Definition

An inflammatory condition of the skin where sebaceous glands are most numerous and active: on the face, neck, chest, and back.


Symptoms

Characterised by blackheads, whiteheads, pustules, inflamed and infected nodules, sacs, and cysts. Infection occurs in the pilosebacceous follicle (hair follicle in the sebaceous gland). This may cause permanently dilated pores, obstruction of the pilosebacceous opening, and severe scarring.


Etiologic Considerations


Puberty
Androgenic hormones increase sebaceous gland activity.
Psychological.
Zinc deficiency.


Diet
Excess saturated fat (especially homogenized cow's milk) Dairy products Meat, Fried food, pastry, hydrogenated fats, Excess sugar, which potentiates the effect of fats; detrimental effects on system are threefold. Nutritional deficiency or excess need for development Zinc Lack in diet, soil depletion, Increased need for in puberty. Rapid growth requires excess malabsorbtion hydrochloric acid deficiency reduces zinc absorption.


Vitamin B6
Individual excess need.
Menstrual related deficiency common
Birth control medication (progesterone)-related B6 deficiency

Excess sugar, refined carbohydrates, junk foods, chocolate, cocoa, caffeine (coke, pepsi cola, tea, coffee), salt, alcohol
(see Hypoglycemia) overeating. Improper liquids, carbonated beverages. Lack of green vegetables.


Poor Elimination's
Bowel lesion (thinning) due to diet or stress, constipation, liver congestion or toxicity.
Overstressed kidney function.
Poor skin elimination's.


Inco-ordination of deep and superficial circulation's
Toxic elimination via skin associated with poor elimination's, spinal lesion.



How to use Natural Medicine


Menstrual acne
Part of premenstrual triad of fluid retention, irritability, and acne flare.
Vitamin B6 related in many cases.


Food allergy
Food additives, specific food allergies - especially dairy products, wheat, yeast.


Cosmetics

Lack of exercise, Anemia, Rapid growth, Family history, Stress.


Discussion

Acne occurs most frequently in the teenage years when it affects 80 percent of all teenagers to some degree. This has been associated with an increase in sex hormone activity which causes an increase in the sebaceous gland output. This can also be seen in cases of infantile acne just after birth, due to high levels of circulating sex hormones. Acne is rarely found in eunuchs. The incidence of teenage acne is so high as to be considered "normal" in developed nations. This fails to consider that not all populations experience such high rates of acne. One such population was the Canadian Eskimos who, prior to 1950, had no incidence of acne. Later, as more modern foods, including sugar and refined carbohydrates, were introduced in their diets, acne became common.

The main dietary offender in the modern diet is its high saturated fat content. A diet high in animal proteins, cheese, and milk causes abnormal development of the sebaceous glands, leading to acne. The modern teenage diet is a prescription for acne, with cheeseburger, hot dogs, french fried potatoes, corn chips, potato chips, fried eggs, french toast, butter, milk shakes, milk, sugar, candy, cola, and chocolate.

Although meat (especially pork fat) and hydrogenated fats are detrimental, milk fat is often the main offender. We are the only species that feeds our young milk after weaning. The situation would probably be less serious if we gave our children mother's milk, but we give them cow's milk, with its excessive fat.

The link between diet and acne has long been recognized by both naturopathic physicians and the lay public. Every teenager knows that chocolate may aggravate acne. Other detrimental substances in the diet are coffee, tea, alcohol, and sugar. Sugar in particular facilitates the action of saturated fatty acids, making it the number two offender.

A second major cause of acne is an incoordination of the elimination's. This may include sluggish bowel and skin function, a toxic liver, or overstressed kidneys. When the eliminating organs become imbalanced, the superficial circulation becomes filled with toxic eliminants which then clog the superficial capillaries and small lymphatic vessel which feed the sebaceous glands and cause inflammation with secondary infection. This incoordination between deep and superficial circulation may also be due to spinal lesions which upset the cerebrospinal centers located in the ganglia of the automatic nervous system which control these circulation's.

Another common finding is areas of the bowels that have thinned walls allowing leakage of toxins into the system. (See Psoriasis or allergy for more details on this conditions. Refer also to constipation as it relates to incoordination of elimination.)

