Acne or pimples is a skin condition characterized by appearance of ‘whiteheads’, ‘blackheads’ and ‘inflamed red pimples’ or ‘zits’.

People of any age can get acne, but it is the most common among adolescents. Nearly 85% of adolescents & young adults in the age group of 12-24 develop acne. Acne is normally not seen after the age of 35 but still some may continue to have acne in their 40’s and 50’s.

Acne is the disorder of skin’s sebaceous glands that result in blocked skin pores commonly called pimples. Hair is formed inside the skin by hair follicle. Small glands located around hair follicle called sebaceous (oil) glands produce an oily substance called sebum. Sebum seeps on to the skin surface through the opening of the follicle which keeps skin lubricated and helps in removal of old skin cells. Acne occurs when sebum is not able to pass through the hair follicle. Skin cells lining the follicles shed too fast and clump together, blocking up the follicles’ opening so sebum can not pass through. The mixture of sebum and cells allows bacteria to grow. The blockage is called plug or comedone.

The comedone or plug can be Closed; with white top (Whiteheads) or Open having black top (Blackhead).

The bacteria commonly involved with acne produce chemicals and enzymes that can lead to redness with swelling (inflammation). When the inflamed lesion is not able to hold its contents, it bursts and spills the bacteria, sebum and dead cells on to nearby skin. This further helps in spread of the acne.

Acne /pimples occur most on face, neck, back, chest & shoulders because ‘Pilosebaceous units’ (i.e. hair follicle + sebaceous gland) are biggest and most abundant on these areas. However, acne may even appear on abdomen, arms, legs and buttocks.

According to modern medical science Acne can be caused by a number of factors including :

•  Male sex hormone i.e. androgens increase among both boys & girls during puberty. More androgens result in enlargement of sebaceous (oil) glands that lead to more sebum production. A high level of these hormones is the most important cause of Acne.
•  Hereditary or family (parents’) history.
•  Hormonal changes among females due to: menstruation, pregnancy, contraceptive pills.
•  Prolonged stress
•  Greasy make up
•  Drugs like- androgens, lithium and barbiturates.
•  Environmental pollutants, irritants or increased humidity.
•  Pressure from bike helmets, tight collars or backpacks

• White heads
• Black heads
• Small pinkish bumps (Papules)
• Pus filled lesions (Pimples)
• Big, hard, painful skin-deep lesions (Nodules)
• Deep, pus filled lesions (Cysts) that may lead to scarring.

According to Ayurved, the problem of Acne or pimples develops among the youth & originates due to the vitiation (abnormality) of Kaph & Vat along with Rakt. This concept can be easily understood if correlated with the modern day knowledge on causes of Acne, in the following manner:

- Hormonal changes in blood is a sign of abnormality in rakta,
- Excess sebum secretion is a result of abnormal Kapha,
- The excess shedding of skin cells and stress relates to abnormality of vata, and
- Bacterial infection leading to redness, swelling and pus formation is a combined effect of vata, kapha & rakta.

Treatment

Acne is not a severe health threat and normally subsides after the adolescence but may continue longer in some cases.

In modern Allopathic Medicine acne is usually managed by Dermatologist (skin specialists) and responds well within a few weeks’ medication. Some cases of severe acne may result in scarring if not managed in time. The medication may include: Local medication in form of lotion, creams, vitamin A derivatives or antibiotics and other formulations. Oral medicines include antibiotics, vitamin-A derivatives etc.

Ayurved- the most ancient, experiential and time proven health science advocates the holistic approach in understanding disease and executing its management. The holistic management of Health Problems in Ayurved comprises the three fold scientific approach i.e. through Ahar (Diet), Vihar (Lifestyle/Routione) & Aushadhi (Medicine).

As discussed above Ayurved relates ‘acne’ to abnormal functioning of Vat, Kaph & Rakt hence the holistic management of acne should involve correction of these vitals through Diet , Lifestyle and appropriate external & /or internal Medicines.

• Diet or Food to be avoided -
  -Excess Chilly, Sour or Salted / Spicy food items.
  -Excessive of fried food -Consumption of Fast / junk foods.
  -Intake of liquor In addition minimal consumption of Fish, Egg (yellow part), Urad (Kali dal), Garlic, Onion, Ginger, Black pepper, Khoya based Sweets and Curd is recommended.
  
  
• Faulty Lifestyle or Habits that should be avoided -
  -Excess physical or mental Stress and Anger.
  -Late nights -Excessive exposure to sun specially between 9 am to 4 pm.
  -Staying or spending long hours in humid or polluted environment / climate.
  
  
• Medicines for External application:Ayurved proposes a number of effective medicinal plants & other natural substances that have been documented for benefits in treating acne. Among these some common herbs are:
  
  Neem (Margosa) leaves, Haldi (Turmeric), Kali Mirch (Black pepper), Manjishtha (Indian Madder) etc.
  
  After cleaning the face, paste of any of the above herbs is applied on acne/pimples and gently rinsed off. Lukewarm water should be preferred for cleaning & rinsing. Neem leaves are also useful if their decoction is used for rinsing, washing & bathing.
  
• Medicines of Internal use:A good number of classical & proprietary Ayurvedic formulations based on single or more medicinal plants are beneficial in acne treatment. Since, orally consumed medicines have advantage of reaching & releasing their actives in blood (Rakt), their potential to correct the abnormalities of all vitals (involved in origin & manifestation of acne viz. Vat, Kaph & Rakt) becomes many folds effective.
  
  Notably, as per Ayurved the ideal planning for Diet, Routine & Medicine is highly specific and varies from individual to individual depending upon various factors including Prakriti (one’s physical & mental constitution) & Vikriti (signs & symptoms of physical abnormality).
  
  Therefore, before initiating any external or internal Ayurvedic / Herbal/ Natural medicines it is highly recommended that a qualified Ayurvedic physician is consulted and accordingly the appropriate advice is followed.
  
  Prevention
  
  Absolute prevention of acne is not possible; however the effects of acne can be minimized. Following steps/precautions are beneficial:
  
• Wash the skin gently with any mild cleanser/soap and lukewarm water only once or twice a day. Do wash after exercise or sweating but avoid excessive or repeated rinsing.
• In case of oily hair rinse them daily and comb them back i.e. away from the face.
• Avoid greasy cosmetic or make ups.
• Do not pick, prick or squeeze acne/pimples.
• Avoid rubbing affected skin with scrubs or rough surfaces.
• Avoid repeated touching of face, affected skin or acne with fingers.
• Practice regular meditation, yoga & like measures to manage stress.