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- Strong Scientific Evidence:
[Vitamin A]: Derivatives of vitamin A, retinoids, are used to treat skin disorders such as acne. Vitamin A supplements should not be used simultaneously with prescription medications, especially Accutane ®, due to a risk of increased toxicity.
- Good Scientific Evidence:
[Zinc]:
Several studies identify a positive correlation between serum zinc levels and severity of acne, however others did not, and it remains to be determined to which degree internal zinc levels may correlate with the severity of acne. Based on high quality studies, topical or oral use of zinc seems to be a safe and effective treatment for acne vulgaris.
- Unclear or Conflicting Scientific Evidence:
[Guggul]:
Guggul (Commiphora mukul), an herbal supplement commonly used in India, has been found to possess anti-inflammatory properties and has been suggested as an oral therapy for acne. Preliminary data from small, methodologically weak human studies suggest possible short-term improvements in the number of acne lesions. Caution is advised when taking guggul supplements as adverse effects including drug interactions are possible. Guggul is not recommended during pregnancy or breastfeeding unless otherwise advised by a doctor.
[Tea tree oil]: Topical application of tea tree (Melaleuca alternifolia) oil may be beneficial in acne. The tea tree is found in Australia and its oil is used for antibacterial effects, including positive studies on preventing and healing acne outbreaks. Tea tree oil is applied (diluted) onto areas with acne, three times daily.
- Traditional or Theoretical Uses Lacking Sufficient Evidence:
[Aromatherapy]: The use of essential oils may decrease the symptoms of acne. Essential oils are antibacterial and may kill the bacteria associated with acne. Apply diluted oils on a cotton ball to face as needed. Lavender essential oil may also be used topically to reduce scarring. Note: Essential oils are not to be consumed orally, as internal consumption can cause serious side effects.
[Boswellia]:
Boswellia (Boswellia serrata) is an anti-inflammatory herb that has traditionally been used in acne therapy. Caution is advised when taking boswellia supplements as adverse effects including drug interactions are possible. Boswellia is not recommended during pregnancy or breastfeeding unless otherwise advised by a doctor.
[Burdock]: Burdock root (Arctium lappa) is traditionally used for a wide range of conditions including acne. Although no scientific evidence exists for the use of burdock for acne, traditional uses support burdock's benefits in acne. Caution is advised when taking burdock supplements as numerous adverse effects including drug interactions are possible. Burdock is not recommended during pregnancy or breastfeeding unless otherwise advised by a doctor.
[Calendula]: Calendula (Calendula officinalis), also known as pot marigold, is traditionally used for a wide range of conditions including acne. Although no scientific evidence exists for the use of calendula for acne, traditional uses support calendula's benefits in acne. Caution is advised when taking calendula supplements as numerous adverse effects including drug interactions are possible. Calendula is not recommended during pregnancy or breastfeeding unless otherwise advised by a doctor.
[Cat's claw]: Cat's claw (Uncaria tomentosa) is a vine found in South America used traditionally for a wide range of conditions including acne. Although no scientific evidence exists for the use of cat's claw for acne, traditional uses support cat's claw's benefits in acne. Caution is advised when taking cat's claw supplements as numerous adverse effects including drug interactions are possible. Cat's claw is not recommended during pregnancy or breastfeeding unless otherwise advised by a doctor.
[Chasteberry]: Chasteberry or vitex (Vitex agnus-castus) is reported to have hormonal effects similar to progesterone in the body, and one of the causes of acne may be hormonally related. Vitex was reported in one human study to improve the symptoms of acne. Caution is advised when taking vitex supplements as numerous adverse effects including drug interactions are possible. Vitex is not recommended during pregnancy or breastfeeding unless otherwise advised by a doctor.
[Danshen]: Danshen (Salvia miltiorrhiza) is widely used in traditional Chinese medicine (TCM), often in combination with other herbs. Although no scientific evidence exists for the use of danshen for acne, traditional uses support danshen's benefits in acne. Caution is advised when taking danshen supplements as numerous adverse effects including drug interactions are possible. Danshen is not recommended during pregnancy or breastfeeding unless otherwise advised by a doctor.
[Echinacea]: Echinacea is used traditionally for a wide range of conditions including acne. Although no scientific evidence exists for the use of echinacea for acne, traditional uses support echinacea's benefits in acne. Caution is advised when taking echinacea supplements as numerous adverse effects including drug interactions are possible. Echinacea is not recommended during pregnancy or breastfeeding unless otherwise advised by a doctor.
[Milk thistle]:
Milk thistle (Silybum marianum) is used to detoxify the liver and as an antioxidant. Detoxification therapies can be helpful in decreasing acne outbreaks and symptoms. Caution is advised when taking milk thistle supplements as adverse effects including drug interactions are possible. Milk thistle is not recommended during pregnancy or breastfeeding unless otherwise advised by a doctor.
[Moxibustion]: Moxibustion is a Traditional Chinese Medicine technique that uses cupping and heat to stimulate circulation and break up congestion or stagnation of blood and chi. A study of 47 individuals found that moxibustion was effective in acne treatment.
[Nicotinamide]: Studies have reported that nicotinamide in doses of 750 milligrams, combined with zinc 25 milligrams, copper 1.5 milligrams, and folic acid 500 micrograms, is effective in treating acne vulgaris with or without antibiotics.
[Omega-3 fatty acids]: Omega-3 fatty acids, such as fish oils, help with inflammation and immunity associated with acne. Experts recommend choosing quality fish oil supplements, as heavy metals have been reported in some fish oil supplements. The label should say if the product has been tested for heavy metal contamination (such as lead and mercury).
[Phototherapy]: Studies have reported that visible light may successfully be used to treat acne, particularly intense blue light generated by purpose-built fluorescent lighting, dichroic bulbs, LEDs or lasers. Used twice weekly, this has been reported to reduce the number of acne lesions by about 64%.
[Probiotics]: If a patient is taking antibiotics for acne, probiotic supplements may be effective in reducing effects associated with antibiotic and antiviral therapies such as diarrhea or constipation. The gastrointestinal tract normally has bacteria such as Lactobacillus acidophilus (considered a probiotic)
that help in balancing the immune system. Probiotics are generally safe in recommended dosages, but may cause mild diarrhea.
[Saw palmetto]: Saw palmetto (Serenoa repens) may help balance male hormonal levels and may be used in acne therapy. Although no scientific evidence exists for the use of saw palmetto for acne treatment or prevention, traditional uses support saw palmetto's benefits in acne. Caution is advised when taking saw palmetto supplements as numerous adverse effects including drug interactions are possible. Saw palmetto is not recommended during pregnancy or breastfeeding unless otherwise advised by a doctor.
- Stress reduction: Stress has been associated with occurrence of acne.
[Meditation], [exercise], [music therapy], and [massage] have been reported to decrease stress.
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