ACNE (PIMPLES) – A COMPLETE REVIEW WITH HOMOEOPATHIC APPROACH.

Abstract

Acne is one of the most common skin conditions of all age group individuals especially among the teenagers. The clinical presentation of acne can range from a mild comedonal form to severe inflammatory cystic acne of the face, chest, and back. Acne can occurs during a time of low self-esteem and high concern about appearance. This article review about causes, risk factors, different type, clinical presentation general management including some home remedies management and homoeopathic way of treatment of acne. Homoeopathy treats the person as a whole. It means that homoeopathic treatment focuses on the patient as a person, as well as his pathological condition.

Introduction

Acne, medically known as Acne Vulgaris, is a skin disease that involves the oil glands at the base of hair follicles. Acne, or the presence of pimples or blackheads, can be a problem on the face, chest, and back. Although it is most common during adolescence, acne can occur at other times in life. Acne is the common cause of spots. Boys are more commonly affected than girls.

The severity can range from mild to severe. About 9 in 10 teenagers develop some degree of acne. Often it is mild. However, it is estimated that about 3 in 10 teenagers have acne bad enough to need treatment to prevent scarring. Untreated acne usually lasts about 4-5 years before settling. However, it can last for many years in some cases. Good hygiene and diet play an important role in resolving this complaint. The acne vulgaris is perhaps one of the most dreaded problems many people face. The main cause behind the fear is obviously the degree of “loss of confidence” this problem causes in the population than the actual lesion.

Causes and Risk Factors of acne

Acne is a skin condition that occurs when hair follicles become plugged with oil and dead skin cells.

·        Androgen level - Nobody is completely sure what causes acne. Experts believe the primary cause is a rise in androgen levels - androgen is a type of hormone. Androgen levels rise when a human becomes an adolescent. Rising androgen levels make the oil glands under your skin grow; the enlarged gland produces more oil. Excessive sebum can break down cellular walls in your pores, causing bacteria to grow.

·        Genetic factor - Some studies indicate that a susceptibility to acne could also be genetic. Medications - Some medications that contain androgen and lithium may cause acne. Greasy cosmetics may cause acne in some susceptible people.

·        Pregnancy - Hormone changes during pregnancy may cause acne either to develop for the first time, or to recur.

·        Recent research narrates that everyone has acne-causing bacteria living on their skin, but researchers at the Washington University School of Medicine have identified that there are "good" and "bad" strains of the bacteria, which determine the frequency and severity of developing pimples.

·        High GI-diet and dairy intake linked to acne - A diet high in glycemic index foods and dairy products is now linked to acne, according to a new study published in the Journal of the Academy of Nutrition and Dietetics.

Other condition which worse acne includes

·        The progestogen-only contraceptive pill may make acne worse. In women, the hormonal changes around the monthly period may cause a flare-up of spots.

·        Picking and squeezing the spots may cause further inflammation and scarring.

·        Sweating heavily or humid conditions may make acne worse. For example, doing regular hot work in kitchens. The extra sweat possibly contributes to blocking pores.

·        Spots may develop under tight clothes. For example, under headbands, tight bra straps, tight collars, etc. This may be due to increased sweating and friction under tight clothing.

Classification and Clinical Manifestations

Whiteheads - remain under the skin and are very small

Blackheads - clearly visible, they are black and appear on the surface of the skin. (Remember that a blackhead is not caused by dirt. Scrubbing your face vigorously when you see blackheads will not help)

Papules - visible on the surface of the skin. They are small bumps, usually pink

Pustules - clearly visible on the surface of the skin. They are red at their base and have pus at the top

Nobules - clearly visible on the surface of the skin. They are large, solid pimples. They are painful and are embedded deep in the skin

Cysts - clearly visible on the surface of the skin. They are painful, and are filled with pus. Cysts can easily cause scars.

General Management

·        Wash your face about twice each day. Do not wash it more often. Use a mild soap and lukewarm water. (Very hot or cold water may worsen acne.) Do not scrub hard when washing acne-affected skin. Do not use abrasive soaps, cleansing granules, astringents, or exfoliating agents. Use a soft washcloth and fingers instead. Excess washing and scrubbing may cause more inflammation, and possibly make acne worse.

