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Q&A Topics

Acne


Yesheen (dr.) Singh Medical Doctor View profile

Dear K



Thank you for your question. It is quite difficult for me to provide you with an accurate response with the little information you provide. There are many causes of adult acne and usualy it requires an in-depth history taking and clinical exam to ellicit the possible causes. Usually it has something to do with the balance of various forms of oestrogens within the body. I can recommend something like Saw Palmetto for example which is know to be of assistance in some cases but if it works, or does not, we will not know why without proper investigation.



You are welcome to try the Saw Palmetto - Solgar make a great product - but if you would like to discuss this further please contact me via www.healthnation.co.za to make an appointment.



Many thanks and warm regards

Yesheen Singh

Yesheen (dr.) Singh Medical Doctor View profile

Dear R



Thank you for your question. BioOil uses a base of petroleum-derived oil so I would not recommend it for anyone, let alone people with sensitive skin.



With regards to helping reduce scarring from acne there are no products that will completely rid your skin of the scars. For that you will have to experiment with dermabrasion of laser therapy with a registered therapist. IF you are looking to minimise them though then I would recommend a combination of rosehip, lavender and geranium oil in a mixture applied twice daily to the affected areas. Gentle exfoliation twice a week also helps to stimulate scar reduction. Make your own exfoliator with oatmeal, avocado and some of the oils I mentioned above. Also include a high-dose omega 3 supplement and consider ading in some MSM to help build collagen.



Many thanks and warm regards

Yesheen Singh

HealthNation

Felicia Rubin Pharmacist View profile

Dear Wendy,

Thank you for your question regarding Oratane 20mg & your interest in your health.

I am sure your dermatologist has explained the use over a period of 4-8 months as well as the effect should you have any existing medical problems.

However, your dosage is not high & am sure you are taking same according to your prescription.



Oratane does have side effects as do all medicines, of which dryness causes the most discomfort.

As far as long term use, the liver needs to be taken into consideration, & perhaps a liver detox, on a homeopathic level, would be most useful. (Heel Detox Kit)

Thus alcohol would not be recommended.

Further, check your cholesterol by means of a fasting Lipogramme, as the good cholesterol (HDL) maybe reduced.

,& Triglycerides increased.

Most of all, avoid prolonged exposure to UV rays or sunlight.



Best wishes

Yours in Health, Felicia Rubin (Senior Pharmacist & Integrated Health Practitioner)













Angela Lombard Nursing Practitioner View profile

Dear S

Many thanks for your question.

Being under 19 years of age indicates that you are post pubescant and with your current signs and symptoms of the skin, you are therefore understandably experiencing a hormonal flux. Some teenagers experience this more than others.

With the introduction of hypertension at the age of you being under 19, I suspect you that you may be overweight. Nutrition is always paramount when treating acne, or pimples of any kind. Avoid all white foods like white bread, white sugar, pastries, and all fast foods. Do eat lots of fresh vegetables (5 - 7 daily) and fruit (3 - 4 daily). Prepare meat like fish and chicken by means of grilling, steaming, baking, and poaching. Do not fry or boil your food. Drink up to 3 litres of filtered water daily - if you find this difficult, then work towards 2 litres and top up with herbal teas.

Regular facial cleansing morning and evening is also very important, using a cleansing, toning and nourishing routine.

I recommend that you also take the following :

KALI SULPH TISSUE SALTS NO. 7, as x1 celloid (tablet) 3 times a day - Please use the Allison Effting range of tissue salts as the formulation is triple strength. Kali Sulph is a mucous membrane supporter and will renew skin cells from the matrix up.

REGENERATING GEL by Simply Aloe Botanical Skin Care, to be applied lightly once a day after a morning cleanse.

These products will work parallel with the medication your medical specialist prescribed and will not interfere in any way at all.

I suggest that you visit one of our Natural Medicine Dispensaries so that you can be visually assessed in order to further treat the acne scarring. Nearer the wedding you could invest in a good quality light foundation so as to cleverly conceal any scarring. You are welcome to make an appointment to see me so that I can show you how to apply this for scarring.

Concentrate on your nutrition, drink sufficient water, have a proper cleansing routine and take the above products mentioned, and you will feel and look better.

Good luck, and persevere, you will win!

