Embarrassing? Maybe. Common? Perhaps more than you think.
Hidradenitis Suppuritiva is an acne related condition involving recurrent boils and cysts in the apocrine areas. These especially include under the arms around the breasts, in the groin and buttock areas. It may be confined to just to just a few small cysts, or develop into large cysts with multiple training points. At its worst, they can be painful and make it difficult to carry out ordinary activities.
This condition is sometimes treated with injected steroids, topical or oral antibiotics, and surgical drainage. More radical treatment includes cutting out the entire affected area into the deeper fat or down to the fascia. That kind of surgery can require a long recovery time.
More recently, powerful immunosuppressants known as Biologics have been used with some success. Unfortunately, these carry a very large price tag both an actual dollar cost, and in the possibility of leading to development of infections like tuberculosis, or cancers like lymphoma.
I’ve been successful in improving the condition the patients with Hidradenitis using a similar approach to that which I use in acne. That involves correcting digestive and hormonal imbalances, and removing toxins from the skin. My report of success met with considerable resistance at the Second International Meeting of the Hidradenitis Suppuritiva Foundation in San Francisco some years ago.
Another unintended consequence of acne blogs and information you may find on the Internet on acne related sharing sites, is that you will not have enough information about the individuals who report either success or failure with various treatments they suggest to understand whether those treatments will be successful for you.
Although there are many common features of various illnesses such as acne, there are also many individual variations in both genetics and exposure history. As a result, Even if the report of the success after a particular novel acne treatment is accurate, it still may be impossible to know whether you have the same conditions are such that the same remedy will work for you. As a result of this individual variation, what will work for another person may not be effective for you.
Furthermore, it may take a lot more depth of understanding of the physiology of the acne to be able to even ask the right questions of the person who benefited from a new remedy, to know if that remedy would be of any use to you. This is why it's worth seeing a holistic doctor who can really ferret out your particular issue and finally help you get to the bottom of it.
Another unintended consequence of acne blogs is that it may give you an excuse to delay definitive treatment of your condition. For people with progressive acne, and especially those with cystic acne, the possibility exists that they will have significant increase scarring the longer they hold off getting their condition under control.
It's important to prevent deep of scarring, by making sure that you have more severe acne treated promptly if it is severe and you are not making progress with the suggestions that you find in the blogs and online.
See a physician like Dr. Dattner if your skin lesions become exacerbated.
Another unintended danger of reading acne blogs is that you may fail to get examined by a dermatologist or other physician when lesions arise that you interpret as acne may perhaps be due to some other, more serious cause. This could include Staphlococcus or Strep infections which have the danger of spreading externally or worse, internally.
These lesions could also include skin syndromes that you do not recognize that require further diagnosis and treatment. If there is anything unusual about your acne, or if you feel otherwise ill when you develop it, it is best to get it checked out by a dermatologist or other doctor. It is really important to know if something else is going on instead of what you interpreted to be acne, and make sure that condition gets treated properly.
One unintended danger of reading acne blogs is that you will see the suggestions given as all that is necessary to clear up your skin.
For many people, there are a variety of different habits and conditions that are leading to their acne, and a variety leading to the acne cure. Fixing only one or two factors may not be sufficient to give you a good improvement. Several different changes may be necessary in the right order or all together in order to clear up acne naturally.
So besides not getting better from following a specific suggestion in a blog, danger exists that you will decide if that a particular diet or lifestyle change does not clear you up, it is of no use at all. As a result, you may believe that it is useless for you as part of a more comprehensive program, and disregard it.
Indeed, it may be a crucial step when put together with a more complete series of therapeutic changes. It is important not to "write off" various lifestyle changes suggested as useless because they were ineffective when applied without comprehensive health care support.
If you need more support for a skin condition than you are getting online, contact me.
At some point, if you really want to clear up your face, you have to draw the linebetween doing things that are likely to aggravate your acne and those that are not.
If that means not touching your face repeatedly and squeezing lesions you got to give that a try and draw the line on doing those harmful activities. If eating various kinds of foods like sugar and dairy and junk food are likely to be aggravating your problem, at some point you have got to draw the line, and just stop eating them.
