Do Natural Remedies Really Work? Trusted Treatments for Acne
Having the occasional spot is something most of us have experienced at some time or other, especially during our teenage years. But if you have acne, you may be affected by more severe and persistent spots. These can develop from blocked pores called comedones (you may know these as blackheads or whiteheads), causing what doctors refer to as papules, pustules, nodules and cysts. In this piece, we discuss natural remedies for acne and explore whether they really work.
The low down on acne
This often debilitating condition is common in teenagers, with one study finding that 20 percent of young people have moderate to severe acne.i However, it can last into early adulthood too, with 64 percent of people in their 20s and 43 percent of those in their 30s also thought to be affected to some degree or another.i
And while having spots on your face, back or chest isn’t anything really serious where your health is concerned, the effect it can have on your emotional wellbeing can be devastating. Since this is just one of the PCOS symptoms that impacts women’s emotional wellbeing, it is important to try and optimise your emotional health when you can. Facial acne, in particular, can have a negative effect on your confidence and self-esteem, as it’s the most visible and therefore the hardest to cover up.
A survey by the British Skin Foundation suggests a lack of confidence is just the tip of the iceberg.ii In this survey, 20 percent of people with acne admitted they’d had a relationship end as a result of it ; 10 percent said they’d been unfairly dismissed at work because of their acne; and more than half claimed they’d experienced verbal abuse from friends, family and others owing to their skin condition.
As it affects so many people, it’s no surprise that acne is the subject of a huge range of information. However, some of this can be confusing, not to mention misleading. But by arming yourself with the proven facts about acne, it is very possible to control your skin – rather than letting your skin control you.
Acne and PCOS
Acne is one of the main symptoms of polycystic ovary syndrome (PCOS), with one study suggesting that 27 per cent of all women with acne also have PCOS, and another finding 67.5 percent of women with PCOS have acne.iii Since some healthcare professionals believe women aged 25 or older who have persistent acne should be assessed for PCOS, it is important that you understand the link between acne and the condition so you can treat it effectively.
If you have PCOS-related acne, you may tend to have spots in hormone-sensitive areas such as your cheeks, jawline, chin and upper neck, and more likely to have more nodules and cysts than papules and pustules. Your spots may also flare up when your period is due, and they may take some time to die down.
But why are PCOS and acne linked? The main culprits are a type of hormone called androgens – so-called ‘male’ hormones including testosterone, androstenedione, dehydroepiandrosterone (or DHEA) and DHEA sulphate. High androgen levels, also known as hyperandrogenemia, is one of the three main features of PCOS, though not all women with the condition are affected.
Having high levels of androgens also causes acne, since it makes the sebaceous glands in your skin produce too much oil. This, along with a build-up of unshed dead skin cells, blocks your pores, causing comedones to develop. The excess oil also affects a bacterium that lives on everyone’s skin called P.acnes, causing it to multiply. This, in turn, triggers inflammation and the development of acne spots.
Another feature of PCOS is insulin resistance, which is when your body doesn’t respond normally to the hormone insulin. This can cause high blood levels of insulin, which has also been linked with high levels of androgens because too much insulin makes your ovaries produce too much testosterone. Some experts believe PCOS may be linked with low-grade inflammation in the body, which may play a part in the development of the larger acne spots, specifically nodules and cysts.iv
How is acne treated?
Mild cases of acne can be treated with over-the-counter pharmacy products such as creams, gels and lotions containing benzoyl peroxide, azelaic acid or salicylic acid. However, if you have PCOS-related acne, you may have found that these standard acne treatments aren’t particularly effective – though they’re always worth a try.
Instead, you may be better suited to treatment with the combined oral contraceptive pill, as taking the pill may help reduce your androgen levels. One particular type of pill named co-cyprindiol but marketed as Dianette, may be the most suitable as it contains the anti-androgen ingredient cyproterone. But as this has a higher risk of causing deep vein thrombosis than other oral contraceptives, it is usually only recommended when other treatments fail.
But what about natural treatments?
Eating a healthy balanced diet with plenty of fresh fruit and vegetables is essential as it can help support your skin and your overall health. Avoiding food and drink ingredients thought to boost your androgen levels may be useful too, such as alcohol, caffeine, sugar and saturated fats. It’s worth cutting back on foods that are made with hydrogenated fats (also known as trans fats), as these may promote the inflammation associated with acne. These fats are often found in processed foods, so try to limit how many biscuits, cakes and pastries you eat.
