Acne – A natural medicine perspective?
Pimples are not just the curse of the teenage years. Whilst it can be common during adolescence, adult acne can also occur for a variety of reasons and it’s not something you should put up with. There are various ways a naturopath can help.
Firstly, how and why does acne occur?
The development of acne is multi factorial and is usually associated with congestion at the hair follicle. This occurs due to –
- Over production of sebum (ie the oil in the skin and hair that keeps it moisturized). This can happen due to a hormonal imbalance such as elevated androgens (in PCOS) as well as changes to neuro endocrines such as Substance p (which is released during times of stress).
- Excessive keratinisation (ie rapid shedding of skin cells) in the hair follicle which creates a blockage leading to acne formation. This can happen due to a lack of linolenic acid as well as the production of 5 – alpha reductase and interleukin 1-alpha.
- Alterations in the microbiome on the skin. A specific bacteria identified, Cutibacterum acnes (C.acnes), is able to form a biofilm ( glue like substance ) on the skin to protect itself against the environment. This bacteria also stimulates the immune system and contributes to inflammation (swelling and redness) at the site. Staphylococcus epidermidis is another pus forming bacteria present in acne that contributes to congestion and inflammation.
- Insulin-like growth factor 1 (IGF-1), which increases during puberty as well as with diets rich in carbohydrates, may also be contribute to acne by altering androgens in the skin.
- Local oxidative stress on the skin which can contribute to tissue damage and irritation.
- Side effect of certain medications such as anti depressants.
So, how can a naturopath help reduce acne lesions and scarring?
First step is to identify the driving factors and then treat accordingly.
Driving factors could be –
- Hormonal imbalance
- A run away inflammatory cascade and immune dysfunction
- Poor diet
- Blood sugar dysregulation
- Altered microbiome
- Stress related neuro endocrine imbalance and altered gut-skin-brain axis.
- Nutritional deficiencies
- Over-burdened detoxification pathways (liver, gut, kidney).
Once the main drivers have been identified (through comprehensive case history, clinical observations and pathology testing) treatment usually involves supporting the patient to reduce high GI foods and ensure adequate nutrition for skin health and scar reduction. Herbal and nutritional medicine may also be prescribed to reduce the stress response, normalise hormone levels and re-establish a healthy microbiome. A detoxification program may be prescribed depending on the drivers and severity of the condition. Attention will also be given to eliminating skin irritants and ensuring healthy dermal hygiene habits. Topical preparations are also used to restore healthy microbiome, pH and heal the tissue.
Acne is not only a chronic inflammatory skin condition, it can also impact self-confidence, mood and social life. There is a lot we now know about how acne lesions form, so Naturopathic medicine can use this understanding to formulate an individualised treatment plan to address the underlying drivers. As acne is a multifactorial condition, naturopathic treatment will often involve multiple concurrent approaches to restore balance to the follicle and surrounding tissue.
If you are concerned about acne or your skin health please contact Kath Mcfarlane for more information.
Bronsnick T, Murzaku EC, Rao BK. Diet in dermatology: Part I. Atopic dermatitis, acne, and nonmelanoma skin cancer.J Am Acad Dermatol. 2014 Dec;71(6):1039.
Dréno B, Layton A, Zouboulis CC, López-Estebaranz JL, Zalewska-Janowska A, Bagatin E, Zampeli VA, Yutskovskaya Y, Harper JC. Adult female acne: a new paradigm. J Eur Acad Dermatol Venereol. 2013 Sep;27(9):1063-70
Tan A.U, Schlosser B, Paller A. A review of diagnosis and treatment of acne in adult female patients. Int J Womens Dermatol. 2018 Jun; 4(2): 56–71. 2017 Dec 23.