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Introduction

Acne is the most common of allthe skin problems of which three majorforms, acne vulgaris, acneconglobata and acne rosacea areprevalent. Acne vulgaris is characterizedas a superficial disease that affects the hairfollicles and oil secreting glands of theskin. It manifests as blackheads,whiteheads and inflammation (redness).Acne vulgaris is the least severe formof acne. Acne conglobata is a moresevere form with cyst formation andsubsequent scarring. Acne rosacea is achronic acne-like eruption on the face ofmiddle aged and older adults associatedwith facial flushing (Murray & Joseph,1998).

Acne affects both males andfemales although males tend to have morewith the onset of puberty. The occurrenceis due to the fact that male sex hormonessuch as testosterone stimulate the cellsthat line the follicular canal to produce

keratin and the enlargement of thesebaceous glands that results in theproduction of more sebum. This resultsin the formation of the pimple and theblockade of the canal. If the blockade iscomplete, it results in the formation ofwhite head and if the blockade isincomplete, black head will be formed.The blockade of the canal also leads tothe over growth of Propioniobacteriumacnes (Corynebacterium acnes),

which releases enzymes that breakdownsebum and promote inflammation.Inflammation results in the redness of thepimple. Another cause for acne is the lowlevels of 5-α-reductase, which convertstestosterone to a more potent formdihydrotestosterone (DHT) (Takayasu etal, 1980). Intestinal toxemia, where moretoxins are absorbed from the intestine,which in turn leads to increased bloodlevel of toxins, is yet another contributorto acne (Juhlin & Michaelson, 1983).

Treatment of acne

Treatment of acne is directedtowards correcting the altered pattern offollicular keratinization, decreasing

sebaceous gland activity,decreasing P. acnespopulation and producinganti-inflammatory effect.Treatment of acne withbroad-spectrum antibioticsoften develops intestinal

Herbal remedies for acne

Abstract

Acne represents a significant challenge to dermatologists because of its prevalence,complexity and range of clinical expression. It is the single most common skin disease affecting85% of teenage boys and 80% of teenage girls and can continue throughout adulthood. Treatmentof acne with topical and systemic allopathic medicines results in mild to severe side effects. Hence,herbs and herbal preparations play a significant role as alternative line of treatment. This articledescribes the commonly used herbs in the treatment of acne.

Keywords: Medicinal herbs, Acne, Skin diseases.

IPC code; Int. cl.7— A61K 7/00, A61K 35/78, A61P 17/00, A61P 17/10

S Mahesh Kumar*, MJN Chandrasekar, MJ Nanjan and B SureshTIFAC-CORE (Herbal Drugs)

JSS College of Pharmacy, Ootacamund – 643 001, Tamil Nadu, India* Correspondent author

Celandine

ArnicaCalendula

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overgrowth of the yeast Candidaalbicans. This chronic yeast infectionmay actually make acne worse and mustbe treated when present (Murray & Joseph,1998; Lucinda & Wallace, 1998).

Ayurvedic perspective

According to Ayurveda, acne isgenerally excess of pitta. Therefore,Ayurveda approaches acne fromsymptomatic and causative levels toremove symptoms, herbs and herbalpreparations can be used. Simultaneously,the excess pitta and toxins inside the bodyshould be reduced. If neglected, pitta andtoxins will cause acne to reappear ormanifest as illness in another part of thebody. For causal balancing and healingpersons should follow a fire reduction diet,which reduces pitta (Uniyal et al, 1998).

Herbal treatment

Several plants and plant-basedpreparations are used for the treatmentof acne. Some of them are discussedbelow:

Amaranth

Amaranthus hypo-chondriacus Linn. and A. cruentusLinn. (Family: Amaranthaceae) arenative to China and Mexico. Amaranthusseeds and leaves have been used effectivelyas an astringent and also make a goodwash for skin problems ranging from acneand eczema to psoriasis (Heinerman,1996). The main constituents aresaponins.

Arnica

Arnica is a perennial herb nativeto the mountainous regions of Europe to

southern Russia (Bisset, 1994). The driedflower heads of Arnica montana Linn.(Family: Asteraceae) and several otherrelated species of Arnica are useful inthe treatment of acne, bruises, sprains,muscle aches and as a general topicalcounterirritant (James & Tyler, 1999). Theplant contains a number of sesquiterpenelactones (helenalin, dihydrohelenalin,arnifolin and the arnicolides), flavonoidglycosides and about 0.3% of a volatileoil (Newall et al, 1996). The essentialactive principles are helenalin anddihydrohelenalin esters (Dermarderosian,2001; Newall et al, 1996; Bisset, 1994),which have been shown to have strongantimicrobial, antioedema and anti-inflammatory properties (James & Tyler,1999).

