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Acne Vulgaris: What Can You Do?

Written by

Deborah Freudenmann BHSc

Acne is a multi-factorial inflammatory disease of the sebaceous follicles of the face, breast and upper region of the back, which predominantly affects adolescents. Acne is the most common of all skin conditions and approximately 80-95% of adolescents develop some degree of acne. Moderate to severe acne affects approximately 20% of adolescents and young adults.

Typically, the prevalence of acne declines and resolves over subsequent years around the age of 20. However, in some cases acne will continue into later life affecting both men and women.

Despite the cosmetic nature of acne vulgaris, the effects can go far deeper than the surface of the skin. Acne has a heavy emotional and psychological burden on individuals that may be far worse than its physical impact. Studies have shown that onset in adolescence may add to the emotional and psychological challenges experienced during this period, and can lead to developmental issues of body imagine, socialization, and sexuality.

Furthermore, resulting in dissatisfaction of appearance, embarrassment, self-consciousness, lack of self-esteem as well as social dysfunction, reduced or avoidance of social interactions. It is a very real concern and for anyone who has suffered from acne either in the past or present will be able to relate to the aforementioned psychological impacts.

Types Of Acne: What Type Of Acne Do I Have?

    • Open comedones (blackheads)
    • Closed comedones (whiteheads)
    • Nodules
    • Papules
    • Cysts
    • Pustules

How Does Acne Develop?

Acne is a dermatological condition characterized by lesions that most often appear on the face, neck, chest, back, shoulders and upper arms. Acne is a condition typified by inflammation of the pilosebaceous follicles in the skin. The pathogenesis of acne is an increase in circulating androgens (male sex hormone, such as testosterone) stimulating sebaceous gland activity, and the resulting sebum production triggering hyperkeratosis (abnormal thickening of the outer layer of the skin).

This process blocks the follicle and results in dilation and the ultimate formation of a comedone. The transition from a comedone to a lesion such as a pustule, papule or nodule is believed to be due to bacterium colonizing the follicle and triggering an inflammatory response within the follicle wall. This cascade triggers the immune system involving the white blood cells which infiltrate the area.

Once an inflammatory cascade has begun, hyperproliferation (an abnormally high rate of proliferation of cells by rapid division)of follicles can occur. As keratinized cells and sebum compact within the follicular lumen a plug is formed. This process ultimately results in the development of a comedone.

What Can Cause The Development Of Acne?

Acne is a multi-faceted inflammatory disease which requires us to look beyond the skin at other systems including nervous system, endocrine system, gastrointestinal system and hepatic system. As with all dis-ease states it is imperative to address the underlying root causes, such as:

  • Increasing and supporting the body’s ability to detoxify
  • Supporting a healthy gut microbiome
  • Reducing oxidative load and improving antioxidant status
  • Regulating blood sugar levels if imbalanced
  • Reducing overall inflammation
  • Regulating and supporting the nervous system (stress response)
  • Balancing serum androgen levels
  • Reducing sebum production
  • Reducing bacteria load in the body


The symptoms of acne vulgaris are worse in times of psychological stress. Physiological adaptation to stress may be a contributing factor to acne vulgaris due to the hormonal cascade this produces. Furthermore, stress itself negatively effects all systems within the body, resulting in further imbalances.
How Can I Reduce Stress?
First and foremost is determining when and where you experience stress and then trying to lower or remove your stress triggers. Stress triggers may include factors such as working excessive hours, stressing about exams or assignments, not creating time for relaxation and maintaining toxic relationships etc.

  • Consider support groups or counselling
  • Determine what it is that allows you to relax. Find space in your life to do things that allows you to unwind naturally.
  • Find something you really enjoy doing that could replace your unhealthy stress habit.
  • Surround yourself with family and friends (especially those that influence you to be healthy and feel good about yourself), and try not to isolate yourself from your loved ones.

Androgen Metabolism & Clearance

The skin has an important role in detoxification, particularly through phase 2 enzymes. A compromised or stressed liver detoxification may place further burden on the skin, thereby aggravating dermal conditions such as acne vulgaris. Therefore, supporting the liver and detox pathways is important!

How Can I Support This?

Including herbs and spices into your daily diet such as turmeric, cumin, caraway and dill. Every day consumption of vegetables from the Brassicaceae family e.g. broccoli, kale, cabbage, cauliflower and Brussel sprouts. Additionally, incorporating beetroot into the diet. Beetroot’s are full of betaine, which is needed for methylation to take place. Beets are also packed with vitamin C, vitamin A, magnesium, calcium, folate, and phosphorous. Studies have also shown that beetroots protect the liver against damage and support phase 2 detoxification.

Additionally, they support a healthy level of stomach acid which is necessary for proper digestion and absorption of nutrients. A healthy consumption of dark green leafy veggies, citrus fruits, berries, carrots and organic nuts & seeds such as Brazil nuts, almonds, pecans,pumpkin seeds,hemp seeds among other things will provide a balanced source of nutrients.

Eating liver from an organic, pasture-raised animal provides powerful nutritional support for liver health. Including grass-fed beef liver, fish liver, wild-game liver or pasture-raised chicken liver. Pasture-raised eggs are also an incredible source of liver supportive nutrients such as sulfur compounds, methyl-donors and glutathione precursors.

