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15% off salves and free class!

I want to clear out my salves from last year to start fresh for the new season. So, take 15% off all salves (with the exceptions of Owie Ninja Balm and Antiseptic Ointment) until the  spring Equinox!

I’ll be teaching Herbal Medicine for the Family on Sunday, Feb 21st at 1pm in Asheville at the Free Skillshare Asheville Weekend Gathering. It’s free! We’ll discuss common conditions and how to treat them in children and babies first, then we will stop for a Q & A roundtable discussion before working backwards to pregnancy and postpartum (so that those folks with kids that aren’t planning any more can leave if they wish). Y’all should come!

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Rewilding that bit of earth

The National Wildlife Federation recently publicized a plea to homeowners: leave the leaves where they fall, don’t rake them up! It’s nice to hear a tiny bit of sanity from an organization people trust, and in the years we’ve lived here my partner and I have gone around loading up bags of leaves left out on the curb, and distributing them in our yard and gardens. No, the neighbors don’t like us much, but that’s not our problem- we’ve tried to be friends with different habits, even gone out of our way to bring them homemade Christmas cookies- complete with a trip to the store for traditional ingredients that I don’t even eat myself (and, need I note, I do not myself celebrate Christmas, either!)- and they still haven’t brought back our plate.  Their house is in the artificial zone. During the summer, their lawn is mown often multiple times a day (really, it doesn’t grow that fast, I think Mr. Cut just likes driving that riding mower in circles when he’s bored). Everything that touches their land is tightly and artificially controlled. The other day, they expressed their dismay at finding a black rat snake (which they promptly killed). Clearly, it was the fault of our unmown meadow. “A rat snake!” I exclaimed. “That’s wonderful! They eat venomous copperheads, you know, and keep them away!” This was met with outright denial and the declaration that all snakes must die. This was obviously a losing battle, and I maintained my friendly composure and let it drop. I think in general what it comes down to is a couple things: first a lack of education, and then, if someone is actually educated on the damage their manicured lawn is doing, a sense of powerlessness in the face of peer pressure to maintain a certain look.

Leaves and unmown spaces are valuable wildlife habitat. Want more butterflies? Leave the leaves. Stop mowing that lawn. Replace it with living, organic gardens or rewild your bit of earth! The argument I most commonly hear for lawns is that the kids need a place to run around. But consider this. When you stop mowing, you increase diversity. What is your kid doing out there in that lawn? Playing with plastic toys over a flat patch of mown grass monoculture? What would actually happen if you stopped mowing and allowed some variety in? Since I haven’t mowed my lawn (ever), I’ll tell you: Wildflowers. Tall grasses that bend in the wind. Saplings. Trees. Vines. Bugs. Butterflies. Fewer mosquitos, more beneficial spiders. Squirrels, bunnies, beneficial snakes. Birds! Beautiful, singing, happy birds! Healthy food and/or medicine, if you’ve planted an organic garden in its place. Your kids will learn a greater connection and interest in the natural world. They will improve their motor-coordination through playing in a space that is not always the same, flat space, devoid of diversity. They will use their imaginations and create new games and stories in this landscape. Of course they will still play on playgrounds, lawns, and parks that are mowed (and probably chemically fertilized and sprayed with toxic herbicides like RoundUp, as is the case with most city parks)- you certainly won’t be keeping them from that experience. But you will be expanding their exposure to nature, something all children need a lot of for healthy development.

We still manage our land- pulling out thorny starts, removing poison ivy, etc- people have always managed land, and I believe it is part of our natural heritage. Lawns originally were pasture- there was a lawn because there were animals that ate the grass. Practical. Now it is a gross demonstration of the waste of the wealthy. Wasted space that could be used for gardens, animals, natural habitat, or other resources.

What have you done with your bit of earth?

Baby’s Bum Balm

This multi-purpose balm I made for my baby’s bum has been great at stopping rashes before they start. I have not noticed any issues with it with using cloth diapers, but I personally don’t really care about stains if they happen (I mean, come on, it’s a diaper), so you may want to use caution if you care about that.

While there are a lot of herbs, they are not all necessary- you can just use what you can find. Most of them are free weeds you can easily find, and I never traveled outside my own yard for any of them. I’ve put a star next to the ones I find most important to include.

Use at least one or two (or all) of the following- gather fresh and let wilt overnight:

Violet (leaves, flowers ok too), plantain leaves, cleavers, chickweed

Use dry or fresh:
*Calendula (whole flowers), *comfrey (leaves and/or root), lavender.

The following are the oils I used with my last batch, but they can be modified if you like. I don’t use palm oil anymore due to environmental issues with harvesting, but I still had some organic sustainably harvested palm oil left so I used that. Grapeseed or olive oils are good oils to use instead- you’ll just have to use more beeswax to thicken it. Sometimes I like to add (organic, fair trade) shea butter as well.

