Tuesday, August 14, 2012

Is Acne All In Your Brain?

A lot has been written about acne and stress. Some recent research suggests that the kind of stress that causes acne is an inability to express feelings.

Acne and Alexithymia: A Healing without Medication Update

Among the latest avenues for acne research is the interaction between acne and a psychiatric condition known as alexithymia. Literally meaning "without words for describing feelings," alexithymia is a term used to describe some people who have problems expressing their own emotions or understanding the emotions of other people. The problem isn't that emotions are suppressed, but rather that they aren't understood and can't be communicated. Feelings are there, but talking about feelings about is difficult or impossible.

For nearly 50 years, researchers have recognized that alexithymia makes certain kinds of illnesses more likely and makes treating them more difficult. Sufferers of alexithymia often suffer lower back pain, irritable bowel syndrome, asthma, allergies, acid reflux disease, or acne, and often some combination of two or more conditions on this list. Having one of these conditions doesn't mean that you have alexithymia, but having difficulty explaining how you feel seems to make your skin break out.

The Skin-Brain Connection

Alexithymia makes it difficult for people who have it to tell difference between feelings called by emotions and feelings caused by physical health problems. People who have this psychological condition often describe their lives as being out of control. They tend to be grounded in the here and now, seldom indulging in fantasies. But they are usually in physical or emotional pain.

Constant physical or emotional pain affects the nervous system. The sympathetic nerves that control voluntary movements (including tapping the fingers, tapping the feet, rocking back and forth, and so on) become hyperactive. The heart rate accelerates but the output of the heart decreases, resulting in oxygen deprivation all over the body. Inflammatory compounds that reach the skin aren't easily circulated away. Any kind of stress is felt in the skin and muscles more rapidly and more intensely. Acne is redder and more inflamed than it otherwise might be.

The Skin Has Its Own Brain

The reason that stifled emotional expression is linked to acne is that the skin has its own "brain." Just as the brain releases a chemical called corticotrophin stimulating hormone when it senses stress, the skin releases the same stress hormone when the brain senses stress or the skin senses infection by acne bacteria. The bacteria that cause acne usually aren't particularly damaging in and of themselves. 

The redness and swelling that makes your skin break out is actually the skin's reaction to the stress hormone. Corticotrophin stimulating hormone causes tiny packets of histamine, the chemical that induces allergy symptoms, to break open inside the skin. The hyperactive skin also generates immune system chemicals to attack acne bacteria, but the bacteria release chemicals known as chemotactins that redirect the immune system's chemicals to the skin itself. All of this makes the skin more acne-prone, especially in people who endure chronic, unresolved emotional pain.

What Can Be Done About Acne and Alexithymia?

It's beyond the scope of Healing without Medication to suggest methods for do-it-yourself psychiatry. But there are some things you can do about acne that is aggravated by stress.

About 1930, two scientists in the USA noticed two things about people who consumed large amounts of probiotic foods, such as yogurt with live cultures of Lactobacillus. They tended to have lower levels of anxiety and depression, and they also had less acne.

It was over 80 years later that two more scientists, one in the USA and one in Canada, observed that the connection between the brain and the skin is the immune system. 

Probiotics are helpful bacteria, but the immune system is programmed to fight them anyway. If you eat probiotic foods on a regular basis, however, eventually the immune system learns that it doesn't have to attack them with inflammatory chemicals. As contact with probiotic bacteria "trains" the immune system not to attack helpful bacteria, the immune system also learns not to attack essentially harmless bacteria like those found in whiteheads, blackheads, and pimples.

Even if you don't resolve your emotional issues, you can reduce your acne. And that in turn lowers stress. It's one more way probiotics are good for your skin, whether they are in your digestive tract or they are applied directly to your skin. And you might at least save a trip to dermatologist in addition to any trips to the psychologist.

Bowe WP, Logan AC. Acne vulgaris, probiotics and the gut-brain-skin axis - back to the future? Gut Pathog. 2011 Jan 31;3(1):1. PMID: 21281494 [PubMed] PMCID: PMC3038963 Free PMC Article 

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