·        Don't try to burst the pimples. It may push the infection further down, causing more blocking and worse swelling and redness. Popping pimples makes scarring more likely.

·        Keep your hands clean, wash them regularly

·        Always wash your hands before touching your face.This includes before applying lotions, creams or makeup

·        Glasses should regularly be cleaned. They will collect sebum and skin residue

·        You skin needs to breathe. If your acne is on your back, shoulders or chest try wearing loose clothing. Tight garments, such as headbands, caps and scarves should be avoided - if you have to wear them make sure they are cleaned regularly

·        Hair collects sebum and skin residue. Keep your hair clean and away from your face

·        Too much sun can cause your skin to produce more sebum.

Home Remedies:

1.      Ice can be used to quickly reduce the redness, swelling and inflammation of pimples. It helps in improving blood circulation to the affected area, and in tightening the skin pores and removing dirt and oil accumulated on the skin. You can use ice cubes or crushed ice, whichever is convenient. Wrap the ice in a piece of cloth and hold it on the affected skin area for a few seconds. Wait a few minutes and repeat the process.

2.      Another quick way to get rid of pimples is the use of lemon juice, which is rich in vitamin C. Lemon juice helps pimples dry up faster. Be sure to use fresh lemon juice and not bottled juice, which has preservatives. There are a couple of ways to apply this remedy. Dip a clean cotton swab in fresh lemon juice and apply it to the pimples before going to bed. You can also mix one tablespoon of lemon juice with one teaspoon of cinnamon powder and put it on the pimples overnight. In the morning, wash the skin well with lukewarm water. However, this particular remedy is not suitable for those with sensitive skin.

3.      The toothpaste that you use every morning to clean your teeth also can be used to treat pimples quickly. It is most effective when used following the ice remedy. You must use white toothpaste; avoid using gel toothpaste. The toothpaste that you use every morning to clean your teeth also can be used to treat pimples quickly. It is most effective when used following the ice remedy. You must use white toothpaste; avoid using gel toothpaste. Apply some white toothpaste over the affected skin area before going to bed. In the morning, wash your face with water and you will see a significant improvement in the swelling.

4.      Garlic is an antiviral, antifungal, antiseptic and antioxidant agent that can help in the fast treatment of pimples. The sulfur in garlic also promotes quick healing of pimples. Cut a fresh garlic clove into two pieces. Rub the garlic on the pimples and leave it for five minutes before washing the skin with lukewarm water. Repeat the treatment several times a day. Eating one raw garlic clove daily can also help purify your blood. But do not to eat too much raw garlic as it can upset the stomach.

HOMOEOPATHIC MANAGEMENT

The homeopathic medicines are selected after a full individualizing examination and case analysis, which includes the medical history of the patient, physical and mental constitution etc. A miasmatic tendency (predisposition/susceptibility) is also often taken into account for the treatment of chronic conditions. The medicines given below indicate the therapeutic affinity but this is not a complete and definite guide to the homeopathic treatment of acne. The symptoms listed against each medicine may not be directly related to this disease because in homeopathy general symptoms and constitutional indications are also taken into account for selecting a remedy.

Some Homoeopathic remedies for Acne are Sulphur, Sanguinaria, Kali bromatum, Antimonium crudum, Asterias Rubens, Belladonna, Hepar Sulphur, Calcarea Silicata, Nux vomica, Arsenicum iodatum, Causticum, Chelidonium majus, Graphites, Psorinum, Sabina, Calcarea phosphoricum, Ledum palustre, Nitricum acidum, Bovista, Tuberculinum