In order of most to least:
Coconut oil, palm oil, castor oil (very little), beeswax.

 

Instructions:
Combine all ingredients EXCEPT the beeswax in a crockpot. Just eyeball it to your liking. Heat on low for a few hours. Leave the lid off. After a couple hours I like to strain it and add more freshly wilted plant material, but most people don’t so do whatever you want.

Strain well, leaving no plant material behind.

Add beeswax. Again, I just eyeball it and test it. You can put a spoon in the melted mixture and put it in the freezer for a few minutes to get an idea of how thick it will be when done, and adjust accordingly.

Pour into jars and let cool.

You’re done!

 

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Fire Cider

My first memory of trying fire cider is some eleven years ago, when I was coming down with something and my neighbor handed me a small jar, telling me it would kick it in the butt. I took a sip and felt that jolt of firepower from the strong stuff. It cleared out the yucks quick and clean as wildfire, no doubt! Today I share with you the way I make this wonderful concoction, in hopes that it will inspire you to try your own creation of this time-honored brew.

I’ll just be honest here, I don’t measure. It’s always an intuitive, enjoyable process for me and measuring just takes the fun out of it. You can find plenty of other recipes for fire cider in books, videos, classes, and online where they give precise measurements if you are one of those “must measure!” types. Every recipe you’ll find varies a little, and every time I make my own it varies a little. Which, in my opinion, is wonderful.

Ingredients (all organic, local if possible, from the garden even better!):

Honey-infused fresh turmeric
Honey-infused fresh ginger
Honey-infused hibiscus
Fresh horseradish
Cayenne peppers (fresh or dry)
Fresh garlic
Apple cider vinegar

I LOVE infused honeys. I am a total infused honey addict. If you’d rather just add the macerated herbs and honey separately, that’s fine- but I’ll briefly explain how to make an infused honey, should you desire to become an addict to deliciousness, like myself. If you want to skip this messy, amazing, tasty step, go right ahead.

To make infused honeys:

Macerate your fresh roots in a food processor (or chop finely). If you are using dry herb, such as lavender or hibiscus, this is unnecessary. Scoop herb into a crockpot, cover with honey (blending it in), and leave on “warm” for a few hours, stirring occasionally. While it’s still warm, pour it through a mesh strainer. In the container below you will have your infused honey, in the strainer above you will have your honey-infused herb. An alternative way people make infused honeys, is to simply put the herbs and honey together in a jar and let sit for a number of weeks. However, I personally find the warming method more effective. Plus when you are done scraping out the crockpot, you can pour in a hot cup of tea, melt the remaining honey into it, and have a yummy sweet cup of tea and waste minimal honey at the same time. 🙂 Granted it’s still a messy process. But life is messy.

So, for this recipe, I use the honey-drenched herb left over from making my infused honeys. For a quart jar, I use about three large spoonfuls each of turmeric, ginger, and hibiscus. I must give credit for the awesome addition of hibiscus to one of my fabulous herbal teachers Juliet Blankespoor, who shares her delightful fire cider recipe here (complete with measurements)!

In a Quart Jar:

Three large spoonfuls each of the honey-infused turmeric, ginger, and hibiscus
2-5 (depending on your fire level) large cayenne peppers, crumbled
1 small chopped fresh horseradish root
3-8 cloves of chopped fresh garlic
Apple cider vinegar to cover

Put ’em all together, shake ’em up, and let sit for 2-6 weeks. Strain out the material and you got it! Fire cider! It should be okay on the shelf for a long time, but to be safe I refrigerate mine after straining, and use within a few months. Take a few sips anytime you are feeling under the weather or need a power boost. Many folks who tend to run cold or have poor circulation take it daily as a tonic. I probably don’t need to say it, but this stuff is SPICY! Use caution. It can be blended with a little juice to make it more tasty if desired. I take a sip of my Fire Cider and a tablespoon of my Stay Well Juice (elderberry syrup) anytime I have been exposed to illness, cold, or stress, as a preventative to keep me healthy.

Yeah, making infused honey is messy. And YUMMY!

Yeah, making infused honey is messy. And YUMMY!

Honey-infused turmeric, ginger, and hibiscus, in jars to use in making ciders, teas, or elixirs.

Honey-infused turmeric, ginger, and hibiscus, in jars to use in making ciders, teas, or elixirs.

Or you can use straight herb and just add plain honey to the jar, if you wish. Hibiscus.

Or you can use straight herb and just add plain honey to the jar, if you wish. Hibiscus.

Garlic and ginger

Garlic and ginger

Turmeric

Turmeric

Dried cayenne peppers, from my summer garden.

Dried cayenne peppers, from my summer garden.

