Acné
Acné volgens Natural Standard.
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. Avoid if allergic or hypersensitive to vitamin A. Vitamin A toxicity can occur if taken at high dosages. Use cautiously with liver disease or alcoholism. Smokers who consume alcohol and beta-carotene may be at an increased risk for lung cancer or heart disease. Vitamin A appears to be safe in pregnant women if taken at recommended doses; however, vitamin A excess, as well as deficiency, has been associated with birth defects. Excessive doses of vitamin A have been associated with central nervous system malformations. Use cautiously if breastfeeding because the benefits or dangers to nursing infants are not clearly established.
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. Zinc is generally considered safe when taken at the recommended dosages. Avoid zinc chloride since studies have not been done on its safety or effectiveness. Avoid with kidney disease. Use cautiously if pregnant or breastfeeding.
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. Avoid if allergic to guggul. Avoid with a history of thyroid disorders, anorexia, bulimia or bleeding disorders. Signs of allergy to guggul may include itching and shortness of breath. Avoid if pregnant or breastfeeding.
Tea tree oil: Topical application of tea tree (Melaleuca alternifolia) oil may be beneficial in acne vulgaris. 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. Avoid allergic or hypersensitive to tea tree oil (Melaleuca alternifolia), any of its constituents, balsam of Peru, benzoin, colophony (rosin) tinctures, eucalyptol, or other members of the Myrtle (Myrtaceae) family. Avoid taking tea tree oil by mouth. Avoid if taking antineoplastic agents. Use tea tree oil applied to the skin cautiously in patients with previous tea tree oil use. Avoid if pregnant or breastfeeding.
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, a form of the vitamin niacin, 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.
Prevention
Wash the face with mild soap and water several times daily to prevent pore clogging and oil buildup.
Avoid repeated exposure to an environment that promotes oil production and clogging of the pores.
Rubbing and friction from clothing, hair, and sporting equipment may also irritate acne-prone skin.
Try not to "pop" pimples or touch them, as infection may occur.
Avoid skin irritants such as cosmetics or shaving with an electric razor.
Stress has been associated with occurrence of acne. Meditation, exercise, music therapy, and massage have been reported to decrease stress.
Nutritional changes along with the addition of supplements (vitamins, minerals and herbs) may be effective in preventing acne, improving immunity, decreasing stress, and in supporting general health.
Taking a multivitamin that contains the antioxidant vitamins A, C, and E, the B-complex vitamins, and trace minerals such as magnesium, zinc, and selenium can help protect the body from acne.
Although still controversial, consuming less dairy products such as milk and cheese, may decrease acne. It is thought that the hormones contained in milk may be a causative factor in developing acne. Drinking soy milk or organic milk that does not contain hormones may help decrease acne.
Try to avoid refined foods such as white breads, pastas, and sugar. The high glycemic index of these foods has been reported to increase acne outbreaks and symptoms.
Eat antioxidant containing foods, including fruits (such as berries, grapes, and tomatoes), and vegetables (such as peppers and carrots). Studies report that oxidation may be a causative factor in developing acne.
Seafood, which contains high levels of iodine, has been reported to increase the incidence of getting acne. Avoiding seafood may decrease the chances of developing acne.
Chocolate has been thought to cause acne for years, but scientists have found no link between chocolate consumption and acne outbreaks. However, overconsumption, especially of milk chocolate, may cause poor glycemic control which may increase the chances of acne outbreaks.
References
American Academy of Dermatology. www.aad.org. Accessed February 24, 2009.
American Dermatological Association. www.amer-derm-assn.org. Accessed February 24, 2009.