The habit of hot showers or baths is another factor that upsets skin function and causes an incoordination between deep and superficial circulation. Prolonged heat causes a vasodilatation or a lax condition of the superficial blood vessels, leading to poor local circulation and congestion.

Certain dietary deficiencies have been associated with acne. Of these, vitamin B6, zinc, and essential fatty acids (EFA) are the most common. Vitamin B6 deficiency is common in acne related to the menstrual cycle, where acne is worse prior to or during menstruation and premenstrual symptoms of irritability and water retention are severe. Zinc is a common deficiency, especially during puberty with rapid growth, which requires and excess of this mineral. Zinc is deficient in most soils and therefore most foods.


Treatment

The orthodox treatment for acne is palliative rather than curative. The patient is usually told he or she will grow out of it and may be given antibiotics topically or orally if the condition is very severe. In some cases, if the acne occurs in an older female, oral estrogen's are used. These treatments are not only ineffective, they are detrimental. Most teenagers grow out of their acne, but not before some scarring. Many never grow out of it and suffer acne lesions nearly all their lives.

Antibodies are used to combat the secondary infections and often must be repeated every 3 to 6 months. This has a bad effect on the entire body by destroying friendly bacteria essential to our well-being.

The skin is made from the inside out. It takes 20 to 30 days for the skin now being formed to reach the surface. It is obvious then that external treatments can do little to affect this developing skin. Acne is an internal problem, not an external one. A possible exception would be cosmetic acne due to excessive use of facial creams and lotions, which clog the pores and in some cases cause and allergic reaction. Poor hygiene will also affect the skin, but the majority of cases are caused by internal factors. True healing must come from within. This healing will take some time. Even if you begin today, the results will only start to show themselves in 20 to 30 days, usually more like 60. If any severe acne lesions are present, these will take even longer, due to the great damage that has already occurred in these areas. Perseverance and absolute adherence to the diet below are essential to get results.


Diet

Our main concern is to eliminate as many saturated fats as possible. Ideally the diet should contain no saturated fat. I find it best to restrict to diet to no saturated fat for a reasonable length of time in the beginning, so that you can begin to see true results rapidly. If you can be motivated enough and convinced that this short-term, very strict diet will have some very long-term advantages, I advise 6 to 8 weeks of a no-saturated-fat diet. this includes plenty of non citrus fruits, raw vegetable juice, salads, cooked vegetables, vegetable and seaweed soups, seeds and nuts in moderation, whole grain, and vegetarian proteins such as beans and tofu. Seaweed's are suggested for their high iodine content, as are pumpkin seeds for their zinc. All junk foods, refined foods, and carbonated drinks or alcohol are prohibited. A short vegetable juice fast of 1 to 7 or more days with enemas on days 1, 2, 3, 5, and 7 is useful to speed the healing process. These should be done every 2 to 4 if possible. The diet that follows allows nonfat dairy products, but by no means suggest it. If possible, dairy products should be excluded from the diet until the skin is perfectly clear. This is not always possible.

The fat content of milk is fairly complex and must be understood if proper milk products are to be added safely to the diet. The following summary should prove helpful:

Ice cream Evaporated whole milk Whole milk Homogenized milk Evaporated low fat Low fat Nonfat, skim . Dried skim . Evaporated skim . True buttermilk . Dry curd cheese .

10% to 20% butterfat 8% + butterfat 4% to 6% butterfat 4% butterfat 4% butterfat 2% butterfat 5% butterfat 1% butterfat 25% butterfat 5% butterfat 5% butterfat

Of these milk preparation only dried skim or evaporated skim have a low enough butterfat content to consumed in moderation daily. Skim milk yogurt is acceptable one to two times per week. Real buttermilk (butterfat removed) is acceptable on occasion. Dry cur cheese is also acceptable on occasion. No more than 6oz of skim or buttermilk three times per week, 2oz powdered skim per day, or 1 cup per day of dry curd cheese is allowed. All cottage cheese are to high in fat, as is butter. Margarine is generally made by hydrogenating unsaturated fats and making them partly saturated. Those fats are entirely unnatural to the body and should be reduced or avoided altogether whenever possible.

