|Acne - the potentials of cosmetic prevention|
Acne does not only appear during adolescence but can also be constant companion of adults. Cosmetic preparations can help in getting a grip on it.
How does acne develop? Acne is caused by cornification disorders (keratoses) on the orifices of the sebaceous glands but also by sebaceous hyperplasia, inflammatory alterations and bacterial infections. Follicular hyperkeratosis in the context of acne usually has hormonal causes. Consequently there are typical phenotypes such as pubertal, preovulatory, premenstrual acne and acne after pregnancy.
Acne in adults (acne tarda) occurs after 30 and is also hormonally controlled. It is characterized by dry and scaly skin while pubertal acne shows moist and oily skin. These distinctions should be considered when selecting the appropriate skin care. Skin care preparations for the treatment of the different types of adolescent acne should be low-fat formulations and in the case of very oily skin the cream can be omitted. In these cases, the active agents and sera are applied in pure form. The same applies for the oily skin of older men when pale yellow comedones develop on front and cheeks.
The effects of nutrition
Dietary habits can intensify the genetic and psychogenic disposition to acne. Relatively high carbohydrate consumption does not only affect the skin structure, just to mention the keyword glycation in this context, but obviously also influences the intensity and the progression of acne. The same applies for a nutritional imbalance in fatty acids or in other words, for disproportions between saturated and essential fatty acids and between omega-6 and omega-3 unsaturated fatty acids. Overweight individuals who reduce their calorie intake also reduce the androgen and sebum production. Side effects of pharmaceutical drugs as for instance of hormone preparations and contraceptives are another source of problems.
Comedogenic substances in cosmetic preparations are a frequently discussed topic. What often is overlooked in the process is that it is not the substance as such but rather the physical properties dependent on the respective concentration that can turn the balance. Typical examples are saturated lipophilic compounds such as stearic acid ("stearate creams") and cetyl alcohol with melting points, that exceed the skin temperature, in high concentrations. In low concentrations the comedogenicity is rather low or even non-existent. The situation is different with substances that form aggressive peroxides under the influence of atmospheric oxygen and radiation. Among them are:
A further group is represented by lipophilic cream components such as paraffin oils, vaseline and mineral waxes. They form films on the skin surface which facilitate the growth of anaerobic bacteria such as propionibacterium acnes. The situation is quite similar with filmogenic long-chained silicones. Lanolin can also play a part in this context particularly when the skin is moist and oily. A prerequisite for the comedogenic activity of the mentioned substances however is the respective disposition of the individual person. By contrast, chlorine acne which is triggered by chlorinated hydrocarbons explicitly has a molecular structural background. Preservatives and disinfectants that contain preservatives belong to this group.
Excess skin care
Besides hereditary dispositions and inadequate composition of cosmetics, excess skin care plays a significant part in the acne formation process. Sebumetric measurements conducted by the author on a routine base on the occasion of cosmetic trade fairs showed that the skin of every other female visitor was overloaded with lipid substances or in other words, the measured data were at the upper limit of the measuring range. The measured values included the natural sebum and the lipid substances of the skin care preparations. Consequently, a 50 percent reduction of the amount of the products applied already is a simple and effective measure to prevent compromised skin with the additional benefit that it saves money and is less counterproductive with regard to the physiological conditions of the skin. The living conditions for facultatively pathogenic and anaerobic acne bacteria thus are considerably constrained.
Preventive skin care
Already the dermatological therapy should use cream bases that not only can integrate pharmaceutical active agents such as antibiotics, antiseptics and vitamin A acid (recovery) but also are formulated to match with the individual skin conditions. Unfortunately, white Vaseline, PEGs and preservatives still belong to the ingredients of prescribed pharmaceutical cream bases for acne patients.
Phosphatidylcholine (PC) is a multifunctional natural substance and should be an integral part of the skin care program for acne affected persons. A multicentric clinical study based on a half-side test with application of a PC containing liposome concentrate (without additional active agents) on acne vulgaris 1nd and 2nd degree shows a comedone reduction of 65% within a period of 4 weeks. PC is rich in linoleic acid (see above), fluidizes both skin barrier and sebum and also is effective in other keratoses. In addition, the sebum secretion in oily skin is reduced, a recovery of the skin is observed and the remaining acne scars are improved or in other words, indurations are smoothed.
Dr. Hans Lautenschläger
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