Acne Vulgaris

Risk factors/Triggers

1. Food/Diet

Foods such as nuts, cola, milk, cheese, fried foods and iodised salts have been implicated as triggers of acne vulgaris; however, the connections between nutrition and acne has not definitely been proven as they are rarely supported by good analytical, epidemiological or therapeutic studies [4, 5]. On the other hand, recurrent acne as noted by Niemeier et al (2006) may be a cutaneous sign of an underlying eating disorder.

2. Genetics

A genetic background is supported by a case control study by Goulden et al, as noted by Rzany et al (2006). This stated that the risk of adult acne vulgaris in relatives of patients with acne as compared with those of patients without acne is significantly higher [4].

3. Hormones

According to Rzany et al (2006), hormonal influences on acne vulgaris are undisputed as shown by the higher incidence of acne in male adolescents. Premenstrual flare has also been recorded as causing acne [5].

4. Nicotine

Smoking has also been named as a risk factor for acne vulgaris; however, conflicting data exists as to the link between smoking and acne. Some population based studies have found links between smoking and acne whilst some others have not [4].

Important!

Contrary to popular misconceptions by young patients and occasionally their parents, acne does not come from bad behaviour nor is it a disease of poor hygiene. It also has nothing to do with lack of cleanliness [2].

Types of acne vulgaris

There are two main types of acne vulgaris, inflammatory and non-inflammatory; these can be manifested in different ways,

1. Comedonal acne, which is a non-inflammatory acne

2. Papules and pustules of inflammatory acne

3. Nodular acne (inflammatory acne)

4. Inflammatory acne with hyperpigmentation (this occurs more commonly in patients with darker skin complexions) [1]

Clinical manifestations

In general, acne is limited to the parts of the body, which have the largest and most abundant sebaceous glands such as the face, neck, chest, upper back and upper arms. Among dermatologists, it is almost universally accepted that the clinical manifestation of acne vulgaris is the result of four essential processes as described below [1, 6],

1. Increased sebum production in the pilosebaceous follicle. Sebum is the lipid-rich secretion product of sebaceous glands, which has a central role in the development of acne and also provides a growth medium for Propionibacterium acnes (P acnes), an anaerobic bacterium which is a normal constituent of the skin flora. Compared with unaffected individuals, people with acne have higher rates of sebum production. Apart from this, the severity of acne is often proportional to the amount of sebum produced [1, 6].

2. Abnormal follicular differentiation, which is the earliest structural change in the pilosebaceous unit in acne vulgaris [1].

3. Colonisation of serum-rich obstructed follicle with Propionibacterium acnes (P acnes). P acnes is an anaerobic bacterium which is a normal constituent of the skin flora and which populates the androgen-stimulated sebaceous follicle [androgen is a steroid hormone such as testosterone or androsterone, that controls the development and maintenance of masculine characteristics]. Individuals with acne have higher counts of P acnes compared with those without acne [1, 6].

4. Inflammation. This is a direct or indirect result of the rapid and excessive increase of P acnes [1].

Non-inflammatory acne lesions include open and closed comedones, which are thickened secretions plugging a duct of the skin, particularly sebaceous glands. Open comedones, also known as blackheads, "appear as flat or slightly raised brown to black plugs that distend the follicular orifices". Closed comedones, also known as whiteheads, "appear as whitish to flesh-coloured papules with an apparently closed overlying surface" [1].

Inflammatory lesions on the other hand include papules, pustules, and nodules; papules and pustules "result from superficial or deep inflammation associated with microscopic rupture of comedones". Nodules are large, deep-seated abscesses, which when palpated may be compressible. In addition to the typical lesions in acne, other features may also be present. These include scarring and hyperpigmentation, which can result in substantial disfigurement [1].

Psychological Aspects

Numerous psychological problems such as diminished self-esteem, social embarrassment, social withdrawal, depression and even unemployment stem from acne. However, differential diagnosis from a psychosomatic point of view indicates two serious psychological problems, which can arise from acne. These are,

1. Psychogenic excoriation, and

2. Body dysmorphic disorder (BDD)

Psychogenic excoriation also referred to as neurotic excoriation, pathological or compulsive skin picking "is characterised by excessive scratching or picking of normal skin or skin with minor irregularities" [5]. According to Niemeier et al (2006) it is estimated to occur in 2% of dermatological patients. Patients with this disorder can also have psychiatric disorders such as mood and anxiety disorders, as well as associated disorders such as obsessive compulsive disorder, substance abuse disorder, obsessive compulsive personality disorder, compulsive buying, eating disorder, and borderline personality disorder, to mention a few [5].

