|
“I still have acne even though I’m an adult,” writes this week’s House Call contributor. “Do I need to take antibiotics and put all these drugs on my face? Is there another approach to take?” “作为一个成年人还长痤疮，我该怎么办？我应该用一些抗生素吗，还有别的办法吗？” Studies show acne can place a heavy emotional and psychological burden on patients that possibly surpasses its physical impact. Researchers find acne’s toll can increase anger, fear, shame, anxiety, depression, embarrassment, bullying and stigmatization within peer groups. 研究表明痤疮造成的巨大的精神压力甚至超过了对身体的损伤，并可能引发愤怒、害怕、羞愧、焦虑、抑郁、霸凌等情绪表现。 While acne affects more than 85 percent of teenagers, this skin condition has also increased among adults. In fact, some eight million people visit the dermatologist every year for their skin. We spend over a billion dollars for prescriptions and over-the-counter (OTC) products to cure acne, yet at best these are short-term solutions. Conventional medicine deals with symptoms, so their solutions for acne include lathering on potions and lotions, popping and pricking pimples and taking antibiotics or strong liver-damaging medications. There’s got to be another way, right? 痤疮的发病率在青少年中占到85%，而在成年人中发病者也不在少数。事实上，每年有超过八百万人需要看皮肤科，在处方药和非处方药治疗痤疮上的花费更是过亿，但这些还只能是短期的解决办法。传统治疗就是针对症状，所以一般都是外用的乳液，抗生素或肝脏损害比较大的药物，所以，我们需要找到其他的解决方案。 Fortunately, there is with Functional Medicine, which addresses the problem’s root cause. From this lens, we can understand that numerous factors contribute to acne, including nutritional status, stress, toxicity, inflammation and hormonal and gut imbalances. That’s actually good news because it empowers us to make dietary and lifestyle changes that reverse acne and improve our overall health without the adverse side effects of pharmaceuticals and other invasive procedures. 幸运的是，功能医学的出现，可以帮助我们找到疾病的源头。从这样的视角，我们可以知道引起痤疮的原因有很多很多，包括营养状况、压力、毒素、炎症、荷尔蒙失衡和肠道健康等。这就使得我们可以不必借助药物，只需通过调整饮食和生活方式来改善痤疮和促进整体健康。 My Struggle with Acne I want to tell you my own experience with acne. I never had it. That is, until I got sick with chronic fatigue syndrome. Chronic fatigue syndrome involves toxicity, gut damage, inflammation, hormonal imbalances and stress, among other things. 我与痤疮的抗争…… 跟大家分享一下我自己的经历，之前我从未得过痤疮，直到我出现慢性疲乏症候群，慢性疲乏症候群通常与毒素、肠道损伤、炎症、荷尔蒙失衡、压力等相关。 I have told the story of my illness and recovery many times, but I don’t usually talk about the skin problems I had. My acne was triggered by a severe intestinal infection that resulted from an overload of mercury and stress. Right away, my skin changed. My skin color turned gray and I developed dark circles under my eyes. I started getting pimples all over my face (a new adventure for me at age 36), and strange rashes around my eyes whenever I ate certain foods. I even developed itchy red patches on different parts of my body. 我曾经说过很多关于我的病症和治疗，但几乎没怎么提过皮肤的问题。在由于压力和汞过量引起的肠道感染之后出现了痤疮。那时，我的皮肤发生了很大的变化，皮肤颜色变暗，黑眼圈也出现了，整张脸开始长痘痘（36岁的再次发育？），眼睛周围也出现了皮癣，当我吃了某些食物，甚至全身开始长红斑。 So what did I do? Well, I didn’t need creams, gels or lotions such as benzoyl peroxide, retinoid acid, salicylic acid, glycolic acid peels, or topical antibiotics (all of which might have helped symptoms a little bit). I certainly didn’t need oral antibiotics (which can cause long-term gut complications, immune problems and yeast overgrowth), or Accutane (which can cause liver damage and increase the risk of depression and suicide), or oral contraceptives (which I would have been offered had I been a woman). 我该怎么办…… 我想，我并不是需要外用的啫喱、乳液或者抗生素，那些都只能起到一点点抑制症状的作用，更不需要口服抗生素（可导致长期肠道失调、免疫问题和菌群过度增长）或者青春痘特效药（可导致肝脏损害、抑郁或自杀等情绪问题），以及口服避孕药（女性）。 