Acne

For many people acne is less an ailment than a curse. It often occurs at a time-during adolescence-when self-consciousness is most acute and self-esteem most vulnerable. In addition, there’s no simple remedy, even if you resort to the most extreme traditional cures. Fortunately, there is good news on the natural front. I’ve had great success with both adults and adolescents by going to the root of the problem. Acne is a disease of the skin that causes the pores to clog and produce pimples known as whiteheads and blackheads, most often on the face, but sometimes spreading to the neck, upper back, chest, and shoulders.

It usually starts in adolescence-by age seventeen over 84 percent of American teens have had acne-and disappears by early adulthood, but in a few instances may continue through life. We don’t know exactly what causes acne, which is why it’s been so difficult to treat. Heredity seems to play a distinct role; oily skin, while it does not cause acne, appears to aggravate the condition. Other aggravators include stress, seasonal changes, diet, and sun exposure. In people who develop acne in their twenties or thirties, allergies to cosmetics or food may be to blame. In my experience, detection and elimination of hidden food allergies is the most important approach in the successful treatment and prevention of acne.

While acne does not have any serious physical side effects, it’s often deeply troubling to the four out of five teenagers who suffer from it. Their embarrassment is aggravated by the myths about acne, such as its being caused by too much or too little sex or unsanitary conditions. The myths are unfounded. Acne is activated by natural hormonal activity, and, in some women, it may flare up before a menstrual period.

Typically, acne starts at puberty along with an increase in androgens, the male sex hormone produced by the testes or ovaries and adrenal glands in both Sexes. The increased androgens stimulate the oil glands to produce increased amounts of sebum, which comes up through the hair follicles to lubricate the skin. In acne, excess sebum combines with skin pigmentation to form blackheads on the surface of the skin, or it may block the pores beneath the surface of the skin, forming whiteheads. In either case, if the follicle ruptures due to irritation and pressure, bacteria may enter the area to produce additional inflammation and painful nodules and cysts that can cause scarring if improperly treated.

Severe acne is usually treated with antibiotics to prevent scarring. However, there are problems associated with long-term antibiotic therapy. Yeast infections, one of the most frequent side effects, clear when the antibiotic is discontinued, but the acne returns. Many of my patients with acne first came to see me because they found themselves caught up in this cycle of antibiotics. I begin by checking their history for potential allergies. Is there a history of allergies in the family? Were they allergic as children? Did the start of their acne coincide with the use of a new cosmetic, moisturizer, or sunscreen? Or with the start of a new diet?

Since allergies to food or cosmetics play an important part in adult onset acne, you should use only hypoallergenic products, and take hypoallergenic vitamins and minerals, because even the binders and fillers of over-the-counter vitamins and minerals may cause allergic reactions. You should, of course, avoid any food or drink to which you are allergic. For more information on this subject, refer to Food Allergy, page 146, and follow the suggestions.

It’s important to evaluate what you eat because there seems to be correlation between acne and our Western diet, which tends to be too high in fat and too low in fiber. Some interesting observational studies have shown that people on low-fat, high-fiber diets have far less acne than their counterparts perhaps because dietary fat is believed to promote sebum, the lubricant that causes pimples when trapped by clogged pores. I tell my patients to reduce their dietary fat to 20 percent of their caloric intake and to supplement their fiber with 1 ounce of an all-bran cereal (see Blueprint for Health, page xvii).

There are natural treatments for acne, some of which can make a dramatic difference if used in conjunction with a healthy diet. Vitamin A has been shown to virtually eliminate acne in its milder cases; it should be a staple supplement. An important antioxidant and immune-system enhancing vitamin that helps to maintain a healthy skin, vitamin A and it derivatives have also been found to reduce the production of pore-clogging sebum. I prescribe vitamin A in doses ranging from 10,000 to 25,000 I.U. Since higher doses of vitamin A can cause side effects, it should be taken only under your doctor’s supervision.

Vitamin E affects the biologic utilization of vitamin A: It promotes maximum vitamin A absorption. Therefore, I recommend that you take vitamin E along with vitamin A. Zinc insufficiency is found in patients with aggravated acne, and several nutrient studies in zinc supplements have cleared up the condition. A doctor in Sweden, who conducted several studies to gauge the effectiveness of zinc supplements, found that, taken over twelve weeks, they were as effective in clearing up acne as antibiotics or Accutane, and without the serious side effects!