Reconsidering the Use of Blue Cohosh in Pregnancy

I was taught in herbal medicine school that the use of blue cohosh (Caulophyllum thalictroides) as a partus preparator is a misunderstood and outdated practice that is not considered safe for the newborn. Yet, as a currently pregnant woman myself, I continue to see it suggested in classes, books, ninth-month formulas, by midwives and self-prescribed by pregnant women themselves who may have read or heard somewhere they should take it.

As responsible herbalists and birthworkers, I feel it is important that we continually update our knowledge and remain flexible to new observations and information, in order to make more educated suggestions to our clients and provide them with honest information.

Let’s take a moment to consider the reasons why women take partus preparator formulas. Often there is a thought that the woman’s own body needs help, that it is somehow insufficient to safely and easily give birth itself without intervention. Of course, the idea that an herb could make things easier sounds great, and I admit I’ve been drinking raspberry leaf tea myself with the idea of supporting a strong birth and transition. But this is something to truly think about when talking with women and suggesting things: It should be about empowering the woman, and not subtly sending a message that she needs help. Other common reasons labor-inducing herbs are taken during the last 6 weeks include the real anxiety of medical intervention should the pregnancy go beyond the mathematical amount of time deemed appropriate by the woman’s care providers. Another reason is personal comfort, and I can attest to this that being heavily pregnant is a frankly exhausting affair filled with numerous achy, painful, and uncomfortable reasons one might want to be done with it as soon as healthfully possible. Given these understandings, a “ninth month” formula may be appropriate in some situations, particularly in the case of desiring to avoid medical interventions. However, is blue cohosh appropriate to be included in that formula?

Blue cohosh is considered a low-dose botanical. It contains compounds toxic in high doses. To the mother, it may not present any symptoms of toxicity, but for the fetus, many adverse outcomes have been reported- including tachycardia, perinatal stroke, myocardial infarction, congestive heart failure, and other cardiotoxic effects; increased menconium, fetal distress, shock, increased need for neonatal resuscitation at birth, and a high-pitched neonatal cry. Severe multi-organ failure, hypoxic-ischemic injury and central nervous system damage have also been reported. Alkaloid and vasoactive constituents present in blue cohosh (i.e., methylcystine, caulosaponins, caulophyllosaponins), as well as suspected teraogenicity, mutagenicity, and oxytoxicity, may be responsible. As a mother, I say these risks are not worth it.

Often I have heard it repeated that Native American Indian women have taken blue cohosh in late pregnancy for hundreds of years to prepare the uterus for birth. Yet in searching through the ethnobotanical literature, this does not actually seem to be the case. Rather, this is a wistfully romantic vision of natives using the bounty of the earth to facilitate natural childbirth, that has been repeated through generations of European-descent herbalists. As far as what we can truthfully tell at present day, it was historically used in very difficult labors (during labor, not before) (in addition to its use as an abortifacient, emmenogogue, structural reproductive short term tonic, and so on for non-pregnant or non-desiring to be pregnant women and men). Regardless, just because something has been used in the past does not mean it was a wise usage, no matter who was doing the using! Paul Bergner, a respected herbalist, describes his efforts to track back the historical uses of blue cohosh as a partus preparator in his article, Caulophyllum: Cardiotoxic Effects of Blue Cohosh on a Fetus, published in the Medical Herbalism Journal for the Clinical Practitioner:

“The use of blue cohosh as a preparation for pregnancy appears to have entered the American medical literature in the works of medical botanist Constantine Rafinesque in 1828. He states that Native Americans employed “. . . constant use of tea 2-3 weeks prior to partruition,” attributing this information to a commercial pamphlet published in 1813 in Cincinnati by an “Indian doctor” named Peter Smith who sold the herb commercially. Note that the term Indian doctor at that time did not necessarily refer to someone of Native American ancestry, and the doctor had not necessarily studied with Native Americans. It was a description of an herbalist who used the native North American plants, plants whose uses had for the most part not entered into regular medicine. Smith’s statement cannot be accepted as a primary reference to native American use, although it was repeated in medical literature for the next hundred years on the strength of Rafinesque’s reputation. Rafinesque himself only stated that the plant deserved further study…the major source for taking it as a partus preparator is from a single reference by Peter Smith, …repeated in Rafinesque.

In conclusion, considering the adverse fetal outcomes associated with the use of this herb in the final weeks of pregnancy, I believe it is our responsibility to educate our pregnant clients about the risks, and to remove it from our formulas for use in pregnancy. Thanks for reading.