While these are the tools of modern dermatology, they overlook the role of overall health in the health of your skin. I didn’t need any of these things. 以上都是现代皮肤科的手段，只关注皮肤问题，而整体健康则被忽视。 我并不需要这些！ Instead, what I needed was to heal my leaky gut, correct my food allergies and nutritional deficiencies, detoxify from mercury, reduce inflammation, and rebalance my stress hormones. And that’s just what I did. 相反的，我应该做的是修复肠漏，纠正食物敏感和营养缺乏，祛除重金属汞，降低炎症，平衡压力荷尔蒙。 ——这就是我的治疗方案。 My pimples vanished, the skin around my eyes cleared up, and my rashes went away (along with my chronic diarrhea, disabling fatigue, brain fog, mouth sores, muscle pain and more). A miracle? Hardly! I have seen this happen with so many of my patients. 痘痘消失了，眼周的皮肤也发亮了，黑眼圈不见了，皮疹也都没有了，同时消失的症状还有慢性腹泻、疲乏、脑雾、口腔溃疡、肌肉疼痛等等。 奇迹吗？当然不是，我的许多病人都经历过这样的转变。 A Different Way to Approach Acne Rather than attack acne through superficial solutions, Functional Medicine takes a roots-deep approach to acne and other skin problems. From that perspective, oxidative stress triggers inflammation, which in turn contributes to acne and a host of other problems. 换一种角度来看待…… 功能医学从根源来解决痤疮的问题，而绝不是简单改善症状，从这个角度来看，氧化压力触发炎症，这会引起痤疮和一系列问题。 What is oxidative stress? Well, your mitochondria (which create energy to run your cells) are built to convert calories and oxygen into energy that the body can use called ATP (adenosine triphosphate). Our cells contain a total of one hundred thousand trillion mitochondria, which consume 90 percent of our oxygen intake. This oxygen is necessary to burn the calories we eat in food. But free radicals are produced as a by-product of this combustion, much like exhaust that comes out of the tail pipe of your car. These free radicals are dangerous because they damage or oxidize the molecules and cells throughout our bodies. 什么是氧化压力——我们的线粒体是用来转化热量和氧气,使之变成能量维持身体运作，这被称作ATP 我们的细胞内有亿万个线粒体，它们消耗身体摄入氧量的近90%，燃烧食物中含的卡路里。 氧自由基作为一个副产品也同时出现，这很像是你的汽车尾气排放，这些自由基会破坏身体的分子结构，是有危害的。 This damage is called oxidative stress. More damaged cells equal more oxidative stress or “rusting”. This, in turn, leads to damaged DNA, damaged cell membranes, rancid or oxidized cholesterol (which is what truly makes cholesterol harmful), stiffened arteries that look like rusty pipes, wrinkled skin, and damaged brains. 这种对身体的损害被称作“氧化压力”，受损细胞越多就意味着“氧化压力”越高。这会导致DNA受损，细胞膜受到破坏，胆固醇酸败或者氧化（这是真正使胆固醇变得有害），血管硬化的好像生了锈的管道，皮肤起皱，大脑受损等。 We have our own built-in antioxidant factories that produce molecules that seek out free radicals and clean them up before they rust our bodies. But these systems are easily overwhelmed by a toxic, low-nutrient, high-calorie diet like the ones most Americans eat. 我们的身体有自己的抗氧化机制，找到自由基并清除它们，但是，这些机制很容易受到影响，比如毒素过多、营养缺乏、高热量饮食等，而这却是大多数美国人的日常饮食！ We can get more of these important antioxidant molecules if we eat the right foods. But most of us don’t. The single most important controllable factor regulating the oxidative stress in your body is your diet. Eating too many calories and not enough antioxidants from colorful plant foods results in the production of too many free radicals, wreaking havoc on our bodies and our minds. Oxidative stress, as I mentioned, creates inflammation. While a number of things including toxicity, allergens and nutrient deficiencies contribute to inflammation, the biggest culprit is a processed, sugary diet. 其实我们可以通过正确的饮食来获得更多的抗氧化物质，但很遗憾，大多数人们并没有这样做。事实上，调节氧化压力的最简单可控的因素就是饮食。高热量和不能从彩色蔬果中获取足够抗氧化物质的饮食习惯会导致身体自由基产生过多，对身体造成大肆影响。前面提到的，氧化压力可以导致炎症，其众多致炎因素中，如毒素蓄积、过敏、营养缺乏，其中最大的元凶就是——精加工含糖饮食。 