Acne is a skin condition characterized by reddened, inflamed lesions (sometimes called pustules or “whiteheads”) on the face, neck, shoulders, and elsewhere. Acne occurs most commonly in teenagers and to a lesser extent in young adults. The condition results in part from excessive stimulation of the skin by androgens (male hormones). Bacterial infection of the skin also appears to play a role.

Dietary changes that may be helpful: Many people assume certain aspects of diet are linked to acne, but there isn’t much evidence. Preliminary research found chocolate was not implicated, for example.[1] Similarly, though a diet high in iodine can create an acne-like rash in a few people, this is rarely the cause of acne. In a preliminary study, people who thought that certain foods triggered their acne turned out to be consistently wrong.[2] Despite the lack of evidence, some doctors of natural medicine continue to believe that food allergy can play a role, at least in adult acne.[3]

Nutritional supplements that may be helpful: Several studies indicate that zinc supplements reduce the severity of acne.[4] In one study, zinc was found to be as effective as oral antibiotic therapy.[5] Nutritionally oriented doctors sometimes suggest that people with acne take 30 mg of zinc two or three times per day for a few months, then 30 mg per day thereafter. It often takes twelve weeks before any improvement is seen.

Large quantities of vitamin A—such as 300,000 IU per day for females and 400–500,000 IU per day for males—have been used successfully to treat severe acne.[6] However, those quantities of vitamin A are quite toxic. Moreover, unlike the permanent actions of synthetic prescription versions of vitamin A (such as Accutane), the acne will return several months after real vitamin A is discontinued. Therefore, vitamin A is generally a poor treatment for acne and should be taken only under the supervision of a health professional if at all.

An isolated trial using pantothenic acid reported good results.[7] In that trial, people with acne were given 2.5 grams of pantothenic acid four times per day (for a total of 10 grams per day)—a remarkably high amount. A cream containing 20% pantothenic acid was also applied topically four to six times per day. With moderate acne, near complete relief was seen within two months, but severe conditions took at least six months to respond. Eventually, the level of pantothenic acid was reduced to 1–5 grams per day—still a very high level.

Niacinamide was found to substantially help people with acne in a double blind trial lasting two months and using topical gel containing 4% niacinamide applied twice per day.[8] There is little reason to believe that the vitamin would have similar actions if taken orally, however. Vitamin B6 at 50 mg per day may alleviate premenstrual flare-ups of acne experienced by some women.[9]

Are there any side effects or interactions? Refer to the individual supplement for information about any side effects or interactions.

Herbs that may be helpful: A large study compared the topical use of 5% tea tree oil to 5% benzoyl peroxide for common acne. Although the tea tree oil was slower and less potent in its action, it had far fewer side effects and was thus considered more effective overall.[10] For topical treatment of acne, the oil may be used at a dilution of 5–15%.

Historically, tonic or alterative herbs, such as burdock, have been used in the treatment of skin conditions. These herbs are believed to have a cleansing action when taken internally.[11] Burdock root tincture may be taken in 2–4 ml amounts per day. Dried root preparations in a capsule or tablet can be used at 1–2 grams three times per day. Many herbal preparations combine burdock root with other alterative herbs, such as yellow dock, red clover, or cleavers.

Some older German literature suggests that vitex might contribute to clearing of premenstrual acne.[12] Women in these studies used forty drops of a concentrated liquid product once daily.[13]

Are there any side effects or interactions? Refer to the individual herb for information about any side effects or interactions.


[1] Fulton JE Jr, Plewig G, Kligman AM. Effect of chocolate on acne vulgaris. JAMA 1969;210:2071–74 [2] Anderson PC. Foods as the cause of acne. Am Family Phys 1971;3:102–3. [3] Gaby A. Commentary. Nutr Healing Feb 1997;1,10,11. [4] Hillstrom L et al. Comparison of oral treatment with zinc sulfate and placebo in acne vulgaris. Br J Dermatol 1977;97:679–84. [5] Michaelsson G et al. A double blind study of the effect of zinc and oxytetracycline in acne vulgaris. Br J Dermatol 1977;97:561–66. [6] Kligman AM et al. Oral vitamin A in acne vulgaris. Int J Dermatol 1981;20:278–85. [7] Leung LH. Pantothenic acid deficiency as the pathogenesis of acne vulgaris. Med Hypoth 1995;44:490–92. [8] Shality AR, Smith JR, Parish LC, et al. Topical nicotinamide compared with clindamycin gel in the treatment of inflammatory acne vulgaris. Internat J Dermatol 1995;34:434–37. [9] Snider B, Dietman DF. Pyridoxine therapy for premenstrual acne flare. Arch Dermatol 1974;110:130–31. [10] Bassett IB, Pannowitz DL, Barnetson RS. A comparative study of tea-tree oil versus benzoyl peroxide in the treatment of acne. Med J Austral 1990;53:455–58. [11] Hoffman D. The Herbal Handbook: A User’s Guide to Medical Herbalism. Rochester, VT: Healing Arts Press, 1988, 23–24. [12] Amann W. Improvement of acne vulgaris with Agnus castus (Agnolyt ™). Ther Gegenw. 1967;106:124–26 [in German]. [13] Amann W. Acne vulgaris and agnus castus (Agnolyt ™). Z Allgemeinmed 1975;51:1645–58 [in German].

The information contained in this article is for information and education purposes only and is not medical advice. Do not use this information as an alternative to obtaining medical advice from your physician or other professional healthcare provider. Always consult with your physician or other professional healthcare provider about any medical conditions you are experiencing. If you are experiencing a medical emergency, contact your local emergency services for help.


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