Medical Herbalism: Clinical Articles and Case Studies

Search entire site by keyword(s)
Free electronic MH newsletter
Information on Distance Learning in Herbalism
Back to articles index page
Back to

Skin - Acne cases


Linda Showler, ND

Medical Herbalism 2(1):5,8

Acne vulgaris cases are almost always quickly responsive to simple naturopathic treatment, as two of these cases demonstrate. I usually adjust the diet, especially looking for any tendency toward constipation and any underlying hormonal imbalances.

Gentler cleansing herbs such as dandelion (Taraxacum off.) and chicory (Chicorium intybus) will be appropriate for beginning treatment and for more sensitive patients. Stronger laxatives and cholegogoues like barberry (Berberis vulgaris) and yellow dock (Rumex crispus) (stronger still) will be more suitable for more robust types or for adding later on when the patient has begun to adjust to the detox process. In Case 1, dandelion root is replaced with barberry three weeks later. In Case 3, added to the milder trio of predominantly “broad spectrum” alteratives are the more digestive-tract-specific burdock and barberry directing the action of the combination closer to the root of the problem.

Especially in a young woman, I want to ascertain whether she’s a more androgenic or estrogenic type. If androgenic (thin, “straight from the shoulders down,” light periods, acne), then herbs such as the amphoteric Chaste-tree (Vitex agnus-castus), or Helonias (Chamaelirium luteum) will be most beneficial. I have seen several cases improve remarkably with the combination of vitex and taraxacum root, equal parts, 1 ml three times a day, along with a change in diet. If the woman is estrogenic (larger hips and thighs, heavier periods, acne), then liver herbs and a diet low in animal products will benefit.

In Case 1, I learned a great deal about the addition of herbs to hydrotherapy treatments. It is possible to achieve excellent results with hot and cold water alone for non-compliant patients. The addition of nettles to the diet in Case 1 is inspirational, but sheer brilliance is demonstrated by the clinician’s ability to get the teenager to comply! Nutritive cleansers like nettles and chickweed should be taken in food quantities this way rather than as part of a tincture, where the dose will be too small to make any difference.

In Case 2, there is a very impressive resolution of acne rosacea. In contrast to this case, however, I am always in favor of using the reliable bitters first, such as Gentian and Artemesia, without the addition of exogenous digestive aids. Let’s see how well we can help the digestive organs do their job before we testify to their failure by calling in outside aid. The bitters will work much more potently if dissolved in water and sipped, like an aperitif to be savored. The patients’ initial protests almost always transform into such comments as “You know, I’ve grown to actually like my bitters!”

In Case 3, we have a lifting of depression, and I look at the case and think this must be due to the homeopathic Sulphur. My first choice of an herb in this case would have been Vervain as it is both a delightful mood elevator and a digestive bitter. Oat groats could also be included in the diet to add a soothing mucilaginous bulk to the stool and to gradually tonify the nervous system.
Copyright 2001 Paul Bergner    370


    Medical Herbalism: Clinical Articles and Case Studies    

Linda Showler is a naturopathic physician with a private practice in Port Townsend, WA. She taught botanical medicine at Bastyr college in Seattle for three years.

CASE 1 Acne vulgaris

Patient: High school student. 15 year-old female. 5"1; 103 lbs.

Physician: (from teaching clinic of National College of Naturopathic Medicine)

Diagnosis: Acne vulgaris

Diet: “Normal” American diet. (lot’s of “junk” food)

Treatment Outline:

1) Burdock, Dandelion root, Echinacea, and Licorice. Tincture with equal parts. Take 30 drops three times a day.

2) Facial treatment: Apply hot Dandelion Root tea compress for three minutes, then cold water for 30 seconds. Repeat 5 cycles. Do Twice a day.

3) Facial wash: Calendula and Comfrey succus (low-alcohol tincture), equal parts, mixed with equal part water. Massage into face for five minutes daily.

4) Add Dandelion leaves to salads.

5) Oatmeal mask once a week. Apply oatmeal paste and leave on till dry. Then rinse off.

6) Diet: decrease sugar and fats, increase raw foods (especially salad)

7) Supplements: High potency multiple vitamin.

8) Exercise: Daily for 15 minutes.