Warm regards

Angela

Yesheen (dr.) Singh Medical Doctor View profile

Dear B



Thank you for your question. There are many reasons for the development of adult acne and in women it usually revolves around an imbalance in oestrogen metabolism. Without knowing too much about your case I recommend you begin some Saw Palmetto (Solgar make a good product) to help streamline the flow of oestrogen through your body. If this does not work after three months I would recommend making an appointment for a proper consultation.



Many thanks and warm regards

Yesheen Singh

Yesheen (dr.) Singh Medical Doctor View profile

Dear Q



I have replied to your similar question in an earlier response. Please refer to that for an answer.



Many thanks and warm regards

Yesheen Singh

Yesheen (dr.) Singh Medical Doctor View profile

Dear Q



Thank you for your question. You acne problem sounds like it may be related to an imbalance in your oestrogen balance. I cannot confirm this without a proper consult. You are wlecome to make an appointment via www.healthnation.co.za



In the interim try adding Saw Palmetto to you daily regime and see if this helps to balance out your oestrogen levels and improve your acne. Also ensure that you are using body and face products that do not contain any colourants, perfumes, synthetic or processed ingredients and definitely no petroleum-derived compounds.



Many thanks and warm regards

Yesheen Singh

Yesheen (dr.) Singh Medical Doctor View profile

Dear F

Thank you for your question. Dermatologists sometimes prescribe a tetracycline-type of antibiotic for low-grade acne as a long-term therapy. The aim is to kill the unhealthy bacteria they assume is living inside the skin pores and contributing to the formation of white-heads. This type of therapy is usually for 3 to 6 months. This does not make any difference in the hormonal imbalance which is a greater contributing factor. There are several repercussions to the chronic use of antibiotics, such as a decrease in your healthy GIT flora which in turn negatively impact your immune system, making you more susceptible to opportunistic infections. Long-term use of tetracyclines is also associated with increased incidence of diarrhoea, colitis, yeast overgrowth, tooth discoloration, increased sensitivity to sunlight, brittle nails and anaemia among others.

Femitibb, on the other hand, is a homeopathic remedy aimed at balancing your body's own hormonal production. I haven't prescribed it personally so will be unable to afford an opinion on the efficacy of its use.

One supplement I do find very effective in the control of adult acne in young females is Saw Palmetto. It helps to prevent to conversion of Oestrogen to Testosterone in you body, which is most often the hormonal cause of the acne. Saw Palmetto is also very useful for boosting energy and encouraging a positive mood, all related to the testosterone:oestrogen balance.

I hope you find this helpful.

Many thanks and warm regards

Yesheen

Yesheen (dr.) Singh Medical Doctor View profile

Dear J

Thank you for your question. The management of adult acne involves a multi-pronged approach. Firstly one has to ensure that the skin is kept clean and allowed to breath at all times. This means washing with a gentle soap-free formula that will not unnecessarily dry it out followed by a non-comedogenic moisturiser that returns the skin pH to a slightly acidic level. Do this at least morning and night, and during the day if your skin oil production is quite high. Look for products that contain Tea Tree Oil as this helps sterilise the pores.

Secondly look at what you eat. Although there aren't any conclusive studies associating any particular food group with the development of acne I find that cutting the following food types out of your diet go a long way to helping calm the inflammation: Sugar, Wheat, Diary, Preservatives, Artificial Colouring and other chemical-based ingredients. Whole food or food containing ingredients you recognise are a safe way to go. Exercise is a third step in the process, where the increased movement of blood through your skin together with the increased perspiration flushed out the toxins that contribute to the development of acne.

With regards to supplementation and medication I would begin with something like Saw Palmetto to help balance the testosterone-oestrogen ratio that often contributes to the development of acne.

If after applying all these steps and at least a month of this supplement you are still experiencing severe acne I would recommend visiting you GP or Dermatologist to discuss a stronger medical option.

Many thanks and warm regards

Yesheen

Yesheen (dr.) Singh Medical Doctor View profile

Dear K

Thank you for your question. I find it curious that you are using Spiractin, also known as Spironolactone, as a primary means to manage an hormonal imbalance. It is primarily a diuretic and indicated for use in patients with hypertension or oedema and is not scheduled for use in the treatment of acne although it is being used off-code by some dermatologists.