Body dysmorphic disorder (BDD) "is a condition characterised by an extreme level of dissatisfaction or preoccupation with a normal appearance that causes disruption in daily functioning" [3]. Niemeier et al (2006) described it as "a syndrome characterised by distress, secondary to imagined or minor defects in one's appearance." The onset of BDD is usually during adolescence, and it occurs equally in both male and female. Common areas of concern include the skin, hair and nose, with acne being one of the most common concerns with BDD patients [3].

According to the Diagnostic and Statistics Manual of Mental Disorders (2000), BDD has three diagnostic criteria,

1. A preoccupation with an imagined defect in appearance; where a slight physical anomaly is present, the person's concern is markedly excessive,

2. The preoccupation causes clinically significant distress or impairment in social, occupational, or other important areas of functioning,

3. The preoccupation is not caused by another mental disorder (e.g. Anorexia Nervosa)

Characteristic behaviours include skin picking, mirror checking, and camouflaging by wearing a hat or excessive make up. Apart from these, patients often seek reassurance frequently by asking questions such as "Can you see this pimple?" or "Does my skin look okay?" Some patients also have a tendency to doctor shop, which is essentially going from one specialist to another in search of a dermatologist or plastic surgeon, willing to carry out a desired procedure or dispense a certain drug, to improve their perceived defect [3, 5].

Although it is a relatively common disease, BDD is still an under diagnosed psychiatric disorder and is estimated to affect 0.7 to 5% of the general population. Other psychiatric conditions associated with BDD include major depression, anxiety, and obsessive compulsive disorder. It is also associated with high rates of functional impairment and suicide attempts, high levels of perceived stress, and markedly poor quality of life [3, 5, 8].

Acne Treatment

1. Topical treatment, particularly for individuals with non-inflammatory comedones or mild to moderate inflammatory acne (See types of acne vulgaris). Medications include tretinoin (available as gels, creams, and solutions), adapalene gel, salicylic acid (available as solutions, cleansers, and soaps), isotretinoin gel, azelaic acid cream, benzoyl peroxide (available as gels, lotions, creams, soaps, and washes), to mention a few [1, 2].

2. Oral treatment, particularly for acne that is resistant to topical treatment or which manifests as scarring or nodular lesions. Medications include oral antibiotics (e.g. tetracycline, doxycycline, minocycline, erythromycin, and co-trimoxazole), oral isotretinoin, and hormonal agents (e.g. oral contraception, oral corticosteroid, cyproterone acetate, or spironolactone) [1, 2].

3. Physical or surgical methods of treatment, which are sometimes useful as adjuvant to medical therapy. Methods include comedo extraction, intralesional injections of corticosteroids, dermabrasion, chemical peeling, and collagen injections, to mention a few [1, 9].

4. Sun exposure, reported by up to 70% of patients to have a beneficial effect on acne [10].

5. Light therapy, which is becoming more popular due to the growing demand for a convenient, low risk and effective therapy, as many patients fail to respond adequately to treatment or develop side effects, from the use of various oral and topical treatments available for the treatment of acne [11]. Methods include the use of visible light (e.g. blue light, blue/red light combinations, yellow light, and green light), laser treatment and monopolar radiofrequency [11]. Many of these light therapy treatments can be used at home.

Recommended Products for Acne

References

1. Brown SK, Shalita AR. Acne vulgaris. Lancet 1998; 351:1871-1876.

2. Webster GF. Acne vulgaris. Br Med J 2002; 325: 475-479.

3. Bowe WP et al. Body dysmorphic disorder symptoms among patients with acne vulgaris. J Am Acad Dermatol 2007; DOI: 10.1016/j.jaad.2007.03.030.

