Acne: Holistic Treatment for a Common Teenage Problem
Zits! Horrid, dreaded, hated. Zits!
No earthly good can come from a zit. Ask any teen who stares into the mirror before a date. Why don’t those teenage models in fashion magazines have zits? The airbrush. “Mom can you get me an airbrush?” No magic wand exists, but there are measures that work to prevent and treat acne. A combination of approaches will bring the best results.
Will teenagers make the effort and take the time to institute preventive measures for acne? Some will, especially if the measures are not too complicated. For those people whose acne persists into the adult years, the dietary and lifestyle changes will have overall beneficial effects on health as well.
The androgenic hormones, particularly testosterone, that increase at puberty, and the surge of premenstrual hormones, trigger increased production of sebum in the sweat glands. The pores become clogged with both sebum and dead skin cells creating a prime breeding ground for bacteria. These bacteria and the breakdown products of sebum cause irritation and inflammation in the pores. The result is acne – blackheads, whiteheads, pustules, and cysts in the skin. Unfortunately, certain people are genetically predisposed to have more problems with acne than others.
Chinese medicine theory attributes acne to Heat and Toxicity in the Blood. Because acne lesions often occur along the classic T pattern, on the forehead, around the nose, and on the chin, where the energy meridians of the Stomach, Small Intestine, and Large Intestine originate and end, acne is also seen as a digestive problem. The skin has become an eliminating organ because of toxins resulting from poor digestion or chemical exposure.
What to do?
The measures to prevent and cure acne include diet, hygiene, nutritional supplements, and medicines. Maintain a consistent preventive and treatment program and acne will resolve. Natural treatments have no side effects. Drugs can cause problems, but may be necessary in persistent cases. Most problems with acne, however, will respond to natural treatments and a diligent program of diet and skin care.
The type of fats in the diet are a key factor for acne control. Use olive oil for cooking and on salads. Saturated fats and partially hydrogenated fats cause damage to body tissues and promote inflammation. Saturated fats are solid at room temperature and usually come from animal sources. Eat non-fat or low-fat dairy products. Cut back on red meats and butter. Partially hydrogenated fats are even worse because they replace unsaturated fats in cells. Eliminate partially hydrogenated fats from the diet. Avoid packaged snack foods, chips, crackers, and cookies that contain these fats. Read the labels on packaged products. Never eat margarine. Avoid fried foods. Oils that are heated and re-used to make French fries and fried chicken contain particularly harmful toxins. Supplement the diet with the omega-3 fats found in salmon and flax seeds. Avoid the omega-6 fats of vegetable oils (corn oil, safflower oil, soybean oil, cottonseed oil) because they promote inflammation.
It is also important to eat adequate quantities of protein and not overeat carbohydrates in order to prevent inflammation. Cut back on baked foods made with wheat flour and any foods containing large amounts of sugar. Overloading on carbohydrates is a major cause of weight problems and tissue damage. Overeating also increases testosterone levels and promotes acne. Do not eat more than necessary to maintain body weight and energy expenditure.
Eat plenty of fresh fruits, vegetables, and salads. The vitamins contained in these foods can have a significant beneficial effect on acne. The fiber is essential for healthy digestion and elimination. Foods high in vitamin A and beta-carotene are especially good nutritional sources (carrots, sweet potatoes, apricots, and green leafy vegetables, spinach, kale, and romaine lettuce).
Avoid foods that increase Heat in the body, spicy foods, garlic, and coffee. Drink plenty of purified water or spring water (up to 4 quarts of water a day) to flush out toxins and transport nutrients.
1. Cut back on saturated fats (whole milk, cheese, and red meat).
2. Eliminate partially hydrogenated fats. (Read labels. They are contained in chips crackers, and cookies, all those snack foods in a box or bag).
3. Eat fresh fruits, vegetables, and salads.
Nutritional supplements for acne will decrease inflammation and infection and nourish the skin. If consumption of fresh fruits and vegetables is low, take a multi-vitamin supplement. Buy supplements at a health food store rather than a discount store or supermarket. The vitamin and mineral sources will be higher quality. Remember that foods provide a more balanced and absorbable form of nutrients than pills. Reliance on supplements as the only source of vitamins will not produce adequate results.
The most important vitamins and minerals for acne eruptions are vitamin A/beta-carotene and zinc. Vitamin A is necessary for skin healing. Take 25,000 units of vitamin A or beta-carotene twice a day. Zinc aids in healing of tissue and assists in preventing scarring. It also helps the body resist infection and inflammation. Zinc is one mineral that has shown to benefit acne in a scientific study. Take 50 mg of zinc in combination with 5 mg of copper, which can become deficient during zinc supplementation. Do not take more than 100 mg of zinc in supplements per day.
