Acne is caused by an excess production of sebum, the waxy substance that our skin produces. The overproduction clogs the skin’s pores, leading to blackheads, pimples and pustules. Nearly everyone at some time will have this problem but unhappily it can be very severe in a few of us.

There is some correlation between poor diet or hygiene and acne, and a certain amount of improvement can be made by changes of habit. Very often the difficulty lies in the sebum being too viscous, and dehydration may be a major factor. Secondary infection by skin bacteria worsens the situation.

Any skin problem may have a psychological basis. Stress causes adrenaline-like substances to be produced that cut down the blood flow to the skin. This prevents nutrition, protection and healing from reaching the skin at the necessary levels.

There is a correlation between acne and hormonal changes or imbalances. Acne is most prominent in teenagers going through puberty. The actual mechanism is uncertain but may be due to the hormonal effect on sebum-producing cells, on skin bacteria or the effect of hormones on the skin blood supply thereby encouraging more oxygen and nutrition to either the sebum-producing cells or the skin bacteria.

Ensure that you are drinking half a pint of water for every one foot of your own height.

Use non-medicated soaps and no oil-based cosmetics. Try sandalwood or Calendula soap if available.

Some people will benefit by reducing fried foods, spicy foods, citrus and all refined (white) sugars.

Teatree oil (one drop to five drops of olive oil) applied to the skin after cleaning can be curative. Dilute further if this stings.

In moderate to severe cases use a teaspoonful of chickpea flour with a teaspoonful of almond powder mixed in goat’s milk. Apply for a few minutes twice a day.

Try Evening Primrose Oil (lg three times a day), zinc (15mg before sleep) and copper (2mg with breakfast).

Homeopathy can work wonders. Look up the remedies sulphur, Kali bromatum, and Antimonium tartaricum. A homeopath’s opinion is well warranted.

Deal with your stress levels. Learn some basic meditation and visualization techniques. I am often amazed at how swiftly skin conditions, including acne, will clear when anxieties are relieved.

Consider hypnotherapy if basic relaxation has no impact.

Under the supervision of a complementary medical practitioner, try a natural oestrogen extract and if this does not work try a natural progesterone treatment. The herb Agnus castus can be very beneficial.