4. Rzany B, Kahl C. Epidemiology of acne vulgaris. JDDG 2006; DOI: 10.1111/j.1610-0387.2006.05876.x

5. Niemeier V, Kupfer J, Gieler U. Acne vulgaris-Psychosomatic aspects. JDDG 2006; DOI: 10.1111/j.1610-0387.2006.06110.x

6. Gollnick H. Current perspectives on the treatment of acne vulgaris and implications for future directions. Eur Acad Dermatol Venereol 2001; 15 (Suppl. 3):1-4.

7. American Psychiatric Association. Diagnostic and Statistics Manual of Mental Disorders. 4th Ed. Accessed via: BehaveNet® Clinical CapsuleTM; http://www.behavenet.com/capsules/disorders/bodydysdis.htm. Accessed on: 28th June 2007.

8. Phillips KA et al. A retrospective follow-up study of body dysmorphic disorder. Comprehensive Psychiatry 2005; 46: 315-321.

9. Taub AF. Procedural treatments of acne vulgaris. Dermatol Surg 2007; 33: 1-22.

10. Cunliffe WJ, Goulden V. Phototherapy and acne vulgaris.Br J Dermatol 2000; 142 (5): 855-856.

11. Dierickx CC. Lasers, Light and Radiofrequency for treatment of acne. Med Laser Appl 2004; 19: 196-204.

Disclaimer

This article is only for informative purposes. It is not intended to be a medical advice and is not a substitute for professional medical advice. Please consult your doctor for all your medical concerns. Kindly follow any information given in this article only after consulting your doctor or qualified medical professional. The author is not liable for any outcome or damage resulting from any information obtained from this article.

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Adult Acne - Getting Rid of it!

If you were part of the majority of people that were unlucky to be plagued with teen acne, just think of all the snickers, jests and humiliation you had to go through, then it easier for you to understand why most adult acne sufferers go through a lot of hassles to remove adult acne from their lives. We both know that adult acne is not a terminal disease (you can't die from having it, I guess you knew that uhhh?). The major thing acne gives us are ugly scars and sometimes they could be really ugly, like mine was at a certain time.

Most of we adults afflicted with acne are usually on the look out for the magical cure that would gives us the fresh and smooth face or skin we had when we were eleven years old. Before we go on a wild goose chase looking for the magical acne medication that would rid us of adult acne lets understand why and how these little annoying monsters grow on our faces.

Why do so many adults still have acne?

It seems from all the amount spent on all those expensive research they still tell us the same thing that we were have all read in encyclopedias, the major cause of adult acne always has something to do with our hormones running wild and also genetics (my dad had a very bad case of acne when he was younger, more severe than mine was). The genetics part simply means that your biological family history has a large chunk of the blame of why you are suffering from adult acne. But aside those there are some other factors that are responsible for worsening your acne condition, some of them include:

• Side effects from some drugs - (such as corticosteroids, androgenic steroids, and lithium)
• Picking at or squeezing at the pimples
• Harsh scrubbing of the skin
• Oil based cosmetic products - (I guess you know this one already)
• Stress, illness or exhaustion
• Heat and moisture
• Diet has a some amount of influence on acne - (and please eating chocolate does not cause acne, where the heck did you hear that from)
• Pregnancy
• Menstruation
• Menopause

How does Adult Acne form on the Skin?

The formation of adult acne as we all know has something to do with sebum, follicle and all those big words that I read in some 21 inches thick encyclopedia. In simple words it is formed when oil (also know as sebum) that is produced underneath the skin surface is blocked from reaching the skin surface where it always flows to, through a hair-containing canal called a "follicle".

The follicle wall sheds cells often and the canal is used to remove dead cells, which sort of become sticky and block the opening as they attempt to leave the follicle. The blockage results in increased bacteria growth in the follicle, which turns the trapped sebum into a very irritating substance and results in an inflammation that is widely known as acne.

Pheww!!! All that explanation reminds me of high school biology (so painfully boring to me).

In one sentence on how acne forms it is simply put as "Dead skin cells clog the pores, and bacteria cause inflammation which results in acne on the skin".

Although so many adults like you have tried many acne medications and cosmetics to combat acne, we tend to wonder why they seem not to get rid of the problem once and for all but still they re-occur. It seems that acne forms when one or more of these conditions occurs:

• A blockage in the follicle
• There is an over production of sebum (oil)
• Increased bacteria growth within the hair follicle.

