I recently graduated with a M.A. in Integrative Health Studies from the California Institute of Integral Studies in San Francisco, CA.
Yoga, meditative walking with my dog, hiking, healthy home cooking, sleeping, regular acupuncture, supplementation, juicing, jin shin jyutsu (on myself and the doggies)... (more)
Depression and anxiety
Integrative Health Practitioner
Nice experience with Guided Imagery by Leslie Davenport of California Pacific Medical Center's Institute for Health and Healing in San Francisco, CA.... (more)
Integrative Health Practitioner
Integrative Medicine can be used for many conditions. I will use acne as an example.
Standard treatments for acne include topical retinoids, benzoyl peroxide, azelaic acid, antibiotics, oral isotretinoin, and oral birth control. Some new allopathic treatments are being developed. There is concern of increasing antibiotic resistance to the standard treatments of tetracyclines, trimethoprim, and macrolide antibiotics; new antibiotics such as lymecycline, azithromycin, and new tetracycline formulations have been developed to combat this resistance. Insulin sensitizing agents such as metformin have been developed to combat hypoandrogenism, a common factor of polycystic ovary syndrome. Zinc gluconate has been proposed as an alternative treatment for inflammatory acne, especially in pregnant women. New topical treatments such as clindamycin/zinc, picolinic acid gel, and dapsone gel have been added to the topical arsenal. Photodynamic therapies using a topical cream of with aminolaevulinic acid or methyl aminolaevulinate then employing lasers, red light, or blue light have been tested for inflammatory acne (Katsambas & Dessinioti, 2008, p. 86-91).
A Nutritional Medicine approach by Haas suggests to reduce fried foods and hydrogenated fats from the diet, as well as increase water consumptions, vitamin A and B, zinc, essential fatty acids, pantothenic acid, calcium, and sulfur. Haas also recommends aloe vera gel applied to the skin and also applying goldenseal powder and comfrey compresses to acne blemishes (2006, p. 607).
An Ayurvedic perspective indicates that acne is an imbalance in the dosha, most likely a Pitta imbalance (although there can be imbalances in Vata and Kapha too). Ayurveda calls acne symptoms “Tarunya Pitika” (the pimples on the face during adolescence) or “Mukhadusika” (one which spoils or disfigures the face). The Ayurvedic health literature Bhavaprakasha and Charak Samhita describe formulations to treat acne. Lalla, Nandedkar, Paranjape, and Talreja conducted a randomized, double-blind, placebo-controlled study in 2001 that explored the internal and external formulations outlined in the Bhavaprakasha and Charak Samhita. 52 subjects were divided into four groups: 1) active oral tablets and active topical gel, 2) active oral tablets and active topical cream, 3) active oral tablet and placebo topical preparation, and 4) placebo tablet and placebo topical preparation. They used a preparation of aloe barbadensis, azardirachta indica, curcyma longa, hemidesmus indicus, terminalia chebula, terminalia arjua, and withania somnifera for the gel and cream topical preparation. They used the same ingredients plus piper longum for the oral tablets. They found that the combined treatments of group 1 and 2 had better results than the oral tablets alone. For example, in group 1, 32% of patients showed “good to excellent” improvements and 63% showed “slight to fair” improvements. In group 2, 58% showed “good to excellent” and 26% showed “slight to fair.” In group 3, the results were 100% “slight to fair” and in Group 4, there were no improvements (p. 101).
In a study by Magin, Adams, Heading, Pond, and Smith (2006), 26 subjects were interviewed on their CAM usage for acne. The majority of those interviewed used CAM therapies such as witch hazel, tea tree oil, citrus washes, aloe vera, zinc tablets, “tissue salt” tablets, and evening primrose oil. The researches found that the CAM therapies were considered “to be more efficacious than ‘mainstream’ topical therapies, although less efficacious than oral isoretinoin and, perhaps, less efficacious than oral antibiotics.” The subjects felt the CAM therapies gave them more self-efficacy and control over their acne (p. 452-3).