Indicated Remedies	Indications
Asterias rubens	Considered as one of the chief dugs for treating acne, Itchy acne, Skin seems less elastic, Acne eruptions with fetid pus, Acne rosacea, Acne affecting back, shoulders, sides of nose, chin, Flabby patient with lymphatic constitution, Sycotic diathesis, Sexual excitement in both sexes, Fear of bad news in adolescent girls, Worse coffee, left side
Belladonna	Red, hot facial skin,  Scarlet rash like acne, Suddenly spreading acne lesions, Alternate redness and dullness of skin, Pustular eruptions on skin, Skin feels smoothly red but burns, Acne leading to swelling of glands of neck, chin, Bluish, red acne lesions, Shiny red eruptions
Sulphur	Is perhaps the remedy most often indicated in this affection, especially if chronic. The skin is rough and hard and the acne is associated with comedones and constipation; great aggravation from water is the characteristic leading to Sulphur in skin affections. Face is Pale, sickly color. Heat and spotted redness of face. Black pores. Itching intensely in evening and from warmth. The acne punctata is the variety corresponding most nearly to Sulphur. Simple forms yield to Belladonna or Pulsatilla. Acne rosacea yields to Arsenicum iodatum or Sulphur iodide.
Kali bromatum	Acne on the face, neck and shoulders. We frequently find acne in Epileptics who have been maltreated by bromides. This remedy is especially adapted to the acne simplex and the acne indurata, especially in hyperaesthetic, nervous females. Face flushed. Acne of face, pustules. General failure of mental power, loss of memory, melancholia, anesthesia of the mucous membranes. Suicidal mania with tremulousness. Itching of skin worse on chest, shoulders, and face. Anesthesia of skin. This remedy may be given if Asterias Rubens fails. Dr. J.H.Clarke says, “I know of no remedy of such universal usefulness in cases of simple acne as Kali bromatum 30,” and the late Dr.A.M. Cushing recommended Arsenicum bromatum 4x as very efficacious. Thuja is one of our best remedies for acne facialis. Calcarea picrata is also a useful remedy for acne; clinically it has been found one of the good remedies. Calcarea sulphurica is indicated where the pimples suppurate.
Antimonium crudum	Small red pimples on face, acne in drunkards with gastric derangements, thirst and whitecoated tongue. Face with sad expression Fat, fretful, cross and peevish; cries if looked at, touched or washed. Ecstatic, dreamy, sentimental. Pustules.
Natrum muriaticum	It acts especially on the sebaceous glands, and is a very helpful remedy in acne. In this affection attention must be directed especially to the patient’s type, temperament and tendencies and the general symptoms are far mores important than the local ones.
Radium brom	Acne rosacea with red pimply rashes, Small eruptions with itching, burning, swelling, and redness, Excessive itching with burning of skin as if on fire, Painful pimples, Acne with scars that take long time to heal, May be associated with itchy dermatitis of skin and/or trophic changes in fingernails, Acne seem worse after getting up in the morning, Better, in open air and hot bath
Bovista	Acne in sensitive girls, Crusty eruptions around mouth and nostrils Acne from overuse of cosmetics, Swollen look of cheeks, Sensitive skin with tendency to leave deep impression with blunt instruments Itchy eruptions, May have had an attack of urticaria or tendency to recurrent urticaria, Pimples covering the entire body, Acne always worse in summer
Hepar Sulphur	Papules prone to suppurate and extend. Acne in youth. Suppurate with prickly pain. Easily bleed. Unhealthy skin; every little injury suppurates. Cannot bear to be uncovered; wants to be wrapped up warmly. Sticking or pricking in afflicted parts. Great sensitiveness to slightest touch. Constant offensive exhalation from the body Face, Yellowish complexion. Suits especially scrofulous and lymphatic constitutions that are inclined to have eruptions and glandular swellings. Unhealthy skin. Great sensitiveness to all impressions. The lesions spread by the formation of small papules around the side of the old lesion. Chilliness, hypersensitiveness, splinter like pains, craving for sour and strong things are very characteristic.
Calcarea Silicata	Pimples, comedones. A deep, long acting medicine for complaints which come on slowly and reach their final development after long periods. Hydrogenoid constitution. Skin Itching, burning, cold and blue, very sensitive. very sensitive to cold. Patient is weak, emaciated, cold and chilly, but worse from being overheated; sensitive generally.
Merc sol	Syphilitic acne, Earthy, puffy, dirty looking face, Pustular acne, Constantly perspiring skin, A big pimple surrounded by many small pimples, Itchy eruptions worse from the warmth of bed, Eruptions in private parts, buttocks. Skin and mucus membranes affected at the same time, Yellowing brown or greenish pus from Pustular acne, may be streaked with thin blood. Extremely fetid suppuration Worse extremes of temperature, night, dampness, perspiration

Conclusion

The main outcome of Homoeopathic approach is to regains the body's natural healing and immune the body cells to treat the conditions that affect the body, prevent it and restore the good level of health and well-being. Along with Homoeopathic medicines, the lifestyle, personal habits & food habits modification may be useful for treatment of patients with acne. 

