Botanical Skin Care Course Unit 2

Unit 2
Skin Care from the Inside

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LESSON 1: THE SKIN AS AN

ELIMINATORY ORGAN

INTRODUCTION

The human body has a built-in detoxification system that allows for the elimination of waste products
through the skin, liver, kidneys, intestines, and lungs. These waste products can take the form of gases,
liquids, and solids; they include metabolic waste (compounds produced through normal cellular
processes, such as respiration and protein breakdown), endogenous compounds (substances produced
within the body, such as hormones and cholesterol), and xenobiotics (chemical substances that enter
the body from the outside—for example, pharmaceuticals, food and cosmetic additives, and
environmental pollutants).

In this lesson, we’ll examine some of the ways the skin works in tandem with the other eliminatory
organs, particularly the liver, to keep the body in balance.

ELIMINATION THROUGH THE SKIN

Sweating primarily serves to cool the body and provide chemical protection by helping to maintain the
skin’s acid mantle, but it also functions as a route of elimination for some waste products. Normally,

© Herbal Academy Botanical Skin Care Course: Unit 2 theherbalacademy.com | page 2

sweat is mostly composed of water, minerals, and a small amount of metabolic waste products,
including lactic acid and urea (Yokoyama et al., 1991). However, it can also contain other compounds
the body needs to excrete, including toxins such as heavy metals (Tang et al., 2016), organic pollutants,
and byproducts of the breakdown of pharmaceuticals (Daughton & Ruhoy, 2009). What’s more, the skin
has a direct role in the detoxification of these xenobiotics, which can be broken down by enzymatic
activity within the cells of the skin (Svensson, 2009). (We’ll cover the process of cellular detoxification in
greater detail later in this lesson, when we discuss the connections between the liver and skin health.)

The lungs, kidneys, liver, intestines, and skin work in an interconnected fashion to break down and
excrete this cocktail of compounds; if one or more of the eliminatory organs are functioning poorly, the
other systems may have an increased burden of elimination to compensate. This is a widely held theory
among holistic practitioners, but may not be as accepted in a biomedical model, although there are
some specific areas where cause and effect can clearly be observed. For example, the concentration of
urea (a metabolic byproduct of protein digestion, normally excreted mostly through kidneys in urine)
found in sweat increases when kidney function is impaired (Al-Tamer & Hadi, 1997; Huang et al., 2002),
as the body attempts to compensate for decreased renal elimination by getting rid of urea through the
skin.

Consequently, when considering how to support the health of the skin using a holistic framework—and
particularly when addressing chronic inflammatory skin conditions—we can also look to the function of
our other eliminatory organs. The liver and the digestive system are key players here, and we’ll cover
each of these in more detail later in the course—but first, let’s take a look at one of the ways we can
provide foundational support for all of our organs of elimination, using a class of herbs known as
alteratives.

Alteratives for Skin Support

Alterative herbs improve nutrient assimilation, metabolic function, and elimination; they improve our
ability to excrete metabolic waste products and often act by supporting the function of one or more of
the excretory organs (liver, kidneys, colon, skin, and lungs) and/or the lymphatic system. Most alteratives
have an overall restorative effect on the body and may be used for an extended period of time.

This is a fairly broad category of action, but we can narrow in on the use of individual herbs according to
their specific affinity or niche action. According to herbalist David Hoffmann, the “leafy” alteratives
(alterative herbs from which the aboveground parts are used) tend to have more activity on the lymphatic
system and kidneys, while the “rooty” alteratives (alterative herbs from which the roots or bark are used)
generally support the function of the liver and colon (Hoffmann, 2003). Since strengthening the other
excretory organs will help reduce the eliminatory burden on the skin, all alterative herbs can potentially
have an indirect supportive effect in addressing skin conditions. However, some alteratives have a
particular affinity for the skin; these include chickweed (Stellaria media) aboveground parts, burdock
(Arctium lappa) root, red clover (Trifolium pratense) aerial parts, cleavers (Galium aparine) aboveground
parts, and violet (Viola spp.) aerial parts.

Cleavers – Galium aparine (Rubiaceae) – Aboveground parts

Covered in coarse, hooked hairs, the above ground parts of cleavers are characteristically clingy and
easily attach themselves to clothing, hair, and sometimes even skin. This explains other common
names for cleavers, which include sticky willy and catchweed. Cleavers grows in temperate zones on


all continents (Kew Science, 2017) and is best harvested when it is flowering and beginning to form
seeds (Tobyn et al., 2016). There are more than 600 species in the Galium genus (Kew Science, 2017);
not all are interchangeable, but some herbalists do use local alternate species, particularly sweet
woodruff (Galium odoratum), in a similar fashion to cleavers (Masé, 2010; Tobyn et al., 2016).

Actions: Alterative, anti-inflammatory, antimicrobial,
antitumor, astringent, bitter, diuretic, hepatic, laxative

Energetics: Cooling and drying

Use: Cleavers has been used as a “blood purifier” since
the era of ancient Greek medicine, when it was
employed to “destroy and expel eruptive poisons in the
blood” (Tobyn et al., 2016, p. 175), particularly when
taken daily for several weeks (typically in the spring
when a fresh juice could be prepared). Cleavers is still
used by modern herbalists as a spring tonic to help
revitalize immune function, digestion, and elimination
(Masé, 2010). Though we may describe it somewhat
differently, the basic principle at work is similar: use of
alterative herbs, aligned with the seasonal shift from
winter into spring, in order to improve metabolic
function, assimilation of nutrients, and excretion of waste
products.

The alterative function of cleavers can have a profound
effect on skin conditions related to systemic
accumulation of metabolic waste products; for this
purpose, cleavers can be used both internally as a
succus (juice) or other extract, and externally as a
poultice or compress on affected skin. Cleavers may also be used both internally and topically to
support the lymphatic system, enhancing the clearance of metabolic waste and overall immune
function (Holmes, 2006); it may be particularly indicated when there is swelling of the lymph nodes in
the throat, and it can also be applied topically, in an oil or salve, to any swollen nodule, cyst, or boil
(Tobyn et al., 2016).

When taken internally as a succus, tea, or tincture, cleavers has a notable diuretic effect. It has an
affinity for the kidneys and bladder and is often included in formulas to help normalize urine flow and
overall urinary tract function, particularly where there are signs of heat, swelling, and inflammation
(Tobyn et al., 2016), as in the case of cystitis or prostate inflammation. This draining, diuretic effect
makes cleavers ideal for use in damp conditions with swelling and accumulation of fluid.

Although dried herb can be used, cleavers is ideally used fresh, and it can be prepared as a hot or
cold infusion, succus, puree, or tincture of fresh herb (Hoffmann, 2003; Tobyn et al., 2016).

Safety: No side effects or drug interactions have been reported (Hoffmann, 2003). No information on
the safety of cleavers in pregnancy or lactation has been identified in the scientific literature (Gardner
& McGuffin, 2013).


Dose: Infusion: 2-4 g dried aboveground parts/day divided into 3 doses; Tincture: 4-8 mL (1:5, 25%),
3x/day; Juice/puree: 5-15 mL fresh aboveground parts/day, drunk immediately or frozen (Hoffmann,
2003).

Red clover – Trifolium pratense (Fabaceae) – Aerial parts

Red clover leaf and blossom should be
harvested throughout the growing season on
sunny days—due to the formation of dicoumarol
(a potential blood thinner) when the plant is dried
ineffectively, it’s best not to harvest the flowers
and leaves on damp days, or just after rain
(Garran, 2008). Some herbalists suggest
harvesting when the blossoms are slightly damp
with dew in order to retain the beautiful
purple-pink color, but thorough and quick drying
would be especially important if harvested this
way.

Actions: Alterative, anti-inflammatory,
antispasmodic, demulcent, expectorant,
lymphatic, nutritive

Energetics: Neutral to cooling and moistening

Use: Red clover is yet another alterative with an affinity for the skin, but with its own unique niche.
Whereas cleavers is cooling and slightly drying, red clover is more neutral in temperature and slightly
moistening; according to herbalist Matthew Wood, red clover is particularly indicated for dry, irritated
skin conditions (Wood, 2008). Red clover is also used in the Chinese materia medica to clear heat and
restore yin; translating these concepts into the language of Western herbalism, red clover is indicated
when there are signs of heat (e.g., redness, irritation) with underlying dryness and deficiency (Holmes,
2006). This is where red clover shines as a nutritive alterative, helping to calm signs of heat and
inflammation by supporting both assimilative and eliminative function.

Red clover can also be applied to the same pattern when it manifests in the respiratory system.
Though it’s easily forgotten, the respiratory system is also a route of elimination for metabolic waste,
and alteratives can have a supportive function here. Red clover acts as a relaxing expectorant; while it
can be useful in soothing an acute cough, it is ideal when there is chronically poor respiratory function
with signs of heat and inflammation, particularly when heat and dryness are also present in the skin
(Holmes, 2006). One classic example of this pattern is the common co-occurrence of atopic eczema
and asthma, presenting with signs of heat and dryness in both the skin (red, itching, burning, and/or
cracking eczema patches) and lungs (tightness in chest with wheezing or a dry or rasping cough).

Another common application of red clover, which may also derive from Chinese medicine, is its
specific indication for hard and swollen nodes, glands, cysts, and other lumps or masses (Garran,
2008). Red clover is sometimes recommended as a specific for breast lumps or dense, fibrocystic
breast tissue; while its action as a lymph mover certainly helps here, this indication may also derive


from the phytoestrogenic activity of red clover isoflavones. Prior to menopause, these and other
phytoestrogens act as competitive inhibitors of estrogens, decreasing overall estrogen activity
(Cabrera, n.d.).

Safety: Red clover is often listed as contraindicated with blood-thinning medications because it
contains coumarins. In fact, the dicoumarol in clover blossoms only takes on an anticoagulant effect
when the herb is fermented—which is why it’s important to dry clover blossoms carefully; as long as
clover is not moldy or fermented, it does not have a blood-thinning effect.

Dose: Infusion: 10-16 g dried aerial parts/day divided into 3 doses; Tincture: 2-4 mL (1:5, 40%) 3x/day
(Hoffmann, 2003; Holmes, 2006).

Violet – Viola spp. (Violaceae) – Aerial parts

Violet is among the welcome spring herbs that
can be used as both a deeply nourishing food
and a therapeutic herb. Violet leaf is loaded with
minerals and vitamins A and C, with a pleasantly
sweet, mild flavor that makes it an easy addition
to salads, pesto, smoothies, and herbal infusions
(Groves, 2016).

The wild strains of blue and purple violet species
are typically used, particularly the European
native sweet violet, Viola odorata; however,
related species such as Viola tricolor (heartsease
or wild pansy) are virtually interchangeable, as
are most native violet species (de la Forêt, n.d.).
(But take note that the African violets widely used as ornamentals in the U.S. are not actually in the
Viola genus and shouldn’t be consumed.) Fortunately, many violet species can be cultivated in the
garden or on shady borders for a sustainable harvest.

Actions: Alterative, aperient, anti-inflammatory, expectorant, lymphatic, nutritive

Energetics: Cooling and moistening

Use: Violet leaf and flower is one of the most moistening of the “leafy” alteratives. It’s much less
diuretic than many of the other nutritive spring greens, so it’s particularly useful for those with a very
dry constitution who may find tonics such as nettle (Urtica dioica) leaf and dandelion (Taraxacum
officinale) leaf too drying (Groves, 2016).

If you have the opportunity, try slowly chewing a fresh violet leaf or flower; as it breaks down, you’ll
notice a distinct mucilaginous quality, which is what gives violet its moistening properties. Although
the roots of Viola species have a frank laxative effective, the aerial parts act more as a moistening,
gentle aperient; this makes them useful for those with a tendency to constipation, which can often
accompany a dry constitution. This mucilaginous quality combines with the saponins in violet leaf to


make a useful expectorant, stimulating the expulsion of mucus while also soothing irritated tissues in
the throat and respiratory tract (Hoffmann, 2003).

Like red clover and cleavers, violet has an affinity for the lymphatic system and can be useful when
there is lymphatic congestion resulting in swollen nodes, glands, or other masses; it can be used as a
topical compress, poultice, or infused oil, or can be taken internally, typically as an infusion (de la
Forêt, n.d.). Likewise, violet can be used both internally and topically to support the skin through its
alterative and anti-inflammatory action and is useful for inflammatory skin conditions including eczema
and psoriasis. In infants, violet can be used externally as a wash for cradle cap and other skin
irritations.

Violet contains some salicylic acid—the same compound found in willow bark, originally used as the
base for aspirin—which may underlie its use as an anti-inflammatory and mild analgesic. Violet can be
included as part of a long-term strategy for addressing pain and inflammation in the musculoskeletal
system, such as arthritis, particularly when there are indications of heat and dryness (de la Forêt, n.d.;
Hoffmann, 2003).

Safety: Violet aerial parts are generally considered safe; there are no reports of adverse events or drug
interactions. However, violet root can cause nausea, vomiting, and diarrhea in high doses (de la Forêt,
n.d.).

Dose: Infusion: Up to 30 g dried aerial parts/day divided into 1-4 doses, steeped 4-8 hours (de la
Forêt, n.d.); Tincture: 1-2 mL (1:5, 40%) 1x/day (Hoffmann, 2003).

Leafy Alterative Tea

This mild-tasting tea can be used daily for several months as an alterative and mineral-rich preparation
to support general skin health. Prepare the tea in the evening, let steep overnight, and enjoy
throughout the following day.

Ingredients

2 tbsp violet (Viola spp.) aerial parts
2 tbsp nettle (Urtica dioica) leaf
2 tbsp red clover (Trifolium pratense) aerial parts
2-4 cups (16-32 fl oz) water

Directions

● Crush dried herbs in a mortar and pestle or clean hands and place in a heat-safe glass
canning jar or teapot.
● Pour 2-4 cups just-off-the-boil water over the herbs and allow to steep for 4-8 hours.
● Strain and enjoy.


Rooty Alterative Tincture

For those who prefer the convenience of tinctures, these “rooty” alteratives can be combined in a
synergistic formula. Note: this formula can also be prepared as a decoction; simply use equal parts of
each dried herb (perhaps with the addition of some chai spices to make it a bit tastier!) and simmer in 4
cups (32 fl oz) of water for approximately 20 minutes.

Ingredients

4 tsp (20 mL) dandelion (Taraxacum officinale) root tincture
4 tsp (20 mL) burdock (Arctium lappa) root tincture
4 tsp (20 mL) sarsaparilla (Smilax spp.) root tincture

Directions

● Combine all tinctures in a 2-ounce dark-colored glass bottle.
● Cover, and shake well.
● Label, and store in a cool, dry place.
● Take ½ teaspoon 2-3x/day for up to 3 months.

Blushing Blossom Shrub

A shrub is a syrup made from fruit- or herb-infused vinegar sweetened with sugar or honey, and can be
used as a base for all sorts of beverages. This recipe calls for fresh violet and red clover blossoms;
since both plants aren’t necessarily in bloom at the same time, you may need to first make your violet
vinegar, then wait patiently until it’s clover blossom time and re-infuse your vinegar. If that’s more than
you’re in the mood to manage, you can simply use one or the other!

Ingredients

Fresh violet (Viola spp.) blossoms
Fresh red clover (Trifolium pratense) blossoms
Unpasteurized apple cider vinegar
Raw honey
Fresh or frozen and thawed blueberries (optional)

Directions

● First, make an infused violet vinegar: place fresh violet blossoms in a clean glass jar and add
apple cider vinegar to cover. Place a piece of natural waxed paper on top and seal with a lid.
Allow to infuse for 1-2 weeks.
● Fresh clover blossoms can be added at any point during maceration, if they come into bloom!
Just add your blossoms to the jar and add apple cider vinegar as needed to cover. Allow to


steep for an additional 1-2 weeks after adding the blossoms, then strain out and discard all
herbs.
● If your violet vinegar is finished before clover season sets in, simply store it in the refrigerator
until you can harvest clover blossoms; then repeat the infusion step, using your strained violet
vinegar to cover the clover blossoms. Top with natural waxed paper and a lid, and allow to
macerate for 1-2 weeks, then strain and compost or discard herb.
● Add the blueberries to the infused vinegar; cover with waxed paper and a lid, and let macerate
for 24 hours before straining. This will give your shrub a bit of lovely color and sweet-tart
flavor, but you can skip this step if you prefer.
● Add honey to taste. Some people add as much honey as vinegar, though this makes a fairly
sweet drink.
● Store in a glass jar or bottle, refrigerated, for up to 6 months. (If including blueberries or other
fruit, shelf life may be as short as 1 month.) Make a simple beverage by combining your shrub
with still or sparkling water to taste, use as a mixer in cocktails or mocktails, or add to salad
dressings.

