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Dermatology


Acne, Folliculitis, Keratosis Pilaris, etc


The Health Industry Benefits From Keeping Patients Sick

Don't underestimate commerce to prey on people's health needs and keep them in a cycle of spending.

There are some really helpful forum threads that acne.org has “archived”, maybe due to their helpful nature.

Example:
https://web.archive.org/web/20201203014332/https://www.acne.org/forums/topic/220222-tiny-tiny-rice-grains-in-every-pore-anyone-else-have-it/page/3/

Images from thread:


Milia On Skin

Keratin On Arms

Keratosis Pilaris

The keratin images are different from what you will find in a Google image search for the keratin based afflictions.

This is not in itself proof, just one more thing I noticed. If you need proof, then there is science for that.


Being Healthy is the Best Acne Preventative

I found the following post to be both funny and intuitively true to me:

Your skin has evolved over millions of years and knows how to regulate itself better than you do. Adding BP or any other chemicals that aren't natural will only cause problems logically because your skin wasn't designed to deal with chemicals.

Your skin will eventually become dependent and even start to break down after a while, not to mention lose its ability to fight off acne on its own. Notice how sooo many people have problems quitting medication. Do yourself a favor and NOT ruin your skin for the sake of killing a zit.

Basically eat healthy (Low GI) and exercise daily is the best way to clear up. Also, don't over wash your face; you NEED a lot of the oils your skin produces naturally. You have to understand that there's a reason that Americans have the most acne around the world, they sit on their asses and drink Mountain Dew and then wonder why they look like shit. Natural selection is brutal. Everyone isn't genetically supposed to go through acne because of “hormones”. source

All the things you keep hearing: diet, exercise, and rest, those things which keep you healthy, these are the best treatment for acne. There can be all kinds of reasons why you have acne, that are resistant to just being healthy, but trying anything too aggressively will likely cause a backlash.


Diet

Foods consumption resulting in an insulin response causes system-wide inflammation. Sugar is the worst culprit. Acne is all about inflammation to the presence of bacteria, even if the bacteria would do no harm if there wasn't inflammation.

One hypothesis is that if you become vegan, your skin will be less inflamed, less acne prone. Has to do with a lessening of the mtor or mtorc1 pathway. A research review here, with special emphasis on milk. A healthline article here showing that higher insulin and IGF-1 increase acne.

Cocoa can also affect acne::
https://www.healthline.com/health/does-chocolate-cause-acne

Having a food allergy increases keratin production?:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7676854/


Stress

Acne is caused by many factors, including stress.


Compulsive Skin Picking

https://www.nbcnews.com/healthmain/when-you-cant-stop-pick-pick-picking-your-skin-777574
Motivational video: https://www.youtube.com/watch?v=rGmKsfA-T28

What works for me, is to grow my nails long. I can't feel for bumps, as it's my fingertips that are most sensitive, so I therefore lose the urge to isolate and raise the bump to behead (for me they are keratin plugs). I hate long fingernails though.


Comedogenesis

Acne may be caused by oxidation of sebum 2 3 4. Maybe the harsh cleansers cause the sebum to oxidate? Even pollution has been implicated. A higher pH for the skin was associated with acne. Consider that harsh cleansers are defined by a high pH.

So let me think in terms of basic chemistry. Oxidation is defined as the loss of electrons. An alkaline cleanser has an overabundance of electrons compared to neutral water? Not necessarily. You would think an alkaline cleanser, having an overabundance of electrons, would actually reduce the sebum rather than oxidize it. But there is not a one-to-one correlation between the ph scale and oxidation-reduction reactions. The research claims that acne is caused by sebum oxidation, but the cause doesn't seem to be known. Squalene is the component of sebum that causes blockage upon oxidizing. There is a hypothesis that in people without acne, antioxidants, mainly vitamin E, are sufficient in the sebum to keep the squalene from oxidizing. Read more from this researcher.

Acne prone skin also lacking linoleic acid: https://www.ncbi.nlm.nih.gov/pubmed/2936775
Someone else looking up research: https://www.acne.org/messageboard/topic/314390-acne-prone-skinsebum-deficient-in-linoleic-acid-possible-topical-solution


Additional References

Research Quality Grading

Chinese Guidelines for the Management of Acne Vulgaris: 2019 Update

Acne Management Guidelines by the Dermatological Society of Singapore, Oon et al 2019

Personal Log Battling Acne, which can be skipped: preferable to read Skin Care Section Below


Skin Care

Sorry about this section being a disorganized mess. I wrote this a long time ago and am slowly improving my writing skills, I hope.


