When it comes to herbal supplements, it seems like there is some exotic plant-in-a-pill for everything and anything imaginable. Because the market for herbal supplements is highly unregulated (as long as the claims aren’t too specific) it is easy to combine different herbs and plant extracts, slap some snazzy packaging on it and market it as a natural cure for anything from warts to emphysema. The problem with all of this is that there is very little actual science going on to validate any of these claims and very little standardization to ensure consistency from batch to batch and product to product. That said, there is undoubtedly some truth to be found in the midst of all the BS. If nothing else, the thing I hope that you take away from this section (and this site in whole) is the impulse to ask “why?” before simply accepting that something is true or false, good or bad. That said, in this section we cover some common herbal supplements used in the naturopathic and homeopathic treatment of acne.
Khadir (Black Clutch, Acacia catechu)
Khadir is a deciduous, thorny tree which is native to India, China and other areas of southeast Asia. Khadir is rich in phenolic compounds such as tannins, catechins and catechols. While there is some research indicating that these types of compounds may have anti-bacterialeffects when used topically, there is little evidence that ingestion leads to significant changes. Khadir has been used for centuries in ayurvedic medicine, primarily as a breath freshening agent.
Neem (Azadirachta indica)
A tree in the mahogany family, Neem is native to India and southeaest Asia. The Neem tree has a long history in Ayurvedic medicine and other traditional medicines for a wide range of uses. Neem oil contains potent insecticidal chemicals that prevent parasitic insects from molting, growing and mating. It is used widely in organic farming applications because of this property. Usually for the treatment of acne, bark of the Neem tree is ground into a poultice and applied to the affected area. Different preparations of neem are taken internally to relieve fever and as an anti-malarial drug.
Haemafine Syrup is a blend of more than a dozen herbs that is marketed in Ayurvedic medicine as a “blood purifier.” The idea is that impurities in the blood are manifest as acne and that by removing these impurities the symptoms of acne should resolve. While it is true that some types of impurities or toxins in the blood could cause sickness and disease (including acne), in most cases acne is not directly caused by “impurities” in the blood. In addition, “impurities of the blood” is almost impossibly vague (and kind of non-sensical considering how complex blood actually is) and beyond that, there is really no reasonable mechanism for how this blend of herbs might remove said impurities. Bottom line: Give it a shot if you want, but don’t get your hopes up.
Oregon Grape (Mahonia aquifolium)
Oregon grape is another plant that has a long history of use in traditional medicine, in this case that of the Native Americans of the Pacific Northwest. Recent research has demonstrated that at least two components of oregon grape, Berberine and 5′methoxyhydnocarpin, are biologically active. Berberine is a well characterized alkaloid that is also found in goldenseal. It has anti-bacterial and anti-fungal properties and is also an effective anti-inflammatory. 5′methoxyhydnocarpin (5′MHC) can inhibit part of the antibiotic resistance system of some pathogenic bacteria, which improves the efficacy of co-administered antibiotics. In short, Oregon Grape appears to be a plant that contains multiple useful molecules and is deserving of further study.
Goldenseal (Hydrastis canadensis)
Goldenseal is a perennial herb in the Buttercup family. It has a long history of use in Native American traditional medicine. Like Oregon Grape, it contains berberine and other related alkaloids and can be used as a topical or oral antimicrobial. Unfortunately, extensive use and habitat destruction has severely impacted the native population.
Burdock, Yellow Dock and Dandelion
Burdock is a type of thistle, whose burs were the original inspiration for the invention of velcro. In naturopathic medicine, Burdock, Yellow Dock and Dandelion are used “blood purifying” agents. Like Haemafine syrup, the blood purifying effects of Burdock are, at best, extremely dubious. Extracts from the seeds are diaphoretic (they induce sweating). Extracts from the roots are often used in topical applications for acne.
There are over a dozen closely related plants in the Elderberry family. Most parts of the plant contain a toxic glycoside that can lead to cyanide poisoning if eaten in significant quantities. The ripe berries do not contain significant amounts of this molecule and are safe to eat. Recent research has shown that an extract of black elderberry, but not extracts from other elderberry species, was an effective treatment for influenza. There is a minimal amount of evidence supporting the use of elderberry in acne treatment, however.
Black Walnut (Juglans nigra)
Black walnut is a large deciduous tree that is native to North America. The nut itself is similar to the more common English Walnut, and is rich in linoleic acid and oleic acid. The common naturopathic preparations are prepared from the bark, roots, nut husks and leaves of the plant. These preparations are rich in a molecule and called jugalone, an aromatic compound that is herbicidal and insecticidal. Black Walnut is most commonly recommended as a topical treatment for acne, but some homeopathic regimens utilize it as an ingested supplement. There is little scientific research into the efficacy of Black Walnut for the treatment of acne, but an efficacious topical treatment seems plausible. Oral supplementation with Black Walnut is unlikely to be helpful.
Red Clover (Trifolium pratense)
Red clover is a common species of clover that is native to Europe and western Asia, but grows all over the world. Red Clover is a nitrogen fixing plant (it takes nitrogen from the air and converts it into bio-available nitrogen) and is used in agriculture to recharge fallow fields. With respect to medicine, Red Clover contains high levels of isoflavones, such as irilone and pretensein. These isoflavones are known as phytoestrogens because of their chemical similarity to mammalian estrogen hormones. These isoflavones are capable of stimulating estrogen receptors, mimicking elevated levels of estrogen hormone. In fact, sheep grazing in areas rich in Red Clover have decreased fertility due to excessive stimulation of the estrogen receptors. With respect to the treatment of acne, the effect of Red Clover is likely similar to taking birth control pills. Excitation of the estrogen dependent pathways can antagonize (inhibit) some of the androgen dependent pathways, which includes sebaceous gland activity. Red Clover is indeed an interesting plant, but it is important to carefully evaluate the composition and concentration of active ingredients in any supplement before use.
Evening Primrose Oil
Evening Primrose (Oenothera biennis, King’s Cure-All), is a flowering plant native to North America. Evening primrose oil is harvested from the mature seeds. In naturopathic medicine, evening primrose oil is taken orally for rheumatoid arthritis, premenstrual syndrome, eczema, fatigue, diabetic neuropathy and acne, among other things. Evening primrose oil two important fatty acids, gamma-linolenic acid (GLA) and standard linoleic acid. It is thought that GLA may be converted to dihomo-gamma-linolenic-acid, a prostaglandin precursor. Accumulation of this prostaglandin could potentially help reduce certain types of inflammation. Overall, the research is mixed regarding the efficacy of evening primrose oil supplementation, although some small studies have demonstrated a beneficial effect.