HEALTHY WEIGHT MANAGEMENT WITH SUPPORT OF HOMOEOPATHY

Obesity is one big stressful health issue that distress people of all age groups. Many children’s and young people struggle with excess weight. Weighing too many increases the chances that young people may develop some health problems now and later in life. Overweight and obesity are a serious medical condition that affects children and adolescents. Overweight is defined as having excess body weight for a particular height from fat, muscle, bone, water, or a combination of these factors. Obesity is defined as having excess body fat. Clinical obesity is considered to be present when a person has a Body mass index of 30 or over

                                                                 Weight in KG

                                                BMI = ––––––––––––––––

                                                             (Height in meters) ²

WHO Classification of over Weight

Classification	BMI (KG/ M2)	Associated health risk
Under weight	< 18.5	Low ( But risk of other clinical problems increased)
Normal	18.5 – 24.9	Average
Over weight	≥ 25
Per obese	25 – 29.9	Increased
Obese class I	30 – 34.9	Moderately increased
Obese class II	35 – 39.9	Severely increased
Obese class III	≥40	Very Severely increased

Causes of Obesity:

Many factors lead to overweight and obese like

·        Simple: Endogenous – constitutional, Exogenous – Over eating lack of exercise

·        Endocrine causes

v Pituitary – Frohlich’s syndrome , Pregnancy, Climacteric both males & Female

v Thyroid                      -  Hypothyroidism

v Adrenal cortex          - Cushing’s Syndrome

v Gonads                       - Polycystic ovaries

v Pancreas                    - Islet cell tumors

v Hypothalamus          - Encephalitis, Meningo encephalitis, Cranio pharyngioma,   3rd ventricle tumors      

·        Drugs: Anti convulsants, Anti psychotics, Anti depressants, Cortico steroids, Insulin

Types of body fat distribution

Pear type:  Fat accumulates mainly around hips and thighs (Gynoid distribution) characteristics of females.

Apple type:    Fat storage mainly in the abdomen (Android distribution), found in both sexes.

Effects of obesity (Complications)

·        Brain                          - Cerebro vascular accidents (CVA), mental disturbances.

·        C.V.S.                         - Coronary Heart diseases (CHD)

·        Vascular                    - Hypertension , varicose vein, pedal edema,

·        Respiratory               - Dyspnoea

·        G.I.T                           - Hiatus hernia, Gall stone, Constipation.

·        Joints                          - OA, Backache

·        Endocrine & Metabolic    - NIDDM, Hyper lipidemia, menstrual irregularities,     

                                         Impotence 

·        Malignancy               - Cancers such as ca.ovary, endometrium, cervix, breast, prostate

·        Skin                            - Rashes

·        Pregnancy                  - Perinatal mortality, per eclampsia, Gestational diabetes,             

                                   Caesarian sections 

·        Psychic                   -These individuals are very unhappy. Different psychosomatic                    

                                   problems may also develop.

 

MANAGEMENT

Successful management for weight loss include setting goals and making lifestyle changes such as eating fewer calories and being more physically active. Drug therapy and weight loss surgery are also options for some people if lifestyle changes don’t work. Set Realistic Goal Setting the right weight loss goals is an important first step to losing and maintaining weight.

Lifestyle Changes - For long-term weight loss success, it’s important to make lifestyle changes like Focus on energy intake (calories from food and drinks) and energy output (physical activity),Follow a healthy eating plan, Learn how to adopt more healthful lifestyle habits. Over time, these changes will become part of everyday life.

Healthy Eating Plan - A healthy eating plan gives our body the nutrients it needs every day. It has enough calories for good health, but not so many that gain weight.

Healthful foods include:  Fat-free and low-fat milk and milk products such as low-fat yogurt, cheese, and milk. Lean meat, fish, poultry, cooked beans, and peas. Whole grain foods such as whole wheat bread, oatmeal, and brown rice. Other grain foods like pasta, cereal, bagels, bread, tortillas, couscous, and crackers.

Fruits, which can be canned (in juice or water), fresh, frozen, or dried. Vegetables, which can be canned (without salt), fresh, frozen, or dried. Canola or olive oils and soft margarines made from these oils are heart healthy. 