Adebamowo CA, Spiegelman D, Berkey CS, et al., Milk consumption and acne in adolescent girls. Dermatol Online J. 2006;12(4):1. View Abstract
Amann W. [Improvement of acne vulgaris following therapy with agnus castus (Agnolyt)]. Ther Ggw. 1967 Jan;106(1):124-6. View Abstract
Arbesman H. Dairy and acne-the iodine connection. J Am Acad Dermatol. 2005;53(6):1102. View Abstract
Arican O, Kurutas EB, Sasmaz S. Oxidative stress in patients with acne vulgaris. Mediators Inflamm. 2005;2005(6):380-4. View Abstract
Bassett IB, Pannowitz DL, Barnetson RS. A comparative study of tea-tree oil versus benzoylperoxide in the treatment of acne. Med J Aust. 1990;153(8):455-8. View Abstract
Chen D, Jiang N, Cong X. 47 cases of acne treated by prick-bloodletting plus cupping. J Tradit Chin Med. 1993;13(3):185-6. View Abstract
Chiu A, Chon SY, Kimball AB. The response of skin disease to stress: changes in the severity of acne vulgaris as affected by examination stress. Arch Dermatol. 2003;139(7):897-900. View Abstract
Doron S, Gorbach SL. Probiotics: their role in the treatment and prevention of disease. Expert Rev Anti Infect Ther. 2006; 4(2):261-75.
Ernst E, Huntley A. Tea tree oil: a systematic review of randomized clinical trials. Forsch Komplementarmed Klass Naturheilkd. 2000;7(1):17-20.
Logan AC. Omega-3 fatty acids and acne. Arch Dermatol. 2003;139(7):941-2; author reply 942-3. View Abstract
Magin PJ, Adams J, Pond CD, Smith W. Topical and oral CAM in acne: a review of the empirical evidence and a consideration of its context. Complement Ther Med. 2006;14(1):62-76. View Abstract
Natural Standard: The Authority on Integrative Medicine. Copyright © 2009. www.naturalstandard.com. Accessed February 24, 2009.
Niren NM. Pharmacologic doses of nicotinamide in the treatment of inflammatory skin conditions: a review. Cutis. 2006;77 (1 Suppl):11-6. View Abstract
Simopoulos AP. Evolutionary aspects of diet, the omega-6/omega-3 ratio and genetic variation: nutritional implications for chronic diseases. Biomed Pharmacother. 2006;60(9):502-7. View Abstract
Thappa DM, Dogra J. Nodulocystic acne: oral gugulipid versus tetracycline. J Dermatol. 1994;21(10):729-31. View Abstract
Acne treatment with Vitex agnus castus
Two uncontrolled clinical studies and one observational report have assessed the effects of extracts of the fruit on acne due to hormone imbalance. In one open study, 118 people with acne were treated with a fruit extract (20 drops twice daily for 4–6 weeks, then 15 drops twice daily for 1–2 years) and the results were compared with those of conventional treatments for acne. Patients treated with the fruit extract reported a quicker healing rate after 6 weeks and after 3 months of therapy, 70% of patients treated with the fruit extract had complete healing.
Amann W. Akne vulgaris and Agnus castus (Agnolyt®). Zeitschrift für Allgemeinmedizin, 1975, 51:1645–1648 [in German]. Giss G, Rothenberg W. Phytotherapeutische Behandlung der Akne. Zeitschrift für Haut- und Geschlechtskrankheiten, 1968, 43:645–647.
Akne Pflanzliche Wirkstoffe
Auch gegen Akne sind Kräuter gewachsen
Pflanzliche Wirkstoffe wie die Kamille und Wirkstoffe wie die medizinische Hefe können unterstützend zur Therapie der leichten bis mittelschweren Form der Akne eingesetzt werden. Die Hefe wird dabei vor allem weniger als Arzneimittel sondern als Nahrungsergänzungsmittel verwendet. Die Wirkstoffe können unterstützend zur Langzeittherapie eingesetzt werden, natürlich in Absprache mit dem behandelnden Arzt.
Echte Kamille (Matricaria chamomilla oder auch Matricaria recutita)
Wirksam gegen Bakterien, die Entzündungen der Haut auslösen, sind ätherische Öle in Pflanzen. Hier bietet sich besonders die Echte Kamille (Matricaria chamomilla oder Matricaria recutita) an. Sie enthält neben vielen weiteren Wirkstoffen Chamazulen, ein blaues Öl, und das alkoholische Bisabolol. Diese beiden Inhaltsstoffe allein sind bereits entzündungshemmend. Die Kamille entfaltet ihre Wirkung jedoch durch die gelungene Zusammensetzung aller ihrer Inhaltsstoffe. Eingesetzt werden ölige Auszüge im Kamillenöl, alkoholische Auszüge in Tinkturen oder wässrige Auszüge im Kamillentee. Kamille hat sich über Jahrhunderte in der Volksheilkunde bei Hautproblemen bewährt. Den positiven Effekt von öligen Auszügen auf die Wundheilung bewies eine iranische Forschergruppe der Universität Semnan im Jahr 2010 an Ratten.