Commercial peanut butters also often have hydrogenated fats. Check all labels before purchasing. In general I restrict peanut butter and encourage other nut or seed butters such as almond, sunflower, or cashew. Peanuts are not nuts anyway - they are legumes.
Commercial breads usually contain about I percent saturated fat and must be avoided. Either buy well-labeled whole grain breads from reliable bakers to bake your own with cold pressed vegetable oils. Commercial baked goods often contain up to 20 percent fat and should be strictly avoided.
In later stages of this diet (and in some cases very early on) poultry in moderation and fish may be added, but never served fried. Cold water ocean fish (i.e., cod or salmon) is suggested as the best fish source and has been found to reduce blood cholesterol levels.
Cold pressed unsaturated vegetable oils in the diet are acceptable in moderation, but never heated. It is suggested that you add 400 IU of vitamin E to a newly opened vegetable bottle to prevent rancidity and keep refrigerated. These should be used as salad dressings with lemon juice (the only citrus in the diet) or apple cider vinegar. Any herbs for taste are fine. Use plenty of onion and garlic.


ACNE DIET

The following diet may be of some use as a basic guideline. Choose from the following...


Breakfast
Non citrus fruit
Non citrus fruit plus skim yogurt
Whole grain cereal (no sugar) with soy milk, skim milk, dried skim, or evaporated skim milk
Poached eggs and whole wheat toast


Mid-Morning
Whole meal pancakes
Vegetable juice (carrot, lettuce, nettle, and watercress)
Potassium broth
Herbal tea


Lunch
Fresh raw salad with plenty of green leafy vegetables, watercress, lettuce, cabbage, kale, chard, parsley, alfalfa sprouts, celery, onions, garlic, seaweed, sprouts, etc., with carrots and other combinations. Keep the salads varied and interesting. Salad dressing used should be based on cold pressed vegetable oil and lemon juice or apple cider vinegar. Garlic, various herbs, and honey may be used to add variety to the dressing. I suggest you obtain a good salad cookbook and experiment. Tofu or soybeans. A few nuts , brown rice of millet


Mid-Afternoon
A mid-morning supper as lunch, or conservatively cooked (baked or steamed) vegetables, especially green and yellow vegetables. Carrots are also good. Use a wide variety. Tofu or soy protein beans Fish (never fried), Turkey or chicken (never fried), Whole grains (especially brown rice and millet), Dry curd cheese.


Evening
As midmorning and Mid-afternoon

Drink 6 to 8 glasses of water each day.

FOODS OF SPECIAL USEFULNESS...

Green vegetables Carrots Onions Garlic Watercress Vegetables juices (carrot, lettuce, nettle, and watercress) Nettles

Kelp Seaweed's Fish (cold water ocean) Whole grains Sprouts Dandelion Greens

In some cases wheat allergy may be a causative factor and should be avoided in all stages of the diet. Prior to therapy a radioallergosorbent test (RAST) and cytotoxic test should be done. Wheat, yeast, dairy products (even nonfat), citrus, or even eggs may be a major factor in individual cases.
Refer to Constipation if this is a problem.


Physiotherapy

Daily Wash: Warm water wash two times per day with mild calendual or castile soap. Alternate warm, then cold applications should follow.

* Ice applications directly on lesions has helped some.

* Hot steam or hot fomentation's may help lesion mature.

* Ultraviolet (UV) applications daily are very useful. Note: Excess IV light can cause skin cancer. Use common sense and do not overexpose the skin. The exact amount of exposure that is safe depends on individual skin type.

* Lemon juice diluted in water may be applied externally for its antiseptic and astringent effect.

* Vitamin B6 cream locally in menstrual acne. (100 mg vitamin B6 per gram of ointment)

* Spinal manipulation - cervical and upper middorsal, weekly.

* Sun and air baths

* Ocean bathing

* Daily skin brushing to entire body with loofa or soft bristle brush.

* Sulfur ointment (3 to 10%) topical.

* Dilute calendula tincture wash as antiseptic following maturation of lesions by hot fomentation's.



Therapeutic Agents

VITAMINS AND MINERALS

Vitamin A (micellized):- high doses 50,000 to 100,000 IU per day for several months in micellized form. Care must be taken to monitor for toxic symptoms with these and the higher doses sometimes used. Serum vitamin A levels should be tested periodically. The frequency of test depends on dose used.

Vitamin B complex: 25 to 50 mg twice daily. If yeast allergy is diagnosed of suspected, use a non-yeast source.

Vitamin B6: 50 to 250 mg two times per day in menstrual related acne.