HEPATIC HEALTH AND THE SKIN

Biotransformation and Detoxification

Every substance that we take into our body—whether it comes in through our mouth, lungs, skin, or
mucous membranes—will pass through the liver as it moves through the circulation. This is also true for
endogenous substances (compounds manufactured within the body), including cholesterol and
hormones such as estrogen. Regardless of whether they come into the body through food, medication,
cosmetic products, or environmental pollutants, most compounds will need to be broken down into
component parts that can either be used by the body or easily eliminated as waste. The technical term
for this process is biotransformation, but in everyday language it’s often called detoxification.

Biotransformation primarily takes place within the liver, but to a lesser extent also occurs in other cells;
skin cells contain enzymes that initiate biotransformation, and, consequently, the skin is also a
significant site of metabolic detoxification (Svensson, 2009). For the most part, the detoxification
process consists of a series of enzymatic reactions that make the target compounds (the chemicals we
need to metabolize) more water-soluble, and thus more easily excreted in urine, feces, or sweat.

Biotransformation is generally understood to work in two phases. In the simplest terms, we can describe
phase I as breaking down the substances into intermediate compounds, and phase II as rejoining, or
conjugating, those intermediate compounds with other molecules.

However, there’s also a crossover point between phase I and phase II that’s crucial to understand—it
can have some far-reaching consequences in the body, and it’s one of the major intersections between
hepatic function and overall health, including the health of the skin.

Phase I reactions generate reactive oxygen species, which, as you learned in Lesson 2, can cause
oxidative damage to cells, including cumulative inflammatory damage to the skin and other parts of the
body. Here’s the important point: the metabolites, or byproducts, created during phase I reactions can
be even more damaging to the body than the original parent compounds—that’s why it’s so important
that the body is primed to move these intermediate products swiftly into phase II reactions, which create
more stable, more water-soluble compounds that are ready for excretion through urine, feces, or sweat.


If that doesn’t happen, and phase I breakdown reactions outpace phase II binding reactions, we can end
up with an accumulation of unstable, oxidative compounds in the body that cause damage to cells and
DNA, promote inflammation, and may lay the groundwork for chronic disease (Liska et al., 2004).

An imbalance between phase I and phase II reactions can arise when phase I enzymes are upregulated
(their function is increased by cellular or genetic regulation) or when there’s a deficiency in the
compounds that drive phase II reactions (Liska et al., 2004). Both genetic and environmental factors play
a big role in the detoxification systems of the body; in particular, there are a number of genetic variations
that can alter the activity of phase I enzymes, affecting the body’s ability to effectively metabolize certain
substances (Hodges & Minich, 2015) and altering the balance between phase I and phase II reactions.

Visit the course to download the Biotransformation worksheet as a PDF.

Regulation of these metabolic pathways is also influenced by the foods (and herbs!) we consume. The
enzymes that regulate phase I reactions are endogenous compounds that don’t come directly from the
diet—but their activity can be stimulated or inhibited by food and herbs.

Phase II reactions usually involve “quenching” the reactive intermediate compound by attaching a donor
group; they rely on the presence of both the donor compound, such as a sulfur or methyl group, and the
transferase enzymes that shuttle the donor compound to the attachment site (Hodges & Minich, 2015).


These donor compounds can be produced by the body, but their building blocks need to be replenished
through the diet (Hodges & Minich, 2015; Jeffery, 2006). (Imagine this as a bucket of water that’s slowly
being refilled by a trickling hose; if we’re taking a lot of water out of the bucket, it will empty more quickly
than it’s refilled—that’s what happens when we have a lot of detoxifying to do, but we don’t have
enough of the building blocks for those phase II enzymes. Adding foods and herbs that provide donor
compounds for phase II activity is like turning up the pressure on the hose: now the bucket doesn’t
empty even though we’re still taking water out at the same rate.)

It’s certainly possible for some foods and herbs to stimulate only phase I enzymes, and consequently
promote the production of damaging intermediate metabolites—caffeinated beverages, alcohol, and
charbroiled meats are classic examples of foods or beverages that induce phase I enzymatic activity.
However, it appears that while isolated compounds may show standalone stimulating or inhibiting
effects on just phase I or phase II reactions, many whole foods and herbs have a modulatory effect on
the detoxification process as a whole; they may have a stimulating effect only when enzymatic activity is
low, or they may simply contain multiple compounds that have a number of different actions, resulting in
a net balancing effect on hepatic metabolism (Hodges & Minich, 2015).

Because the liver is the primary site of metabolic detoxification, keeping the liver in prime shape is one of
the ways we can reduce the eliminatory burden on the skin and the body as a whole. In the next section,
we’ll describe some of the specific foods and practices that can help support the liver’s detoxification
processes.

Dietary Support for Liver Health

Because phase I reactions are constantly creating reactive compounds, the body’s antioxidant stores
can easily be depleted if they’re not being replenished by the diet (Jeffery, 2006). Consequently, adding
foods and herbs that promote antioxidant activity, as will be discussed in Lesson 2, is one way to
protect against oxidative damage as a byproduct of phase I metabolism.

● Foods containing vitamins A, C, and E are excellent sources of dietary antioxidants; dark leafy
greens, including kale, collards, and spinach, contain all three of these vitamins, along with other
nutrients that support hepatic metabolism.
● Potent antioxidant herbs can also be included in the diet—green tea (Camellia sinensis), oregano
(Origanum vulgare), turmeric (Curcuma longa), and cocoa (Theobroma cacao) are all strongly
antioxidant herbs that also have a modulatory effect on hepatic detoxification systems (Hodges
& Minich, 2015).
● B vitamins (particularly B2, B3, B6, and B12) are necessary cofactors in phase I detoxification;
vitamin B12 also supports methylation, a phase II reaction (Romm, 2018). Dietary sources of B
vitamins include organ meats, eggs, spinach, sardines, and soybeans, tofu, and tempeh.
● Flavonoids found in virtually all colorful plant foods have antioxidant activity and support phase I
detoxification processes (Romm, 2018).
● Trace minerals (copper, selenium, zinc, and manganese) found in shellfish, seaweeds, and organ
meats act as phase I cofactors.

We can support phase II metabolism by making sure the body is replete with the requisite donor
compounds and cofactors.

● Brassicas and alliums contain multiple substrate compounds (glutathione, sulfate, and methyl
donor groups) and increase the activity of certain phase II transferase enzymes (Hodges &
Minich, 2015; Jeffery, 2006). Brassicas includes the dark leafy greens such as kale and collards


(which, as mentioned, also contain vitamins A, C, and E), as well as cabbage, cauliflower, and
many other vegetables; alliums include garlic, onions, leeks, and shallots.
● In addition to brassicas and alliums, other foods that boost production of glutathione, one of the
key substrates in phase II reactions, include spinach, egg yolks, whey protein, red peppers,
lentils, and oats (Romm, 2018).
● High-protein foods, particularly eggs, meat, and dairy, are ideal sources of the amino acids that
are necessary for methylation. (As we’ve noted in other lessons, meat and dairy should be
organic and/or pastured.)


Visit the course to download the Liver Supportive Foods & Herbs worksheet as a PDF.


Gingery Green Juice

Adapted from Aviva Romm (Romm, 2018).

This sweet-and-sour smoothie makes a great afternoon pick-me-up and comes loaded with vitamin C
and other antioxidants.

Ingredients

2 cups spinach, baby kale or chard, and/or parsley
½ cup berries, fresh or frozen
½ lemon, juiced (add the zest if you like it super-lemony!)
1-2 thin slices of fresh ginger root
1 thin slice fresh turmeric root OR ½ tsp turmeric powder
1 cup (1 fl oz) coconut milk, almond milk, or water

Optional add-ins:
1-2 tbsp chia seed
1 tbsp flax seed, ground
1 tsp milk thistle seed, ground

Directions

● Blend all ingredients in a high-powered blender or juicer; add more liquid as needed to get
your desired consistency.
● Stir in the chia, flax, or milk thistle seeds, if using.

This can also be made in a regular blender, but will be a little on the crunchy side! If using a standard
blender, you can shred fresh ginger and turmeric on a zester before adding to the blender, if desired.

Beet and Carrot Salad

With a combo of B vitamins, antioxidants, and the methyl donor betaine, beets are a liver-support
powerhouse! This simple slaw balances the earthy taste of raw beets with the sweetness of fresh
carrot; it can stand on its own as a winter salad, but also makes a great tangy topper for grain bowls,
tacos, and wraps or sandwiches. For best results, use fresh, crispy carrots in this recipe; save the
elderly ones for cooking!

Ingredients

1 large or 2 medium beets
4 carrots
2 tbsp (1 fl oz) fresh lemon juice
1 tbsp (0.5 fl oz) apple cider vinegar


1 tsp lemon zest (optional)

1 tsp raw honey (optional)
Salt and pepper to taste

Directions

● Scrub carrots thoroughly with a vegetable brush. (Although you can peel the carrots if you
want them extra-sweet, the skins contain beneficial nutrients, so it’s worth keeping carrots
intact if possible.)
● Peel the beets; trim tops and bottoms as needed.
● Shred beets and carrots using a box grater or food processor.
● In a medium bowl, combine the lemon juice, vinegar, a generous pinch of salt and pepper,
honey, and lemon zest, if using.
● Add the shredded beets and carrots and toss well to combine.
● Allow to sit for 15 minutes so the veggies can absorb the citrus and vinegar.
● Taste, and adjust seasoning as desired.

Kale and Shiitake Soup

Adapted from The Splendid Table (Hyams & O’Keefe, 2017).

Chock-full of vitamins A, B, and C, this beautiful green soup will keep you and your liver happy!

Ingredients

16 shiitake mushrooms
5 shallots, halved
4 garlic cloves
2 tbsp (1 fl oz) sesame oil
2 bunches kale, rinsed and roughly chopped
4 cups (32 fl oz) mushroom stock
½ lemon, juiced
½ tsp maple syrup
Smoked sea salt and cracked pink peppercorns to taste

Directions

● Preheat the oven to 375 degrees F.
● Place shiitake mushrooms, shallots, and garlic cloves (unpeeled) on a baking sheet and
sprinkle with sesame oil. Season with salt, and roast for 15-20 minutes.
● Place chopped kale in a large pan, and dry fry over medium heat until it is softened.
● Peel the roasted garlic and add the garlic, shallots, and four of the shiitake mushrooms to the
pan. Slice the remaining shiitake mushrooms, and set aside.
● Continue to sautée kale, garlic, shallots, and mushrooms for 2 minutes, stirring periodically.


● After 2 minutes, pour the stock, lemon juice, and maple syrup into the pan, then bring to a
boil. Lower heat to a simmer, and simmer for 15 minutes.
● Puree with an immersion blender, then add the sliced shiitake mushrooms and pink
peppercorns. Simmer for 2 minutes, and enjoy!

Choosing Hepatics for Skin Support

We can also support the liver with hepatic herbs.
Broadly speaking, any herb that promotes the
health of the liver can be considered a hepatic, so
it’s helpful to be more specific about how an herb
affects the function of the liver. Hepatic herbs are
generally hepatoprotective (protecting the cells of
the liver from damage), cholagogue and/or
choleretic (increasing the production or flow of bile
from the liver and gallbladder), or alterative. Some
hepatics are also true liver tonics—that is, they
help to restore normal hepatic function.

Because of their action to support eliminative
function, hepatic alteratives are frequently
indicated for skin conditions; cholagogues can
also help by easing digestive stagnation and
constipation that make the skin work eliminative
overtime. And in practice, most hepatic herbs will
offer more than one of these actions.

Research has indicated that many hepatic herbs
have an influence on the enzyme systems that are
involved in both phase I and phase II activity; this
may explain at least part of their action in the liver
and on metabolic processes. However, this in vitro
research does not always translate directly to the
effects of herbs in the body; there are many
enzymes involved in detoxification processes, and
as we’ve mentioned, herbs can have multifaceted
and complex effects, upregulating some enzymes while inhibiting others. To make it even more complex,
these effects can be dose dependent; some herbs inhibit enzyme activity at low concentrations, but
stimulate enzymes in high amounts (Bunce, 2014), and it can be difficult to extrapolate the amounts
used in research data into real clinical application.

Given all this complex cellular information, what’s an herbalist to do? Fortunately, we can rely on our
traditional systems of assessment and indication to help guide our choice of herbs.

Many skin conditions will present with classic heat symptoms, such as redness, irritation, or
itchiness—we may even be able to feel heat in the affected skin, or the skin may feel like it’s burning.
These hot conditions are often improved by the application of cooling topical herbs, which we’ll discuss
later in the course, as well as the internal use of cooling herbs, including cooling hepatics such as


Oregon grape (Berberis aquifolium) root, dandelion (Taraxacum officinale) root, yellow dock (Rumex
crispus) root, and yarrow (Achillea millefolium) aerial parts. These herbs are mildly stimulating to the liver
and are consequently sometimes even described as liver-warming herbs (because they stimulate liver
function, and stimulation is usually warming)—but nonetheless they generally have a beneficial cooling
effect on hot skin conditions and are energetically cooling.

It may be appropriate to use more warming hepatics, such as turmeric (Curcuma longa) rhizome or
schisandra (Schisandra chinensis) berry, when an individual shows overall constitutional signs of cold,
damp, and stagnation, even if their acute skin condition is hot. (Signs of cold include physically feeling
cold, lethargy, poor circulation, sluggish digestion, and metabolic hypofunction such as hypothyroidism.)
However, a very important caveat here is that the use of strong hepatic herbs—even those considered
cooling!—can sometimes worsen inflammatory skin conditions. It’s possible that this side effect may be
due to an imbalance between phase I and phase II reactions, with excess reactive metabolites triggering
an inflammatory cascade; it can be helpful to make sure the diet is replete with foods and herbs
necessary for both phases of detoxification, particularly emphasizing antioxidant and phase II support.

Oregon grape – Berberis aquifolium (Berberidaceae) – Root, bark

Various Berberis species are used in
Chinese medicine, Ayurveda, and North
American indigenous medicine; the common
name Oregon grape is applied to several of
the species native to the Western part of the
U.S. Although barberry (Berberis vulgaris) is
often thought of as North America’s premier
source of the key compound berberine,
Oregon grape has similar activity to barberry
and also has a high concentration of
berberine and other active alkaloids (Mirhadi
et al., 2018).

Actions: Alterative, antiemetic,
anti-inflammatory, antimicrobial, aperient,
astringent, bitter, cholagogue, choleretic, hepatic


Use: Eclectic physicians considered Oregon grape root to be one of the premier alteratives for use in
chronic skin conditions, particularly those with dry or scaly presentation, as well as acne, pruritis, and
other skin eruptions (Ellingwood, 1898/1983; Felter & Lloyd, 1892/1983).

Oregon grape was also favored by Eclectics to resolve psoriasis, and modern research gives us some
interesting insight into this use. Oregon grape root extract was shown to be more effective for
controlling characteristic hyperproliferation of skin cells than several other widely used drugs,
including hydrocortisone (Brinker, 2003). In a report compiled from three clinical trials of patients using
topically applied 10% Oregon grape cream for psoriasis, the researchers report that Oregon grape is a
safe and effective treatment for mild to moderate psoriasis (Gulliver & Donsky, 2005).


