Physical Treatment

Many abrasive materials, usually based on polyethylene and aluminum oxide, are of little value.
Comedone Extraction
Mechanical extraction of open comedones, by applying light pressure over individual lesions with a comedone extractor, may be useful. There is a great variety of specially shaped tools, particularly for blackhead re- moval.
Electrocauterization
Light cautery after the application of a local anesthetic with EMLA cream (0.025% lidocaine and 0.025% prilo- caine) for 60–90 min beneath an occlusive dressing, has been shown to help patients with multiple macro-white- heads and blackheads greater than 1.5 mm in diameter . The electrocautery is used at a very low setting so as to produce little or no pain. The aim is to produce very low-grade thermal damage so as to stimulate the body’s own defence mechanisms to eliminate the comedones.
Cryotherapy
The beneficial effects derived from the use of low tem- peratures in the treatment of different dermatological conditions have long been known. In that respect, cold compresses, to relieve inflammatory acne, as well as car-
Less Common Methods to Treat Acne Dermatology bonic snow, alone or combined with sulfur and acetone, are used to treat sequels of superficial scars.
Cryoslush Therapy
Solid carbon dioxide is mixed with acetone to produce a slush-like mixture that is brushed lightly over the skin. It produces erythema and desquamation. The degree of erythema and peeling is determined by the amount of time the slush is in contact with the skin.
Liquid Nitrogen
The superficial freezing with liquid nitrogen will hasten the resolution of chronic fluctuant nodular lesions and is comparatively painless. Two freeze/thaw cycles of 15 s each are recommended. This therapy works by producing cold damage to the fibrotic cyst wall, resulting in chemotaxis of neutrophils, whose proteases will subsequently, hopefully, destroy the wall and allow healing .
Radiation Therapy
The introduction of isotretinoin and a better management of its usage successfully solve nearly all cases of acne. Radiation therapy is being reserved at present for the most recalcitrant cases and should be administered only by highly skilled people who are fully aware of its risks.
Intralesional Corticosteroids
In nodular lesions, an intralesional injection with corti- costeroids (triamcinolone 2.5 mg/ml) may be used. It may be administered using a syringe with a 30-gauge needle. If placed too superficially or too deeply, it may cause atrophy.
Phototherapy
Ultraviolet light is scarcely used. Yet, it is well known that acne often improves clinically after exposure to sun- light or artificially produced solar radiation and more than 70% of patients report definite improvement after exposure to the sun during the summer.
Reddening, as well as ultraviolet light-induced tan, produce a camouflage effect. Its therapeutic action might be linked to a biologic effect of the sunlight on the pilose- baceous system. It may have an anti-inflammatory action in acne, possibly by its effect on follicular Langerhans cells. P. acnes produce porphyrins which absorb light energy at the near ultraviolet and blue light spectrum. Irradiation of P. acnes colonies in vitro with blue visible light leads to photoexcitation of bacterial porphyrins, sin- glet oxygen production and eventually bacterial destruction . As well, they have comedogenic potential because squalene is oxidized to squalene peroxide, which, in turn, may irritate the follicular keratinocytes. The use of visible light alone is perhaps the most practical, common and free treatment existing. However, it is carcinogenic and the photoaging effects render its use unwise. Blue light is theoretically the most effective visible wavelength for photoactivation of the major endogenous porphyrin component of P. acnes, but has poor depth of skin penetration. The red light is less effective at photoactivating porphyrins, but penetrates more deeply into tissue. Red light may also have anti-inflammatory properties by influence of cytokines released from macrophages . Light in the violetblue range (407–420 nm) has been shown to exhibit a phototoxic effect on P. acnes when irra- diated in vitro. This effect is most likely due to the destruction of porphyrins necessary in heme biosynthesis. Stillman et al.  conducted a study to determine if the levels of P. acnes decreased when irradiated in vivo with this radiation. This study examined two groups of patients simultaneously irradiated twice a week with a highintensity fiber optic lamp emitting visible light in the vio- letblue range for a total of 4 weeks. Different parts of the face were treated either on the forehead or the cheek for a
20-min session with the lamp placed 5 cm from the skin. After 6 sessions, both the treated and the untreated sym- metric area demonstrated a significant reduction in the levels of P. acnes. They also observed that 7 of 10 patients with mild-to-moderate acne showed significant improvement in reducing the number of non-inflammatory, inflammatory and total facial lesions. The authors conclude that the use of visible light may inhibit heme production in P. acnes. Papageorgiou et al. conducted a study to evaluate the use of blue light (peak 415 nm) and a mixed blue and red light (peaks at 415 and 660 nm) in the treat- ment of acne vulgaris. They examined 107 patients with mild-to-moderate acne vulgaris that were randomized into four treatment groups: blue light, mixed blue and red light, cool white light and 5% benzoyl peroxide cream. Patients in the phototherapy group used portable light sources and irradiation was carried out daily for 15 min. Assessments were performed every 4 weeks. After 12 weeks of active treatment, a mean improvement of 76% in inflammatory lesions was achieved by the combined blue-red light phototherapy and the result was significant- ly superior to that obtained with the other treatments. Regarding comedones treated with the blue-red light combination, a 58% of improvement again indicates better results than those achieved by the other treatments. Con- sidering all the groups under study, the authors concluded

Acne and Green Tea by Elaine Clay

Green tea is used by the Chinese as a traditional medicine to treat many ailments including acne and to improve general well-being. But does it provide an effective herbal alternative to modern medication? The answer seems to be ‘Yes’. There are only two herbal treatments that are known to be effective in treating acne and green tea is one of them. In a recent study by Jennifer Gan-Wong, M.D. a green tea cream was trailed against a 4% benzoyl peroxide solution on people suffering with moderate to severe acne. The results from this research study showed that green tea was just as good in treating acne as the benzoyl peroxide. But benzoyl peroxide dries out skin causing itching or allergic reactions. Unlike green tea that has the added advantages of natural anti-bacterial properties and antioxidants, particularly epigallocatechin gallate which is 200 times more powerful than vitamin E at fighting free radicals.
Green tea also helps to reduce inflammation, hormonal activity and aids in detoxification – which is all good news for acne sufferers.
Green tea extract is an extremely versatile herbal supplement – it can be administered topically, often being used in creams, taken as a in the form of a pill or incorporated into your diet and drunk as a tea. This last method is very popular (Green Tea with Honeysuckle is often known as ‘Pimple Tea’ in many Chinatowns) when drunk after a meal it aids digestion and helps to detoxify your system, getting rid of the toxins that can cause acne. Tip: don’t drink it with sugar, this will neutralize the worthwhile effects of the tea. It seems that taking green tea for acne is a win-win situation… It has many beneficial properties which promote good all-round health with little or no known side effects and for the price, green tea it’s definitely a herbal treatment that’s worth trying.