Researchers have found out that the hormone responsible for acne, which is called "testosterone". Yes you have heard of it before it is the male hormone (it is found in both males and females but it is produced in high levels in males). Testosterone is responsible for increasing production of sebum (oil), which results in more pimples. Since testosterone is an androgen and is more in males than females, this explains why men tend to have more severe cases of acne than women (at least that explains why I used to have more pimples on my face than my elder sister although she started having pimples on her face before I started having mine).

Adult acne occurs as visible bumps on the surface of the skin usually on the face, although body acne is also common. Adult Acne is seen as pus-filled blisters; small reddish bumps, ugly looking thick red skin on the nose, cheeks and forehead, and small reddish blood vessels all seen on the skin surface. Acne outbreaks usually occur on the face, neck, chest, and shoulders and back. A highbrow term for adult acne is "acne rosacea".

For so many folks stress seems to be one of the major factors in aggravating their acne condition. When I was in college towards the end of the semester when the amount of work we had to do increases, I tend to have more break outs of pimples maybe as a result of the stress or because I had lesser time for acne skin care. It seems aside the fact that you have to contend with hormones and genetics being the major cause of you acne condition you also have things like stress to worsen it.

Achieving Acne Control with the best Acne Medication

The first step in treating your adult acne condition has to do with proper acne skin care.

• First of all AVOID the temptation of SQUEEZING your PIMPLES. Most of the time this results in the scars you see on your face. The bigger a pimple is the higher the chances it will leave a scar if you "pop" it.
• Remember to wash your skin gently only twice a day; this is very helpful in removing surface dirt and excessive oil, which could worsen your acne condition by clogging the pores. Also please do not use abrasive soaps. They could damage your skin pores and leave your skin too dry.
• If you currently use oil-based cosmetics it's time you switch to water-based, non-comedogenic cosmetics as oil-based creams or lotions irritate oily skin and cause further breakouts and blemishes.
• You should also make it a habit to always remove your makeup before going to bed.
• Consider applying an oil-free moisturizer to your skin after washing. This helps your skin replenish its own moisture and keeps the oil glands from over producing.
• Always remember to shampoo regularly. This prevents oily hair from rubbing off on your skin.
• Like we learnt in biology class, a balanced diet is necessary for optimum health. A balanced diet and drinking 10-12 glasses of water a day can help keep your skin healthy. There are some physicians that believe that an increase in iodine consumption aggravates acne and recommend a reduction or elimination of fish and iodized salt.
• Relax a little to reduce stress and try planning out your activities so you are not under a lot of pressure from your daily activities.

In case you are looking for a more aggressive adult acne treatment to totally banish those little monsters of your face/body you should try using a combination of treatment like that offered by clear pores system which consists of a facial/body wash, facial/body protection cream and a herbal supplement which fights the acne from the inside and the outside. This triple combination is guaranteed to get rid of acne from your life.

Another very impressive acne treatment available is acnezine, which has natural ingredients that work to take care of the skin. They help control free radicals that cause skin damage, aging and wrinkling, and that can contribute to infection. Acnezine limits inflammation, helping take care of the ugly redness, and working to limit the inflammatory response that can cause scarring. And, Acnezine promotes healing. Acnezine consists of skin anti-Oxidant Capsules and acne Moisturizing Crème which ensures acne is combated from both inside and outside the body.

For more information on how you can permanently get rid of Adult Acne from your life and look more youthful and beautiful visit adult acne treatment a brand new blog that gives information, tips and advice on how to solve the problem of acne.

Tim Orlando is a young man who is passionate about educating teenagers and young adults solve their acne problem just like he solved his. Visit his blog clear-adult-acne.blogspot.com where he discusses more on the monster called "Acne".

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Let's Talk about Acne - Learn the Truth and Myths About Acne

Having great looking skin doesn't stop at the ladies, a massive number of males are very interested in making the most of them-selves and it all starts with the skin.

