In controlling excess sebum production and combating the bacteria that proliferate in the follicles.

A combination of internal and external
treatment brings the best results. However,
no clinical trials support this claim.
INTERNAL TREATMENTS A daily dose of
chasteberry (Vitex agnus-castus) may help
to control surges of the hormones (espe-
cially at puberty) that increase the size of
sebaceous glands and the production of
sebum. Sage (Salvia officinalis), mother-
wort (Leonarus cardiaca) and red clover
(Trifolium pratense) may also help to
reduce surplus sebum by modulating hor-
mone levels. Regular cups of green tea
(Camellia sinensis) may adjust the over-
production of male and other hormones.
Extracts of poke root (Phytolacca decan-
dra), a herb restricted to professional use,
seem to cut down the flow of sebum and
restrict bacterial proliferation. Burdock

(Arctium lappa) root and leaf also combats
bacteria and reduces inflammation.
An overloaded bowel is a frequent cause
of acne. Rhubarb (Rheum palmatum) root
eliminates toxic wastes and reduces bacter-
ial inflammation. It is laxative, so take it
only for a short time. Oregon grape root
(Mahonia aquifolium) can significantly
reduce acne eruptions, while the bitters in
artichoke (Cynara scolymus) leaf stimulate
the liver and production of bile.
EXTERNAL TREATMENTS help to unblock
sebaceous glands and kill off bacteria that
lead to inflammation of the skin. Try the
gel of tea tree (Melaleuca alternifolia) oil,
which in clinical trials was as effective as
conventional treatments.
Washes of astringent herbs, such as rose
(Rosa gallica), witch hazel (Hamamelis vir-
giniana), burnet (Sanguisorba officinalis)
root, elderflower (Sambucus nigra) or cold
Earl Grey tea, can clear impacted sebum.
Applying fresh lemon juice and/or live
yoghurt to your skin can also help, espe-
cially after a chamomile (Matricaria
recutita) steam bath has opened up the
sebaceous glands. Allow the steam made
from chamomile tea to rise over your face.

The evidence suggests acne responds well to homeopathy.

SULPHUR AND SILICEA  Two of the most
commonly indicated medicines are  Sul-
phur and  Silicea. Rashes that respond to
Sulphur are typically very itchy, particularly
in the heat. Sulphur constitutional types
are usually extroverted, untidy and may be
opinionated or garrulous. They tend to be
hot-blooded, needing fewer clothes than
most people. In particular, their feet may
be hot and smelly.
Acne that responds to Silicea features pus-
tules that never seem to discharge: they sit
under the skin for weeks without bursting,
but often forming cysts. Silicea people are
usually chilly and feel cold, even in a warm
room. They tend to be pale and thin, with
fine hair and weak, ridged nails. Their
hands and feet are cold yet clammy.
OTHER REMEDIES  Kalium bromatum is
recommended when the spots are often
itchy. Individuals complain of poor sleep,
frequently disturbed by bad dreams. They
may be mentally slow, finding it hard to
remember and think.
Calcarea sulphurica is suitable when
there are large yellow pustules that are slow
to heal. They may also be itchy. Acne spots
which respond to  Hepar sulphuris cal-
careum are very sensitive to touch or are
painful as they develop.
Pulsatilla is particularly (but by no
means exclusively) helpful for girls when
crops of spots develop in the week before a
period. It is prescribed mostly on constitu-
tional grounds .
Pulsatilla types
are mild-tempered or sweet-natured. They
lack assertion and are indecisive. Although
they easily feel cold, they like fresh air (pro-
vided they are well wrapped up) and hate
stuffy atmospheres.

Nutritional Therapy,acne

WHOLEFOOD DIET Evidence is emerging
that the prevalence of acne in developed
countries is related to a glut of foods high
in refined sugars and starches. These tend
to cause the body to secrete copious quan-
tities of insulin, which seem to increase the
levels of the male hormones that may be at
the root of many acne cases. Cutting back
on refined and processed carbohydrates is
an important step in clearing acne.
DETOXIFICATION AND OTHER DIETS In
natural medicine, acne is viewed as a prob-
lem of excess toxicity. Clinical experience
shows that detoxification can be effective
in reducing acne and in improving the
condition of the skin. A common factor in
acne is an overgrowth of yeast organisms
and food sensitivity also appears to be a
common underlying theme in acne. (See
p.40 for diets to address these problems.)
ANTIOXIDANTS There is evidence to sug-
gest acne is an inflammatory condition in
which free radicals play a role. Antioxi-
dants can help to reduce the inflammation
by neutralising the damaging free radicals.
Eating plenty of antioxidant fruit and veg-
etables is important.
Regular intake of carrot juice, for exam-
ple, can provide you with beta-carotene, an
antioxidant and a precursor to vitamin A,
which helps to control acne. Supplements
can help, too: in one study, taking 200mcg
of the mineral selenium together with
20IU of vitamin E each day helped to
reduce acne symptoms.
FISH OIL SUPPLEMENTS  can also help to
reduce the inflammation that may be asso-
ciated with acne. This inflammation may
be linked to excessive amounts of omega-6
fatty acids (found in vegetable oils),
accompanied by a relative lack of omega-3
fatty acids (found in oily fish). There is
some evidence that many people with acne
are generally deficient in the essential fatty
acids they need.
You may be able to control your acne by
cutting down on both margarine and vege-
table oils and by eating more oily fish
(such as salmon, mackerel and trout), wal-
nuts and flaxseeds.
You may also reduce the inflammation
associated with acne by taking essential
fatty acids, such as gamma linolenic acid
(GLA). These are derived from evening
primrose (Oenothera biennis), borage
(Borage officinalis) or blackcurrant (Ribes
nigrum) oil, as well as from fish oil.
ZINC from food sources, such as pumpkin
seeds, or supplements can be effective for
people with acne. One study found that
zinc therapy worked as well as antibiotic
treatment. Take 30mg of zinc supplements
three times a day for 3–4 months and then
reduce the dose to 25mg once a day. Tak-
ing zinc for a long period can deplete the
body of copper, so take 1mg of copper for
each 15mg of zinc.
VITAMIN B6 can help some women whose
acne flares up before a period. A significant
proportion of female acne sufferers have
high levels of male hormones (androgens).
Women with pre-menstrual acne may
benefit from taking a 50mg vitamin B6
supplement a day.

