Acne and the Number 15

85% (15% don't therefore) of the population at some point in their lives suffers from acne. Most of those people are between the ages of 12 and 24, with 6 to 8 years being the average time a person suffers with breakouts of pimples and blackheads.

15% of acne sufferers contract late onset acne, or ‘adult acne’ which can appear from the late 30s. Others just have troublesome oily skin. 15% of acne sufferers get depression and 15% of these attempt self harm. 15% of acne sufferers suffer permanent physical scarring.

There are already many products available as acne treatments on the market, either as an over-the-counter medicine, cosmetic or prescription medicine. All these acne products have one thing in common; they all only address part of the problem and therefore are not the complete acne solution. Aknicare® is a medical device which offers a completely different skin management strategy for acne sufferers.

All the products on the market tend to be combinations of one or more of the following;

• Antibiotics / antibacterials - important if bacterial levels become a serious complication
• Exfoliants - physical or chemical to try and remove plugs and increase skin shedding to prevent plug from forming
• Detergents - to wash away oil that is being produced
• Moisturisers to prevent skin from drying out as a consequence of stripping away surface sebum. These range from barrier moisturisers which block water escaping and can actually on their own create more problems as they just add to the things that can cause blockages; to non barrier moisturisers which use natural chemicals like hyaluronic acid which in the skin chemically capture and hold water molecules thereby slowing down water loss.

The removal of sebum at the surface causes the skin to respond by actually increasing oil production in order to protect the skin. Therefore some products can make the problem actually worse. After using a powerful detergent and exfoliant, the skin will respond very quickly in trying to replace the oil removed. Hence one fluctuates between dry skin and increasing oily skin on a daily basis.

The Acne Process

The principle behind acne is well understood by scientists but doctors continually address the consequences of acne and not the cause. Roaccutane and even the contraceptive pill Dianette go some way to correcting the cause but because they are taken orally then their effect is on a much wider basis and can influence other functions including mental attitude in the case of Roaccutane.

Acne is fundamentally caused by a change in hormonal balance.

At times of our lives our well known hormones etc can fluctuate away from the normal and the skin becomes 'aware' and sensitive to a hormone known as DHT which it normally pays no heed to.

• Through puberty and teenage years to approx. 22 on average
• When pregnant or on the pill
• As a result of long term stress
• During the menopause
• And at other times for example, certain medical conditions

DHT sensitivity causes fatty acid depletion in the skin which is very hard to replace orally as very little reaches the skin. As a consequence of this depletion, the oil producing glands in the skin respond by increasing oil production

Typically the skin starts to thicken (called keratinisation) and skin shedding slows (called hyper cornification). In many, (not all) the cell linings of the internal walls of the hair follicle duct where the oil produced by sebaceous glands comes out of, thickens and so the tube narrows in diameter, so you have more oil trying to get out of a narrower tube. Also skin cells become stickier and clump together, so the rate at which we naturally shed skin slows down, resulting in the build up of surface skin debris which in conjunction with excess oil forms a 'plug' in the duct opening which is closing as a result of skin thickening. This creates a blockage.

So far you don't have acne; you do have comedones or pimples. However skin bacteria which prefer a low oxygen environment such as p.acnes build up under the 'plug' in this oxygen deficient environment and start to digest the plug which creates by-products, which cause inflammation. Bacteria are therefore not the primary cause of acne but their response to the changes in the skin which leads to spots. So if you can control the underlying sensitivity then the bacteria will not be such a problem. Also you must control the p.acnes bacteria without attacking the healthy skin bacteria like Staph epidermidis which can induce resistant bacteria and may well be a leading cause of hospital super bug resistance The by-products produced cause inflammation and damage to surrounding cells resulting in a spot, and now you have a pustular acne lesion or 'yellow head'.

The skin returns to normal once hormonal levels balance out and the skin becomes 'unaware' of DHT and acne free. However in a significant number of people they are left with a residual local sensitivity to DHT, even with a normal hormonal balance and this can cause long term spots and acne and the infamous T Zone.

So acne is not caused by bacteria, they are a secondary cause which results in the painful unsightly spot.