Oregon grape is a relatively strong bitter with a stimulating effect on the liver and gallbladder that
helps to promote the flow of bile and regulate sluggish digestion. It also has an astringent and
tonifying effect on the gut mucosa that can help to promote effective absorption. As an alterative,
Oregon grape works on several fronts simultaneously: supporting hepatic function, assisting nutrient
assimilation, and promoting elimination of waste through the colon; this constellation of effects may
be one of the reasons Oregon grape shines as an herb for chronic skin conditions that are rooted not
in the tissues of the skin, but in systemic accumulation of metabolic waste that taxes the body’s
eliminative system.

When utilizing Oregon grape for systemic skin conditions, both internal and external use is suggested.
Francis Brinker, N.D. (2003) notes that topical use of Oregon grape, specifically, has two advantages:
it allows direct contact of the alkaloids with affected tissues and it also addresses compliance issues
based on Oregon grape’s bitter taste.

Topical use is also appropriate to help stave off or resolve microbial infections, as Oregon grape and
its constituent berberine have antibacterial and antifungal activity (Bone & Mills, 2013). Oregon grape
has a cooling, drying effect that makes it suitable for use in addressing athlete’s foot, ringworm, and
other fungal infections of the skin and nails, which usually have a hot, damp presentation. For topical
use, Oregon grape decoction can be used as a wash or compress or made into a cream, or powdered
herb can be combined with clay in a skin powder.

Safety: Oregon grape root is contraindicated in pregnancy and should be used with caution during
lactation (Gardner & McGuffin, 2013).

Dose: Decoction: 3-6 g dried root/day divided into 1-3 doses; Tincture: 1-2 mL (1:2, 40%) 3x/day
(Mills & Bone, 2005).

Burdock – Arctium lappa (Asteraceae) – Root

Burdock is a biennial herb that can be grown
in the garden or harvested from the wild. The
root should be harvested in the fall of the
plant’s first year—this is the time when most
of the plant’s energy is in its root and it likely
has the highest inulin content. A traditional
food in Japan (where it is known as gobo),
nutrient-dense burdock can be considered a
superfood when it comes to skin health! Try
roasting, pickling, or adding it to your stir-fry
or soup!

Actions: Anti-inflammatory, alterative,
aperient, bitter, hypoglycemic, lymphatic,
prebiotic

Energetics: Cooling


Use: David Hoffmann (2003) has described burdock as a plant that helps to return the body to its
original, primal state of wellbeing. Observing its tenacious manner and its stubborn, hairy taproot, one
can see burdock’s profound ability to “root” through chronic conditions that have accrued over time
and tap into the forces of vitality and health to restore balance.

Burdock root contains inulin, which nourishes beneficial gut microorganisms and supports intestinal
health. As a mild bitter, burdock root also tonifies the digestive system by stimulating the secretion of
bile and other digestive secretions, improving appetite, digestion, and assimilation. Burdock’s
anti-inflammatory properties make it especially useful for individuals who are prone to acid reflux,
diarrhea, sour belches, and quick transit times—all of which can be a sign of heat in the digestive
tract.

Herbalist Matthew Wood teaches that burdock root is indicated for dry conditions where body tissues
need cleansing, increased secretions, and nourishment (Wood, 2008). This, in addition to burdock’s
bitter, lymphatic, and alterative nature, may help to improve digestion and the absorption of nutrients,
which can then be better distributed throughout the body.

These qualities also make burdock root an excellent ally for skin support; by tonifying digestive
function and stimulating lymphatic elimination, burdock helps reduce eliminative burden on the skin.
Wood recommends burdock root for any dry skin condition, as well as for blocked sebaceous glands
resulting in acne, boils, or papules; in contrast, herbalist jim mcdonald suggests that burdock’s
normalizing effect extends to the skin, and it is useful whether “the skin is too dry, too oily, or too oily
here and too dry there” (mcdonald, n.d., para. 11). For skin support, burdock can be used both
internally and topically; dry burdock root can be used in salve, and poultices of burdock leaf have a
drawing, cooling, and astringent quality that can be useful for burns, cystic acne, or other skin
eruptions.

According to mcdonald, burdock root is best used as a long-term balancing and nourishing tonic and
is not ideal for a quick response to acute conditions; burdock seed has similar lymphatic and alterative
properties and may elicit a faster response, but lacks the root’s nutritive and tonifying qualities
(mcdonald, n.d.).

Safety: Individuals with allergic sensitivity to Asteraceae (daisy) family plants may be sensitive to
burdock.

Dose: Decoction: 6-18 g dried root/day divided into 1-4 doses; Tincture: 2-4 mL (1:5, 30%) 3x/day
(Kuhn & Winston, 2008).

Spiced Burdock Bitters

A traditional preparation for stimulating appetite and digestion before meals (or supporting healthy
digestion afterward), aromatic bitters take many forms. This version combines burdock with other
aromatic, bittersweet ingredients—angelica root, cacao nibs, and cardamom seed—for a carminative,
tasty blend that is lovely on its own, or added to club soda or ginger ale.


Ingredients

2 tbsp burdock (Arctium lappa) root
1 tsp angelica (Angelica archangelica) root
1 tsp roasted chicory (Cichorium intybus) root
1 tbsp cacao (Theobroma cacao) nibs
½ tsp cardamom (Elettaria cardamomum) seed
2 tsp ginger (Zingiber officinale) rhizome

Directions

● Combine dried herbs in an 8-ounce glass jar and cover with brandy.
● Cap, label, and store in a cupboard. Check back the next day and top off with brandy, if
needed, to cover herbs after they have absorbed some of the menstruum.
● Macerate for 4-6 weeks, gently shaking the jar every few days.
● Strain, bottle, and label.
● Take a dropperful or two before meals to aid digestion.

Reishi – Ganoderma lucidum (Ganodermataceae) – Mushroom

Reishi is a beautiful fungus with a long and
venerable history of use in Chinese medicine
and other Asian medical traditions. Reishi
modulates the immune response and is also
used to tonify the lungs, and is said in
Chinese medicine to nourish the Heart and
calm the shen, or spirit, promoting a sense
of calm, contentment, and grounding.

Actions: Adaptogen, antioxidant,
anti-inflammatory, antiviral, cardioprotective,
hepatic, hypotensive, hypolipidemic,
immunomodulant, kidney tonic, lung tonic,
nervine

Energetics: Drying and neutral to warming

Use: Like many other bioactive mushrooms, reishi is an excellent immunomodulant that can be
effective whether the immune system is hyper- or hyporeactive; it helps to stimulate the activity of
lymphocytes and other immune effector cells, but can also help re-balance immune hyperactivity
toward normal function (Bhardwaj et al., 2014).

Reishi assists the liver in metabolic detoxification by modulating phase I CYP enzymes and stimulating
the activity of phase II enzymes (Wasser, 2005). This combination of immunomodulant, hepatic, and
alterative activity makes reishi a useful ally for those with allergies, atopic eczema, and other
manifestations of hyperactive immunity and eliminative overload. Because it also supports lung


deficiency, reishi is particularly indicated for the atopic triad of eczema, allergies, and allergy-induced
asthma.

With its combination of immunomodulant and anti-inflammatory properties, reishi may also be useful
for support with autoimmune conditions affecting the skin; reishi is traditionally used internally, but
topical treatment with reishi has been reported to significantly improve cutaneous sarcoidosis lesions
(Kurtipek, 2016) and psoriasis (Bhardwaj, 2014).

Reishi can be quite drying when used internally; for those with dry conditions or constitutions,
including tendency to dry skin, it may be important to balance with moistening herbs to avoid
aggravating symptoms.

Extra care is required when preparing reishi as a decoction or tincture to fully extract its beneficial
constituents. Decoctions should be allowed to simmer for a minimum of 1 hour, and can benefit from
a much longer extraction, up to 24 hours. (A slow cooker can be an excellent tool here!) There are
some extra steps required when making a mushroom tincture, so if you’re planning to make your own,
take time to do a little research on the best methods first—that way you can be sure you’ll get the
most benefit out of your extract!

Safety: Reishi should be used with caution in individuals taking immunosuppressant, anticoagulant, or
antiplatelet medications and should be avoided by individuals with mushroom allergies (Gardner &
McGuffin, 2013).

Dose: Decoction: 3-12 g dried mushroom/day divided into 1-3 doses; Tincture: 4-8 mL (1:5, 30%)
3x/day (Kuhn & Winston, 2008).

Roasty Reishi Roots Tea

The roots and mushrooms in this tea really need a long slow extraction, so making a large batch in a
crockpot is ideal! You can also scale this recipe down to smaller batches, if you prefer.

Ingredients

4 slices reishi (Ganoderma lucidum) mushroom
¼ cup burdock (Arctium lappa) root
¼ cup roasted dandelion (Taraxacum officinale) root
1½ tbsp cardamom (Elettaria cardamomum) seed (or 2-3 tbsp if using whole pods)
2 tbsp coriander (Coriandrum sativum) seed
2 tsp cinnamon (Cinnamomum verum) bark chips
2 tsp black pepper (Piper nigrum) fruit
Pinch sea or mineral salt

Directions

● Crush the cardamom, coriander, cinnamon, and black pepper in a mortar and pestle. Use your
hands to break the reishi slices into smaller pieces.


● Combine all ingredients in a slow cooker; cover with 5 cups water.

● Cook on low heat for 4-8 hours; this works well as an overnight preparation.
● Strain and compost or discard the herbs.
● Add the salt.
● This tea can be enjoyed as is, warm or cool, or can be dressed up as you like with a bit of
honey, maple syrup, milk, or non-dairy milk. Store any unused tea in the refrigerator for up to
2 days.


Visit the course to download the Alteratives & Hepatics worksheet as a PDF.


CONCLUSION

By taking a broader view of the body, we can see that the skin functions as one organ within an
interconnected network. Although we may not think of the skin as first and foremost an eliminatory
organ, by supporting this crucial function of the skin—and the body as a whole—we can get to the root
of a number of skin troubles.

In this lesson, we focused on the liver as an allied system for skin function. In the next lesson, you’ll learn
more about another key area for skin health, the digestive system, as we explore the connections
between diet, digestion, and skin health.

RECOMMENDED RESOURCES

How to Make a Medicinal Mushroom Double-Extraction Tincture (Herbal Academy Blog):
https://theherbalacademy.com/make-medicinal-mushroom-double-extraction-tincture/
The Role of Herbs in Detoxification (Video):
https://wholisticmatters.com/the-role-of-herbs-in-detoxification/


LESSON 2: NUTRITION FOR HEALTHY

SKIN

INTRODUCTION

In this lesson, we’ll talk about some specific nutrients and dietary patterns that support skin health.
Much of what we know about how nutrition affects the skin—or anything else in the body,
really!—comes from research on isolated constituents, such as lycopene extract or vitamin C, rather
than whole foods or specific dietary patterns. For one thing, it’s a lot easier to conduct controlled studies
on supplements than on foods: it’s much simpler to give participants a couple of pills or a placebo than
it is to engineer and monitor their entire diet for months or years! There is also more financial incentive to
conduct expensive clinical trials on supplements that can be patented and marketed, rather than
researching the effects of foods that anyone can buy and sell.

But does that mean we need to take vitamin pills or other supplements?

There is a slew of benefits to relying on whole foods for our nutrition. Fruits and vegetables come loaded
with a range of vitamins and minerals, along with fiber and a cocktail of beneficial phytonutrients that are
only found in plants. Another consideration is the biological activity or bioavailability of whole foods
compared to supplements. Many supplements include synthetic molecules that may not be
well-absorbed, or may lack the cofactors that are necessary for their uptake and use in the cells of the
body.


Increasingly, nutrition researchers are recognizing (or perhaps we should say remembering!) that foods,
as we find them in nature, are a complex mixture of many different constituents, and the combination of
all of these different nutrients together within foods can actually be much more beneficial than
consuming isolated nutrient extracts. Thousands of different phytonutrient compounds have been
identified in foods, so it’s simply not possible to replicate the natural diversity of plant chemistry through
the use of supplements alone (Liu, 2003). This is a very simple, very old idea made new again—it’s
sometimes called “food synergy” or “food-first nutrition”—but frankly, it just means “Eat real food!”

When it comes to clinical research, we can sometimes extrapolate from supplements to foods. For
example, if lycopene supplements help protect the skin, then adding lycopene-rich tomatoes, red
grapefruit, and watermelon to our diet may confer the same benefit, along with providing a boost of fiber
and other phytonutrients that are conveniently packaged together in fruits and vegetables! However, it’s
important to take note of how much of a supplement or substance is required to get the benefits
described. For example, let’s say research shows that taking 5 grams per day of supplemental fish oil
gives sun-protection benefits—you’d have to eat almost a pound of wild salmon every single day to get
that amount of fish oil (Seafood Health Facts, 2018)!

So while we can rely on a nutrient-dense, varied diet as the basis for most of our nutritional needs,
supplements may be useful, at times, for specific additional support. And, of course, we’re all unique:
some individuals have particular health concerns, such as digestive issues or genetic variations that
affect nutrient absorption or metabolism. The information provided here is a good starting point, but
individual concerns are best addressed with the support of a nutrition professional.

OXIDATIVE DAMAGE AND ANTIOXIDANTS

In Unit 1, you learned about some of the extrinsic (external) factors that cause skin damage, such as
ultraviolet (UV) radiation exposure and tobacco smoke. Let’s look a little more closely at how these kinds
of factors damage skin cells, and what you can do about it.

There’s a common denominator between exposure to UV radiation from sunlight and other radiation
sources, certain chemicals (like those found in cigarettes, pesticides, and cleaning products), and
naturally occurring ozone from the atmosphere: they all cause oxidative stress, the primary trigger for
skin damage and visible signs of aging.

Oxidation is a chemical reaction between unstable, oxygen-containing molecules—called free radicals,
or reactive oxygen species (ROS)—and other molecules. Oxidation is a common, naturally occurring
reaction within the body, and it can be either beneficial or harmful.

Antioxidants are molecules that help stabilize ROS without becoming unstable in the process—they
serve as a natural check and balance system. Some antioxidants are endogenous (produced within the
body), while others are exogenous (they come from the foods we consume). When more ROS are
produced than can be balanced by the body’s existing antioxidant capacity, the resulting oxidative
stress causes damage to lipids, proteins, and DNA (deoxyribonucleic acid, the cellular material that
carries genetic information).

Oxidative stress results in damage to fats and proteins in both the dermal and epidermal layers of the
skin, and is directly associated with the development of skin wrinkling (Purba et al., 2001). Specifically,
oxidative reactions cause protein cross-linking that damages the collagen and elastin matrix that gives
the dermis its structure, and impairs the function of most skin cells, including Langerhans cells,
melanocytes, keratinocytes, and fibroblasts (Dalle Carbonara & Pathak, 1992). Oxidative stress also


drives the development of skin cancers—particularly due to UV radiation exposure (Katta & Brown,
2015)—and plays a role in inflammatory skin conditions like rashes, psoriasis, and eczema (Wagener et
al., 2013).


Visit the course to download the Reactive Oxygen Species & Antioxidants worksheet as a PDF.


Since oxidative stress causes skin damage, and antioxidants counterbalance oxidative stress, it only
seems logical that increasing the amount of antioxidants in the body should help prevent skin damage,
right? Well, yes—but it’s a little more complicated than that.

For one thing, it’s important to remember that not all antioxidants are the same; our endogenous
antioxidant system relies on a complex interaction of many enzymatic processes working in concert.
There are hundreds of substances that act as antioxidants, and each molecule or compound will have
many actions throughout the body in addition to acting as an antioxidant. And while many antioxidant
compounds have been researched for their health benefits (both in the skin and throughout the body),
studies can’t always determine if positive outcomes are actually due to their antioxidant activity or some
other effect. Other chemical reactions and bodily processes also contribute to skin health and aging;
although providing antioxidant support certainly appears to be beneficial for the skin, it’s not a magic
bullet—just because something has antioxidant capacity, that doesn’t mean it’s automatically going to
prevent or reverse signs of aging!

