When your hormones trigger acne

Dear Doc,

I am not comfortable with my face because of pimples that are becoming seasonal. I don’t travel. I keep on scratching my face with the hope that they may disappear. Is there natural medicine for the pimples and black spots?

Lynnette

Dear Lynette,

The most common cause of pimples is acne. Acne is a skin disorder where the pores of the skin get clogged, causing bumps on the skin, that is, pimples. On the skin, there are pores or hair follicles and within them, there are glands which make oils or sebum. Usually, this sebum travels up through the hair follicle to the skin. However, if these follicles or pores are blocked by dead skin, then the sebum builds up causing a small swelling. Skin bacteria can also multiply within the serum build-up, worsening the inflammation. The resulting pimples may have a white part on top (whiteheads/closed comedones), or a black part (blackheads/open comedones), or they may be infected, forming pustules (small pimples filled with pus). Other types of pimples include nodules (large, firm and painful swellings deep in the skin) or cysts (deep and painful swellings that are full of pus, and leave a scar when they heal). Pimples caused by acne usually appear on the face, the chest, the upper back, neck, upper arms and the shoulders.

Scratching, rubbing too hard and squeezing can actually make the pimples worse.

Acne develops as a result of hormonal changes, either within the body (menstrual cycle, pregnancy), or due to outside causes of hormonal change such as due to hormonal medication like birth control medication. Other types of medications can also trigger development of pimples. Genetics, diet, cosmetics, oils from the scalp, stress and climate may also play a role.

There are different medications used to treat acne and they may be in the form of a topical application or tablets, or both. The treatments may be given to kill the bacteria or to reduce inflammation, or to help unplug the pores, or to prevent scarring, or to control the hormones. There’s also a laser procedure that may be used to control acne and other procedures that may be used to manage scarring. Treatments usually take several weeks to months to work, so be patient.

While there are many home remedies suggested for managing pimples, without adequate scientific evidence, it is best to follow the directions from a skin specialist/dermatologist on how to manage the pimples.

Measures to take care of your skin include:

i) Establish a good skincare routine and be consistent with it.

ii) Use the right products for your skin type after advice from a skin specialist.

iii) Use products that are non-comedogenic and are alcohol-free, and avoid irritating skin products.

iv) Wash your face gently twice a day with a gentle cleaner.

v) Keep hair off your face and clean the hair regularly.

vi) Reduce sun exposure and use sunscreen.

vii) Eat a healthy balanced diet and take adequate amounts of water.

Treat any skin conditions early and properly.

How can someone stop spitting while talking? It is very embarrassing and it is interfering with my social life.

Mutiso

Dear Mutiso,

Spitting saliva while talking may happen when you are excited and you are talking fast, and speaking deliberately and at a calm rate reduces the risk of spitting while talking. You can also take a video of yourself speaking or practise in front of a mirror so that you can see at what points you spit and be able to address this, to improve your confidence while speaking.

Spitting while talking may also happen because you are making more saliva. This can be triggered by eating spicy or acidic foods, starchy or sweet foods, mouth infections, hyperacidity and reflux or due to pregnancy. It can also be caused by some seizure medicines or medicines for schizophrenia. It can happen if the mouth muscles are a bit weak due to a nerve problem.

If being deliberate about how you talk does not reduce the spitting, then it would be good for you to be reviewed by a dentist so that any underlying cause can be identified and treated. Any underlying issue should be addressed such as reducing intake of sugary foods or drinks; treating gum disease or reflux. Medication may also be prescribed to reduce the amount of saliva you are making.

Dr Flo,

I started eating stones three years ago when I was pregnant and I never stopped after giving birth. Every day I have to eat them, otherwise I feel like I am lacking something. What could be my problem and how do I stop?

Dear reader,

When you crave for and eat something that is not considered a food item or has no nutritional value such as stones, it is called pica, and it is considered an eating disorder.

It may be triggered by iron deficiency, zinc deficiency, malnutrition or pregnancy. It may also be part of obsessive-compulsive disorder (OCD). OCD is a disorder where a person has recurrent unwanted thoughts, ideas or sensations (obsessions) that cause severe anxiety and make him/her feel the need to do something repeatedly (compulsion).

Eating stones is not advisable as it causes damage to the teeth and infection with bacteria, worms or other parasites. It can also lead to constipation or intestinal blockage and cause tears in the lining of the digestive tract. It can also interfere with eating healthy food.

To manage it, you need to be examined for iron and other nutrient deficiencies, and if present, they should be corrected. Chewable nutrient supplements, if needed, may be a healthy alternative to eating stones. You also need to maintain a healthy balanced diet and have a dental checkup. You may also benefit from support from a mental health professional, to assist with regulating your behaviour.

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