Eating more foods that contain omega-3 oils, including oily fish such as salmon, herring, pilchards and sardines, might be helpful because Omega-3s may help reduce oil production in your skin. A study has concluded that fish oil supplementation is associated with an overall improvement in acne severity.v
Ayurvedic medicine, which is part of the ancient healing system of India called Ayurveda, might also be worth a try. There is some evidence to suggest that certain Ayurvedic herbs may improve acne symptoms. One study assessed the effectiveness of a concoction containing aloe vera, turmeric, arjun, ashwagandha and other Ayurvedic herbs, and found that if it was taken internally and used on the skin it may significantly improve acne symptoms in just four weeks.vi
Meanwhile, there’s also evidence the following nutritional supplements may help control acne:
Also known as pantothenic acid, this is believed to help with acne because it reduces the amount of oil produced by your skin. In one study, volunteers who took a vitamin B5 supplement had fewer spots after 12 weeks compared to those who took a placebo.vii A slow releasing vitamin B5 supplement is recommended.
Some experts believe zinc is an important nutrient for reducing or preventing acne as some studies have found that people with acne have lower-than-normal zinc levels.viii Unfortunately, much of the evidence to support zinc as an effective treatment for acne involves high doses of the nutrient, which can be harmful. However, some studies involving lower doses claim zinc may be helpful too.ix Zinc may also be beneficial for boosting immune system function.
Antioxidant supplements that contain selenium may be useful for acne too. In one report, researchers tested a group of antioxidants including selenium on volunteers with acne and found they were all beneficial, with selenium reducing the number of spots and inflammation.x As with zinc, selenium might also be worth trying because of its positive effect on the immune system.
It is clear that natural remedies do work, but not for every individual. While cleaning up your diet and drinking plenty of water are often recommended, testing out a number of different vitamins that might work for you is always worth a shot. Do ensure you speak to a medical professional for advice before trying any supplements.
Explore the rest of our PCOS hub to see how you can manage symptoms effectively and safely here.
Bhate, K., Williams, H.C. Epidemiology of acne vulgaris. Br J Dermatol. (2013 Mar). ;168(3):474-85. Available online: https://www.ncbi.nlm.nih.gov/pubmed/23210645?dopt=Abstract
Over half of acne sufferers experience verbal abuse from friends & family due to their condition. British Skin Foundation. (2014-2015). Available online: http://www.britishskinfoundation.org.uk/LinkClick.aspx?fileticket=i2bE2n4c8m0%3d&tabid=172
Kelekci, K.H., et al. Ovarian morphology and prevalence of polycystic ovary syndrome in reproductive aged women with or without mild acne. Int J Dermatol. (2010 Jul). ;49(7):775-9. Available online: https://www.ncbi.nlm.nih.gov/pubmed/20618496
Gowri, B.V., et al. Correlation of Skin Changes with Hormonal Changes in Polycystic Ovarian Syndrome: A Cross-sectional Study Clinical Study. Indian J Dermatol. (2015 Jul-Aug). ;60(4): 419. Available online: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4533553
Deluba, A.J., Dokras, A. Is PCOS an inflammatory process? Fertil Steril. (2012 Jan). ;97(1):7-12. Available online: https://www.ncbi.nlm.nih.gov/pubmed/22192135
Khayef, G., et al. Effects of fish oil supplementation on inflammatory acne. Lipids Health Dis. (2012). ;11: 165. Available online: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3543297
Lalla, J.K., Nandedkar, S.Y., Paranjape, M.H., et al. Clinical trials of ayurvedic formulations in the treatment of acne vulgaris. J Ethnopharmacol. (2001). ;78:99-102. Available online: https://www.ncbi.nlm.nih.gov/pubmed/11585696
Yang, M., Moclair, B., et al. A randomized, double-blind, placebo-controlled study of a novel pantothenic Acid-based dietary supplement in subjects with mild to moderate facial acne. Dermatol Ther (Heidelb). (2014 Jun). ;4(1):93-101 . Available online: https://www.ncbi.nlm.nih.gov/pubmed/24831048
Amer, M., Bahgat, M.R., Tosson, M., et al. Serum zinc in acne vulgaris. Int J Dermatoll. (1982). ;21:481-484. Available online: https://www.ncbi.nlm.nih.gov/pubmed/6217164
Meynadier, J. Efficacy and safety study of two zinc gluconate regimens in the treatment of inflammatory acne. Eur J Dermatol. (2000). ;10:269 273. Available online: https://www.ncbi.nlm.nih.gov/pubmed/10846252
Sahib, A., Al-Anbari, H., et al. Effects of Oral Antioxidants on Lesion counts Associated with Oxidative Stress and Inflammation in Patients with Papulopustular Acne. FJ Clin Exp Dermatol Res. (2012). 3:163. Available online: https://www.omicsonline.org/effects-of-oral-antioxidants-on-lesion-counts-associated-with-oxidative-stress-and-inflammation-in-patients-with-papulopustular-acne-2155-9554.1000163.php?aid=10078