What you eat becomes the root cause of most acne. Along with a high-processed, high-sugar, high-dairy diet, studies show nutrition-related lifestyle factors can contribute to and exacerbate acne. In fact, if I could narrow down the culprits to two, they would be: 饮食是痤疮形成的根源问题——深加工、高糖、高奶，研究表明营养相关的生活方式是形成和加重痤疮的重要因素。如果一定要找出两个罪魁祸首，它们就是： 1. Sugar (including flour). Sugar raises insulin levels, which promotes the production of testosterone in women, and inflammation in general, causing acne. Large randomized prospective controlled trials (the gold standard of medical research) found people who had higher sugar intake and a high glycemic load diets (more bread, rice, cereal, pasta, sugar and flour products of all kinds) had significantly more acne. 糖（包括面粉）， 糖能提高胰岛素水平，使女性体内睾酮水平升高，导致炎症，引发痤疮。大型随机前瞻性对照试验（医学研究的黄金标准）发现，摄入大量糖分或高升糖指数饮食（面包，大米，谷物，面食，糖和各种面制品），痤疮发作机率更大。 2. Dairy consumption. Hormones (including growth hormones) in dairy contribute to acne. Two large controlled trials found cow’s milk increased both the number of people who got acne and its severity. 奶制品。 奶制品中的激素（包括生长激素）可引发痤疮。 两项大型对照试验发现，牛奶会增加患痤疮的人数及其严重程度。 Other acne-triggering dietary culprits include processed fats like trans fats, which increase arachidonic acid levels and compete with omega-3 fats in the body, leading to more inflammation and acne. 其他引发痤疮的饮食： 加工的脂肪——反式脂肪酸，其增加花生四烯酸水平并与体内的Omega-3脂肪酸竞争，导致更多的炎症和痤疮。 But the big two – dairy and sugar (in all its blood sugar-raising forms) – cause spikes in certain pimple-producing hormones. Dairy boosts male sex hormones (various forms of testosterone or androgens) and increases insulin levels, very similarly to sugar and starchy carbs, which quickly raise blood sugar and spike insulin. 最大的两个因素——奶制品和糖（所有升血糖形式）——会使导致皮疹的激素水平达到峰值。 奶制品促进男性性激素（各种形式的睾酮或雄激素）和胰岛素水平升高，这也类似于糖和碳水化合物的快速升糖、升胰岛素作用。 Insulin resistance, the inevitable result of chronically elevated insulin levels, becomes bad news. It leads to hair growth on the face and body and loss of hair on the head in women. Many women also get acne and irregular menstrual cycles. For some, it manifests as polycystic ovary syndrome (PCOS), primarily caused by too much sugar, which becomes associated with acne among other problems. 胰岛素抵抗。胰岛素水平长期过高必然没有好结果，它会导致面部、身体毛发过重,女性脱发，许多女性还会出现痤疮和月经失调。对一些人来说,它表现为多囊卵巢综合征(PCOS),主要是由于太多的糖引起的,并发痤疮和其他问题。 While pimples are not as simple as too much milk or sugar, both have a significant impact on acne. The biggest factor affecting your hormones is the glycemic load of your diet (how quickly the food increases your blood sugar and insulin levels). 影响激素水平最大因素是饮食造成的血糖负荷，食物增加血糖和胰岛素水平的速度非常快。 To reverse insulin resistance, inflammation and other acne triggers, you’ll want to eat a diet rich in omega-3 fats and fiber (to reduce testosterone in women), cut out sugar (to reduce insulin), and consume whole soy foods to help balance hormones. 为了逆转胰岛素抵抗、炎症和其他触发痤疮的因素，建议多摄入富含Omega-3脂肪酸和纤维的饮食（减少女性睾酮），限制糖摄入（降低胰岛素水平），摄入豆制品帮助平衡激素水平。 Gut health certainly plays a role in skin health: Foods like gluten, dairy, yeast, and eggs can be problems if you have a leaky gut. 肠道在皮肤健康中起着重要作用：如果你有肠漏，食物中如面筋、奶制品、酵母和鸡蛋都有可能造成不良影响。 But many of these conditions trigger or exacerbate elevated insulin levels, knocking other hormones out of balance and contribute to inflammation, metabolic havoc and conditions like acne. 这些触发因素会加剧升高胰岛素水平，导致其他激素失衡，并引发炎症、代谢失衡，最终产生痤疮。 Simply put, to get your acne under control, get your insulin levels under control. 简单点说——想要控制痤疮，就要控制胰岛素水平。 10 Ways to Eliminate Acne In my practice, I’ve seen numerous patients struggle with acne and other skin problems. I find these 10 strategies almost always remedy the issue without resorting to harmful antibiotics and other conventional therapies. 