Acne And Carbs

The good news: chocolate has been cleared of the gossipy charges that eating it is a sure path to acne troubles. The bad news: baked potatoes, French bread, jellybeans and other foods with a high glycemic rating are being fingered for causing zits.
The glycemic index (GI) was introduced in 1981 by University of Toronto professor of nutrition Dr. David Jenkins to unravel which carbohydrate foods best suited a diabetic diet. The GI ranking is a measure of how a food affects blood sugar levels. The faster a food breaks down during digestion, the higher the GI. Likewise, the longer it takes for a food to digest, the lower the ranking.
A study recently conducted by Loren Cordain, PhD, a Colorado State University health and exercise scientist, and his colleagues, (and published in the Archives of Dermatology), decided to see how the glycemic rankings impacted skin. The researchers looked at the skin of more than 1,300 Kitivan Islanders of Papua New Guinea and the Ache hunter-gathers of Paraguay who ate traditional diets. Cordain found that none had an active case of acne. In contrast, of those living in modern, Western societies eating a typical Western diet, between 79 and 95 percent of adolescents were battling acne and between 40 and 54 percent of men and women 25 and older were still breaking out. Cordain suggests that the difference is environmental, particularly the diet differences between the two groups.
The typical Western diet is heavy on refined grain breads, sugar-laden soft drinks, French fries, and processed treats like cookies and cakes. The Kitivans load their diets with fruit, fish, and tubers. Likewise, the Ache fuel up on whole foods found locally such as peanuts, wild game, and the sweet native root, manioc.
So exactly how does what you eat affect your skin? The study theorizes that our high glycemic diet dials up insulin levels, which then steers our system into acne mode by indirectly bumping up oil (sebum) and skin cell production in our pores. Higher sebum levels and cells stuck deep within the pores provide a veritable feast to bacteria that make a home within follicles. When the pores become clogged with excess oil and skin cells, you get a pimple. Clog a lot of pores and you get a lot of pimples.
The study goes on to predict that if you change your diet to incorporate low glycemic foods while keeping your plate free of high glycemic eats, your skin should show an improvement. A study published in 2001, and cited in the acne study, showed that a low glycemic diet would alter your system to produce less sebum and regulate skin cell production, which would tame acne, if not eliminate it altogether in many cases. Less oils on the skin, less acne, period (hence the beauty of using oil reducing agents).
Navigating the glycemic index isn’t difficult. It’s simply a scale based on glucose, which is rated at 100. The lower the glycemic index of the food you eat, the less it will trigger the release of insulin. But the index isn’t foolproof and it can be more daunting to change your diet over a prolonged period of time. While a baked potato ranks an 85 on the index, when you add butter or sour cream, the fat in those foods will slow the release of insulin the would have been caused by the potato alone. And most of us don’t just eat one food at a time, so other factors such as when you last ate and what else you are eating at the time can alter the insulin impact. Finally, only about 1,000 carbohydrate foods have been evaluated for their glycemic index. As a general guide though, here are some examples of high, medium, and low glycemic foods:

High Glycemic Foods (71-100+ on the scale)
Tofu frozen dessert 115
Dates 103
French bread 95
Crisped Rice cereal 88
Baked potato 85
Corn flakes cereal 84
Pretzels 81
Jelly Beans 80
Donut 76
French fries 76
Frozen waffle 76
Graham crackers 74
Corn chips 73
Mashed potatoes 73
Bagel 72
Watermelon 72
Carrots 71

Medium Glycemic Foods (55-70 on the scale)
White bread 70
Instant oatmeal 66
Table sugar 65
Raisins 64
Ice cream 61
Granola bar 61
Blueberry muffin 59
White rice 56
Brown rice 55

Low Glycemic Foods (less than 55 on the scale)
Sweet potato 54
Long grain rice 47
Heavy, mixed grain bread 30-45
Fettuccini 32
Fat free milk 32
Peach 28
Lentils 28
Plum 24
Cherries 22
Soybeans 18
Tomatoes 15
Broccoli 15
Asparagus 15
Cucumber 15
Peanuts 14

Skincare Recommendation for Acne Prone Skin

I have fought acne most of my life, and have tried any things. I have been using Arbonne for over 4 years and have incredible skin. Through trial and error I have come up with a regimen that seems to work very well on my clients with acne. I know much that goes on with our skin is not only determined by what skincare line you use, but also what supplements you take. I will give you a few options with scenarios to choose from, depending on the skin type and needs.
Young Severe Acne Prone Skin

Clear Advantage Wash
Clear Advantage Toner
Re-9 Serum (just a pea size…massage it on fingertips and then tap it directly on the face)
Clear Advantage Acne Lotion
**If they have dry skin, I recommend using the RE-9 daycreme’ (just a pea size).
**If they have oily skin, I recommend them using the Basic Normal to Oily Moisture Cream.
**If they have dry skin, I recommend using the RE-9 Night Crème at Night (just a meringue pie peak amt with the spatula).
**If they have oily skin, I recommend them using the Basic Normal to Oily Night Cream (just a small amount on fingertips, with a spatula).
Supplements:
*Clear Advantage Acne Supplement
*Herbal Colon Cleanse
*Multi Vitamin & Calcium
*Drink their body weight in ounces of water a day (If you weigh 120 lbs, then you would drink about 120 ounces of water a day)
*Proleif (This will be regulated with your period. You will start this the 12th day after your period starts to the 26th day after your period starts. I recommend using about a œ a pump in the morning and a full ump at night. If you want to learn more about the progesterone cream go to www.johnleemd.com .) I have found through my own experience as well as many of my clients that this will help to alleviate the hormone induces acne, as this will help to balance the hormones.)
Adult Acne Prone Skin
Re-9 Wash n the morning & Clear Advantage Acne Wash in the evening
Re-9 Toner in the morning and night
Re-9 Transforming Lift in the morning
Re-9 Day & Night Serum in the morning and at night
Clear Advantage Lotion in the evening
Re-9 Day crème’ in the morning (If you have oily skin use only about Œ of a pump on your fingertips, and rubs together, then spread a light glaze on your neck an face, if you have dry skin , you may need a full pump.)
Re-9 Night Crème’ (use your spatula to tap a small amount, a meringue pie peak, then put on your fingertips to rub a light glaze on your neck and face.)
Supplements:
*Clear Advantage Acne Supplement
*Herbal Colon Cleanse
*Multi-Vitamin & Calcium
*Proleif (or you are experiencing Menopausal symptoms…the PhytoProleif has proven to work the best for most of my consultants and clients.)
*ReSist Anti-Aging Supplement
*Drink your body weight in ounces of water a day
***This is only to be used as a recommendation for you’re to pass onto your clients/consultants. This is what I have found through trial and error over the past 4 years. I have found that when someone has acne scarring, many clients have noticed a quite noticeable difference in the texture of the scars. I have personally watch my own mild acne scarring diminish over the past 3 years that I have used the Re-9 line consistently both morning and night. I started out with the above skincare regimen, and then later after my acne was gone, I went completely to the Re-9 line, and have been using it exclusively for 2 œ years. If you experience breakouts the first 2 to 3 months, that could be perfectly normal. Just stay the course, your skin has to have time to detoxify itself of all the other products your exposed yourself to, that didn’t have the Pure, Safe, and Beneficial Guarantee that Arbonne International has. I have noticed with my own experience as well as through my clients/consultants own personal experiences that during stressful times, or when I have eaten high amount of sugar that it has affected the clarity of my skin. Skincare is very important, but hormones do play a HUGE factor in your skin, so that is why I feel the supplements are so important. I remember imagining that one day I would have clear skin, and I would be able to wake up in the morning and not have to worry about whether I had a breakout on my face, and thanks to Arbonne’s skincare and nutrition line, I have been living that way for the past 3 years since my acne has went away. If you are going though a tough time with your acne, just borrow my belief in what these products will do for you. Don’t get discouraged, just stick with it and one day, you too will have the same results.

SKIN DEEP

Eczema/Atopic Dermatitis, Psoriasis and Acne

Teleconference Notes

INTRODUCTION

Eczema/Atopic Dermatitis, Psoriasis and Acne are the 3 most common skin disorders today. Eczema/Atopic (increased likelihood of developing allergies) Dermatitis are interchangeable terms.

EXCEMA/ATOPIC DERMATITIS (AD)
10% of the population have this skin disorder. In the UK that figure is 12%.
Pathogenesis (origination and development of a disease) for eczema is a disordered immune regulation, genetic factors and environmental triggers. Our genes haven’t changed; however the environment we live in has, which has ultimately affected our immune systems.
70% of cases are onset before the age of 5 years. That is 17% of children – nearly 1 in 5 and there is considerable evidence that the prevalence is increasing.
Several theories have been put forward to explain this increase, most of them focusing on early life events. One example of such theories is the ‘hygiene hypothesis’. This hypothesis argues that early childhood exposure to infections inhibit the tendency to develop allergic disease. As a consequence, children with westernised lifestyles, protected as they are from the infectious burdens of early life that are common in the developing world, suffer an increased risk of developing allergic disease. Therefore the hygiene hypothesis is all about keeping kids too clean.
Today there are items such as anti-bacterial wipes on the market – we’ve become obsessed and petrified of bugs. A child’s immune system can become an allergic immune system if the immune system isn’t used. If you don’t use your immune system, you’ll lose it and it will become allergic. Children must be allowed to build up their immune systems when they are young. If they are protected from infections when young, they are more prone to diseases and illnesses as they get older.
Researchers suggest that frequent respiratory infections early in life prevent the development of atopy and allergic respiratory disease. The following are protective effects against asthma and AD:

Living with pets (cats and dogs have bacteria)
Living with several brothers and sisters (other sick children)
Drinking unpasteurized milk (milk has enzymes and bacteria)
Living on a farm (playing in the dirt that has bacteria from animal faeces)
Living in close proximity to farm animals

These findings indicate that certain amounts of bugs and bacteria when a child is young are good. Plus there is also a strong environmental component, indicating that illness is not just genetic.
Unfortunately the prognosis is worse with early onset as it’s associated with hayfever, asthma and atopic dermatitis. Asthma is present in 60% of children with severe AD. They’re also saying now that there is a correlation between autism and eczema too.
With regard to immunity, it comes down to what a person’s immune system can tolerate.
Skin deep handout – you can see the hands and face which have the highest percentages are exposed areas. What goes on inside the body will eventually affect the outside. Many use the analogy of dishwashing liquid giving people eczema on their hands. The dishwashing liquid is the trigger, but what’s going on inside is the gun. You need to balance your immune systems see-saw.
Remember the Immune system see saw – you’ll either be Th1 high and Th2 low or vice versa. A very allergic condition is where the Th2 is high and the Th1 is low. Rheumatoid arthritis is a Th1 condition and Hashimoto’s disease is a Th1 condition. When the Th1 is low, the body is over-reactive and can generate organ-specific autoimmune disease (eg arthritis, multiple sclerosis, type 1 diabetes).
When you have achy joints and a fever, you’re fighting off the virus. Try not to take medication at this time. This way you are going to heal quicker. If you are prone to lots of infections, then your Th1 cells are down and losing their protection against infections.
Arthritis sufferers should wear a copper bracelet on their wrists if they have the disease in their hands. Copper can increase SOD.
Why are children getting eczema?
Pregnancy is a high Th2 condition. When a pregnant woman becomes Th1 dominant she is subject to miscarriage. Hence the need to look after your immune system. The outcome of a high Th2 pregnancy is that the baby will be born Th2 dominant. Interestingly babies delivered by caesarean section haven’t been exposed to the bacteria that a baby from a natural birth has. With the increased rates of caesareans come the increased rates of eczema. We have interfered with the natural process here. Given a natural birth has far more health benefits for a child.
When they say allergies run in the family, it doesn’t mean it’s genetic. It means that what the mother has been exposed to, the infant will be as well.
What is the best food?
Literature strongly supports the use of exclusive breast milk feeding for all infants for the first 4 – 6 months of life, even longer. However when a mother is unable to feed this way, the question of formula foods become real. The basic problem with formula is that the infantile immune system reacts to foreign protein (eg. cow, soy, goat etc).
In a study where there was a late introduction of solid foods (after 4 – 6 months) there was a decreased risk of food allergy and AD up to 3 years and recurrent wheeze/asthma up to 6 – 17 years. Even the WHO recommends breast feeding for the first 6 months as an allergy-prevention measure. Note: there is a product called Neocate which is a pharmacy product should you know anyone in this situation.
Foods that cause allergies
Cows milk – dairy boards around the world say that cows milk is only a problem in 2 – 3% of children. Well, why then do 73% of children who have allergies, have allergies to cereal? Interestingly, these products go hand-in-hand (cereal is served with milk).
As a side note here, if you have to go off dairy products, take some cheese.
Medications may cause allergies
People can be allergic to antibiotics. Penicillin for example, knocks out bacteria in the gut, which normalises the immune system.
Here you need to take a probiotic and AIM has Flora Food, which is available through the AIM New Zealand office. Many people ask the question when taking antibiotics – what do they take first – the antibiotics or the probiotic? Experts say to finish taking the antibiotics then start the probiotics.
Vaccines may cause allergies
Natural therapists and some doctors believe flu vaccines impair the immune system. The system is reporting that vaccine reactions are poor. There are no controlled studies that assess vaccine and non-vaccinated people. If you are about to receive a flu vaccine, be careful if you have cancer, as it may cause increased morbidity. If you visit the Australian Vaccine Network Site there is some pretty horrific reading by Bronwyn Hancock.
Also vaccines could induce asthma.
In a study in England of 446 children. In 203 of these children who had not been vaccinated for pertussis (whooping cough), 2% had a diagnosis of asthma at 8 years of age, compared to 11% of the 243 children who had been vaccinated for pertussis.
Researchers have also seen an association been smoking parents and dermatitis and eczema.
Stress & the immune system
Short-term stress is good for the immune system. Stress suppresses Th1, which can lead to health issues such as cold sores. We are stressed more than ever before – so hence more illness.
Foods
Take allergic foods out of diets. For example dairy and processed foods.
Natural Treatments for Eczema
Glutathione Peroxidase – buy off the shelf in QLD, however banned in VIC. It’s a very powerful intracellular antioxidant. It’s good for longevity and is an enzyme that makes an antioxidant.
Fish oil – no more than 4gm per day (mothers can become deficient from morning sickness)
Probiotics – did you know that you have 2 kilograms of bugs in your body? Take Flora Food. Unfortunately yoghurt is a mild source of good bacteria, but not a great source. Probiotics strengthen gut defence barrier mechanisms. Try and get 4 billion bugs per day.

Nutrition
Did you know that hot dogs are the most popular take-away food in the US? What’s a hot dog made up of? Margarine, white flour and processed meat. All bad! Body needs good antioxidants such as Proancynol, obviously with dietary antioxidants such as VC, VE, beta-carotene and foods rich in antioxidants.
Minerals
Zinc is a powerful mineral for boosting the immune system. 80% of the Australian population is zinc deficient. If you increase zinc, mouth ulcers will disappear. We don’t need more than 70mg per week on top of the diet. Too much zinc will also suppress the immune system. 30 – 40 mg of zinc is lost during sex. Men are particularly deficient. Zinc loss is women can result in stretch marks. Start on 35 mg per day and increase to 70 mg if you are deficient, then cut back again.

Herbs
Barbarry (a berberine herb) – which is in AIM’s Herbal Release.
Korean (panax) Ginseng – has a normalising effect on the immune system.
PSORIASIS
Is a Th1 dominant condition. Here the immune system misfires and inappropriately causes inflammation and an accelerated growth of skin cells.
Between 1 and 3% (or 1 in 50 people) of the population around the world has it. Most often occurs between the ages of 15 and 35.
It is partly genetic – if one parent has it children have 10 – 25% of developing psoriasis. If both parents have it, the children have 50% chance of development.
It normally takes 4 – 5 days to come through on the skin. Normal skin replacement is every 28 days.
Typically treated with cyclosporine or methotrexate. Methotextrate has terrible side effects including bone marrow toxicity, nausea and anaemia. Cyclosporine side effects include hypertension and liver dysfunction. There are also new anti psoriasis drugs that aren’t available in Australia yet, however are dangerous.
Psoriasis is better in summer and worse in winter. So the sun, Vitamin D and solariums are used in treatment.
Triggers include: stress; vaccinations, sunburns, scratches, lithium, anti-malerials, allergies, poor diet and dry weather.
Natural treatments
Exercise – highly intensive exercise does wonders for psoriasis.
Homocystine tests – ask to be tested by your GP via a blood test. Homocystine levels should be below 6.3. Not many people are under 8.
Nutrition
Folate from leafy greens and AIM’s BarleyLife, iron and water. Zinc, evening primrose oil, fish oil and herbs such as St Johns Wort.
Eliminate caffeine and alcohol.
DHEA – available through AIM’s CWR.
In the Alternative Medicine Review (Sept 2004) the following was suggested:
Researchers also suggest Traditional Chinese Medicine which is concerned with the six common pathogens – Wind, Cold, Dampness, Dryness, Heat & Fire.
ACNE
Acne usually begins at puberty, however peaks at the age of 17. Approximately between the age of 16 & 17 for girls and 17 – 18 in boys.
Researchers believe it may indicate deeper diseases such as polycystic ovaries or excessive hairiness.
Acne is increasing especially in women – probably due to hormonal influences, stress and an increased sociocultural emphasis on cosmetic appearance. It may also be increasing from excessive sugar consumption. Figures reveal that US citizens consume 70 kg of sweeteners (sugars, corn syrup, honey etc) per person per year.
A recent study has found that a diet that restricts refined carbohydrates has proven beneficial for the treatment of acne.

