looking, instant results. In addition, it is chemical-free and hypoallergenic, recommended even for those with hair loss and sensitive scalps.
In my dermatology practice, almost all patients suffering from hair loss had also done their due research online about possible causes of hair loss before seeing me. The real problem though, medical websites are not written for the layperson and the lists of diagnoses of conditions that lead to hair loss simply leave the hair loss sufferer worried and fearful. Those that do their research on forums and beauty websites are none the wiser, as they suggest many non-evidenced backed methods of hair growth or causes of hair loss which is simply unscientific and wrong information.
There are many different causes of hair loss, which can occur at the same time or individually, and dermatologists are best positioned conduct a thorough history taking, medical evaluation/examination and may recommend blood tests and other tests before diagnosing the cause of hair loss. For some rare causes of hair loss, especially of what is termed scarring alopecia, a scalp biopsy, which is where samples of the scalp are taken for microscopic examination may be required.
3. Consult a dermatologist for scarring on the skin
Treatment of scars on one’s skin can be in the form of chemical peels or lasers, which can be both ablative and non-ablative. Your dermatologist will advise which treatment option is best suited for your skin. In the meantime, a good concealer consists of a colour corrector. Orange is well suited to conceal dark scars and pigmentation whereas green conceals redness. Follow up with a CC cream with cosmeceutical active ingredients to treat and conceal your blemishes at the same time – achieving an overall even complexion.
Sugar in diet is measured by the Glycemic Index (GI)– a value assigned to foods based on the effect they have on your blood sugar levels. Studies have suggested that diet, particularly dietary GI, may aggravate existing moderate-cystic acne. A high GI diet increases sebum production, contributing to acne formation. Additionally, high-glycemic foods can also accelerate aging theoretically via an increase in the breakdown of collagen fibers, a process known as glycation.
2. How exactly do low and high (GI) sugar in diet affect the body?
This is how sugar in diet works – carbohydrates with a low GI value are more slowly digested and absorbed, causing a lower and slower rise in blood sugar and, therefore, insulin levels. Conversely, consuming carbohydrates with higher GI translates to higher blood sugar and insulin levels. Insulin is a hormone responsible for the decrease in blood sugar levels. It also stimulates the synthesis of another group of hormones (known as androgens) which leads to high sebum production, a recognized correlation to acne severity.
3. How much sugar is too much, or should we cut it out completely?
I think it is very important, as part of a balanced diet, to incorporate all elements of the food pyramid. In my personal view, the presence of sugar in diet with natural foods such as fruits and honey is not something that is harmful. In fact, these sugars are essential for our body’s nutrition.
The problem arises when sugar is consumed in excess or when it is consumed in the form of refined artificial sugars. This is because one can easily down a lot more sugar without feeling full, for instance when one consumes a cake or a baked item. On the other hand, the amount of sugars present in natural fruits will lead to one feeling full before one consumes a real excess of it. The key thing here is balance. In terms of the actual scientific evidence, there are some conflicting viewpoints regarding this issue.
The main thing is that excess sugar in diet can definitely trigger conditions, such as metabolic syndrome which comes with an increase in risk of cardiovascular mortality and other conditions like diabetes. Another thing to take into consideration is inter-individual differences in metabolism and genetics.
The lifestyle of the individual plays a part as well. For example, someone who is very athletic would naturally need more sugar in diet for metabolism. Meanwhile, someone who is sedentary needs minimal calories in their diet and having excess sugars will just contribute to calorie intake and in turn obesity which is a risk factor for worsened skin diseases. Overall, I would strongly recommend a well-balanced diet and the limiting of artificial sugars as there are innate health risks with high sugar diets which include an increased risk of developing diabetes and pre-diabetes.
4. Is eliminating added sugar in diet effective for rosacea-prone skin?
Medical studies have not conclusively proven the link between a high sugar diet and the worsening of existing conditions, such as rosacea and eczema. Most of the studies have been focused on the role of a high sugar diet for patients with existing moderate to severe acne.
Theoretically, high sugar content does promote an inflammatory state and both rosacea and eczema are linked to underlying inflammation. Although there is a theoretical possibility that it could lead to worsening of the condition, it is not proven at this juncture. In fact, a German study specifically ruled out the worsening of eczema due to a high sugar diet.
In my personal clinical practice, I have not observed any such links. I do not routinely advise dietary modifications for people with these conditions. For acne however, I do recommend reducing the presence of trans-fat, dairy products and high sugar foods simply because they can potentially slow down the recovering process. Nevertheless, treating acne with dietary modifications alone does not work. It is more of an adjunct to medical treatments.
5. What are some guidelines to follow, if people do decide to reduce their sugar intake? For instance, is there certain fruit we should avoid, is alcohol a no-go too?
First of all, take sweets in moderation. This includes candies and baked goods which are particularly high in sugar content. Secondly, be aware beverages contain sugars as well. I would stick to plain water and perhaps an occasional natural fruit juice that doesn’t contain added sugars. However, diet alone is not sufficient. It is important to understand that you would need some form of energy output instead of just input. I would recommend an active lifestyle with a minimum of three exercise sessions a week, each with a duration of at least 20 minutes.