Never has your appearance been more important than at this time. We judge people within seconds of seeing them. We have an opinion of a person who is covered in spots; we come to our own conclusions rightly or wrongly if we see someone who has eczema or dry flaky skin. If someone is unshaven, dirty, wears heavy dark makeup, has lank greasy hair, has acne, like it or not we make instant decisions on how we look. It also affects our mood and behaviour.

As there are three types of acne past, present and future signs of acne you need to first establish which type are YOU

I will prove to you in a matter of moments why you can trust me to expose you to the whole truth AND Myths about the world of acne.

So what is Acne?

Acne is an inflammatory skin condition that occurs when sebum (oil) and dead skin cells block the pore opening, causing sebum to build up inside the pore. Although acne is a common skin condition, if left untreated it can lead to severe inflammation and permanent scarring.

Who is affected by Acne?

Acne affects people regardless of age, gender, or race. More than 80 % of people suffer from acne at some point in their lives, many into adulthood. Did you know 20% of all adults suffer with active acne? and of the 85% of young adults (between ages 12 and 24) that suffer from acne, 25% will have permanent scars ranging from mild to severe.

Knowledge is POWER!! To be able to rid ourselves of ACNE we first must need to know what it is

Learn about the Acne Life Cycle

Stage One: Clogged Pores

o Each pore in your skin is essentially a hair follicle lined by cells from the epidermis (the upper most layer of the skin). The hair follicle is connected to multi- lobed sebaceous glands (oil producing glands).

o Sebaceous glands produce sebum, a natural substance that lubricates the hair and provides essential fatty acids and lipids that are necessary to maintain the skin's protective moisture barrier.

o As part of the skin's healthy processes, cells that line the pore are continuously shed.

o They mix with sebum and flow out of the pore onto the surface of the skin.

o If the sebaceous glands produce too much oil, generally in response to hormones, the mixture of dead skin cells and sebum form a plug, blocking the pore opening.

Stage Two: Bacteria

o Dead skin cells lining the pore continue to be shed and oil is still produced by the sebaceous glands, both of which build up behind the plug.

o The accumulated mixture of sebum and dead cells attracts the bacteria found naturally in the skin (known as P.acnes or propionibacterium acnes), which feeds on oil and multiplies rapidly inside the pore.

Stage Three: Inflammation

The bacteria overgrowth triggers the body's natural inflammatory immune response: white blood cells to flood the area. This causes swelling and redness in the region, which can ultimately lead to the discoloration and scarring associated with acne.

Which Type are You?

There are many types of acne breakouts, all of which result when oil and dead skin build up and clog the pore opening. Blackheads, whiteheads, pustules (or nodules), and cysts are the four most common types of acne breakouts.

Blackheads (or open comedones) are clogged pores that are only partially plugged, allowing some of the trapped sebum and oil to escape the pore. The sebum within the hair follicle solidifies. The dark colour associated with blackheads is due to the oxidization of sebum and melanin in the dead skin cells when they come into contact with the air. Blackheads are generally not inflamed or infected with bacteria and do not cause scaring.

Whiteheads (or Closed comedones) are the result of completely clogged pores. Below the skin, excess oil and dead skin cells fill the pore and begin to create a small whitish bump. Limited bacterial growth and a low grade immune response create the white pus associated with whiteheads. They are not highly inflamed and do not generally cause scarring.

Pustules (or nodules) are red, inflamed acne breakouts that occur when clogged pores become infected with bacteria (P.acnes). A pustule is similar to a whitehead, but is highly inflamed and appears as a red bump with a white or yellow centre. Because of the inflammation and swelling, pustules cause the distinctive discolouration associated with acne and may also cause scarring.

Cysts are severely inflamed and pus-filled acne lesions that occur when the contents of a clogged pore seep into the dermis (lower layer of the skin). The deep inflammation and infection cause a severe immune response: white blood cells flood the area, which then becomes swollen and sore. This results in the formation of a cyst. Acne cysts are painful and often cause scarring. The white blood cells can overreact and damage the pore and surrounding area. After the cyst heals, a permanent scar may remain.

OK, So All This Information Is All Well and Good But, How Do We Treat ACNE!!
Because acne can begin 2 - 3 weeks before blemishes are visible on your skin, the secret to controlling acne is prevention. Prevention includes eating a balanced diet, exercising and reducing stress, as well as cleansing with a proper treatment system.

