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April 27, 2012, last updated July 24, 2014

By Alison Turner, Featured Columnist

Tea Tree Oil: An Historical Drink, a Contemporary Trick for
Clearer Skin.
There is room for a bit of confusion with these
three words being tied together: since when does tea come
from trees?  The tea tree is not to be, though easily is,
confused with the tea plant that makes tea the drink, but is a
tree that was named by sailors on the swampy Australian coast
in the eighteenth century, who made a different sort of tea
from the leaves of that tree.  Tea tree oil can be applied
topically to the skin for infections on the skin, on nails, for
athlete’s foot, against ring worm, added to bath water to treat
cough and lung inflammation , and may also reduce acne

In 2007, experts with the Isfahan University of Medical
Sciences in Iran, including  Shahla Enshaieh with Department of
Dermatology,  set off to find “an effective treatment for acne
that is well tolerated by patients.”  They gathered 60
participants with mild to moderate acne, who were randomly
divided into two groups to be treated with either tea tree oil gel
or placebo.  Results showed a “significant difference” in the
improvement of the number of acne lesions in the participants
using tea tree gel versus placebo.  The team concludes that a
“topical 5% tea tree oil is an effective treatment for mild to
moderate acne vulgaris.”  

You could also finagle it into a decent cup of tea, if the
tastebuds of sailors from hundreds of years ago are to be
trusted (though making tea from a topical ointment would be
an impressive feat).

Even Though it Might Be Painful, You Might Have to Just Say
No to Facial Massages.
 What you’re about to read may be hard
to take in, and you may want to ignore it and carry on with the
way things were before; sadly, science suggests that facial
massages may actually be bad for our skin.

In 2002 Drs. Neena Khanna and Siddhartha Gupta from the
Departments of Dermatology and Venereology and Pathology
at the All India Institute of Medical Sciences in New Delhi,  
observed for twelve weeks the skin of over 140 women who
had received facial beauty treatment in three “well-established
beauty parlours” in New Delhi.  

Most of the facial treatment included “vigorous massaging”
with various off the self creams, herbal creams, and creams
with “exotic ingredients, such as gold salts,” steaming of the
face, and the application of a face mask containing adsorbents
and astringents.  

Before the bad news, there were some benefits to these
massages: almost 60% of the women reported a “feeling of
freshness and rejuvenation, while slightly less noted a “feeling
of warmth and tightening of the skin”, and almost 15% state a
delay in “the onset of wrinkles.”  This all sounds great – but
the report continues.

Results showed that in addition to the above-listed benefits,
over 36% of patients developed “puffiness” directly after the
treatment that lasted for 2 to 6 hours; almost 5% developed
“mild dermatitis” (inflammation, redness and/or itchiness) on
the face in 2 to 7 days after the treatment; over 70%
“developed an acneiform eruption after every facial massage.”  
The researchers conclude that despite any “subjective benefits
with facial beauty treatment”, negative side effects occur in
nearly one third of patients receiving facial beauty treatment.  

Let’s look on the bright side: this could mean that instead of a
facial beauty treatment, what we really need is a full body

Skin Problems From the Environment: Chloracne.  

In some cases, acne may not come from under or within the
skin, but from what is around our skin.  Whether it is because
of where we work, where we live, where we happen to be
staying for a long amount of time, or even the kinds of foods
that we eat, the waste or products from chemical processes
could be changing out skin.  Chemicals and other
environmental pollutants can be risky to human health in
several ways, one of which is “chloracne,” a skin disease
caused by environmental conditions that is characterized by
eruptions of blackheads and white heads, cysts and pustules.   

The chemicals and situations causing chloracne are various.  In
2009, experts from Shanghai and Nanjing in China, and
Dessau, Germany, including Qiang Ju with the Department of
Dermatology at the Shanghai Skin Disease and STD Hospital,  
compiled several examples of the development of chloracne.  

One study of 109 people who produced a chemical called
pentachlorophenal, for example, showed that in some areas of
the plant over 95% of the workers had chloracne.  Less
severely, a chemical called Tetrachlorodibenzop-dioxin (TCDD)
is thought to be responsible for the chloracne in about 7% of a
group of citizens in Italy who was exposed after an accident at
a nearby chemical plant.  

