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The Best Food for Acne

We hear a lot about traditional Chinese herbal medicine, but less about the herbs used in Japan. There is a root called Rhizoma coptidis that appears to have similar anti-acne activities to drugs like Accutane, a drug infamous for its side effects that has been since pulled from the market. But there are side effects to the root, too. A poor fellow took it to clear up his skin and as you can see in my video, let’s just say it made things  worse.

The anti-acne active component of the root is thought to be berberine. Is there any way to get the active ingredient in a safer plant? Yes, apparently: barberries, which I cover in my video Treating Acne with Barberries. You may remember barberries as being perhaps the most antioxidant-packed dried fruit available (see my video Better Than Goji Berries). You can find them cheap at Middle Eastern grocers, since they’re used to make a signature Persian rice dish. Their taste is described as “pleasantly acidulous,” which is just doctor-speak for sour. I love sprinkling them on my oatmeal just because I love their taste, but, evidently, they have played a prominent role in herbal healing for thousands of years around the world. They have been described rather flamboyantly in a pharmacology journal as an “herbal remedy [that] has no match in serving the human race.” And I just thought they were kind of tangy.

The problem with the herbal medicine literature is that there is often a long, impressive list of traditional uses, but little or no science to back them up. And what does exist is often either test tube or animal data that has questionable clinical applicability. Who cares, for example, if barberries “induce menstruation in a guinea pig” (except maybe the guinea pig)? So, you end up with drug companies injecting herbs into the penises of rabbits in hopes of coming up with the next Viagra, but they conduct few, if any, human studies.

I’ve seen petri dish studies over the years suggesting anti-cancer effects of barberries on human tumor cells in a petri dish or having anti-acne effects on hamsters, but there weren’t any such human studies… until, now.

Evidently, there had been anecdotal reports of acne clearing up after barberry juice consumption, so researchers decided to put it to the test in a double-blind, randomized, placebo-controlled clinical trial of fifty 12- to 17-year-olds with moderate to severe acne. Half got a sugar pill, and the other half got the equivalent of about a teaspoon of dried barberries three times a day for a month.

The results were remarkable. After four weeks on the placebo, as expected there was no change. The teens had just as many pimples as before. But in the barberry group, there was a 43 percent drop in the number of zits and about a 45 percent drop in the number of inflamed zits. That’s extraordinary. A spoonful of dried barberries costs about eight cents. Barberries have no reported side effects, and they are healthy for you anyway. The only potential concerns I could find were about eating them during pregnancy, and we don’t have good data on barberry consumption during lactation, so it’s best to stay away from barberries during breastfeeding as well until we know more.


For more on acne check out these older videos:

And a few new ones I just released this year:

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

Discuss

Michael Greger M.D., FACLM

Michael Greger, M.D. FACLM, is a physician, New York Times bestselling author, and internationally recognized professional speaker on a number of important public health issues. Dr. Greger has lectured at the Conference on World Affairs, the National Institutes of Health, and the International Bird Flu Summit, testified before Congress, appeared on The Dr. Oz Show and The Colbert Report, and was invited as an expert witness in defense of Oprah Winfrey at the infamous "meat defamation" trial.


35 responses to “The Best Food for Acne

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  1. Great respect for Dr Greger in his field(s) of expertise but clearly, herbalism is not one of those. Herbs are “soft” pharmaceuticals and should be treated with respect. Proper diagnosis of overall constitution and health status is essential to avoid side effects.

    Coptidis can be extremely hard on digestion. For someone with robust digestion and overall strong constitution, it is fine. For many people, a dose that is useful for acne may well cause abdominal cramping, gas, diarrhea, and overall low energy/fatigue. A far better “general use” herb for acne is burdock root which is much easier to digest and won’t likely cause. Similar side effects to those of Coptidis are possible but much less likely. Also, burdock root is widely available whereas Coptidis not as much.

    1. Right. James Sloane warns against berberine use because it kills intestinal flora. He has an “ask the herbalist” youtube video about it.

  2. A plantbased diet should have given me even better complexion (I never had issues) but actually, quite the opposite, due to only one factor (tried time and again and is 100% proven) – B12 supplements.
    I ‘ve tried cyanocobalamin and methylcobalamin, they both do.
    What do you suggest , Dr?

