Acne

cystic acne hormonal

Naturopathic Treatment of Acne

by Dr. Pamela Frank, BSc(Hons), ND

Acne in women beyond puberty is caused by persistent hormone imbalances usually estrogen dominance or androgen (male hormone) excess.  Symptoms of estrogen dominance can include very heavy and/or very painful periods, tender breasts, weepiness or feeling highly emotional.    Androgen excess usually manifests as deeper, cystic type acne on the chest, back and/or jaw line and is often accompanied by other symptoms of excess androgens including thinning hair, irregular periods, infertility, and excessive hair growth in unwanted areas.

The Naturopathic Approach to Acne

  1. Balance hormones (estrogen, progesterone, testosterone, DHT and DHEAs) through:
    • healthy diet
    • regular exercise
    • stress reduction
    • liver detoxification (not through the kits from the health food store!)
    • mineral support
  2. Increase healthy skin nutrients through diet and/or supplementation.
  3. Decrease excess oil production in the skin
  4. Improve immune system function to prevent excessive bacterial growth on the skin
  5. Testing for and elimination of food allergies

The Benefits to Naturopathic Acne Treatment

  1. Better hormone balance to prevent hormone related conditions like breast cancer
  2. Healthier looking skin without chemicals on your skin
  3. Healthier looking skin without chronic antibiotic use
  4. Healthier looking skin without hormone treatments like birth control pills
  5. Healthier looking skin without harsh drugs like accutane
  6. Lasting improvement versus recurrence every time you stop treatment
  7. Lower overall (systemic) levels of inflammation

Research on Natural Treatment for Acne

Diet & Acne: Observational studies reported that cow’s milk intake increased acne prevalence and severity, and a positive association between a high-glycemic-load diet, hormonal mediators, and acne risk. Source: Skin Therapy Letter, Volume 15, Issue 3, pages 1-2, 5, March 2010.

Probiotics & Health: Probiotics have been found to help irritable bowel related diarrhea and pain, chemotherapy- and radiation-induced diarrhea, constipation, immunity, allergies and acne.  Source: Complementary Prescriptions Journal, Vol.26, Issue 12, Dec. 2012

Fish oil & Acne: Fish oil supplementation may be associated with an improvement in ratings of overall acne severity in those with inflammatory acne. Source: Lipids Health Dis. 2012 Dec 3;11:165.

Diet & Acne: There are lower incidences of acne in non-Western populations. Their diets do not contain processed foods, dairy, sugars and refined oils. Instead, they eat mainly fresh food, fruit, vegetables, meat, chicken, and grilled seafood.  Source: An Bras Dermatol. 2010 Jun;85(3):346-53.

Barberry: Fouladi RF. Aqueous extract of dried fruit of Berberis vulgaris L. in acne vulgaris, a clinical trial. J Diet
Suppl . 2012; 9(4):253-61.
After 4 weeks of treatment, mean # of non-inflamed, inflamed and total lesions, plus Michaelson’s acne severity score, decreased significantly in barberry group (ages 12-17)

Aloe vera gel: Hajheydari Z, Saeedi M, Morteza-Semnani K, Soltani A. Effect of Aloe vera topical gel combined with
tretinoin in treatment of mild and moderate acne vulgaris: a randomized, double-blind, prospective trial. J Dermatolog Treat. 2014; 25(2):123-9.
The combination of TR/AVG was significantly more effective in reducing non-inflammatory, inflammatory and total lesion scores compared to control group; at the end of the study, erythema in the TR/AVG group was significantly less severe.

Lactobacillus fermented Hinoki Cypress Cream: Kwon HH, Yoon JY, Park SY, Min S, Suh DH. Comparison of clinical and histological effects between lactobacillus-fermented Chamaecyparis obtusa and tea tree oil for the treatment of acne: an eight-week double-blind randomized controlled split-face study. Dermatology . 2014;
229(2):102-9.
Comparison between lactobacillus-fermented Hinoki cypress cream vs. tea tree oil finds the cream was more effective at reducing the number of inflammatory acne lesions (although both treatments reduced the number), worked faster than tea tree oil, decreased size of sebaceous glands and sebum output – there were also significant decreases in NFkB, IL-1alpha, IL-8, insulin-like growth factor 1 receptor and sterol regulatory element-binding protein 1.

