Natural Treatments for Acne

Overview 

While acne is most commonly seen in teenagers (particularly in males) due to hormonal fluctuations that occur during puberty, this condition isn’t limited to adolescents. In fact, approximately 20% of all adults (most of them women) experience an unwelcome resurgence of acne long after the senior prom. Overall, acne is the most common skin condition for people of all ages. 

Regardless of age, acne occurs by the same process and its cause is rooted in the pilosebaceuous unit of the skin, also known as the common pore. The skin of the average person contains about 4 million pores, each of which are constructed of a hair follicle and surrounding sebaceous glands that provide nutrients and lubricating oils (sebum) via the follicle canal, or comedo.  Hormones, such as testosterone, stimulate the cells of the follicular canal to make keratin, a protein and building block of skin, hair and nails. At the same time, these hormones trigger the sebaceous glands to produce excess sebum. From here, dead skin cells can become trapped by the sebum and block the follicular canal, causing the follicular canal to become inflamed. If the block is partial, it becomes visible on the skin as the common blackhead. However, if the blockage is complete, a white head occurs, which remains under the skin and usually fails to ‘come to a head.’ Further, if the bacterium Propionibacterium acnes gains access to the site, it feeds on the excess sebum and causes even more inflammation. In any case, the result is the same--a pimple is formed.  

It’s easy to see how this process is promoted by excess testosterone production in teenagers. However, an imbalance of hormones also occurs in adults, particularly in perimenopausal women. Yet another biological action may contribute to the reintroduction of acne in adults. Researchers have found that adult subjects with acne exhibit elevated levels of the enzyme 5-alpha-reductase as well, which causes the conversion of testosterone into its concentrated form of dihydrotestosterone. (Incidentally, this substance not only encourages acne in both adult men and women, but is also a major factor in male pattern balding and enlarged prostate in men.) 

Common Myths About Acne 

It is a common belief that consuming certain foods, such as soda, chocolate, potato chips and French fries, can lead to frequent acne breakouts. In truth, there is no scientific evidence that supports this belief. In fact, it’s more likely that these foods have become so strongly associated with acne simply because teenagers often indulge in them. However, since the skin is an organ of filtration and elimination, it might be prudent to reduce your intake of foods with a high concentration of refined sugars, oxidized fatty acids (fried oils) and trans-fatty acids and adopt a low-fat diet rich in whole grains, fruits and vegetables instead. If there’s any proof that such a diet may prevent acne altogether, it would be evidenced by several indigenous populations located throughout the world where neither processed foods nor any cases of acne can be found. 

One caveat: it should be noted that there is a correlation between acne and iodized foods, such as salt. This list can be extended to include naturally iodine-rich foods as well, including kelp, liver, cheese and shellfish. 

Another popular misconception is that one can prevent or treat acne flare-ups with frequent and vigorous cleansing. However, harsh cleansers and even washcloths can irritate and further inflame acne-prone skin, not to mention strip the natural oils from skin that are needed to nourish follicles and help neutralize invading bacteria. There is also the fact that acne is formed under the skin and not on the surface, as many advertisements for acne treatments would lead you to believe. 

Treating Acne Naturally 

As the old adage says, beauty is skin deep. The same philosophy can be applied to treating acne—start from the inside, no matter what your age, skin type or snack preference. The following are some general recommendations: 

-         Handle skin gently. Washing with a mild cleanser, warm (not hot) water and with only the aid of your hands is sufficient. Over-cleansing will compromise your skin’s pH balance and only lead to more irritation and, possibly, more pimples.

-         Don’t forget to moisturize. Dry skin also contributes to break outs, so be sure to use a non-greasy daily moisturizer to keep skin subtle and maintain a healthy pH.

-         Strive to use natural cosmetics and avoid liquid creams and foundations that usually contain heavy oils. In fact, the popular mineral-based makeup is ideal for sensitive, acne-prone skin and can now be found on the common market at an affordable cost for most people.

-         Nourish your skin from the inside out by adhering to a healthy diet low in fat and high in whole grains, fruits and vegetables. 

