Break free from acne breakouts. Put your best face forward with a
few simple, yet effective, acne fighting actions. According to research or other evidence, the
following self-care steps may be helpful:
- Clean your skin
- Washing with cleaning lotions and using oil-removing pads can help
- Use acne-fighting lotions
- Lotions that contain niacinamide gel (4%) and tea tree oil (5%)
can be helpful
- Try zinc
- 60 to 90 mg a day of this mineral improves some people’s
- Add copper
- If taking extra zinc, your body will need 1 to 2 mg each day of
copper to avoid deficiency of this mineral
These recommendations are not comprehensive and are not intended to replace
the advice of your doctor or pharmacist. Continue reading the full acne vulgaris article for
more in-depth, fully-referenced information on medicines, vitamins, herbs, and dietary and
lifestyle changes that may be helpful.
About acne vulgaris
Acne vulgaris, also known as common acne, is an inflammatory condition of the sebaceous
glands of the skin. It consists of red, elevated areas on the skin that may develop into
pustules and even further into cysts that can cause scarring.
Acne vulgaris occurs mostly on the face, neck, and back of most commonly teenagers and to a
lesser extent of 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
Product ratings for acne
What are the symptoms?
Acne is a skin condition characterized by pimples, which may be closed (sometimes called
pustules or “whiteheads”) or open (blackheads), on the face, neck, chest, back,
and shoulders. Most acne is mild, although some people experience inflammation with larger
cysts, which may result in scarring.
Over the counter products such as astringent lotions, oil-removing pads, and medicated bar
soaps are used to keep the skin clean. Non-prescription topical agents containing salicylic acid (Clearasil Acne-Fighting Pads®,
Stri-Dex Pads®) and benzoyl peroxide (Oxy 10 Maximum Strength Advanced Formula®,
Fostex 10% Wash®, Clear By Design®) are often recommended to prevent the formation
of pimples and to treat preexisting cysts.
Topical prescription medications include benzoyl peroxide (Benzac®, Desquam®,
Triaz®); antibiotics such as erythromycin (Akne-mycin®, Erygel®), clindamycin (Cleocin T®), and azelaic acid
(Azelex®); and tretinoin (Retin-A®).
Oral antibiotics such as erythromycin
(Ery-Tab®, E-Mycin®) or tetracycline
(Sumycin®) are often prescribed. Women with severe acne are sometimes treated with birth control pills. People with the most severe
acne are usually prescribed isotretinoin
Dietary changes that may be helpful
Many people assume certain aspects of diet are linked to acne, but there is not much
evidence to support this idea. Preliminary research found, for example, that chocolate was not
implicated.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, foods that patients believed
triggered their acne failed to cause problems when tested in a clinical setting.2
Some doctors of natural medicine have observed that food allergy plays a role in some cases of acne,
particularly adult acne.3 However, that observation has not been supported by
Vitamins that may be helpful
In a double-blind trial, topical application of a 4% niacinamide gel twice daily for two months resulted in
significant in improvement in people with acne.4 However, there is little reason to
believe this vitamin would have similar actions if taken orally.
Several double-blind trials indicate that
zinc supplements reduce the severity of acne.5 6 7
8 In one double-blind trial,9 though not in another,10 zinc was
found to be as effective as oral antibiotic
therapy. 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 12 weeks before any
improvement is seen. Long-term zinc supplementation requires 1–2 mg of copper per day to
prevent copper deficiency.
Large quantities of vitamin A—such as
300,000 IU per day for females and 400,000–500,000 IU per day for males—have been
used successfully to treat severe acne.11 However, unlike the long-lasting benefits
of the synthetic prescription version of vitamin A (isotretinoin as Accutane®), the acne typically
returns several months after natural vitamin A is discontinued. In addition, the large amounts
of vitamin A needed to control acne can be toxic and should be used only under careful medical
In a preliminary trial, people with acne were given 2.5 grams of pantothenic acid orally four times per day, for a
total of 10 grams per day—a remarkably high amount.12 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, while severe conditions took at least six
months to respond. Eventually, the intake of pantothenic acid was reduced to 1 to 5 grams per
day—still a very high amount.
A preliminary report suggested that vitamin
B6 at 50 mg per day may alleviate premenstrual flare-ups of acne experienced by some
women.13 While no controlled research has evaluated this possibility, an older
controlled trial of resistant adolescent acne found that 50–250 mg per day decreased
skin oiliness and improved acne in 75% of the participants.14 However, another
preliminary report suggested that vitamin B6 supplements might exacerbate acne
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 clinical trial 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.16
One controlled trial found that
guggul (Commiphora mukul) compared favorably to tetracycline in the treatment of cystic
acne.17 The amount of guggul extract taken in the trial was 500 mg twice per
Historically, tonic 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.18 Burdock root tincture may be taken in the
amount of 2 to 4 ml per day. Dried root preparations in a capsule or tablet can be used at 1
to 2 grams three times per day. Many herbal preparations combine burdock root with other
alterative herbs, such as yellow dock, red clover, or cleavers. In the treatment of acne, none of these
herbs has been studied in scientific research.