Topicals

Doing nothing is better

Obsessing over acne can rob you of time you could be doing other more positive things. A healthy lifestyle will likely be your cure for acne.

This section exists because I can't follow my own advice. Also, maybe after decades of being horrible to your skin, it needs extra help from topicals.

Natural is better

DIY products can be more effective than pharmaceuticals or store bought skin care products. There is lots of advertising and even lots of research that will push society towards artificial products. Store bought products need to have a long shelf life for companies to gain the most profit, so they will often have less active ingredients (active ingredients tend to be unstable), or will have toxic preservatives to increase shelf life.

Case in point, rubbing your skin with a lime is more effective than serum products touting 20% Vitamin C. These store bought products use Sodium Ascorbyl Phophate as a source of Vitamin C, which is effective, but not as effective as the less-shelf-stable Citric Acid, as found in a lime.

Whatever you use, it will likely work for a while and grow less effective with time, so it's good to alternate skin care with healthy options.

Maybe it would be fun to try some bentonite clay or dead sea mud masks, but I don't know what these things do to the acid mantle. I'm trying to simplify, after all. It's hard not to want to do something to take care of your acne. But in the end, if I stopped spending any time on it, including picking my skin, the skin would be in much better condition.

I used to use home-made acne pads, similar to stridex or oxy. I kept the pads in a bath of witch-hazel, apple cider vinegar, and salicylic acid (yes, you can buy salicylic acid in powder on the internet) ACV+WH+SA.

Note: The pads I used are thin, waffle weave pads 2, made from polypropylene and rayon. They are hard to come by, but I liked them better than cotton rounds.

More toners:

Pharmacological Effects of Rosa Damascena
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3586833

Antibacterial Activity of Ethanolic Extract of Cinnamon Bark, Honey, and Their Combination Effects against Acne-Causing Bacteria
https://doi.org/10.3390/scipharm85020019

I was considering using a soap alternative. There is a Quora suggestion to use “besan or gram flour mixed with curd/lemon” which I guess means besan with curdled milk. However, I would like something I don't have to prepare. Something “ph balanced” to match the skin's ph of around 5.5? How about apple cider vinegar with some flour? At this site someone used apple cider vinegar with oatmeal, and she stores the extra in the fridge. I'd want at least a week supply! My wanting convenience is leading me towards Amazon.

Alternatively, you can try using any water based moisturizing cream like a soap. I think these water based creams are called oil-water emulsions. You rub the emulsion on your face, and the oil in the creme mixes with the oil on your face, creating a new emulsion with the two oils. You then wash off that emulsion with water. This has been my experience using moisturizing creme to wash off dirty mechanic's hands. It's less drying on the hands than soap, but surprisingly more drying than not having gotten your hands dirty in the first place.

There is, of course, the oil cleansing method. You will not want to do this in the shower, or you will leave the bath tub oily. It's common sense that this does not happen in the shower, but lifetime habits can be hard to think around. In the shower or at the sink, you only rinse with water. Afterwards when your skin dries, you massage the oil about your face, and wipe off the excess with a paper towel. Sites describing the oil cleansing method, often mention using a comfortably-hot rag to hold against your face once you've applied the oil, that will help the oil penetrate, but that's too much work for me. My way involves even less time, especially compared to the marketed three: cleanser, toner, moisturizer. You only use one product: oil. There are many types of oils like olive and coconut. Make sure they are first cold pressed. In case of olive oil, a low acidity level means the olives were in good condition (0.5% or less).

I tried hemp oil because it is supposedly non-comedogenic. See: skincareox.comholistichealthherbalist.com. However, these two sites provide no references to research. They likely fabricate data to make money using referral profits. The Truth About Comedogenic Ratings And Acne, Anjali Lobo 2018.

The skin takes time in adjusting to a new regiment. It may take up to and over a month for the skin to normalize from a transition in skin care, so don't be quick to give up on a new regiment.

Bacteria are a normal part of your skin. There is one hypothesis, that says the bacteria cause a problem, when, in the process of “cleaning” your skin, you remove the acid mantle. The acid mantle is a protective barrier, and having removed it by aggressive cleaning, bacteria can enter the hair follicle and sebaceous glands. Here the bacteria can cause inflammation and produce by-products that leads to blockage of the follicle which leads to acne.

I stopped having acne on my back and shoulders, when I stopped using soap in those areas. I just left it alone. Now I only use soap under the arms and the groin area. But I still have acne, or keratosis pilaris, on my scalp, most likely because I keep picking at it. My skin produces excess keratin on my scalp because the skin is damaged.