Resources

American Herbal Pharmacopoeia and Therapeutic Compendium: Blue Cohosh Root and Rhizome: Standards of Analysis, Quality Control, and Therapeutics: http://lgdata.s3-website-us-east-1.amazonaws.com/docs/2614/941316/AHP-Blue_Cohosh.pdf
The Essential Guide to Herbal Safety
Botanical Medicine for Women’s Health
Botanical Safety Handbook
Caulophyllum: Cardiotoxic Effects of Blue Cohosh on a Fetus, by Paul Bergner from the Medical Herbalism Journal for the Clinical Practitioner: http://medherb.com/Materia_Medica/Caulophyllum_-_Cardiotoxic_effects_of_Blue_Cohosh_on_a_fetus.htm
http://www.ncbi.nlm.nih.gov/pubmed/18204101
Thanks to classes, discussions, and readings from: Juliet Blankenspoor, Aviva Romm, Paul Bergner, Roy Upton, and others

Healing Lyme Disease

                                                   Spirochetes: Masters of Deception

                                                Healing Lyme Disease with Herbs and Hope

                                                       Guest post by Danielle Eavenson

Lyme disease is plaguing us more than ever before in history.  For those of us who find our sanctuary in the forest, tiny ticks are a huge haunting deterrent to entering our playground. If you live in tick country, it is particularly prevalent and important to understand prevention, diagnosis, and options for treatment.

Discovered in 1975 in Old Lyme, Connecticut after a strange outbreak of rheumatoid arthritis in children, lymes disease was found to be an infection of Borrelia burgdorferi (Bb), a spiral shaped bacterium carried and transmitted through tick bites. Deer ticks are the most common carriers, harboring the bacteria and spreading it as they feed on the blood of animals and humans. (6) In approximately 37% of cases, it presents as a red, circular bulls-eye rash (Erythema migrans) radiating from the bite.  Initially, flu-like symptoms are common often along with painful joints.  Once these clever spirochetes (spiral shaped bacteria) enter the bloodstream, inflammation and infection of many different tissues may arise, effecting all systems of the body. (3)  Symptoms and misdiagnoses include, but are not limited to, intermittent arthritic pain, stiff neck and headaches, problems with eyesight, fever and chills, swollen lymph channels, insomnia, myalgia (muscle pain), toothaches, neurological problems, numbness, digestive disturbances and malabsorbtion of nutrients, tingling of hands and feet, multiple sclerosis, rhematoid arthritis, chronic fatigue, syphilis, alztheimers, colitis, lupus, scleroderma, chronic pain in entire body, paralysis and psychosis.  Lymes disease is progressive and changes form as it goes untreated.

According to the US Center for Disease Control (CDC), there were about 25,000 reported cases in 2011, mostly in the North Eastern US. (2) However, studies from Harvard claim 200,000 new cases per year. (1) One of the biggest challenges that faces lyme disease sufferers is misdiagnosis.  “No other disease fools doctors more than lyme disease.”, states herbalist and lyme specialist, Wolf D. Storl.  (6) Tests are unreliable and for good reason. These stealth spirochetes are masters of deception and can imitate most any other disease. They can penetrate all types of body tissue and imitate the host’s own body cells, fooling the defense mechanisms of the body. (1) They successfully hide in synovial fluid of the joints and are, therefore, undetected by most tests.  Borrelia are highly mobile and can cross the blood brain barrier within ten days, which even our white blood cells cannot do.  So, as you can imagine, the accuracy of the test themselves is only 55%. (6) Might as well flip a coin, right?  An average patient goes through seven doctors and twenty-two months before a correct diagnosis of lyme. (5) Finally finding the true root of one’s health challenges can be a great relief as the inability to accurately diagnose is often as debilitating as the disease itself.

Antibiotics are the preferred and only tool of most doctors to treat lyme.  Often they work, especially if given within the first month or two of infection.  Many times, however, they are ineffective and have a reverse effect, diminishing the bodies natural defenses and thus creating a wonderful environment for Borrelia to thrive.  In my opinion, antibiotics are worth trying as it is much easier to recover from a round of drugs than a deeply invested lyme condition. However, opinions vary greatly on treatment.  Lyme disease specialist, Dr. Dieter Klinghardt, states, “One recognizes the novice when it comes to lyme disease treatment.  Antibiotics are pedantically prescribed which help only in the short term and seldom bring long-term relief.  We have observed (with long-term antibiotic treatment) serious and permanent side effects, for example, kidney failure, tinnitus, and a weakening of the immune system, among other things.” (6)

Aho! This is when our sweet herbal allys get to shine!  Herbal protocol are proving invaluable for ridding the body of spirochete born illnesses, especially Borrelia.  Although one may never hear of such treatments from conventional doctors, there are thousands of cases studies available online showing their effectiveness.  I share from my own experience with clients as well as from other experienced herbalist’s research and clinical practice.

There is a wildly beautiful herb growing mostly on roadsides and in waste places with a distinctive spikey flower head of lavender. Her name is Teasel and she is often seen in dried flower arrangements.  I brought her dried inflourescence to one of my clients, bedridden and almost without hope, to keep by her side while she used her medicine.  The dried teasel is still there looking pretty, but my client is up and about, feeling more life in her body than she can remember!