Some older, preliminary German research suggests that vitex might contribute to clearing of premenstrual
acne, possibly by regulating hormonal influences on acne.19 Women in these studies
used 40 drops of a concentrated liquid product once daily.20
Are there any side effects or interactions?
Refer to the individual herb for information about any side effects or interactions.
Holistic approaches that may be helpful
Acupuncture may be helpful in the treatment
of acne. Several preliminary studies have reported that a series of acupuncture treatments (8
to 15) is markedly effective or curative in 90 to 98% of patients.21 22
23 Besides traditional Chinese acupuncture using needles alone, a technique called
“cupping” is frequently used in the treatment of acne. Cupping refers to the use
of cup-shaped instruments to apply suction to the area being needled. Two preliminary trials
of cupping treatment for acne reported marked improvement in 91 to 96% of the study
participants.24 25 Controlled trials are necessary to determine the true
efficacy of acupuncture and other traditional Chinese therapies in the treatment of acne.
Some hypnotherapists believe that hypnosis
might help prevent facial scarring associated with acne. In one case study, a patient was
instructed to say the word “scar” in place of picking her face, and the scratch
marks resolved. The underlying acne was unaffected.26
1. Fulton JE Jr, Plewig G, Kligman AM. Effect of chocolate on acne
vulgaris. JAMA 1969;210:2071–4.
2. Anderson PC. Foods as the cause of acne. Am Family Phys
3. Gaby A. Commentary. Nutr Healing 1997;Feb:1,10–1.
4. Shality AR, Smith JR, Parish LC, et al. Topical nicotinamide compared
with clindamycin gel in the treatment of inflammatory acne vulgaris. Internat J
5. Hillström, L Pettersson L, Hellbe L, et al. Comparison of oral
treatment with zinc sulfate and placebo in acne vulgaris. Br J Dermatol
6. Verma KC, Saini AS, Dhamija SK. Oral zinc sulphate therapy in acne
vulgaris: a double-blind trial. Acta Dermatovener (Stockholm)
7. Dreno B, Amblard P, Agache P, et al. Low doses of zinc gluconate for
inflammatory acne. Acta Dermatovener (Stockholm) 1989;69:541–3.
8. Michaelsson G. Oral zinc in acne. Acta Dermatovener
(Stockholm) 1980;Suppl 89:87–93 [review].
9. Michaelsson G, Juhlin L, Ljunghall K. A double blind study of the
effect of zinc and oxytetracycline in acne vulgaris. Br J Dermatol
10. Cunliffe WJ, Burke B, Dodman B, Gould DJ. A double-blind trial of a
zinc sulphate/citrate complex and tetracycline in the treatment of acne vulgaris. Br J
11. Kligman AM, Mills OH Jr, Leyden JJ, et al. Oral vitamin A in acne
vulgaris. Preliminary report. Int J Dermatol 1981;20:278–85.
12. Leung LH. Pantothenic acid deficiency as the pathogenesis of acne
vulgaris. Med Hypotheses 1995;44:490–2.
13. Snider B, Dietman DF. Pyridoxine therapy for premenstrual acne flare.
Arch Dermatol 1974;110:130–1 [letter].
14. Joliffe N, Rosenblum LA, Sawhill J. Effects of pyridoxine (vit B6) on
resistant adolescent acne. J Invest Dermatol 1942;5:143–8.
15. Braun-Falco O, Lincke H. The problem of vitamin B6/B12 acne. A
contribution on acne medicamentosa. MMW Munch Med Wochenschr 1976;118(6):155–60
16. Bassett IB, Pannowitz DL, Barnetson RS. A comparative study of
tea-tree oil versus benzoyl peroxide in the treatment of acne. Med J Austral
17. Thappa DM, Dogra J. Nodulocystic acne: oral gugulipid versus
tetracycline. J Dermatol 1994;21:729–31.
18. Hoffman D. The Herbal Handbook: A User’s Guide to Medical
Herbalism. Rochester, VT: Healing Arts Press, 1988, 23–4.
19. Amann W. Improvement of acne vulgaris with Agnus castus
(Agnolyt ™). Ther Gegenw 1967;106:124–6 [in German].
20. Amann W. Acne vulgaris and Agnus castus (Agnolyt
™).Z Allgemeinmed 1975;51:1645–58 [in German].
21. Xu Y. Treatment of facial skin diseases with acupuncture—a
report of 129 cases. J Tradit Chin Med 1990;10:22–5.
22. Xu YH. Treatment of acne with ear acupuncture—a clinical
observation of 80 cases. J Tradit Chin Med 1989;9:238–9.
23. Liu J. Treatment of adolescent acne with acupuncture. J Tradit
Chin Med 1993;13:187–8.
24. Chen D, Jiang N, Cong X. 47 cases of acne treated by
prick-bloodletting plus cupping. J Tradit Chin Med 1993;13:185–6.
25. Ding LN. 50 cases of acne treated by puncturing acupoint dazhui in
combination with cupping. J Tradit Chin Med 1985;5:128.
26. Shenefelt PD. Hypnosis in dermatology. Arch Dermatol