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Skin - Acne

by Paul Bergner

Medical Herbalism 2(2):1,4-5

Acne is the most common of skin diseases. It affects males more severely than females, and typically accompanies the hormonal changes of puberty, mild to severe acne being almost universal among adolescents in the U.S. Acne is a self-limiting condition, usually passing on its own in the late teens or early twenties without particular treatment. It is a common cause of discomfort to self-conscious teenagers and others, however, who often seek medical advice or use over-the-counter products to control it. Lesions may affect the face, neck, upper back, shoulders and chest. Besides its more temporary embarrassing social effects, severe acne can lead to permanent scarring.

Acne, Diet, and Supplementation

Despite the popular assumption that specific foods bring on an acne attack, controlled studies fail to bear this out. Many patients report that their acne worsens within 36 hours of eating a particular food, that it will worsen in proportion to the amount of the food eaten, and that the acne-flareup will last 3-5 days. Experimental groups of such patients, all “sensitive” to the same food, ate large amounts of the offending food daily for a week. No major flareups of acne appeared, and about half the patients (as would be expected by chance) actually showed improvement.(Anderson, 1971)

Acne has been positively associated with some dietary factors, even if not with specific foods. The incidence of acne in young black populations (eating a traditional diet) in both Zambia and Kenya is much less than that of young blacks in the U.S. Observational studies indicate that a low fat, high fiber and low refined carbohydrate diet may be beneficial for acne (although compliance with a teenager may be a challenge!) (Frank, 1971; Kaufman, 1983; Ringsdorf et al., 1976) The interaction of sugar and acne may be profound; oral glucose tolerance is unchanged in acne, but skin glucose tolerance is impaired. (Abdel et al., 1977) One researcher has even called acne “diabetes of the skin,” (Cohen et al., 1959) and acne has been treated successfully with insulin. (Grover et al., 1963)

Acne may also be related to zinc deficiency. (Pohit et al. 1985)

Zinc supplementation at levels of 90-150 mg zinc a day for 12 weeks may give significant improvement for 70-85% of acne patients, giving better results than oral antibiotics with fewer side effects. (Michaelsson et al., 1977[a,b]; Hillstrom, 1977)

Conventional Medical Treatment

Although pustular discharges from acne are often sterile, or contain only normal skin bacteria, the conventional treatment relies on long-term use of antibiotics, usually for years. Oral antibiotics and antibiotic ointments are used, and are associated with systemic side effects (vaginal candidiasis) and the development of resistant strains of bacteria when continued for long periods of time.
Copyright 2001 Paul Bergner    367


    Medical Herbalism: Clinical Articles and Case Studies

More recently the drug isotretinoin (Accutane) has been hailed as “revolutionary” development in the treatment of acne. (Merck, 1987) Isotretinoin acts by drying up the glandular secretions of the skin. It has almost universal side effects of dryness of the eyes, lips and genitalia. Isotretinoin also causes birth defects, and should never be used by women of child bearing age not using birth control. While isotretinoin may be a godsend in a rare case of severe disfiguring acne, it does nothing to treat the underlying conditions permitting the acne to run rampant, and is not appropriate for the great majority of acne patients. If conventional physicians better understood the use of diet, botanicals, and lifestyle modification in the treatment of disease, they would not have to rely on such drastic agents.

To wash or not to wash

Conventional medical texts in the U.S. also advocate frequent washing of oily skin although acknowledging that it has no effect on acne. (Merck, 1987) French physicians, on the other hand, advise against excessive washing in skin diseases (often no more than once a week), warning against a condition of “reactive seborrhea,” where washing oily skin causes greater amounts of oil to be secreted. They especially caution against using soap and water. (Payer, 1988)

Botanical Treatments

Botanical treatments will work best in conjunction with dietary changes. Usually 3-12 weeks are required to effect changes from combined dietary and herbal treatment. Botanical treatments might include:

1) Bitter tonic herbs.

These improve the digestion and tonify the liver, which is important for regulation of the hormones involved with acne. The classic herb for liver-skin conditions is burdock root (Arctium lappa) which may be drunk freely as a tea or eaten in food quantities. Other bitter tonics are Dandelion root, Oregon Grape, Barberry, and Chicory.

2) Immune stimulating herbs.

These assist with any infection that might be present. The classic herb for such “surface” conditions as acne (or colds) is Echinacea. Echinacea also has a bitter and cooling quality that supports the action of bitter tonics.

3) Compresses

Astringent and demulcent herbs applied directly to the face may help to dry and heal the pustules, as well as give the patient something to do directly for the problem.
Copyright 2001 Paul Bergner    368


    Medical Herbalism: Clinical Articles and Case Studies    

4) Nutritive herbs.

Teenagers often have poor diets, and getting compliance for diet or exercise changes is a challenge. Adding nutritive herbs, such as Nettles or Alfalfa to the diet can be beneficial.


Anderson PC. “Foods as a cause of acne.” Am Fam Phys 3(3):102-03, 1971.

Abdel KM et al.; Glucose tolerance in blood and skin of patients with acne vulgaris. Ind J Derm 22:139-49. 1977.

Cohen J and Cohen A. Pustular acne staphyloderma and its treatment with tolbutamide. Can Med Assn J 80:629-32, 1959

Frank SB Acne Vulgaris. Springfield, Charles C Thomas (publisher) Springfield, Ill. 1971

Grover R and Arikan N: The effect of intralesional insulin and glucagon in acne vulgaris. L Invest Derm 40:259-61, 1963

Hillstrom L Brit J Derm December 1977

Kaufman WF. “The diet and acne.” Arch Dermatology 119(4):276, 1983.

The Merck Manual, fifteenth Edition. 1987.

Michaelsson G et al. A double blind study of the effect of zinc and oxytetracycline in acne vulgaris. Brit J Derm 97:561, 1977

Michaelsson G et al. Effects of oral zinc and vitamin A in Acne. Arch Derm 113:31-36, 1977

Payer L. Medicine and Culture Henry Holt and Company. New York 1988 p.67-68

Pohit J et al. Zinc status of acne vulgaris patients. J

Applied Nutr. 37(1):18-25, 1985

Ringsdorf, Wm Jr., Cheraskin E. “Diet and dermatosis.” South Med J 69(6):732, 1976.
Copyright 2001 Paul Bergner    369