Additionally, tainted rice cooking oil in Yucheng, Taiwan, is
believed to be the cause of the 17.5% rate of chloracne in the
surrounding area.  Finally, what may perhaps by the most
familiar example to Americans, a study of nearly 300
Vietnamese veterans who were exposed to Agent Orange
approximately 20 years earlier showed an 11.5% rate of

It is not possible to list all of the feasible sources of chloracne;
however, knowing that the chemicals around us may have
greater consequences than we think, may help us to diagnose
any previously unknown causes of our struggles with
breakouts.  Unfortunately, the report above concludes that
“chloracne appears to be resistant to all tested forms of
treatment.”  We can, however, still attempt to manage
outbreaks of chlorance by preventing exposure to the guilty
chemicals in the first place (or, of course, to limit that exposure
once it has been realized).

Tobacco and Acne: May Your Healthy Skin Go Up in Smoke.  
Smoking causes cancer, smoking stains your teeth, smoking
makes your fellow diners dislike you, smoking may be
associated with heart disease – well, here we go, here’s
another one: smoking may also be associated with acne.

In 2009 a team of experts working out of the San Gallicano
IRCCS (or, in its sexier, Italian full name, the Istituto di
Ricovero e Cura a Carattere Scientifico), in Rome, including Jo
Linda Sinagra with the Pediatric Dermatology Department,  
analyzed how post-adolescent acne in over 1000 women was
affected by smoking.  Amongst these women the Italian team
found “a strong correlation” between acne and “smoking
habit.”  Indeed, the link between smoking and a certain type of
acne, which they called “clinically non-inflammatory,” or APAA,
was so strong that the team suggests that APAA type of acne
may be a “new entity” that could be called “smoker’s acne.”

Perhaps acne will be the straw that breaks the smoker’s pack.

The Immune System Attacks! Thyroid Autoimmunity May be
Associated with Acne
.  It may sound like a grade B horror film,
but it’s true: our immune system can attack our very own
thyroid gland.  The thyroid gland is located above our
collarbones and described by the more poetic members of the
scientific community as “butterfly-shaped.”  The thyroid gland
is responsible for the hormones that help to set our
metabolism, which determines how our bodies get energy from
the foods we eat .  When the immune system attacks the
thyroid gland the potentially uncomfortable condition of
autoimmune thyroid disease may occur, wherein the thyroid
inflames and cannot produce hormones as before.   This
condition can change your metabolism, and may have
produceother symptoms such as constipation, fatigue, hair loss,
missed menstrual periods in the ladies, unexplained weight
gain, depression   and, according to recent research, breakouts
of adult acne.

Autoimmune thyroid diseases are most common in women
between the ages of 40 and 60.   Accordingly, in 2011 a team
of experts from various departments at the Athens University
School of Medicine and the Alexandra Hospital in Athens,
Greece, including T. Vergou with the Department of
Dermatology at the first,  evaluated the association between
thyroid disorders and adult acne in 107 women with acne, and
60 controls without acne.  Results showed a “statistically
significant difference” in the prevalence of positive
antithyroglobulin antibodies (which can lead to the destruction
of the thyroid gland, and are likely to appear only after thyroid
gland swelling and/or injury)  in women with acne versus
those without.  The team concludes that “it is likely that thyroid
autoimmunity might be more frequent in the adult acne patients
and this should be kept in mind when screen women with post-
adolescent acne.”

Think of it this way:  in some cases, acne may be a warning
sign of a more (physically) serious condition.

The National Library of Medicine reports that autoimmune
thyroid diseases are most often hereditary in origin, though
certain drugs and the consumption of iodine may play a role in
the progression of the disease.  Treatment options for
autoimmune thyroid disease include taking synthetic thyroid
hormones.  Some cases may also resolve themselves over time.