Second visit: (2 weeks later)


1) The Dandelion tea would not stay hot for 3 minutes, so switched hydrotherapy treatment to three minutes hot water followed by 30 seconds cold Dandelion tea.
Copyright 2001 Paul Bergner    371


    Medical Herbalism: Clinical Articles and Case Studies

2) Add a facial steam twice a week: equal parts of peppermint, oat grass, chamomile, rosemary, Red Clover, and Euphrasia: add 3 T of dried herb mixture to pot of boiling water, turn off heat, let sit 10 minutes, sit under towel with face in steam from pot until it cools. Finish with cool rinse.

3) Add Nettles to the diet. One serving steamed daily.

Third visit (1 week later)

Results: Acne improved in the three weeks of treatment. (Practitioner comments: “The Treatments employed usually take longet to act in a case like this; the effects may be more placebo than physiological.”

Treatment Plan:

1) Change face wash to Comfrey tincture and Calendula succus, to add the astringent action of the alcohol.

2) Change tincture prescription: equal parts of Sarsaparilla, Echinacea, Chickory, and Oregon Grape; 30 drops three times a day.

3) Reevaluate in 2-3 weeks.

Important elements of case: both internal and external treatment. External treatments may be especially important for teenagers. Nutritive herbs. Periodically switching herbs.

CASE 2: Acne Rosacea

Physician: (from teaching clinic of National College of Naturopathic Medicine)

Patient: Twenty year-old female Height 5’6"; Weight 120 lbs.

Diagnosis: Acne Rosacea; on forehead and chin.


1) Gentian-Wormwood capsules. 3 “00”capsules before each meal.

2) Calendula-Witch Hazel Ointment. Apply to face at least twice a day.

3) Burdock tea: 4 Tablespoons dried root per quart of water. Boil 5 minutes. Drink througout the day.

4) Bromelain and HCl tablets before each meal.

5) Homeopathic: Rhus Tox 30c

Second visit: (three weeks later)

Results: Face completely cleared. Patient very satisfied with treatment.
Copyright 2001 Paul Bergner    372


    Medical Herbalism: Clinical Articles and Case Studies    

Treatment Plan: discontinue Bromelain and HCl. Continue Gentian/Wormwood. Continue Burdock Tea; switch to Dandelion Root tea in one month.

Important Elements of Case: Burdock ad libitum. Wholistic treatment. Astringent ointment for face. Homeopathic treatment. Good results within 3 weeks. Switch of tea in plan.

CASE 3 Acne vulgaris

Patient: Twenty-year-old female college student. Height 5’6"; Weight 130 lbs.

Physician: (from teaching clinic of National College of Naturopathic Medicine)

Diagnosis: Acne, with feelings of depression.


1) One ounce each of Red Clover, Echinacea, and Taraxacum. One tsp per cup of water. Two cups per day.

2) Supplements: Safflower oil; 1 Tbs/day. Beta-Carotene 100,000 IU. Zinc Gluconate 50 mg/day

3) Diet Modification: Cut out Diet Pepsi.

Second Visit: (two weeks later)

Results: No change in symptoms.


1) Add equal parts of Burdock Root powder and Oregon Grape Root to tea.

2) Increase Zinc gluconate to 50 mg. Three times a day.

3) Homeopathic: Sulphur 6c three times a day.

Third visit: (two weeks later)

Results: Fifty percent improvement in skin condition. No more pustules or lesions. Depression gone. No more sensitivity to touch or pressure.

Treatment Plan:

1) Continue present treatments.

2) Add 30 second face immersions in cold water. Get more sun.

Important elements of case: Zinc. Burdock and Berberis. Homeopathics.
Copyright 2001 Paul Bergner    373


    Medical Herbalism: Clinical Articles and Case Studies

CASE 4: Acne vulgaris with premenstrual exacerbation

Patient: Thirty-one year old female. Height 5’4". Weight 115 lbs.

Physician: (from teaching clinic of National College of Naturopathic Medicine)

Diagnosis: Acne vulgaris, with exacerbations around ovulation and at menses. Eruptions on face, behind ears and down the sides and back of neck.

History: Used birth control pills for 8 years, but not for last 4 years. Tried Lipotropic factors at an earlier visit, but found that they caused nausea.


1) Eight parts Burdock root: 1 part Dandleion root. Tincture, 30 drops twice a day.

Second Visit: (three weeks later)

Lessening of facial lesions, but no change behind ears or on neck.

Change not necessarily due to treatment; condition often varies during menstrual cycle.
Copyright 2001 Paul Bergner    374