Alternative and complementary healthcare measures are gaining popularity. Alternative medicine refers to medicine that’s used in place of conventional medicine. Complementary medicine is a treatment that is used in addition to conventional medicine.

I explore treatments that are alternatives to the conventional approaches that are described in the rest of this book. I look back to the past (B.C. — Before Clearasil) and I investigate the present from the ashrams of Asia to the beauty counters at Bloomingdale’s.

Does Alternative Acne Medicine Work?

Although more research is needed to investigate the effectiveness and safety of alternative and complementary methods, some people with acne have described an improvement in their skin after taking certain herbs, undergoing acupuncture, and exploring mind/body relaxation techniques such as meditation, biofeedback, and hypnosis.

Right from the get-go I must tell you that the treatments I describe in here are not ones I subscribe to. I’m presenting them for the sake of being as inclusive as possible and to let you know that they’re out there.

My medical views and opinions come from the traditional Western medical perspective that’s based upon the scientific method and what is known as evidence-based medicine.

The evidence-based method focuses on using the best available scientific evidence as a basis for devising treatments. The clearing of acne by spontaneous remission may play a role in the popularity of some of these natural treatments; in fact, they may simply work by the placebo effect.

A placebo is a substance or procedure that contains no medication or obvious physical delivery of energy. Instead, placebos simply reinforce a patient’s expectation to get well. So if patients think they will get better by taking them, they do.

Placebo effects can be powerful, of course, but the potential benefit of relieving symptoms with placebos should be weighed against the harm that can result from relying upon — and wasting your money on — ineffective products and procedures. Having said that, keep an open mind and I’ll try to keep mine open too.

Traditional Chinese Medicine

The term Chinese medicine refers to a number of practices, especially acupuncture and herbal formulas. Chinese medicine has been practiced for over 4,000 years. The long-established concept has been that any illness is a reflection of an imbalance or blockage of energy or chi (pronounced chee), in the body.

One of the major assumptions inherent in traditional Chinese medicine is that disease is a loss of balance between Yin and Yang, the opposite poles of energy.

Yin and Yang are the dynamic force of the Tao, constantly interacting with one another. Thus, in Chinese medicine, the physician will treat the underlying imbalance, not the symptoms of the disease itself.

Trying Chinese herbs

For thousands of years, Chinese formulas (along with Indian, Tibetan, and Japanese approaches) have been used to treat acne. Herbal medicines are the prevalent tools used by Chinese physicians to reestablish the balance of Yin and Yang, returning the body to a healthy, balanced state (homeostasis).

Both herbs and acupuncture (described in the next section) are methods intended to restore homeostasis. Chinese herbalists usually don’t prescribe one single herb for their patients. Herbal preparations are usually made by blending a variety of different herbs.

The individual ingredients are weighed, combined, and then cooked into a souplike mixture and drunk like a tea. The mixture can be very foul tasting. The problem with herbal medications is that it’s hard to know exactly what’s in them because there is no regulation regarding their contents.

Herbs can be just as potent as a medicine you get from your pharmacy. There have been reports of severe toxic reactions, so you should be very cautious before trying anything that is untested. For those of you herbalists or do-it-yourselfers, I list just a few of the ingredients that are sometimes used to treat acne.

The various herbs are combined based upon the type of acne that is present:

• Flowers of honeysuckle, dandelion, chrysanthemum
• Fruit of forsythia, Cape jasmine
• Roots of scutellaria, platycodon, licorice, red sage, Chinese angelica, scutellaria, scrophularia, coptis, red peony
• Leaves of loquat
• Bark of moutan and mulberry trees
• Seeds of tangerine
• Bulbs of Zhejiang fritillaria

Modern research techniques have been done on very few of these botanicals; however, feverfew, a member of the chrysanthemum family, has been shown to have anti-inflammatory properties in the treatment of mild acne when it’s applied twice daily for six weeks.

Sometimes, if the smell or taste of the herbal medicine is unbearable, you can take capsule or tablet forms of herbal medicines instead. This method is supposed to work very slowly.

Some of those who are very committed to herbal medicine have reported that if they persevere, the herbs will work as a preventative as well as a treatment of their acne.

But many Western doctors — myself included — believe that the acne would have cleared on its own and that any successes had more to do with belief in the treatment itself than in its efficacy. Let your healthcare provider or dermatologist know about any herbal products you’re taking or considering taking.

Acupuncture for acne

Acupuncture is a traditional Chinese treatment often used to relieve pain. But many people have seen therapeutic effects by using it to stop smoking, lose weight, and to improve acne. Your chi, or energy, travels through the body by way of invisible meridians.