Nutrition
Zinc – 30 mg per day of zinc gluconate.
Fish oil.
Burdock root – which is in AIM Herbal Release.
Witch hazel and fruit acids.
AIM BarleyLife – there is azelaic acid, which is found in wheat, rye and barley. This reduces the proliferation of the bacteria that drives the inflammatory aspect of acne.
To treat the stress – try forms of relaxation training.

I have fought acne most of my life, and have tried any things. I have been using Arbonne for over 4 years and have incredible skin. Through trial and error I have come up with a regimen that seems to work very well on my clients with acne. I know much that goes on with our skin is not only determined by what skincare line you use, but also what supplements you take. I will give you a few options with scenarios to choose from, depending on the skin type and needs.

Young Severe Acne Prone Skin

Clear Advantage Wash

Clear Advantage Toner

Re-9 Serum (just a pea size…massage it on fingertips and then tap it directly on the face)

Clear Advantage Acne Lotion

**If they have dry skin, I recommend using the RE-9 daycreme’ (just a pea size).

**If they have oily skin, I recommend them using the Basic Normal to Oily Moisture Cream.

**If they have dry skin, I recommend using the RE-9 Night Crème at Night (just a meringue pie peak amt with the spatula).

**If they have oily skin, I recommend them using the Basic Normal to Oily Night Cream (just a small amount on fingertips, with a spatula).

Supplements:

*Clear Advantage Acne Supplement

*Herbal Colon Cleanse

*Multi Vitamin & Calcium

*Drink their body weight in ounces of water a day (If you weigh 120 lbs, then you would drink about 120 ounces of water a day)

*Proleif (This will be regulated with your period. You will start this the 12th day after your period starts to the 26th day after your period starts. I recommend using about a œ a pump in the morning and a full ump at night. If you want to learn more about the progesterone cream go to www.johnleemd.com .) I have found through my own experience as well as many of my clients that this will help to alleviate the hormone induces acne, as this will help to balance the hormones.)

Adult Acne Prone Skin

Re-9 Wash n the morning & Clear Advantage Acne Wash in the evening

Re-9 Toner in the morning and night

Re-9 Transforming Lift in the morning

Re-9 Day & Night Serum in the morning and at night

Clear Advantage Lotion in the evening

Re-9 Day crème’ in the morning (If you have oily skin use only about Œ of a pump on your fingertips, and rubs together, then spread a light glaze on your neck an face, if you have dry skin , you may need a full pump.)

Re-9 Night Crème’ (use your spatula to tap a small amount, a meringue pie peak, then put on your fingertips to rub a light glaze on your neck and face.)

Supplements:

*Clear Advantage Acne Supplement

*Herbal Colon Cleanse

*Multi-Vitamin & Calcium

*Proleif (or you are experiencing Menopausal symptoms…the PhytoProleif has proven to work the best for most of my consultants and clients.)

*ReSist Anti-Aging Supplement

*Drink your body weight in ounces of water a day

***This is only to be used as a recommendation for you’re to pass onto your clients/consultants. This is what I have found through trial and error over the past 4 years. I have found that when someone has acne scarring, many clients have noticed a quite noticeable difference in the texture of the scars. I have personally watch my own mild acne scarring diminish over the past 3 years that I have used the Re-9 line consistently both morning and night. I started out with the above skincare regimen, and then later after my acne was gone, I went completely to the Re-9 line, and have been using it exclusively for 2 œ years. If you experience breakouts the first 2 to 3 months, that could be perfectly normal. Just stay the course, your skin has to have time to detoxify itself of all the other products your exposed yourself to, that didn’t have the Pure, Safe, and Beneficial Guarantee that Arbonne International has. I have noticed with my own experience as well as through my clients/consultants own personal experiences that during stressful times, or when I have eaten high amount of sugar that it has affected the clarity of my skin. Skincare is very important, but hormones do play a HUGE factor in your skin, so that is why I feel the supplements are so important. I remember imagining that one day I would have clear skin, and I would be able to wake up in the morning and not have to worry about whether I had a breakout on my face, and thanks to Arbonne’s skincare and nutrition line, I have been living that way for the past 3 years since my acne has went away. If you are going though a tough time with your acne, just borrow my belief in what these products will do for you. Don’t get discouraged, just stick with it and one day, you too will have the same results.

SKIN DEEP

Eczema/Atopic Dermatitis, Psoriasis and Acne

Teleconference Notes

INTRODUCTION

Eczema/Atopic Dermatitis, Psoriasis and Acne are the 3 most common skin disorders today. Eczema/Atopic (increased likelihood of developing allergies) Dermatitis are interchangeable terms.

EXCEMA/ATOPIC DERMATITIS (AD)
10% of the population have this skin disorder. In the UK that figure is 12%.
Pathogenesis (origination and development of a disease) for eczema is a disordered immune regulation, genetic factors and environmental triggers. Our genes haven’t changed; however the environment we live in has, which has ultimately affected our immune systems.
70% of cases are onset before the age of 5 years. That is 17% of children – nearly 1 in 5 and there is considerable evidence that the prevalence is increasing.
Several theories have been put forward to explain this increase, most of them focusing on early life events. One example of such theories is the ‘hygiene hypothesis’. This hypothesis argues that early childhood exposure to infections inhibit the tendency to develop allergic disease. As a consequence, children with westernised lifestyles, protected as they are from the infectious burdens of early life that are common in the developing world, suffer an increased risk of developing allergic disease. Therefore the hygiene hypothesis is all about keeping kids too clean.
Today there are items such as anti-bacterial wipes on the market – we’ve become obsessed and petrified of bugs. A child’s immune system can become an allergic immune system if the immune system isn’t used. If you don’t use your immune system, you’ll lose it and it will become allergic. Children must be allowed to build up their immune systems when they are young. If they are protected from infections when young, they are more prone to diseases and illnesses as they get older.
Researchers suggest that frequent respiratory infections early in life prevent the development of atopy and allergic respiratory disease. The following are protective effects against asthma and AD:

Living with pets (cats and dogs have bacteria)
Living with several brothers and sisters (other sick children)
Drinking unpasteurized milk (milk has enzymes and bacteria)
Living on a farm (playing in the dirt that has bacteria from animal faeces)
Living in close proximity to farm animals