Vitamin C: 250 to 1000 mg three times per day; antibiotic, antioxidant, stress reducer.

Vitamin E: 200 to 400 IU two times per day.

Zinc: 25 to 45 mg three times per day. Reduce dose if bowel upset occurs. Add 1 to 3 mg copper per day at higher doses. Selenium also may need to be increased 100 mcg per day at higher zinc levels.
Trace minerals


OTHERS

Atimodine or 636 (Cayenne Products) Note: Excess iodine from atomodine or 636 could become toxic, especially if taken with kelp in the diet. Take only under medical supervision. Some patients are sensitive to iodine and experience worsening of their acne with use.

Chlorophyll: The more the better; detoxifies intestines.

EFA 2 to 4 capsules two to three times a day.
(essential fatty acids)

EPA): 1 to 3 capsules two to three times per day.
(eicosapentaenoic acid - cold water marine body oils.)

Garlic: 2 capsules with meals.

GLA, or gamma-limolenic acid (oil of evening primrose)

Glandular substances): Raw thymus, tablets helps immune response. raw thyroid, tablets with thyroid involvement.
(on doctor's prescription)

Glucose tolerance factor (GTF) Yeast: To normalize blood sugar levels.

Hydrochloric acid: If previous high levels of supplements were useless or other signs of mineral malabsorption exist, and hydrochloric acid deficiency has been demonstrated with hydrochloric acid deficiency has been demonstrated with hydrochloric acid adequacy test, take with meals.

Kelp: 2 to 4 tablets two to three times per day.

Lactobacillus: 2 capsules three times per day (especially following use of antibiotics)

Lecithin: 2 capsules two to three times per day.
(as concentrated phosphatidylcholine)

Sulfur: 1 to 30 grains per day, or as homeopathic dilution. Larger doses may cause intestinal irritation and loose stools.

BOTANICALS

Aloe (Aloe Vera): Local, topical use.

Blue flag (Iris Versicolor): Excellent alternative; corrects imperfect lymphatic elimination; is glandular stimulant (especially thyroid).

Barberry: (Berberis vulgaris)

Burdock Root: Good alternative with skin disorders. Restores oil and sweat gland function; is antibacterial.
(Artiumlappa)
Coneflower: Alternative (blood purifier), anti-infective, bacteriostatic. dose (tincture): 15 to 60 drops (1/4 to 1 (Echinacea angustifolia) tsp) diluted in water, three to four times per day.

Dandelion: Detoxifies liver; is cholagogue and alternative.
(Taraxacum officinale)

Oregon Grape: Alternative, activates lymphatic system . Dose (tincture) : 10 to 20 drops three to four times per day.
(Berberis aquifolium)

Red Clover: Alternative.
(trifolium pratense)

Yellow dock: Alternative.
(Rumex cripus)


Therapeutic Suggestions

Initially high doses of vitamin A micellised form are used. This should be closely monitored for toxic reactions. As found in many other conditions, those who need a therapeutic supplement most often have a greater need than those the average person, and therefore a much higher dose is often well tolerated with out producing toxic manifestations. It should also be remembered that in cases of malabsorbtion, extremely high doses may not cause toxic reactions since only a small fraction of this dose may be assimilated. Use any dose of vitamin A over 50,000 IU per day with medical supervision only. Monitor higher doses with serum vitamin A test regularly.

A well-balanced B complex vitamin is also routinely suggested. Try to find one that does no have equal portions of all the B vitamins (i.e., 50 or 100 mg for each B1, B2, B3, B6, etc.), but rather one more balanced to reflect the body's true physiological needs, and not just the marketing appeal for the vitamin company. If any of the B vitamins are taken in excess they tend to deplete others in the group. Vitamin B complex is needed up to three times per day with the higher doses being reserved for those with blood sugar irregularities, or those under excessive stress. Vitamin E taken once or twice daily is also useful. Take the micellized form if poor fat absorption is suspected or known to be a problem.

Essential fatty acids are also always a regular part of the regimen. In addition to suggesting an increase in dietary sources, I recommend essential fatty acids (EFA), aicosapentaenoic acid (EPA), and cod-liver oil capsules. Lecithin in its concentrated (phosphatidylcholine) form as a fat emulsifier is also suggested three times daily.

