Natural Products for Acne

I don't sell any natural products for acne, but over the years I've reviewed most (and once, served as an expert witness in a trial about one that seemed to cause skin spots). Here is what you need to know about readily available, inexpensive, natural products and what they and can't do for acne.

Selenium is an important cofactor for vitamin E. Adult male acne patients have low levels of the antioxidant glutathione peroxidase, which normalizes with vitamin E and selenium treatment. Glutathione peroxidase puts a brake on inflammatory reactions throughout the body, especially in the skin. Selenium depresses the parts of the immune system that cause allergic reactions, but encourages the parts of the immune system that respond to bacterial infection. There is also evidence that selenium compounds control the breakdown of thyroid hormones into forms that do not aggravate acne.

Selenium from yeast is the best form of selenium for treating acne, but it should be taken with care. Taking selenium at the same time as vitamin C reduces the absorption of selenium, and you should never take more that 1,000 mg of selenium a day.

The first sign that you have overdosed selenium is usually a garlicky breath odor. Excessive use of selenium can also cause hair loss, fatigue, irritability, and hyperreflexia or "jumpiness." Horizontal streaking, blackening, and fragility of the nails when you take selenium is a sure sign you are taking too much or you are taking a product that has been improperly standardized.

Both men and women with acne benefit from taking selenium with vitamin E in the form of mixed tocopherols. Taking these two nutrients together is especially important for acne that has reached the pustule stage.

Vitamin E is also an important cofactor for vitamin A. In laboratory studies with animals, the amount of vitamin A in the bloodstream stays low regardless of intake until vitamin E levels are normal. Vitamin E supplementation is useful even if you do not take vitamin A, since it complements the vitamin A available from the diet.

Vitamin A is the naturally occurring analog of the prescription drug tretinoin (Accutane). Like its chemical cousin, vitamin A reduces the production of sebum and slows the rate at which skin cells produce keratin. Together, these actions keep pores open and reduce the probability of infection.

The drawback to using vitamin A as a supplement is that a dose that is big enough to stop acne is big enough to cause side effects. Problems from using even up to 300,000 IU of vitamin A per day are rare, but they are significant. The first signs of vitamin A overdose are dry skin and chapped lips, especially in dry weather. Later signs of toxicity are headache, mood swings, and pain in muscles and joints. In massive doses, vitamin A can cause liver damage. In the first 3 months of pregnancy, it can cause birth defects. Women who are or may be come pregnant should not use more than 5,000 IU of vitamin A per day, which is not enough to improve acne. Discontinue high-dosage vitamin A at the first sign of toxicity, and never use it for more than 3 months at a time.

In true vitamin C deficiency, acne, along with gum sores, is a key diagnostic symptom. Just a tiny dose of vitamin C, however, a mere 10 mg a day, is enough to correct acne caused by vitamin C deficiency.For people who do not have scurvy, vitamin C does not have a scientifically demonstrated direct effect on acne, but it makes other vitamins more available. Studies at the Northern Ireland Centre for Diet and Health have found that taking vitamin C increases the amount of available vitamin E in the bloodstream by about 10 percent. Taking vitamin E increases the amount of available vitamin C in the bloodstream by about 60 percent.

Vitamin C also may protect against the side effects of prescription acne drugs. Tetracycline antibiotics for acne, especially minocycline (Cyclimycin, Minocin, or Trimomin), cause a condition known as "blue smile," a discoloration of the tongue and teeth. Scientists at the Baylor College of Dentistry in Dallas have found that giving vitamin C to lab rats at a dosage approximating 1,000 mg per day in humans prevents staining of teeth during minocycline therapy.

Several clinical studies report that zinc is only slightly less effective than antibiotics in controlling acne (although antibiotics by themselves seldom are adequate treatment). The key to using zinc effectively is buying the right kind of zinc. Researchers using an effervescent (fizzy) form of zinc sulfate found it to be about as effective as the antibiotic tetracycline. Researchers using a plain form of zinc sulfate found that it appeared to have a somewhat beneficial effect on pustules but not on blackheads, white heads, nodules, or cysts.

The most recent clinical study found that acne patients given a moderate dose of zinc gluconate (30 mg) per day were about half as likely to be completely cured after 90 days as those given the minocycline. Among patients who did not achieve total remission, however, zinc treatment eliminated over 90 percent as many lesions as treatment with the antibiotic after 30 days and over 80 percent as many lesions as the antibiotic after 90 days.

The bottom line of these studies is, if you have acne, take zinc and be prepared to wait a couple of months for results. The best-absorbed form of zinc is zinc picolinate. Do not take more than 50 mg of any zinc supplement daily. In rare cases, excessive intake of zinc depletes copper to cause anemia, that is, a deficiency of red blood cells, and neutropenia, a serious deficiency of white blood cells. If you take tetracycline antibiotics for skin infections, chances are you are deficient in zinc. Taking tetracycline interferes with the body's absorption of zinc (and taking zinc interferes with the body's absorption of tetracycline).