These findings indicate that certain amounts of bugs and bacteria when a child is young are good. Plus there is also a strong environmental component, indicating that illness is not just genetic.
Unfortunately the prognosis is worse with early onset as it’s associated with hayfever, asthma and atopic dermatitis. Asthma is present in 60% of children with severe AD. They’re also saying now that there is a correlation between autism and eczema too.
With regard to immunity, it comes down to what a person’s immune system can tolerate.
Skin deep handout – you can see the hands and face which have the highest percentages are exposed areas. What goes on inside the body will eventually affect the outside. Many use the analogy of dishwashing liquid giving people eczema on their hands. The dishwashing liquid is the trigger, but what’s going on inside is the gun. You need to balance your immune systems see-saw.
Remember the Immune system see saw – you’ll either be Th1 high and Th2 low or vice versa. A very allergic condition is where the Th2 is high and the Th1 is low. Rheumatoid arthritis is a Th1 condition and Hashimoto’s disease is a Th1 condition. When the Th1 is low, the body is over-reactive and can generate organ-specific autoimmune disease (eg arthritis, multiple sclerosis, type 1 diabetes).
When you have achy joints and a fever, you’re fighting off the virus. Try not to take medication at this time. This way you are going to heal quicker. If you are prone to lots of infections, then your Th1 cells are down and losing their protection against infections.
Arthritis sufferers should wear a copper bracelet on their wrists if they have the disease in their hands. Copper can increase SOD.
Why are children getting eczema?
Pregnancy is a high Th2 condition. When a pregnant woman becomes Th1 dominant she is subject to miscarriage. Hence the need to look after your immune system. The outcome of a high Th2 pregnancy is that the baby will be born Th2 dominant. Interestingly babies delivered by caesarean section haven’t been exposed to the bacteria that a baby from a natural birth has. With the increased rates of caesareans come the increased rates of eczema. We have interfered with the natural process here. Given a natural birth has far more health benefits for a child.
When they say allergies run in the family, it doesn’t mean it’s genetic. It means that what the mother has been exposed to, the infant will be as well.
What is the best food?
Literature strongly supports the use of exclusive breast milk feeding for all infants for the first 4 – 6 months of life, even longer. However when a mother is unable to feed this way, the question of formula foods become real. The basic problem with formula is that the infantile immune system reacts to foreign protein (eg. cow, soy, goat etc).
In a study where there was a late introduction of solid foods (after 4 – 6 months) there was a decreased risk of food allergy and AD up to 3 years and recurrent wheeze/asthma up to 6 – 17 years. Even the WHO recommends breast feeding for the first 6 months as an allergy-prevention measure. Note: there is a product called Neocate which is a pharmacy product should you know anyone in this situation.
Foods that cause allergies
Cows milk – dairy boards around the world say that cows milk is only a problem in 2 – 3% of children. Well, why then do 73% of children who have allergies, have allergies to cereal? Interestingly, these products go hand-in-hand (cereal is served with milk).
As a side note here, if you have to go off dairy products, take some cheese.
Medications may cause allergies
People can be allergic to antibiotics. Penicillin for example, knocks out bacteria in the gut, which normalises the immune system.
Here you need to take a probiotic and AIM has Flora Food, which is available through the AIM New Zealand office. Many people ask the question when taking antibiotics – what do they take first – the antibiotics or the probiotic? Experts say to finish taking the antibiotics then start the probiotics.
Vaccines may cause allergies
Natural therapists and some doctors believe flu vaccines impair the immune system. The system is reporting that vaccine reactions are poor. There are no controlled studies that assess vaccine and non-vaccinated people. If you are about to receive a flu vaccine, be careful if you have cancer, as it may cause increased morbidity. If you visit the Australian Vaccine Network Site there is some pretty horrific reading by Bronwyn Hancock.
Also vaccines could induce asthma.
In a study in England of 446 children. In 203 of these children who had not been vaccinated for pertussis (whooping cough), 2% had a diagnosis of asthma at 8 years of age, compared to 11% of the 243 children who had been vaccinated for pertussis.
Researchers have also seen an association been smoking parents and dermatitis and eczema.
Stress & the immune system
Short-term stress is good for the immune system. Stress suppresses Th1, which can lead to health issues such as cold sores. We are stressed more than ever before – so hence more illness.
Foods
Take allergic foods out of diets. For example dairy and processed foods.
Natural Treatments for Eczema
Glutathione Peroxidase – buy off the shelf in QLD, however banned in VIC. It’s a very powerful intracellular antioxidant. It’s good for longevity and is an enzyme that makes an antioxidant.
Fish oil – no more than 4gm per day (mothers can become deficient from morning sickness)
Probiotics – did you know that you have 2 kilograms of bugs in your body? Take Flora Food. Unfortunately yoghurt is a mild source of good bacteria, but not a great source. Probiotics strengthen gut defence barrier mechanisms. Try and get 4 billion bugs per day.

Nutrition
Did you know that hot dogs are the most popular take-away food in the US? What’s a hot dog made up of? Margarine, white flour and processed meat. All bad! Body needs good antioxidants such as Proancynol, obviously with dietary antioxidants such as VC, VE, beta-carotene and foods rich in antioxidants.
Minerals
Zinc is a powerful mineral for boosting the immune system. 80% of the Australian population is zinc deficient. If you increase zinc, mouth ulcers will disappear. We don’t need more than 70mg per week on top of the diet. Too much zinc will also suppress the immune system. 30 – 40 mg of zinc is lost during sex. Men are particularly deficient. Zinc loss is women can result in stretch marks. Start on 35 mg per day and increase to 70 mg if you are deficient, then cut back again.

Herbs
Barbarry (a berberine herb) – which is in AIM’s Herbal Release.
Korean (panax) Ginseng – has a normalising effect on the immune system.
PSORIASIS
Is a Th1 dominant condition. Here the immune system misfires and inappropriately causes inflammation and an accelerated growth of skin cells.
Between 1 and 3% (or 1 in 50 people) of the population around the world has it. Most often occurs between the ages of 15 and 35.
It is partly genetic – if one parent has it children have 10 – 25% of developing psoriasis. If both parents have it, the children have 50% chance of development.
It normally takes 4 – 5 days to come through on the skin. Normal skin replacement is every 28 days.
Typically treated with cyclosporine or methotrexate. Methotextrate has terrible side effects including bone marrow toxicity, nausea and anaemia. Cyclosporine side effects include hypertension and liver dysfunction. There are also new anti psoriasis drugs that aren’t available in Australia yet, however are dangerous.
Psoriasis is better in summer and worse in winter. So the sun, Vitamin D and solariums are used in treatment.
Triggers include: stress; vaccinations, sunburns, scratches, lithium, anti-malerials, allergies, poor diet and dry weather.
Natural treatments
Exercise – highly intensive exercise does wonders for psoriasis.
Homocystine tests – ask to be tested by your GP via a blood test. Homocystine levels should be below 6.3. Not many people are under 8.
Nutrition
Folate from leafy greens and AIM’s BarleyLife, iron and water. Zinc, evening primrose oil, fish oil and herbs such as St Johns Wort.
Eliminate caffeine and alcohol.
DHEA – available through AIM’s CWR.
In the Alternative Medicine Review (Sept 2004) the following was suggested:
Researchers also suggest Traditional Chinese Medicine which is concerned with the six common pathogens – Wind, Cold, Dampness, Dryness, Heat & Fire.
ACNE
Acne usually begins at puberty, however peaks at the age of 17. Approximately between the age of 16 & 17 for girls and 17 – 18 in boys.
Researchers believe it may indicate deeper diseases such as polycystic ovaries or excessive hairiness.
Acne is increasing especially in women – probably due to hormonal influences, stress and an increased sociocultural emphasis on cosmetic appearance. It may also be increasing from excessive sugar consumption. Figures reveal that US citizens consume 70 kg of sweeteners (sugars, corn syrup, honey etc) per person per year.
A recent study has found that a diet that restricts refined carbohydrates has proven beneficial for the treatment of acne.

Nutrition
Zinc – 30 mg per day of zinc gluconate.
Fish oil.
Burdock root – which is in AIM Herbal Release.
Witch hazel and fruit acids.
AIM BarleyLife – there is azelaic acid, which is found in wheat, rye and barley. This reduces the proliferation of the bacteria that drives the inflammatory aspect of acne.
To treat the stress – try forms of relaxation training.

I have fought acne most of my life, and have tried any things. I have been using Arbonne for over 4 years and have incredible skin. Through trial and error I have come up with a regimen that seems to work very well on my clients with acne. I know much that goes on with our skin is not only determined by what skincare line you use, but also what supplements you take. I will give you a few options with scenarios to choose from, depending on the skin type and needs.

Young Severe Acne Prone Skin

Clear Advantage Wash

Clear Advantage Toner

Re-9 Serum (just a pea size…massage it on fingertips and then tap it directly on the face)

Clear Advantage Acne Lotion

**If they have dry skin, I recommend using the RE-9 daycreme’ (just a pea size).

**If they have oily skin, I recommend them using the Basic Normal to Oily Moisture Cream.

**If they have dry skin, I recommend using the RE-9 Night Crème at Night (just a meringue pie peak amt with the spatula).

**If they have oily skin, I recommend them using the Basic Normal to Oily Night Cream (just a small amount on fingertips, with a spatula).

Supplements:

*Clear Advantage Acne Supplement

*Herbal Colon Cleanse

*Multi Vitamin & Calcium

*Drink their body weight in ounces of water a day (If you weigh 120 lbs, then you would drink about 120 ounces of water a day)

*Proleif (This will be regulated with your period. You will start this the 12th day after your period starts to the 26th day after your period starts. I recommend using about a œ a pump in the morning and a full ump at night. If you want to learn more about the progesterone cream go to www.johnleemd.com .) I have found through my own experience as well as many of my clients that this will help to alleviate the hormone induces acne, as this will help to balance the hormones.)

Adult Acne Prone Skin

Re-9 Wash n the morning & Clear Advantage Acne Wash in the evening

Re-9 Toner in the morning and night

Re-9 Transforming Lift in the morning

Re-9 Day & Night Serum in the morning and at night

Clear Advantage Lotion in the evening

Re-9 Day crème’ in the morning (If you have oily skin use only about Œ of a pump on your fingertips, and rubs together, then spread a light glaze on your neck an face, if you have dry skin , you may need a full pump.)