Low Glycemic Index Diet: Smith RN, Mann NJ, Braue A, Makelainen H, Varigos GA. A low-glycemic diet improves symptoms in acne vulgaris patients: a randomized controlled trial. Am J Clin Nutr . 2007; 86(1):107-15.
Male acne patients (ages 15-25) for 12 week – low glycemic diet was 25% energy from protein and 45% from low-glycemic-index carbohydrates; control diet emphasized carbohydrate-dense foods without reference to glycemic index.
● Total lesion counts decreased in low-GI group compared to control group
● Experimental diet also resulted in greater reduction in weight and BMI and improved insulin sensitivity compared to control

Great summary of the research on acne and plants:

A review of phytotherapy of acne vulgaris: Perspective of new pharmacological treatments 

Acne Medications:

  1. Antibiotics – such as clindamycin, doxycycline, erythromycin, and tetracycline. Excess oil production on the skin and poor immune function can lead to excessive bacteria growth on the skin.  Antibiotics will help kill of the bacteria on the skin but they also can disrupt the beneficial bacteria in the digestive tract and weaken the immune system. Killing off the bacteria on the skin isn’t really addressing the root of the problem which is the hormone imbalance that leads to the excessive oil and bacteria growth, so antibiotics are only a temporary solution.  Antibiotic side effects include: Nausea, vomiting, diarrhea, lightheadedness, dizziness, unsteadiness, drowsiness, mouth sores, cough, sunburn (sun sensitivity), muscle pain, difficult or painful swallowing, change in the amount of urine, pink urine, brown/gray tooth discoloration, blue/gray/brown discoloration of the skin/lips/tongue/gums, numbness/tingling of the hands/feet, unusual fatigue, stopping of menstrual periods, or new signs of infection (e.g., fever, chills, persistent sore throat, yeast infection).
  2. Oral Contraceptives – birth control pills will provide measured amounts of hormones and can help shut down excessive hormone production from the ovaries.  However, that doesn’t really fix the underlying problem, it just masks it temporarily while you take the pill.  Balancing hormones means ensuring that diet is clean, stress is managed, you exercise regularly and your liver is efficiently managing hormones and chemicals that can be acting like hormones.  Common side effects of the birth control pill include: Acne; breast tenderness or enlargement; changes in appetite; changes in sexual interest; changes in weight; dizziness; hair loss; headache; nausea; stomach cramps or bloating; unusual spotting or bleeding; vomiting.
  3. Spironolactone – is an anti-androgen medication that helps block the male hormones.  This still doesn’t address the root of why the male hormones may be too high and will only provide a temporary solution while taking the medication.  Side effects of spironolactone include: Drowsiness, dizziness, lightheadedness, upset stomach, diarrhea, nausea, vomiting, or headache, increased thirst, change in the amount of urine, mental/mood changes, unusual fatigue/weakness, muscle spasms, menstrual period changes, breast pain, breast enlargement (gynecomastia) in men, and sexual function problems.
  4. Accutane (Isotretinoin) – Accutane is a powerful vitamin A derivative that blocks vitamin A receptors.  It comes with many side effects: it is teratogenic and can cause dry lips and mouth, swelling of the eyelids or lips, crusty skin, nosebleeds, upset stomach, or thinning of hair, mental/mood changes (e.g., depression, aggressive or violent behavior, thoughts of suicide), tingling in the skin, sun sensitivity, back/joint/muscle pain, signs of infection (e.g., fever, persistent sore throat), painful swallowing, and peeling skin on palms/soles.

DISCLAIMER: The information provided here may not apply precisely to your individual situation. Diagnostic and therapeutic choices must always be tailored to the individual patient’s circumstances, and consultation with a licensed naturopathic physician should be undertaken before following any of the treatment strategies suggested in this web site.

Summary
Acne
Article Name
Acne
Description
Acne in women & men beyond puberty is caused by persistent hormone imbalance such as excess estrogen or excessive male hormones like testosterone & DHEAs.
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