The most common adult hormonal fluctuation associated with acne is the menstrual cycle. But that begs the question of why Sally gets acne with her cycle and Louisia does not. One factor is simple predisposition; some of us have oilier skin and higher testosterone levels, but a big factor, too, is stress and your reaction to it.
Role of Stress
Stress increases nervous system activity and adrenalin, which set in motion cascades of hormonal and neurotransmitter repercussions, not the least of which involve the adrenal glands and ovaries. When the adrenal glands get overstimulated, this in turn sends messages that suppress ovarian function. Progesterone and estrogen levels become unstable.
This is mother nature's way of protecting women. She does not want you getting pregnant during times of great stress. This is a huge issue with fertility, too. Women that allow themselves to become stressed out about getting pregnant, have a much harder time getting pregnant. Not to mention the stress they already have from modern life. This is one reason why acupuncture works so well with fertility and acne; it takes you out of the stress response and into the relaxation response.
What the Face Tells You--The Geographic Distribution of Acne
What is interesting, is that when you see acne that is due to stress alone, with elevated adrenalin, but stable menstrual hormones, it typically presents on the forehead, at the temples, and on the cheeks in front of the ears.
But in young females, when you see dramatic flare-ups in acne the week or so before the period, especially that improves after bleeding, you know there is a relationship to the menstrual hormones, with or without stress as a main factor. In these cases the acne is often alongside the mouth from the cheeks to the chin.
Menstural Hormones vs. Stress Hormones
When we see this pattern of acne, and when we see acne anywhere on the face or back that is dramatically worse premenstrualy, or occurs only premenstrualy, then this points us towards a particular pattern of acupuncture treatment to regulate the Chong and Ren extraordinary channels and herbal therapy that restores balance to the hormones, as well choosing a treatment that clears damp-heat and nourishes the blood in the skin.
On the other hand, when you see acne along the side of the face, in front of the ears up to the temples, especially if it is unchanged through the cycle, it is generally stress induced. %his is a completely different pattern, requiring a different acupuncture and herbal treatment one that clears "damp-heat from the liver and gall bladder channel," using the Dai vessel and points like San Yin Jiao.
Different Pattern, Different Treatment
In my treatment of acne with acupuncture, Ayurveda, and Chinese herbal medicine, I have been very successful tailoring the treatment according to the geographical and temporal patterns of the skin disruption.I have also found that in all cases it is very important to correct errors in the diet, such as the consumption of ice cold beverages that lead to hot stagnation in the stomach, (the stomach's normal function is interfered with by cold things, and it overheats in response to compensate, or just fails to work properly at all, --to know if this is a factor look at your tongue and see if there is a thick greasy coat, especially a dark one).
So each pattern will require different acupuncture point locations, and in the case of pre-menstrual acne, you must treat twice a month, just before ovulation and a week to 10 days before menstruation. If there are cramps and other problems with the bleeding we may do acupuncture treatment or cupping with the bleeding.
Herbal prescriptions are tailored in the same way. For severe cases of cystic acne on the face and or back, unrelated to the cycle, and/or in men, I always use Neem Plus, a product that contains Neem extract (not the whole leaf, but the leaf that has been cook with triphala, the tradtional and correct way, to reduce toxicity and maximize absorption and make it safe for long term use, otherwise Neem will aggravate Vata and Kapha due to its very strong cold energy).
If the bowels are not moving, you must address that, which I typically do with diet and Triphala. Good Triphala should taste bitter, astringent, salty, spicy, sour and sweet all at once. But more astringent than anything else.
If there is Liver/Gall Bladder toxicity, I like to address this with Chinese Herb prescriptions, such as Long Dan Xie Gan Tang. I only use Blue Poppy brand herbs in this case, because they are tested for heavy metal and pesticide residue and I can see those reports.
For young women with menstrual irregularity and acne I often use Young Fem, by Ayush, and may combine that with Neem or a Chinese herb formula, depending on the pattern.
The beauty and brilliance of Asian medicine, practiced in the classical way, is that we never treat a disease, we always treat a person.And each individual person has their own unique pattern that is manifesting at this point in time.
The disease is the unhealthy plant growing in the soil. The soil is the person.
To cure the disease in a plant, the first thing you do is check the soil. Then you cut off the diseased branches and spray what medicines you will. But the foundation of a garden is the soil. And my idea of being a physician is that I am a gardener and my patients are the garden.
copyright Eyton J. Shalom, M.S., L.Ac. San Diego, CA All Rights Reserved, Use With Permission Ayurveda, Acupuncture, and Chinese Medicine in San Diego http://www.bodymindwellnesscenter.com