Acne

Acne vulgaris is one of the most common chronic inflammatory conditions, affecting more than 640 million people worldwide. It is typically considered a condition of adolescence, with global estimates suggesting that between 35% and 100% of young people are affected at some point during their teen years, However, acne often persist or develops well into adulthood. In fact, it appears that 10% of acne develops after the age of 25 age, while adolescent acne is more common in males, adult acne is more common in females.

Acne typically presents as comedomes (blackheads), papules and pustules. As well as then obvious physical manifestation of acne on the face and body, the diagnosis carries some significant social and mental consequences, including low self-esteem, poor body image, anxiety and depression.

The proliferation of the bacteria Cutibacterium (C. Acnes) plays a role in eliciting an inflammatory response that is thought to be important for the pathogenesis of the disease. Although serum androgens are viewed as the major hormonal trigger for acne, emerging evidence suggests insulin-like growth factor (IGF-1) also plays a key role. IGF-1 increase during puberty and increasing prevalence of acne is being linked to the Western diet and specifically high-glycemic foods which stimulate sebum production.

Several studies have found increased serum levels of antioxidants such as vitamin A, C and E, zinc, selenium and glutathione in acne patients.

C. Acnes and the skin microbiota

The skin microbiota is the second largest microbiota, home to four main phyla (probiotic phage system) and three genus. Similar to microbes in the intestine, resident skin microbes act to stabilize the skin barrier by defending against pathogens and interacting with immune cells, thereby modulating host immunity.

Acne and the gut microbiota

The skin and the gut are engaged in an important relationship whereby both organs exert critical neuroendocrine and immune functions. Many studies clearly highlight the link between intestinal health and skin homeostasis. Acne patients generally exhibit decreased levels of gut Lactobacillus and Bifidobacteria species.

Targeting acne through herbs and nutrients

Zinc

Meta-analytic data has demonstrated tat serum zinc levels tend to be significantly lower in those with acne compared to controls, and zinc appears to be efficacious in reducing acne-related symptoms. In all my years of practice very, very few of my lovely patients with acne have passed the zinc taste perception test. Zinc is anti-inflammatory and exerts a bacteriostatic effect via the inhibition of C. acnes and is essential in wound repair, cell replication and immune activity, Zinc also suppresses sebaceous gland activity and blocks the conversion of testosterone to dihydrotestosterone.

A review examining zinc supplementation for acne vulgaris, encompassing nine randomized trials, 17 controlled trials, 13 noncontrolled trials concluded that zinc is an effective option for managing the condition.

Beta-carotene

Beta-carotene acts as a provitamin A, thus it is converted to retinoic acid within the intestine and liver. By virtue of its anti-inflammatory, anti-oxidant and immunomodulatory effects, beta-carotene is a highly versatile supplement that interacts with multiple inflammatory targets and shows potential for managing inflammatory-related conditions.

Arctium lappa (Burdock)

Burdock root has been used for over 300 years for the treatment of boils, sores and abscesses, Burdock acts upon the gland that lie under the skin, heaving positive effects on skin conditions such as acne. The burdock root promotes skin circulation to the skin surface, thereby enhancing skin quality and texture. It is an herb with anti-inflammatory, antibacterial and immunomodulatory effects and is an essential component in the herbal medicine mixes I prescribe for acne in the clinic.

Silybum marianum (St Mary’s Thistle)

St Mary’s Thistle is an efficacious liver tonic, recognized for its powerful antioxidant, anti-inflammatory and immune regulatory properties.

These potent anti-inflammatory effects may represent a rational explanation for the positive results observed in clinical trial involving acne patients, where participants experienced a significant decrease in the number of papulopustular inflammatory lesions after eight weeks of use.

Calendula officinalis (Calendula)

Calendula efficacy in supporting skin inflammation is well-documented, mainly due to its anti-inflammatory, antioxidant, anti-bacterial, antifungal and hypoglycemic effects.

Calendula enhances the uptake of blood and oxygen to the wound site, which encourages tissue regeneration. Furthermore, this rather unique herb has been shown to dramatically increase wound angiogenesis (development of new blood vessels) and collagen metabolism, which may aid in softening scar tissue. Since scarring is a common concern facing a significant number of acne patients, calendula may be an effective adjunct to prevent scar development and improve clinical outcomes.

Lastly, Calendula in in vitro studies has demonstrated antibacterial activity against acne., highlighting its potential in addressing an underlying driver of acne development.