Please Do Not Be Mislead Acne can take anywhere Between 8 - 12 weeks to treat. However, most people can see a difference very quickly.

When treating acne topically, dermatologists recommend a three pronged approach.

o Unclog pores and keep them clear.

o Control oil, which helps to limit bacterial growth

o Reduce inflammation.

The skin takes time to adjust to a new system. During this time, breakouts may appear worse before they get better; this is NOT uncommon as pre-existing blemishes are beginning to surface. Improvements should be visible within a few weeks and continue throughout the next eight to twelve weeks.

MOST SYSTEMS DO NOT MATCH THESE CRITERIA

We have discussed the Truth about Acne now the interesting bit .... the myths!!

ACNE MYTHS

Myth#1: Scrub face clean to treat acne!

Vigorous washing and scrubbing can actually irritate the skin and make acne worse. The best approach to good hygiene and treating acne is to gently wash your face twice a day with a mild cleanser, pat dry and use an appropriate acne treatment.

Myth#2: You have to let acne run its course!

The truth is acne can be cleared up! Using a high quality, efficacious acne treatment system can address the stages of acne: clogged pores, bacteria and inflammation.

Myth#3: Acne is just a cosmetic condition!

While acne poses no serious threat to one's health, it does affect the way people look and can affect the way people feel about themselves. Acne should be taken seriously and treated to prevent permanent physical scarring.

Myth #4: Acne is not related to diet!

While thus far science has not found a solid connection between diet and acne, research is being revisited in this area. Some studies indicate a relationship between acne and high-glycemic foods such as sodas, pastries and breads. Other studies have looked at the impact of dairy-rich diets on skin health. Many people insist certain foods affect their acne. When controlling acne, eating a balanced diet is always a good idea.

Myth#5: There is no correlation between stress and acne!

Acne not only causes significant stress, but is also made worse by stress. in a recent study, Standford University students with acne were analyzed before and after exams. The study showed the students' acne worsened when under pre-exam stress. When you're under stress, your body produces stress hormones such as cortisol, which stimulate an over production of oil in the skin. When this excess oil mixes with dead skin cells, it promotes bacterial growth and can cause acne to develop or become worse. This can, in turn, lead to ore stress, plunging you into a Stress-acne cycle.

You now understand the Facts about Acne - the Truth and the myths

Take a good long look at your skin in the mirror - what do you see? Do you like the image? Are you projecting the right image for who you are? How does your skin measure up? Is it clear, glowing with health, a joy to look at? Or like so many people are you suffering with spots, blemishes, dark circles with a generally tired thick complexion. If one or all of these best describes your looks don't worry the good news is, that all can change within 30 days.

Why 30 days?

This is the average time it takes for new cells to rise to the surface of your skin. As that happens the old cells on the surface fall off, so you can technically say you are a completely different person every 30 days!

Over the next few pages I will discuss various methods that will guarantee your skin to be beautiful, blemish free, a joy to look at, no matter what nationality you happen to be or how long you have been suffering with problem skin.

First though you need to know a little about the skin.

Well it's the largest organ of the body and probably the most abused. It is made up of layers - the epidermis, dermis and the subcutaneous layers. Skin consists of hair follicles, sweat glands, sebaceous glands, melanins and connective tissue. Proper care is essential for normal skin functions. You see the skin wasn't designed to have problems it's construction is actually designed to combat most conditions. In our modern days though it does need a little help and I will discuss this later, but for now nature made sure that our skin can fight infections and bacteria's so most common issues we have is because our skin is unable to work at it's optimal level. As I mentioned on average the new skin cells rise to the surface approx. 30 days. It has a high concentration of water and needs the pores open to enable the skin to breathe.

Acne:

As you are probably aware our skin secretes an oil called sebum, which is naturally produced. Sebum is the chemical that helps to keep the skin at the correct levels of pH to enable the skin to fight bacteria and infections. You see we were not designed to suffer with spots, eczema, dry skin, etc., without this correction your skin will not be able to perform at it optimal level.