Just as the above measures can help to improve the overall health of your skin and reduce the occurrence and severity of acne, there are also a few precautions you can take to avoid damaging skin further, such as: 

-         Avoid overusing commercial acne treatments that can burn the skin, especially those containing benzyl peroxide, sulphur or zinc. Instead, look for topical acne products that contain botanicals such as green tea, which provide antioxidant properties to help minimize inflammation. Topical applications of products containing tea tree oil are very effective in checking many kinds of bacteria, including Propionibacterium acnes. Of particular interest is the ingredient azelaic acid, a naturally occurring acid derived from grains, such as wheat, rye and barley. The efficacy of azelaic acid in terms of regulating keratin production has been compared to topical Retin-A and the antibiotic tetracycline, but without harmful side effects.

-         Be aware that although oral antibiotics may help to reduce acne flare-ups, they can also destroy beneficial intestinal flora needed to maintain healthy digestion and to neutralize toxins, even those generated from normal metabolism in the body.

-         Consider that other oral medications commonly used in the treatment of acne, such as isotretinoin, are linked to serious birth defects if taken during or immediately prior to becoming pregnant. These medications are also known to contribute to depression, arthritis and a loss of bone density. 

Supplements in the Treatment of Acne

Vitamins and Minerals 

Vitamin B-6, in the form of pyridoxine, promotes normal metabolism of steroid hormones. In fact, a deficiency of this vitamin is associated with impaired uptake and sensitivity to testosterone. 

Vitamin A effectively improves acne by inhibiting the excessive production of sebum and keratin. Prescription doses of vitamin A have demonstrated its value as an anti-acne treatment. However, supplementing with very high doses of this vitamin does pose certain risks, including potential birth defects. On the other hand, an adequate intake of vitamin A can be ensured by consuming at least five servings of fresh fruits and vegetables a day. 

Selenium has a direct impact on gluthathione peroxidase, an enzyme that helps to reduce inflammation of hair follicles. As with the case of vitamin B-6, many acne sufferers are found to be deficient in selenium.  

Vitamin E not only provides antioxidant value, but it is also necessary for the successful metabolism of vitamin A and selenium. 

Zinc also supports the mechanism of vitamin A, as well as inhibiting the conversion of testosterone to dihydrotestosterone. (It is interesting to note that blood levels of zinc are often lower in 13 to 14-year old males than in any other age group.) The most effective form of zinc in the treatment of acne appears to be zinc gluconate. The best dietary source of this common form of zinc is animal protein, particularly darker meats (i.e., beef, pork, etc.). Plant-based forms of zinc are not as readily absorbed and utilized by the body, indicating that the treatment of acne with this mineral for those who partake of a vegetarian or vegan diet necessitates supplementation. 

Helpful Herbs to Treat Acne 

Burdock 

Burdock has long been used to treat a variety of skin disorders, including acne. The liquid extract obtained from the root of this plant contains at least 14 different polyacetylene compounds, two of them with demonstrated antibacterial, antifungal and anti-inflammatory properties. The dried root, however, does not possess the same level of benefit as the liquid extract. Fortunately, the fresh root is quite edible. In fact, cooked, steamed or baked burdock root is common to Asian cuisine, where the tender young taproots are referred to as gobo. 

Yellow Dock Root 

While there is not a great deal of clinical evidence that this botanical is beneficial in the treatment of acne, herbalists have recommended it for this purpose for many years. The reason for this may be due to the fact that preparations made from the dried root stimulate gastric secretions, in effect aiding in digestion and, possibly, purification of environmental and dietary toxins. Yellow dock root is also a rich source of selenium and magnesium, which may have helped to further this herb’s reputation for helping to improve acne. 

Red Clover 

Red clover contains the isoflavones biochanin, daidzein, formononetin and genistein, all of which possess estrogenic properties. For this reason, it is often taken to help reduce the severity and frequency of menopausal symptoms in women. However, it is also possible that this herb may help to improve acne as well as other skin conditions due to its hormone balancing action. 