Cholesterol is found mainly in Egg yellow yolks, Organ meats such as liver, Shrimp and Whole milk or whole-milk products, including butter, cream, and cheese

Physical Activity

Staying active and eating fewer calories will help you lose weight and keep the weight off over time. Physical activity also will benefit you in other ways.

 In general, adults should follow these guidelines in relation to physical activity.

·         For overall health and to lower the risk of disease, aim for at least 30 minutes of   moderate-intensity physical activity most days of the week.

·         To help manage body weight and prevent gradual weight gain, aim for 60 minutes of        moderate-to-vigorous intensity physical activity most days of the week.

·         To maintain weight loss, aim for at least 60 to 90 minutes of daily moderate-intensity      physical activity.

In general, children and teens should aim for at least 60 minutes of physical activity on most, if not all, days of the week.

Behavioral Changes - Changing your behaviors or habits around food and physical activity is important for losing weight. The first step is to understand the things that lead you to overeat or have an inactive lifestyle. A record of your food intake and the amount of physical activity that you do each day will help to inspire you.

Surgical therapy like Gastroplication,  Jejuno ileal by pass and +Starvation therapy  may be helpful sometime

HOMOEOPATHIC MANAGEMENT

Homoeopathy is very proficient in managing all the symptoms of Obesity (weight Loss) and furthermore plays a vital role in preventing relapse of the condition. Homoeopathy is one of the most popular holistic systems of medicine. The selection of remedy is based upon the theory of individualization and symptoms similarity by using holistic approach. This is the only way through which a state of complete health can be regained by removing all the sign and symptoms from which the patient is suffering. The aim of homoeopathy is not only to treat obesity but to address its underlying cause and individual susceptibility. As far as therapeutic medication is concerned, several remedies are available to treat obesity and overweight that can be selected on the basis of cause, sensations and modalities of the complaints. For individualized remedy selection and treatment, the patient should consult a qualified homeopathic doctor in person. A holistic approach considering the lifestyle, personal habits, food habits, inclusion of nutrients and diet, etc. along with homoeopathic treatment helps in overcoming overweight and obesity of individuals. The medicines given below indicate the therapeutic affinity but this is not a complete and definite guide to the treatment of this condition