Asparagus

Asparagus officinalis Linn.(Family: Liliaceae) is a dioeciousperennial herb, native to Europe and Asiaand is widely cultivated. The fleshy rootsand seeds have been used for medicinalpurposes. Roots contain inulin, fructo-oligosaccharides, glycoside bitterprinciples (officinalisins I and II),β-sitosterol, steroidal glycosides(asparagosides A to I) and asparagusicacid, yamogenin (Leung, 1980). Homeremedies containing the shoots extractsare used as topical application to cleansethe face and acne form lesions(Dermarderosian, 2001).

Birch

Betula alba Linn. (Family:Betulaceae) is found mainly in theNorthern U.S, Canada and NorthernEurope. The tree bark has been used

successfully for the treatment of psoriasis,eczema, acne and similar chronic skindiseases (Heinerman, 1996). The mainconstituents are phenolic compound,salicylic acid and guaiacol; terpenoids,betulin, ylangene, betuloside; and flavone,sakuranetin (Jeffery et al, 1999).

Burdock

The roots and leaves of Arctiumlappa Linn. (Family: Asteraceae) aremost widely used for treating chronic skinproblems including acne (Foster & Tyler,1999; Bradley, 1992). It grows in Europeand North America. The main constituentsare arctiopicrin (sesquiterpene lactone),arctigenin (lignan), inulin (fructosan)and mucilage (xylocan) (Jeffery et al,1999).

Calendula

The flower heads of Calendulaofficinalis Linn. (Family:Asteraceae) have long been used for thetreatment of various skin ailments and tofacilitate healing and reduce inflammation(James & Tyler, 1999). The herb containsflavonoids (quercetin), triterpinoidsaponins (arvenoside A), essential oils andpolysaccharides (Evans, 2002).

Celandine

Chelidonium majus Linn.(Family: Papaveraceae) is a perennialherb. It grows in Europe and temperateand subarctic region of Asia. Any part ofthe broken herb exudes an acid, stickyorange juice with unpleasant odour. Thesticky juice is used for the treatment ofpimples (Heinerman, 1996). The main

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Rhubarb

Rheum officinale Baill.(Family: Polygonaceae) and otherspecies of rhubarb are native to SouthernSiberia, China and India. The mainconstituents include potassium, calciumand lesser amount of phosphorus. Theanthraquinones present are rhein,emodin, chrysophanol (Sukhdev et al,1999) in rhubarb are useful to relieve theitchness and pain accompanying psoriasisas well as Acne vulgaris (Heinerman,1996).

Rose

The aqueous extract of the petalsof the Rosa species (Family: Rosaceae)are used for the daily care of the skin.The rose water is also effectiveagainst acne and black heads (Heinerman,1996). The main constituents aretanninseugeniin, pentagalloyl, pyrogallol;monoterpenoids-eugenol, geraniol; andrugosal and phenylethyl alcohol (Jefferyet al, 1999).

Soapwort

Saponaria officinalis Linn.(Family: Caryophyllaceae) is aperennial herbaceous plant native toNorthern Europe. Soapwort has beenadministered topically for thetreatment of acne, psoriasis, eczemaand boils (Dermarderosian, 2001). Itcontains water-soluble steroidalsaponins (saponoside D) found in allparts of the plants (Meyer, 1934) and actsas surface-active agent to facilitatecleaning.

Stinging Nettle

Stinging nettle herb consists offresh or dried aerial parts or leaves ofUrtica dioica Linn. (Family:Urticaceae). Stinging nettle leaf andherb contains mineral salts, mainlycalcium and potassium salts of silicicacid; phenolic ketones-acetophenone;amines-acetyl choline, betaine, choline,histamine, 5-HT, lecithin; flavanoids-quercitin, isoquercitin, rutin, kaempferol;β-sitosterol, tannins, volatile oil, vitaminsA, B

2, C, K, folic acid and pantothenic acid

(Bradley, 1992 ; Bruneton & Seancur,1995; Escop, 1997; Newall et al, 1996).The alcoholic solution of distilled nettlehas been used traditionally to treat acne(Bruneton & Seancur, 1995).

Tea tree oil

Melaleuca alternifolia(Maiden & Betche) Cheel or tea tree(Family: Myrtaceae) is a small treenative to Australia. The leaves of the plantused medicinally are the source of valuabletherapeutic oil. The essential oil isobtained by steam distillation of leaves(Bruneton & Seancur, 1995). The mainconstituent in tea tree essential oil isterpin-4-ol, present in concentrations of40% or more. Tea tree oil is effectiveagainst a wide range of organismsincluding twenty seven of the 32 strainsof P. acnes (Carson & Riley, 1994; Bassetet al, 1990). It has good penetration andis non-irritating to the skin.

