Types of Acne Lesions Natural Cures Vitamins And Herb Treatments

Open comedones (blackheads): These are dilated hair follicles that are filled with sebum, dead cells and bacteria, and which have central, dark, solid plugs. The follicles are not completely blocked; the black appearance is caused by oxidation, not dirt.

Closed comedones (whiteheads): These form when skin cells and oil completely block the opening of a hair follicle, usually after a blackhead has formed.
Nodules: These are solid, dome- or irregularly shaped, inflamed lesions that extend deep into the skin, sometimes causing tissue damage and scarring if not treated. Nodular acne, which can be painful, is the most severe form of the disease.
Papules: This type of whitehead (5 mm or less) is one that has become swollen, red and inflamed

Cysts: These sac-like lesions contain white blood cells, bacteria and dead cells in a liquid or semi-liquid state. They can result in scarring, and may be very painful and severely inflamed. Cysts and nodules often appear together to form nodulocystic acne, also very severe.

Pustules: This whitehead is pus-filled and inflamed. Once they rupture into the skin, they form pustular heads.

Nutritional and Alternative Therapies
Nutritional and alternative therapies for acne can help reduce inflammation, and infection, and may be used alone or to complement conventional medical treatment, especially in cases of severe or difficult-to-treat acne.

Vitamins A and E. The benefits of vitamins A and E in acne was highlighted in a recent study in which investigators identified plasma vitamin A and E concentrations in 100 untreated patients with acne, compared with 100 healthy controls. Plasma concentrations of both vitamins in patients with acne were significantly lower than those of the controls, and a strong relationship between a decline in vitamin A and E levels and an increase in the severity of acne was noted (El-Akawi Z et al 2006).

This study supports previous work in which researchers found that supplementation with vitamin A is beneficial in inflammatory conditions, including acne, and conversely that vitamin A deficiency induces inflammation and aggravates existing inflammatory conditions (Reifen R 2002). In fact, vitamin A in retinoid form has long been an important treatment for acne.

Lipoic acid. Research into the efficacy of lipoic acid in the treatment of acne goes back several decades. Reportedly, lipoic acid activates a factor in the body known as AP-1, which produces enzymes that digest damaged collagen and helps erase scars, including acne scars (Kovalev VM 1981a,b). Lipoic acid is an ingredient in several topical acne remedies, but it can be taken as an oral supplement as well.

Zinc. This mineral appears to perform a threefold role in the treatment of acne. It helps reduce inflammation; kills Propionibacterium acnes, the main bacteria associated with the disease, and produces changes in the skin environment that make it more hostile to this bacterium for a longer time. A two-month study of the efficacy of zinc gluconate (30 mg once daily) in 30 patients with inflammatory acne showed a reduction in the number of inflammatory lesions after the treatment period, and improved effectiveness of the antibiotic erythromycin among patients with antibiotic-resistant organisms (Dreno B et al 2005). In a double-blind study, a combination of 1.2 percent zinc and 4 percent erythromycin in a topical lotion was used by 14 individuals with acne. The combination significantly reduced secretion of sebum after six weeks of treatment (Pierard-Franchimont C et al 1995). Further, a topical preparation of zinc acetate was found to prolong the duration of erythromycin on skin, potentially overcoming some mechanisms of erythromycin resistance (van Hoogdalem EJ et al 1996).

In addition, clinical trials of zinc preparations have demonstrated their equivalence to antibiotics, with the added benefit of more convenient dosing schedules. A study that compared a cream containing chloroxylenol and zinc oxide showed no difference in efficacy compared with 5 percent benzoyl peroxide, but it did find significantly less skin drying and irritation with the zinc-containing cream (Papageorgiou PP et al 2000). Finally, a 2005 study demonstrated that a gel containing clindamycin plus zinc, applied once or twice daily, achieved the same benefit obtained by clindamycin lotion alone used twice daily (Cunliffe WJ et al 2005).

Niacinamide (nicotinamide). One of the two principle forms of niacin, niacinamide is effective when applied topically to acne. In a State University of New York study, a 4 percent nicotinamide gel was compared to a 1 percent clindamycin gel for the treatment of moderate inflammatory acne in 76 patients. Treatment was applied twice daily for eight weeks. At the end of treatment, 82 percent of the nicotinamide patients and 68 percent of the clindamycin patients were improved. The fact that the use of topical clindamycin is also associated with the development of resistant microorganisms makes niacinamide even more preferred (Shalita AR et al 1995). Nicotinamide cream has also been shown to reduce the amount of sebum present on the skin (Draelos ZD et al 2006).

Essential Fatty Acids. The omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are well-known anti-inflammatories that have been shown in dozens of studies to reduce inflammation. Although they have not been extensively studied in acne or skin inflammation, their ability to reduce inflammation in general suggests a role in the treatment of acne. Several studies have found that omega-3 fatty acids are absorbed through the skin and can reduce inflammation in a particular area (Puglia C et al 2005; Shahbakhti H et al 2004).

Tea Tree Oil. Tea tree oil is derived from the leaves of the tea tree (Melaleuca alternifolia), an evergreen that grows in Australia and Asia. The oil contains chemicals known as terpenoids which kill bacteria, including some bacteria that are resistant to antibiotics. In a double-blind study in which 5 percent tea tree oil was compared with 5 percent benzoyl peroxide in the treatment of acne, the oil was more effective overall and had far fewer side effects, although it was slower in action than the benzoyl peroxide (Bassett IB et al 1990). In a subsequent study, researchers determined that the major components of tea tree oil are active against Propionibacterium acnes, lending further support to its use in the treatment of acne (Raman A et al 1995).

Herbal Therapy. Herbal therapy is often suggested for acne, but few controlled scientific studies have been conducted to verify any claims. In a double-blind, placebo-controlled clinical trial of Ayurvedic (ancient Hindu) herbal preparations, researchers randomly assigned either placebo or one of four Ayurvedic formulas to 82 people with moderate acne. One formulation, Sunder Vati, significantly reduced the number of inflammatory and noninflammatory acne lesions. Sunder Vati consists of ginger (Zingiber officinale), Holarrhena antidysenterica, and Embelia ribes (Paranjpe P et al 1995).

Several other herbs have anti-inflammatory properties that may be helpful in the treatment of skin conditions, although no scientific studies have been performed with acne. The herbs include calendula (Calendula officinalis), German chamomile (Matricaria recutita), witch hazel (Hamamelis virginiana), and licorice root (Glycyrrhiza glabra) (Brown DJ et al 1998). These are found in some natural skin-care products, and may be effective on an individual basis.

Light-based therapies. Numerous studies have shown that laser and other light-based therapies are safe and effective in the treatment of acne. In a study in which 45 patients with mild-to-moderate acne were treated with high-intensity pure blue light (two 20-minute treatments per week for four to eight weeks), 50 percent were highly satisfied with the treatment, 20 percent had complete clearing at eight weeks, and no side effects were reported (Tremblay JF et al 2006). Similarly, researchers in Japan reported a 64.7 percent improvement in acne lesions among 28 adults who were treated with a total of eight biweekly 15-minute treatments (Omi T et al 2004), while in yet another study investigators reported that 85 percent of acne had cleared two months after eight pulsed-light and heat-energy treatments (Elman M et al 2004).

In addition, a combination of topical medication and light therapy has also proved effective. Santos and colleagues found that topical 5-aminolevulinic acid, along with intense pulsed light, is superior to light treatment alone in the treatment of acne, and may be used with other acne treatment methods (Santos MA et al 2005).