This is a guest post by Dr. Lara Briden who blogs about hormones over at LaraBriden.com
As a naturopathic doctor specializing in PCOS and period problems, I treat a lot of acne. I can’t imagine doing it without the herbal medicine berberine.
Berberine simply works for acne, and the best thing is that it works quickly. One clinical study found that berberine improved acne by 45% after just four weeks .
What is Berberine?
Berberine not one herb. It is a phytonutrient or active constituent found in a number of different herbs including the much-loved goldenseal (Hydrastis canadensis), barberry (Berberis vulgaris) and the Chinese herb Phellodendron amurense.
All of those berberine-containing herbs have a long history (centuries) of traditional use.
4 Ways that Berberine Helps Acne
- It’s a natural antibiotic. Berberine has antimicrobial properties so it reduces the number of Propionibacteria that contribute to acne.
- It improves insulin sensitivity . In other words, berberine lowers insulin. This is important because high insulin is a key driving factor behind acne. Insulin triggers the release of a hormone called IGF-1 and an enzyme called mTOR. Both IGF-1 and mTor are a perfect storm for acne because they promote excessive production of sebum, keratin and inflammation. The insulin-acne link is explored in the research paper “Diet in Acne: Further Evidence for the Role of Nutrient Signalling in Acne Pathogenesis” .⇒Tip: Berberine lowers insulin, but it’s important to combine it with an insulin-lowering diet, which means reducing or eliminating concentrated sugar and dairy products.
- It reduces testosterone in women. Berberine blocks the production of testosterone by ovarian thecal cells . This makes berberine a particularly good choice for PCOS-sufferers with acne.
- It reduces inflammation. Berberine inhibits the expression of inflammatory cytokines , which (together with its anti-microbial effect) explains why it works so quickly.
How to Take Berberine
Berberine-containing herbs taste quite bitter, so they’re best taken as a tablet or capsule.
A number of supplement brands offer tablets of goldenseal, barberry, or phellodendron extract.
If you use goldenseal, then please choose a sustainably sourced product, as goldenseal is endangered in the wild.
A good product I recommend is Thorne Berberine, sourced from Indian barberry.
What to Expect
Most of my patients report some improvement (30 or 40%) within 6 weeks of starting berberine.
It works best in combination with diet and other acne supplements such as zinc.
Full improvement of acne (with any treatment) can take up to six months or longer. (That’s because it takes that long for the pore to expel the sebum plug.)
Berberine is a safe herb, and has a long track record in traditional use. However, it should not be taken during pregnancy or breastfeeding.
And it should be used with caution when combined with prescription medication such as antidepressants, beta-blockers or immunosuppressants, because it can alter the blood levels of those medications.
If in doubt, please seek professional advice.
One final caution is that berberine is anti-microbial, so it will affect intestinal bacteria.
In the short term, this effect is beneficial. Berberine has been shown to improve bowel health  and repair intestinal permeability .
In the long term, however, I am cautious with berberine. I usually recommend taking it six days per week (one day break), and stopping it for one month after three month’s use.
It can then be resumed, if needed. Often, it is not needed again because the other treatments (diet and zinc) will have had a chance to work.
- Fouladi RF. Aqueous extract of dried fruit of Berberis vulgaris L. in acne vulgaris, a clinical trial. J Diet Suppl. 2012 Dec;9(4):253-61. PMID: 23038982
- Kong WJ, Zhang H et al. Berberine reduces insulin resistance through protein kinase C-dependent up-regulation of insulin receptor expression. Metabolism. 2009 ;58(1):109-19. PMID: 19059538
- Melnik BC. Diet in acne: further evidence for the role of nutrient signalling in acne pathogenesis. Acta Derm Venereol. 2012 May;92(3):228-31. PMID: 22419445
- Zhao L, Li W et al. Berberine reduces insulin resistance induced by dexamethasone in theca cells in vitro. Fertil Steril. 2011 ;95(1):461-3. PMID: 20840879
- Wang Q et al. Effect of berberine on proinflammatory cytokine production by ARPE-19 cells following stimulation with tumor necrosis factor-α. Invest Ophthalmol Vis Sci. 2012 Apr 30;53(4):2395-402. PMID: 22427564
- Han J, Lin H, Huang W. Modulating gut microbiota as an anti-diabetic mechanism of berberine. Med Sci Monit. 2011;17(7): 164-167. PMID: 21709646
- Gu L et al. Berberine ameliorates intestinal epithelial tight-junction damage and down-regulates myosin light chain kinase pathways in a mouse model of endotoxinemia. J Infect