    1. Apparently it is possible (not common but not that rare either), to be allergic to cobalt which is at the core of the B12 molecule! The only advice I’ve ever been able to find for that issue is to take the very minimum necessary dose to ensure health. That is only about 2.5 mcg (micrograms) a day. Not likely to find supplement that is dosed that low in pill form but you can get liquid and dilute accordingly. Example: Pure Encapsulations Liquid B-12 had 1000 mcg in a dropper full, about 30 drops.
      So one drop= about 33 mcg. So if you put 1 drop of the B-12 in 1 teaspoon of water, 12 drops of that mixture will should get you close. DON”T TRUST MY MATH!!!! I SUCK AT IT!!!!! Do your own calculations but at least that gives you the idea

    2. Hi I’m a RN health support volunteer. Thanks for your question. My understanding is that it is excess Vitamin b12 that tends to cause breakouts. How much are you taking? Many supplements are much more than the recommended daily amount. Dr. Greger recommends 25000mcg cyanocobalamin sublingual once a week and even that is listed is well above the RDI. If you are taking more than this, try reducing it to this dose and and see if you do any better. Good luck.

      NurseKelly

  3. Also for those dealing with acne, Nina and Randi Nelson’s Clear Skin Diet book has helpful suggestions backed by impressive case studies of those who adopted a whole foods, plant-based, no oil diet plus a specific skin care regimen.

  4. Barberries are not cheap…10 pounds cost me 120.00 shipped on ebay….I will continue to eat them because I like the very tangy flavor…..They did not help the strange adult acne like condition I started getting 2 years ago….(whiteheads but not swollen pimples…..)….
    I also started taking berberine, hesperidin,quercetin and gynostemma powder everyday (because it’s a metformin like life extender substitute)….That didn’t help…..THEN I added Nugenics modified citrus pectin and one scoop twice a day (I saw this recommended on the internet) seemed to help a lot and cut the whiteheads by 3/4s…..Why the MCP works who really knows….

  5. Dr Greger, Accutane is still available under generic names. The company who made Accutane sold their rights to generic companies.

  6. I woke up thinking about Berberine today.

    Pondering things, which might help my dog fight this stupid infection.

    His lung sounds are better most of the time, since I started D-Mannose.

    But I haven’t started the list of things, which might help.

    Berberine and Olive leaf extract are on my researching radar.

    Bringing back green tea for a few days or even introducing a half clove of garlic.

    One of the women whose dog lived for 6 years after this diagnosis used garlic 3 times per day.

    I am a little concerned whether any of the things I am giving will cause Hemolytic Anemia, because things like garlic and onion do cause it in dogs and I found one person who kept their dog alive a long time with the various things, but the dog ended up dying of Hemolytic Anemia.

    They were frustrated that they weren’t warned about it and they felt it was related to the mushroom supplements.

    I need a scan, so I can back him up to food and not have his system so riled up that it starts producing too many of the wrong antibodies.

    1. Sounds to me like finding a “holistic” veterinarian would be the call at this point. Rather than asking random, dubiously qualified strangers on the internet (the anonymity can give a false sense of validity to what they say), find a truly qualified professional. I have a friend whose dog has cancer. I went with as “designated driver” to first couple appointments and though my friend was doing a lot right, she was also making some very serious, possibly dog life threatening mistakes just because of not being aware of the nuances of differences in dog vs human metabolism. Also, there were things reveled by the lab tests that dramatically changed some aspects of the treatment. Do far, dog is thriving!

      1. Thanks Geoffrey!

        I did look for holistic vets, but there weren’t any within a half hour drive and, honestly, my vet comes to my house and does do the labs and things and my dog loves him and he has a nice personality and is willing to do this process.

        My dog collapsed almost 9 weeks ago and had to be carried into the vets office and was diagnosed with Hemangiosarcoma. He had, what my vet called, “a basketball-sized tumor” but I would have called a melon-sized tumor. The vet said that it was the biggest he had ever seen.

        I didn’t do surgery or chemo. I am doing food and have been doing supplements based on dog studies on PubMed. I laugh that PubMed has dog studies, too. Hooray for animal studies.

        I have also gone to every holistic vet site that I can find and have looked up what they do for Hemangiosarcoma and I have a list of all of it. Plus, I went to all the dogs who survived. Some for one year. Some for 6 years. and I have a list of what they did. Those are the people who used things like green tea and garlic, which if I gave my dog 34 cloves of garlic, he would get hemolytic anemia. I am not giving him garlic or green tea, but the people who did, succeeded, so I haven’t cut those things out. I just feel like vegan could actually do it all by itself, because people with vegan dogs did have things like liver cancer just go away.