Vorsicht bei der Anwendung von Kamille ist bei allergisch reagierenden Menschen geboten, besonders bei solchen, die unter Heuschnupfen oder Heuasthma leiden. Es sind nach Trinken von Kamillentee Nesselsucht (Urticaria), Schwellungen der Haut (Angioödem) und Atemnot (Dyspnoe) und bei Waschungen mit Kamillentee Entzündungen der Bindehaut des Auges (Conjunctivitis) nachgewiesen.
Linolsäure
Die Linolsäure ist eine zweifach ungesättigte Fettsäure, die in vielen Ölen vorkommt, etwa in Distelöl. Sie gehört zu dem Omega-Sechs-Fettsäuren und gilt als Haut pflegend. Eine Forschergruppe der Universität im belgischen Lièges, die sich mit der gestörten Abschuppung in den Talgdrüsenfollikeln von Akne-Betroffenen und mit der Zusammensetzung des Hauttalgs beschäftigte, wies 1998 nach, dass die äußerliche Anwendung von Linolsäure nach einem Monat eine Abnahme von Micro-Komedonen, aus denen sichtbare Mitesser entstehen, um 25 Prozent stattgefunden hatte. Die Forschung weiß aber auch, dass bei Einnahme aus der Umwandlung der Linolsäure im Körper unter anderem Arachidonsäure entsteht. Arachidonsäure ist entzündungsfördernd.
Bierhefe (Saccharomyces cerevisiae) und Medizinische Hefe (Saccharomyces boulardii)
Die Hefen gehören zu den Pilzen, und Pilze bilden in der Biologie neben den Pflanzen und Tieren eine eigene Klasse. Seit Menschengedenken wird Bierhefe in der Nahrungszubereitung verwendet, etwa zur Herstellung von Brot, von Bier und von Wein. Die Bier- oder Backhefe (Saccharomyces cerevisiae) enthält die B-Vitamine Thiamin (B 1), Riboflavin (B 2), Niacin (B 3), Pantothensäure (B 5), Pyridoxin (B 6) und Folsäure (B 9) sowie die Mineralien Kalium, Phosphor, Magnesium, Calcium, Natrium, Zink, Eisen, Mangan, Kupfer und Selen.
In der Volksheilkunde gilt Hefe lange schon als Haut pflegend, und zwar sowohl innerlich (systemisch) durch ihre Einnahme als auch äußerlich (topisch) durch das Auflegen von Masken. Obwohl der genaue Wirkungsmechanismus noch nicht abschließend erforscht ist, konnten wissenschaftliche Studien die Wirksamkeit von Bierhefe bei Akne bestätigen.
Bereits 1989 wiesen die Forscher Weber, Adamczyk und Freytag in einer Doppel-Blind-Studie eine deutliche Wirksamkeit der Bierhefe gegen Akne nach. 2010 bestätigte eine Forschergruppe der Universitäts-Hautklinik in Freiburg die Wirksamkeit von Bierhefe und bestätigte ihr die Fähigkeit, nach weiteren Forschungen in der Akne-Behandlung als Standard-Wirkstoff eingesetzt werden zu können.
Empfohlen wird auch die Anwendung der lebensfähigen Spezialtrockenhefe Hansen CBS 5926 (Saccharomyces boulardii). Sie kann haarähnliche Anhangsgebilde (Fimbrien oder Pilii) mancher Bakterien binden, hemmt so deren Wachstum und wirkt dadurch antibakteriell. Im Verdauungstrakt bewegt sie Fresszellen (Phagozyten) zu erhöhter Aktivität gegen schädliche Keime.