Patients with severe, or postular acne, are often deficient in the trace mineral selenium, and selenium supplements have helped to clear up the condition. The recommended antioxidant multiple vitamin and mineral supplements will contain adequate selenium for this purpose. Vitamin B6 may also be helpful in controlling acne, particularly for women who experience flare-ups of acne before and during their menstrual period. Some experts recommend taking B6 for the week before and the week after a period; my patients have found better results by taking it every day all month.

And then there are the essential fatty acids or “omegas,” whose effectiveness against various inflammations is just beginning to be fully understood in the prevention and treatment of skin disease. For acne, I prescribe omega 6, which is found in evening primrose oil, black currant or borage seed oil. These oils are composed of both linolenic and linolenic fatty acids, which have been shown to reduce, and sometimes eliminate, inflammatory skin conditions.

There is one more thing that my patients have found helpful. Topical tree oi1, an essential oil of the Australian native tree Melaleucea alternifolia, has an antimicrobial effects and when used on the skin affected by acne, can be of help in reducing outbreaks. It is usually compared to benzoyl peroxide, but it has fewer undesirable side effects. It does take longer to work, so you have to be patient. You apply it topically to the affected area daily. The effects of a low-fat, high-fiber diet, supplemented with vitamins and minerals, should become evident within a period of three months. In the meantime, to minimize irritations and to prevent possible scarring, you must be sure to take proper care of your skin.

Guidelines for Skin Care

• Wash your face gently. Use a mild soap, such as Dove or Neutrogena. The bacteria that cause acne are not on the surface of the skin, so scrubbing with harsh soaps will not help, and may make things worse by irritating the skin. You may also use a cleanser containing salicylic acid, which will loosen the debris so you can just rinse it away.
• Whiteheads are clogged pores beneath the outermost layer of skin and should not be squeezed. They will go away on their own within three to four weeks. Squeezing can make them inflamed or infected and can cause scarring. The only time you should squeeze a pimple is when it’s already infected, and has yellow pus. Take a warm bath or shower or apply a warm moist compress to the area for a few minutes to help open the pores. Then squeeze the pimple gently with a tissue until the pus pops out so that the remaining pimple can heal more quickly.
• Remove blackheads carefully. Blackheads are plugs of oil that darken upon contact with the air. They are not dirt, and scrubbing will only make them worse. You can, however, remove blackheads with an extractor, which you can buy at any pharmacy, after taking a warm bath or shower to open the pores. Never use your hands or fingernails, as this may cause scarring of the skin.
• Discourage new blemishes with medicated lotions. Lotions with benzoyl peroxide are very helpful in controlling acne. However, since these can dry and redden the skin, start with a 5 percent concentration, which can be as effective as the l0 percent. Apply the lotion to the affected area and about an inch of the surrounding skin. To minimize irritation, don’t leave the lotion on for extended periods. You can apply it in the evening, leave it on for a couple of hours, and wash it off before going to bed. Alternatively, you can try tea-tree oil, the natural substitute for benzoyl peroxide, which I mentioned above.
• Use moisturizer if your skin is dry, but be sure that it’s hypoallergenic.
• Use hypoallergenic makeup and suntan lotions.

Natural Prescription for Acne

• Modify your diet: Eat a low fat (no more than 20 percent of calories from fat), high-fiber diet, Eat lots of fresh fruits and vegetables and whole grain breads and cereals.
• Investigate the possibility of food allergies. See Food Allergy, page 146, for more information, If you have no success dealing with this on your own, see a doctor who specializes in nutritional medicine. Once you’ve identified a food allergy, you must be scrupulous in eliminating it from your diet. You may find that you’re allergic to several foods or the whole Category, such as dairy foods.
• Take special daily care of your skin and follow the skincare guidelines given above.

In Addition to your daily supplements, take:

• Vitamin A: 10,000 I.U. daily. (Note: See your doctor before taking a higher dosage or if taking vitamin A for extended periods.)
• Vitamin E can be taken in conjunction with Vitamin A): 400 I.U. daily.
• Zinc: 50 mg. daily.
• Vitamin B6: 50 mg, daily: (Note: Vitamin B6 is particularly helpful for women who experience premenstrual acne flare-ups, who should take it throughout the month.)
• Evening primrose oi1: 500 mg. three times daily,
• Tea-tree oil: Apply topically to affected area once daily.