Complaints & connections · borters.ch
Not a question of hygiene but of hormones, sebum and bacteria — and almost always well treatable.
Also known as: acne · acne vulgaris
Open in the tool — with search and all the links →This compilation is for information and replaces neither medical diagnosis nor treatment. If you have symptoms, see a doctor.
Four things come together in the sebaceous gland: more sebum than usual, a keratin-plugged opening, bacteria that thrive there, and inflammation around it. The driver is androgens, the male sex hormones that women have too. That is why acne mostly starts at puberty and why it sits where the glands are dense: forehead, nose, chin, back, chest. What it is not: a matter of cleanliness. Frequent, harsh washing tends to make it worse, because it damages the barrier. What it is also not: purely cosmetic — inflamed nodules leave scars, and scars are hard to treat, whereas starting treatment early is easy. In adult women, especially with acne on the chin plus irregular bleeding or increased body hair, a look at the hormones is worthwhile; PMOS is then one of the possibilities. On food the picture is soberer than the reputation: a link with milk, above all skimmed milk, and with heavily sugared food is described, but weaker than many guides claim. Chocolate alone has not been convicted.
Stubborn acne on chin and jaw in a woman, together with long or absent cycles, is a reason to look at the hormones. The condition has been called PMOS since 2026 and PCOS before that.
Painful, deep lumps in armpits, groin, on the buttocks or under the breast that keep coming back in the same place are an illness of their own. It is not a question of hygiene — and the earlier it is treated, the less it scars.
Twice a day with a mild cleanser is enough. Alcohol toners and scrubs irritate the barrier and increase redness without reducing acne.
Squeezing turns an inflamed spot into a deeper one. The scars that stay with people for decades mostly arise this way.
Acne often outgrows itself, scars do not. With inflamed nodules, seeing a dermatologist is the single most effective step.
The link is described but weak. An eight-week trial is fair; if nothing changes it belongs stopped rather than tightened.
Irregular bleeding, increased hair growth and acne together are a pattern, not a coincidence. It is worth naming it as one.
Benzoyl peroxide kills the bacteria in the oil duct, retinoids loosen the horny plug, antibiotics damp the inflammation. Isotretinoin shrinks the oil gland itself and is the only one acting on the cause. All need weeks — it shows after six to eight.
Almost all teenagers have acne at times; in about twenty to forty in a hundred women it stays or begins in adulthood. Every treatment needs six to eight weeks before anything shows — the first two weeks say nothing.
Benzoyl peroxide bleaches towels, pillowcases and coloured hair — use white linen and start at low strength every second evening. Retinoids often make the skin look worse for the first four to eight weeks before it improves; they are applied in the evening, a pea-sized amount for the whole face. Topical antibiotics always belong together with benzoyl peroxide, otherwise resistance develops. Doxycycline is taken upright with plenty of water and not together with milk, calcium, magnesium or iron — these bind it.
One reason lies in the treatment: doxycycline, isotretinoin, the retinoids and, more mildly, salicylic and fruit acids make skin light-sensitive; with doxycycline little sun is enough for sunburn, also in the shade and behind glass. The other lies in the skin: the dark marks after a healed spot are pigment, and UV light makes them darker and keeps them longer. Both lead to the same conclusion — daily sun protection on the face, at least SPF 30, as a gel or light fluid rather than a rich cream. The sunbed and letting it heal in the sun reverse after a short time: the redness vanishes into the tan, and the acne comes back stronger afterwards.
Dry lips, eyes and nose in almost everyone — lip care belongs with it from the start, and contact lenses often become uncomfortable. Blood lipids and liver values are checked during the course; a worsening at the beginning is common. The substance severely harms an unborn child, even in small amounts and even in the first weeks — which is why reliable contraception throughout the treatment and for one month beyond it, along with pregnancy tests, belongs with it. Which form of contraception that is, you decide yourself; that one has to be there is decided by the substance. If mood changes: raise it, do not sit it out.
If insulin works less well, the pancreas releases more of it — and that surplus lowers SHBG in the liver, the protein that binds testosterone. Less SHBG means more free testosterone, and more free testosterone means more sebum. This is the path along which sugar, cycle and skin are connected, and it explains why exercise works here through insulin action and not through weight. In PMOS, formerly PCOS, this very path is why the word metabolic stands in the name.
Mornings: wash gently, light moisture, sun protection. Evenings: wash gently, the prescribed treatment, moisture on top. Washing twice a day is enough. And only one new thing every two to three weeks — otherwise you cannot tell afterwards what worked and what irritated.
Five per cent tea tree oil — one part oil to nineteen parts carrier oil, or a ready-made gel — dabbed onto the spot with a cotton bud, once or twice a day.
Blackheads are not dirt but discoloured keratin. They are the basic form — without them it is more likely something other than acne.
Red, raised, tender. The deeper and more painful, the likelier a scar — which is the reason to treat early rather than wait.
If an adult woman’s acne sits mainly along the jaw and shifts with the cycle, the hormonal share is larger. Testosterone and SHBG are then worth measuring.
Especially on darker skin. These are not scars but pigment — they fade over months, faster with sun protection and without squeezing.
Helmet, rucksack straps, tight collar, heavy cover-up: pressure and occlusion increase plugging. That explains acne in unusual places.
Compared with benzoyl peroxide in studies; it works more slowly but irritates less.
The link with highly processed carbohydrates and milk is described in studies, but varies greatly between people.
Burdock root is the traditional skin remedy of folk medicine, inwardly as a decoction and outwardly as a wash. Barely studied — the use is old, the evidence practically empty.
Drunk as a course over four to six weeks, traditionally for “blood cleansing”. What measurably happens is more urine — no more, and saying it that way is more honest than the old word.
Common as a facial steam bath. With inflammatory acne hot steam is not comfortable for every skin, though — daisy-family allergy ruled out.
Compared with benzoyl peroxide in studies; apply spot by spot, never undiluted over large areas.
The Stomach meridian runs across the face — which is why TCM assigns spots on chin and cheeks to the digestive area. Today’s explanation runs through hormones and sebum.
Spicy, fried food and alcohol count as “heating” and are avoided with acne. Only one of these is studied: milk and heavily sugared food are linked with more acne.
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