Acupuncture works by using tiny needles to stimulate these pathways at specific pressure points in order to restore the balance between Yin and Yang. Tiny sterile needles are inserted into the skin at specific points on your body.

The needle is left in place or stimulated either by twirling it, by using a heat preparation known as moxa, or by an electric current. An acupuncturist may also prescribe an herbal formula for a person to take in addition to the treatment.

Although there have been no well-designed studies evaluating the use of acupuncture for acne, there have been several reports that auricular (acupuncture applied to the ear) and electroacupuncture (acupuncture delivered by an electrical current) therapies may have lessened the inflammatory component of acne. But, on the whole, acupuncture is an unproven acne treatment.

Herbs and Supplements

You can find herbs, herbal remedies, and products infused with herbs just about anywhere these days. Health food stores, drugstores, your local market, even the cosmetics counter at the department store all have products that contain herbs and botanicals.

In this section, I help guide you down the road to figuring out what herbs might actually be helpful for your kind of acne. If you’re interested in finding out more information about herbs check out the National Center for Complementary and Alternative Medicine part of the U.S. National Institutes of Health, to find out the latest on herbal treatments.

My advice is to not ingest any herb or supplement without first discussing the matter with a qualified healthcare practitioner. Just because something is touted as natural doesn’t mean it’s safe. Actually, natural means, “occurring in nature.”

By the way, cyanide and arsenic are found in nature and so are hurricanes, earthquakes, and tornados. So, I’d say that the label natural is virtually meaningless. Besides, many of the so-called “natural” products also contain many other “unnatural” chemicals including preservatives, dyes, stabilizers, and fragrances.

In fact, if a product was truly natural, you probably wouldn’t want to use it anyway. It might not stay fresh; it might smell really bad, and it might not penetrate your skin where it has to do its work.

Fighting bacteria with botanicals

There is a budding interest to study plants that contain antimicrobial substances that may help eliminate P. acnes (the bacterial strain associated with acne), thereby potentially reducing inflammation associated with acne. Here are a few of the more promising candidates:

• Tea tree oil: Tea tree oil (derived from the tea tree plant native to Australia) has long been regarded as a topical antiseptic in Australia. A laboratory study found that certain active components of tea tree oil effectively slow the growth of P. acnes. The oil’s proponents claim that even severe cases of acne have been shown to benefit from it.

• Green tea cream: This herbal treatment is derived from the medicinal portion of the green tea leaf. Its advocates believe that the leaf is as effective as benzoyl peroxide in treating acne (see Chapter 7 where I talk about benzoyl peroxide).

• Calendula: Commonly known as pot marigold, you can buy this popular ornamental plant for your garden at most nurseries in the spring. Its orange flowers can be made into tinctures, lotions, and creams. Acne suffers are encouraged to wash their skin with tea made from the flowers. If marigolds don’t clear your acne, try planting them in your backyard.

Reducing inflammation with herbs

The following herbs have been considered to have general antiinflammatory properties and claims have been made that they may be helpful in the treatment of acne:

• German chamomile
• Witch hazel
• Licorice root
• Flaxseed and flaxseed oil
• Black currant seed oil
• Evening primrose oil
• Echinacea
• Goldenseal

Some herbalists contend that certain compounds can help specific types of inflammatory acne:

• Belladonna: For people who experience flushes of heat to the face or who have inflamed pustular acne that improves with cold applications

• Hepar sulphur: For painful, pus-filled acne

• Kali bromatum: For deep acne, especially on the forehead, in persons who are chilled and nervous

• Silicea: For pustules or pit-forming acne

Herbs can be as toxic and dangerous as prescription drugs!

Herbs at the cosmetic counter

Many cosmetic counters make statements about the botanical and natural ingredients that are found in their products. A variety of vitamins, minerals, and herbs can be quite appealing to those who seek a natural treatment for their acne. Green tea has become a popular ingredient in many cosmetic and health products: moisturizers, cleansers, bath products, shampoos, toothpastes, and perfumes.

Finding a professional herbalist

Before ordering a concoction of herbs from the Internet or just picking up a bottle of herbs off the shelf in a health food store, you should get advice from a qualified herbalist. As with all alternative treatments, you should always have a degree of skepticism.