However, there are some specific nutrients that do have substantial evidence to support their benefits
for skin health—in general, and perhaps not surprisingly, these tend to be the antioxidant compounds
that are naturally found in the skin, such as vitamins C and E, beta-carotene (a precursor of vitamin A)
and other carotenoids, and coenzyme Q10 (Rinnerthaler et al., 2015). In addition to antioxidant activity,
these compounds have other beneficial effects that help to prevent chronic disease and inflammation
(Yahia, 2018), including prevention of skin damage.

It’s worth noting here that some research has found that high doses of isolated antioxidant supplements
may have some negative health consequences. For example, some studies from the 2000s found an
increased association between high doses of vitamin E and prostate cancer, and beta-carotene and lung
cancer—however, these results have not been consistently upheld by more recent research (Klein et al.,
2011), so at this point the jury is still very much out regarding the risks of supplemental antioxidant
therapy.

Fortunately, the same risks don’t apply to dietary consumption of antioxidant-rich foods. Many fruits,
nuts, legumes, and veggies are rich in protective antioxidants and, as mentioned, have a slew of other
health benefits to boot—so go ahead and get your five (or 10!) a day. Many herbs and spices are also
highly antioxidant, including some of the herbs we come across most routinely in our diets: coffee,
cocoa, tea, and even common culinary spices like rosemary, mint, allspice, and cloves (Carlsen et al.,
2010). Generally speaking, plant-derived foods are much higher in antioxidant activity than
animal-derived foods (Carlsen et al., 2010), so eating a plant-centric diet, including nutritive herbs, is a
great foundation to help make sure your body is replete in antioxidants.


NUTRITIONAL SUPPORT FOR THE SKIN

Vitamin C

Like most organs, normal, healthy skin contains a high amount of vitamin C. In addition to its protective
antioxidant function, vitamin C is an essential cofactor for collagen production, and insufficient vitamin C
leads to degradation of the collagen matrix that provides the structure of the skin’s connective tissue
(Pullar et al., 2017). Extreme vitamin C deficiency, known as scurvy, causes extensive bruising and skin
fragility that can lead to severe skin damage and ulceration; more mild vitamin C insufficiency is linked
with poor wound healing and keratosis of the hair follicles, particularly on the upper arms (Schagen et al.,
2012).

Because of its role in collagen production and its antioxidant activity, vitamin C may protect against skin
damage and wrinkling and has been suggested as a therapy to prevent or reverse skin
hyperpigmentation, such as age spots and melasma, though this hasn’t been conclusively demonstrated
in clinical trials (Pullar et al., 2017).

Several clinical trials have indicated that increased dietary intake of vitamin C can contribute to
improvement in overall skin health and appearance, resulting in both reduced markers of oxidation and
in visible changes such as skin elasticity, moisture, evenness, and dark spots. Notably, the most
significant improvements seem to result from a combination of antioxidants rather than monotherapy
with vitamin C alone (Pullar et al., 2017). In some studies, antioxidant supplements derived directly from


foods, such as a fermented papaya extract, were found to be even more effective than a combination of
synthetic antioxidant vitamins and minerals (Bertuccelli et al., 2016).

Foods rich in vitamin C include red, yellow, and green peppers, kale, broccoli, spinach, guava,
strawberries, oranges, papaya, lemon, and kiwi (United States Department of Agriculture [USDA], 2019).
Some herbs, such as parsley leaf, ginger root, violet leaf, and hibiscus flower contain an appreciable
amount of vitamin C as well (Murray et al., 2005, Pedersen, 2010). Exposure to air quickly destroys the
vitamin C content of food, therefore it is important to eat cut fruit and vegetables as soon as possible
after preparation (Murray et al., 2005). Canning and cooking at high heat also destroy vitamin C (El-Ishaq
& Obirinakem, 2005), as does drying (Santos & Silva, 2008); fresh fruit and vegetables should be
prepared either raw or lightly steamed in order to maximize vitamin C content.

Vitamin E

Vitamin E is another essential nutrient necessary
for skin health. Whereas vitamin C is water
soluble and primarily found in the cytosol (the
intracellular fluid), vitamin E is fat soluble, and
primarily found in the cellular membrane and
other lipid structures. Vitamins C and E appear to
work synergistically, and their antioxidant and
photoprotective effects are dramatically increased
when taken together (Pullar et al., 2017). There
are actually two families of compounds that make
up vitamin E: tocopherols and tocotrienols. Any of
the compounds within these families may be
loosely referred to as vitamin E, although most
dietary sources and supplements are tocopherols.

Tocopherols in vitamin E help to stabilize cell
membranes and prevent oxidation to the fatty
acids found in the skin; this inhibits collagen
cross-linking that contributes to the appearance
of aging (Schagen et al., 2012). Vitamin E
supplementation has been shown to help resolve
a number of skin disorders that result in visible
pathology and deformation of the skin surface,
and to help with wound healing; there is some
clinical evidence that it may be beneficial in
treatment of atopic dermatitis (eczema), psoriasis,
and autoimmune skin conditions such as
scleroderma and lupus (Keen & Hassan, 2016).

In its tocopherol form, vitamin E is found in the oily parts of all grains, seeds, and nuts. Some particularly
good sources include sunflower seeds, whole wheat (containing wheat germ), almonds, hazelnuts,
avocados, seaweed, and spirulina (USDA, 2019).


Carotenoids

Carotenoids are a group of many different nutrients that, collectively, give fruits and vegetables their red,
yellow, and orange colors. The most prevalent dietary carotenoids are alpha-carotene, beta-carotene,
lutein, lycopene, and zeaxanthin (Pérez-Sánchez et al., 2018). Alpha- and beta-carotene are metabolized
by the body to make the active form of vitamin A, so they’re sometimes described as “provitamin A.” In
general, carotenoids act as antioxidants, and particularly as photoprotectors against UV radiation
damage.

Some studies have found that oral administration of either a beta-carotene supplement or a
carotenoid-rich diet reduced burning from UV light exposure (in other words, sunburn) (Stahl & Sies,
2002). Many studies have demonstrated the effect of carotenoids in preventing damage from sun
exposure, but there is little evidence that carotenoid supplements can help to reverse visible signs of
existing sun damage.

However, carotenoids can be helpful in promoting general skin health and appearance; clinical trials
have found that a combination of antioxidant supplements, including carotenoids, selenium, and
tocopherols, improved parameters of skin health such as roughness, thickness, and scaling (Heinrich et
al., 2006), and that both oral and topical use of carotenoids can improve skin hydration and elasticity
(Palombo et al., 2007). In general, it appears that carotenoids are most effective when used in


combination with other types of antioxidant molecules—in other words, as they would naturally be found
in foods!

The colors of plant foods are a natural advertisement for the nutrients they contain. Virtually all
orange-colored vegetables, including carrots, pumpkins, and sweet potatoes, are high in alpha- and
beta-carotene. Some green vegetables, such as spinach, turnip greens, kale, and parsley, also contain
alpha- and beta-carotene, along with lutein and zeaxanthin (USDA, 2019). Lycopene is predominantly
found in red- or pink-colored fruits and vegetables including tomatoes, red peppers, guava, papaya,
grapefruit, and watermelon.

Coenzyme Q10 (CoQ10)

Coenzyme Q10 (CoQ10) is sometimes considered “the essential non-essential nutrient.” It’s technically
non-essential, because (unlike vitamins) it can be synthesized by the body—but practically speaking, it’s
truly essential for cellular energy transfer and is consequently found in virtually all human cells. CoQ10 is
normally found in epidermal and dermal cells, and in the skin surface lipids of the stratum corneum
(Knott et al., 2015).

CoQ10 is also an important cellular antioxidant. Like vitamin E, it helps prevent oxidative damage to
cellular membranes, and like vitamin C, it participates in the regeneration of vitamin E (Addor, 2017).
CoQ10 also promotes collagen production and helps to prevent enzymatic breakdown of collagen and
elastin (Vollmer et al., 2018).

CoQ10 levels in the skin naturally decline with age and in response to UV radiation exposure. Clinical
trials have found that oral supplementation with CoQ10 can improve some visible signs of skin damage
and aging, including elasticity, smoothness, and the appearance of fine lines and wrinkles (Žmitek et al.,
2017).


Plant Polyphenols

Flavonoids and other polyphenolic compounds have also received a lot of attention for their potential in
mitigating signs of aging and UV radiation damage in the skin.

First, a little background chemistry. Phenolic compounds include a broad range of molecules that,
collectively, are found in most plants. They can be classified into flavonoids (including flavones,
isoflavones, and anthocyanidins) and non-flavonoid compounds (phenolic acids, lignans, and tannins).
Most of the phenolic compounds in plants have more than one phenol ring in them, so they’re described
as polyphenols—poly means “many.” Flavonoids are the most common and abundant dietary
polyphenol (Działo et al., 2016)—virtually all plants and plant-derived foods contain flavonoids.

In general, many of the benefits of phenolic compounds come from their antioxidant and
anti-inflammatory effects as well as their ability to support the body’s innate detoxification mechanisms
(Davinelli et al., 2018). Many polyphenolics, including most flavonoids, have low bioavailability (Higdon et
al., 2016), but they are metabolized in the liver into secondary compounds that have a range of
anti-inflammatory and antioxidant activities; in the skin, this includes prevention of collagen breakdown,
increased production of collagen precursors, and prevention of oxidative damage to cellular lipids
(Davinelli et al., 2018). Some phenolics also have the capacity to absorb UV radiation, so in addition to
counteracting the oxidative damage caused by UV radiation, they may also have some direct sun
protection factor (SPF) capacity when applied directly to the skin, acting in a similar manner to
sunscreen (Davinelli et al., 2018; Działo et al., 2016). When consumed or applied topically, polyphenolics
may be helpful in addressing inflammatory skin disorders such as eczema, psoriasis, and rosacea
(Działo et al., 2016). Flavonoids—particularly the flavanols found in cocoa—can also increase circulation
to the skin when incorporated into the diet, supporting skin health and appearance by improving delivery
of oxygen and nutrients (Neukam et al., 2007).


While almost all polyphenolic compounds have some degree of antioxidant and anti-inflammatory
effects, it’s important to realize that this is a very large and diverse group of phytochemicals—there are
thousands of different known phenolic compounds in plants—and variation in their individual molecular
structure will modulate their effects, as well as their ability to penetrate the skin (Działo et al., 2016). In
general, while all polyphenolics have the potential to exert beneficial anti-inflammatory and antioxidant
effects in the skin and throughout the body, a more nuanced look at the constituents of individual foods
and herbs will help determine exactly which polyphenolic compounds may be most appropriate for
supporting the skin.

Some of the most-researched polyphenolic compounds for skin health are epigallocatechin-gallate
(EGCG), found primarily in green tea (Camellia sinensis) leaf; resveratrol, found in grape skins (and also
red wine) and Japanese knotweed (Reynoutria japonica) root; and curcumin, from turmeric (Curcuma
longa) rhizome (Davinelli et al., 2018).

Trace Minerals: Copper, Zinc, and Selenium

Copper, zinc, and selenium are essential trace minerals that are crucial for maintaining skin health. All
three promote the expression of endogenous antioxidant molecules and help prevent lipid peroxidation
(Vollmer et al., 2018). Zinc and copper are cofactors for collagen formation (Low Dog, 2016), while
copper and selenium both help to stabilize and prevent the enzymatic breakdown of collagen and elastin
(Borkow, 2014; Vollmer et al., 2018).


It’s important to use caution when supplementing with some trace minerals, since both copper and zinc
can cause liver toxicity when they overaccumulate in the body (Borkow, 2014; Low Dog, 2016). For daily
use, it’s suggested to rely on dietary sources of these trace minerals in combination with a balanced
multivitamin-mineral complex when needed (Low Dog, 2016).

Oysters and other shellfish, organ meats, sunflower seeds, pumpkin seeds, aduki beans, lima beans,
black beans, hazelnuts, and almonds are good sources of all three minerals, while Brazil nuts are notable
for being among the highest dietary sources
of selenium (USDA, 2019).

Essential Fatty Acids
(EFAs)

As discussed in Unit 1, lipids are an essential
component of the skin—they make up a large
portion of individual cell membranes and play
an integral role in maintaining the skin’s
barrier integrity. The type of dietary fats we
consume directly influences the composition
of the fatty acids and other lipids found in the
skin, and can also affect chemical signaling
molecules (eicosanoids) that play a role in
skin inflammation (Angelo, 2012).

There are two general families of essential
fatty acids (EFAs)—the omega-3 and
omega-6 types—and both are important for
skin health. EFA deficiency causes dry skin,
dermatitis, and reduced epidermal barrier
function (Angelo, 2012). EFAs are considered
“conditionally essential” for some other
tissues in the body—that is, we can either get
them from our diet or they can be synthesized
within the body from other lipid molecules.
Since the cells of the skin lack the enzymes
needed to produce the functional form of
these fatty acids (Chapkin & Ziboh, 1984),
EFAs are truly essential for the skin: we have
to get them from our diet, and our skin can’t
function properly without them (Angelo,
2012).


Visit the course to download the Omega-3 Pathway worksheet as a PDF.


The omega-6 EFAs are relatively common in the American diet, since they’re found in vegetable oils,
nuts, seeds, and some vegetables. Omega-3 EFAs can come from plant sources (such as walnuts and
hemp, pumpkin, chia, and flax seeds) or animal sources (primarily oily fish, including salmon, herring,
and mackerel). However, plant sources contain only one type of omega-3, alpha-linolenic acid (ALA),
which must then be converted by the body into the other essential omega-3 EFAs, eicosapentaenoic
acid (EPA) and docosahexaenoic acid (DHA). Conversion of ALA to EPA and DHA is not a very efficient
process, so practically speaking, we need to have some direct intake of EPA and DHA in order to meet
our nutritional needs (Angelo, 2012). Vegetarians may benefit from taking an algae-based omega-3 DHA
or DHA/EPA supplement.

Topical application of oils rich in EFAs can also help correct fatty acid deficiency in the skin, and may be
the most efficient way of resolving its cutaneous symptoms since the lipids are delivered directly to the
skin (Angelo, 2012).

SUPPORTING COLLAGEN PRODUCTION

You may remember from Unit 1 that much of the structure of the dermis is composed of collagen, a
protein that’s found abundantly throughout the body. Collagen production declines with age and as a
consequence of UV radiation exposure and oxidative stress, and the breakdown of dermal collagen is a
key factor in skin wrinkling.


Collagen is generated within the body from dietary nutrients: amino acids from proteins, plus vitamin C,
zinc, and copper, all of which can be found in a balanced whole foods diet. Collagen is found in the skin,
bones, and connective tissue of animals, which is why bone broth (stock made from boiling chicken,
beef, or other animal bones) is often touted for its collagen content. In order to be digestible, the
long-chain amino acids in collagen need to be broken down into smaller amino acid chains, or peptides,
through the process of hydrolysis. Heat is one way to do this; in the long cooking process used to make
bone broth, intact animal collagen is broken down into gelatin, which is partially hydrolyzed collagen. (Of
course, it’s important to think about other considerations for the source of animal products, including
bones and bone broth—it won’t help our overall health if we’re adding antibiotics, residual hormones, or
other pro-inflammatory compounds along with our collagen boost! It’s best to use organic, pastured
animal bones when making stock or bone broth.)

Collagen is also a popular dietary supplement, and an ingredient in many topical skin care products,
particularly anti-aging products. Collagen supplements and powders are usually made from hydrolyzed
collagen, also called collagen peptides. Numerous controlled clinical trials have shown that consumption
of hydrolyzed collagen products increased dermal collagen deposition and improved dryness,
roughness, wound healing time, and wrinkle depth (Vollmer et al., 2018). It’s worth noting that many of
these trials are funded by product manufacturers—but they do provide a growing body of evidence in
support of the potential benefits of hydrolyzed collagen products. Most collagen supplements are
derived from bovine collagen; although there are no vegetarian collagen supplements, some collagen
supplements, usually marketed as “marine collagen,” are derived from fish skin and scales.

Although there are many skin creams and other products that include collagen peptides, topical
application of collagen is unlikely to do much for skin structure and appearance, since the molecular
weight of collagen is too high to allow it to penetrate the epidermis (Baumann & Baumann, 2009).