        He wasn’t vegan before, but as of his diagnoses, I am doing supplemented vegan, which most of them don’t do though I have found dogs, who were healed from Cancer just doing vegan, with no supplements at all, so I genuinely want to do it this way.

        I have been using PubMed studies and feel like the Cancer is going away. I just need a scan. There are seriously positive changes. When he first came home, he messed the floor a few times, but that never happens anymore. He is getting up better and has more energy and he used to walk outside, then, lay down, but now, he can walk all the way around the yard and go back in without resting. I got rid of the wet lung sounds this week. Working on infection.

        I honestly can’t afford to keep doing expensive supplements and expensive food. (Even me doing it myself is expensive.) So I need to have him scanned again soon.

        The scan is $300 or something like that. I ponder it versus just finding my infrared camera. I know it never got put back in its case a few years ago. I remember my carpenter using it, when I showed him that the people who worked in the attic hadn’t put the insulation back.

        Frustrating that I don’t have it, because I feel like I could have monitored this cancer all the way down.

        1. Sounds like you have a gem of a vet! The one I drove my friend to is a little over an hour each way, but we live in very rural area so that’s pretty much what you expect. She was giving him gradual entry to keto diet but some test showed that he was not digesting fats very well so she went to more just low glycemic, grass fed meats, broccoli, maybe some sweet potato. Not a lot of supplements but yeah, she spends more on the dog than she does on herself. Ya gotta do what ya gotta! I think you are on a very good path. Hard without solid support but maybe your vet is enough back-up for that.

          1. Goeffry,

            Yes, my vet is a sweetheart.

            He had me sit down and list every supplement I am giving and give the justification. He is good for me, because I know that I chose vegan and most animal people would already start arguing. He got silent for a day and talked with me and said that he had never had anyone do this, but that he would support me and see what happens and that if I am successful, he will use it.

            For one thing, I am going to have a print out of the Purdue study at his office, so people will know to feed their dogs raw vegetables, even if they use kibble.

            I have been giving my dog broccoli and sweet potatoes and pumpkin and chick peas and artichoke and pineapple and watermelon and barley and berries and a few other vegetables, plus flax and hemp seed and some Tempeh.

            I added in a can of vegan Halo, because I know my whole ratio of proteins to fats to carbs might be off.

            Can I say that I don’t fully trust the experts about dogs, because they are highly pro-keto and highly, highly, highly against vegan. They call the vegan protein sources inferior and use the same exact logic of the human being version of anti-vegan.

            I do know that the Purdue study told me enough. Giving raw vegetables decreases cancer in dogs by 90% and THAT was feeding the dogs KIBBLE. If you listen to the dog cancer videos out there, they all blame the kibble and I am going to say that kibble may have a lot of processed junk in it, but every diet, which succeeded added raw vegetables, so I don’t focus on Keto. I focus on vegetables.

            MOST of the experts would already start wanting to string me up.

            There was a vegan dog, who was the longest living dog in the Guiness World book of records. It looks like another one has replaced that dog, but I found dogs who got healed of Cancer just going vegan and they are having their dogs eat things like rice, so most of the logic just is the exact same as Keto logic.

            To me, having my dog eat raw vegetables is number one through ninety.

            To me, having him not eat meat, means the digestive enzymes can eat the cancer protective cell wall and that will make it easier for his immune system to deal with it.

            Plus, it cuts out excess growth hormone and methionine and gets rid of the risk of cancer viruses and bad bacteria and it is a way for me to test my diet versus cancer.

            I have one person and one person only in my life who has turned to WFPB and they turned a few months ago and everybody else is in the Keto group and psychologically, I had to wrestle with that as a diet more than with any other diet ever.

            Does it heal cancer? Eventually, I will be walking through with human beings and this is helping me think through what I believe.

            Last night, I watched John McDougall talking about MS and when I scrolled down to look at the comments on YouTube, people are indoctrinated that it is gluten, which causes leaky gut. John can present information where people have 95% improvement and the people will comment about how he is outdated and isn’t acknowledging that gluten causes it.

            In my mind, I know that 95% improvement is already such a good answer that I don’t want people to put down what he is communicating, but people are indoctrinated in a different direction and I haven’t researched that direction to see if that works, too.