Omega-3 fatty acids have antibacterial and anti-inflammatory effects. They maintain healthy cell membranes and ensure the normal transport of nutrients into cells. For those reasons, a supplement of omega-3 fats is one of the most important nutrients for acne. Take one tablespoon of flaxseed oil each day. The easiest way is to blend a smoothie with fruit, yogurt or milk, and flaxseed oil. Add a scoop of protein powder (soy or whey powder) to boost protein intake as well. For those people who find it difficult to use flaxseed oil, take capsules of concentrated fish oil (three 1,000 mg. capsules per day).
Acidophilus is a normal intestinal bacteria that can be easily destroyed. Take a supplement of acidophilus to maintain normal digestive function.
For people with especially oily skin, digestive (pancreatic) enzymes are important. Fats may not be fully digested and a supplement with meals will provide the enzymes lipase, protease, and amylase for adequate break down of fats, proteins, and carbohydrates, improving the digestive process.
Nutritional supplement essentials
1. Flaxseed oil – 1 tablespoon per day with meals
Concentrated fish oil – 3 capsules per day
2. Zinc with Copper (50 mg zinc and 5 mg copper per day)
3. Acidophilus capsules (1 capsule twice/day) with meals
There are two reasons for people with acne to apply things to the skin. One is to exfoliate skin cells. Hormones that cause acne also cause excess shedding of skin cells, which block the pores. Exfoliants will correct abnormal shedding and unclog the pores. The second type of application, antiseptics and antibacterials will help prevent infections in the pores.
It is important to maintain an acid environment in the skin. Do not wash the skin with soap, which is too alkaline and debrides the acid mantle of the skin. Instead, use a facial brush and hot water. Do not use products that contain alcohol.
Alpha-hydroxy acids are naturally occurring acids found in sugar cane and citrus fruit. They augment the skin’s exfoliating abilities and decrease the build-up of dead skin cells. They have been shown to improve acne. The most common are lactic acid and glycolic acid.
Lemon juice wash
Wash with hot water and a facial brush or washcloth. Squeeze a fresh lemon into a small bowl and put the juice on a cotton ball. Apply cotton ball to face. Repeat soaking of cotton ball in lemon juice as needed. Let lemon juice dry on face for about 10 minutes then rinse with cool water. The lemon juice should make your face sting or mildly burn. For sensitive skin, dilute juice with filtered water.
Once the skin is regenerating (after two weeks using gentle, natural treatments) you may want to add a stronger facial exfoliant. Many cosmetic manufacturers produce Glycolic acid formulas (15 percent strength). Avoid products that contain heavy moisturizing ingredients and alcohol. Glycolic acid helps loosen or break up the outer layer of the skin and prevents excessive build-up of dead skin cells.
Vitamin A derivatives (retinoids) – topical vitamin A acid – normalizes the way skin grows and sheds and stabilizes the openings of pores. It also creates an unwelcome environment for bacteria. Retin-A and other retinoids in cream or gel are available by prescription only. Side effects include red skin and peeling, and sun sensitivity. Do not use during pregnancy.
Antiseptics and antibacterials
Use uncooked honey, apply to face and pat until sticky. Leave in place for five minutes. Honey enzymes rejuvenate the skin and act as an antimicrobial.
Tea tree oil has been shown to remove and stop the growth of bacteria on the skin. An Australian study showed that a 5 percent tea tree oil gel was as effective as 5 percent benzoyl peroxide. Tea tree oil is the only essential oil (except for lavender) that can be applied directly to the skin with no carrier oil. Like other antimicrobials, tea tree oil should be used in a consistent daily regimen to prevent infections.
Benzoyl peroxide reduces bacteria on the skin and helps to peel the superficial layer of cells. Gentler, lower strengths (3-5 percent solutions) are less irritating and equally effective as stronger solutions. Again, avoid formulas that contain alcohol or cleansers. Benzoyl peroxide is a bleach. It may bleach clothing and can be irritating. Side effects include irritation, drying, itching, redness, and peeling.
Azelaic acid is found naturally in wheat, rye and barley. It acts as an antimicrobial, but also assists the normal sloughing and regrowth of skin cells. Apply it topically in a 20 percent cream formula (Azelex). Azelaic acid is a scavenger of free radicals and inhibits the negative effects of testosterone in the skin. It may cause irritation, redness, peeling, and depigmentation of the skin. Use it as a second line of treatment after instituting more natural, regenerating methods.