Re-9 Night Crème’ (use your spatula to tap a small amount, a meringue pie peak, then put on your fingertips to rub a light glaze on your neck and face.)

Supplements:

*Clear Advantage Acne Supplement

*Herbal Colon Cleanse

*Multi-Vitamin & Calcium

*Proleif (or you are experiencing Menopausal symptoms…the PhytoProleif has proven to work the best for most of my consultants and clients.)

*ReSist Anti-Aging Supplement

*Drink your body weight in ounces of water a day

***This is only to be used as a recommendation for you’re to pass onto your clients/consultants. This is what I have found through trial and error over the past 4 years. I have found that when someone has acne scarring, many clients have noticed a quite noticeable difference in the texture of the scars. I have personally watch my own mild acne scarring diminish over the past 3 years that I have used the Re-9 line consistently both morning and night. I started out with the above skincare regimen, and then later after my acne was gone, I went completely to the Re-9 line, and have been using it exclusively for 2 œ years. If you experience breakouts the first 2 to 3 months, that could be perfectly normal. Just stay the course, your skin has to have time to detoxify itself of all the other products your exposed yourself to, that didn’t have the Pure, Safe, and Beneficial Guarantee that Arbonne International has. I have noticed with my own experience as well as through my clients/consultants own personal experiences that during stressful times, or when I have eaten high amount of sugar that it has affected the clarity of my skin. Skincare is very important, but hormones do play a HUGE factor in your skin, so that is why I feel the supplements are so important. I remember imagining that one day I would have clear skin, and I would be able to wake up in the morning and not have to worry about whether I had a breakout on my face, and thanks to Arbonne’s skincare and nutrition line, I have been living that way for the past 3 years since my acne has went away. If you are going though a tough time with your acne, just borrow my belief in what these products will do for you. Don’t get discouraged, just stick with it and one day, you too will have the same results.

SKIN DEEP

Eczema/Atopic Dermatitis, Psoriasis and Acne

Teleconference Notes

INTRODUCTION

Eczema/Atopic Dermatitis, Psoriasis and Acne are the 3 most common skin disorders today. Eczema/Atopic (increased likelihood of developing allergies) Dermatitis are interchangeable terms.

EXCEMA/ATOPIC DERMATITIS (AD)
10% of the population have this skin disorder. In the UK that figure is 12%.
Pathogenesis (origination and development of a disease) for eczema is a disordered immune regulation, genetic factors and environmental triggers. Our genes haven’t changed; however the environment we live in has, which has ultimately affected our immune systems.
70% of cases are onset before the age of 5 years. That is 17% of children – nearly 1 in 5 and there is considerable evidence that the prevalence is increasing.
Several theories have been put forward to explain this increase, most of them focusing on early life events. One example of such theories is the ‘hygiene hypothesis’. This hypothesis argues that early childhood exposure to infections inhibit the tendency to develop allergic disease. As a consequence, children with westernised lifestyles, protected as they are from the infectious burdens of early life that are common in the developing world, suffer an increased risk of developing allergic disease. Therefore the hygiene hypothesis is all about keeping kids too clean.
Today there are items such as anti-bacterial wipes on the market – we’ve become obsessed and petrified of bugs. A child’s immune system can become an allergic immune system if the immune system isn’t used. If you don’t use your immune system, you’ll lose it and it will become allergic. Children must be allowed to build up their immune systems when they are young. If they are protected from infections when young, they are more prone to diseases and illnesses as they get older.
Researchers suggest that frequent respiratory infections early in life prevent the development of atopy and allergic respiratory disease. The following are protective effects against asthma and AD:

Living with pets (cats and dogs have bacteria)
Living with several brothers and sisters (other sick children)
Drinking unpasteurized milk (milk has enzymes and bacteria)
Living on a farm (playing in the dirt that has bacteria from animal faeces)
Living in close proximity to farm animals

These findings indicate that certain amounts of bugs and bacteria when a child is young are good. Plus there is also a strong environmental component, indicating that illness is not just genetic.
Unfortunately the prognosis is worse with early onset as it’s associated with hayfever, asthma and atopic dermatitis. Asthma is present in 60% of children with severe AD. They’re also saying now that there is a correlation between autism and eczema too.
With regard to immunity, it comes down to what a person’s immune system can tolerate.
Skin deep handout – you can see the hands and face which have the highest percentages are exposed areas. What goes on inside the body will eventually affect the outside. Many use the analogy of dishwashing liquid giving people eczema on their hands. The dishwashing liquid is the trigger, but what’s going on inside is the gun. You need to balance your immune systems see-saw.
Remember the Immune system see saw – you’ll either be Th1 high and Th2 low or vice versa. A very allergic condition is where the Th2 is high and the Th1 is low. Rheumatoid arthritis is a Th1 condition and Hashimoto’s disease is a Th1 condition. When the Th1 is low, the body is over-reactive and can generate organ-specific autoimmune disease (eg arthritis, multiple sclerosis, type 1 diabetes).
When you have achy joints and a fever, you’re fighting off the virus. Try not to take medication at this time. This way you are going to heal quicker. If you are prone to lots of infections, then your Th1 cells are down and losing their protection against infections.
Arthritis sufferers should wear a copper bracelet on their wrists if they have the disease in their hands. Copper can increase SOD.
Why are children getting eczema?
Pregnancy is a high Th2 condition. When a pregnant woman becomes Th1 dominant she is subject to miscarriage. Hence the need to look after your immune system. The outcome of a high Th2 pregnancy is that the baby will be born Th2 dominant. Interestingly babies delivered by caesarean section haven’t been exposed to the bacteria that a baby from a natural birth has. With the increased rates of caesareans come the increased rates of eczema. We have interfered with the natural process here. Given a natural birth has far more health benefits for a child.
When they say allergies run in the family, it doesn’t mean it’s genetic. It means that what the mother has been exposed to, the infant will be as well.
What is the best food?
Literature strongly supports the use of exclusive breast milk feeding for all infants for the first 4 – 6 months of life, even longer. However when a mother is unable to feed this way, the question of formula foods become real. The basic problem with formula is that the infantile immune system reacts to foreign protein (eg. cow, soy, goat etc).
In a study where there was a late introduction of solid foods (after 4 – 6 months) there was a decreased risk of food allergy and AD up to 3 years and recurrent wheeze/asthma up to 6 – 17 years. Even the WHO recommends breast feeding for the first 6 months as an allergy-prevention measure. Note: there is a product called Neocate which is a pharmacy product should you know anyone in this situation.
Foods that cause allergies
Cows milk – dairy boards around the world say that cows milk is only a problem in 2 – 3% of children. Well, why then do 73% of children who have allergies, have allergies to cereal? Interestingly, these products go hand-in-hand (cereal is served with milk).
As a side note here, if you have to go off dairy products, take some cheese.
Medications may cause allergies
People can be allergic to antibiotics. Penicillin for example, knocks out bacteria in the gut, which normalises the immune system.
Here you need to take a probiotic and AIM has Flora Food, which is available through the AIM New Zealand office. Many people ask the question when taking antibiotics – what do they take first – the antibiotics or the probiotic? Experts say to finish taking the antibiotics then start the probiotics.
Vaccines may cause allergies
Natural therapists and some doctors believe flu vaccines impair the immune system. The system is reporting that vaccine reactions are poor. There are no controlled studies that assess vaccine and non-vaccinated people. If you are about to receive a flu vaccine, be careful if you have cancer, as it may cause increased morbidity. If you visit the Australian Vaccine Network Site there is some pretty horrific reading by Bronwyn Hancock.
Also vaccines could induce asthma.
In a study in England of 446 children. In 203 of these children who had not been vaccinated for pertussis (whooping cough), 2% had a diagnosis of asthma at 8 years of age, compared to 11% of the 243 children who had been vaccinated for pertussis.
Researchers have also seen an association been smoking parents and dermatitis and eczema.
Stress & the immune system
Short-term stress is good for the immune system. Stress suppresses Th1, which can lead to health issues such as cold sores. We are stressed more than ever before – so hence more illness.
Foods
Take allergic foods out of diets. For example dairy and processed foods.
Natural Treatments for Eczema
Glutathione Peroxidase – buy off the shelf in QLD, however banned in VIC. It’s a very powerful intracellular antioxidant. It’s good for longevity and is an enzyme that makes an antioxidant.
Fish oil – no more than 4gm per day (mothers can become deficient from morning sickness)
Probiotics – did you know that you have 2 kilograms of bugs in your body? Take Flora Food. Unfortunately yoghurt is a mild source of good bacteria, but not a great source. Probiotics strengthen gut defence barrier mechanisms. Try and get 4 billion bugs per day.