Warning:

If you have suffered from acne for a while you will know that as soon as you find a new product that promises clear skin, you use it for a day or so and it looks like it is working only to discover that it doesn't. This is because your skin is a very clever organ; it adjusts to whatever you do to it very quickly. The biggest misconception is that you need to buy a product either soap or cleanser that is so harsh it strips ALL the oils from the skin. This simply encourages the skin to produce more oil, you then think you need to use more of the harsh product and the skin produces even more oils, a vicious circle. Break this cycle NOW.

Stop using everything you have tried or are thinking of trying. For a couple of days leave your skin, allow it to "rest". Simply rinse with warm water but no products. Try not to get your hair products on your face; these too can be so harsh that the skin can react to them.

Once your skin has rested then I recommend a product that has absolutely NO bad ingredients, this isn't as easy as it may seem as many companies will promote the good ingredients and not mention the bad fillers used. Even the most well respected companies within the industry use these bad ingredients; price also is not an indicator of quality. With these fillers it doesn't matter how much good natural ingredients are used they will not work as the fillers will block the pores preventing them from being effective. Do not mix different company products ie a cleanser from Clarins, toner from body shop and moisturiser from Clinique this again is damaging your skin. Every company works on a different method some use exfoliation to get some results, some use "sealing in" the moisture. Keep to one product line.

If you are in any doubt then please feel free to email me on sarah@dermassists.com and I will be happy to give you a personal consultation. I have researched for many years companies that will provide only the good and none of the bad.

Getting back to acne, to restore your skin to it youthful, glowing and healthy state I recommend the following five point daily regime:-

Cleanse:

This is essential to clear the pores and remove toxins from the skin. Do not use anything with soap, coal tar or similar harsh cleansing agents, these damage the skin structure and creates further problems.

Exfoliate:

Be careful too much exfoliating and this will damage the skin. Use a mild, exfoliant preferably with marine diatoms, which will not damage the skin. Too many companies including the large, well-respected companies work with exfoliating the skin with very harsh ingredients. This is not desirable as it strips the skin of the sebum making the skin go to work on creating more.

Re - balance or Tone:

I have many people telling me even now, that the pores are closed with toners. This is not true, pores cannot be closed, they can be blocked but not closed. It is with the pores that the skin breathes if the pores are closed or blocked then the skin is in trouble and dies. Toners were created for two reasons, one was to firstly remove the oil and petroleum left on the skin from traditional cleansers and secondly to retract the pores after the debris had been removed. Every hour of every day our skin is exposed to pollutants and dirt, this is held within the pores stretching them, if the pores are not cleansed thoroughly and then helped to retract to their original size, the result is very large exposed pores. Most toners have harsh alcohols, which again will cause further problems; natural Witch Hazel will retract the pores and restore the pH levels of the skin making the skin work at its optimal levels. This is one of the most important products your skin needs but it can be the most damaging if using the wrong product.

Hydrate:

A good hydrating product can work wonders for scar tissue, and will assist the skin in the healing process and hydrate the skin. The side effects of this product are that it assists the elastin and collagen to perform better, hence younger skin!

Moisturise:

Use only moisturisers with humectants and with an SPF, humectants are water magnets, which will attract the moisture from the air - totally different from the "sealing in" process. Technology has moved so much within the skin care products and using oils and petroleum by products is such an old method to use, that now we know does not work.

I have found that many companies claim to have a successful regime. Time and time again they will promote one or two good ingredients only to find that the bulk of the products are useless and in many cases damaging to the skin.

The Do's and don't on Good Skin Care.

Do: Use high quality ingredients This does not mean the dearest

Do: Keep to a simply regime

Do: Use the right products for your skin type

Do: Remember your skin will change, whether you move to a different location or if you stop or start smoking. Treat your skin accordingly.

Do: Cleanse, Tone, Hydrate and moisturise twice a day.

Don't: Mix different company's products

Don't: Use products with cheap bulking agents such as petroleum by products, oils, coal tar, harsh alcohol etc.,

Don't: Tear at the skin this will create lines and wrinkles too early.

You now understand the Facts about Great Skin

Sarah Rendle has been involved in the Personal care industry for some 12 years. She has trained hundreds of people on the best practises of good skin care concentrating on only using natural ingredients and that has been proven by science to actually do what the products are supposed to do.

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