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What Is The Cause And Treatment For Acne Break Outs?
Question: Hi, I am 33 acne started when I was 21 after I drank too much wine. stopped eating milk and it improved but still occurred. I became vegetarian/vegan around 2004. I began to take antibiotics in 2004 including doxycycline, minocycline and lymecycline. I had been off antibiotics for a while although started doxycycline again in Dec 2013. I began taking it irregularly. I then changed my diet and cut out wheat and soya and just ate cooked vegetables. I stopped taking the doxycycline however, a few days later it was hot one night and I broke out in the worst acne ever. I was prescribed azithromycin 500mg for 5 days and also started Clindamycin HCl. a nutritionist suggested I stop eating sugar because of the acid and that led to a massive improvement. however my skin is now hypersensitive - I cant eat anything acidic - i can only eat alkaline foods - everything else gives me acne. i used to be able to eat everything, but now if I do I can get really bad acne that lasts for weeks. i have also just had another massive outbreak i cannot really explain. hope 4 ur advice!
Brief Answer:
I suggest starting reducar...
Detailed Answer:
Hi XXXX
I have gone through your medical history and can say as following:
1. To my opinion, there is no need to continue with oral antibiotics as they will cause side effects.
You can ask to do culture of the pus or pimple secretions to determine the right causative agent and the right antibiotic to use. The long-term use of antibiotics is often associated with antibiotic resistance and gastrointestinal problems.
2. I strongly suggest to discuss with your dermatologist about new treatment strategies. I would like to suggest starting Reducar ( isotretionin) to treat your acne problem . Reducar contributes to the normalization of terminal cell differentiation, and decrease the formation of detritus and makes it easier to evacuate. Due to this reduced production of sebum Reducar is of help in the process of normalization of skin structure. Its a prescription medication and needs to be taken under the careful guidance of your dermatologist.
3. I also recommend avoiding acidic foods such as sugar, starch, milk, fatty acids (especially red meats). I recommend a Mediterranean diet reach in proteins (salats, olive oil,) and fish meat (white meats).
4. I recommend to increase recreational therapies (like sport, yoga etc) which will increase your positive energies and will help to deal with stress.
Hope this was of help!
Wish you a fast recovery!
Dr. Klerida
I suggest starting reducar...
Detailed Answer:
Hi XXXX
I have gone through your medical history and can say as following:
1. To my opinion, there is no need to continue with oral antibiotics as they will cause side effects.
You can ask to do culture of the pus or pimple secretions to determine the right causative agent and the right antibiotic to use. The long-term use of antibiotics is often associated with antibiotic resistance and gastrointestinal problems.
2. I strongly suggest to discuss with your dermatologist about new treatment strategies. I would like to suggest starting Reducar ( isotretionin) to treat your acne problem . Reducar contributes to the normalization of terminal cell differentiation, and decrease the formation of detritus and makes it easier to evacuate. Due to this reduced production of sebum Reducar is of help in the process of normalization of skin structure. Its a prescription medication and needs to be taken under the careful guidance of your dermatologist.
3. I also recommend avoiding acidic foods such as sugar, starch, milk, fatty acids (especially red meats). I recommend a Mediterranean diet reach in proteins (salats, olive oil,) and fish meat (white meats).
4. I recommend to increase recreational therapies (like sport, yoga etc) which will increase your positive energies and will help to deal with stress.
Hope this was of help!
Wish you a fast recovery!
Dr. Klerida
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Hi Dr Klerida,
Thank you so much for your reply.. I wrote this reply to you some days ago.. however I now see my follow up question is not appearing .. so I will repost here..
1) Yes I agree absolutely however it may be difficult for me to get the cultures.. I will ask at a clinic near me.
2) thank you, I may have to resort to Isotretinoin, I have some pills already but it is very strong and I would prefer to find out what the real problem is before overriding it with such strong medication.
3) Yes, I have no choice but to avoid foods at the moment! This is what I mean, something quite serious has happened because I cannot even Touch these foods
4) Yes ok! ;)
Well it seems I am now not able to digest Any acid-forming foods without having an extreme inflammatory response. The difference really does seem to be the acid aspect; sugar and alcohol are the worst, then meat, corn and even too much rice. I really want to understand what has occurred - because I am not just a 'bit' sensitive, I am now 'Super-sensitive' to acid-forming foods and I never was before, so can I ask you also please,
1) Can you explain how the body breaks down acid-forming foods? what is different to the digestion of alkaline-forming foods?
2) why do you think am I having an inflammatory reaction to the digestion of acid-forming food? That is, what is going wrong in the digestion process? Do you think the overuse of antibiotics ruined my ability to digest acid-forming foods?