It is known to have an anti-androgen effect, in other words it blocks the effect of androgen-based hormones like testosterone on the peripheral tissues of your body such as your skin, resulting in less oil production and less acne. But it blocks the effect of the androgen-hormones on all tissues of the body, and as such should never be used in males, who would not develop their normal secondary sex characteristics. I would use it with caution in females as well be cause even though females are reliant of oestrogen for their secondary sex characteristics testosterone plays a vital role in maintaining other valuable hormone-related pathways in the body such as maintaining muscle mass. I am not a fan of any drug that blocks instead of moderating.

Your feeling of dehydration makes sense when you understand that the primary aim of Spiractin is to push fluid out of your body. Chronic use will definitely result in dehydration and even low sodium levels which can be dangerous. Your weight loss can be a result of the dehydration, or result from the loss of muscle mass which would be an indirect result of the androgen-blocking effect of the drug on your skeletal muscle tissue.

I would reconsider it's use, perhaps try switching to something more natural like Saw Palmetto or Maca Root powder. These are both adaptogens and help moderate instead of block. There are other nutraceuticals available to help maintain hormonal balance but these are best prescribed after a more detailed history and examination. If you would like more information please don't hesitate to contact us at www.healthnation.co.za.

Many thanks and warm regards

Yesheen

Yesheen (dr.) Singh Medical Doctor View profile

Dear S

Thank you for your question. The answer depends on the severity and the extent of your acne. I would begin with a twice-daily routine of cleansing and moisturising, only with natural chemical-free ingredients, and supplement with a good Saw Palmetto product. Solgar makes a good product.

I would also alter your diet to maintain as even an insulin level as possible, i.e. low GI carbs, and exlude other potentially inflammatory foods such as dairy or wheat.

If these measures do not work after a three to six month trial I would then consult with a GP or dermatologist for further advice. There are a myriad of topical and systemic products available to help manage the various degrees of acne. In my experience most people who adhere to the initial plan successfully outgrow the acne without the need for pharmaceuticals.

Many thanks and warm regards

Yesheen

Gabriell (dr.) Prinsloo Medical Doctor View profile

Hi

It often takes up to 4 to 6 weeks before one even starts to notice a difference, so hang in there! Your dose of Acnetane is the correct starting dose. This may be increased after a few weeks depending on your response, however it needs to be increased incrementally and this should ONLY be done by your Dermatologist or Dr.

There are also different oral contraceptives that are specifically for improving skin such as Diane-35. However managing acne needs a coordinated approach as many different products and medications can interact. So stick to the plan that your Dr has set. S/he will adjust your medication if needed.

You can keep track of anything that impacts your skin. Do you have a flare up when you are stressed or if you eat certain foods? Once you know what these are then you can correct them.

Good luck and hang in there. Your skin will get better.

Warm regards

Gabriell

Gabriell (dr.) Prinsloo Medical Doctor View profile

Hi

I apologise for the late response! Blotchy skin is definitely NOT desirable on your wedding day! Fortunately there is enough time to get the acne under control.

Environ contains Vitamin A and can result in redness or a mild breakout if your skin is not used to it. However it would not cause full blown acne. The most likely reason for your acne is a combination of stress and hormones.

I will give my opinion however I would suggest that you go to see a good dermatologist. S/he will examine your skin and be able to give a much more accurate recommendation than I can over the internet.

My opinion would be to stop the antibiotics and start taking a high dose pill such as Diane 35. This will rapidly bring your hormones into balance. Diane contains cyproterone acetate which effectively manages acne. This is generally used for about 6 months. After your wedding you can then wean onto a lower dose pill and then go off the pill. During the next few months it is also important to explore the underlying causes of the acne. Obviously a wedding can be very stressful! Are there any other stresses? Finding ways to manage stress well will also help your skin to improve. There are other ways to manage acne including homeopathy, however as it is important for you to have good skin on your wedding day, I would suggest going for the big guns so that you are sure of a desirable outcome. After your wedding if the acne reoccurs (which it probably wont) you can explore other more holistic options.

Good luck and may you have beautiful skin by February next year!

Warm regards

Gabriell

Felicia Rubin Pharmacist View profile

Thank you for your question which is not an unusual one. Ginette is a combination oral contraceptive used for treatment in more severe acne.

However, there are side effects to consider before your medical prtactitioner prescribes Ginette.

