WHY DO I KEEP GETTING ACNE? Britain’s Top Integrated Health Expert

Q I am 16 years old and suffer from acne. I have horrible scars from previous spots, which make me very self-conscious. I recently heard of a contraceptive pill called Dianette that helps to prevent acne. Would you recommend it or do you have any alternative treatments?

A This inflammatory skin disease, which affects the skin pores and the oil glands attached to them, is an abnormal response to normal levels of the male hormone testosterone in the blood. Both male and female reproductive hormones are made from cholesterol. The male hormones (androgens), including testosterone, are synthesised first. Then, in women, they are converted to oestrogen in the ovaries. Additionally, androgens in the adrenal glands are converted to oestrogen in fat cells.

During puberty, however, the upsurge of hormone production reaches such a pitch that many boys have an excess of testosterone. Girls also have a surplus because the ovaries can’t convert it all to oestrogen. The body tries to expel this surplus through sebaceous glands in the skin.

These glands produce oil (sebum) to keep skin and hair waterproof.

Generally, all fat-soluble excess substances are excreted through sebaceous glands. As hormones are fat-chain complexes, they are deposited in the sebaceous glands and produce the characteristic yellow pus. Germs, given the opportunity to enter the sebaceous glands (eg, when a spot is touched), have a feast. This causes inflammation. The infected pus builds up and, when ripe, the spot bursts open, releasing the contents on to the skin. The cavity then fills with scar tissue, which ultimately causes pigmentation. If you squeeze spots prematurely, you spread the infection by pushing the pus over surrounding skin. The result is a larger area of scarring.

In principle, acne is the body’s cleaning up process so it’s a useful function. Unfortunately, it is unsightly. The clever thing to do is to work with the body.

My advice is to keep the skin hygienic and healthy so that the spots don’t get infected.

I also believe that if the body’s general functions improve, hormones will become more balanced.

Dianette (also a contraceptive pill) blocks the process whereby the androgens are excreted through the skin.

It can work for acne although it may take several months. Dianette is an anti-androgenic progestogen, which blocks the receptors in the body that the androgens work on. (Progestogens are a group of female reproductive hormones.) As with all prescription drugs, talk to your doctor about all the risks and side effects before deciding whether or not to take it.

Many people think that acne is caused by poor diet. This is a myth, but eating fatty and sugary foods and drinking orange juice, which encourages inflammation of the skin, can weaken the body’s ability to function well. A good diet helps you to cope with any disease better.

. Help your digestion by chewing food well.

. Make yourself fresh fruit and vegetable juices daily: try combining carrot, celery, apple and ginger.

. Eat oily fish (for essential fatty acids), avocados (for vitamin E), carrots (for betacarotene), pomegranates (to fortify blood), and yams (to help hormonal balance).

. Add one dessertspoon of wheatgerm daily to your food.

. Avoid yeast products, deep fried foods, chocolates, sweets, excess salt, alcohol, coffee and citrus juice.

. Drink two litres of still water daily between meals.

. Zinc (Biocare zinc citrate, Pounds 4.50 for 90 tablets): take one daily for two months for skin maintenance.

. Kadu and kariatu: soak three kadu twigs and one third of a teaspoon of kariatu in a cup of hot water at night; in the morning, strain, add a little hot water then drink. This acts as a good detox. (Kadu, Pounds 4 for 50g; kariatu, Pounds 4.50 for These are my suggestions Diet . Choose organic produce.

Supplements 100g, both Top Op Foods.) . Skin Oil (Alive, Pounds 6 for 20ml): apply on a cotton bud to sore spots in the evening, two to three hours before washing, to aid healing.

. Borolene cream (GD Pharma, Pounds 4.50 for 21g): massage this antiseptic cream into affected areas at bedtime.

To help scarring . Ganpati cream (Pounds 8): apply a small amount to the scar tissue and pigmented area after washing with mild soap and water. Leave overnight and wash off in the morning. Only use this on existing pigmented scar tissue, for two months.

. Apply pure aloe vera gel. Crush the leaves of an aloe vera plant (available from some health food shops), then apply the gel that oozes out with a cotton bud every morning. Also take two aloe vera capsules (Vega, Pounds 7.50 for 60) twice daily for three to four months.

. You could also try vitamin E oil. Prick a vitamin E capsule with a pin and apply the contents on to the scars. Rosehip oil may also help.

Complementary therapies I suggest that you consult qualified practitioners of homoeopathy and nutritional medicine, and use organic beauty products such as Dr Hauschka.