Reader Question: Body Acne And Tongue Coating

Reader Question: Body Acne And Tongue Coating

No matter how much I write there are always some questions I haven’t answered. That’s why I like getting questions and feedback from you. They also give me more material to write about.

After an email from a reader in Norway I got this idea of answering some of the questions as Reader Questions posts. Please let me know what you think about these. If you, the readers, see this as a good idea and keep sending me questions, I’ll keep posting these.

Let’s get started with this post, which deals with differences in body and facial acne and tongue analysis advice from alternative medicine website.

Is body acne different from facial acne?

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Okay, so now I have been following your guidelines the last couple of weeks and have been reaping the benefits from it. My face is more or less clear, apart from 5-6 red marks and a couple of small zits. The biggest cull-print, as always, is my chest (and to some extend my back). I can\’t seem to get to the end of it, no matter what I do. I should add that It is much better, but still with lots of red mark that usually turn in to zits after a while. I haven\’t seen anything from your writing that would suggest that body acne differs from facial acne. What are your thoughts on this?

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Is there a difference between facial and body (truncal) acne? I have to say I don’t know for sure. The vast majority of acne research either deals with facial acne or doesn’t make a distinction between facial and body acne.

I’m mixing the terms here a bit for convenience. Truncal acne refers to acne on the back and chest, but since it’s such a stupid sounding word (at least in my head), I’ll just talk about body acne.

After a quick search there’s very little research done on body acne, searching truncal acne on PubMed only brings up 31 papers. Only a handful of those are focused on body acne.

Nothing I’ve ever seen suggests there’s a big difference in body and facial acne in terms of causes and development. So I don’t see a point in separating them. I can say from personal experience that my scalp acne responds to diet and gut issues pretty much the same way as my facial acne does.

Mind what you apply on the skin

The biggest difference I’ve noticed is that shampoo horribly aggravates my scalp acne. As long as I was using normal commercial shampoo my scalp was just horrible. Strict diet helped a bit, but I still had my head full of painful bumps. It was only after that I got a sulfate-free shampoo that I got it fully under control. I still don’t know for sure what is it that aggravates my scalp, but I suspect it’s either sodium laureth sulfate or sodium lauryl sulfate.

Which brings me back to you. Have you checked the soaps and body washes you use? Most soaps are highly alkaline and damage the acid mantle and the skin barrier function. This leaves the skin vulnerable to bacteria and inflammation.

Mechanical irritation

Dan at has an article on back acne. In it he talks about acne mechanica, which is acne caused by mechanical irritation, such as backpack rubbing on your back. Maybe that’s something to think about?

Sweat might also irritate your chest? I’ve noticed my throat gets irritated when I sweat and don’t clean it quite quickly. On the other hand, one rather small study found no links between exercise-induced sweating and body acne. But it was a small study and thus not at all definitive.

Body acne treatment

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You have written a lot on topical treatments. Any suggestions just for back and chest? Do they differ from facial ones? I live in Norway, which perhaps makes it kind of hard to get the products you have been recommending. Should I separate between putting things on for all of my red marks (lots of them on back and chest) and active zits?  How about scars?

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The few articles I saw on body acne mentioned that treatment guidelines are similar to facial acne. And that would most likely mean antibiotics and topical wash. I’m not a big fan of antibiotics and wouldn’t recommend going down that path.

I found one review paper that showed topical benzoyl peroxide is effective also in body acne. That’s probably a good idea to try. The paper mentioned that shorter (a few minutes) contact time was as effective as leave-on cream. Leave-on creams can bleach your clothes.

In case of inflammatory acne I would also recommend some soothing moisturizer or cream. It should be easy to find something with vitamin E, B3 or aloe vera. Both vitamin E and B3 (niacin/nicotinamide) can reduce inflammation and acne.

I wouldn’t separate between red marks and active zits.

Body acne scars are probably very difficult to treat, I’m sorry to say. This is something you have to talk with dermatologist. Deep scars probably require invasive treatment, such as laser, chemical peels or needling the skin.

One paper noted that body acne is prone to scarring. If those are a big problem for you, I would even consider Accutane (Roaccutane in Europe). Especially if your acne doesn’t respond to diet and other things I’ve talked on this site.

Tongue analysis?

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Which leads me to my previous \”mentor\” (that doesn\’t really sound good, does it), a girl called Shelley from a website called askshelley. I wasn\’t by any means a full-blooded skeptic back in those days, so I probably should have been a bit more critical to all the suggestion which emphazised ph-levels, tongue analysis, and all the really strict rules that made up the Power of Digestion (no disrespect to her for trying to help me without charging!) What are your viewpoints on tongue-analysis and these kind of things? I do have a coated tongue, which I always heard was a pretty vital sign of weak digestion. Sounds a bit far-fetched, perhaps?

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I think I remember that website. I used to read it a lot when I was more into alternative medicine and natural health.

The thing with a lot of the alt-med advice is that there’s a seed of truth in it and it makes sense. And when you don’t know any better it’s really easy to buy into it. This happened to me. The problem is that they pretty quickly ride their woo-fuelled pony off the cliff of reason and evidence.

I don’t know what advice she’s been giving you. But anytime someone starts talking about pH-levels and alkalizing the body my warning bells go off. Blood pH is by breathing and carbon dioxide concentrations in the blood. CO2 will override any effect diet could possibly have on blood pH.

Power of Digestion again seems to make superficial sense. Healthy digestion is certainly important for gut health, and I’ve written here how important gut health can be for your skin health. But I don’t think digestion is the one overriding issue in gut health. It’s a part of the puzzle.