消除痤疮的10种办法…… 在临床实践过程中，我看到许多患者在与痤疮和其他皮肤问题做斗争。脱离了抗生素和一些其他常规疗法，以下这些方法几乎可以用来解决所有皮肤问题。 1. Go low glycemic. Cut out all sugar and processed food. Opt instead for whole, real, fresh foods, which tend to be lower glycemic. One randomized controlled trial showed a low-glycemic-load diet improved symptoms in acne vulgaris patients. 降低血糖。停掉所有的糖与加工食品。选择品种丰富的新鲜食物。一项随机对照试验显示，低升糖指数的饮食可改善患者的痤疮症状。 2. Eliminate food sensitivities. That includes gluten, dairy and processed foods, but also processed soy products, nuts, citrus and other culprits. I’ve found an elimination diet can become very powerful here. 祛除敏感食物。常见的如麸质、奶制品与深加工食品，另外还包括一些豆制品、坚果、柑橘类等。祛除饮食的效果是非常显著的。 3. Eat an anti-inflammatory diet. Foods like wild-caught fish, turmeric, ginger, green tea, dark purple and red foods such as berries, green foods like dark leafy vegetables, and barnyard-raised eggs all helpreduce inflammation that contributes to acne. 抗炎饮食。如野生鱼类、姜黄、姜、绿茶、深紫色和红色的食物（如草莓），绿色食品如深绿色的蔬菜，散养鸡蛋等都有助于减少导致痤疮的炎症发生。 4. Fix your gut. Taking probiotics (such as lactobacillus), prebiotics, anddigestive enzymes can improve acne. Work with an integrative physician to correct leaky gut and other gut issues. I have seen serious cystic acne resulting from gut imbalances and parasites that resolve when the gut is fixed. 修复肠道。服用益生菌（如乳酸杆菌）、益生元以及消化酶皆可改善痤疮，治疗肠漏症和其他肠道问题。当解决了肠道菌群失衡与寄生虫的问题，肠道得到修复，严重的囊性痤疮问题也就迎刃而解。 5. Stress less. Chronic stress causes acne flare-ups by increasing inflammation and oxidative stress, raising cortisol and depleting zinc,magnesium, and selenium, which help control acne. Stress also causes poor dietary choices. You can manage stress through meditation, yoga, saunas, massage, biofeedback, aromatherapy, and more. Relaxing is anti-inflammatory. 减少压力。慢性压力可增加炎症与氧化应激，引起痤疮。升高皮质醇水平，锌、镁、硒都可以帮助控制痤疮。压力也会减少饮食的可选择性。管理压力的方法包括冥想、瑜伽、桑拿、芳香疗法、生物反馈等。放松其实就是一种抗炎疗法。 6. Address nutritional deficiencies. These include zinc, omega-3 fats, and some anti-inflammatory omega-6 fats like evening-primrose oil, which can boost immunity, reduce inflammation and reduce acne. Saw palmetto, most often used for prostate health, can reduce facial hair and acne in women. Take 320 mg twice a day, once with breakfast and once with dinner. You can find all of these nutrients and more in my store. 补充缺乏的营养素。 包括锌、Omega-3脂肪酸和一些抗炎的Omega- 6脂肪酸（月见草油），可提高免疫力，减少炎症，改善痤疮。锯棕榈常被用做支持前列腺健康，也可以减少女性的面部毛发和痤疮，用量为320mg BID，早晚餐后服用。补充缺乏的营养素。 包括锌、Omega-3脂肪酸和一些抗炎的Omega- 6脂肪酸（月见草油），可提高免疫力，减少炎症，改善痤疮。锯棕榈常被用做支持前列腺健康，也可以减少女性的面部毛发和痤疮，用量为320mg BID，早晚餐后服用。 7. Get great sleep. Studies show sleep loss contributes to inflammation, which feeds the flames of acne and numerous other issues. Those are among the many reasons you want to aim for eight hours of solid, uninterrupted sleep every night. 保证充足睡眠。研究表明睡眠不足造成的炎症可引发痤疮以及一系列问题。这也是为什么我们一定要保证每晚8小时不间断睡眠。 8. Get more antioxidants. I find antioxidant levels are low in acne patients, especially vitamins A and E, which are critical for skin health. People who eat more fruits and vegetables (containing more antioxidants and anti-inflammatory compounds) have less acne. 摄入抗氧化物质。我发现痤疮患者的抗氧化水平普遍较低，尤其是对皮肤健康至关重要的维生素A和维生素E。多吃水果蔬菜（含有更多的抗氧化剂和抗炎化合物）的人群患痤疮的概率较低。 9. Exercise regularly. Among other benefits, exercise helps improve insulin function, reduces inflammation and boosts self-confidence. 规律运动。运动有助于改善胰岛素功能，减少炎症，增强自信。 10. Choose skin care products wisely. There are some good skin care products out there. Just make sure they aren’t toxic or otherwise harmful. 选择适用的护肤品，确保里面不含有毒素或对皮肤有害的物质。 |
|
|
