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ScienceDaily (Feb. 7, 2008) — Chemical peels using either alpha-hydroxy acid or beta-hydroxy acid are both highly effective in treating mild to moderately severe facial acne, researchers at the Saint Louis University School of Medicine have found - the first study to compare the two different types of acid peels as therapies for the skin disorder.

Peels using beta-hydroxy acid (or BHA) had slightly fewer side effects and results that lasted a bit longer than did peels using alpha-hydroxy acid (or AHA), the study found. But overall, both types of treatments were similarly effective in reducing lesions caused by acne vulgaris, the medical term for common facial acne, which affects some 85 percent of all people 12 to 24 years old.

“This is good news for the millions of Americans who suffer from mild to moderately severe facial acne,” said Dee Anna Glaser, M.D., vice chair and professor of dermatology at the Saint Louis University School of Medicine. “This provides more options for patients and doctors to chose from when it comes to tailoring a treatment program for each individual.”

AHA (which is also called glycolic acid) and BHA (also called salicylic acid) are frequently used by physicians to induce light skin peels, which help treat fine lines and wrinkles, acne and uneven texture and coloration. The peel removes a very thin layer of skin, which in turn promotes the growth of new, smoother skin.

Both types of acid are derived from organic compounds. AHA has the same active ingredient that’s found in sugar cane juice, sour milk and tomato juice, while BHA is derived from salicin, which is closely related to the active ingredient in aspirin.

The study involved 20 patients with moderate to severe facial acne. Their average age was 24 years; 13 were women. Each was treated with a chemical peel every other week for six weeks, with follow-up visits one month and two months after the last treatment.

Each treatment involved applying alpha-hydroxy acid to one side of the face and beta-hydroxy acid to the other side. Neither the patient nor the person who later evaluated them were aware which side of the face had been treated with which acid.

The study found that both types of chemical peels significantly reduced acne lesions within two weeks of the first treatment, and patients continued to see a reduction in lesions through the first follow-up visit a month after the treatments had finished.

At the time of that first post-treatment visit, 94 percent of patients were judged to have had good or fair improvement in acne lesions on both sides of the face, as assessed by a blinded evaluator.

A month later, at the second post-treatment visit, 81 percent of the sides of the face treated with beta-hydroxy acid still showed good or fair improvement in acne lesions, compared with 75 percent of the sides of the face treated with alpha-hydroxy acid. However, the sides of the face treated with alpha-hydroxy acid had developed a few new lesions - though this was judged not to be significant.

In general, both types of acid peels yielded the same side effects, which typically decreased over the course of the treatments. The most common of these included redness, peeling and scaling - though with alpha-hydroxy acid, the degree of the peeling and scaling was judged to be greater.

The research is published in a recent edition of Dermatologic Surgery.

In addition to Glaser, other researchers involved in the study included Katherine Flanagan, M.D., and Edward Kessler of the Saint Louis University of Medicine; Christina Chia, M.D., of the Yale University School of Medicine; and Cynthia Rogers, M.D., of Port Saint Lucie, Fla.

http://www.sciencedaily.com/releases/2008/02/080206121508.htm

Diet, though not a direct cause of acne, does have an indirect effect on acne. That is why so many ‘acne cures’ recommend dietary changes in conjunction with whatever else they are advocating.

Because diet has an indirect effect on acne, individuals will get variable results when changing what they eat. This is because we all metabolize foods differently. Some people may be more sensitive to certain foods, and so those foods will have a greater impact on their acne than others that don’t have those metabolic issues.

For example, skin with a tendency for acne has been shown to be insulin resistant. Insulin is a hormone that regulates carbohydrate metabolism, as well as playing a role in protein metabolism and fat metabolism. Insulin regulates the way our cells use the available energy in the bloodstream - so insulin makes the liver and fat cells (adipose tissue) take in some of the glucose in the bloodstream and stores it as fat.

People with insulin resistance don’t respond to the normal amounts of insulin released in the body. Because the regulation of blood glucose levels (which insulin ultimately is responsible for) is so important, the pancreas starts producing more insulin when the liver and fat cells don’t respond. Blood glucose levels can build up if the body still doesn’t respond.High levels of insulin can cause high blood pressure, fluid retention, and can lead to type 2 diabetes.

Thus, for those with insulin resistance, poor quality carbohydrates such as white bread, sugar, and sugary foods, may be a problem. These types of carbohydrates are digested quickly and enter the blood stream rapidly. Normally, insulin would trigger the body removing those excess blood sugars into cells. But with insulin resistance, they hang around longer in the blood, as well as causing the body to have high levels of insulin in the blood.

This is important for acne sufferers, particularly women, in that excess insulin can cause higher levels of male hormones. These androgen hormones have long been implicated in acne. They increase the oil production of the sebaceous glands, which leads to clogged pores and provides a breeding ground for the acne bacteria.

In another study, researchers implicate the high levels of refined carbohydrates (such as bread and cereals) in teenage acne. Following a similar rationale, they suggest that high levels of blood sugars increase the levels of insulin and insulin-like growth factor (IGF-1), which leads to excess production of male hormones. These male hormones then trigger acne outbreaks.

And as well as that, insulin-like growth factor (IGF-1) encourages certain skin cells (keratinocytes) to increase. Keratinocytes are also implicated in acne.

Source: http://www.healthguidance.org/authors/144/Rebecca-Prescott