DEVELOPMENT OF ACNE VULGARIS

Sebaceous glands around the hair follicles
produce sebum (an oily substance) to
lubricate hair growth and waterproof the
surface of the skin. Sometimes too much
sebum is produced during puberty in both
sexes due to male hormones (androgens).
The excess sebum becomes mixed with
dead skin cells, clogging the follicle
opening and encouraging bacteria to
breed. The result is inflammation and acne.
1 HEALTHY SKIN
The sebaceous glands sit in the dermis layer
of the skin, where they produce the right
amount of sebum to lubricate the hair shaft
and waterproof the epidermis.
2 BLACKHEAD
A surge in production of sebum blocks the
pore. The plug of sebum, bacteria and skin
debris reacts with oxygen in the air and
turns black (blackhead or “open comedo”).
3 WHITEHEAD
Sometimes the plug of sebum does not
break through the skin, when it is known as
a whitehead or “closed comedo”. As it
grows larger, it presses on the hair follicle.
4 INFECTED FOLLICLE AND ACNE
Sebum and the bacteria that feed on it leak
from the growing whitehead into the
dermis. The surrounding skin tissue and the
hair follicle become inflamed (acne).

Conventional Medicine for skin

After making a diagnosis, and depending
on the severity of your symptoms, your
doctor may recommend antibiotics and
other drugs in the form of creams as well
as preparations to be taken orally. You may
also be referred to a dermatologist.
TOPICAL KERATOLYTICS,such
as salicylic acid, help to relieve
mild acne. Your doctor may prescribe a
cream containing these. They help to break
down the oily plugs that block the opening
to the hair follicle and loosen the dead or
hardened cells on the surface of the skin.
As a result, the trapped sebum can flow
out and air can enter the follicle, reducing
the chances of bacterial infection.
TOPICAL ANTIBIOTICS AND
RETINOIDS can help acne that
is mild to moderately severe. Your doctor
may prescribe creams or ointments con-
taining these. Retinoids work by reducing
sebum production.

ORAL ANTIBIOTICS AND RETOINOIDS If
your acne is moderate to severe, your doctor
may prescribe oral antibiotics, such as tetra-
cycline, which you need to take for at least
3–4 months. For severe acne, dermatologists
may prescribe a course of retinoids, such as
isotretinoin, which is usually taken for four
months.Over 90 per cent of patients respond
to this therapy. Many people are cured by a
single course of retinoids, but in some cases
a second course may be prescribed.
CERTAIN COMBINED ORAL CONTRACEP-
TIVES reduce male hormone (androgen)
levels and have been shown to reduce the
severity of acne in some women. These
combined pills may need to be taken for at
least six months.

If you have acne, SELF-HELP

If you have acne, the following
steps may help you:
● Wash twice a day with warm water and
a mild cleanser, but do not scrub your
skin too vigorously.
● Do not pick your spots and pimples, as
this may make them worse and even
result in scarring.
● Apply benzoyl peroxide cream to your
acne every day.

Acne vulgaris is more common and more severe in males than in females.

Acne vulgaris is more common and more
severe in males than in females. The skin
condition is triggered by changes in hor-
mones, such as testosterone and other
androgens, associated with puberty. The
rash usually subsides after adolescence, but
can occasionally persist after the age of 30
and scars may form on the skin.
Various factors may predispose an indi-
vidual to develop acne  , including
genetic factors, since acne vulgaris some-
times runs in families. Stress can make the
acne worse. The condition can cause great
psychological distress, and often arises dur-
ing the period when teenagers are most
self-conscious about their appearance.
OVERACTIVITY OF SEBACEOUS GLANDS
Acne vulgaris is caused by the overproduc-
tion of an oily substance called sebum,
WHY DOES IT OCCUR?
which is secreted by the sebaceous glands
in the skin .    Sebum
normally drains into the hair follicles and
flows out through the follicle openings on
the skin surface, lubricating the skin and
keeping it supple. However, excess sebum
blocks the follicles and hardens into tiny
plugs. Bacteria multiply in the blocked fol-
licles, releasing fatty acids from the sebum,
inflaming the surrounding tissue.
In some cases, the follicles may become
blocked with keratin, a tough protein that
is produced by skin cells to strengthen the
epidermis. Keratin is also a constituent
of hair and nails.
OTHER TYPES OF ACNE Less common
forms of acne include occupational acne,
which may result from exposure to certain
industrial oils; and drug-induced acne,
which may be due to prescribed drugs,
such as corticosteroids.