This patient is most likely the woman with adult acne not responding to dietary changes or nutritional supplements, but returning when the antibiotics are stopped. What needs to be done is to establish why the woman has acne in first place, instead of just suppressing the condition with drugs.

In my experience, the most common reason for women to have acne is the presence of ovarian cysts. (A cyst is a sac-like cavity filled with liquid or semisolid material, rather like a haemorrhoid.) Usually linked to polycystic ovarian syndrome (PCOS), enlarged cystic ovaries may occur in the absence of characteristic symptoms: hirsutism (abnormally hairy), infertility and scant periods. They are found in women who have conceived and are not hairy, in infertile women with regular periods, and in those with ovaries that are small or normal in size.

In the absence of suspect symptoms, acne associated with ovarian cysts can be diagnosed by ultrasound, preferably transvaginally, and by blood tests.

A herbal remedy A well-researched alternative treatment is Vitex agnus castus, a Mediterranean shrub. In classical times, it was used for disorders of the female reproductive system, and is mentioned in the medical writings of Hippocrates, Plinius, Dioscorides and Galen. Extract of agnus castus (EAC; from the berries) has a regulating effect on ovarian hormones, as confirmed by laboratory examinations (Hippokrates, 1954; 25: 717; Deutsche med Wochenschr, 1954; 79: 1271). EAC also reduces follicle-stimulating hormone production in the pituitary, and gently increases luteinising hormone (LH) and prolactin secretion.

Excessive menstrual bleeding, unduly frequent periods, persistent acyclic haemorrhages and similar menstrual disorders can controlled by using 30-40 drops of EAC in water once daily (Deutsche med Wochenschr, 1955; 80: 936). Improvement in the cystic ovarian overgrowths can be monitored by ultrasound. Premenstrual syndrome and quick-temperedness can be improved from the very next cycle (Zeitschr Allgemeine Med, 1981; 56: 295).

Because EAC promotes the secretion of LH, it contributes to progesterone synthesis (Selecta, 1977; 19: 3688), which makes it of immense value in the successful treatment of endometriosis.

My own experience has shown that myomata (fibroids) situated within the walls of the uterus not only cease to grow, but actually shrink, as confirmed by ultrasound, with EAC treatment lasting for eight months. In addition, I have seen that, within a month of starting EAC treatment, the acne visibly begins to subside in most cases and does not return, even after the treatment has ended.

(For alternatives for preventing acne, see page 11.)

Harald Gaier Harald Gaier is a registered naturopath, osteopath, homoeopath and herbalist. He can be contacted at The Diagnostic Clinic, London, tel: 020 7009 4650