One other supplement is helpful if you exercise and you have acne. Aerobic exercise helps acne by increasing circulation to the skin, but anaerobic exercise (huffing and puffing to the point of exhaustion) without antioxidant supplementation may aggravate acne. Strenuous exercise depletes glutathione. This naturally occurring antioxidant slows inflammatory reactions and is essential to the normal function of estrogen and testosterone. Laboratory studies with animals have found that supplementation with alpha-lipoic acid keeps glutathione from breaking down, especially in the liver and in the bloodstream.

Also in laboratory experiments with animals, vitamin B6 (pyridoxine) deficiencies cause increased sensitivity to testosterone.Women who have flare-ups of acne along with PMS often improve after taking vitamin B6. Women who develop acne during testosterone treatment usually benefit from taking B6.

A study conducted at the Royal Prince Alfred Hospital in New South Wales, Australia, found that a 5 percent tea tree oil solution was as beneficial as a 5 percent benzoyl peroxide cream in reducing the number of pimples. Benzoyl peroxide got faster results, but tea tree oil had fewer side effects. Tea tree oil is antibacterial against 27 of 32 strains of Propionibacterium acnes, the infectious agent most commonly associated with the disease.

Tea tree oil may be used at a strength of up to 15 percent for especially severe cases of acne. There are very few reports of problems with tea tree oil, although it can cause allergies and should be kept away from small children.

Calendula and marigold are the same herb. The botanical term calendula is used to name bath products and the common term marigold is used to refer to the plant as a healing herb. Calendula soaps are a very useful complement to tea tree oil. They kill Staphylococcus aureus, a bacterium not affected by tea tree oil. The essential oil in the herb is a potent anti-inflammatory agent, offering about the same degree of pain relief as the over-the-counter nonsteroidal anti-inflammatory agent indomethacin (Indocin), but without side effects on the digestive tract. Marigold oil applied to the skin with a cotton swab has the same analgesic effect.

About 1 in 500 people is allergic to calendula. Test the soap or oil on a small area of skin before using it on a large patch of skin.

There are several other natural products you can use to treat acne. Alpha hydroxy acids are commonly found in and isolated from fruits of all sorts. Exactly how they help control acne is not fully understood, but they function in at least two ways. They act as a humectant, increasing the water content of the skin and moisturizing the outer layer of the epidermis. This makes the skin softer and more flexible. Secondarily, alpha-hydroxy acids reduce skin cell adhesion and accelerate skin cell proliferation within the basal cell layers.

Alpha-hydroxy acids encourage the growth of blood vessels to oxygenate the skin. They activate an internal clock inside skin cells at the surface reminding them of the time to die and be sloughed off, providing room for the growth of new, healthy skin. The growth of skin underneath the follicle forces it open and allows the release of dead skin cells and irritants.

Alpha hydroxy acids are a good match for skin that is oily, firm, and pigmented in persons who are not prone to allergies. In rare instances, alpha hydroxy acids can cause temporary pigmentation of the skin in people who have chemical sensitivities. Alpha hydroxy acids may make dry or wrinkle skin more sensitive to sunlight.

Azelaic acid is a naturally occurring hydrocarbon, found in wheat, rye, and barley. It is one of the acids used in "facial peels" performed in a doctor's office. This organic product prevents the process of hyperkeratosis, or overgrowth of skin cells, forcing follicles shut. By reducing the rate at which skin cells grow in the linings of pores, it keeps pores open.

It is antibacterial, controlling both Propionibacterium acnes, the microorganism that flourishes in clogged pores, and Staphylococcus aureus, the bacterium that also causes abscesses, boils, and impetigo.

Physicians at the University of California at San Francisco have found that a cream containing 20 percent azelaic acid is as effective in treating acne as benzoyl peroxide gel (5 percent concentration), tretinoin cream (0.05 percent concentration), erythromycin cream (2 percent concentration), and oral tetracycline given at a dosage of 500-1,000 mg per day, provided it is used to treat pimples and mild to moderate inflammatory acne.

However, azelaic acid is less effective than Accutane for the treatment of acne conglobata, the form of the condition that produces large, deep pustules.

Azelaic acid cream should be applied twice daily for at least 2-3 months. It can be used for up to 1 year. Im provement should be detectable within 1-2 months. To ensure adequate penetration, the cream should be rubbed thoroughly (but not too vigorously) into clean skin for 2-3 minutes. An advantage of azelaic acid over antibiotics is that azelaic acid does not cause bacteria to become antibiotic-resistant. Azelaic acid seldom produces adverse effects, the most common being short-term itching and burning sensations. About 10 percent of people who use azelaic acid will experience burning and itching during the first 2-4 weeks it is used.

Azelaic acid has a special application for persons of Asian, especially Korean, descent who use skin lighteners. Alternated with hydroquinone products (which are available in the US, although not in Asia) every 2 to 4 months, azelaic acid may prevent the freckles and age spots that can occur as a paradoxical effect of hydroquinone skin care products.

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