            I have a friend who has serious problems with MS and there was already an answer ten years ago, when she lost the ability to walk properly and her doctor probably doesn’t even know it. Her mother keeps having to do months of care-taking and had to give up her job and diet could have helped her, but we will have people putting down Swank, rather than refining what he accomplished and that is the sign of the times.

            Everything is politics. Even what people feed their dogs has become political.

            1. If 90% of dogs don’t get Cancer if they eat raw vegetables, it makes the whole “don’t vaccinate and don’t use flea and tick medication” seem “iffy” to me, too.

              I listened to all of them and am giving him Modified Citrus Pectin to get some of the toxins out of his system, but… my mind tells me that it is the raw vegetables, which is the most important part.

          2. By the way, you get Kudos from me that you drove your friend an hour to the vet.

            That makes you a genuine friend.

            Your friend is lucky to have you.

            1. I read this again tonight about enzymes on:

              https://www.whole-dog-journal.com/issues/4_1/features/Enzyme-Therapy-for-Canine-Injuries_5019-1.html

              “In New Hampshire, one of Susan Appelin’s Greyhounds had part of a rib removed to treat a hemangiosarcoma, but the tumor grew back. Another Greyhound was diagnosed with a mast cell sarcoma. “These cancers are almost always fatal,” she says, “and my veterinarian gave me no hope for the dogs’ survival. I decided I would not give up and prayed for guidance.” When a holistic physician told her about Wobenzym N, she added between-meal enzymes to a regimen of vitamins and home-prepared food for her dogs.

              “Eighteen months ago, the dog with the hemangiosarcoma was given 30 days to live,” she says, “but thanks to Wobenzym, his tumor shrank and disappeared. The other dog has been in remission for 12 months. I now have all four of my Greyhounds and five cats on Wobenzym.”

              That’s the thing, one of the theories, which I heard 2 years ago was simply that people don’t eat enough raw fruits and vegetables and, as they get older, their stomach becomes less acidic and they can’t digest their food properly and they get Cancer.

              That lines up with the Purdue study, in my opinion.

              I was happy to see my dog’s type of Cancer mentioned.

              It seems like there are so many ways of getting rid of Cancer, but I like simple answers best.

    2. Deb

      If you are feeding your dog a completely vegetrian diet, are you ensuring that he gets the B12 that he would otherwise have obtained from animal foods?

  7. Hi Dr. Greger,

    They have been described rather flamboyantly in a pharmacology journal as an “herbal remedy [that] has no match in serving the human race.” And I just thought they were kind of tangy.

    You my friend are a man after my own heart. With an endorsement as such I am going to have pick some up today.

    Thanks for all you and the associated volunteers do for us,
    Mike Stilinovich

    1. Laughing, yes, that paragraph made me smile, too.

      I was fond of: “pleasantly acidulous,” which is just doctor-speak for sour…….

      Yes, something tells me that doctor-speak is charming in some cultures.

      Laughing again, because I think I chose vegan, because the doctors ARE charming OR they are characters. Some of them are both.

      Not gonna name names.

  8. Tried the barberries in my 2 teens’ morning smoothies for 4 months at the recommended TBS per day. Didn’t work for acne at all in their case. Started giving red raspberry leaf instead (to regulate menstrual cycles) and now their acne has improved along with their cycles. Go figure.

    1. Herbs do work in some ways like pharma drugs i.e. take “this” to cure “that” but also they have many other properties that can and will cause “unexpected” results if you are not deeply trained in some traditional body of herbal knowledge. Chinese (Traditional Chinese Medicine), Indian (Ayurveda), Japanese (Kampo), etc. Overall genetic and epigenetic constitution as well as current health status can have major impact on how an herb acts in a particular person at a particular time.

      1. I agree with you. However, some herbs are classified as “tonic” and/or “nutritive” and can be taken freely. Barberries and raspberry leaves are 2 such herbs. But we also have to be aware that all those traditions you mentioned also govern and classify food intake according to an individual’s constitution. Unfortunately I don’t have a TCM doctor floating around advising me although I wish I did!

