Acne Treatment - Environ Skin Care Products

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Acne Treatment - Environ Skin Care Products

By Dr. Des Fernandes

"Acne is the formation of sebaceous follicle abscesses created in follicle plugging comedos formed by abnormally inflammatory sebum and increased intra-follicular epithelial flaking in response to the activity of abnormally sensitive sebocyte testosterone nuclear receptors."

This abnormal sensitivity can be blocked out by a female hormone in females only, yet in both genders the abnormal quality and amount of sebum as well as the increased flaking of the sebaceous follicle can be normalised by the use of vitamin A. Vitamin A has repeatedly been described as the normalising vitamin. This is what will be required to keep acne clear and normalize the activity of the sebaceous glands.

I have often wondered why such high doses of vitamin A would be required to cure acne as in the normal 120mg/kg cumulative dose prescribed for Roacutane. My own thoughts are that it is because of the special nature of the sebum producing cells, also called sebucytes and the intricate mechanisms of the retinoid nuclear receptors.

Sebucytes are so called holocrine cells. In other words the entire cell and its contents are shed when the sebum is set free. To normalise the sebucyte functions means that every successive generation of cells has to be exposed to high levels of both all-trans retinoic acid (stimulating the RAR receptors) and 9-cis retinoic acid (stimulating the RXR receptors where the testosterone will also be active). Because these nuclear receptors regulate themselves with regards to their numbers, level of activity and because they are the central mechanism for the production of other healthy cell receptors (which will include the other testosterone receptors in the sebucytes), this mechanism must be fed with vitamin A in a form which the cells can turn into the active stimulating molecules (ligands) constantly and in adequate quantity.

Studies on Roacutane show that the high doses taken by mouth produce larger quantities of the all-trans retinoic acid through the liver metabolism, providing excessive amounts of both the active vitamin A molecules (ligands) in the sebucytes, active on both the vitamin A receptor systems. Through trial and error it was learned that a specific cumulative dose of 120mg/kg over 4 to 6 months will result in a cure of acne in about 85% of patients.

Physiologically acceptable levels of vitamin A are unlikely to cause this "receptor toxic" effect of the cumulative doses of Roaccutane/Isotretinoin. Such physiological levels DO, however, improve sebum production to more normal quality and quantity and reduce the excessive sebum follicle flaking - and therefore offer a powerful "receptor modulating" effect. Naturally, should the vitamin A supply to these cells be stopped, the acne-genic sebum production and flaking will come back.

So how can this approach be at all successful to cure acne? Probably through the biological genetic clock mechanism. We know through observation that acne "burns out" in most cases even if nothing is done to treat it. Obviously genetic mechanisms, which are still mysterious, cause the abnormal testosterone sensitivity to stop at some point; and the acne then stops. In men this generally happens around 20, and in women around 28.

A topical retinoid application (ideally formulated as Environ is) can therefore be very successful to control the sebum production and epithelial cell behaviour of sebaceous follicles, while the disease runs a natural course to its designated "genetic end point." It is tempting to think that providing a normalised cell differentiation mechanism through the vitamin A stimulation will hasten this natural end of the disease, but that is purely based on logical thought rather than evidence.

Understanding these mechanisms clearly spells out that acne treatment requires the clearing of the lesions of the skin (because that is the most immediate problem and the crisis for the patient/client), but that specific alteration of the function of the sebucytes needs to be addressed in the long term if a cure is to be effected. I am convinced that the need to "poison" the receptor systems with massive doses of an active vitamin A ligand such as Isotretinoin can be avoided with the advent of enhanced penetration techniques which the DF machine offers.

Dr. Des Fernanades

Dr. Fernandes is the Chief Medical Advisor for Environ Skin Care and Vivida SA. He remains at the forefront of highly advanced research in topical vitamin application. His bold combination of vitamins A, C, and beta carotene, administered safely and effectively with the Environ® Ionzyme DF machine which promotes advanced penetration, has produced significant results.

Dr Fernandes designed the Environ® ROLL-CIT specifically for percutaneous collagen induction (mesotheraphy) and created a company to market it. His range of skin care products, marketed under the name of Environ®, are formulated to deal with vitamin depletion from sun and photo-exposure.

For more information please visit www.environ.co.za or call (877) 377-6227.