Topical antibiotics work by reducing inflammation rather than killing bacteria, since most bacteria become resistant. The antibiotics for this purpose, erythromycin and clindomycin, are available by prescription only in creams, gels, pads or lotions.
Seek out a practitioner of traditional Chinese medicine for herbal treatments to remove Heat and Toxins and also correct the energetic imbalances associated with acne. A practitioner will determine the correct herbal formulations for each individual based on symptom expression.
If natural methods of treatment have not succeeded after a six-month trial, then a course of oral (systemic) antibiotics may be required. The most common antibiotic prescriptions are erythromycin, minocycline, and tetracycline. A short course of 5-7 days is safest. Be aware that antibiotics may cause unwanted side effects, especially if used over an extended period of time. It is possible that antibiotics can aggravate acne symptoms, or replace a primary infection with a secondary acne infection. Antibiotics may also cause yeast overgrowth symptoms, vaginal yeast infections, upset stomach, allergies, increased susceptibility to sun-damage, yellowing of teeth, decrease in absorption of some vitamins and minerals, and increased bacterial resistance.
Homeopathy and cystic acne
Severe acne symptoms may be helped by treatment from a homeopathic practitioner. A constitutional homeopathic prescription can raise resistance, increase immune system strength, and help resolve the tendency to develop severe acne lesions.
Natural program for acne
Diet – stop bad fats, drink water, and eat fruits and vegetables
Supplements – zinc, acidophilus, flaxseed oil
Skin treatments – lemon juice wash, honey facials or tea tree oil
then glycolic acid and azelaic acid
Referral sources for medical care
American Association of Oriental Medicine, aaom.org, 888 500-7999
California State Oriental Medical Association, csoma.com, 800 477-4564
Council for Homeopathic Certification, homeopathy-council.org, 415 789-7677
National Center for Homeopathy, healthy.net/nch, 703 548-7790
My thanks to Efrem Korngold OMD, author of Between Heaven and Earth: A Guide to Chinese Medicine, (Ballantine Books, 1991), and to Thomas Munyon MD, dermatologist, for their valuable insights into acne treatment.
Med J Aust 1990 Oct 15;153(8):455-458 A comparative study of tea-tree oil versus benzoyl peroxide in the treatment of acne. Bassett IB, Pannowitz DL, Barnetson RS
Lett Appl Microbiol 1995 Oct;21(4):242-245 Antimicrobial effects of tea-tree oil and its major components on Staphylococcus aureus, Staph. epidermidis and Propionibacterium acnes. Raman A, Weir U, Bloomfield SF
Br J Dermatol 1979, 101, 321-325 A double-blind trial of a zinc sulphate/citrate complex and tetracycline in the treatment of acne. Cunliffe, WJ, et al.
Clin Ther 1998 Jul-Aug;20(4):711-21 Efficacy and safety of azelaic acid and glycolic acid combination therapy compared with tretinoin therapy for acne. Spellman MC, Pincus SH
Dermatology 1998; 196(1):130-4 An overview of topical antibiotics for acne treatment. Toyoda M, Morohashi M.
Dermatology 1998;196(1):108-15 Coping with acne vulgaris. Evaluation of the chronic skin disorder questionnaire in patients with acne. Niemeier V, et al.
Dermatology 1998;196(1):59-66 Bacterial resistance in acne. Eady, EA
Lancet 1998 Feb 7;351(9100):422 Antibiotic resistance can be an unwelcome side-effect of acne treatment. Dawson J
Encyclopedia of Nutritional Supplements, Michael T. Murray, N.D., Prima Publishing (1996)
Herbal Healing for Women, Rosemary Gladstar, Simon & Schuster (1993)
A.N. Chiang, et al., “Excess Energy and Nitrogen Balance at Protein Intakes Above the Requirement Level in Young Men,” Am. J. Clin. Nutr. 48 (1988) : 1015-1022.
G.B. Forbes, et al., “Hormonal Response to Overfeeding,” Am. J. Clin. Nutr. 49.4 (1989) : 608-611.
G.B. Forbes, et al., “Lean Body Mass in Obesity,” Int. J. Obes. 7.2 (1983) : 99-107.
Jebb, et al., “Changes in Macronutrient Balance During Over- and Underfeeding Assessed by 12-Day Continuous Whole-Body Calorimetry,” Am. J. Clin. Nutr. 64 (1996) : 259-266.