Yarnell and Abascal wrote about different herbal approaches to acne. Antimicrobial herbs could be used to combat P. acnes and S. epidermidis bacterium. The most commonly used antimicrobial herb is tea tree oil (often diluted in jojoba oil). Basil oil, eucalyptus and Oregon grape are also promising antimicrobials. Since inflammation plays such a large role in acne, Orgeon grape, barberry, goldthread, goldenseal, yellowroot, scute, and magnolia are suggested. For anticomedogenic herbs such as guggul can help keep the follicle and pore open and clean. For hormonal acne, chaste tree and saw palmetto are recommended. (2006, p. 303-8). Pitchford also suggested eating chlorophyll-rich foods and ingesting blood-purifying diaphoretic herbs such as sarsaparilla root, sassafras root, burdock seed, and yarrow leaves and flowers (2002, p. 441).
From a Traditional Chinese Medicine viewpoint, acne results from an abundance of heat in the body; it is associated with dysfunction in the Lung, Spleen, Stomach, Large Intestine, and Heart channels and wind-heat, damp-heat, phlegm, and stagnation are the primary causes. Liu and Jiang suggest specific treatments for Wind/Heat in the Lung channel, Damp-heat in the Stomach and Large Intestine, Phlegm and blood stasis with heat and Spleen deficiency, and Exuberant fire in the Heart channel. Each condition has specific clinical manifestations that an acupuncturist can diagnose by appearance, tongue and pulse. They suggest 20 minute treatments every other day for ten sessions. (2006, p. 30-32).
Lifestyle Management Plan for Acne
A multi-pronged approach to lifestyle may help people with acne. This comprehensive plan addresses diet, hygiene, herbal supplementation, mind-body, physical activity, and environmental considerations.
Anti-inflammatory diet. Increase omega-3 fatty acids, fruit, and vegetable intake. Eliminate or greatly reduce trans-fats, simple carbohydrates, animal products, fried foods, and iodized salt. If you do consume animal products, especially milk and meats, make sure they are organic and have no exogenous hormones typically given to non-organic animals. Use bitter herbs before meals if you have problems with malabsorption or other digestive issues.
Hygiene. Cleanse the skin daily with a gentle non-medicated soap. You may want to apply 5-50% tea tree oil diluted in jojoba oil once or twice a day after skin cleaning. Use natural skin moisturizers as needed. Continue using exfoliants such as salicylic acid and cell renewal creams like topical retinoids.
Herbal Supplementation. Use the following herbs as desired both internally and topically: orgeon grape (M, AM, AC, bitter herb), scute (M, AC), yarrow (IM, AM, bitter), tumeric (IM), guggal (AC, IM), licorice (IM, AM), devil’s club (for stress), chaste tree (for hormone balancing), and saw palmetto (for androgen balancing). Key: Inflammation-modulating (IM), Antimicrobial (AM), Anticomedogenic (AC). (Yarnell & Abascal, 2006, p. 307)
Mind-Body Protocol. Reducing stress will benefit your skin. Devote time for sleep (7-8 hours) and keep consistent bedtimes and waking times. Keep good sleep hygiene such as keeping the bedroom dark, cool, and quiet, avoiding naps, and only using the bedroom for sleep and sex. Engage in stress-reducing activities such as meditation, gentle yoga, guided imagery, breathwork, prayer, therapeutic art, dance, and music. A regular practice of the relaxation response will help keep cortisol in check.
Physical Activity. Exercise has the potential to help acne by reducing stress, reducing the “flight or fight” response, and increasing circulation. Any exercise is good: walking, running, hiking, biking, strength training, tennis, swimming, etc. for at least 30 minutes most days of the week.
Environmental Considerations. The main environmental issues to consider are contaminants in the food such as mercury in fish, antibiotics and hormones in meat and milk, and pesticides on produce. Eat organically as much as possible and use high-quality supplements.
Acne can be a difficult and embarrassing condition that can be difficult to treat. You can have clear and healthy skin if you take a multi-pronged approach to your lifestyle: eat a healthy anti-inflammatory diet, be gentle when cleaning your skin and continue use of exfoliants, use herbal supplements when desired, manage stress, include exercise, and avoid hormones and antibiotics in your food.... (more)
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