Most experts agree that "hormones cause teenage acne".

Studies show that the hormone 17-nor testosterone can rise to 15 times the normal blood level, in teenage girls. Therefore the hormone has been the cause of the acne. (It is supposed to be there as a normal event in the female biochemistry of hormones, as you know). In other words, there is something strange and very wrong with your female patient. She is a physical freak – a genetic aberration. She has grown excessive amounts of hair, a deepish voice, a hard body and narrow hips. All these things are irreversible and irrevocable. Give her some palliative treatment lasting a few years and try to avoid giving her a giant inferiority complex or psychosocial disorder.

Right?

Let me explain…

You see… you must ask yourself what happens at puberty. You will no doubt come up with something like the following sequence.

The child has been growing up on a food intake which is mineral poor (check the last four Aust. Dietary surveys). Zinc (and other trace element) reserves have become marginal, as a result much of the zinc reserve is stored in the skin. Zinc is a major player in many immune-function - and eighty-odd other - enzyme cascades. Some of these may help break down anabolic, androgenic (and perhaps oestrogenic) hormones (after they have stimulated their end-receptors).

The puberty growth spurt occurs. Yes, hormones cause this, but it is a normal event.

Sex organs and all protein (contractile and connective) tissue – all needing zinc in their formation – grow suddenly.

Huge demands are made on zinc (and other mineral) reserves.

The reserves become exhausted, causing…

• The immune system collapse to some degree or other and…

• The hormone’s catabolic enzymes to exhaust, causing…

• a raised hormone level, causing…

• excessive oily secretions, epidermis hyperplasia and the downstream effects of comedome formation that are so familiar.

To cap off a somewhat unsavoury story, we have vital, zinc-dependent neurotransmitter-forming enzymes being inactivated causing…

• a decline in serotonin and acetyl-choline (and other neurotransmitter) production, causing a partial shut-down of the central nervous system, causing…

• symptoms of sleeplessness and anxiety, otherwise known as a condition which I have dubbed…

Teenage Schizophrenia

Adding to all this an excess intake of refined foods will directly lead to a deficiency of Chromium, which – when combined with B3 deficiency (all used up from the anxiety attacks) will cause – Hypoglycaemia, which causes…

• Sudden mood swings, dark moods and lassitude. (Sound familiar?)

The craving for sugar may lead to over-ingestion of soft drinks. Many of these also contain copious amounts of caffeine (measured by the kilojoule). The caffeine withdrawal (between drinks) puts them into a depressed mood, intensified by the sudden drop in Blood Glucose Level. In my opinion, this tragic cycle is a major cause of youth suicide in Australia and is to be avoided at all cost.

Finally, those unfortunate enough to inherit a tendency to develop food allergy, will suffer even greater malabsorption, leading to an exacerbation of all of the above symptoms AND a more severe case of acne.

The scary sequel is that incorrectly prescribed antibiotics will lead to a candida complication, which – while initially confined to the gut – will become systemic, following repeated doses of antibiotic. When this occurs, the yeast spreads to all tissue – and especially the skin. It causes widespread inflammation under the skin surface and – in my opinion – is the major (perhaps only) cause of rosacea.

The thrush proceeds to slowly destroy tissue and cause scarring.

Unwind the whole thing back to square one, treat wholistically, attack the underlying cause and gently bring the condition under control. Correct diet, lifestyle adjustments, herbs and nutrition are the go, along with plenty of collaboration with the Dermo or GP, if they and the patient are willing.

The more entrenched the condition, the longer it will take to heal. In really severe cases, it may take up to 18 months or more. The briefer a condition has existed, usually the quicker it will clear up.

By the way, follow Raymond Khoury’s advice and NEVER take the patient off steroidal suppressive medication suddenly. Also, take Jenny McCarthy’s advice and NEVER give silica if there’s a ball or wedding coming up in a few weeks.

A message for pharmacists and medicos reading this – please team with a trusted local Nutritionist, Herbalist or Naturopath. One thing they are really good at is to tidy up dietary influences, which compound your patient’s acne problem.

Boys are usually worse affected than girls in most of the above because their endogenous testosterone levels reach greater heights.

And finally – don’t prescribe or self-medicate – with vitamins and minerals in such cases WITHOUT COLLABORATION WITH a trained nutritionist or naturopath. The reason? Imbalances in nutritional intake can lead to severe downstream problems – even deformities in successive generations. Vitamin A and Zinc toxicity symptoms mimic deficiency symptoms. (If you think I’m being melodramatic, read Prasad’s work with zinc (in the 70’s and 80’s). There are thousands of zinc studies – AND MANY Vitamin A studies - to look up.

In fact, the first step in your collaboration is to request your natural therapist colleague to ALWAYS monitor your patient’s zinc/vit A intakes. Ask him why, and she will tell you how their activities inter-relate, the joys of getting it right and the nightmare of getting it wrong. (A little like prescribing digoxin).

However, in the right hands, mineral and vitamin supplementation is safe AND effective – just like prescription medicine with doctors (and S2 and S3 drugs with pharmacists).

(In fact, some drugs are unscheduled – like aspirin and paracetamol – which should NEVER be taken without a pharmacist’s advice. Others – like Nizoral – are threatened with descheduling, which will lead to even more chaos, wrongful self-medication and more eventual rebound resistance and toxicity effects. eg, Nizoral is an extremely hepato toxic substance and WILL accumulate if over-used. See the original studies of the oral preparation).

The moral of the story? Leave it to the experts. Together, you all make a great team. Don’t try and tread on each others’ toes – waltz to the health symphony of your inquisitive patients instead.

Let’s hear it for health.