In Ayurveda, different categories of herbs may be used to treat acne. Alterative herbs classified as blood cleansers (e.g., aloe) are thought to cool the blood and reduce excess of the dosha pitta. In general, these cooling herbs correspond to antimicrobial and antibacterial properties that fight infection. Another type of herb categorized as astringent may help by inhibiting excessive secretions of sebum (e.g., turmeric), while nervine/antispasmodic herbs (e.g., licorice and guggul) can alleviate stress associated with acne. Emmenagogue herbs (e.g., licorice) regulate menstruation, which is directly related to hormonal activity that can affect acne. Each herb may have properties of different Ayurvedic categories.¹

Traditional Chinese Medicine (TCM) herbal formulas are composed based on a 4-tier hierarchy of relative importance of the herb in treating a specific health condition. Determining factors in these formulas are related to balancing the Five Elements of TCM (wood, earth, fire, metal, and water) as well as Yin-Yang, that correspond to function, outside influences, and qualities of organs (e.g., season, climate, physical senses, and emotion).¹

Clinical trials on Ayurvedic and TCM herbal formulations have shown several to be effective remedies for acne:

• Results of a randomized clinical trial involving 53 acne patients demonstrated that an Ayurvedic formula containing aloe, ashwagandha, turmeric, and other Indian herbs was more effective on reducing acne lesions than any of the herbs alone.² The formulation worked better than placebo in both oral supplemental and topical ointment form.³
• Sunder Vati, an Ayurvedic herbal formula, effectively reduced lesion count in a double-blind, randomized clinical trial involving 82 acne patients who took two 250 mg supplements three times a day. The formula contains four Indian herbs:^2,3
  • Ginger—juice from the root and also ground dried root of this common spice is used in natural medicine for topical pain relief and as an anti-inflammatory; it also exhibits antibiotic and antifungal effects.⁴
  • Holarrhena antidysenterica—commonly called kutaj, the bark exhibits antimicrobial behavior.⁵
  • Embelia ribes—Biranga fruit is traditionally mixed with other herbs and honey and applied topically to infected pustules.⁶
  • Indian gooseberry—believed to have antimicrobial and antibacterial properties, the edible fruit, juice, and leaves of this native Indian and Middle Eastern tree have been used for centuries in Ayurveda natural medicine.⁷
• Quingre Cuochuang. Randomized clinical trials showed that this TCM preparation (in tablet form) was as effective as antisterone, tetracycline, and metronidazole, while Xiao Cuo Fang with adapalene in a gel topical form was more effective than retinoic acid cream with less adverse side effects.²

Ayurveda and TCM practitioners also recommend the following, either by themselves or in herbal mixtures:

• Aloe (topical and juice)^8,9
• Turmeric (oral supplement, topical, or in liquid drinks)¹⁰
• Guggulu (topical and oral supplement)¹⁰