Search Skin Biology
Controlling Oily Skin, Sebum, Blackheads, & Acne
Oily skin with excessive sebum production presents a special problem.
The excessive sebum can harden and block the hair pores. The plug is called a comedo.
Plugs start as a white-colored blockage (or whitehead), then air oxidation darkens the sebum to form a "blackhead".
Bacteria in the blocked hair pore begins to multiply and produce the irritation that becomes acne.
Birth control pills, steroid hormones, and androgenic hormones such as testosterone can cause or aggravate acne. Acne tends to flare up during the menstrual cycle as hormonal fluctuations are experienced prior and during ovulation.
Cystic acne, comedonal acne, papular acne, pustular acne, nodular acne are all variations of the same basic disorder. Acne may occur on all areas of the body, but is more prevalent on the face, back and chest.
For badly infected acne, dermatologists often prescribe a oral and topical antibiotics to reduce the risk of scarring.
Retinoic acid (also called vitamin A acid, Retin A®, Tretinoin) and Accutane® (13 cis retinoic acid (also called isotretinoin) are two acid forms of vitamin A (retinol). Retinoic acid and Accutane both reduce sebum production and minimize acne but can often be very irritating to the skin.
Differin®, which has a chemical name of adapalene, is a product of Galderma Laboratories. It is a new anti-acne retinoid which is available as adapalene topical cream, 0.1% and adapalene topical gel, 0.1%.
Like retinoic acid, it is a potent modulator of cellular differentiation, and appears to normalizes the differentiation of follicular epithelial cells resulting in decreased oil production.
It prevents or reduces the production of blackheads, whiteheads, and microcomedones. It is said to be less irritating and more effective than retinoic acid but side effects can occur such as erythema, dryness, scaling, burning and hypersensitivity to sunlight.
Certain patients may be hypersensitive to the drug and it is not recommended for pregnant women or those who may become pregnant.
One very promising new non-drug approach to clear blocked pores acne is the use of "paste-on" strips that are coated with a adhesive glue which bonds to the blackhead.
The strip is applied to the affected area of the face, allowed to dry, then pulled off along with the blackhead or comedo. Products such as BioRe Cleansing Strips (sold by The Andrew Jergen Company) and similar products are sold in most stores that carry skin products.
Many people prefer another approach to unblock pores that uses a glue-like liquid that is spread on affected areas of the face. The liquid hardens and is then peeled off alone with the blackheads.
Questions or Advice?
Email Dr. Loren Pickart at drlorenpickart@gmail.com
Call us at 1-800-405-1912 Monday Through Friday (8 am to 6 pm) PST
Saunas, Hot Tubs, and Steam Baths
Saunas and hot tubs are best known for their beneficial effect on skin. Skin is nourished from the inside - in contrast externally applied moisturizing creams provide only temporary palliatives.
The high heat of the sauna floods the skins cells with a greatly enhanced blood flow. Pore-clogging oils and waxes are softened to allow normal pore function and removal of pore-clogging waxes.
The skin is a major excretory organ for wastes - the heat - induced perspiration cleans the accumulated residue of dead cells, rancid oils, bacteria and perspiration wastes.
The warming of saunas and hot tubs improves blood flow and lowers blood pressure, kills disease organisms and inhibits cancer growth.
Levels of hormones such as thyroid stimulating hormone, adrenaline, noradrenaline, growth hormone and renin are increased.
While some gerontologists have suggested that higher heat may increase free radical production in the body, such concerns appear unfounded.
The maximum lifespans of humans in warm areas of the world are similar to those in cold areas. Also, many cold-blooded reptiles are short-lived while birds such as crows with temperature of 105 to 110F can live over 90 years.
Although concerns are often raised about the effect of heat and water on the skin, most of these problems are due to overuse of saunas and hot tubs, and to detergents and disinfectants used in the water.
Also, sometimes improperly cleaned hot tubs have bacteria which produce "hot tub itch".
It is reputed the in the 5th century B.C., Scythians north of the Black Sea used steam as a ritual for purification of the body and soul.
Hot rocks were carried into a teepee-like steamhouse and plunged into water creating the steam for bathers.
In Rome, the first public bathhouses were constructed during the reign of Augustus in 20 B.C.E.
The painting at the left is an 18th century artist's conception of women bathing in the baths at Rome.
Building of baths reached its climax in 217 C.E. with the completion of the baths of Caracalla. This 33 acre complex could accommodate 18,000 bathers at one time and featured gigantic bathing facilities offering hot-air and hot-water bathing, massage rooms, gymnasia, gardens, theaters, and even libraries - its ruins remain a tourist attraction today.
The Finns developed the modern type of steam bath with the sauna (pronounced "saw-na") and profoundly believed that the sauna purged the body of impurities and emotional fatigue.
Traditional Finnish saunas are housed in a wooden building built of logs and heated by a wood-burning stove called a "kula". The purist Finns hold that any and all time in the sauna must be considered leisure time and sacred territory - in which to meditate and relax - or at the most quietly socialize.
Starting Sauna and Hot Tub Use
Some cautions are necessary when beginning hot tub and sauna use.
Use a heat level that you can tolerate - with time there is a tendency to increase the temperature (you start feeling cold in a sauna at 160 degrees F).
But let your body adapt over several weeks to the use of higher temperatures and longer times.
Start with low temperatures and short times of heating. Do not eat for 2 hours before heating your body. You should not raise your body temperature above about 105 degrees F - even after becoming acclimated to the sauna.
Red blood cells begin to harden at 117 degrees F (48 degrees C) which can impede their passage through capillaries.
Pregnant women should be especially cautious and avoid long-lasting saunas and heated baths which may harm the fetus.
The maximum lifespans of humans in warm areas of the world are similar to those in cold areas. Also, many cold-blooded reptiles are short-lived while birds such as crows with temperature of 105 to 110F can live over 90 years.
However, a study of Finnish women - of whom 98.5% use saunas while pregnant - found common birth defects to be among the lowest of any country in the world.
In males, sperm numbers fall for a week after sauna use but recover in 5 weeks. In cases of suspected male infertility, excessive heat should be temporarily avoided.
Persons with hereditary pyropoikilocytosis, a rare congenital disease observed in patients of African extraction, possess unusually sensitive red blood cells that can be damaged by temperatures as low as 107 degrees F and should be especially cautious.
Alcohol use coupled with the heat of a sauna or hot tub can cause extreme vasodilation.
This combination can lower blood pressure to the point of fainting and unconsciousness. Inebriated hot tubbers have been found after several days of slow cooking in tubs.
After the bathing, let your body cool slowly down- for the same reason as after vigorous exercise - to allow your vascular system to readjust to normal function. The traditional Finnish sauna of 200-210 F is very hot and the steam from the water poured on the rocks causes profuse perspiration.
After the sauna, allow the body to cool slowly - wrap it in a towel if necessary.
Cold showers should not be taken for at least half an hour.
Mineral spas are much the same as hot tubs - except the highly mineralized water bring minerals to the skin surface. Some of the beneficial effects of mineral baths may be the uptake of minerals into the body.