Depressive moods,abdominal cramping bloatedness, nausea, & hypertension are possible. Staying on the medication is not ideal.

I trust you had an appropriate medical assessment prior to taking Ginette,. However, should you stop taking the pill right now, you would disrupt your menstrual cycle., & may be advised to complete the course of 28 tablets.

If you are taking Ginette only for acne, I would suggest you discontinue immediately , but first contact your doctor. He will prescribe another brand or alternative medication. An oral contraceptive should not be stopped without adopting alternative contraception.

Please feel free to visit Wellness Warehouse & consider a natural approach to acne, using specialised skin products & nutritional supplements.

Yours in health, Felicia Rubin, (Senior Pharmacist & Integrative Health Practitioner, Kloof Street)

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Gabriell (dr.) Prinsloo Medical Doctor View profile

One of the side effects of Acnetane is that your skin becomes more sensitive to the sun, so you are more likely to get a tan when spending time outside. Your complexion will return to normal if you stay out of the sun and when you stop using the Acnetane. I would suggest wearing a hat and extra sunscreen when you are outside while you are on the Acnetane and then for a month afterwards to give your skin extra protection.

Kind regards

Dr Gabriell Prinsloo

Megan (dr.) Jones Homeopath View profile

I’m a bit lost with some of the the abbreviations but I think I get the just of your question: Natural solutions for problem skin. Your hormones play a big role in balancing your skin. I would suggest Omega oils to balance your hormones. The balance between the Omega 3, 6 and 9 is important. You usually get sufficient quantities of Omega 6 and 9 in your diet but when you are experience symptoms of imbalance I would suggest supplementing with an Omega blend that gives you Omega 3 plus 6, such as Solgar’s EPA/GLA. Omega oils also have an anti-inflammatory effect, and aid in nerve and cardiovascular health and functioning. Zinc (100mg daily) is a good mineral to take when you have a break-out as it aids healing. It is also fantastic for healthy functioning of your immune system. Don’t take it continuously (greater than 6 months) as it may disrupt the balance of other minerals but it is safe to take as needed. Chinaherb does a very nice Acne formula that can be taken daily. Easy daily changes for good skin health include drinking 2 litres of water daily, eating a well balanced fresh food diet, using good products on your skin and cleansing regularly. Tea tree active products can provide anti-bacterial benefits but don’t use products that dry your skin out too much. Dairy is also noted to affect the skin so try cutting down on these foods. Unfortunately there is no natural solution for birth control, besides abstinence, barrier-methods (condoms), and the rhythm method (abstinence at the time of ovulation). In good health, Dr. Megan Jones, Homoeopath

Sean (dr.) Gomes Medical Doctor View profile

It depends on how you plan to detox as detoxing incorporates a wide range of practices. Cutting out alcohol, fatty foods, meat etc. will result in you losing more weight. Doing a liver/bowel cleanse has the following general benefits: weight loss, greater mental clarity, skin vitality, energy, improved digestion and mood elevation. The key components of this kind of detox are 1) a fibre complex to assist with gastrointestinal function, normalise gut flora and support the colon 2) Cleavers for lymphatic support and gentle elimination of excess fluid 3) Milk Thistle which is shown to support the liver and gall bladder function as well as to exert antioxidant effects. For more information on the best detox options please visit one of our Natural Medicine Dispensaries in either Kloof or Cavendish. Regards Dr Sean Gomes

Sean (dr.) Gomes Medical Doctor View profile

We have a few excellent detox kits available such as Viridian 10 Day Detox Box and Goodhealth Body Cleanse. It is always a good idea to do a general detox. I would follow on with Amipro Colon Ecology Powder in your case. It is an advanced formula which contains, probiotics, fibre, enzymes and herbal concentrates such as Aloe and Prune Juice. It is always a good idea to maintain your colon health with digestive enzymes and probiotics. We have a wide range of excellent multivitamins. It is important to get a good multivitamin that is naturally based that allows for maximum absorption. You could try Enzyme Process Multi-Life, Foodstate Multivitamin for Men, Viridian High Five or Garden of Life Living Multi. We have a super organic Multivitamin for Men based on organic superfoods called Vita Synergy which you may consider. This is one of the more superior multivitamins. You are welcome to come and see me regarding any further questions you may have.

