Last Updated on July 29th, 2020
By Dr. Jaggi Rao, MD, FRCPC, Double board-certified dermatologist
One of the newest topics in acne research is the relationship between a psychiatric condition known as alexithymia and acne. Alexithymia is a personality trait that causes difficulty in expressing, understanding, or describing emotions. The Greek words from which the term is derived literally mean “without words for emotions.” The experience of alexithymia is not a condition in which emotions are repressed, but rather one which people do not know how to communicate or understand them.
Researchers have recognized for nearly 40 years that the inability to express or understand emotions makes all kinds of illnesses more likely and all kinds of treatments less effective. 😐 People who have alexithymia tend to get lower back pain, fibromyalgia, irritable bowel syndrome, allergies, asthma, nausea, and, scientists have recently discovered, acne.
Having acne does not mean that you have alexithymia. However, having alexithymia means that it is more likely that you have acne. The relationship between the inability to express emotions and the appearance of acne is explained in terms of the brain-skin connection.
People who have alexithymia tend to have difficulty distinguishing between feelings caused by emotions and feelings caused by physical conditions. They tend to think in terms of events that go on outside their control. 🐉 They seldom have fantasies, and they have difficulty describing how they feel to other people.
This combination of psychological symptoms occurs with a combination of physical symptoms. The nerves that control voluntary movements tend to become overly activated. The heart beats faster but pumps less blood so that tissues all over the body receive less oxygen. The skin becomes a better conductor of electricity so that any kind of stress in the skin is felt in the skin more intensely and more rapidly. Also, the skin’s reactions to stress are more intense.
When it comes to dealing with stress, the skin has its own “brain.”
Just as the brain releases a chemical called corticotrophin stimulating hormone when it sense stress to trigger the release of stress hormones by the adrenal glands, the skin also releases corticotrophin stimulating hormone when it senses stress. This stress hormone activator in the skin sends a message to cells that store the inflammatory chemical histamine to break open the storage packets containing histamine. The histamine begins to dissolve nearby skin cells as if they were harboring a thorn or a splinter or an infection. The skin becomes redder and itchier and may break out in bumps, all because of heightened sensitivity in its nervous system.
People who have both alexithymia and acne have some treatment options, but they are not what either a psychiatrist or a dermatologist is likely to suggest. 👩🏽⚕️ While natural therapies don’t relieve the combination of disordered brain chemistry and negative personal experiences that cause alexithymia, there is a natural therapy that may at least relieve the acne.
In the early 1930’s, scientists in the United States noticed two things about people who consumed large amounts of foods that contain probiotic bacteria, such as Lactobacillus acidophilous. 🧑🏻🤝🧑🏽 People who consume probiotics tend to suffer less anxiety and depression. They also tend to have less acne.
For nearly 75 years scientists did not understand the connection between probiotics, depression, anxiety, and acne. But about 5 years ago a team of American scientists realized that the common element in all the three factors is inflammation, and that probiotics can reduce inflammation by “training” the immune system not to overreact.
Depression and anxiety are to a certain extent caused by inflammation in the brain. Acne is to a certain extent caused by inflammation in the skin. It may not be possible through holistic health means to stop the kinds of workings of the mind that cause an inability to express emotions and the excessive activation of the nervous system that results. It may be possible, however, to take inflammation out of the equation so that the effects of “nerves” on the skin are greatly reduced.
The way probiotics reduce inflammation is by training the immune system to release less inflammation.
Lactobacillus bacteria don’t cause disease. They don’t release toxins. It is theoretically possible to have too many of them (this can happen if someone takes an entire bottle of probiotic supplements or regularly eats large amounts of yogurt containing active cultures), but this is very rare. The immune system, however, doesn’t know that Lactobacillus bacteria don’t cause disease until it encounters them.
At first the immune system attacks Lactobacillus by generating inflammatory chemicals. 🤺 These inflammatory chemicals don’t get rid of the bacteria. However, the bacteria don’t cause disease. When no disease symptoms are detected, the immune system stops releasing as many inflammatory chemicals in the bowel.
Some of the same white blood cells that are trained in the intestine not to attack Lactobacillus bacteria circulate to the skin. When they encounter acne bacteria, they don’t unleash inflammation against the bacteria there, either. Because acne bacteria are capable of releasing chemotactins that “distract” the immune system so that it actually inflames healthy skin cells rather than attacking the bacteria, one important cause of acne inflammation is removed.
While bacteria may not offer any benefit for the process caused by the peculiar brain chemistry of alexithymia, they may reduce overall inflammation so that acne does not break out.
Taking probiotics is a lot easier to understand than doing psychotherapy. It produces much more immediate results. At least as far as acne is concerned, probiotics may do what doctors focused on the psychiatric condition usually cannot. People who have any mental health issue should seek mental health treatment, but the secondary effects often can be managed naturally.
Are you interested in the medical literature on this topic? 📖 Here is the information you can use to locate the research on probiotics and acne on PubMed and find a no-cost copy of the original research:
Bowe WP, Logan AC. Acne vulgaris, probiotics and the gut-brain-skin axis – back to the future? Gut Pathog. 2011 Jan 31;3(1):1. PMID: 21281494 [PubMed] PMCID: PMC3038963 Free PMC Article.
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