3) Do you have any more natural ideas as to how I can repair my digestion system? For example I tried taking probiotic supplements for about a month but nothing has changed so far.
I have taken some blood tests, they said all was normal only bit low on vitamin D so now taking a supplement. I also have some other tests (abdominal ultrasound as well as I think a thyroid ultrasound) that I can scan and email.
Someone here recommended an upper digestive endoscopy and a gastric biopsy but I wasn’t sure if it was worth the time..?
Thank you very much for your time,
XXXXXXX
Thank you so much for your reply.. I wrote this reply to you some days ago.. however I now see my follow up question is not appearing .. so I will repost here..
1) Yes I agree absolutely however it may be difficult for me to get the cultures.. I will ask at a clinic near me.
2) thank you, I may have to resort to Isotretinoin, I have some pills already but it is very strong and I would prefer to find out what the real problem is before overriding it with such strong medication.
3) Yes, I have no choice but to avoid foods at the moment! This is what I mean, something quite serious has happened because I cannot even Touch these foods
4) Yes ok! ;)
Well it seems I am now not able to digest Any acid-forming foods without having an extreme inflammatory response. The difference really does seem to be the acid aspect; sugar and alcohol are the worst, then meat, corn and even too much rice. I really want to understand what has occurred - because I am not just a 'bit' sensitive, I am now 'Super-sensitive' to acid-forming foods and I never was before, so can I ask you also please,
1) Can you explain how the body breaks down acid-forming foods? what is different to the digestion of alkaline-forming foods?
2) why do you think am I having an inflammatory reaction to the digestion of acid-forming food? That is, what is going wrong in the digestion process? Do you think the overuse of antibiotics ruined my ability to digest acid-forming foods?
3) Do you have any more natural ideas as to how I can repair my digestion system? For example I tried taking probiotic supplements for about a month but nothing has changed so far.
I have taken some blood tests, they said all was normal only bit low on vitamin D so now taking a supplement. I also have some other tests (abdominal ultrasound as well as I think a thyroid ultrasound) that I can scan and email.
Someone here recommended an upper digestive endoscopy and a gastric biopsy but I wasn’t sure if it was worth the time..?
Thank you very much for your time,
XXXXXXX
Brief Answer:
Following answers on acid-forming foods
Detailed Answer:
Hi back XXXXXXX
Thank you for your follow up queries!
The pH of the stomach is not the same as the pH of our blood. However, foods we eat can influence blood pH.
1. The acid-forming foods are metabolized and the final metabolites can turn the blood pH to acidic. The blood pH will determine the pH of the extra cellular fluid.
The contrary happens when alkaline forming foods are being consumed.
2. When the pH of blood and/or extracellular fluid is changed to acidic, it will induce an immune/inflammatory response. This is associated with increased numbers of inflammatory mediators.
In such environmental changes, there is increased chance to develop various fungal infections.
Skin is one of the organs mostly susceptible to pH changes. When acidic foods are being consumed, there is increased chances to develop various skin lesions.
3. I advise to continue taking probiotics and schedule upper endoscopy.
Dr.Klerida
Following answers on acid-forming foods
Detailed Answer:
Hi back XXXXXXX
Thank you for your follow up queries!
The pH of the stomach is not the same as the pH of our blood. However, foods we eat can influence blood pH.
1. The acid-forming foods are metabolized and the final metabolites can turn the blood pH to acidic. The blood pH will determine the pH of the extra cellular fluid.
The contrary happens when alkaline forming foods are being consumed.
2. When the pH of blood and/or extracellular fluid is changed to acidic, it will induce an immune/inflammatory response. This is associated with increased numbers of inflammatory mediators.
In such environmental changes, there is increased chance to develop various fungal infections.
Skin is one of the organs mostly susceptible to pH changes. When acidic foods are being consumed, there is increased chances to develop various skin lesions.
3. I advise to continue taking probiotics and schedule upper endoscopy.
Dr.Klerida
Above answer was peer-reviewed by :
Dr. Yogesh D
Thank you so much for your reply Dr Klerida,
I have waited a long time to speak to a gastroenterologist about this so I am happy to pay again for more of your time, I just really want to ask you a many questions as I can, I hope we can keep in contact for now until I resolve this problem because your advice is really important to me! as I say, I am willing to pay again for more of your time if necessary.
So, thank you for this information. Actually since speaking to you it seems to have progressed much worse, the other day I got a fungal infection which has never happened before and now I am constantly going to the loo, again which has never happened before, I am quite worried so I am going to a hospital today and will get back to you.
I was actually recommended an upper endoscopy but the procedure/benefits were not explained to me so I was not sure it was worth it.. if you think it is worth it I will book it.