Your body needs a consistent message, so stay with better eating and avoid going back to old bad habits. Drawing the line on harmful behaviors for your skin and giving a real trial to healthier habits and eating can make a big difference. Even if this is not sufficient to clear your skin, it makes it a lot easier for a knowledgeable doctor to clear you up and help cure your acne using natural treatments and methods.
One line that you must literally draw is the line in front of the mirror: no squeezing, no picking. Some people even have to go so far as to put a piece of tape on the floor in front of the sink in the mirror, where they would stand when they are up close and looking at their face. Once you cross this line, it is important to remember not to touch your face or squeeze any pimples or other lesions there. Although some may appear slightly smaller after squeezing, inflammation will usually restore their size.
Even worse, if the pimples or cysts break under the skin from squeezing, the material emerging will act like a foreign body to often create even more inflammation and larger cysts. Those cysts can then become the ones that go on to enlarge, and cause even more inflammation. And when they eventually calm down, cause depressed scars (and sometimes depressed people). A lot of the visible red scars and depressed scars on some people with acne are more due to the squeezing and trauma then the acne itself. Do yourself and your face a favor and don't touch or squeeze your face, once you cross that line in front of the sink or the mirror.
Replacing acne-causing foods with skin friendly foods can make a big difference in your appearance, over time. A clean diet makes for a clean face. A diet filled with vegetables is a great natural acne cure.
1. Salad!At lunch, have a delicious salad topped with grilled chicken or fish instead of a pizza. If you are vegetarian, consider a rice and bean dish with celery or red pepper chopped in. If you need a real pick me up, consider juicing vegetables to make a green smoothie. Throwing in a little bit of protein powder can make this work as a meal.
2. Protein! If nuts work for you, almonds or almond butter can be the protein source in your lunch. A sandwich on yeast-free bread, with a thin slice of banana on top, may be just the thing you need for a quick lunch. For some people, a little tofu can be added to soups salads or rice for extra protein.
3. Vegetables! Be sure to fire up the steamer pot and steam some fresh broccoli cauliflower, zucchini or other quick cooking vegetable for lunch, and if possible for every meal. Tossing that vegetable with a little bit of oil and lemon juice and a touch of salt can make it a pleasure to eat rather than a chore. If you prepare vegetables in that way, they can be put aside in the refrigerator and heated up as part of your lunch in the next day or two after you made it in. This way, lunch can be both quick to prepare, and healthy, and your face will grow clearer and more free of acne.
Having healthy snacks available at home and when you’re out is an important way to get control of your acne. After all, if your hungry, need a pick-me-up, it’s going to be very hard to resist if your friends offer you some kind of acne-producing junk food, and you have nothing to substitute for that.
But if you plan ahead, you can pull your healthy snack out of your bag and enjoy it. Examples of healthy snacks might can might include a small container of steamed vegetables, a bag of carrots and celery, or a small container of rice and beans.Thin slices or raw turnip or parsnips or radish also make a good snack, depending on your taste. Even a small plastic container with a little bit of last night’s dinner, with a cold pack if necessary, can also do the trick.
Vegetables are one of the healthiest snacks that you can eat to help with acne. Raw vegetables are good if you chew them really well or blend them. Get a stack of small plastic containers, and be sure to prepare a little bit extra when you make salad or vegetables. Put some of those leftover vegetables in a container in the refrigerator and use them in the next day or two and snacks that you carry with you.
One advantage of preparing them before you go out is that you can season them with a little bit of salt and perhaps olive oil or lemon juice or both, so that they are delicious and ready to eat. In the winter, you can usually simply place the container in the pack that you carry with you. In the summer, you can place the vegetable container in the small cold pack with an ice pack from the freezer. That way, you have delicious healthy fresh vegetables as a snack when you need them.
Q: Dear Dr. Dattner, I'd like to see you for an appointment, but I’m a bit reserved (not about your fees by the way… I am HAPPY to pay them), but after 25 years of seeing Harvard, Dartmouth, and Georgetown-educated Dermatologists, I am just kind of curious as to why no one else utilizes this holistic approach, at least where I live, which is only 90 miles above the medical centers of Boston… please understand my concerns.
Respectfully, and best regards,
A: Dear Sam, I must say that your reply set off quite a spark in my head, and got me really thinking about the answer.