Nutrition
Did you know that hot dogs are the most popular take-away food in the US? What’s a hot dog made up of? Margarine, white flour and processed meat. All bad! Body needs good antioxidants such as Proancynol, obviously with dietary antioxidants such as VC, VE, beta-carotene and foods rich in antioxidants.
Minerals
Zinc is a powerful mineral for boosting the immune system. 80% of the Australian population is zinc deficient. If you increase zinc, mouth ulcers will disappear. We don’t need more than 70mg per week on top of the diet. Too much zinc will also suppress the immune system. 30 – 40 mg of zinc is lost during sex. Men are particularly deficient. Zinc loss is women can result in stretch marks. Start on 35 mg per day and increase to 70 mg if you are deficient, then cut back again.

Herbs
Barbarry (a berberine herb) – which is in AIM’s Herbal Release.
Korean (panax) Ginseng – has a normalising effect on the immune system.
PSORIASIS
Is a Th1 dominant condition. Here the immune system misfires and inappropriately causes inflammation and an accelerated growth of skin cells.
Between 1 and 3% (or 1 in 50 people) of the population around the world has it. Most often occurs between the ages of 15 and 35.
It is partly genetic – if one parent has it children have 10 – 25% of developing psoriasis. If both parents have it, the children have 50% chance of development.
It normally takes 4 – 5 days to come through on the skin. Normal skin replacement is every 28 days.
Typically treated with cyclosporine or methotrexate. Methotextrate has terrible side effects including bone marrow toxicity, nausea and anaemia. Cyclosporine side effects include hypertension and liver dysfunction. There are also new anti psoriasis drugs that aren’t available in Australia yet, however are dangerous.
Psoriasis is better in summer and worse in winter. So the sun, Vitamin D and solariums are used in treatment.
Triggers include: stress; vaccinations, sunburns, scratches, lithium, anti-malerials, allergies, poor diet and dry weather.
Natural treatments
Exercise – highly intensive exercise does wonders for psoriasis.
Homocystine tests – ask to be tested by your GP via a blood test. Homocystine levels should be below 6.3. Not many people are under 8.
Nutrition
Folate from leafy greens and AIM’s BarleyLife, iron and water. Zinc, evening primrose oil, fish oil and herbs such as St Johns Wort.
Eliminate caffeine and alcohol.
DHEA – available through AIM’s CWR.
In the Alternative Medicine Review (Sept 2004) the following was suggested:
Researchers also suggest Traditional Chinese Medicine which is concerned with the six common pathogens – Wind, Cold, Dampness, Dryness, Heat & Fire.
ACNE
Acne usually begins at puberty, however peaks at the age of 17. Approximately between the age of 16 & 17 for girls and 17 – 18 in boys.
Researchers believe it may indicate deeper diseases such as polycystic ovaries or excessive hairiness.
Acne is increasing especially in women – probably due to hormonal influences, stress and an increased sociocultural emphasis on cosmetic appearance. It may also be increasing from excessive sugar consumption. Figures reveal that US citizens consume 70 kg of sweeteners (sugars, corn syrup, honey etc) per person per year.
A recent study has found that a diet that restricts refined carbohydrates has proven beneficial for the treatment of acne.

Nutrition
Zinc – 30 mg per day of zinc gluconate.
Fish oil.
Burdock root – which is in AIM Herbal Release.
Witch hazel and fruit acids.
AIM BarleyLife – there is azelaic acid, which is found in wheat, rye and barley. This reduces the proliferation of the bacteria that drives the inflammatory aspect of acne.
To treat the stress – try forms of relaxation training.

Accutane – an oral prescription acne medication that inhibits oil production, and helps control severe acne. Some side effects may include hair loss, headaches, liver problems, extreme dryness of the skin and eyes. Glycolic acid and retinol products should not be used while taking accutane and for 6 months after you stop the medication.
Acne – an inflammation caused by blockage of the oil glands, which results in blackheads and pimples. Abnormal clumping of cells in the follicle.
Aesthetician – a trained professional who provides treatments such as facials, chemical peels, microdermabrasion, extractions and other procedures that relax the body and clean or beautify the skin.
Alpha hydroxy acid (AHA) – A classification of acids which come from natural sources used to chemically exfoliate the top layer of skin. These acids are derived from citric acid, tartaric acid, malic acid, lactic acid, and glycolic acid; also known as fruit acids. There are many forms of aha’s, however the most effective form is Glycolic Acid because it has the smallest molecular size and is able to enter the follicle (pore) and purge the dead cells that form and clog your pores. Glycolic acid is often used to describe all AHA products. It is used to refine the skin and removes discoloration, fine lines and wrinkles, small acne lesions and keratinocytes or dead skin cells leaving the skin lighter, fresher, with less discoloration and a smaller looking pore size. Since AHA or glycolic acid does not change the structure and function of the skin it is not classified as a drug. Preparations containing glycolic acid range from 4% to 20% for everyday use on the skin and may be combined with other ingredients like salicylic, hyaluronic and Vitamin C. AHA’s are non Comedogenic. The pH should be between 3.0-3.5 for home care glycolic products as this will stimulate collagen production in the epidermis.
Anagen – The active stage of hair growth where the root is attached to the papilla. This is the ideal stage in which to have an Electrolysis treatment. Hair treated in this stage has a lower change of growing back.

Folliculitis

Folliculitis is a somewhat nonspecific term that refers to inflammation of the hair follicle (in clinical practice, this term does not include acne vulgaris). The most common etiology of folliculitis is bacterial infection, often due to Staphylococcus aureus. The usual clinical presentation is superficial pustules and/or papules in the distribution of the hair follicles. The face, chest, back, thighs, and buttocks are often involved. Folliculitis is frequently initiated by mild physical injury to the follicles, such as friction caused by tight-fitting garments, or by ingrown hairs in the beard area in men. Less commonly, folliculitis is caused by infection by fungi, such as dermatophytes or Pityrosporum. Folliculitis due to Pseudomonas aeruginosa (“hot tub folliculitis”) may occur in patients exposed to water sources that are contaminated by that organism. Treatment of folliculitis is aimed at eliminating the offending agent(s), and includes topical and/or systemic antibacterial or antifungal preparations.

Androgen Receptor Blockers

Spironolactone
Within the class of androgen receptor blockers, the drug options are spironolactone, cyproterone acetate, and flutamide. In the United States, spironolactone is the drug most commonly used. Oral spironolactone decreases se- bum excretion rate and inhibits .Recommended doses for the treatment of acne are
50–100 mg, taken with meals [50]. However, many wom- en respond well to 25 mg twice daily, and some even respond to just 25 mg a day. These low doses in healthy young women are well tolerated. However, if this drug is used in older women with other possible medical prob- lems, or if higher doses are used for conditions such as hirsutism or androgenic alopecia, serum electrolytes should be monitored. Side effects to be aware of include breast tenderness and menstrual irregularities.
Cyproterone Acetate
Through dual activity, cyproterone acetate inhibits ovulation and blocks the androgen receptor. There are two ways to use cyproterone acetate: low dosage at 2 mg per day in combination with ethinyl estradiol in an oral contraceptive (Diane, Dianette) or high dosage at 50–100 mg from days 5 to 14 of the menstrual cycle [51]. There can be improvement in 75–90% of patients who are treated with the high-dose regimen.

Flutamide
Flutamide, a very potent antiandrogen that is also used to treat prostate cancer, can be used in the treatment of acne, hirsutism, and androgenic alopecia . It can be given in doses of 250 mg twice daily, in combination with an OC. Fatal hepatitis is a concern with this drug, and liver function tests should be followed [53]. The hepato- toxicity associated with flutamide seems to be doseand age-dependent . Low dose (62.5–125 mg) has been reported to be safe and effective .