Bone Broth Three Ways

Bone broth is inexpensive and easy to make at home; you can make it on the stove top in a large stock
pot, or use a pressure cooker or slow cooker if you have one. You don’t have to follow a recipe
precisely to make a good bone broth, but here’s one that will get you started! This recipe includes
options for stove top, pressure cooker, and slow cooker.

Soup bones from pastured or grass-fed animals can be purchased from many grocery stores and
butchers, either frozen or fresh; you may also be able to get them at your local farmers market. You
can also recycle bones you’ve used in other roasted meat dishes into bone broth—instead of
composting your leftover bones, put it in the stock pot!

Ingredients

3-4 pounds mixed chicken, turkey, beef, and/or lamb bones
2 medium carrots, roughly chopped
1 large red or yellow onion, quartered
2-3 stalks celery, roughly chopped
1 bay leaf
⅛ cup (1 fl oz) apple cider vinegar
1 tbsp salt


Optional add-ins: fresh or dry mushrooms, garlic, ginger, parsley, and/or other herbs (burdock root,
astragalus root, and nettle leaf are great herbal additions!)

Directions

● Optional: To bring out a richer flavor in your broth, you can start by tossing the bones with
olive oil and roasting them in a 400 degree F oven for about 45 minutes. You can skip this
step, or even better, use leftover bones from previously cooked meats—bones leftover from
roast chicken are ideal here!
● Combine all ingredients in a large stock pot, pressure cooker, or slow cooker. Since this
recipe includes vinegar, it’s best not to use a cast iron pot, which can produce an “off” flavor.
● Add water to cover, making sure the ingredients are covered by a few inches. (If you’re using
a pressure cooker, make sure you don’t exceed the maximum water line!)
● Follow one of the methods below to cook the broth:

Stove top method: bring water to a rapid boil over high heat, then reduce heat to lowest setting. Cover
and cook for 12-24 hours. Check the pot periodically and skim foam off the top as needed. Add water
as needed to keep everything submerged.

Slow cooker method: Cover and cook on high for 1 hour, then reduce to low heat and cook an
additional 12-24 hours. Check the pot periodically, and skim foam off the top as needed. Add water as
needed to keep everything submerged.

Pressure cooker method: Seal the lid and cook at high pressure for 2 hours. Allow the pressure to
release naturally.

● At the end of this time, the broth should be somewhere between golden brown and a very
dark brown, depending on the type of bones and extra ingredients you’ve used. There may be
foam on the top, which you can skim away; the broth may be very cloudy (or not), and the
bones may have crumbled (or not)—that’s all okay!
● Allow the broth to cool a bit for easier handling, then strain through a fine mesh sieve or
cheesecloth to remove the solids.
● Store in the refrigerator or freezer. As the broth cools, fat may solidify on top; this can be
incorporated into other cooking or left with the broth. The broth may also take on a gelatin-like
solidity once it’s chilled—that’s okay, too! It will liquify again when reheated.
● Broth can be stored in the refrigerator for five days or frozen for later use. If the bones have
not crumbled, they can be stored in the freezer and included in your next pot of broth.

AGING AND AGEs

We know that exposure to tobacco smoke and UV radiation can trigger oxidative stress that ultimately
damages the skin. Another source of oxidative stress and skin damage we haven’t covered yet comes
from AGEs, which stands for advanced glycation end products.

AGEs are formed during a chemical reaction between sugars and proteins—otherwise known as the
“Maillard reaction.” We can see this process at work in the kitchen, where it results in the golden color of
toast and those delicious crispy-brown bits of roasted veggies. AGEs can come from the
diet—particularly from charred, grilled, or broiled meats and other animal products (Uribarri et al.,


2010)—but they also form in the body, particularly in response to elevated levels of blood glucose
(Gkogkolou & Böhm, 2012).

While AGEs are normal substances in both the diet and in the body, elevated levels of AGEs can be
problematic, since they trigger oxidative stress and pro-inflammatory cellular activity (Uribarri et al.,
2010). This is a relatively new area of exploration, but AGEs do appear to be associated with the
development of many chronic diseases (Uribarri et al., 2010).

AGEs accumulate naturally in the skin as it ages; tobacco use, exposure to UV radiation, consumption of
dietary AGEs, and high blood sugar levels all increase the presence of AGEs in the skin and other tissues
(Gkogkolou & Böhm, 2012). The damaging effects of AGEs include breakdown of collagen and elastin,
decreased cell regeneration, loss of elasticity, and increased inflammation (Gkogkolou & Böhm, 2012),
so avoiding formation and accumulation of excess AGEs may promote the maintenance of healthy skin.
A diet that is rich in plant-based foods, minimizes charred, grilled, or broiled meats and animal products,
and avoids the excess sugars and refined carbohydrates that cause elevated blood glucose is likely to
help reduce accumulation of AGEs in the body.

PUTTING IT TOGETHER: DIETARY PATTERNS

We’ve covered some of the most important individual nutrients for healthy skin—but what does this tell
us about the types of foods we should eat?

As mentioned above, controlled clinical studies on dietary interventions are hard to come by. One
observational study in Australia determined that certain foods do seem to protect against visible skin
damage, particularly skin wrinkling; diets emphasizing fruits and vegetables, legumes, fish, and olive oil
were the most protective against skin wrinkling (Purba et al., 2001). Another observational study found
that regular consumption of dark leafy vegetables and citrus fruits appeared to have a protective effect
against the development of skin cancers (Fortes et al., 2008).

Putting this together with the nutritional information we’ve just covered brings us back around to a few
common sense, skin-friendly dietary guidelines.

● Eat plenty of fruits and vegetables!
● Eat the rainbow—consuming fruits and veggies from across the color spectrum will help ensure
you get a diversity of plant nutrients in your diet, including a range of carotenoids and
polyphenols.
● Include healthy fats from multiple sources such as oily fish, olive oil, and nuts and seeds in your
diet.
● Limit consumption of excess sugars and refined carbohydrates to help maintain stable blood
sugar levels.
● Include skin-supportive nutrients in your diet, such as vitamin C, vitamin E, carotenoids, copper,
zinc, selenium, flavonoids, and essential fatty acids.


Visit the course to download the Skin Friendly Dietary Guidelines worksheet as a PDF.


CONCLUSION

We know there’s no such thing as a one-size-fits-all diet, and our ideas about what constitutes a
“balanced diet” have certainly changed over the years. Yet there’s plenty of evidence to show that a
nutrient-dense, whole foods diet, including a diversity of fruits and vegetables, can boost our antioxidant
defense system, promote connective tissue integrity, and support the appearance and function of the
skin.

Consuming the nutrients and foods we’ve covered here is just one way we can approach skin health
from the inside. In the next lessons, we’ll explore the interaction between the skin, the digestive system,
and the liver, including more foods—and lots of herbs!—that help to build the foundation for healthy and
radiant skin.


Nutrients in Skin Health from Linus Pauling Institute’s Micronutrient Information Center, Oregon State
University: https://lpi.oregonstate.edu/mic/health-disease/skin-health
Nutritional Herbology by Mark Pedersen
Nutritional Skin Care: Health Effects of Micronutrients and Fatty Acids by Esther Boelsma, Henk F.J.
Hendriks, and Len Roza: https://academic.oup.com/ajcn/article/73/5/853/4739553
Staying Healthy with Nutrition, 21st Century Edition: The Complete Guide to Diet & Nutritional Medicine
by Elson M. Haas and Buck Levin
The Encyclopaedia of Healing Foods by Michael Murray, Joseph Pizzorno, and Lara Pizzorno


LESSON 3: DIGESTIVE HEALTH AND

THE SKIN

INTRODUCTION

The digestive tract and the skin have quite a bit in common, starting with the huge amount of physical
space that they occupy on and in our bodies—these are our largest organs, after all! The gut and the
skin also share critical roles as the primary interface with the outside world: these systems serve as
gatekeepers against pathogens of all sorts, and they are vitally important in maintaining the body’s
homeostasis. In addition, both operate as neuro-immuno-endocrine organs, in the sense that they
participate in and mediate complex exchanges between the nervous, immune, and endocrine systems.

Modern scientific research has recently begun to explain the details of these interactions, but the topic
of the gut-skin relationship is hardly new—herbalists have long observed the strong connections
between gastrointestinal health and the appearance, condition, and function of the skin.
Nineteenth-century Eclectic physicians, for example, associated chronic gastritis with skin eruptions and
imbalances, including severe acne, eczema, lichen planus, and rashes (Ellingwood, 1910). Ellingwood’s
contemporary, physician Milton Mack, noted the connection as well, writing that in relation to the
digestive system, “[A]cne and eczema are both traceable to this fountainhead of diseases … if in a case
of urticaria we look to the intestinal tract, why not in eczema and acne?” (Mack, 1911, p. 311). The
interaction between the intestinal microflora, skin health, and the nervous system was first hypothesized
by two dermatologists in 1930 (Salem et al., 2018). Nearly 80 years later, cellular and genetic research
has finally caught up with their insight!


THE GUT-SKIN AXIS

The connection between the gut and the skin is now well established, confirming traditional
understandings, and is referred to as the gut-skin axis. Gastrointestinal (GI) function has an impact on
the function (and by extension, the condition and appearance) of the skin in so many ways! For one, the
assimilation of nutrients in the gut—or the lack thereof—is critically important to skin health. A number of
nutrients are key in supporting the skin’s integrity and ability to repair itself, including fatty acids, protein,
zinc, vitamins A, C, and E, and the amino acids arginine and glutamine (Saghaleini et al., 2018).
Consuming adequate amounts of these nutrients is just the first step—we also need a healthy, fully
functioning digestive system in order to assimilate nutrients into our cells and tissues. “You are what you
eat” may be a popular saying, but it’s more accurate to say that you are what you assimilate.

Many of the interactions between the skin and the GI tract depend on the gut microbiome, which plays a
pivotal role in maintaining skin allostasis, beginning with our ability to break down and absorb dietary
nutrients; gut bacteria are crucial to digest polysaccharides and even play a role in vitamin biosynthesis
(D’Argenio & Salvatore, 2015).

In addition, commensal bacteria in the gut interact with the immune system in several ways that can
have downstream effects on the skin. Normal gut flora compete with pathogens for space in our
intestinal lining by binding to epithelial cells, thereby providing immunoprotection (Kosiewicz et al.,
2014). Beneficial organisms also mediate the relationship between pathogens entering the gut and
toll-like receptors (TLRs) located on immune cells. TLRs are receptors that recognize the molecular
patterns associated with specific pathogens, and in response, trigger a cascade of chemical responses
through signaling pathways, ultimately leading to the activation of immune responses in the gut (Boyle et
al., 2011; Kosiewicz et al., 2014).


When the function of the gut is compromised or imbalanced, inflammatory skin conditions may be more
likely to arise. Many skin-related pathologies—including eczema, psoriasis, and acne —have been
shown to have a direct link to the state of the gut’s tissues and function.

Psoriasis and Other Skin Imbalances are Linked to
Microflora Balance

When the gut environment is out of balance, the metabolites generated by certain bacterial species can
affect and damage tissues both in the gut and throughout the body. They may access the blood
circulation, accumulate in tissues, and affect cell differentiation and the overall integrity of the skin. When
the balance of the gut microbiota is compromised, skin hydration and keratinization can even be
impaired (Salem et al., 2018.), and when non-beneficial bacteria proliferate and overtake the gut biome,
an immune-related skin imbalance can occur.

Let’s look at psoriasis as one example of this process in action. A relatively common skin disorder,
psoriasis is mediated by the immune system, but has a wide variety of environmental and internal factors
that typically result in thickening and scaling of skin in painful, itchy patches or plaques (Salem et al.,
2018). Although psoriasis is primarily understood as a skin disorder, it operates both on local and
systemic levels and involves a complex immune response that can generate inflammation throughout the
body, including the cardiovascular and digestive systems. For example, up to 11% of inflammatory
bowel disease (IBD) patients also have psoriasis, as compared to less than 3% of the general population
(Takeshita et al., 2017). Likewise, psoriasis patients are far more likely to have cardiovascular disease,
heart attack, or stroke. The common theme here is excess inflammation—and changes in the gut flora
may play a big role. Many of the bacterial species associated with psoriasis originate in the gut, and
metabolites produced by the gut biome can influence immune function, shifting the body toward a state
of inflammation. But there isn’t one specific germ or microbial group that is driving psoriasis—instead,
psoriasis may hinge on the state of balance or imbalance among different complex and individually
specific groups of bacteria (Codoñer et al., 2018; Salem et al., 2018)!

On the other hand, a healthy gut biome can confer skin health benefits, including the modulation of
inflammation, a key factor in addressing psoriasis and, indeed, most chronic conditions. Lactobacillus
species have been shown to selectively bind to immune and epithelial cells, and they can secrete
peptides that have immunomodulatory effects, including regulation of cytokine expression (Wells, 2011).
This may be one reason why probiotic therapy has been shown to improve acne; among other things,
commensal bacteria downregulate certain hormones and cytokines that trigger inflammatory acne. There
are likely to be other mechanisms at work here, too—for example, the introduction of beneficial gut
bacteria can also result in shifts in the flora of the skin, decreasing the presence of acne-causing
microorganisms (Salem et al., 2018).

Inflammation Connections: Leaky Gut and Dysbiosis

As discussed above, the links between inflammatory skin conditions and gut dysbiosis (microbial
imbalance) are well documented. Scientists have learned that a lower diversity of gut flora is associated
with a higher incidence of allergic imbalances; conversely, increased microbial diversity is associated
with a reduction of symptoms in inflammatory skin imbalances such as atopic dermatitis (Vaughn et al.,
2017). But microbial diversity and dysbiosis aren’t the only players in the game; the state of the intestinal
tissue and its mucosal lining may also be a major factor in the gut-skin connection.


Many herbalists and health professionals also point to increased intestinal permeability, also known as
leaky gut, as a key factor that impacts the level of inflammation in the body. The gut has a tricky role to
play, in that it must be permeable enough to allow absorption of nutrients, while maintaining a barrier
against antigens (toxic or foreign substances that elicit an immune response in the body) and harmful
microorganisms. Herbalist Paul Bergner (2001) discusses the paradox: “The gut is typically partly ‘leaky,’
allowing particles as large as bacteria and entire undigested proteins to cross it, and it is normal to find
gut bacteria in the portal blood, on the ‘wrong’ side of the gut barrier” (p. 14). In a healthy individual,
small amounts of antigenic (immune-stimulating) material are easily managed without creating any
systemic immune response; however, when the gut epithelium becomes excessively porous, larger
amounts of bacteria and proteins end up in systemic circulation, kicking off an immune response that
can have wide-ranging effects throughout the body (Bergner, 2001).

There are many factors that impact intestinal permeability, notably the diet (and especially food
sensitivities and allergies), alcohol consumption, stress, infection, dysbiosis of the gut flora, antibiotics,
non-steroidal anti-inflammatory drugs (NSAIDs), and poor nutrition (Bergner, 2001; Mu et al., 2017).
Those are a lot of potential inputs to gut health!

Regardless of the specific trigger, leaky gut is part of a cycle that begins with inflammation in the gut.
Inflammation can impair nutrient absorption, barrier function, and even cause reduced cell mass;
ultimately this creates a hyperpermeable gut lining that allows larger molecules (including food antigens)
to pass across the mucosal barrier and into the bloodstream and lymphatic circulation.

Under normal circumstances, the immune tissues of the gut and the liver are able to keep any antigens
in check, but if the body is suddenly flooded with large amounts of antigens (as in the case of leaky gut),
the immune system can be overwhelmed, causing a cascade of inflammatory responses as invading
cells are tagged and attacked. Eventually, the overload on the liver’s antioxidant systems can also begin
to impair hepatic function (Bergner, 2001).

Leaky gut can also trigger autoimmune responses, including those in which immune cells attack the
skin. Autoimmune diseases that may affect the skin include systemic lupus erythematosus (lupus),
psoriasis, dermatomyositis, scleroderma or epidermolysis bullosa, Sjogren’s syndrome, and many others
(Campbell, 2014).