I used to think my face would feel disgusting if I didn't use soap. I exfoliate my face and scalp without soap by cleaning my hands with soap and using my fingertips. I liked how clean my face felt with soap, but I've read on some sites that the “squeeky clean” feeling I like is equal to having destroyed my protective acid mantle. Other sites say the acid mantle recovers within a short time after using an alkaline soap, but I'm going to assume that stripping the acid mantle has unwanted end effects. Exfoliation without soap is gentler than stripping the acid mantle.

Some recommend harsher exfoliation, chemical peels, and everything possible to prevent clogging of the pores. They also support a three step process that involves a cleaner, a toner, and a moisturizer (capitalism rejoice). The toner can be used to re-acidify the skin. The moisturizer to replenish the protective barrier that was lost in the first step. This may work for some people who's sebum lacks antioxidants. This antioxidant lacking sebum clogs easily.

A different affliction is keratosis pilaris, where there isn't excess sebum with low levels of antioxidants (see comedogenesis above). Instead there is excess keratin production.

After a gentle exfoliation without soap, you can add some oil of your choice as moisturizer, to help dissolve keratin, to get better flow from your pores. I like mixing coconut oil with a little tea tree essential oil. While coconut oil is said to be comedogenic, I think the tea tree oil mixed in changes this property.

Also, I get excellent exfoliation because my feline companion loves coconut oil.

An essential oil such as tea tree oil requires a carrier oil because an essential oil is too strong to apply by itself. The best oil could be considered to be the oil that best penetrates the skin. One study among five oils shows that olive oil may be best: Penetration enhancing effects of selected natural oils utilized in topical dosage forms, Viljoen et al 2015.

More studies on oil as topical

Scanning the internet I found the following helps with keratin plugs:

  • Moisturizing leads to soft skin and avoids the hard plugs that clog hair follicles.
  • Urea exfoliates and moisturizes.
  • Exfoliants: Salicylic acid, or Alpha Hydroxy Acids (AHA), including lactic acid, glycolic acid, mandelic acid.
  • Retinol


Retinoids

I found isotretinoin gel effective, but it is no longer made. There is a 2002 study comparing isotretinoin gel and adapalene gel that has no COI declaration, which states that adapalene gel is just as effective with lesser side effects.

In different therapeutic schemes, ADP is more effective in combination with other active substances. New topical combinations with adapalene include ketoconazole (antifungal), mometasone furoate (anti-inflammatory corticosteroid), nadifloxacin (fluoroquinolone), and alfa and beta hydroxy acids. Recent Advances Regarding the Therapeutic Potential of Adapalene, Rusu et al 2020

There is a natural retinoid that causes less irritation than pharma retinoids called bakuchiol. According to an article on harvard.edu, more research is needed to prove its efficacy. “File bakuchiol under the “promising, but unproven” category.” Bakuchiol: Does it make skin look younger?, Stephanie Watson 2022. There is a more upbeat article on draxe.com: Bakuchiol: A ‘More Natural Retinol’ That’s Equally Effective for Skin, Christine Ruggeri 2020


Antivirals

Radio Frequency (RF) Treatments

It is unlikely I will be finding high quality studies for light and RF therapies, given that the Singapore review rates these treatment modalities as Level 2 Grade D.

Examples


Shower Filters

https://chriskresser.com/is-your-daily-shower-making-you-sick/

For those that don't have water filtration for the entire home, a shower filter can reduce the amount of chemicals reaching your skin. The sources I have for information may be biased since they are commercial, but it's what I have for now.

According to tappwater.co, which sells filters, shower filters do not filter chloramines:

Chloramines are used instead of chlorine by some public water suppliers. Many of the shower filter brands and especially vitamin C ones claim that they can also remove chloramines.

There are no conventional shower filters that will remove more than a small amount of chloramines from your shower water.

San Francisco Public Utilities Commission states on their website that only Vitamin C can be used to remove chlormaines from municipal water but the test was carried out using 1000 mg of Vitamin C in bath water,

On the other hand there is plenty of evidence that it will not be as effective for a shower filter. Screw on type of shower filters that claim to eliminate choramines are unlikely to work. While they may reduce chloramines slightly, it is highly dubious that they actually eliminate chloramines because the flow of water through a shower filter is too high to result in contact of the water with the filtering compound for a long enough duration of time.

Be sure to check out the claims of these chloramine filter manufacturers. Ask for independent research that proves the effectiveness of their shower filters. You probably won’t find it. We haven’t been able to find any. Facts about water in your shower are very important to be known.