Medicine	Indication
Ammonium  muriaticum	Especially suited to those who are fat and sluggish and whose bodies are large and fat with large buttocks, fatty tumors and thin legs. All mucus secretions are increased and retained. Generally suffering from respiratory troubles and associated affections of liver. Obstinate constipation accompanied by much flatus. Hard, crumbling stools require great effort in expulsion; crumble from the verge of anus.
Thyroidinum	It produces anemia, emaciation, muscular weakness, and sweating, tingling and increased heart rate. It exerts great influence over goiter and excessive obesity and acts best in females with paleness and uterine fibroids or mammary tumors.
Antimonium crudum	Obesity in young people with excessive irritability and fretfulness together with a thickly coated white tongue. All the conditions aggravate by heat and cold bathing. Tendency to grow fat. For children and young people inclined to grow fat, for the extremes of life. Old people with morning diarrhea suddenly become constipated or alternate diarrhea and constipation, pulse hard and rapid. Sensitive to the cold. < After taking cold. Child is fretful, peevish, cannot bear to be touched or looked at, sulky, and does not wish to speak or be spoken to, angry at every little attention. Great sadness, with weeping. Longing for acids and pickles. Gastric and intestinal affections: from bread and pastry; acids, especially vinegar; sour or bad wine; after cold bathing; overheating; hot weather. Worse – After eating; cold baths, acids or sour wine; after heat of sun or fire; extremes of cold or heat. Better – In the open air; during rest; after a warm bath.
Graphites	Tendency to obesity in females with delayed menstruation. The patients are stout, of fair complexion and tendency to skin affections and constipation, fat, chilly and costive. Take cold easily. Tendency to obesity and swollen genitals with indurations of tissues.
Phytollaca	An important remedy for obesity. Reduces fat and false growths. It is preeminently a glandular remedy with glandular swellings –heat and inflammations. Helps to reduce fat and thus reduce weight. It is useful in rheumatism of syphilitic origin where the pains are wandering, shifting and shooting. Burning in throat as from coal fire and cannot swallow hot liquids. General soreness, lameness, bruised feeling over whole body causes the patient to groan. Intense prostration, sitting upright makes him faint and dizzy. Mother tincture is used for weight reduction.
Fucus	A good remedy for obesity and nontoxic goiter (also exophthalmic). Digestion is improved and flatulence diminished. Obstinate constipation. Thyroid enlargement in obese people.
Calcarea arsenicum	Complaints in fat women around climacteric or women approaching climaxis. The females tend to become fleshy and obese around menopause. Chilliness with dropsicalaffections. Cancer of uterus, affections of spleen and mesenteric glands are often found associated. Great mental depression. The slightest emotion causes palpitation of heart
Capsicum	Suits nicely those people who are of lax fibers, weak, diminished vital heat, fat/obese, indolent and have no vital heat or no reactive force. General uncleanliness of body and opposed to physical exertion. Burning pains and general chilliness with marked tendency to suppuration in every inflammatory process are found.
Phosphorus	Persons of waxy, translucent skin, half anemic, young people growing too rapidly, fair, blondes, quick and hemorrhagic diathesis. It affects the nutrition and function of every tissue of body. It causes pseudohypertrophy of muscles. Adapted to tall slender persons of sanguine temperament, fair skin, delicate eyelashes, find blond or red hair, quick perceptions, and very sensitive nature. Young people, who grow too rapidly, are inclined to stoop who are chlorotic or anemic; old people, with morning diarrhea. Hemorrhagic diathesis; small wounds bleed profusely from every mucous outlet. Longs for: cold food and drink; juicy, refreshing things; ice cream > gastric pains. As soon as water becomes warm in stomach it is thrown up. Worse – Evening, before midnight, lying on left or painful side; during a thunderstorm; weather changes, either hot or cold. Cold air relieves the head and face symptoms but aggravates those of chest, throat and neck. Better – In the dark; lying on right side; from being rubbed or mesmerized; from cold food, cold water, until it gets warm.
Lac defloratum	Useful in obesity and where diseases are associated with faulty nutrition. Sick headaches with intense throbbing, nausea and vomiting, prostration and all complaints aggravated during menses.
Kali bichromicum	It is specially indicated for fleshy, fat, light haired complexioned people with scrofulous or syphilitic history. Symptoms tend to increase in the morning and all pains migrate quickly with rheumatic and gastric symptoms alternating. Catarrhal stage of all mucus membranes.
Pulsatilla	It is preeminently a female remedy with tendency to obesity in mild, gentle, yielding females who are sad, cry easily and weeps when talking. The symptoms are changeable and contradictory. The patient seeks the open air and feels better in it. Thirstlessness and chilliness in fat females. Aversion to fatty foods, still grows obese. Adapted to persons ofmild, gentle, timid, yielding disposition – the woman’s remedy. Weeps easily: almost impossible to detail her ailments without weeping. Especially, in diseases of women and children. Women inclined to be fleshy, with scanty and protracted menstrual tion.
Sepia	Obesity in females with weakness, yellow complexion and bearing down sensations. Pains extend down to back and patient chills easily. Obesity in menopausal females with hot flushes and perspirations. Particularly sensitive to cold air, “chills so easily;” lack of vital heat, especially in chronic diseases. Great sadness and weeping. Dread of being alone; of men; of meeting friends; with uterine troubles. Indifferent: even to one’s family; to one’s occupation, to those whom she loves best. Greedy, miserly.
Senega	Especially suited for persons of lax fibers who tend to become obese and also to children who are chubby in appearance. These children usually suffer from repeated respiratory catarrhal affections where rattling cough and profuse mucus but difficult raising are characteristics.

Some mother tinctures useful are

Phytolacca. Berry Q (Phytoline Q) - Attended with difficulty in walking, sitting, palpitation, dyspnea on the least exertion, nausea, eructations. A great fat reducer.

Aesculentine Q- Another great fat reducer, may be alternated with phytoline.

Calotropis Q – Obesity, while flesh decreases, muscles becomes, harder and firmer

Fucus. Vesiculosis Q, 1x, if attended with indigestion and flatulence.  A remedy for obesity and non-toxic goiter, obstinate constipation, thyroid enlargement in obese subjects.