For example, in lupus, the uptick in immune activity can lead to increased photosensitivity, rashes,
lesions, alopecia, and other cutaneous manifestations. Significant and ongoing immune attacks on the
skin can lead to pigmentary changes, permanent scarring, tissue atrophy, and alopecia (Uva et al.,
2012).

Fortunately, there’s plenty we can do to keep the gut and the skin working in balance; scientific research
and traditional practices suggest that nourishing and supporting the healthy function of the gut and liver
are among the keys to overall health, including glowing skin. Let’s look at some of the ways we can
support a healthy gut-skin axis.


HEALTHY GUT FUNCTION

Mindful Eating

Mindful, relaxed eating is one of the key ways that we can support the health of the digestive system.
What does it mean to eat mindfully? Simply put, mindful eating is keeping your attention on your meal as
you eat it. Ways to encourage mindful meals include sitting down while eating, perhaps in the relaxed
company of others, savoring the smell and taste of every bite, and eating without the distraction of work
or electronics. Eating while under stress can affect digestion in a significant way. The gut-brain axis is a
conductor for chemical signals and substances including serotonin, cortisol, and neurotransmitters that
can affect us deeply when we’re stressed, causing physiological changes that can reduce blood and
oxygen flow to the GI tract, affect gut flora balance, and otherwise contribute to impaired digestive
processes (Mittal et al., 2017). When we enjoy meals in a relaxed and mindful way, paying attention to
our full sensory experience, we also get to enjoy a more relaxed and effective digestive experience.

Routine

Eating meals on a regular schedule is also a way to support healthy digestion. When we keep a
consistent meal schedule, we help to maintain the body’s natural rhythms of digestion, absorption,
processing in the liver, and excretion. Nourishing our bodies on a regular basis also helps to maintain a
healthy balance of glucose, insulin, the “hunger hormones” ghrelin and leptin, and other substances that
support healthy metabolic function.


Food Sensitivities and Diet

As discussed previously, food sensitivities and allergies are linked to a higher incidence of skin disorders
and can create inflammation and other immune responses and symptoms in the gut. Dairy, soy, wheat
and gluten, egg, beef, corn, fish and shellfish, and nuts are among the most common allergens (Shreffler
et al., 2012), but keep in mind that individual sensitivities and their effects on the body can manifest in
many ways.

Food sensitivities and intolerances aren’t the only diet-related culprits in skin disorders. A high glycemic
load diet—fairly normal among Westerners—has been linked to gut dysbiosis as well as a higher
incidence of acne. Modern researchers noticed this link when comparing young people following a
standard American diet with Kitavan Islanders of Papua New Guinea and the Aché people of Paraguay.
It was found that the American diet, typified by higher glycemic load foods, was linked to a significantly
higher incidence of acne among young people; among the Kitavan and Aché who consumed more
traditional foods, acne was essentially nonexistent (Cordain et al., 2002).

HERBS THAT BENEFIT THE SKIN BY SUPPORTING THE
GUT

Topical skin applications are important, but healthy skin truly begins within! When we take steps to
support our gut—and the communities of bacteria that live there—we can also make a huge difference in
the health and wellness of our skin. Certain herbs and actions have a particular affinity for the gut-skin
axis, as well as digestive and eliminative functions. Let’s take a look at some of these actions below.

Astringents

Astringent herbs tighten and tone tissues by contracting proteins. This action effectively reduces
discharge, such as excessive perspiration or bleeding, and restores membrane integrity. Many astringent
herbs have a particular affinity for the skin and mucous membranes and can be used topically as well as
internally. While they are commonly used in topical skin preparations (think witch hazel and rose water),
astringent herbs can also help support gut health. For example, in the case of “leaky gut,” astringent
herbs can help restore tone and barrier function to the intestinal epithelium, and thus keep proteins from
infiltrating the bloodstream.

Astringent herbs are generally high in tannins and related polyphenols, common constituents that share
the property of reacting with protein molecules on contact, tightening and “tanning” them. Strong herbal
astringents have been traditionally employed in a wide range of ways. For example, astringent plants
such as oak (Quercus spp.) bark and galls can be used to tan leather; the same chemical principles form
the basis of action of witch hazel (Hamamelis spp.) bark, wild geranium (Geranium maculatum) root, and
tormentil (Potentilla tormentilla) root first aid washes for wounds and third-degree burns (Bone & Mills,
2013; Pengelly, 2004). We can also think about these, and other astringent herbs, as “wound washes”
for the micro-wounds caused by inflammation in the gut.

Although astringent herbs can feel drying to the mouth or upon contact with the skin, that tightening of
tissues is what is useful in retaining fluids. Herbalist jim mcdonald writes that astringents “were
sometimes referred to as ‘tonics’: herbs that restored tone to tissues. In most cases, short term use of


astringents causes a localized dryness, while helping to preserve fluids constitutionally” (mcdonald, n.d.,
para. 16).

Plantain – Plantago major, P. ovata, P. lanceolata (Plantaginaceae) – Leaf,
seed

The plantain leaf can be easy to miss in the temperate landscape, although it is ubiquitous in some
places and is often considered a weed! A low-growing perennial, this particular plantain isn’t to be
confused with the banana relative popular in Caribbean and Latin American cuisines.

Actions: Alterative, antibacterial, antihistamine,
anti-inflammatory, antioxidant, astringent,
demulcent, vulnerary

Energetics: Neutral to cooling, and moistening

Use: Plantain leaf is cooling, nourishing,
astringent, and vulnerary for gastrointestinal
mucous membranes, helping to soothe
inflammation and tonify mucosal tissue. Plantain
leaf is not the only part of the plant that is useful
for the GI tract, however. The seed and husk
(the papery covering of the seed) of Plantago
ovata and other Plantago species are more
commonly known as psyllium and are commonly used as a supplemental dietary fiber, facilitating
healthy peristalsis and bowel movements. This may be the most common use of plantain, although
many people don’t realize it comes from the same genus of plants!

In a clinical trial, researchers compared psyllium seeds to a pharmaceutical drug (mesalamine)
commonly used for ulcerative colitis and found that Plantago ovata seeds may be as effective as
mesalamine in maintaining remission of ulcerative colitis (Fernández-Bañares et al., 1999). In a large
clinical trial, Bijkerk et al. (2009) demonstrated that psyllium seeds (10 g/day for 3 months) significantly
reduced the severity of irritable bowel syndrome (IBS) symptoms.

Plantain leaf is also used topically in infusions, poultices, infused oils, and salves to support the skin in
acute and chronic conditions. It can gently soothe hot, irritated, and inflamed skin and mucous
membranes (some even consider it somewhat interchangeable with calendula (Kress, 2015), but it can
also act quite powerfully. If you’ve ever used a fresh poultice of plantain on a bee sting, you’ve
experienced its strong anti-allergic action. Herbalist Matthew Wood (2008) even cites its historical use
in snakebite and other severe wounds in which strong drawing action was necessary.

Plantain is still a first aid favorite among herbalists: Herbalist Robin Rose Bennett (2014) suggests
plantain leaf as a simple or in combination with other wound-healing herbs to bring out its
anti-infective and immunomodulating qualities, particularly on open wounds and inflamed skin.
Herbalist Stephen Harrod Buhner (2012) prefers fresh pressed juice of plantain leaf, stabilized with a
small amount of alcohol. At the same time, it’s not uncommon to see Plantago on the list of
ingredients in skin creams and serums at the local health food store.


Current clinical evidence backs up plantain’s traditional use as a skin wash for itchy rashes. Its ursolic
acid, oleanolic acid, and α-linolenic acid content shows inhibitory effects on COX-2 catalyzed
prostaglandin, which downregulates inflammation and its symptoms (Ringbom et al., 1998). Luteolin,
one flavonoid present in plantain, also suppresses leukocyte migration and inhibits mast cell activity
and histamine production, giving it powerfully effective anti-inflammatory and anti-allergic effects (Finn
& Walsh, 2013).

Additional constituents in plantain include flavonoids, alkaloids, terpenoids, phenolic acid derivatives,
iridoid glycosides, fatty acids, and polysaccharides (Adom et al., 2017). A nutritious wild edible,
plantain leaf is high in calcium and vitamins A, C, and K (like other leafy greens!). Young leaves can be
included raw in salads, and mature leaves can be deveined and cooked in stews and soups (North
Carolina State Extension, n.d.; Nyerges, 2016).

Safety: Plantain leaf is generally regarded as safe. Plantain seed should be avoided by individuals with
bowel obstruction, and should be taken with at least 240 mL (8 fl oz) of liquid. Plantain seed should be
taken at least 2 hours apart from other drugs (Gardner & McGuffin, 2013).

Dose: Fresh leaf juice: equivalent of 3-6 g per day (Buhner, 2012); Infusion: 3-4 g dried leaf/day
divided into 1-3 doses; Tincture: 3-6 mL (1:2, 30%) 3x/day (Kuhn & Winston, 2008); Salve, cream, or
poultice as needed.

Self heal – Prunella vulgaris (Lamiaceae) – Aerial parts

A favorite in both traditional Western and Eastern herbal systems, self heal is native to Europe and
Asia, but has become naturalized throughout North America. Commonly found in temperate woods,
self heal prefers cool and shady locations, popping up along the edge of well-visited trails and damp
lawns. The clambering, flowering stalks of this perennial Lamiaceae (mint) family plant can climb from
8 inches to nearly 3 feet, with bluish-purple snapdragon-like flowers (Duke, 2001; Soule, 2005).

Actions: Anti-inflammatory, antimicrobial,
antimutagenic, antipyretic, antiviral, astringent,
immunomodulant, styptic, tonic, vulnerary

Energetics: Cooling and slightly moistening

Use: Self heal’s leaves have a cooling,
mucilaginous quality that make them ideal for
drawing out heat and infection, and for general
use when skin is irritated and atrophied. Self
heal can also be helpful as a fresh plant poultice
for wounds and lesions, and in salves, creams,
compresses and washes for chronic skin
imbalances like eczema (Wood, 2008).

Just as it soothes and cools the skin when used topically, self heal is taken internally to help clear heat
and inflammation. Part of the traditional Chinese materia medica, the herb—Xia Ku Cao in
Mandarin—is employed as a cooling bitter helpful for reducing Liver fire, dispersing stagnant qi, and


gently nourishing the Liver and Blood (Dharmananda, 2010). Young self heal leaves and stems are
also edible and can be eaten raw or cooked.

Self heal contains a rich variety of anti-inflammatory polyphenols, including flavonoids, tannins, and
caffeic acid. Rosmarinic acid, a primary phenolic compound in self heal, is present in even greater
amounts in self heal than rosemary; this compound has been found to protect human dermal cells
from oxidative damage and slow inflammatory response through its action as a COX-2 inhibitor and
by inhibiting allergic responses and prostaglandins that promote inflammation and pain (Hahn et al.,
2017; Tao et al., 2014). In one study, Prunella vulgaris extract and rosmarinic acid were both shown to
protect the skin against sun damage by suppressing ultraviolet B-induced alterations to keratinocytes
(Vostálová et al., 2010). Like plantain, self heal is rich in the anti-inflammatory compounds ursolic and
oleanolic acid.

Safety: Self heal is generally regarded as very safe, and there are no reports of toxicity or drug
interactions, although there have been reports of rare allergic reaction (Gardner & McGuffin, 2013).

Dose: Infusion: 3-9 g dried aerial parts/day divided into 1-3 doses; Tincture: 1-2 mL (1:2, 45%) 2x/day
(Bunce, 2013); Fresh poultice, infused oil, or salve as needed.

Vulneraries and Anti-Inflammatories

Both plantain and self heal are anti-inflammatory and wound healing (vulnerary) in nature, although they
are also astringents, as discussed above. Astringency is, after all, a helpful action when staunching
blood flow and assisting the skin-healing process.

Vulnerary herbs may have varying modes of action. Some contain soothing, demulcent mucilage, while
others have compounds that stimulate regeneration and repair of tissue by stimulating fibroblasts and
other connective tissue and skin cells (Bone & Mills, 2013).

Herbalist David Hoffmann describes vulnerary herbs as being particularly effective at reducing
symptomatic discomfort of healing skin, while promoting the tissue-healing process (Hoffmann, 2013).
He argues that the green parts of plants are generally rich in anti-inflammatory flavonoids and
chlorophyll, which automatically indicates that they will be helpful for healing wounds (which is one
reason so many plants share the common name “self heal”!). But certain plants are decidedly more
effective at speeding wound healing; these include (in addition to plantain and self heal) calendula
(Calendula officinalis) flower, red clover (Trifolium pratense) aerial parts, St. John’s wort (Hypericum
perforatum) aerial parts, cleavers (Galium aparine) aboveground parts, and nettle (Urtica dioica) leaf.

Calendula – Calendula officinalis (Asteraceae) – Flower

Also known as pot marigold, calendula has been well-loved by herbalists since ancient times. With a
resinous, bright flower that harnesses the moving warmth of the sun, calendula has been employed in
both external and mucosal support, gently warming and protecting tissue against bacterial threats and
soothing inflammation.


Native to southern Europe and the Mediterranean region, but widely naturalized and cultivated around
the globe, calendula’s blossoms have been a mainstay in many aspects of skin care, where they’re
used fresh or dry. From infusions to tinctures, ointments to creams and salves, powders, and washes,
calendula is among the more versatile and
powerful herbs, suitable for a range of skin
preparations and skin types, including sensitive
skin—and places where, as Wood (2008)
describes, “the sun doesn’t shine” (p. 154).

Actions: Anti-inflammatory, antimicrobial,
astringent, cholagogue, hepatic,
immunostimulant, lymphatic, vulnerary

Energetics: Warming and drying

Use: Calendula is a standout herb for skin
support in both traditional use and in modern
clinical research. Applied topically, it is helpful in
situations from minor scratches to serious wounds, and even bacterial skin infections. Calendula
supports the body’s own immune response to allergens or antigens, encouraging macrophagic
activity that gobbles up bacteria and other invaders, making it specifically helpful for hot, red,
pus-filled tissue (Foster, 1993). Acne is one example of a hot, eruptive skin imbalance that can be
supported with topical use of calendula, as are conditions such as dermatitis, bruising, boils, and
rashes (Bisset, 1994). Applied externally, calendula serves as an antiseptic agent.

Sweet, salty, bitter, resinous and slightly pungent, calendula is useful where there is sluggishness of
the digestive, hepatic, circulatory, or lymphatic system along with a need for tissue repair and action
against microbes. These qualities make it an excellent choice for support in bacterial and yeast
infections affecting the skin. Its salty quality makes it helpful as a softening agent, which can be useful
even for hardened masses such as old scar tissue (Wood, 2008).

In vitro studies show that calendula extract protects skin cells against oxidative stress and cell death
and damage by scavenging free radicals (Alnuqaydan et al., 2015). It also appears that calendula
extracts downregulate inflammation by activating transcription factors and protein production by skin
cells and slowing prostaglandin production (Nicolaus et al., 2017). This may be one reason that
calendula is helpful in many reactive, swollen skin conditions such as allergies, atopic dermatitis, and
insect bites.

Calendula can also be used internally, and its slightly bitter taste hints at its use for the digestive
system. Calendula is considered a cholagogue, supporting the gallbladder and liver and consequently
the digestive system and skin. And, just as it helps to resolve infection, irritation, and inflammation in
the skin, calendula works to heal and soothe the gut mucosa, and may also be useful as a systemic
antimicrobial and immune support (Hoffmann, 2003), as it stimulates lymphatic function.

Safety: Those with allergic sensitivity to Asteraceae (daisy) family plants may experience sensitivity to
calendula.

Dose: Infusion: 1-2 g dried flower/day divided into 1-3 doses; Tincture: 5-30 drops (1:5, 70%) up to
4x/day, dilute with several parts of water for topical use (Moore, 1995). Salve, cream, or poultice as
needed.