Teasel’s blossoms encircle her prickly flower head and as one ring continues to bloom towards the sun, the other spirals down, blooming as it goes.  This, to me, is a doctrine of signatures, suggesting use for the ever burrowing spirochete bacteria as well as a picture of the ring that often appears around the initial bite.  The roots are her medicine, drunk as a tea, prepared as a tincture, or powdered and mixed with honey or encapsulated.

Dosage is difficult to discern and variable according to the person being treated.  Herbalist Matthew Wood has had extensive experience using teasel root and believes it is most effective in a homeopathic dose of 3 drops of tincture, three times a day. (7) Storl suggests that  “for roughneck cowboys and cowgirls, tough loggers or truckers, and those who prefer steaks and whiskey to granola, it is probably just not enough.  In such cases, a tablespoon three times a day is just more effective.” (6) However one decides to take teasel, alway do so before a meal on an empty stomach.  Many, such as my client, start with a smaller dose and add a drop a day, often reaching thirty drops, three times a day.  Sometimes the Herxhimer, or die-off reaction of the spirochetes becomes too strong, and one will choose to stop increasing due to side effects.  As a tea, the dosage is three cups of standard decoction (1tsp chopped root per cup of water), three times a day.  For children, the powder is often used, 1 teaspoon rolled in honey per day. (6)

How long before one should see results? From my research, I concluded at least 6 weeks of the mimimum dosage.  Effects may be seen immediately but the nature of Borrelia is that it cycles in intensity and lies dormant from time to time.  As a result, some have taken teasel and/or the following formula for up to two years, increasing to highest recommended dosage and then tapering down. (1, 3, 5, 6)

Stephen Harrod Buhner, a well respected herbalist in North America and specialist in lyme disease treatment, has written several on the subject of lyme disease and has had much success using the following core protocol: (1,5)

Japanese knotweed (Polygonum cuspidatum) (Green Dragon Botanicals) – 1-4 tablets 3-4x daily for 8-12 months

Cat’s claw (Uncaria tomentosa) (Green Dragon Botanicals) – 1-4 tablets 3-4x daily for 2-3 months, then 2-3 capsules 3x daily

Eleuthero (Eleutherococcus senticosus) (HerbPharm tincture) – 1/2 to 1 tsp upon rising and at lunch

Astragalus (Astragalus membranaceus) – 1,000mg daily (not to be used in chronic lyme)

Ashwagandha (withania) to help remedy sleep problems at night and brain fog – 1000 mg at night just before bed. (1, 5)

 
It is important to note that all herbal protocals work best coupled with healing foods and lifestyle choices.  Specifically in treating lymes, it is important to follow a warming and deeply nourishing diet which incorporates traditional foods such as ferments, bone broths, bioflavenoid rich foods, and foods rich in essential fatty acids (EFA’s) such as cold water wild caught fish.  Borrelia creates a cold condition in the body.  It cannot survive in high heat.  Thus the use of saunas, sweat lodges and hot baths is essential alongside a warming diet.  Bringing in the element of fire and heat is ancient healing method, opening pores to sweat out toxins, encouraging blood circulation, and stimulating the bodies immune defenses by creating fever. (6)

Understanding our enemies patterns and proper prevention may be our best ally and cannot be overlooked.  Ticks are shady characters and tend to lurk in moist, grassy places where they lie in wait of a bloodmeal.  They do not climb trees, but rather bushes, up to 1.5 yards up,  the average height of most hosts. They can wait for months and, although blind, they are incredibly sensitive to movement.  Ticks can live in temperatures way below freezing but do not become active until spring when temperature rises above 50 degrees F.  By the end of summer, its too hot and they retreat.(6) Ticks tend to like acidic, sour smealling sweat, which results from stress and overconsumption of rich animal proteins and sugar.

 
Daunting, I know.  But there is hope for us forest lovers! Most bites are harmless, especially if the tick is removed within the first 12 hours.  Only 1.2-1.4% of bites will infect the host. (4)  Taking immune supporting herbs coupled with healthy lifestyle and dietary choices is essential for all disease prevention.  For new tick bites, Buhner suggests 3,000 mg/day of astragalus for 30 days and 1,000 mg day indefinitely. (1) I would suggest also incorporating reishi mushrooms, bone broths and other tonic, anti-inflammatory and liver supporting herbs such as nettles and dandelion if you live in a lyme endemic area.  I would also recommend saving every tick that bites you in the freezer labeled with your name and date.  Testing the tick for lyme is much more accurate and less expensive.

I leave you with a question.  What if this strange, determined bit of bacteria is here to teach us?  To, perhaps, remind us to get naked more?  To have our friends massage our heads while checking for little critters?  Or really, to draw us back to our primal natures.  To the diets we were designed to thrive on.  To remind us of the power of plants and fire.  And prayer.

