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Health Protocols

Acne

Although acne is typically thought of as an ailment of adolescence, millions of adults are also afflicted. In fact, acne among adult females may represent an underappreciated epidemic affecting more than 50% of women aged 20–29 and more than 25% of those aged 40–49. In this population, the presence of acne may indicate underlying hormonal imbalance.

Contrary to popular belief, acne results from multiple processes within the body, the causes of which are known and, most importantly, can be targeted with specific treatments and lifestyle changes.

In this protocol, you will learn how complementing mainstream acne treatments with evidence-based natural interventions, such as zinc and lactoferrin, may improve skin appearance.

Diagnosis

  • Acne can usually be diagnosed based on the appearance of the face, back, upper arms, and chest.
  • Underlying conditions that could cause acne should be ruled out. For example, polycystic ovary syndrome, a condition in which women develop ovarian cysts and produce excessive testosterone, is associated with acne.

Conventional Medical Treatment Includes:

  • Over-the-counter topical agents. These include benzoyl peroxide, azelaic acid, and salicylic acid. They can be used for mild-to-moderate acne and are antimicrobial and anti-inflammatory.
  • Antibiotics (topical and oral). These include erythromycin, clindamycin, and nadifloxacin.
  • Retinoids (vitamin A-related compounds; topical and oral). Retinoids can be used for mild-to-severe acne and are anti-inflammatory. These include tretinoin, tazarotene, adapalene, and isotretinoin.

Novel and Emerging Strategies Include:

  • Hyaluronic acid injections. Microinjections of hyaluronic acid gel into severe acne scars resulted in immediate improvement in a small-scale trial. These injections may be used to improve the appearance of acne scars.
  • Light therapy. Evidence shows exposure to blue light suppresses the bacteria Propionibacterium acnes, which plays a major role in acne-related inflammation. Overall, light therapy is a very effective acne treatment option with minimal side effects. A review of published evidence found that as many as 85% of patients who underwent light therapy achieved at least a 50% reduction in acne severity.

Dietary and Lifestyle Considerations Include:

  • High intake of fats, sugars, and proteins, which typifies the western dietary pattern, may promote acne in a manner similar to excessive androgen production.
  • Gently washing affected areas twice daily with a mild cleanser or gel is suggested for all forms of acne. Excessive scrubbing can make the lesions worse.

Integrative Therapies Include:

  • Fish oil. In a clinical trial, 13 patients with inflammatory acne were given 930 mg of the omega-3 fatty acid eicosapentaenoic acid daily for 12 weeks. Some subjects experienced modest improvements in acne severity following treatment.
  • Zinc. This mineral exerts anti-inflammatory and antioxidant actions, antibacterial effects against P. acnes, modulates the immune system, and reduces the production of sebum. In an open-label trial, 30 subjects with inflammatory acne took 30 mg of elemental zinc daily for 60 days. Lesions decreased significantly by day 30 of the trial, and this reduction was even more pronounced at the end of the trial.
  • Lactoferrin. Lactoferrin, a protein with antimicrobial and anti-inflammatory effects, is a component of the innate immune system. In a trial of 39 subjects with acne, twice-daily lactoferrin tablets over eight weeks resulted in a significant decrease in the number of acne lesions in almost 77% of subjects.
  • Nicotinamide. As a dietary supplement of 600 mg one to four times daily (in combination with azelaic acid, copper, folic acid, pyridoxine, and zinc), nicotinamide reduced symptoms by over 80% after eight weeks of treatment in a clinical trial of 235 subjects.
  • Vitamin E. A deficiency in this antioxidant was correlated with increasing severity of acne. Vitamin E supplementation may also be advisable for those receiving isotretinoin.