I’m not a big fan of strict rules. In some cases, like celiac disease, they are warranted, but I’ve yet to see any evidence that otherwise healthy people need to be too strict with their diet. I doesn’t make evolutionary sense since our long-gone ancestors probably ate a massively varied diet.

As to tongue analysis. I can’t say for sure it’s pure bunk, but it sounds a lot like Candida spit test. I would imagine there are countless things that can affect it. To my surprise I found several medical papers dealing with tongue coating. Here’s a quote from one of them:

Tongue coating comprises bacteria, large amounts of desquamated epithelial cells released from the oral mucosa, leukocytes from periodontal pockets, blood metabolites and different nutrients.

M. M Danser1, S. Mantilla Gómez2, G. A Van der Weijden
Tongue coating and tongue brushing: a literature review
International Journal of Dental Hygiene Volume 1, Issue 3, pages 151–158, August 2003

It looks like the tongue coating is made of bacteria, dead skin cells and scraps of food. Can those be related to digestion? I guess anything’s possible, but I don’t see this being a reliable measure of your digestive powers.

More general point about alt-med diagnostic methods. Most of them were developed during pre-scientific times and relied on pre-scientific theories. During those times we had very limited tools for telling what’s real and what’s not. The powers of subjective human observations are notoriously unreliable.

More often than not there’s little consistency to these diagnostic methods. When two practitioners examine the same tongue they often give different diagnoses. Sometimes even when the same practitioner examines the same tongue twice he gets different results, especially when he doesn’t know he examines the same tongue.

Weight gain

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Finally, I must ask a questions which relates to weight. I know it basically is a question of calories, but as I am 1.90 and weigh 80 kg (well, I already have lost 3 kg the last couple of weeks), which makes it hard to add up when I try to exclude sugar, milk, gluten and carbs with high GI from my diet. Thing is, I actually like and have no problems eating healthy (apart from my occasional sugar cravings), but it is tempting eating unhealthy things just to put on weight, which is a real shame. When I eat lots of healthy fats and proteins, I do go to the bathroom A LOT (like 15 times a day, at most), which is a concern as well. The things you have written on high carb-diets/high-protein diets make sense, so I am aiming for the 50/25/25-ratio. Guess I have to continue eating all that rice.

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I’m pretty sure there’s more than calories when it comes to weight loss and gain. Calories do matter but the body makes metabolic adjustments based on caloric intake. Eating more to some degree increases your metabolic rate and makes you burn more calories.

I can’t say I understand this are too well, so I would rather not comment on this too much. Just what I’ve observed when talking with my website visitors is that cutting out some foods (varies from person to person) can cause a lot of weight loss.

From the little you’ve said it sounds like you may have some digestive issues. Earlier you mentioned some gas and bloating and in this bit you mentioned going to toilet up to 15 times per day, which sounds almost like diarrhea to me. Going very often might mean your gut actively throws out food. Perhaps something you eat irritates the digestive track and causes this. I would keep a food and digestive symptom journal and try to track down the foods that cause this.

That’s it. I hope you got something out of this.

Do you have questions about acne? Please use the comments below or the contact page. I can’t promise I’ll answer every question, but I’ll do my best.

About Me

Hi, I am Acne Einstein(a.k.a. Seppo Puusa). I'm a bit of a science nerd who is also passionate about health. I enjoy digging through medical journals for acne treatment gems I can share here. You can read more about my journey through acne and how I eventually ended up creating this.

3 thoughts on “Reader Question: Body Acne And Tongue Coating”

  1. I love your site! It’s so hard to find info online that’s not semi-obsolete or based on propaganda (…unless you spend hours critically examining research studies, as you are so helpfully doing for your readers!). I’m trying to adopt a regimen based in large part off of the information you’ve featured. Something like this…

    AM: gentle cleanser, drink hacked green tea & apply topically with moisturizer
    PM: 2.5% BP (every other day due to irritable skin) followed 30 minutes later with non-spf vit E moisturizer
    General: decrease dairy and sugar, reduce hours per day spent wearing makeup, drink berry smoothies for extra antioxidants

    Does this sound legit?

    In terms of feedback/ideas, here is a long list of topics I’ve been wondering about that I don’t think (?) have been featured on your blog.

    The effects of the following on acne-prone skin:
    – salicylic acid
    – tretinoin
    – topical clindamycin
    – exfoliation (i.e. with commercial exfoliating washes or manually with tools like the Clarisonic…)
    – astringents
    – birth control pills
    – wearing makeup (perhaps too broad a topic; anecdotally it seems to make my skin oily and irritated)

    Thanks again for the work you do!

    • Gwen, sorry about my late reply. It was my wife’s birthday and we went for a holiday together. Glad to hear you like the site. I also got frustrated with all the non-sense that pervades many of the alt-med and natural healing sites. That’s why I started this site.

      Yes, the regimen you describe sounds legit. When you have more results I can comment further if you want.

      Thanks for the suggested list. I won’t make any promises, but at least a few of the topics seem worthy of further investigation. I’m just afraid that for most of them there’s not going to be much research to go by.

  2. Thought of a few more. The effects of:
    – topical tea tree oil, feverfew, chamomile, etc. There are so many products promoting “natural” ingredients like these, but I have no clue if there’s any evidence for them.
    – the “Oil Cleansing Method”
    – increased water consumption
    – “steaming” your face

    (Sorry there are so many. I obviously don’t expect you to address any or all of these; they’re just ideas!)

Comments are closed.