My client I mentioned earlier is 25 years old and was bedridden for 18 months and on and off antibiotics for 6 years.  She saw no lasting improvement and became chronically weaker until she chose the guidance of nature and God.  Now she is a living miracle and testimony.  She and her mom (who also has suffered with lyme) say, “We know God is the greatest physician and prayer the best medicine.  We also learned that healing requires patience and humility.  We need to learn to respect and embrace nature, rather than fight or fear it.  Our message to others who have lyme disease is to have hope-lyme disease is treatable and you can get your life back.” (8)

Resources:

1. Buhner, Stephen.  http://www.buhnerhealinglyme.com

2. Center for Disease Control and Prevention, http://www.cdc.gov

3. Fogg, Wendy Snow. “Lymes Disease: A Practitioner’s Experience and Discovery” http://www.mistymeadows.org.

4. Four Seasons Pediatrics, http://www.fourseasonspediatrics.com

5. Lymes Disease Research Database, http://www.lyme-disease-research-database.com

6. Storl, Wolf D. “Healing Lymes Disease Naturally”

7. Wood, Matthew.  “ The Book of Herbal Wisdom: Using Plants as Medicine”

8. Smith, Carolyn and Dana.  “Faith, Hope and Family: Dana Smith’s Story” Discover Smith Mountain Lake Magazine, summer 2013

Treating Acne

Guest post by Natalie Day

Description:
Acne is a common skin condition that causes skin irritation and lesions. There are 3 primary types; Acne vulgaris, Acne conglobata and Acne rosacea. Acne vulgaris, the least severe form, is characterized by superficial irritation that affects the hair follicles and sebaceous (oil secreting) glands of the skin. It appears as whiteheads, blackheads and red irritation. Acne conglobata is a more severe form of acne that manifests as deeper inflammation, cyst formation and consequent scarring. Acne rosacea is a more chronic facial irritation that occurs in adults and is associated with facial flushing. It is typically called Rosacea, and will not be discussed in detail in this article.
Both Acne vulgaris and Acne conglobata primarily affect the face, and to a lesser extent the back, chest and shoulders. Acne is typically more common among young males, with 75% of pubescent boys and about 50% of pubescent females affected. However, though acne is thought of as an adolescent ailment it can certainly last, or begin, much later in life.

Causes:
Acne develops as a response to blocked skin pores, also called pilosebaceous units. The pore consists of a hair follicle, sebaceous (oil) and suderiforous (sweat) glands, which connect to the skin through the follicular canal. Sebaceous glands are most concentrated on the face, chest and upper back and produce sebum, a special mixture of oils and waxes that help to protect and lubricate the skin, and prevent loss of water.
Acne is most prevalent in adolescents because andogenous hormones, such as testosterone, (levels of which begin to increase and fluctuate during puberty) stimulate the cells lining the follicular canal to start producing more keratin. Keratin is a group of fibrous proteins; the primary structural component of hair, nails and the outer layer of skin. An overproduction of keratin can clog the skin’s pores. In addition to increasing keratin levels, testosterone causes the sebaceous glands to produce more sebum and become enlarged. The combination of these effects results in blocked pores, and the likelihood of acne inflammation is greatly increased. While pubescent males are typically more affected by their changing testosterone levels, there is an increase in testosterone levels in females during puberty, making them subject to acne as well.

Acne pustules, or pimples, begin when pores are blocked by keratin and sebum, causing a whitehead or blackhead to eventually manifest. A blackhead forms if the blockage is somewhat incomplete, allowing excess sebum to rise to the surface of the skin. A whitehead, however, is the result of a completely blocked pore, creating inflammation due to sebum obstruction. When pores are completely blocked, Propionibacterium, a type of bacteria that occurs on the skin, is allowed to grow excessively inside the pore, releasing enzymes that break down sebum and cause inflammation, which is the source of skin redness. This inflammation can cause a rupturing of the follicular canal and can damage the surrounding tissue. When this happens on the surface of the skin it looks like an inflamed pimple, but if it happens deeper in the follicular shaft it can manifest as a cyst, which tends be painful and cause subsequent scarring.

Acne and the Liver:
In ancient and folk medicine acne was widely considered a byproduct of liver stagnation and intestinal toxemia, and was treated with blood purifiers (also called alteratives) and liver cleansing herbs. Recent studies agree that acne can be a result of compromised liver and kidney function, and is often linked to hormone imbalance related to liver stagnation. The skin and the liver are inextricably linked. One of the liver’s major services to the body is acting as a filter for our blood, helping to remove toxins and hormone by-products. When the liver becomes stressed and overworked due to excess toxins in the bloodstream, a common occurrence in the 21st century, it has a harder time processing all of our toxins, and some of them get cycled back into our bloodstream, often including androgenic hormones, the same ones that cause overproduction of sebum and keratin. Diet plays a large role in acne cause and prevention, especially high-glycemic foods, which raise blood sugar quickly and can throw hormone balance for a loop, affecting the skin secondarily. Studies show that avoiding foods that are high in refined sugars and carbohydrates has a positive effect on acne management. Compromised intestinal flora also seems to be a factor in adults suffering acne; those treated with broad-spectrum antibiotics for long periods of time often develop Candida albicans, an overgrowth of yeast, which can make acne conditions much worse.