The only way to effectively remove chloramines in your shower is to have a whole house filtration system.

Also on the same page:

9. Vitamins C infused shower filters are better for the skin

Probably false.

According to Patricia Farris, a doctor that specialises in dermitology Vitamin C has lots of benefits for the skin. It can be absorbed through the skin if it is formulated properly. Vitamin C can soften lines and wrinkles by boosting collagen production, lighten hyperpigmentation, and protect the skin from UV damage.”

But will it work with a shower filter? “Most likely not. While a vitamin C-infused shower sounds good in theory, it will probably provide very little skin benefit,” says Farris. “Vitamin C must be formulated and packaged in a very careful way in order to stabilize it and prevent it from becoming oxidized [which makes it ineffective]. If it’s just sprayed out of the shower, the majority of it will be inactivated rather quickly as it is exposed to air.”

There is no scientific evidence that Vitamin C showers benefit the skin.

I found a 3 stage shower filter by Pelican that claims to remove chloramines. On Amazon, in the Q&A, someone tested the chloramine removal and answered that it was only a 50% reduction, which I guess is about as good as it's going to get for a shower filter.


Laundry Detergent

Do not use standard laundry detergent. Not only does it add toxins to your clothes that transfer to your skin, it leaves a residue that builds up over time. I have been using only “washing soda” (I've only found the arm and hammer brand), plus a small amount of laundry detergent (labelled “for sensitive skin” “free of dyes and fragrance”). I use a shout brand stain remover to treat stains before washing (or if I find a stain that didn't come out in the wash). Stain removers have enzymes to clean other types of stains not covered by washing soda.

DIY laundry detergent:
Approximate ratio of 5 parts washing soda to 1 part “free and clear” type laundry detergent and/or a tablespoon of dishwashing soap.

DIY fabric softener:
Vinegar + essential oil.

Also see: Tub Clean Cycle

Notes that went into forging the above:


Non-Invasive Facial Cosmetics and Body Contouring


High Intensity Focused Ultrasound HIFU


Aloe Vera Gel instead of Ultrasound Gel

Ultrasound gel is used as a coupling medium in all ultrasound procedures to replace air between the transducer and the patient’s skin, as ultrasound waves have trouble in traveling through air.

At the borderline between media of distinctive acoustic impedances, some of the wave energy is transmitted and some is reflected. The larger the gap in acoustic impedance between the two media, the more prominent will be the reflection, and the less there will be the transmission. For diagnostic ultrasound (US), ultrasound gel having acoustic impedance comparable to soft tissue (1.6 Mrayl) is necessary for the complete transmission of ultrasound waves.

The acoustic impedance of the selected formulation (S1) was 1.45 Mrayl and the acoustic impedance of commercial gel (CG) was 1.5 Mrayl. The results showed that the acoustic impedance of both was very close and similar to the impedance of soft tissues (1.6 Mrayl). The intensity reflection coefficient tells us that 0.6% of sound waves reflect at the boundary between gel and human skin, while 99.4% transmit through the skin, and it is opposite without ultrasound gel. Preparation and Evaluation of Polymer-Based Ultrasound Gel and Its Application in Ultrasonography, Afzal et al 2022

Images recommended as acceptable by raters was 91.7% for Aloe vera lotion and 81.7% for commercial gel. Aloe vera Lotion Used as a Potential Alternative Couplant for Sonography, in a Low-Resource Health Care Facility, Paulinu et al 2022

Aloe vera- based gel is a feasible alternative to commercially available ultrasound gel on diagnostic ultrasound imaging Aloe vera (L.) Burm.f.-based gel as an alternative to commercially available ultrasound gel on diagnostic ultrasound imaging: a phantom study (pdf) Cabataña et al 2020


Household Cleaners

Preventing Poison Ivy Rash

A rash develops not because you got the ivy on you in the first place, but because you fail to wash off the oil that the plant transfers to your skin. If you wash between 2 to 8 hours after exposure, you will avoid the rash.

Most people wash with only soap and water. Dish soap cuts through oil better than soap. But the secret is that you must use friction. A damp soapy wash cloth scrubbed on the skin will remove the poison ivy oil better than any soap alone.

source:
https://www.deeranddeerhunting.com/content/blogs/southern-hunting-for-whitetail-deer/how-to-never-again-suffer-from-poison-ivy

Personally, I have no experience with the rashes, as I am immune to poison ivy.


Discussion

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health/dermatology.txt · Last modified: 2024/03/19 16:20 by marcos