Kind regards

Reena Sukdev
Homeopath – Cavendish

Angela Lombard Nursing Practitioner View profile

I take it that you were on Minerva for 7 years without a rest or break from taking this contraceptive pill. Although Minerva is frequently prescribed for acne based skin problems and is quite effective - not having had a rest from taking it will have resulted in an overload of chemical components and hormones in the systems of the body. Changing over to a different hormonal combination like Ginette 35 which is the generic for Diane 35, of which both are concentrated pills, will undoubtedly have upset your hormonal cycle even further, potentially resulting in an overload of hormones and so reintroducing and accelerating your previous acne problem. I suggest the following: Pop into our Natural Medicine Dispensary and ask to see our resident Homeopath or Naturopath, ask for a suitable liver antioxidant. Consider coming off all contraceptives for a 6 month time span so as to clear the chemical components of these two contraceptive pills out of your systems. A healthy and correct nutritional lifestyle eating plan, gentle exercise, a sufficient water intake and a vitamin B complex supplement will all assist in helping you get back on track. It is also advisable that you consider consulting with a Dermatologist, who may be able to advise other medications to assist with the acne. Kind regards, Angela, Nursing Practitioner

Reena Sukdev Homeopath View profile

I would suggest you continue with the Exfoliac. This will deal on one level with the problem externally. However, we must look beyond this for more sustaining results. Seems like you benefited greatly from the colon hydrotherapy. What may be required is more consistency in dealing with toxic overload. So, ensure you maintain a healthy diet. There could be other factors as well, including hormonal. Is there a pattern to the acne?Is it worse before your periods? Are you on new contraception? Many young women that are in your age group have this problem and often intervention on the hormonal level assists. Yes, sensitivity to clothing may be a factor as well. Avoid tight fitting clothing that could trigger excessive perspiration blocking the sweat glands. Try to use clothing made from cotton which will encourage more air circulation. Stress could be a major toxic factor. Addressing this could in fact be a solution. Another factor could be exposure any
form of toxic pollution that your body may be reacting to. Ensure you include supplements that contain Vitamins A,C,E ,Selenium and Zinc. Have Omega 3 and 6. Please do feel free to come to the Natural Medicine Dispensary at our Claremont Branch if you would like t discuss further. Regards. Reena (Resident Homeopath and Natural Medicine Dispensary Consultant)

Angela Lombard Nursing Practitioner View profile

Thank you for your query. You say that you have been taking Yasmin for 3.5 years - from the formulation of your question, it appears to be that you have had no break/ rest from taking Yasmin during this time span. Firstly, it is really important to give your body a rest from this contraceptive for a minimum period of 3 months, every 1-2 years maximum. It could well be that you now have a build up of the oestrogen component from Yasmin in the different systems of the body, which could contribute to your skin having outbreaks of acne or pimples.

Yasmin is a schedule 3 chemically based contraceptive specifically designed for androgen based problems, i.e. for acne type skin. Secondly, as the skin is the largest living organ of the body, it is always the first system of the body to react to an imbalance. Not eating correctly or having a healthy nutritional intake coupled with an insufficient water intake can all contribute to a skin imbalance. Should Yasmin have suited you up until your skin broke out again, you could simply implement the two suggestions above, and stay on Yasmin. Always be conscious about not touching your face with your hands unnecessarily, as this will exacerbate your skin problem. Always wash your hands with soap and water before performing your cleansing routine with a moisturiser and when applying make-up.

Melodene and Marvelon are also both schedule 3 contraceptive pills, and like Yasmin, are only prescribed by a general practitioner or gynaecologist. These two contraceptive pills were not designed specifically to treat skin problems like Yasmin. It is important however, please, that before commencing either Melodene or Marvelon or any contraceptive pill, that a thorough general medical and gynaecological examination (including a breast examination and a pap smear of the cervix) be carried out and the family history carefully noted. Also, any family disturbances of the cardiovascular system e.g. deep vein thrombosis, stroke, myocardial infarction (heart attack) which occurred at a young age in family members - in these cases the contraceptive pill is contraindicated.

As all contraceptives are chemically based there are many different side effects for each type - there is no ‘perfect’ contraceptive pill - you need to establish which one suits you the most and then stay with it, still attending a family planning clinic and maintaining your annual gynaecological check-ups.

