In addition to compositions of essential oils and other plant extracts, several other topical preparations are used in the naturopathic treatment of acne. One major group of treatments involves the use of clay, sulfur and other earth elements to create face masks, scrubs and purifying washes. Other medicinal sources include animal products, such as eggs, yogurt and honey. In this section we overview some additional topical acne treatments and the science behind them.
Sulfur
Used since antiquity in the treatment of skin diseases, sulfur is one of the most commonly prescribed topical acne therapies in naturopathic medicine. Sulfur itself has antibacterial and antifungal properties. In addition to homeopathic medicine, sulfur is commonly used in organic farming applications to treat plant disease. When used topically, sulfur acts as a keratolytic agent, breaking down keratinized cells at the surface of the skin and promoting cellular turnover. It has also been suggested that sulfur is an anti-inflammatory agent. Sulfur is available as a pure product that can be compounded into a usable form by the user. A prescription product that contains sulfur and sodium sulfacetamide (Clenia) is also available. Available research is split on the efficacy of sulfur, but it appears to be most effective when combined with an additional type of topical treatment.
Zinc
Zinc is widely used as a topical treatment for diaper rash and dandruff. While zinc itself is toxic to bacteria, it also appears to have a beneficial impact on the immune system. Research reports on the effectiveness of topically applied zinc sulfate suggest that it is minimally effective at treating acne, particularly inflammatory acne. This is likely due to the limited penetration of the zinc into the skin However, studies combining topical zinc treatment with topical antibiotic treatment suggested that there may be some benefit in combinatorial therapy.
Silver
Like zinc and sulfur, silver itself is toxic to bacteria. In fact, many pieces of modern medical equipment, like catheters and stents, are now coated with a fine layer of silver to prevent bacterial infection around the surgical site. Colloidal silver is the form of silver usually prescribed for topical treatments in naturopathic medicine. The colloidal silver can be prepared alone, or combined with other products. Extensive use or ingestion of colloidal silver is not recommended, as it can cause a blue-gray staining of the skin known as argyria. Silver is also available in a prescription medicine, silver sulfadiazine (Silvadene). It is commonly used to prevent skin infections in burn patients.
Copper
Like the elements listed above, copper is also toxic to bacteria. It’s use as a topical agent is far less common than the above elements, but new copper based topical treatments may change that. Copper peptides are small molecules that are composed of short chains of amino acids connected to copper ions. They are being used in a number of rejuvenating and skin revitalizing treatments. Colloidal copper and copper salts (copper sulfate) are also available and occasionally used in naturopathic medicine. The efficacy of all these copper therapies in acne treatment remains largely untested and there is little available research on the subject.
Clay
Used for thousands of years, clay masks are a fundamental part of the quintessential spa experience. When you see the woman in the commercial relaxing with the gray rejuvenating mask on her face and cucumber slices on her eyes, that is a clay mask. There are several different types of clay commonly used in these topical treatments, and each has different properties and composition. Clay is enriched in a wide range of trace elements, and also usually contains the elements described above. These masks can be combined with essential oils or other plant extracts to serve many functions. While the clay itself may be beneficial, those benefits depend on the type and quality of the clay, as well as any added components.
Egg Whites
Egg whites contain a large number of nutrients and proteins. If the egg white is used directly from a fresh egg, most of these proteins are biologically active. Egg white contains an enzyme called lysozyme which breaks down the cell walls of gram positive bacteria. Coincidentally, the two bacteria that are usually behind acne breakouts, Propionibacterium acnes and Staphylococcus aureus, are both gram positive bacteria and are susceptible to this enzyme. In addition, egg white contains proteins that can chelate and remove heavy metals. Egg whites are usually prepared into a mask and allowed to dry on the face. Alternatively, an extract containing the active proteins can be prepared and added to a different preparation. The lysozyme enzyme is also available alone, it is most often used in beer and wine making to prevent bacterial contamination during fermentation.
Honey
Another remedy that goes back to ancient times, honey has gained further popularity in recent times with research indicating that honey can facilitate faster wound healing when applied topically. Several products containing medical grade honey are now available and are widely used in parts of Europe and Asia. For the treatment of acne, honey is often applied as part of a mask or blended with other water soluble components. Honey is primarily a mixture of sugars, but contains functional amounts of anti-oxidants, enzymes and antibacterial molecules. There is a difference between raw and pasteurized honey, as the pasteurization process denatures many of the enzymes present in honey. However, both raw and processed honey are used in homeopathic medicine, depending on the application.
Yogurt (aka Yoghurt)
Yogurt is a less common naturopathic treatment, but it does enjoy some popularity as a topical acne treatment, particularly in some middle eastern and asian cultures. Unpasteurized yogurt contains many nutrients and enzymes, as well as live cultures of Lactobacillus delbrueckii and Streptococcus salivarius bacteria. These bacteria are non-pathogenic and ferment milk into yogurt. A byproduct of this fermentation is lactic acid, which makes the yogurt acidic and prevents the growth of other bacteria and yeast. In addition, the bacteria used to make yogurt may also release small quantities of natural antibiotics that are toxic to competing bacteria. Finally, these bacteria secrete digestive enzymes, which may account for the smoothing and toning effect claimed by proponents of topical yogurt treatments. Unfortunately, there is very little actual research on the efficacy of yogurt treatments for acne.
Calamine
Calamine is a combination of zinc oxide and iron oxide and is usually available as a lotion. It has been used extensively as an anti-itch and anti-inflammatory agent for the treatment of poison oak rashes and sunburns. Although calamine lotion has not been extensively studied with respect to acne, it is reasonable to assume that the zinc component features the same anti-bacterial and anti-inflammatory benefits as other zinc preparations. Aside from scientific research, numerous patients have self-reported favorable responses to calamine treatment. In naturopathic medicine, calamine is often combined with sulfur for the topical treatment of acne.
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