Meadowsweet – Filipendula ulmaria (Rosaceae) – Aerial parts

Bitter and aromatic, meadowsweet (also known as “Queen of the Meadow”) was traditionally used as
a strewing herb in medieval times, its delicate white flowers perfuming the air for festivals and
weddings (while perhaps also protecting against illness, given meadowsweet’s antimicrobial
properties!). Tall and graceful, her name may refer to the meadow, a common place to find this herb
thriving; however, its common name is also said to describe its traditional use as a flavoring of meads
and wines. A member of the Rosaceae (rose) family and a European native, meadowsweet is also
known as spirea, an old name that alludes to a
drug that bears a similar name—aspirin.
Meadowsweet does, in fact, have the telltale
bitter and astringent taste of salicin (a precursor
to salicylic acid) but, unlike aspirin, actually
soothes and cools the internal membranes of
the gastrointestinal tract.

Actions: Antiemetic, anti-inflammatory,
antimicrobial, astringent, carminative,
diaphoretic, diuretic, stomachic, vulnerary


Use: Meadowsweet has long been employed as
a stomachic, as it supports digestive health by
reducing inflammation of the mucosal surfaces and glands of the stomach and GI tract (Hoffmann,
2003). It regulates the pH balance of the stomach, soothing gastroesophageal reflux disease (GERD)
and heartburn, and is also employed for nausea and dyspepsia related to gut inflammation.
Meadowsweet contains flavonol glycosides (such as spiraeoside, rutin, hyperin, and kaempferol
glucoside) that cool epithelial inflammation (Mills & Bone, 2000).

Not only is meadowsweet astringent and protective of tissues, it helps to remove the buildup of uric
acid in the blood, muscles, and joints. Historically it was used in rheumatism, where it “expels the
waste, morbid and diseased particles of matter from the body, and by that process removes the
inflammation and pains of the parts affected” (Hool, 1922, quoted by Wood, 2008, p. 256). Excess uric
acid in the body can accumulate and crystalize around joints, causing inflammation and pain, as in
gout.

Modern research points to meadowsweet’s effectiveness as an anti-inflammatory, antioxidant, and
immune-enhancing ingredient in functional beverages, in confirmation of traditional herbal practices.
In one study, an analysis of meadowsweet teas made from Filipendula ulmaria and other species
substitutes (F. camtschatica, F. denudata, and F. stepposa) showed significant free
radical-scavenging activity, protecting against oxidative stress (Olennikov et al., 2016). All
preparations used in the study were rich in methyl salicylate and salicylaldehyde as well as
water-soluble polysaccharides, which also showed anti-complement activity (this means that they
block the actions of the complement system, a part of the immune system that triggers a cascade of
immune responses). The preparations also encouraged phagocytosis (removal of bacteria and cellular
debris), suggesting meadowsweet’s potential use to support immune system function (Olennikov et
al., 2016).


Safety: Meadowsweet contains salicylates and for this reason should be avoided by those with
salicylate sensitivity.

Dose: Infusion: 12-18 g dried aerial parts/day divided into 1-4 doses; Tincture: 2-4 mL (1:5, 50%)
3x/day (Mills & Bone, 2005).

Happy Tummy Infusion

Adapted from Grow Your Own Herbal Remedies by Maria Noël Groves (Groves, 2019).

For those who wish to avoid excessive mucilage in their gut-supporting infusions, this is a lovely option
that retains its soothing, anti-inflammatory, and vulnerary qualities without the “slime” that comes
along with mucilaginous vulneraries, such as marshmallow (Althaea officinalis) root and flax (L
inum
usitatissimum) seed.

Ingredients

1 tbsp plantain (Plantago s pp.) leaf
1 tbsp meadowsweet (Filipendula ulmaria) flower
1 tbsp calendula (Calendula officinalis) flower
1 quart (32 fl oz) water

Directions

● Combine herbs and steep in 1 quart of just-boiled water for 15-30 minutes.
● Strain, and drink throughout the day.
● Once cool, tea can be refrigerated and used within 24 hours.

Bitters and Digestive Wellness

Another way to boost our skin health is by consuming herbs that support efficient digestion, absorption,
and assimilation of the foods we eat. A taste found ubiquitously in the plant world, bitter flavors tend to
be missing from most modern Western diets. This makes sense; after all, bitterness can signal toxicity,
and many bitter-tasting phytochemicals serve as part of a plant’s defense system. However, bitters have
an important role to play in supporting optimal digestive function and, by extension, supporting the
health and wellness of all of the body’s tissues.

Bitters can have an immediate effect on digestive processes. As soon as we taste bitter herbs or foods,
taste receptors in the mouth spark the digestive process by signaling the brain to stimulate the release
of digestive secretions throughout the GI tract, from the mouth to the gut. Salivation in the mouth begins
to break down starches, then the stomach releases hormones, acids, and enzymes, which churn our
food to a digestible chyme containing minerals in a more bioavailable form. Bitters help our bodies
digest and absorb proteins and vitamins and support the pancreas, gallbladder, and liver in facilitating


the healthy flow of digestive enzymes and bile, which break down nutrients, carbohydrates, and fats,
and maintain the balance of digestive fluids in the intestines to ensure ease of digestion and elimination.

In addition to herbs, bitter foods are easy to find and incorporate into seasonal eating. Before the
widespread use of iceberg lettuce, salads were made from more bitter greens and potherbs such as
dandelion, chicory, endive, and arugula, and were often dressed with oil and vinegar, which facilitates
the absorption of minerals (mcdonald, 2010). These plants are still easy to find, grow, forage, and
include in salads. Coffee, chocolate, and citrus peel are also bitter tastants, as are cruciferous
vegetables, such as kale, collards, and broccoli—not to mention more obviously bitter foods like bitter
melon, which is easy to find in international markets.

Chamomile – Matricaria chamomilla (Asteraceae) – Flower

A native of Europe and West Asia, German
chamomile has been an important herb for
millennia; it was highly prized for its healing and
even sacred properties, its use documented by
Hippocrates, Galen, and Asclepius (Alternative
Medicine Review, 2008). Chamomile’s name is
derived from the Greek words for “on the
ground” (khamai) and “apple” (melon) , which
makes perfect sense given the apple-like,
delicate fragrance of the fresh and dried flower
(Franke, 2005). Roman chamomile
(Chamaemelum nobile) is a relative that also
belongs to the Asteraceae family and looks
similar to German chamomile, but has some
significant morphological and phytochemical differences. This monograph will focus on German
chamomile.

Actions: Analgesic, anti-inflammatory, antimicrobial, antispasmodic, carminative, nervine, sedative,
vulnerary


Use: One of chamomile’s gifts is its versatility. It is a useful herb for colicky babies, as well as elders
with deficient digestion; those of delicate constitution to more fiery types are all served by its actions
on the digestive system. Chamomile’s traditional use as a nervine relaxant, mild bitter, and digestive
tonic make it ideal for soothing many kinds of GI imbalances, particularly when stress is wreaking
havoc on digestive function. Its antimicrobial quality (due in part to constituents such as α-bisabolol
and cyclic ethers (Mills & Bone, 2000)) makes it helpful for combating infection both topically and
internally.

Chamomile’s constituents inhibit or modulate the production of inflammatory prostaglandins,
leukotrienes, and pro-inflammatory cytokines (Mills & Bone, 2000), which may help to explain its
traditional use in addressing gastrointestinal and uterine cramping and muscle spasm, insomnia and
anxiety, ulcers and wounds, and rheumatic pain. The Eclectics described chamomile as having
affinities for both the nervous system and the GI tract, subduing irritation in both systems, and aiding
in cases where nervous irritation was itself the cause of gastric upset (Felter & Lloyd, 1983).


In addition to internal use as a tea or tincture, chamomile flowers can be helpful as a poultice or warm
fomentation for inflammation, pain, congestive neuralgia, and swelling (for example, the facial swelling
that accompanies an underlying facial or sinus infection or dental abscess). The sweet, apple-like
scent of chamomile essential oil makes it a popular aromatherapeutic addition to skin and hair care
products; it also has anxiolytic and antidepressant qualities (Srivastava et al., 2010).

Safety: Those with allergic sensitivity to Asteraceae (daisy) family plants may experience sensitivity to
chamomile.

Dose: Infusion: 6-12 g dried flower/day divided into 1-4 doses; Tincture: 1-10 mL (1:5, 40%) 3x/day
(Mills & Bone, 2005).

Orange – Citrus spp. (Rutaceae) – Peel

Oranges are native to eastern Africa, Arabia, and
Syria. It’s believed that their naturalization
around the globe began with the introduction of
the fruit to Europe during the Crusades. Its
common name comes from the Arabic root word
narandj, and it has long been a part of both the
diet and the materia medica of the
Persian-Arabian traditional medical system
Unani-Tibb. The orange fruit has been prized
both for the juicy sweetness of its flesh, and the
bitter, aromatic quality of its peel, which is full of
volatile oils that contribute to its antispasmodic
and carminative qualities. Orange peel essential
oil, orange flower water, and orange peel
hydrosol are other common preparations.

Actions: Antimicrobial, aromatic, bitter, carminative, choleretic, orexigenic

Energetics: Warming and drying

Use: As an orexigenic (an appetite stimulant), orange peel has been traditionally used as a digestive
support in bitters and aperitifs, taken before meals to increase and stimulate the appetite as a simple
way to increase overall nutrition to the body. It is theorized to act on the anterior pituitary, stimulating
digestive secretions, modulating blood glucose levels, and helping deliver increased nourishment and
water to cells—ultimately resulting in more supple, soft, and full skin (Wood, 2008).

Citrus peel is exceptionally rich in volatile oils. The volatile oils found in citrus rind have been shown to
be powerfully aggressive against certain bacteria commonly associated with food poisoning and gut
dysbiosis, including Escherichia coli and Salmonella spp. (Pittman et al., 2011).

Citrus peel also contains monoterpenes, bitter compounds, flavonoids, and alkaloids. A key alkaloid is
synephrine, a sympathomimetic compound similar to epinephrine, which contributes to orange peel’s


stimulating quality (Braun & Cohen, 2010). This, along with its aromatic and carminative qualities,
makes orange peel a popular addition to herbal weight loss formulations.

Safety: In human studies, the fruit juice of bitter orange (C. x aurantium) has been shown to interact
with the drug metabolizing enzyme CYP3A4, so caution is advised when using orange peel with
prescription drugs that are metabolized by CYP3A4 (Gardner & McGuffin, 2013).

Dose: Infusion: 2-6 g dried peel/day divided into 1-3 doses; Tincture: 0.5-1 mL (1:5, 70%) 3x/day
(Braun & Cohen, 2010; Felter & Lloyd, 1983).

CONCLUSION

Healthy, beautiful, balanced skin requires more than just topical products. While cleansers, moisturizers,
and toners can help to improve skin tone and elasticity, true support at the cellular level depends on a
healthy gut and balanced digestive processes. There are many ways we can improve the health of the
skin by supporting digestive function. When the digestive system is working well, we benefit from
optimal nutrient assimilation and efficient removal of waste products, all of which keeps the skin
nourished.

Herbs that support the digestive system are helpful aids that can be incorporated into a variety of
preparations, including infusions, decoctions, tinctures, and glycerites. Depending on the individual need
for digestive support, the herbalist can call upon many actions—astringents and vulneraries, hepatics
and orexigenics, aromatic bitters and carminatives, and others—to address local and systemic
imbalances that affect the skin.


DIY Bitters: Reviving the Forgotten Flavor by Guido Masé and Jovial King
How Your Digestive System Works, a TED animation by Emma Bryce:
https://ed.ted.com/lessons/how-your-digestive-system-works-emma-bryce
Savor: Mindful Eating, Mindful Life by Thich Nhat Hanh
The Center for Mindful Eating: https://www.thecenterformindfuleating.org/


LESSON 4: SKIN CARE IN AYURVEDA

INTRODUCTION

With origins in India, Ayurveda is an ancient healing system that dates back thousands of years. Still in
use today, it is a comprehensive and vast system that includes the use of herbs, dietetics, bodywork,
psychology, and spiritual practices to promote wellbeing. In this lesson, we will delve into the topic of
skin care from an ayurvedic perspective and explore holistic methods for cultivating and maintaining skin
health.

An understanding of the three doshas, vata,
pitta, and kapha, is essential to the ayurvedic
approach to skin health. Made up of varying
combinations of the five elements (earth,
water, fire, air, and ether), the three doshas
are life forces that govern our physical,
psychological, and physiological makeup.
Vata, pitta, and kapha exist within each of us
in varying degrees according to our inherent
constitutional balance. This means that we
are each born with a unique balance of vata,
pitta, and kapha. The exact ratio of the
doshas varies from person to person, but
regardless of constitution, any of the doshas
can become excessive or out of balance, and
ill health inevitably ensues. Thus, even if you
display many of the signs of excess vata in
the body (see table below), that doesn’t
mean that you are immune to pitta– or
kapha-type skin imbalances!

Vata is composed of the air and ether
elements, pitta is composed of fire and
water, and kapha is composed of earth and
water. The five elements represent qualities,
and those qualities are reflected in the doshas. For instance, vata dosha displays many of the qualities
expressed in the air and ether elements, such as lightness, dryness, roughness, and mobility (i.e., an
individual with excessive vata dosha may show signs of dryness, such as dry skin or constipation). Pitta
is characterized by heat, intensity, and oiliness. Kapha is moist, smooth, cool, and heavy. Some specific
indications of each dosha are described in the table below.


Visit the course to download the Signs of the Doshas in the Body worksheet as a PDF.

In order for an ayurvedic protocol to be effective, one must understand the nature of the individual and
the nature of their imbalance—Ayurveda is not a one-size-fits-all approach. Ayurvedic skin care is no
exception; the suggested course of action for any skin disorder will vary depending upon one’s natural
constitution and the nature of the imbalance revealed in their skin.

ROOTS OF SKIN HEALTH

According to Ayurveda, the human body is comprised of seven dhatus (tissues). These seven tissues
can be viewed like concentric circles, progressing from the periphery to the deeper organs of the body.
Healthy skin is chiefly dependent upon the wellbeing of the three outermost dhatus: mamsa (muscle or
flesh), rasa (plasma and other fluids), and rakta (blood). While disharmony anywhere in the physical or
emotional body may show up on the skin, an imbalance in one or more of these three superficial dhatus
is most likely to manifest as a disruption in skin balance. Though not considered a dhatu, the health of
the immune system is also closely linked with skin health, according to Ayurveda, since our skin is the
first line of protection against the outside world.


Skin Health and Rasa (Plasma and Other Fluids)

The most external of the seven dhatus is rasa dhatu. Rasa is an interesting word in Sanskrit, as it
connotes multiple meanings that range from taste to feeling to sap (Svoboda, 1999). When discussing
the body tissues, rasa refers to the plasma and other fluids of the body.

Healthy skin requires healthy fluid balance. Dry skin isn’t caused by a lack of moisturizer, though oiling
the skin may help ease dryness. Rather, it is the result of internal dryness, which correlates to depleted
rasa. When there is adequate moisture in the body and therefore sufficient rasa, the result is soft,
lustrous, smooth skin. However, when rasa is insufficient, skin loses its vitality, and dry skin, wrinkled
skin, goosebumps, chapped lips, and even dry hair or hair loss may result (Lad, 2007).

Dryness is generally linked to a vata imbalance. Since some of the inherent qualities of vata dosha are
lightness, dryness, and roughness, excessive vata has a tendency to deplete bodily tissues, thus
decreasing the moisture and resilience of the skin, muscles, and other affected tissues. For those who
suffer from excess dryness, a vata-pacifying diet and lifestyle program is generally suggested. Such
protocols are typically centered around bringing warmth, strength, and moisture back to depleted
tissues. Drinking plenty of fluids, eating good quality lipids such as ghee and sesame oil, and applying
oils externally to the skin may be part of the suggested program.

Vata-Pacifying Diet and Lifestyle

● Drink plenty of fluids
● Include good quality lipids in diet
● Favor warm, cooked foods
● Favor grounding, nourishing foods (cooked grains, root vegetables, stewed fruits, nuts, spiced
milk)
● Favor sweet, sour, and salty tastes
● Avoid dehydrated food (dried fruit, crackers, jerky, etc.)
● Avoid overly pungent food (cayenne, mustard, etc.)
● Follow a regular daily rhythm
● Apply oil topically
● Bundle up when the weather is cold
● Avoid excessive exercise and favor gentle, rhythmic movement
● Avoid overstimulation (excessive screen time, caffeine, chaotic environments, etc.)