For further advice please feel free to make an appointment to see me at either our Kloof or Cavendish WellClinics.

Good luck and kind regards, Angela, Nursing Practitioner.

Angela Lombard Nursing Practitioner View profile

Thank you for your query.

You have done the right thing by discontinuing with the Nordette contraceptive pill, as it did not suit you and has a higher dose of hormones than Yasmine. The formulation of Yasmine is primarily an androgen based pill for acne related skin problems, and then secondly as a contraceptive. With you having been on Yasmine now for 2 months, and your signs and symptoms of fuller and sore breasts.

I suggest that you schedule an appointment with your medical doctor or family planning sister so as to be reassessed for being on Yasmine. It is great that your skin is clearing, but as a contraceptive this does need to be reappraised please, as there is a slow build up of oestrogen taking place in your body - this now needs to be balanced out.

Please book this responsible appointment.

Kind regards, Angela, Nursing Practitioner

Felicia Rubin Pharmacist View profile

Hi,
Yasmin is an oral contraceptive. The hormone contents are indicated for acne as well.
However as you have been prescribed both by a dermatologist, I am confident the acne will improve.
Please be patient as your menstrual cycle is every 28 days & results may take at least 2 cycles.
Should you not feel well on the medication, best contact your doctor. Feel free to visit one of our practitioners at the WellClinic at Kloof for further advice and consultation.
Kind regards
Felicia (Pharmacy & Natural Medicine Dispensary)

Chase (dr.) Webber Naturopath View profile

Acne and pimples are probably related to changes in your hormonal levels and the influence on your sweat glands. A sluggish digestive system can also be a large factor resulting in you absorbing fats and carbs that the body does not agree with and tries to remove via the sebum glands. Try to cleanse the skin morning and evening using a very gentle chemical free wash, this will help get rid of excess sweat and urea that will irritate the surrounding pores, then take a digestive enzyme supplement with your meals to improve the digestive action this will help decrease the creation of sebum.
The following herbal remedies can help with Acne. • Calendula, Camomile skin wash will help to soothe the skin • A mixture of Yarrow, elder and lavender in a natural cream base will help to soothe and reduce the outbreak. • Infusions of either Nettle, burdock, marigold and dandelion, can be drunk several times a day • Propolis – an antibiotic substance made by bees, can be effective as a cream if it is dabbed onto the spots to prevent bacterial spread, if the acne has formed eruptions. I would additionally advise to take extra Vitamin B and Zinc daily for about 1 month to see if you have a deficiency as this can make you more susceptible to acne. Regards Dr Chase Webber ND

Chase (dr.) Webber Naturopath View profile

Acne and pimples on your back and chest are probably related to your sweat glands and a sluggish digestive enzyme production resulting in you absorbing fats and carbs that the body does not agree with and tries to remove via the sebum glands. Try to have a gentle shower morning and evening using a very gentle chemical free body wash, this will help get rid of excess sweat and urea that will irritate the surrounding pores, then take a digestive enzyme supplement with your meals to improve the digestive action this will help decrease the creation of sebum. regards Dr Chase Webber ND

Chase (dr.) Webber Naturopath View profile

The following herbal remedies can help with Acne Rosacea.
• Calendula, Camomile skin wash will help to soothe the skin
• A mixture of Yarrow, elder and lavender in a natural cream base will help to soothe and reduce the outbreak.
• Infusions of either Nettle, burdock, marigold and dandelion, can be drunk several times a day
• Propolis – an antibiotic substance made by bees, can be effective as a cream if it is dabbed onto the spots to prevent bacterial spread, if the acne Rosacea has formed eruptions.
I would additionally advise him to take extra Vitamin B2 100mg daily for about 10 days to see if he has a deficiency as this can make him more susceptible to rosacea. Regards Dr Chase Webber ND

Chase (dr.) Webber Naturopath View profile

Teething can cause pimples to appear on the cheeks but rarely on the body, as skin reaction can be a sign that he has a sensitive constitution. I would suggest that you switch to a allergen free milk as your son may still be developing his digestive enzymes and the milk formula could be too difficult for his digestion. If there is any family history of asthma, eczema or hayfever it is more likely that he would need more time before being introduced to normal milk products. It would be good to keep him on allergen free protein sources until he is at least 2 years of age. regards Dr Chase Webber ND


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