Zinc stands out as the single most important mineral used, If higher than 50 mg are used per day, a copper supplement of 3 to 3 mg may be necessary. With teenagers use the lower dose. Selenium may also be needed - 50 to 100 mcg per day with high zinc use.

Kelp or other iodine sources (i.e., Atomodine or 636) are often helpful in stimulating the glandular system, especially the thyroid, but may aggravate some cases. Garlic has definite usefulness and should be prescribed routinely.

The botanical remedies of choice are coneflower (Echinacea), Oregon grape, and blue flag. Often, botanicals are used only in the initial stages of therapy and at intervals to encourage deeper elimination, better liver function, and tonic stimulation.


ACNE -- HOMEOPATHIC REMEDIES

Spot skin in face, neck, or back caused by the boost which higher hormone levels give to the production of oily sebum and the growth rate of cells in the epidermis; clogged by a mixture of dead cells and sebum, some sebaceous glands become inflamed, forming raised, red spots or pus-filled pimples; squeezing and picking do not improve matters. Condition is often more severe in boys than girls, but skin usually clears in late teens or early twenties. Lasting scars are rare. In some cases foods such as junk foods in general seem to aggravate condition; STRESS, steroids, and anti-epilepsy drugs may also play a part. In severe cases GP may prescribe an antiseptic lotion which peels top layer of skin, or antibodies, hormones, drugs based on Vitamin A. Homeopathic medicine regards acne as a symptom of fundamental imbalance, so treatment is long-term and constitutional; however, the remedies and self-help measures below may produce some improvement.

Specific remedies to be taken 3 times daily for up to 14 days.

* Itchy spots, fidgety feet, restless sleep, unpleasant dreams - Kali brom 6c.

* Long-standing acne, rough hard skin, condition aggravated by washing, especially is person tends not to feel the cold and is prone to diarrhea first thing in morning - Sulfur 6c.

* Blind pimples and weeping pustules which form yellow crusts, spot slow to heal - Calcarea sulfur 6c.

* Large spots which look like boils - Hepar sulfur 6c.

* Spots made worse by rich, fatty food, especially if person is fair haired, cries easily, and dislikes stuffy rooms - Pulsatilla 6c.

* Where pus-filled pimples are main features - Antimonium tart 6c.

* Where skin scars easily - Silicea 6c.

Self-help Sunlight, Vitamins A and B6, and zinc all have a beneficial effect, although zinc may interfere with the absorption of some orthodox drugs given for acne. Avoid refined carbohydrates and iodine (in some cough mixtures, seaweed, etc.). The liver diet on p. 352 followed for 1 month, should also have a positive effect. thoroughly wash affected areas twice a day that will remove excess sebum and dead cells. Do not take vengeance an spots by scrubbing them - damaged, abraded skin easily becomes infected. Mildly antiseptic over the counter preparations should be used very sparingly as they can cause sensitization reactions.

ACNE ROSACCAE

Produces ACNE-like symptoms, but occurs in middle age; cheeks and nose flush easily, becoming permanently red, with small pus-filled spots; usually aggravated by hot spicy foods, tea, coffee, and alcohol (see also ALCOHOLISM), and by STRESS, but causes are thought to be oral contraceptives, steroid ointments, and possibly a deficiency of Vitamin B2 (riboflavin). Antibiotics are usually prescribed.

If stress is the major factor, homeopathic treatment is constitutional. however, the remedies listed below may be beneficial.
Specific remedies to be taken 3 times daily for up to 3 weeks.

* Face dry and burning, cold applications only make things worse, skin flakes and scales, restlessness, chilliness Arsenicum 6c.

* In early stages, face red, dry, and burning hot - Belladonna 6c.

* Face always red and dry, with pimples and pus-filled spots - Sulfur iod. 6c.

* Burning and itching aggravated by heat, especially in women with scanty periods - Sanguinaria 6c.

* Condition made worse by alcohol, tea, and coffee, person constipated, irritable, and chilly Nux 6c.

* Red, painful, or itchy spots, face puffy and swollen, cold or wet weather makes condition worse - Rhus tox 6c.

* Condition markedly worse in morning and aggravated by alcohol, face reddish-purple and mottled - Lachesis 6c.

* Self-help Take extra Vitamin B2. If you are on steroids, stop taking them if possible. Discuss with your GP.