But if you’re interested in finding out more about traditional herbs, you might ask the people who work in the health food store or check out some of the following Web sites:

• In the United States: www.americanherbalistsguild.com and www.naturalhealthholistic.com
• In the United Kingdom: www.ex.ac.uk
• In Australia: nhaa.org.au
• In Canada: www.ccnm.edu

Going natural with minerals and vitamins

For those of you who wish to try natural products, the mineral zinc and the B vitamin nicotinamide both are believed to have antiinflammatory effects on acne. Their true effectiveness remains to be proven. Here’s some further info on these possibly helpful items:

• Topical zinc is found in certain topical erythromycin ointments. It is possible, but not entirely clear, that the zinc oxide contained in the ointment may contribute to the effectiveness of the product. One such prescription product is Theramycin Z.

• Oral zinc may be an effective treatment for inflammatory acne. It’s available over the counter. Zinc may cause an upset stomach and nausea and it may decrease the absorption of various antibiotics including the tetracyclines.

• Topical vitamin B3 is found in Nicomide-T cream and gel. They’re both available over the counter.

• Oral nicomide, which is available only by prescription, contains vitamin B3 as well as zinc oxide, cupric oxide, and folic acid.

The Ancient Art of Ayurveda

Ayurveda is practiced in India and is gaining popularity in the West. According to Ayurveda, all diseases are caused by poor internal organ imbalances and an improper diet. Dietary measures using quality herbs are stressed to reduce the severity of acne and also to prevent breakouts.

Ayurveda depicts three biological humors or energies called doshas. The three doshas are called vata, pitta, and kapha. For good health and well-being to be maintained, the three doshas within you need to be in balance.

This means that a person needs to maintain his original doshic makeup through life as much as possible to maintain good health. Factors such as the dietary choices you make and the lifestyle you lead can cause one or more of the doshas in your prakriti to increase or decrease from its original level and create an imbalance.

If this imbalance isn’t corrected, you eventually lose your good health. That’s why restoring balance is the central theme of the ayurvedic approach to health. According to Ayurveda, acne is caused by the aggravation of all the three doshas. The primary aggravated dosha, however, is pitta. Pitta dosha symbolizes heat or fire in the body.

Bad food habits such as eating white flour and white sugar products, and greasy, fried, and spicy food, together with stress, tension, polluted environments, and excessive use of chemicals, also aggravate pitta dosha. This aggravated dosha erupts on the skin as acne and pimples. Dietary rules are available in detail at Ayurvedwebline.com.

The following are some suggested Ayurvedic acne home remedies:

• Drinking a half a cup of aloe vera juice, twice daily.

• Applying a paste of nutmeg and a little water to acne lesions and affected areas.

• Using orange peel face packs. The orange peels are pounded into a paste with a little water and applied to the affected areas.

• Drinking the Sunder Vati herbal preparation that includes ginger, Holarrhena antidysenterica, Embelia ribes, and Kampo.

Some Ayurvedic herbal products often contain high levels of heavy metals, which are considered unsafe. Ayurveda methods have not been scientifically tested, so the jury is out.

Aromatherapy

Aromatherapy is a branch of herbal medicine. It uses aromatic essential oils such as jasmine, orange, and rose, which are extracted from plants. The oils are either inhaled or applied directly on the skin.

They’re supposed to modify the immune system as well as promoting calmness and a sense of well-being. Aromatherapy has been reported to be helpful in treating acne, rosacea, and wrinkles through an ability to harmonize moods and emotions.

Some of these plant-derived essences are incorporated into bath products or used for inhalation. For example, ylang-ylang oil, derived from a fragrant tropical flower, has been used for many years in the tropics to induce feelings of tranquility and relaxation.

You can expect aromatherapy will smell good and — not much else! But if stress seems to make your acne worse, I guess you may see some improvement if you find the smells relaxing.

Considering Homeopathy

The word “homeopathy” comes from the Greek words homoios (similar) and pathos (disease). The first homeopathic principle states that anything that is capable of producing symptoms of disease in a healthy person can cure those symptoms in a sick person.

Homeopathy uses a system that treats a disease by the administration of minute, micro-dosages of a remedy that would in large amounts produce symptoms similar to those of the disease. The following are just a few of the numerous homeopathic treatment suggestions for acne:

• Antimonium tartaricum: This remedy claims to be helpful for acne with large pustules that are tender to touch.

• Hepar sulphuris calcareum: This remedy may be indicated when the skin is easily infected, slow to heal, and painful eruptions like boils appear. The pimples are very sensitive to touch and slow to come to a head; eventually, offensivesmelling pus may form.

• Calcarea carbonica: This remedy is supposed to help improve the skin’s resistance to infection, especially in individuals with frequent pimples and skin eruptions, who get chilly with clammy hands and feet, are easily tired by exertion, and are flabby or overweight.

