The Skinny On Skin: Zap The Zits and More

It seems to happen just when the prom is a week away, or on the day before your date with the most popular gal or guy in school.   You get a pimple big enough to get its own name, like Everest or Matterhorn.  What can you do about it?  Could it have been prevented?  If you’re a teenager reading this, and suffer from acne, read closely as there may be an answer to your dilemma. If you’re a parent, maybe you could pass this on.

Acne has a bunch of names, but we bet you could add your own.  Basically, it’s an inflammation of the sebaceous glands, those that make sebum, the stuff that acts as a lubricant for the hair and skin and offers some protection against attackers like bacteria.  The “stuff” consists of fat, keratin, and cellular material that ooze from the follicle, the hair tube to which the sebaceous gland is attached.  As skin cells lining the follicle die off, they are pushed out by a growing hair.  Sometimes too much keratin interrupts this process and the dead skin cells stick together, clogging up the works.  This is how acne starts.  That thing we call a zit or blackhead is known as a comedone.  This word has nothing to do with comedy—there’s nothing funny about it, especially if it’s yours.

Acne is considered a normal response to abnormal levels of the male hormone testosterone.  Women may experience moderate acne due to hormonal changes associated with female health issues that include pregnancy, the use of birth control pills, and menstruation.   Not that this will make you feel any better, but four out of five people between ages twelve and twenty-four will get acne at least once.  As with most horrendous teenage afflictions, there are risk factors for acne, including some you can control and some you can’t.  You might be able to control bacterial growth by frequent and careful washing and rinsing.   You most assuredly can avoid using steroids to bulk up for a sport, and you can avoid skin irritation from scratching or the constant contact of a telephone against your face.  Genes and overproduction of sebum and hormone activity are not under your direct control.  Stress may or may not be, depending on whether or not you share living space with the Wicked Witch or the kindly Wiz.

Treatment for acne is generally based on reducing skin oil production, hastening skin cell turnover, fighting bacterial infection, or all three at the same time.  Topical treatments can do that, sometimes over-the-counter, sometimes by prescription.  Antibiotics, either rub-on or by-mouth, require an Rx.  For acne that fails to respond to other treatment, there’s an oral drug called Accutane, which is the atomic bomb of acne treatments, with a list of precautions, interactions and side effects long enough to choke a giraffe.  Recently, a slightly less offensive medication, a topical formulation called clindamycin phosphate, was matched head-to-head with an all-natural preparation made from vitamin B3 (as nicotinamide) and phosphatidylcholine (PC).

Remember, previously where we said keratin can clog up the works?  That’s termed hyperkeratinization.  That unwelcome activity was found to be reversed and normalized by using topical linoleic-acid-rich PC combined with nicotinamide’s anti-inflammatory character.  Contrasted to clindamycin in a 12-week, double-blind, randomized study, the PC/B3 compound was better tolerated and slightly superior in outcome (Morganti, 2011).

For more than a few years science has been concerned that bacteria are learning to become resistant to medicine’s barrage of chemical agents.  Concurrently, it’s been accepted that natural villains do not generally grow immune to natural heroes.  In the matter of acne, this was realized about nicotinamide more than a decade ago.  The emergence of resistant pathogens led researchers to look in a direction away from systemic and topical synthetic antimicrobials in the treatment of this condition.  Topical nicotinamide as a 4% gel was discovered to be a potent anti-inflammatory agent without the risk of bacterial resistance and, in fact, showed an 82% symptom improvement rate over clindamycin’s 68% (Shalita, 1995).  But wait, there’s a whole lot more to this.  In order for topical treatments to be effective, they have to get through the skin’s horny layer, the stratum corneum, without causing damage to tissue.  What natural substance can do this without unwanted side effects?  Phosphatidylcholine!

The prime phospholipid from which we are made, phosphatidylcholine renders cell membranes vibrant and alive, an activity lacking which we’d all succumb.  But it’s not only a stanchion; it’s also an escort.  PC helps desirable materials to permeate the skin’s stratum corneum and deliver healing, whether all natural or man-made, the former being preferred.  The higher the concentration of PC, the higher the efficacy of the escorted material (Kim, 2002).  While this holds true for nicotinamide, it also holds for drugs.  Indomethacin is an Rx non-steroidal anti-inflammatory drug (NSAID) used to address the discomfort of arthritis, tendinitis, and bursitis and like conditions.  It’s usually taken orally, but an Indomethacin topical gel made with liquid paraffin and mixed with PC was found to be considerably more effective at crossing the skin’s horny layer than the product that omitted the PC (Fujii, 2001).  Compared to conventional petroleum-based carriers of topical interventions, PC-based carriers improve the effectiveness of drugs used for skin cancer, as well (Romagosa, 2000).

PC as an oral supplement has long been known to attenuate serum cholesterol. In combination with niacin therapy for elevated cholesterol, PC is astounding.  No one ever dreamed that it could pass through the skin and have a similar effect.  The University of Miami’s School of Medicine looked at PC through a creative eye, and applied it topically to the shaved backs of rabbits that were bred to develop hypercholesterolemia and atherosclerotic lesions.  After two weeks’ treatment, investigators noted reduced levels of serum cholesterol and LDL, accompanied by less severe signs of atherosclerosis in the aorta (Hsia, 1996).

The incredible characteristics of real phosphatidylcholine—the kind that forms a liposome—are easier to realize than you might think.  Check out for more PC facts.

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Morganti P, Berardesca E, Guarneri B, Guarneri F, Fabrizi G, Palombo P, Palombo M. Topical clindamycin 1% vs. linoleic acid-rich phosphatidylcholine and nicotinamide 4% in the treatment of acne: a multicentre-randomized trial. Int J Cosmet Sci. 2011 Oct;33(5):467-76.

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*These statements have not been evaluated by the FDA. These products are not intended to treat, diagnose, cure, or prevent any disease.