Dandelion 

Dandelion preparations stimulate the production and release of bile from the liver. Aside from the detoxification benefit to be gained, this action also promotes the breakdown of steroid hormones. Herbalists often recommend taking encapsulated dried leaf of dandelion in combination with burdock root extract. 

Neem 

Neem leaf contains the compounds gedunin and nimbidol, which exhibit very effective antifungal qualities. An important botanical in Ayurvedic medicine, neem has been shown to reduce the effect of Propionibacterium acnes by significantly inhibiting inflammatory mediators, such as cytokines.

Safety Precautions 

-         Do not supplement with vitamin A if you are pregnant or may become pregnant. Doses of 5000 IU or more are strongly linked birth defects.

-         Vitamin A supplementation should be also be avoided if you are currently taking blood thinners (warfarin).

-         Zinc may cause digestive upset and/or produce a metallic taste in the mouth in some people.

-         High doses of zinc can deplete copper, magnesium and iron in the body, impair immune function, and reduce serum levels of HDL cholesterol (the ‘good’ kind).

-         Do not take zinc supplements if you are also taking amiloride (a diuretic), or a toxic buildup of zinc may occur.

-         Burdock preparations may cause sensitivity in individuals allergic to chrysanthemums.

-         Burdock may cause uterine stimulation and should be avoided by pregnant women.

-         Be aware that yellow dock can produce a laxative effect. Therefore, do not supplement with this botanical if you are using other stimulant laxatives (such as furosemide). Doing so may cause a potassium deficiency.

-         Avoid red clover if you are taking blood thinners or if you have been diagnosed with estrogen-receptor-positive breast cancer, ovarian cancer or endometriosis due to its estrogenic activity. 

References: 

1. Takayasu S, Wakimoto H, Itami S, et al. Activity of testosterone 5 alpha-reductase in various tissues of human skin. J Invest Dermatol. 1980 Apr;74(4):187-91.
2. Leachman SA, et. al. Bone densities in patients receiving isotretinoin for cystic acne. Archives of Dermatology 1999 Aug;135(8):961-5.
3. Maddin S. A comparison of topical azelaic acid 20% cream and topical metronidazole 0.75% cream in the treatment of patients with papulopustular rosacea. Journal of the American Academy of Dermatology 1999 Jun;40(6 Pt I):961-5.
4. Gibson JR. Azelaic acid 20% cream (AZELEX) and the medical management of acne vulgaris. Dermatological Nursing 1997 Oct;9(5):339-44.
5. Carson CF, Riley TV. The antimicrobial activity of tea tree oil. Med J Aust. 1994 Feb 21;160(4):236.
6. Michaëlsson G, Vahlquist A, Juhlin L. Serum zinc and retinol-binding protein in acne. Br J Dermatol. 1977 Mar;96(3):283-6.
7. Michaëlsson G, Vahlquist A, Juhlin L, et al. Zinc and vitamin A: serum concentrations of zinc and retinol-binding protein (RBP) in healthy adolescents. Scand J Clin Lab Invest. 1976 Dec;36(8):827-32.
8. Tice J, et al. Phytoestrogen Supplements for the Treatment of Hot Flashes: The Isoflavone Clover Extract (ICE) Study: A Randomized Controlled Trial. JAMA. 2003 Jul 9;290(2):207-14.
9. Greenlee H, Atkinson C, Stanczyk FZ, et al. A pilot and feasibility study on the effects of naturopathic botanical and dietary interventions on sex steroid hormone metabolism in premenopausal women. Cancer Epidemiol Biomarkers Prev. 2007 Aug;16(8):1601-9.
10. Di Mambro VM, Fonseca MJ. Assays of physical stability and antioxidant activity of a topical formulation added with different plant extracts. J Pharm Biomed Anal. 2005 Feb 23;37(2):287-95.
11. Zhi X, Honda K, Ozaki K, et al. Dandelion T-1 extract up-regulates reproductive hormone receptor expression in mice. Int J Mol Med. 2007 Sep;20(3):287-92.
12. Jain A, Basal E. Inhibition of Propionibacterium acnes-induced mediators of inflammation by Indian herbs. Phytomedicine. 2003 Jan;10(1):34-8.