by Alakananda Devi (Alakananda Ma), M.B., B.S. (Lond.)
Adolescence represents a time of the greatest change humans experience during their lifetime--the dramatic shift from childhood to adulthood, with all the attendant reproductive capabilities. At one end of adolescence is an innocent child and at the other end a fully grown man or woman. This dramatic time of transformation effects doshic changes that, more often than not, lead to the skin diseases of adolescence, acne vulgaris and keratosis pilaris.
Puberty, the defining event of adolescence, consists of a number of phases of hormonal change that bring to an end the kapha time of life and usher in the pitta time. The first change, occurring about a year before puberty proper, is adrenarche, the maturation of the adrenal cortex, signalled by the appearance of pubic and axillary hair. Adrenarche involves production of the adrenal androgen dehydroepiandrosterone sulfate (DHEA-S). With DHEA-S to stimulate androgen production, gonadarche or maturation of the hypothalamic-pituitary-gonadal axis (HPG axis) occurs about one year later. The rapid changes of this time provoke vata while the onset of the pitta time of life with its attendant androgens can lead to a state of pitta provocation that endures until the body's physiology learns to adapt to its new, adult state.
Skin diseases of adolescence affect upward of 85% of all adolescents in varying degrees of severity. Acne vulgaris is a nearly universal skin disease afflicting 79% to 95% of the adolescent population in Westernized societies (1,2), while keratosis pilaris affects 50-80% of all adolescents. Appearance is extremely important to adolescents, who may suffer intensely due to even a benign or harmless skin condition. To make matters worse, severe acne may leave scars that are permanently disfiguring. Another pitta condition that soars during adolescence is suicidal depression, which may be exacerbated both by the disfigurement of a facial skin disorder as well as by some of the prescription medications given for these conditions (3).