The medical treatment of acne includes antibiotics (oral and topical), birth control pills, and topical corticosteroids. 

Natural medicine uses other approaches.

Acne may be related to excess blood sugar fluctuation. In other words, treat it as one might a hypoglycaemic, pre-diabetic or diabetic. It makes sense to do bloodwork to check blood sugar (check the thyroid too, as hypothyroidism is another cause of acne.) Ways to normalise blood sugar include:

Cutting down on dietary sugars. Candy, biscuits, breads, processed cereals, sugar rich muesli. Everything high on the glycemic index;

Increasing fibre intake. Fibre comes from carbohydrates low on the glycemic index. Fruits, vegetables, whole grains. 

Increasing exercise. Lack of exercise aggravates blood sugar irregularity.

Reduce sugar cravings with herbs.

Another cause of acne is elevated androgens and the enzyme 5 alpha reductase, which converts testosterone to DHT (dihydrotestosterone). Both men and women have androgens. The teenage years are a time of rapid and intense change revolving around the sex hormones. 

The liver metabolises unwanted hormones for excretion. Support the liver in this function. Reduce or stay away from processed foods, particularly junk food. Avoid factory raised meats, including chicken and pig – their meats contain trace amounts of hormones fed to these animals to speed up their growth. 

Herbs to support liver function, like milk thistle and bupleurum. In women, identify and normalise irregularities in the menstrual cycle.

Stress often aggravates acne. The hormones of stress are closely related to the sex hormones including androgen. Find ways to reduce stress. Exercise, meditate, alter, if possible, the situation that creates the stress, and support the stress hormones. Chronic stress can deplete these hormones.

Detoxify through fasting or partial fasting. This helps the liver with its job of metabolism and excretion of toxins and unwanted hormones. Consider (after seeking medical advice) partial fasting for a few days – fresh juices, fruits, non starchy vegetables, broths. Little or no meat, dairy or other animal products. No sugar, processed or junk food.

Topical treatments: Don’t use complex creams, make-up or anything containing additives.Steam the face, or apply hot towels, to loosen the skin and open the pores.

Clay masks or poultices of plantain (Plantago) leaf to help the skin excrete unwanted material.

Keep the skin supple. Dab on a little Vitamin E as needed.