        1. I was a TCM practitioner (acupuncture and clinical herbology) for over 25 years. And even “tonic” herbs can cause problems if used improperly. I first experienced this myself, 1/2 experiment and 1/2 dumb mistake. Tonics are tricky to use when there is active infection because they can “tonify the disease”. I had a cold and was pretty debilitated by it, in recovery phase but early days and feeling very low energy so I took astragalus which is fairly mild tonic (Qi and Blood). A few hours later I felt as though I’d been beaten with hammers and had spiked a mild fever. Here is short list of contraindications for astragalus:

          Do not use during third semester of pregnancy
          Not for excess exterior pathogens
          Not for excess Yang with Yin Deficiency
          Not for upper jiao heat and lower jiao cold
          Not for patients with excess qi
          Not for sores due to heat in the blood
          Not for patients with allergies

          Before I started my training, I took ginseng as prescribed by another practitioner. It took about a week for me to develop ulcers on my tongue and mild nose bleeds. Had I continued to take it, quite possibly high blood pressure would have been next.

          1. Wow. That’s scary. I guess the next question would be how to find qualified TCM practitioner! I know they can be quite successful when accurate in their diagnosis/treatment but didn’t realize so much harm could be done. Maybe I’ll stick with Qigong. Can’t go wrong with that, right?

            1. I think Qi Gong is much safer AND, you can get into trouble if you use force to try to make things happen. There is a wide range of techniques in Qi Gong, and though many are gently and quite safe, there are some that are more forceful, firey, and those can do ya if not properly guided. Mostly pretty obvious when you encounter them though so I wouldn’t worry about it. Qi Gong is a wonderful, magical practice! (Some of Mantak Chia’s stuff I would put in that more forceful category.)

              For acupunture and clinical herbology, I would look here:

              http://www.nccaom.org/find-a-practitioner-directory/

              Though there are many highly skilled practitioners who are not NCCAOM certified, those that are have been very well trained and tested; some states accept that alone for licensing while others require additional testing of their own.

  9. Like anything else – too much is toxic. Too much salt will kill you, too little salt will kill you – same with water – so, what is the optimal dose of barberry or berberine, is the most important question.
    Iran J Basic Med Sci. 2017 May; 20(5): 516–529. doi: 10.22038/IJBMS.2017.8676
    PMCID: PMC5478780 PMID: 28656087
    Toxicology effects of Berberis vulgaris (barberry) and its active constituent, berberine: a review

    Seyede Zohre Kamrani Rad,1 Maryam Rameshrad,1,2 and Hossein Hosseinzadeh1,2,*
    1Department of Pharmacodynamics and Toxicology, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
    2Pharmaceutical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
    *Corresponding author: Hossein Hosseinzadeh. Pharmaceutical Research Center, Department of Pharmacodynamics and Toxicology, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran. Tel: +98-51-38819042; Fax: +98-51-38823251; email: ri.ca.smum@hhedazniessoh
    Author information ▼ Article notes ► Copyright and License information ► Disclaimer

    Huge numbers of published articles on the medical worth of barberry and its constituents have shown that they have a great potential to develop as a useful drug especially in the area of cancer, cardiovascular and metabolic disorders. However, till now no drug has been introduced in the market using pure barberry, berberine or the other barberry components. This might be resulted from low clinical data. Certain information about barberry/its main secondary metabolites toxicity needs to be addressed before they can be used as approved therapeutic drugs in human.

    In the present study, we summarized a variety of scientific articles that evaluated the toxicity of B. vulgaris and berberine. By considering the LD50 values, it is clear that their toxicity depends on the experimental animal species, dose and rout of administration as well as the herb source. The risk of toxicity in oral route is less than IP and IV injections.

    Results in animal and in vitro studies have proved the potential of berberine to induce GI upset and ulceration, immunotoxicity, phototoxicity, neurotoxicity and cardiotoxicity in a dose dependent manner (Figure 4). Besides, there are controversial data in using berberine and its derivative during pregnancy, so the use of them should be cautioned in pregnancy and neonatal. Berberine by inhibiting adenine nucleotide translocase, promoting ROS formation, apoptosis and necrosis pathways induces its toxicity on both normal and cancer cell in a time and concentration dependent manner. Finally, the inhibitory effects of berberine on CYP enzymes should be mentioned which could evoke indirect toxicity. This interaction is important in co-administration with narrow therapeutic index drugs which may increase the drug plasma concentration and toxicity.

  10. Accutane was discontinued by Roche in 2009, but the generic form, isotretinoin, is still used for recalcitrant acne.

  11. Following. I, too, wonder as to the portrayal of barberries as completely safe for consumption, while it is acknowledged by many a herbalist to intefere with the microbiome.

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