What are natural treatments for acne?

Introduction

The blackheads and sometimes painful pimples known as acne occur
most commonly during adolescence, but they also may persist into adulthood. Much
remains to be learned about what causes acne. During adolescence and other times
of hormonal imbalance, such as menopause, glands in the skin increase
their levels of oil secretions. A combination of naturally occurring yeast and
bacteria then breaks down these secretions, causing the skin to become inflamed
and the pimples to eventually rupture. In severe cases, acne can cause permanent
scarring.

Conventional treatment of acne, which usually is quite successful, consists
primarily of oral or topical antibiotics, cleansing agents, and
chemically modified versions of vitamin A. One should not use the
natural treatments discussed here to treat severe acne in which scarring is a
possibility.

Principal Proposed Natural Treatments

Zinc. Studies suggest that people with acne have lower-than-normal levels of zinc in their bodies. This fact alone does not indicate that taking zinc supplements will help acne. Several double-blind, placebo-controlled studies have found zinc more effective than placebo but less effective than antibiotic therapy. In one of these studies, fifty-four people were given either placebo or 135 milligrams (mg) of zinc as zinc sulfate daily. Zinc produced slight but measurable benefits. Similar results have been seen in other studies using 90 to 135 mg of zinc daily, although other studies failed to find that zinc helped. Relatively weak evidence suggests that a lower and safer dose, 30 mg daily, may also be helpful.

A large double-blind trial (332 participants) compared 30 mg daily of zinc with
a tetracycline-family medication often used for acne (minocycline at 100 mg
daily). The results showed minocycline is more effective than zinc.
Tetracycline taken at a dose of 250 mg daily appears to be
no more effective than zinc, but when taken at 500 mg daily, it seems to be
considerably more effective.

Dosages of zinc used in most of these studies are much higher than daily requirements and have the potential for causing toxicity. Case reports indicate that people have become extremely ill after taking zinc in hopes of treating their acne symptoms.

Tea tree oil. Tea tree oil has antiseptic properties and has been suggested as an alternative to benzoyl peroxide for direct application to the skin. The best evidence for benefits with tea tree oil comes from a randomized double-blind clinical trial of sixty people with mild to moderate acne. In this study, participants were divided into two groups and treated with placebo or 5 percent tea tree oil gel. During the forty-five-day study period, researchers evaluated acne severity in two ways: by counting the number of acne lesions and by rating acne severity on a standardized index. The results showed that tea tree oil gel was significantly more effective than placebo at reducing both the number of acne lesions and their severity.

Niacinamide. In a double-blind trial, seventy-six persons with moderately severe acne were treated with either 4 percent niacinamide gel or 1 percent clindamycin gel (a standard antibiotic treatment). Niacinamide proved to be just as effective as the antibiotic in an eight-week trial. However, because this study lacked a placebo group, its results are unreliable.

Other Proposed Natural Treatments

Ayurvedic medicine has shown some promise for acne. One study evaluated the potential benefits of an herbal combination containing the following constituents: Aloe barbadensis, Azardirachta indica, Curcuma longa, Hemidesmus indicus, Terminalia chebula, T. arjuna, and Withania somnifera. In this four-week, double-blind, placebo-controlled study of fifty-three people with acne, combined topical and oral use of the herbal preparation significantly improved acne symptoms. Oral treatment alone was not effective.

Another controlled trial compared an extract of the Ayurvedic herb guggul with
tetracycline for the treatment of acne and found them equally effective. The study
report does not state whether this trial was double-blind, and for this reason the
results are not reliable. Other commonly mentioned natural treatments for acne
include chromium, vitamin E, selenium, burdock, and red clover. There have
been no well-designed studies examining these treatments, however.

The effect of diet on acne is unclear. One far from definitive study compared a low-glycemic-load diet with a high-carbohydrate diet and found that the low-glycemic-load diet reduced acne symptoms.

Herbs and Supplements to Use Only with Caution

Various herbs and diet supplements may interact adversely with conventional (including prescription) drugs used to treat acne, so people should be cautious when considering the use of herbs and supplements.

Bibliography

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Enshaieh, S., et al. “The Efficacy of 5 Percent Topical Tea Tree Oil Gel in Mild to Moderate Acne Vulgaris.” Indian Journal of Dermatology, Venereology, and Leprology 73 (2007): 22-25.

Igic, P. G., et al. “Toxic Effects Associated with Consumption of Zinc.” Mayo Clinic Proceedings 77 (2002): 713-716.

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Porea, T. J., J. W. Belmont, and D. H. Mahoney, Jr. “Zinc-Induced Anemia and Neutropenia in an Adolescent.” Journal of Pediatrics 136 (2000): 688-690.

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Thappa, D. M., and J. Dogra. “Nodulocystic Acne: Oral Gugulipid Versus Tetracycline.” Journal of Dermatology 21 (1994): 729-731.