Acne vulgaris is a skin disease comprised of pustules, papules, and sometimes cysts. Thought to be an overgrowth of a bacterium known as P. acnes, a normal resident of the skin, it is believed to feed off excessive oil or skin that can sometimes be considered a side effect of hormone production or other underlying causes. That understanding of acne, along with other many other etiologies of disease, is rooted in the Germ Theory. This theory was derived by Louis Pasteur not too long ago and it was when we first truly connected the idea that disease itself could be spread not through some spiritual event but rather an organismal one. Mr. Pasteur, a revolutionary in microbiology found that when he boiled broth and it contained an S like neck that prohibited the entry of outside contaminants that nothing would grow, compared to a beaker that was open to the air that following a boiling, became substrate for organisms from the air to seed and grow. It was at this moment in moment in time we were very well equipped to then develop treatments and many preventions for disease because when we understood that if it was a bacterium that had caused disease, we could treat it. This led us to the development of antibiotic therapies. Alexander Flemming first noticed that mold bread mold specifically would inhibit the growth of bacteria around it creating a zone of innovation. He extracted penicillin and then we had the magic bullet of therapies for so many people. My great uncle told me about when he recalled penicillin being invented. Granted he is 98 years old, and his memory may be a bit faded, but he told me how he was very sick for many days and then with one shot of penicillin his illness was cleared up and he was sent home. This is truly a revolutionary story, and the drug itself has saved many others. Now that we have resistant organisms we have had to develop and look for new antibiotics that are quite sophisticated and very effective. It is true that since the invention of antibiotics we have had saved countless lives and things like death rates for infectious disease have dropped significantly, but in the context of treating acne vulgaris, I feel antibiotics in this context, are doing more harm than good. Common treatments for acne include tetracycline, which is applied topically to hopefully knock down bacterial growth and hopefully resolve your skin issues. Unfortunately, many organisms out there are probably tetracycline resistant, and the approach might likely cause the death of bacterium that promote the health of the skin. In my medical opinion, that approach does not stand up to what modern evidence is suggesting, that we must work towards a balance of bacteria on our skin and elsewhere. Although many naturopathic positions will employ antimicrobial agents, often we promote the use of topicals or the dietary inclusion of herbs and things like garlic that are all mildly antimicrobial. I believe I can speak for many of us when we would say our approach is more of something that Pasteur himself admitted was a superior way to approach the management of bacteria. Mr. pasture was quoted in saying that Claude Bernard, a fellow 19th century French biologist, was correct. Louis was speaking to that of a rival microbiologist whose work highlighted the importance of the milieu, or environment of the organism. Today we refer to that environment in which the Organism is growing as its terrain. The way in which our body interacts with microorganisms is profound. Since my graduation I began work as an adjunct professor of microbiology and human disease at the University of Marshall. As faculty there, I have been able to tap into the many resources, as well as hone my understanding of those organisms that cause so many diseases that persist today. The microbiology I teach there is in a healthcare lens, and I work very hard to demonstrate to the students how important terrain is. The book itself that I teach from goes into detail on how terrain that the human body generates for resident microflora is quite complex. It even includes a section describing a vibratory sense that allows communication to pass between bacterial organisms and their host. I like to joke that this is a very important vibe check that we must consider when addressing health. To get the terrain right, it involves the whole system and not simply addressing an area with the abnormal components, but rather those that are most resemblant of our own biology. We produce things like definsins, anti-microbial proteins, which will combat bacteria. We maintain an acid mantle, a low pH, on the skin to inhibit their growth and many other innate immunological defenses that can control a healthy microbiome.
Although I wouldn't ever advocate against the use of mild acids or some antimicrobial agents to treat acute illness, these illnesses will continue to recur if the host is not in a state of optimal health. It understandable that for many, the idea of obtaining optimal health through natural means seems difficult. Having the faith that you, like everyone, has the innate ability to self-heal is a first step in the healing process. While some conventional methods of treating your acne co might include a medication that is toxic enough that you must take multiple forms of birth control to assure that you won't poison a potential child, Naturopathic Medicine methods include reaching a state of health where it is reflected on the skin and increased fertility might be an unintended consequence. When it comes to over the counter topicals or skin care routines that are sold out commercially to promise clear skin, these can also be more harm than good. I do have my own recommendations for topical medications, but usually a very simple oil of nutritionally dense and antioxidant rich components is all I would potentially suggest. That is in large part because my own skin care routine consists of nothing at all but living a naturopathic principled lifestyle. Acne still occasionally appears in my life, but as a sign of healthy detoxification of previous foods I have consumed. If at a wedding I choose foods outside my normal dietary choices, I might expect a blemish or two that thankfully heals rapidly. Choosing to have balance is always important, and the approach that I take medically reflects that. Maintaining a healthy environment, or milieu, at home is the most important and first step, while choosing wisely where you go to enjoy yourself another. Although this can seem out of reach for many, I can assure you that I remain very humbled how some very simple foods and an occasional botanical concoction can do so many things for my patient population and myself. If you are interested in learning more about these principles, reach out because there is always room for you at this practice.
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