Thyme

Thymus Linn. (Family:Lamiaceae) are small, perennial plants

native to Europe and Asia. The threeprinciple varieties are English, French andGerman and they differ in leaf shape, leafcolour and essential oil composition.Salves prepared from the leaves are usefulin the treatment of cuts, burns, acne andrash in the area of the face, neck, throator forehead (Heinerman, 1996). The mainconstituents are carvacrol, p-cymene,thymol, thymol acetate and apigenin(Jeffery et al, 1999).

Turmeric

Turmeric consists of driedrhizomes of Curcuma longa Linn.(Family: Zingiberaceae). The plant iscultivated widely throughout Asia, India,China and Tropical countries. The majorchemical constituents includecurcuminoids, the yellow colouringprinciple, of which curcumin constitutes50-60%; essential oil (2-7%) with highcontent of bisatiolane derivatives (Ohshiroet al , 1990). Turmeric exhibitsremarkable anti-inflammatory activitywhich is attributed to curcumin (Raoet al, 1982; Ammon & Wahl, 1991).

Walnut

Different species like Juglansnigra Linn. and J. regia Linn. (Family:Juglandaceae) are indigenous to EastAsia, South-east Europe, North and SouthAmerica. The tree of walnut makes anexcellent wash for a variety of skininfections including the bad cases of Acnevulgaris (Heinerman, 1996). The mainconstituents include tannins elagitannin;naphthalene derivatives juglone,flavonoids hyperoside and quercitin(Nahastedt et al, 1981).

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Home Remedies

Coriander and Turmeric

Take 2 teaspoons of freshcoriander leaf juice. To this add a pinchof turmeric powder and apply it on face 2to 3 times daily after face wash (Supreeja,2001).

Neem

Crush some leaves to form apaste; apply to acne affected areas on face.Leave for 5 to 10 minutes then wash off.

Orange/ Lemon peels

Take few orange peels and dry itunder shade. Powder the dried peels andsieve them. Take one teaspoon of thispowder and mix it with fresh milk to makea paste. Before going to bed, apply thispaste on the face. Keep it for 10 – 15minutes and wash it off (Supreeja, 2001).Take the peel from an orange or lemonor both and put in a blender. Apply thejuice several times daily to the acneaffected areas for about 5 to 10 minutesthen wash off .

Rose water

Put a handful of dried rose petalsinto little boiling water. Cover and letsteep until cool. Drink two cupfuls a dayor use externally as a wash or wet pack(Heinerman, 1996).

Thyme salve

A nice salve can be made at homefor helping to heal cuts, bruises, acne,rash, etc. Ghee is used as an excellent

base for many herbal salves and oils inIndia by Ayurvedic folk healers. Themethod involves heating the ghee to justbelow the point where it will bubblewithout burning and smoking. Add 2handfuls coarsely chopped and slightlycrushed garden thyme to the pot. Whenthe ghee is heated, and during the gentlecooking of the thyme for an hour, the potshould remain covered. After this, brieflyuncover just long enough to strainthrough a coarse, wire sieve. Return tothe stove and cover again to reheat forabout 5 minutes. Then remove the lid andadd between 1-2 tablespoons of meltedbees wax and stir thoroughly. Also add ½tsp of pure vanilla when putting the beeswax in. Finally, pour the entire contentsfrom the pot into clean jars that are nottoo deep. Allow setting up before screwingthe lids on. Store in a cool, dry place.Massage some of this salve on the skineach day after showering and again in theevening before retiring for the night(Heinerman, 1996).

Walnut

Boil the walnut husks withenough water to cover them to a depth ofabout 2 inches for 1 hour or until halfthe liquid remained (no lid should be puton the pot). This is then strained andstored in corked jugs until ready to beused. The extract can be put on acneaffected areas of the skin (Heinerman,1996).

Conclusion

There are many importantaspects to be considered in the treatmentof acne. An integrated therapeutic

approach is required in order to attainthe desired results. Although there aremany medicines to choose from, plantsare the natural source of medicines, whichplay an important role in the treatmentof acne, without side effects. Hence, theyare the commonly used alternatives tosynthetic medicines for acne.

References

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2. Amann W, Acne vulgaris and Agnuscastus (Agnolyt), Z Allgemeinmed, 1975,51(35), 1645-1648.

3. Ammon HPT and Wahl MA , Pharmacologyof Curcuma longa, Planta Med, 1991,57, 1-7.

4. Basset IB, Pannowitz DI and Barnetson RSC,A Comparative Study of Tea-Tree Oil versusBenzoyl Peroxide in the Treatment ofAcne, Med J Australia, 1990, 153,455-458.

5. Belic, Constituents of Vitex agnus-castusseeds, Part 1,Casticin, J Chem Soc, 1961,2523-2525.

6. Bisset NL, In: Herbal Drugs andPhytopharmaceuticals, CRC Press, Stuggart,Germany, 1994, 83-87, 159, 292-294.

7. Bradley PR, In: British Herbal Compendium,British Herbal Medicine Association,Bournemouth, 1992, 48-49.

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