Conventional Treatment & Side Effects:
Acne can be treated conventionally with a topical application of Benzoyl Peroxide, an over-the-counter cream that acts as an antiseptic for the skin. This treatment is only effective on superficial pustules and can cause dryness, itching, peeling and redness of the skin.
Another pharmaceutical often used for severe acne treatment is Retin-A, which acts in a similar way to Benzoyl Peroxide and can have more pronounced side effects, including severing burning and drying of the skin, as it literally acts to improve acne by chemically burning the skin.i
Though some have found success using these treatments, they are impractical because they require daily application in order to be effective, and they only address acne on a superficial level, not dealing with its root cause for long term healing of the skin. Natural medicine usually approaches acne by treating the underlying imbalance in the body, rather then simply suppressing the symptoms.
For more severe cases of Acne conglobata oral antibiotics, retinoid or hormonal treatments are used. These have varying degrees of effectiveness and a wide range of undesirable side effects, including potential birth defects, chronic intestinal disruption and depression.

Dietary Treatments:
Nutritional treatment plays a major role in preventing and healing acne. Again, avoiding foods high in processed sugars and carbohydrates has shown to be effective in clearing acne, and for some, avoiding dairy is beneficial. Reducing your intake of inflammatory foods can also be very beneficial, Omega-6 fatty acids in particular which are found in many fried, fatty and processed foods. Eating a diet high in whole grains, leafy green vegetables and high quality meat or fish is a good step for helping to nourish the body and keep hormone and blood sugar levels balanced. Anti-inflammatory foods should be added to the diet, specifically Essential Fatty Acids, which fight inflammation and can help to regulate hormone production. EFA’s can be found in several cold-water fish, including salmon, mackerel and trout, in grass-fed meat, dairy and eggs, and in smaller amounts in flaxseeds, sesame seeds and avocados.
There are several minerals that have shown effective in treating acne conditions, one of the leaders being Zinc. When the body contains low levels of zinc andogenous hormone levels become unbalanced, which can create excess sebum and keratin. Zinc stimulates tissue regeneration, inflammation control, and immune function. Many males use it to balance their testosterone levels, as it works by regulating the release and production of testosterone, which can also be beneficial for those with acne. Zinc rich foods include venison and grass-fed meat, sesame seeds, pumpkin seeds and several culinary mushrooms such as cremini and shitake.

Vitamin A works to reduce the size and secretion of sebaceous glands, as well has reduce the amount of sebum in pores, it is also has anti inflammatory actions, and works best in combination with Vitamin E, another anti-inflammatory. Vitamin E is an antioxidant that prevents the propagation of free radicals in tissues. It is found in high levels in wheat germ, as well as in many nuts and oils. Pantothenic Acid, also called vitamin B5, has proven a successful remedy for many with acne. It is found in whole grains, and meats, and its richest sources are cold-water fish ovaries and royal jelly. Pantothenic Acid helps your body break down fats and process them into fatty acids, which will later become hormones. A lack of Pantothenic Acid can lead to excess androgen production, increasing skin irritation.
In some studies, analysis of the level of glucose in the skin demonstrated that patients with acne do not metabolize sugar properly; Chromium is known to improve glucose tolerance and enhance insulin sensitivity, and has been reported in one study to induce rapid improvement in patients with acne.ii Brewers yeast and Propolis both contain high levels of Chromium and are common treatments for acne in Europe.

Herbal Treatment:
Acne is typically treated herbally by addressing the liver, and helping to clear stagnation. Most of the herbs recommended have either a hepatic (liver supporting), or alterative (blood cleansing) action, and can be combined with herbs to support hormone regulation and stress control (adaptogens). These herbs can be very helpful for treating acne, especially when used over a period of several months, and when applied in addition to healthy routines and meals. While herbs have incredible healing power, they are really the icing on the cake, secondary to lifestyle and dietary choices.