Adrenal Androgen Production Blockers
Glucocorticoids
Another option in hormone therapy is to block the pro- duction of androgens, which can be accomplished through the use of oral contraceptives and low-dose glucocorti- coids. This is most commonly used to treat the patient with late-onset congenital adrenal hyperplasia, which is an inherent defect in the 21-hydroxylase or the 11- hydroxylase enzyme. This defect causes a block in the cor- tisol biosynthetic pathway, which results in a buildup of precursors for potent androgens. Low-dose prednisone (2.5–5 mg a day, at bedtime) is one option. Dexametha- sone can also be used, but the risk of adrenal suppression is higher. To ascertain if the therapy is having the desired effect, the serum DHEAS can be monitored. A decrease or normalization of the blood levels indicates that treatment is successful. To check for adrenal suppression, an ACTH- simulation test can be performed. This consists of inject- ing ACTH and assessing the plasma cortisol 30 min later. If plasma cortisol has risen by an appropriate amount, the adrenal gland is not suppressed.

Ovarian Androgen Blockers
In addition to blocking the adrenal production of androgens, production in the ovary can also be blocked through the use of gonadotropin-releasing hormone ago- nists, such as buserelin, nafarelin or leuprolide. These gonadotropin-releasing agonists block ovulation by inter-

Update and Future of Hormonal Therapy in Acne
Dermatology 2003;206:57–67 63

rupting the cyclic release of FSH and LH from the pitu- itary. These drugs are efficacious in acne and hirsutism, and are available as injectable drugs or nasal spray. However, in addition to suppressing the production of ovarian androgens, these drugs also suppress the production of estrogens, thereby eliminating the function of the ovary. Thus, the patient could develop menopausal symptoms and suffer from hypoestrogenism. Headaches can also develop, as well as the occurrence of bone loss, due to the reduction in estrogen.

Oral Contraceptives
Oral contraceptives contain two agents, an estrogen (generally ethinyl estradiol) and a progestin. In their early formulations, oral contraceptives had high concentrations of over 100 Ìg of estrogen. In doses higher than 100 Ìg, estrogens can suppress sebum production. Estrogens also act hepatically to increase the synthesis of sex-hormone- binding globulin. Circulating testosterone levels are re- duced by the increased sex-hormone-binding globulin production, leading to a decrease in sebum production. Oral contraceptives inhibit the ovarian production of androgens by suppressing ovulation. This, in turn, decreases serum androgen levels and reduces sebum production.

Options for Hormonal Therapy

Once the decision has been made to initiate hormonal therapy, there are various options to choose from:androgen receptor blockers, or antiandrogens (this class of drugs block the effect of androgens on the sebaceous gland and on the infundibulum of the follicle);  inhibition of androgen production by the ovary or adrenal gland, or  in the future, inhibition of androgen metabolizing enzymes in the skin may be possible (see
‘Enzyme inhibitors’ section below). It is important to note that hormonal therapy is absolutely contraindicated in women who want to become pregnant due to the risk for sexual organ malformation in a developing fetus.

Acne Genetics

The genetic influence on pathogenesis of acne is well documented in twins  and genealogic studies. In some types of acne, such as acne conglobata, hereditary factors are more apparent, and a correlation has been suggested between neonatal acne and familial hyperandrogenism . Nodulocystic IA is often observed in relatives of patients with extensive steatocystoma, adolescent and postadolescent acne . Fifty percent of postadolescent acne patients have at least one first-degree relative with the condition .
Sebum excretion also correlates with acne susceptibility, and sebum excretion rates are similar in identical twins . Several chromosomal abnormalities,
glycoprotein secreted from various epithelial glands including sebaceous glands. Studies of the respiratory and digestive systems suggest, is involved in the defense system against bacteria by inhibiting their adhesion to epithelium, gene and the molecule produced exhibit extensive polymorphism attributable to a variable number of tandem repeats. A higher frequency of longer repeat length of tandem repeats has been observed in severe acne patients .
The melanocortin 5 receptor is known to regulate seba- ceous gland function in mouse. Genetic diversity is ob- served in human melanocortin 5 receptor coding region. Association between variation at the locus and acne is not found .
In conclusion, the pathogenesis of acne is multifactorial and a greater number of genes than those cited above are probably related to the condition. Genes affecting keratinization and desquamation are suspected to be involved in the pathogenesis of acne and their correlation to acne is yet to be evaluated. Advances in immunogenetic research may shed new light on the understanding of the inflammatory reaction in acne. Genes expressed in the sebaceous glands which exhibit polymorphism are of special interest, regardless of their known function. Any gene polymorphisms found to be related to acne may provide additional insights into the pathogenesis of this condition. Further research is needed to investigate the combined effects of these and other genes.

Prepubertal Acne

Increasing number of early onset acne before obvious signs of puberty is a recognized phenomenon associated more with pubertal development than with age. There is apparently a genetic predisposition.
Pubertal development has two components, normal adrenarche related to maturation of adrenal glands and true puberty because of maturation of testis and ovary mediated by the hypothalamic-pituitary axis.
Adrenarche presents with high levels of DHEA and DHEAS that start rising at 6–7 years in girls and 7–8 years in boys and follow increasing during mid puberty. Exces- sive androgen production may result due to adrenal hyperandrogenism (exaggerated adrenarche, exuberant production of adrenal androgens relative to cortisol), congenital adrenal hyperplasia, Cushing’s disease, 21-hyroxylase deficiency, and more rarely androgen producing tumors. Ovarian contribution to androgens can be through tumors (malignant and benign), but most commonly due to polycystic ovarian disease associated very often with obesity, persistent or resistant acne and insulin resistance .
Acne could be the first sign of pubertal maturation and associated with increase in sebum and urinary excretion of androgenic steroids. A high frequency of acne was found in a longitudinal study of adolescent boys, where the prevalence and severity of acne correlated well with advanced pubertal maturation . A similar study of the same authors in early adolescent girls concluded that acne can be the first sign of pubertal maturation; significant elevations of DHEAS correlated well in girls with comedonal and inflammatory acne. The most common locations of acne in this group were the midforehead, nose and chin .
In a longitudinal study of acne and hormonal analysis, Stewart et al. concluded that girls with severe acne
present a statistically significantly earlier menarche (12.2 years) compared to those with moderate and mild disease (12.4 and 12.7 years). They also concluded that the number of comedones were predictive for the severity of late inflammatory acne. Mid-pubertal girls with severe comedonal acne showed more comedones even three years before menarche. This group also showed higher levels of DHEAS early in life. A correlation between DHEAS, sebum production and free testosterone was found in severe comedonal acne.
Lucky et al.  in a 5-year longitudinal cohort study of 871 girls stated clearly the predictor factors of an acne vulgaris study. They evaluated acne versus hormone levels at various ages before and after menarche. They were able to conclude that there were no ethnic differences in acne or hormone levels in the groups studied that included black and white girls. A progressive increase in number of acne lesions with age and maturation was found. The most common acne was comedonal; girls with severe acne at the end of the study had more comedones and inflammatory lesions by the age of 10 years and 2.5 years before menarche. The onset of menarche was also earlier in cases with severe acne and associated to higher levels of serum DHEAS and total and free testosterone compared to girls with mild-to-moderate disease. Early development of comedonal acne, DHEAS, free and total testosterone were good predictors for severe comedonal acne or a long-term disease.
The differential diagnosis is essentially similar to midchilhood acne. Adverse effects of certain drugs (corticosteroids, anticonvulsants, etc.) and sporadic cases of prepubertal hydradenitis suppurative must be considered .
The therapy of acne at this age is similar to that reported before. Topical retinoids, benzoyl peroxide, antibiotics are appropiate in mild-to-moderate comedonal and inflammatory acne. In more severe cases, especially in risk of scarring, the use of oral antibiotics and oral isotretinoin may be necessary. Resistant, persistent and cases of acne appearing at unusual ages need hormonal evaluation and proper treatment. Adrenal problems may need low doses of oral corticosteroids; polycystic ovarian disease can be treated with oral contraceptives that include antiandrogens such as cyproterone acetate or the new low androgenic progestins. Spironolactone can also be considered.