It's a great question. Why would I have a more effective method for helping certain people with skin disorders than other dermatologists from some of the most prestigious academic centers in the country, if not the world? And if I did, why wouldn’t they be doing what I am doing? For a variety of reasons well beyond trying to engage you as a client, I feel compelled to answer this question. And since you asked it, I think you deserve to hear the answer. It's an answer that will also help you understand my mission in life and how it relates to your skin condition.
The first reasonable question, which you may not have wanted to state outright might be whether I am delusional about my professional abilities. Can I really help some people who my well-trained colleagues cannot? Could my methods really be so different? I know that many dermatologists are brilliant, well educated, and help a lot of people. I also know that I have helped people who have not been helped by a string of dermatologists and other practitioners.
Recently, I saw several patients with challenging and potentially dangerous skin conditions. They had been prescribed toxic drugs to take for several years, as this was the best available treatment from highly-respected, well-intentioned dermatologists. Using only diet changes and supplements, I helped them clear their complex skin conditions. They were elated to have clear skin and also to be able to stop using the drugs they were prescribed. I cannot deny the feedback that I get about their dramatic improvement; in fact it's what gets me up in the morning. My methods are vastly different from those of my dermatologic colleagues who follow an allopathic model, and I will describe them below.
I abhor the use of medications that suppress inflammatory responses because, it is dangerous. As the medicines get stronger, the collateral damage caused by weakening the body’s defense system can be very costly or even fatal. What do I know about the immune system? I started getting involved in tumor immunology 51 years ago at Sloane Kettering in Rye with Dr. Lloyd Old, who is often called the "father of tumor immunology." I took off time to do research in medical school and chose the most vibrant researcher I could find, Dr. Barry R Bloom, turning down an offer I had from Harvard. Barry later became the head of the Harvard School of Public Health for ten years. My sixth immunology lab was at the Dermatology Branch of the National Cancer Institute, where we discovered aspects of the nature of how the immune system recognizes foreign presence in the body. The insights I gained from what we learned form our incredibly productive nearly three years of research confirmed what I had heard from the “alternative” medicine world about the ability of foreign substances such as food, chemicals or microorganisms to set off a very specific response by the immune cells against particular targets in the skin, manifesting as skin disease.
I look to find and remove the cause of skin problems rather than stop the outward manifestation of the problem by suppressing them. It takes a lot of time to probe and find out the network of causes underlying a rash, choose what tools to use (supplements, diet, lifestyle changes, etc.), explain it to the patient, and them motivate them to make difficult lifestyle changes that will benefit them beyond improving their skin. This way of working is resource-intensive; it takes a lot of time and energy, which I am happy to spend, in order to solve and clear mysterious conditions. However, if I were to accept health insurance, I could not afford to practice this way unless I had a huge trust fund to support my practice.
Most dermatologists use a generally effective allopathic approach to help a large number of patients, and could not do that if they spent the amount of time I do, either with patients, or studying the various alternative methods I have pursued. They are likely not versed in botanical medicine, nutritional medicine, Functional Medicine, and numerous other alternative modalities that I integrate into the way I hear a history and create solutions. Even if they educated in this way, and they spent the time I do, under insurance payments, they would quickly have to close their offices due to negative bank accounts. Unfortunately, as you shared with me, the allopathic approach was not effective for you, and likely also not effective for a percentage of the population at large.
Living my approach as part of the integrative medicine world, along with dermatology and the scientific world of immunology for 35 years has given me a rich background of diagnostic and therapeutic tools that are not part of forefront allopathic dermatology. I have also developed some proprietary treatments in the course of all of this that would not be known by other dermatologists, which I am not positioned to reveal. So I guess that is why I can fix problems like yours.
I am about to write the 4th revision of my chapter on Seborrheic Dermatitis on in Rakel’s Integrative Medicine, and I have written the review on the same topic for the American Academy of Dermatology’s Integrative medicine task force. So I guess I am somewhat of a national expert on the subject of integrative treatment–combining conventional, alternative, and scientific methods to treat this condition. If you saw anyone else from Harvard with this perspective and these qualifications, I would very much like to interview them for my latest revision.
Look at the “About” section on my website, holisticdermatology.com, or look up the scientific articles I have written on PubMed, to verify what I have stated.
I hope that I have answered your question, and am happy to hear your comments.