Additional ways to support the liver and clearance of toxins include: Epsom salt baths, coffee enemas, oil pulling, dry skin brushing, and infrared sauna sessions.

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Oxidative Therapy

Ozone is an oxidative therapy and increases the level of Nrf2 protein (Nrf2 is a powerful protein in every cell which functions as a switch to 200 or so genes. It functions specifically for cellular defense such as immune system, inflammatory responses, tissue remodeling etc.), which in turn promotes the antioxidant and detoxifying enzymes of phase II.

Ozone therapy decreases inflammation through the activation of Nrf2 and subsequently the suppression of NFkB (pro-inflammatory signaling pathway). It is highly beneficial for individuals with acne to use mild ozone oils topically as well as daily rectal ozone insufflations.

Solution, Treatment and Maintenance

To reduce inflammation and bacterial infection of the acne vulgaris, it is important to minimise oxidative stress, decrease physiological stress, and reduce inflammatory triggers such as dietary, elevated blood sugar levels and pathogenic bacteria. It is important to address the whole person and reduce any potential pathogenic bacterial or microbial overgrowth in the body.

Rectal ozone insufflations are beneficial in acute and chronic bacterial, viral and fungicidal infections due to the generated reactive oxygen species (ROS), which are natural and effective agents that even antibiotic resistant pathogens cannot resist. Additionally, since ozone improves metabolism and immunological functions, therefore contributing to a heightened outcome in healing.

Management of acne vulgaris usually incorporates an aspect of topical anti-bacterial treatment.

The treatment would be done in 3 steps.

1. You first prime the body with oxygen and activate the NrF2 response with rectal insufflation.
2. Then you wash your infected areas with ozone water.
3. Then use topical Ozone oil locally to the infected area to clean, heal and protect.

Read more HERE to find out which topical ozone oil suits your skin best. With its anti microbial power Ozone oils prevent bacteria overgrow and spreading. This treatment will reduce inflammation and helps with healing of scar tissue. Ozone oils reduces scarring dramatically as tissue forms over infected areas.

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  • Eat foods high in B-vitamins and calcium, such as almonds, beans, whole grains (if no allergy), dark leafy greens (spinach and kale), and sea vegetables.
  • Eat antioxidant-rich foods, including fruits (blueberries, cherries, and tomatoes) and vegetables (squash and bell peppers).
  • Consume fresh garlic and turmeric in the diet as they are both anti-microbial and anti-inflammatory.
  • Eat more lean meats, cold-water fish, fermented tofu (soy, if no allergy), or beans for protein.
  • Use healthy cooking oils, such as olive oil or coconut oil. Healthy fats from avocado, omega 3 fatty acids from fish such as salmon.
  • Drinking at least 2 liters of water a day
  • Enjoying herbal teas like catnip, chamomile, lemon balm, hops, ginkgo, lavender, valerian which are used for reducing stress
  • Avoid refined foods, such as white breads, pastas, and sugar.
  • Eliminate trans fatty acids, found in such commercially-baked goods as cookies, crackers, cakes,
  • French fries, onion rings, donuts, processed foods, and margarine.
  • Avoid any food you are intolerant to. Food intolerances can cause inflammation in your gastrointestinal tract, reducing your ability to absorb nutrients and compromising the gut barrier.

Gut health, gut dysbiosis and leaky gut are all further causes of acne vulgaris.

Through microbiome imbalance and potential dysbiosis, nutritional deficiencies become prevalent. 

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Specific Nutrients Indicated For Acne

Zinc: Beef, egg yolks, ginger, herrings, liver, lamb, oysters, sunflower and pumpkin seeds, sea food, chickpeas, mushrooms

Vitamin C: Aloe Vera juice, blackcurrant, broccoli, kale, Brussel sprouts, citrus fruits, guava, parsley, pawpaw, peppers, pineapple, raw cabbage, berries, sweet potatoes, tomatoes

Omega-3: Salmon, cod liver oil, algae omega oil, mustard seed oil, walnuts, flaxseed, chia seeds

Selenium: Alfalfa sprouts, broccoli, brazil nuts, cashews, celery, eggs, fish, garlic, kidney, liver, oysters, organ meats, onions

Quercetin: Apple, black and green tea, brassica vegetables, broccoli, buckwheat, citrus fruits, raspberries, onion, tomatoes, garlic

Magnesium: Almonds, cashews, cocoa, cod, eggs, figs, kelp, leafy greens, legumes, lima beans, parsnips, pumpkin seeds, sesame seeds, Brazil nuts, quinoa, avocado

B Vitamins: Avocado, bananas, carrot, chicken, egg yolk, legumes, lentils, mackerel, offal, salmon, sunflower seeds, pistachio nuts, oyster, sardines, mushrooms, sweet potato, dark green leafy vegetables, sweet potato, asparagus, lamb, spirulina


Use natural non-toxic cosmetic products on the skin as well as household products. Ensure that you wash your face before going to bed (no makeup) and after sweating. Using ozone water for a cleanse is very good especially for infected area.

Lifestyle Contributors

Predisposing and exacerbating factors relating to the development of acne vulgaris include heavy or irritating clothing, backpacks or helmets and the exposure to increased heat and humidity. These lifestyle contributors may be hard to address however being aware and trying to limit them would be beneficial for the management of acne.

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