Manche Menschen reagieren mit verschiedenen, teils starken Reaktionen allergisch auf Hefen und sollten dann von einer Anwendung absehen. Auch bei Nicht-Allergikern kann es zu Blähungen kommen. Sonst sind schädliche Nebenwirkungen bei der Anwendung von Bierhefe nicht benannt, wenn auch die Deutsche Gesellschaft für Dermatologie auf die Akne fördernde Wirkung der Vitamine B 2, und B 6 hinweist.
Heilkunst aus Asien
Die indische Heilkunst Ayurveda wendet traditionell Pflanzen auch gegen Akne an. Die Forscher Jain und Basal vom King George's Medical College im indischen Lucknow wiesen 2003 die entzündungshemmenden Eigenschaften der Indischen Färberröte (Rubia cordifolia), der Kurkumawurzel (Curcuma longa), der Sarsaparilla (Hemidesmus indicus) und des Neem-Baums (Azadirachta indica) nach. Diese Pflanzen können ihrer Studie nach das Akne-Bakterium Propionibacterium acnes an der Produktion entzündungsauslösender Stoffe hindern.
Auch die zu den Mondsamengewächsen gehörende Guduchi-Pflanze (Tinospora cordifolia) ist bewährt bei Akneproblemen. Mitarbeiter des Chembiotek-Instituts im indischen Kolkata haben 2003 einen umfassenden Artikel zu den Inhaltsstoffen und medizinischen Eigenschaften von Tinospora cordifolia veröffentlicht.
Quellen:
Chan YS, Cheng LN, Wu JH, Chan E, Kwan YW, Lee SM, Leung GP, Yu PH, Chan SW. A review of the pharmacological effects of Arctium lappa (burdock). Inflammopharmacology 2010 Oct 28.
Deutsche Dermatologische Gesellschaft/Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften e.V. (AWMF) (Hg.): Behandlung der Akne. ICD-10 Ziffer: L 70. Berlin/Düsseldorf 2010.
Deutsche Dermatologische Gesellschaft/Deutsche Gesellschaft für Koloproktologie/Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften e.V. (AWMF) (Hg.): Acne inversa / Hidradenitis suppurativa. ICD 10: L 73.2. Berlin/Mannheim/Düsseldorf 2011.
Jain A, Basal E: Inhibition of Propionibacterium acnes-induced mediators of inflammation by Indian herbs. Phytomedicine. 2003 Jan;10(1):34-8.
Jarrahi, M., Vafaei, A. A., Taherian, A. A., Miladi, H., Rashidi Pour, A.; Evaluation of topical Matricaria chamomilla extract activity on linear incisional wound healing in albino rats. Nat Prod Res. 2010 May; 24 (8):697-702.
• Letawe C, Boone M, Pierard GE. Digital image analysis of the effect of topically applied linoleic acid on acne microcomedones. Clin Exp Dermatol. 1998; 23:56-8.
Nam C, Kim S, Sim Y, Chang I. Anti-acne effects of Oriental herb extracts: a novel screening method to select anti-acne agents. Skin Pharmacol Appl Skin Physiol. 2003 Mar-Apr;16(2):84-90. • Plewig, Gerd; Jansen, Thomas; Romiti, Ricardo: Acne fulminans: Schwere Akne mit ungewöhnlichem klinischen Verlauf. Deutsches Ärzteblatt 2000; 97(22): A-1533 / B-1289 / C-1205.
Reuter J, Wölfle U, Weckesser S, Schempp C: Which plant for which skin disease? Part 1: Atopic dermatitis, psoriasis, acne, condyloma and herpes simplex. J Dtsch Dermatol Ges. 2010 Oct;8(10):788-96. doi: 10.1111/j.1610-0387.2010.07496.x. Epub 2010 Aug 5.
Schilcher, H., Kammerer, S., Wegener, T.: Leitfaden Phytotherapie. München 2010.
Singh SS, Pandey SC, Srivastava S, GuptaVS, Patro B, Ghosh AC: Chemistry and Medical Properties of Tinospora cordifolia (Guduchi). Indian Journal of Pharmacology 2003; 35:83-91.
Weber G, Adamczyk A, Freytag S: Treatment of acne with a yeast preparation. Fortschr Med. 1989 Sep 10;107(26):563-6.
Wiesenauer, Markus: Phytopraxis. Berlin/Heidelberg 2011.