Just wanted to ask you for now, a nutritionist suggested I may have lost my enzymes due to the overuse of antibiotics and it does seem as though I am not digesting my food properly at all anymore. Do you think I may have lost my sucrase enzymes for example?
I also noticed it got better when I took strong detox food like ginger so I am considering I may well have leaky gut? gut dybiosis? have you also heard of SIBO?
and also, do you think I could have low stomach acid? and how could I fix these things?
I just bought some enzymes from the pharmacy - pepsin, amylase, lipase and protease, however I think my problem is with digesting sugar (maltase and sucrase) and acid foods in general.. does this sound a reasonable diagnosis to you? do you know which enzymes I would to break down acid-forming foods again??
With thanks for your time,
I have waited a long time to speak to a gastroenterologist about this so I am happy to pay again for more of your time, I just really want to ask you a many questions as I can, I hope we can keep in contact for now until I resolve this problem because your advice is really important to me! as I say, I am willing to pay again for more of your time if necessary.
So, thank you for this information. Actually since speaking to you it seems to have progressed much worse, the other day I got a fungal infection which has never happened before and now I am constantly going to the loo, again which has never happened before, I am quite worried so I am going to a hospital today and will get back to you.
I was actually recommended an upper endoscopy but the procedure/benefits were not explained to me so I was not sure it was worth it.. if you think it is worth it I will book it.
Just wanted to ask you for now, a nutritionist suggested I may have lost my enzymes due to the overuse of antibiotics and it does seem as though I am not digesting my food properly at all anymore. Do you think I may have lost my sucrase enzymes for example?
I also noticed it got better when I took strong detox food like ginger so I am considering I may well have leaky gut? gut dybiosis? have you also heard of SIBO?
and also, do you think I could have low stomach acid? and how could I fix these things?
I just bought some enzymes from the pharmacy - pepsin, amylase, lipase and protease, however I think my problem is with digesting sugar (maltase and sucrase) and acid foods in general.. does this sound a reasonable diagnosis to you? do you know which enzymes I would to break down acid-forming foods again??
With thanks for your time,
Brief Answer:
SIBO due to antibiotics use..no enzyme deficiency...tests advised
Detailed Answer:
Hi back XXXX
Thank you for trusting us in giving second opinion over your actual health problems. I'll try my best to help you find out the right solutions and get improvement of your actual symptoms.
I still think you should run upper endoscopy to further evaluate the condition of your upper GI tract and measure the pH of the stomach through a special examination called esophageal-pH-test. If the pH of stomach will be resulted low, then, antacids and PPIs are recommended to start.
It is true that when antibiotics are used for long-time, the normal bacterial flora will be altered. The final result will be SIBO (small intestines bacterial overgrowth) or gut dysbiosis. In such cases, treatment consists of :
- probiotics
- stopping the use of antibiotics
- diet changes
With regards to fungal infection, I'd advise to run confirmatory tests including:
- culture of stool for candida
- culture of throat swab for candida
Depending on the results, anti-fungal treatment will be advised.
I do not think that the use of antibiotics could lead to low enzymes levels. It is more related to altered bacterial flora, which is also very important in breaking down and digestion of foods. On the other hand, carbohydrates malapsorption might trigger or is often associated with SIBO.
Hope it answered to your queries!
Dr.Klerida
SIBO due to antibiotics use..no enzyme deficiency...tests advised
Detailed Answer:
Hi back XXXX
Thank you for trusting us in giving second opinion over your actual health problems. I'll try my best to help you find out the right solutions and get improvement of your actual symptoms.
I still think you should run upper endoscopy to further evaluate the condition of your upper GI tract and measure the pH of the stomach through a special examination called esophageal-pH-test. If the pH of stomach will be resulted low, then, antacids and PPIs are recommended to start.
It is true that when antibiotics are used for long-time, the normal bacterial flora will be altered. The final result will be SIBO (small intestines bacterial overgrowth) or gut dysbiosis. In such cases, treatment consists of :
- probiotics
- stopping the use of antibiotics
- diet changes
With regards to fungal infection, I'd advise to run confirmatory tests including:
- culture of stool for candida
- culture of throat swab for candida
Depending on the results, anti-fungal treatment will be advised.
I do not think that the use of antibiotics could lead to low enzymes levels. It is more related to altered bacterial flora, which is also very important in breaking down and digestion of foods. On the other hand, carbohydrates malapsorption might trigger or is often associated with SIBO.
Hope it answered to your queries!
Dr.Klerida
Note: For further follow up on digestive issues share your reports here and Click here.
Above answer was peer-reviewed by :
Dr. Prasad
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