Dermatologytimes - looking 'outside box' for acne treatment

DermatologyTimes - Looking 'outside box' for acne treatment
Looking 'outside box' for acne treatment
Some physicians report success with vitamins, herbs, lasers, acupuncture
National report — When typical approaches are not effective, some physicians turn to the atypical to
treat acne. A few doctors have had good success with such unusual treatments as vitamin supplements, Haines Ely, M.D., occasional y uses vitamin B-5 (pantothenic acid) to treat acne in patients who cannot or wil not take more traditional therapy. "I don't do this as first-line or even a second-line treatment," he tel s Dermatology Times. "I do this for people who say, 'I don't want antibiotics, I'm al ergic to benzoyl
peroxide, I don't want to take Accutane.' There's a mil ion reasons why they want something off-the-wal , Dr. Ely, a clinical professor of dermatology at the University of California at Davis who has a private dermatology practice in Grass Val ey, decided to try B-5 after reading a 1997 study by Lit-Hung Leung, M.D., of Hong Kong, published in the Journal of Orthomolecular Medicine (1997;12(2)). He uses a supplement cal ed Evolution-X that contains 510 mg of B-5 per capsule. He recommends that patients start with four capsules a day and increase the dosage, as needed, up to 20 capsules a day. "It's a hard thing to do, taking anywhere from four to 20 capsules a day, but most patients who do say it dries their skin up almost like Accutane," he says.
Anthony Chu, F.R.C.P.C., from the dermatology department of Hammersmith Hospital in London, is also exploring unusual ways of treating acne. His research is based on the premise that acne is an immunological disease. He and his col eagues have had remarkable success treating acne with low fluence to acne treatment are pulsed-dye laser (PDL). In a study recently published in The Lancet (2003; 362(9393):1347-1352), 41 adults u nsuccessful, with mild to moderate facial inflammatory acne received PDL or sham treatment. After 12 weeks, lesion counts fel by 53 percent in the PDL group, compared with 9 percent in the sham Donald Baker, M.D., has had some success treating acne with acupuncture and other alternative therapies, in addition to traditional medicine. "I believe acupuncture is a good adjunctive therapy for acne," he says. "I have found that papular and fine pustular acne respond to therapy faster than comedonal acne, which is very hard to treat with acupuncture alone." Dr. Baker is a clinical assistant professor and director of integrative dermatology at the University of Medicine and Dentistry of New Jersey (UMDNJ) — Robert Wood Johnson Medical School at The process is inconvenient and expensive, however. "Therapy needs to be at least weekly at first, and most adolescents and their parents simply won't tolerate the inconvenience and expense of the intense regimen needed," he says. "They prefer antibiotics and Accutane." Shaobai Wang, M.D., uses a combination of acupuncture, herbs and diet to treat acne. In traditional chinese medicine (TCM), he says, "We consider that everything is related. The weather, diet, and season and other such factors can have pathological effects on human functioning. For TCM science, everybody is different; every problem is different. . We treat disease according to the method of differentiation.
"Here in the United States they treat according to diagnosis: acne," he says. "With TCM, choosing a course of treatment for his acne patients, including how the acne responds to acneform lesions may result from one of a variety of imbalances. We observe and analyze changes in season, hormonal cycle, mood the imbalances to get at the cause of the lesions; this is differentiation." Dr. Wang is a New and diet, as wel as where acne occurs on the York State-licensed acupuncturist who, in July 2004, left his position of 13 years as visiting body. Above patient is a female, age 25 with professor and research scientist in the department of medicine at Columbia University in Ne a DermatologyTimes - Looking 'outside box' for acne treatment
acupuncture needles in the facial area and Dr. Wang considers several factors when choosing a course of treatment for his acne patients, including how the acne responds to changes in season, hormonal cycle, mood and diet, as wel as where acne occurs on the body. Based on the principles of TCM, every acne patient receives an individualized therapy, he says, so it is not possible to conduct a clinical trial examining a specific, uniform TCM treatment for acne, as is done with Western medicine. Clinical trials of TCM treatments can be performed only if the study incorporates the standard procedures for TCM diagnosis and differentiation.
Dr. Baker also looks at the big picture when treating acne with acupuncture and other TCM tools.
"It is also important to treat the patient's underlying TCM imbalances for optimal results, which translates into treating problems like an irregular menstrual cycle first, and then observing the effect on a patient's acne," he says. ". Patients who have an incomplete response to antibiotics but do not want to take Accutane can benefit from combining topical therapy and monthly acupuncture as maintenance therapy, while using doxycycline for acne flares." Dr. Wang, who was educated in China, doubts whether most Western physicians truly appreciate the amount of training that is necessary in both TCM theory and practice. In China, doctors of TCM must undergo a minimum of five years of intensive training, including one year of clinical internship. He does not believe that a few hundred hours of training in acupuncture or a similar TCM treatment is enough to permit doctors to use these tools correctly. Thus, he says, it would be best for Western dermatologists who want to incorporate aspects of TCM into their practice to work in col aboration with a TCM practitioner who has spent several years studying TCM ful -time and is familiar with Western practices. In the wrong hands, he says, TCM, like any medical therapy, can For more information: Additional information about TCM can be found on Dr. Wang's Web site at The role of vitamin B in acne is described on the Web site for Evolution-X at


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