The Ideal Acne Treatment

The ideal acne treatment should according to Prof Tony Chu (President of the UK Acne Charity):

• Reduce oil production - Aknicare® changes the skin's environment and thus reduces oil production by up to 68% according to Prof Chu's study*. This has been further reinforced in studies conducted by Professor Katsambas and Professor Zouboulis of the EADV (European Academy of Dermatology and Venereology).
• Reduce skin thickening and excess surface debris - Aknicare® assists the skin in doing this in three different ways.
• Reduce p.acnes - the bacteria which grow and multiply under the blocked 'pore' and cause damage and inflammation. Aknicare® has four antibacterials, none of which create antibiotic resistant bacteria and hence Aknicare® reduces risk of MRSA super bugs developing.
• Reduce inflammation - Aknicare® reduces inflammation through three mechanisms.

Aknicare® has Acne Covered

To do this, one needs a multi layered approach

• Restore normal skin fatty acid levels - Aknicare® contains Ethyl linoleate which once in the skin is broken down by skin enzymes to release linoleic acid a key omega fatty acid found to be deficient in acne skins.
• Reduce DHT levels - Linoleic acid in conjunction with Triethyl Citrate and Zinc Lactate both also found in Aknicare® create an environment which results in slowing the natural conversion of testosterone to DHT in the acne prone area, so DHT levels are less likely to trigger changes in the pilo-sebceous unit and skin behaviour normalises in the vast majority of users
• Use antibacterials - to reduce the level of p.acnes without destroying the good skin bacteria such as staph. epidermidis, Aknicare® uses four anitbacterials which change the environment restricting p.acnes feeding and thereby reducing its growth -This avoids the risk of using antibiotics which causes bacterial resistance in the skin which can be passed onto staph aureus leading to super bugs. Antibiotics should only be considered in pustular scarring acne and should be used in higher short courses to control the bacteria quickly.
• Use ingredients which alters the skin's environment so that excessive skin cell production slows down and also reduces the deposition of keratin. This helps to reduce thickened congested skin from within. Aknicare® uses Triethyl Citrate to do this as effectively as retinol containing products.
• Use anti-inflammatory and agents and antioxidants. The by-products produced by bacteria cause free radicals to be produced which lead to inflammation and reddening. Aknicare® contains two anti-inflammatory agents and antioxidants to reduce this.
• Use gentle but effective exfoliants -we prefer chemical rather than physical to try and remove plugs and increase skin shedding to prevent plug from forming thereby not creating the oxygen deficient environment for p.acnes to colonies - Aknicare® contains two exfoliants
• Use gentle but effective detergents - to wash away oil that is being produced. This is an important stage in also preparing the skin to get the active ingredients into the skin.
• Use moisturisers to prevent skin from drying out. Aknicare® has a number of water binding moisturisers which use natural chemicals like hyaluronic acid to capture and hold water molecules thereby slowing down water loss- Aknicare® contains products which help in healing and reduces scarring risk

Thereby skin behaviour and oil production normalises. The duct diameter returns to normal and skin cells become less 'sticky' and skin shedding rates normalise. This creates conditions whereby it is very unlikely for a plug to form which means the conditions which the skin bacteria p.acnes like don’t occur and don't build up under the plug.

A completely new way to beat spots - clinically proven in hospital trials*

A UK trial was recently completed by Prof Tony Chu, President of the UK Acne Charity, lecturer at Imperial College and consultant dermatologist at Hammersmith Hospital. Prof Chu may well be the leading dermatologist in researching acne in the UK. His study supported the results of hospital based trials in Europe where oil production (not just oil on the surface) significantly decreased by up to 68% while using Aknicare®. Each week of the study there were less and less new or old inflamed or non-inflamed spots. This study is now published. - Chu et al published in the British Journal of Dermatology October 2007.

Aknicare® works on the surface and in the skin to create the right environment for healthy, spot free skin. Aknicare® addresses both the consequences as well as the source of the problem through using a well-balanced, scientifically proven and clinically tested concept.

The Two Month Rule includes Compliance

Use all three products twice a day until skin behaves normally. This should be your daily skin regime for at least two months and once you have control then just use an exfoliating cleanser and the Cream twice a day as a maintenance dose, keeping the Lotion on hand should there be a 'difficult day'. The Lotion is the potent DHT reducer and linoleic acid enhancer, and is used for acute phases or chronic situations. The Cream has a lower level of the Lotion's active ingredients and is used for maintenance. However the Cream contains anti-inflammatory agents and moisturisers so should be used each time the Lotion is used. If you have sensitive skin, you should start with the two product regime and if tolerated, would then introduce the Lotion. Most people, including those with sensitive skins find the three products compatible.