Contact Dermatitis: An Acne Scar of Irony.  We work out to
be good to our bodies, right?  We invest time at the gym or on
the trail, and money on the newest clothing that will “breath”
better so that we can work out better.  And yet, all of this time
and money that we invest may actually be stabbing us in the
skin (so to speak). That is, working out may cause eruptions of
dermatitis, which can redden and inflame the skin, or even
make it itchy.  Oh, the cruel, cruel irony.

In 2007, experts Brett Kockentiet and Brian Adams at the
Department of Dermatology at Virginia Commonwealth
University in Richmond, Virginia and the University of Cincinnati
School of medicine, respectively , published a review that
emphasized that the skin of athletes “endures repeated
exposure to trauma, heat, moisture, and numerous allergens
and chemicals.”  

These environmental factors combine with certain genetic
predispositions that may cause allergic contact dermatitis
(ACD) and/or irritant contact dermatitis (ICD).  Incidents and
prevalence of ACD or ICD depend on the type of sport and thus
the various exposures to different types of chemicals (think
about hours each day in a swimming pool, versus cocooned in
hockey gear, versus ballet tights).

A 2000 study was conducted that tried to see how common
contact dermatitis is in athletes in general.  Several scientists
with the Department of Internal Medicine at the University of
Bari Medical School in Bari, Italy,  evaluated the prevalence of
allergic contact dermatitis in a group of people “practicing
sports activities.”  They found that several materials led to
allergic contact
dermatitis, the largest of which were thirorams
(causing over 23% of allergies), mercaptobenzothiazole (over
20%), as well as other chemicals that are in clothing,
equipment, topical medicaments, and creams for massages.  
The team concluded that “close contact with sports equipment
may increase the incidence of allergic contact dermatitis.”  

So how can we take the breakout from working out?  We could
use this as an excuse to never work out again.  Then again,
that could lead to obesity, diabetes, heart disease, and all sorts
of other problems.  If the dermatitis is realized, athletes could
experiment using different materials for their equipment, or, if
at all possible, to cease using that equipment.  Perhaps you
could try running without that sweatband, for example, no
matter how cute it looks. (Read more about the
causes of and
natural remedies for dermatitis.)

Follow the Light for Clearer Skin?  

Getting enough sun is one of those semi-myths about acne (it
seems that in many cases sun simply darkens skin so that
breakouts are less visible); however, in the past couple of
years researchers have used artificial light to treat acne, with
more encouraging results.

In 2009, for example, experts with the University of Kansas
Medical School, including Shaundre Terrell  responded to the
use of photodynamic therapy, a treatment that uses certain
drugs along with light usually to kill cancer cells,  as a
treatment for “inflammatory acne” on patients with lighter skin,
but not with African Americans.  

They proudly claim the first successful case of “blue light
photodynamic therapy to treat moderate inflammatory facial
acne on an African American patient.”  This patient had
allegedly tried several topical treatments against acne, none of
which were successful.  However, after only four treatments
spaced throughout one month of “20% aminolevulnic
acid/blue-light photodynamic therapy” the patient reported
“significant improvement of inflammatory acne lesions” –
indeed, she was “virtually clear of all acne lesions after the
third treatment.”

Another variation of the above sort of light treatment is
“intense pulsed light,” which was studied by Dr. Aparanjita
Kolluru with the New York Medical College, and colleagues from
St. Joseph’s Wayne Hospital in New York, in 2011.   

Their study more specifically looked at rosacea, a “chronic
disease that affects the aesthetic appearance of skin,” seeking
to achieve “optimal reduction in the appearance of rosacea
with minimal effects.”  They used various settings of fluence
(the amount of energy over time) and pulse duration of intense
pulse light treatment on 102 patients with mild to severe
rosacea, with an average of 7.2 treatments.  

Results were encouraging:  80% of patients showed
“reduction in redness,” 78% had “improved skin texture” and
72% “noted fewer acneiform breakouts.”

As of now, these forms of light treatment are not quite as easy
as taking a walk under the sun.  While photodynamic therapy is
a one of the less expensive treatments for cancer, it does cost
between $500 and $800,  which is not small change for most

However, if research and design continues at its current rate,
maybe soon we can all hope to follow the light for clearer skin.

Comment on this article.

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