Herbs Against Acne (2024 edition)

We cover this same topic every decade, but it’s always new, because there’s always a new generation of sufferers.  If “suffer” sounds like a big word for what’s basically a cosmetic condition… let me remind the grown-ups how miserable it felt when you were that age, how flat-out tragic every pimple and blemish could be.  It’s hard.  For real.   

So what is this scourge, exactly?

Inside our pores we have sebaceous glands, that produce an oily substance called sebum to protect the skin.  When those pores get clogged, it traps the sebum, and the pore swells.  (Testosterone, produced by both males and females, increases sebum production, which is how those mythical “raging hormones” make acne worse).   On top of that, clogged pores are an ideal home for the bacterium Propionibacterium acnes, which colonizes the pimple and may cause the area to become inflamed.  

So, what can we do?

Diet: Conventional wisdom says you are what you eat, and certainly nobody wants a face like an extra-cheese pizza.  So it makes a certain intuitive sense to limit fats and oils.  Having said that, the research doesn’t necessarily agree. A handful of studies have found a weak link between total fat intake and severity of acne. However, a number of other studies have found no link at all.

But that’s total fat.  And that’s all we could really talk about 10 years ago, last time I wrote one of these articles. (Although I did wonder aloud if new research might show a difference between what we might call “good fats” and “bad fats”…)  Today, we have the research to look at specific fats.  Long story short, traditional “bad fats” like we find in poorly raised meats and dairy products, corn oil, cottonseed oil, and fried foods can make acne worse, while diets rich in omega-3 fats, nut oils and fruit oils may make it better.

Other problem foods?  Chocolate is contributor.  And no, it’s not just the sugar.  They’ve even done studies on pure chocolate in pill form. 

High-glycemic foods (foods that spike blood sugar) make things worse.  So we should be less concerned with total sugars than sugars untethered from the protein, fat, and fiber that slow down digestion and absorption.  Here, whole foods and balanced meals are the key.

Finally, there’s dairy.  The research is especially damning here.  And as much as I’d like to make a case for healthier grass-fed dairy, I don’t think I can. Not here. The problem is inherent to the milk protein itself.   Cutting back on dairy 3-4 weeks will often help noticeably.

Foods that are good for acne?  Beyond a high-fiber diet, I can’t cite definitive research, so let me rattle off some opinions.  Eat a diet rich in whole plant foods.  And follow Michael Pollan’s maxim to eat “more leaves than seeds.”  I’d especially prioritize foods that support the liver: think radishes, burdock, turmeric, and artichoke.  Clean oils, and some sour and bitter tastes.  A simple dish of steamed greens with olive oil, lemon, and garlic would be fantastic. 

Zinc helps the immune system fight infections, is needed to process fats and oils in the body, and helps process testosterone. 13- and 14-year-olds have the lowest zinc levels of any age group, and acne sufferers are even worse off, with less zinc in their blood, hair, nails, and skin compared to others their own age. When you see this, and then remember how important zinc is for normal growth, wound healing, brain chemistry, and liver health, you’d probably want to take zinc, acne or not.

The research on zinc and acne is a little controversial.  On one hand, there are studies which show zinc to be just as effective as antibiotics in treating acne, with fewer side effects.  On the other, there are studies which show zinc to not be effective at all. Why the discrepancy?  Well, sometimes research just happens that way. But it’s worth noting that earlier studies used poorly-absorbed zinc sulfate and showed little or no effect.  More recent studies have had much better results using the better-absorbing forms of zinc.  I recommend the better absorbing forms including zinc picolinate, zinc gluconate and zinc monomethionine (“Optizinc”).

I recommend 30 mg twice a day.  Zinc may make you nauseous on an empty stomach, so take it with food. Also, zinc can displace copper in the body.  Most of us aren’t going to get copper-deficient, but for everyday use, you might want to take a zinc-copper combo, just to be safe.  Most people will notice a reduction in symptoms within two weeks.

Liver-cleansing herbs can also be a big boost for acne sufferers, and they work well together with zinc. Anything supportive of the liver should be helpful here, but what you really want are herbs that increase the production and flow of bile. Look for herbs like yellowdock and burdock, dandelion root, boldo, artichoke leaf, celandine and Oregon grape root. Planetary Herbals makes a nice combo product called Yellowdock Skin Cleanse. 

I mentioned Fiber briefly under Diet, but it deserves a special call-out here.  Soluble fiber can both reduce the glycemic impact of meals, as well as reduce excessive levels of testosterone. Diets higher in fiber are correlated with fewer pimples.

Period Support should also be considered for women whose acne flares in sync with their monthly cycle.  Here, consider 3 tablespoons of finely ground flax seed daily – all month long, or at least for the two weeks leading into the problem times. As the liver filters the blood and tries to reduce excess levels of circulating androgens, flax lignans can help. Vitamin B6 50 mg twice daily can also help balance hormones.  Please note, both of these supplements can improve general period symptoms, but neither are contraindicated in men or pre-teens, or “mess with your hormones” in any weird or potentially problematic way.  If your acne flares in sync with your period AND your period correlates with flares of temper, Chinese herbal formulas that reduce “liver heat” may also be helpful. Xiao Yao, or “Easy Wanderer” is the classic patent formula here. Expect your acne (and your temper) to get worse for a week or so until it gets better.

Finally, let’s talk bodycare.  A gentle facewash with a little tea tree oil may reduce total bacterial load.  Some people report benefit with sulfur soaps. And of course you want to go easy any makeup — even natural makeup — that may clog your pores. But what I really like is zinc.  Again, zinc.  On the face.  And one of the  best ways to get zinc on your face is… diaper rash cream.  Yes, diaper rash cream! Not all diaper rash cream is created equal. The German cosmetic company Weleda makes a Calendula Diaper Care which has been a store favorite for over 30 years — across all age groups.  (My grandmother never left home without a tube in her pocketbook.  She used it on her hands after every time she washed).  This cream is a great spot treatment to help resolve pimples faster. You just have to get over that it’s “diaper cream.”  But I’ve seen it help for decades, literally.  So get over it already!  Strange to think we’ve been around so long we’re writing about and selling the same products to the children and grandchildren of our first customers.