The skin condition acne is often unsightly and may cause considerable distress sufferers. While acne is most common around the time of puberty, it is not uncommon for it to affect individuals, women in particular, well into their twenties and thirties. One of the mainstay medical treatments for acne is antibiotics. However, Swedish research presented at an American conference last week suggests that the bacterium associated with many cases of acne is becoming increasingly resistant to the effects of antibiotics. There is real concern that the overuse of antibiotics may lead to problems with untreatable acne in the future. Also, last week, research was published which showed that a significant proportion of women with acne have high levels of ‘male’ hormones such as testosterone in their systems. Could it be that treating acne with antibiotics is failing to get to the root of the problem in many women, and might, in fact, be storing up problems for later on?

Acne is caused by blockages in the glands in the skin responsible for making a waterproofing agent called sebum. Acne tends to be more common in around puberty and adolescence, when the production of ‘male’ hormones may increase the secretion of sebum. Last week’s research published in the medical journal Fertility and Sterility found that almost two-thirds of women with acne had raised levels of at least one type of male hormone. This most recent study suggests that elevated levels of androgens is a much more common factor in female acne than was previously thought.

High levels of androgens in women are often, but not always, associated with a condition known as polycystic ovarian syndrome (PCOS). As its name suggests, PCOS is associated with multiple cysts in one or both ovaries. Other common symptoms of this condition include breast pain, menstrual irregularities, and excess facial and/or body hair. Women who suffer from acne and also exhibit one or more of these other symptoms should consider consulting their doctor so that relevant investigations for PCOS may be performed if appropriate. If PCOS is diagnosed, then treatment directed specifically at this condition may by most effective in the long term.

One of the most widely used conventional treatments for PCOS is cyproterone acetate, a principle ingredient of the contraceptive pill Dianette. Cyproterone acetate may help PCOS by blocking the effects of androgens in the body. However, more natural approaches do exist. While it is not known what causes PCOS for sure, there is some evidence that the higher than normal levels of androgens generally found in sufferers is worsened by increased levels of another hormone – insulin. Insulin is released in response to carbohydrate foods (sugars and starches), and it makes sense to limit those foodstuffs which give rise to the highest insulin levels. Foods to limit in this respect include sweet foods and sugary foods, white bread, pasta, white rice and potato. Foods that may help stabilise insulin secretion include, meat, fish, eggs, brown rice, beans, pulses, nuts, seeds, green vegetables and fruits other than grapes and bananas.

The symptoms of PCOS and/or raised levels of androgens in the body can often be helped with an herbal approach. The main androgen is a hormone called testosterone. Testosterone in the body can be converted into a more active form of this hormone called dihydrotestosterone. The herb Saw palmetto slows down the conversion of testosterone into dihydrotestosterone, and may therefore help to control acne in women who have high levels of testosterone in their systems. Saw palmetto can be found in health food stores. The standard dose is 320 mg of standardised extract per day. More information about PCOS and its treatment can be obtained by writing to the self-help organisation Verity at 52-54 Featherstone Street, London EC1Y 8RT.

In addition to taking steps to controlling the effects of androgens in the body, other approaches may be effective in treating acne. In natural medicine, acne is often viewed as a problem relating to toxicity within the body. As a result, it can help sufferers to eat as ‘clean’ a diet as possible. This means avoiding fatty foods, and those laced with artificial colourings, flavourings, preservatives and sweeteners. About 2 litres of filtered or still mineral water should be drunk each day, as this will help keep the body free from toxins.

Certain nutrients may be useful in controlling acne. Some women find that their acne can flare up before a period. This sort of acne – known as pre-menstrual acne - is often helped by taking 50 mg of vitamin B6 each day. Another very useful nutrient for the treatment of acne is the mineral zinc. One study published in the British Journal of Dermatology in 1977 found that zinc therapy worked as well as antibiotic medication. I generally recommend patients take 30 mg of zinc, three times a day for 3 – 4 months, after which the dose can be reduced to once or twice daily. Studies do show that it takes 12 weeks of zinc therapy before results are seen. Because zinc therapy can induce copper deficiency, I recommend that 1 mg of copper be taken for every 15 mg of supplemental zinc.

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