• Pulsatilla: This remedy can be helpful if acne is worse from eating rich or fatty foods, and aggravated by warmth or heat. It is indicated especially around the time of puberty, or when acne breaks out near menstrual periods.

• Silicea (also called Silica): This is intended for a person with deep-seated acne. Infected spots are slow to come to a head, and also slow to resolve, so may result in scarring.

• Sulphur: This remedy is meant for itching, sore, inflamed eruptions with reddish or dirty-looking skin.

You can find these items at your local health food store; select the remedy that most closely matches your symptoms. Treatment is taken by mouth in the form of tiny tablets, powder, granules, or liquids. There have been few studies examining the effectiveness of specific homeopathic remedies for acne.

Homeopathic remedies are usually harmless, and its supposed “cures” are probably due to the natural healing tendencies of our bodies. However, if serious acne or an illness strikes you, it’s best to see a conventional physician rather than a homeopath.

Practicing Mind/Body Medicine

Many teens and adults believe that stress can trigger and worsen acne outbreaks. The hormone cortisol, which is released in the body during stressed or agitated states, has gained widespread attention as the so-called “stress hormone.” Excesses of this hormone are believed to worsen acne.

If this is so, stress reduction techniques and relaxation therapies that reduce a person’s cortisol could prove to be powerful ways to treat acne. Psychological therapies, meditation, relaxation therapy, hypnosis, biofeedback, and cognitive imagery have made claims to have some success in treating acne.

Mind/body techniques help to alleviate feelings of anxiety and depression. The measures described in the next section rely on the concept of the interconnectedness of the mind and body. As to whether people experience significant improvement of skin conditions, such as acne, is debatable.

Practicing yoga

Yoga is well known for helping a person deal with stress as well as creating “balance” in the body. Yoga has been reported to offer physiological benefits such as normalizing endocrine function, increasing immunity, and decreasing anxiety.

If you’re interested in yoga, you can look in your phone book under topics like “yoga, exercise, workout, fitness” and anything else that seems appropriate to find a yoga class in your area. You can also look for information at YogaJournal.com.

Or if you’d rather try it at home first, look for a book or video in your local library. Healthy practice . . . yes. Helps to clear acne . . . dubious!

Meditation

Meditation is a way of soothing the body and the mind in a comfortable, quiet place, allowing troubling thoughts to leave the consciousness. The key element of meditation is “focusing” on either something, or nothing. The object is to clear the mind of distracting thoughts.

Millions all over the world use this technique in order to reduce their stress levels. It’s hard to evaluate results; however, the price is right! You don’t need to buy anything to try this out on your own. Here are some basic instructions for meditating:

1. Find a quiet place to sit comfortably. Use a cushion if you’d like.

2. Close your eyes.

3. Breathe naturally. Don’t try to breathe extra deeply, or exhale strongly. Just breathe normally.

4. Gently bring your attention to your breath and begin to think about something or nothing. Choose one thing to think about when you’re starting. Alternately, clear your mind of anything except your own breathing.

5. Don’t try to control your thoughts. Let them come and go as they will. But instead of acting on them, just notice them. Feel sort of detached about them.

6. Continue meditating for 20 minutes or so. You may need to work up to this goal.

7. When you’re done meditating, take about a minute to slowly return to normal awareness. Open your eyes slowly and wait a few minutes before standing, just to let your body return to full awakening.

Relaxing . . . yes. Helps to clear your acne . . . doubtful!

Biofeedback and cognitive imagery

Biofeedback is a technique in which an individual is trained to control certain internal bodily processes that normally occur involuntarily, such as heart rate and muscle tension.

During biofeedback training, a technician helps a person perform a relaxation technique, such as guided imagery, while she’s hooked up to monitors that measure her heart rate and muscle tension. Guided imagery involves the formation of mental pictures to promote a variety of favorable physical and emotional effects.

This combination of biofeedback and cognitive imagery allows an individual to visualize and understand the bodily changes that occur when she changes from being tense to being relaxed. There is no reliable scientific evidence that these techniques have any real impact on acne.

Hypnosis

Hypnosis is sometimes touted as being effective in the treatment for a variety of skin conditions including acne. As with the other mind/body techniques described here, hypnosis may also help to alleviate feelings of anxiety and depression that some individuals experience with this skin condition.

Some researchers speculate that it can help an individual become more relaxed and, as a result, may positively influence the activity of hormones and the immune system (which may contribute to reduced inflammation). There is no scientific evidence that hypnosis does much for acne.