Burdock, Arctium lappa, is a classic remedy for treating skin diseases. It’s hepatic effect on the liver helps to clear toxins and balance hormone levels in the body. The bitterness of this root also helps to stimulate digestion and releases hydrochloric acid in the stomach, aiding digestion.
Yellow Dock, Rumex crispus, is another bitter root that has long been used to stimulate digestion and aid in liver health. It can also aid in iron assimilation and is safe for pregnant mothers who may be dealing with both pregnancy-provoked Acne vulgaris and iron deficiency.
Other bitter herbs indicated for liver related skin conditions are Oregon Grape Root (Mahonia spp.), Gentian (Gentiana spp.) Dandelion Root (Taraxacum officionale) and Milk Thistle (Silybum marianum)

Alterative herbs, such as Cleavers (Gallium aparine) and Red Clover (Trifolium pratense) help with elimination of toxins through the skin, lungs, feces and urine, also improving lymph, liver and digestive function.

Anti-inflammatory herbs can be helpful in keeping skin inflammation minimal. These include Licorice (Glycyrriza glabra) and Turmeric (Curcuma longa), which can be taken tonically.

Another category of herbs that can be beneficial are Adaptogens, plants that help the body deal with non-specific stress or overwork, a major factor for many experiencing acne. These herbs can be taken tonically and help to balance the pituitary, adrenal and hypothalamus glands. Tulsi (Ocimum sanctum), Milky Oats (Avena sativa) and Ashwagandha (Withania somnifera) are all examples of Adaptogens.

This formula contains herbs with many of the above actions and comes from Dr. Aviva Romm:iii
20 ml Skullcap (Skutellaria lateriflora)
10 ml Oregon grape (Mahonia spp.)
20ml Echinacea (Echinacea spp.)
20 ml Dandelion (Taraxacum officionale)
20 ml Licorice (Glycyrriza glabra)
10 ml Ashwagandha (Withania somnifera)

Dosage: 5ml of tincture 2x a day

Topical Treatments:
Azelaic Acid is an organic compound found in Barely, Wheat and Rye and is used to treat acne topically. It can kill the bacteria that infect the skin, as well as decrease the production of keratin. It is also an anti-inflammatory and is used topically in the form of a cream or ointment. It can interact with the synthesis of melanin, sometimes causing hyperpigmentation, and is considered to have mild success.

Tea Tree oil, which comes from Melaleuca alternifolia, a native Australian tree, is an effective topical treatment that has antiviral, antibacterial, antifungal and antiseptic properties.
“In the treatment of moderate common acne, topical application of 5% tea tree oil has shown an effect comparable to 5% benzoyl peroxide. Albeit with slower onset of action, patients who use tea tree oil experience fewer side effects than those that use benzoyl peroxide treatments.”iv

Some people also find herbal facial steams helpful, often using Chamomile (Matricaria recutita) or Tea Tree oil, both of which are antimicrobial. Regular cleansing and occasional exfoliation of the skin is a general recommendation for helping to open pores and keep them free of bacteria. Avoiding the use of synthetic cosmetics and avoiding touching the inflamed skin with hands are practical ways to avoid transferring bacteria and clogging pores.

In summation, acne is a common condition that, with dedicated efforts, can usually be controlled and effectively treated without the use of pharmaceuticals. The treatment is affordable and can be as accessible as making small dietary changes. Nourishing a positive body image is an important part of helping someone deal with acne, especially for adolescents who may be emotionally vulnerable. A healthy diet and lifestyle choices, as well as liver supporting herbs and antimicrobial topical treatments are great allies for treating and preventing this condition.

Sources:

Print:
Beers, Mark (EIC), The Merck Manual of Medical Information. New York, 2003
Gladstar, Rosemary, Herbal Healing for Women; Simple Home Remedies for Women of All Ages. New York, 1993 Hoffman, David, Medical Herbalism, The Science and Practice of Herbal Medicine. Rochester, VT, 2003
Murray, Michael & Pizzorno, Joseph, The Encyclopedia of Natural Medicine. New York: Atria, 2012
Romm, Aviva Jill, Botanical Medicine for Women’s Health. New York, Churchill-Livingston

Electronic Sources:
Applied Health: Acne, http://www.appliedhealth.com/index.php?option=com_content&view=article&id=100022
Acne & Pregnancy, http://www.ncbi.nlm.nih.gov/pubmed/23657872
Implications for the role of diet in acne: http://www.sciencedirect.com/science/article/pii/S1085562905000283
Beliefs & Perceptions of Acne, http://www.ncbi.nlm.nih.gov/pubmed/11209112
Relationship of Diet & Acne, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2836431/
Tea Tree, http://en.wikipedia.org/wiki/Tea_tree_oil
i Page 194, Encyclopedia of Natural Medicine
ii Article: High chromium yeast for acne? M. Mcarthy medical hypothesis. 1984: 307-10
iii Page 120, Botanical Medicine for Women’s Health, Aviva Romm
iv Bassett, IB; Pannowitz, DL; Barnetson, RS (1990). “A comparative study of tea-tree oil versus benzoylperoxide in the treatment of acne”. The Medical journal of Australia 153 (8): 455–8.