Vata-Pacifying Foods

● Fruit: Bananas, coconuts, cooked apples, dates, mangoes, peaches, plums, soaked raisins
and prunes
● Vegetables: Beets, carrots, parsnips, sweet potatoes, winter squash, zucchini
● Grains: Oats, quinoa, rice, wheat
● Legumes: Mung beans, red lentils
● Dairy: Butter, buttermilk, goat cheese and other soft cheeses, milk
● Meat and eggs: Beef, chicken, duck, eggs, salmon, sardines, tuna


● Spices and condiments: Basil, black pepper, cardamom, cinnamon, cloves, coriander, cumin,
dill, fennel, garlic, ginger, lemon, lime, oregano, paprika, parsley, rosemary, tamari, thyme,
turmeric, vinegar
● Nuts and seeds: Chia, flax, pumpkin seeds, sesame seeds, sunflower seeds
● Oils: Ghee, olive oil, sesame oil

The skin is not only affected by insufficient rasa, but also by excess rasa, a state that is generally
associated with kapha dosha. Signs that kapha dosha is affecting rasa dhatu include pallor, swelling,
edema, and cold, clammy skin (Lad, 2007).

When kapha disturbs rasa, a kapha-balancing diet and lifestyle is suggested, with a specific focus on
avoiding excessive water, salt, sugar, and dairy intake. Astringent herbs, such as turmeric (Curcuma
longa) rhizome and coriander (Coriandrum sativum) seed, can be used both internally and topically,
along with herbs and practices that stimulate lymphatic circulation. Encouraging strong agni (digestive
fire) is also key for kapha-balancing, and the digestive stimulating blend known as trikatu, which contains
black pepper (Piper nigrum) fruit, long pepper (Piper longum) fruit, and ginger (Zingiber officinale)
rhizome is often suggested for rasa dhatu that is being influenced by excess kapha dosha.

Kapha-Pacifying Diet and Lifestyle

● Avoid excess water, salt, sugar, and dairy
● Favor pungent, bitter, and astringent tastes
● Favor warm, cooked foods
● Bundle up when the weather is cold
● Vigorous exercise
● Sunbathing
● Garshana (dry brushing)
● Sweating
● Avoid oversleeping

Kapha-Pacifying Foods

● Fruit: Apples, berries, pears, persimmons, pomegranates, prunes, raisins
● Vegetables: Asparagus, beets, broccoli, cabbage, carrots, cauliflower, celery, eggplant, green
beans, kale, mushrooms, peppers, radishes, spinach
● Grains: Barley, buckwheat, corn, millet, rye, tapioca
● Legumes: Adzuki beans, black beans, chickpeas, lentils, lima beans, split peas
● Dairy: Cottage cheese, goat milk
● Meat and eggs: Eggs, rabbit, shrimp, venison
● Spices and condiments: Black pepper, caraway, cardamom, cayenne, cinnamon, clove,
cumin, dill, fenugreek, garlic, ginger, horseradish, mustard, oregano, parsley, rosemary,
thyme, turmeric
● Nuts and seeds: Brazil nuts, cashews, chia seeds, hazelnuts, peanuts, pecans, pine nuts,
pistachios, walnuts
● Oils: Ghee, sunflower oil


Skin Health and Rakta (Blood)

Rakta (blood) is also a crucial component in maintaining good skin health. Disturbance in rakta dhatu
may manifest as eczema, psoriasis, acne, hives, rashes, bruising easily, and/or canker sores and
bleeding from the gums (Lad, 2007). These skin imbalances, which present with redness, irritation, and
inflammation, are generally linked to both the blood and the liver, both of which are closely tied to pitta
dosha and are a sign that pitta has disturbed rakta. On a related note, skin conditions that involve
disturbed pigmentation generally relate to pitta dosha, as bhrajaka pitta (a subdosha of pitta) is largely
responsible for healthy complexion (Frawley, 2000).

For skin imbalances that are caused by excess pitta that has compromised rakta, alterative, bitter, and
diaphoretic herbs, such as burdock (Arctium lappa) root, red clover (Trifolium pratense) aerial parts, and
yarrow (Achillea millefolium) aerial parts may be helpful internally. Also, food that is cooling, bitter, and
astringent may be suggested, such as aloe juice, cucumber, parsley, and leafy greens, along with other
pitta-pacifying diet and lifestyle practices.

Pitta-Pacifying Diet and Lifestyle

● Favor sweet, bitter, and astringent tastes
● Avoid overly spicy or sour foods and beverages
● Avoid fried foods
● Avoid alcohol
● Avoid excess sugar intake
● Relaxing self-care practices: massage, quiet time, spending time with loved ones
● Avoid excess exposure to the sun

Pitta-Pacifying Foods

● Fruits: Coconuts, dates, melons, pears, pomegranates, sweet apples and berries
● Vegetables: Broccoli, cabbage, carrots, cauliflower, celery, cucumber, green beans, kale,
mushrooms, parsnips, peas, sweet potatoes, white potatoes, winter squash, zucchini
● Grains: Amaranth, barley, oats, quinoa, rice, spelt, wheat
● Legumes: Adzuki beans, black beans, chickpeas, kidney beans, lentils, mung beans, pinto
beans
● Dairy: Milk, butter, ghee, goat cheese and other fresh soft cheeses
● Meat and eggs: Bison, freshwater fish, rabbit, venison
● Spices and condiments: Basil, cilantro, cinnamon, coriander, cumin, dill, fennel, fresh ginger,
turmeric
● Nuts and seeds: Flax, soaked and peeled almonds, sunflower seeds
● Oils: Sunflower oil, ghee, olive oil

Skin Health and Mamsa (Muscle)

Though proper fluid balance and healthy blood have a direct impact on skin health, the organ of the skin
itself is part of mamsa dhatu, which also encompasses muscles and ligaments. Mamsa dhatu forms a


protective barrier between the individual and the outside world. It relates to courage, self-confidence,
and one’s ability to exert their will in a healthy way in the world. According to ayurvedic practitioner Dr.
Robert Svoboda (1999), “Your muscle fibers provide you a sense of security: they are the bricks and
stones of your body’s fortifications against attack from without” (p. 77). When mamsa dhatu is excessive
(generally the result of too much kapha dosha) , one may become fearless, but also foolish, suffering from
over-confidence. When mamsa dhatu is lacking (generally caused by imbalanced vata or pitta doshas),
one may experience fearfulness and a lack of self-confidence, as well as thin skin, both literally and
figuratively (Halpern, 1995).

Generally speaking, to maintain balanced mamsa dhatu, Ayurveda suggests avoiding undereating and
overeating, getting plenty of sleep, and managing stress (Lad, 2002). Ayurveda also offers more specific
protocols, depending on which dosha is in excess within mamsa dhatu. When kapha dosha increases in
mamsa dhatu, skin may feel taught or inflexible, and edema may be evident. Avoiding heavy foods and
favoring pungent foods and herbs, such as ginger (Zingiber officinale) rhizome, long pepper (Piper
longum) fruit, and black pepper (Piper nigrum) fruit, along with exercise that promotes flexibility and
circulation, can help to reduce kapha dosha in this case. When there is excess pitta dosha in mamsa
dhatu, skin may become inflamed, and cooling, bitter, and sweet foods and herbs are suggested, such
as barberry (Berberis spp.) root, licorice (Glycyrrhiza glabra) root, and shatavari (Asparagus racemosus)
root. Only gentle exercise is suggested during this type of pitta imbalance. If vata dosha is aggravated in
mamsa dhatu, the skin may become weak, prone to injury, and sensitive to pain. To reduce vata dosha in
mamsa dhatu, warm, sweet, and sour foods should be favored, along with sweet herbs combined with
warm digestive spices, such as ashwagandha (Withania somnifera) root combined with cinnamon
(Cinnamomum spp.) bark or cumin (Cuminum cyminum) seed. A regular daily routine will also help to
manage vata dosha (Halpern, n.d.).

Skin Health and Ojas (Immunity)

Skin health is linked to immunity, both physically and energetically. Ojas is a subtle substance that is
responsible for one’s immunity and overall sense of wellbeing. As declared in the Caraka Samhita (Dash
& Sharma, 2014), “It is the ojas which keeps all living beings refreshed. There can be no life without ojas”
(p. 595). In order for ojas to be built, all seven layers of dhatu must first be nourished. Therefore, ojas and
immunity will be compromised if one of the seven bodily tissues is damaged, bogged down by waste, or
underfed.

Furthermore, our skin is our first line of defense against the outside world, and therefore is a key aspect
of the immune system. Skin that is lustrous and healthy indicates a strong immune system. Skin that is
either too dry or too oily, or that is inflamed or discolored, indicates a compromised immune system
(Frawley, 2000). By nourishing the skin, one maintains a healthy barrier between oneself and one’s
environment. Also, healthy skin indicates a deep inner health, and skin imbalances may reveal
disharmony beneath the surface.

To boost ojas, and therefore promote lustrous, healthy skin, balanced digestion is key (see suggestions
for managing digestion below), since the conversion of food to each of the seven dhatus must first
happen before ojas can be created. One can also promote the production of ojas through meditation,
getting enough sleep, and avoiding depleting or over-stimulating activities, such as excessive exercise
and overuse of electronic devices (Lad, 2002). Ayurveda also considers some foods to be
ojas- promoting, including dates, non-homogenized whole milk, almonds, ghee, coconut water,
mangoes, sesame seeds, and sweet potatoes (Kripalu School of Ayurveda, 2014).


Ojas Milk

Adapted from Kripalu School of Ayurveda Training Manual (Kripalu School of Ayurveda, 2014).

Enjoy a warm cup of ojas milk to build immunity during times of stress, convalescence, or cold and flu
season!

Ingredients

1 cup (8 fl oz) non-homogenized whole milk, or non-dairy milk of choice
10 almonds
2 dates
¼ tsp ginger (Zingiber officinale) rhizome powder
¼ tsp cinnamon (Cinnamomum spp.) bark powder
¼ tsp cardamom (Elettaria cardamomum) seed powder
¼ tsp poppy (Papaver somniferum) seed
1 pinch saffron (Crocus sativus) stigma

Directions

● Soak almonds overnight in room temperature water.
● After almonds have soaked, remove almond “skin,” and chop.
● Place milk, chopped almonds, chopped dates, poppy seeds, and herbal powders in a
saucepan. Bring to a simmer.
● Stir, then turn off the heat.
● Blend with an immersion blender, add saffron, and pour into a mug.


MANAGING DIGESTION FOR HEALTHY SKIN

Ayurveda teaches that strong digestion and a balanced diet are central to good health. Thus, the health
of the skin cannot be addressed without considering digestion. If digestion is strong, one will experience
good circulation, adequate resistance to disease, and a healthy complexion. When digestion is
compromised, one may present with an array of imbalances, including poor complexion, low energy,
and poor resistance to disease (Frawley, 2000).

Furthermore, many skin imbalances are caused by the accumulation of unprocessed metabolic waste,
known as ama. When digestion is sub par and ama is generated, those wastes need to be excreted
somehow, and that path of excretion is often through the skin! Wastes that are excreted through the skin
will likely compromise skin health and clarity (Svoboda, 1999).

Like all things in Ayurveda, there isn’t a cure-all for managing digestion. However, the following basic
guidelines are suitable for most people.

● Small sips of warm water during meals aid digestion. Ice water or excessive water intake will
dampen agni (digestive power). A half cup of warm water with meals is generally advised.
● Digestion begins in the mouth. Proper chewing will support full assimilation and digestion of
foods. Try putting your utensil down between bites—this can help slow down your pace and
serve as a reminder to chew fully before swallowing.
● After a meal, you should feel satisfied, but not stuffed. Eating until approximately 75% full is a
good rule to follow. Eating too much or too little will weaken the digestive fire over time. Some


practitioners suggest that the stomach be filled with one third liquid, one third food, and remain
one third empty.
● Chewing a bit of fresh ginger with salt before meals can help boost digestion. A half teaspoon of
freshly grated ginger with a pinch of rock salt makes a good pre-meal digestive (Lad & Lad,
2006).

HERBS USED INTERNALLY FOR SKIN HEALTH

Managing Pitta Skin Issues

As mentioned previously, skin imbalances that are due to excess pitta are characterized by redness,
swelling, infection, and irritation. In such cases, internal use of alteratives and cholagogues, such as
dandelion (Taraxicum officinale) root, burdock (Arctium lappa) root, aloe (Aloe vera) leaf, turmeric
(Curcuma longa) rhizome, guduchi (Tinospora cordifolia) stem, red clover (Trifolium pratense) aerial parts,
and manjistha (Rubia cordifolia) root, is generally the best course of action, at least initially. In the case of
pitta-type skin irritations, it is best to take these herbs as teas or churnas (powdered whole herbs).
Alcohol-based tinctures are generally not appropriate for pitta-type imbalances, as alcohol is heating
and aggravates pitta. However, glycerites may be appropriate. Aloe juice and aloe gel (food grade) taken
internally are very supportive for acne and other skin issues that involve redness and inflammation.

Guduchi (Tinospora cordifolia) stem protects and rejuvenates the liver, and it is often used in skin
formulas because of this positive effect on hepatic function. Guduchi possesses a mixture of the bitter,
pungent, sweet, and astringent tastes and has a warm energy and a sweet, nourishing post-digestive
effect. It is a tridoshic herb, meaning that it is suitable for all three doshas. However, it is most commonly
utilized for pitta-type imbalances. Guduchi may be taken in cases of rashes, liver issues, gallstones, and
bacterial infections, as well as a host of other scenarios that involve the liver and an aggravated pitta
dosha. Guduchi also protects ojas and helps to regulate the immune system (Dass, 2013).

Manjistha – Rubia cordifolia ( Rubiaceae) – Root

Manjistha is a perennial, climbing plant with long, thin roots. True to its nature, its influence in the
body is also vine-like, spreading throughout the body and into the far reaches of the circulatory
system. Its literal meaning is “bright red,” which is indicative of its affinity for the blood and circulatory
system as well as its appealing red clay color (Pole, 2013).

Actions: Alterative, anti-inflammatory, antilithic, antipruritic, antitumor, astringent, circulatory
stimulant, diaphoretic, diuretic, emmenagogue, hemostatic, vulnerary

Energetics: Cooling, drying

Use: Manjistha is useful in dealing with a host of pitta-related imbalances, and is particularly indicated
for clearing skin issues such as acne, rosacea, eczema, and psoriasis. This is largely due to its
alterative properties and ability to support liver and spleen function (Dass, 2013). Manjistha is
well-known in Ayurveda for its ability to cool the blood, and it helps to clear it of excessive pitta and
ama—both useful attributes for a skin-supporting herb! Manjistha can also help promote the
circulation of blood to the skin, improving the body’s ability to manage slow-to-heal wounds. For
dealing with pitta-type skin conditions, manjistha combines well with neem (Azadirachta indica) leaf,


turmeric (Curcuma longa) rhizome, gotu kola (Centella asiatica) leaf, and aloe (Aloe vera) leaf (Pole,
2013).

Manjistha is not only used internally for skin
afflictions though. It is antipruritic and can help
to ease the itchiness of eczema, psoriasis, and
other itchy skin conditions when used topically.
It even has a special ayurvedic action known as
varnya (a substance that improves the
complexion) (Pole, 2013).

Manjistha is a useful hemostatic in cases of
excess bleeding and helps to break up
accumulations of kapha in the bladder, liver, and
uterus. This softening quality is why manjistha is
often suggested in instances of kidney stones,
gallstones, and fibroids. Manjistha can also be
used to help soothe mental irritability, especially
when combined with nervines such as gotu kola
(Centella asiatica) leaf, skullcap (Scutellaria
lateriflora) aerial parts, and shankhpushpi
(Evolvulus alsinoides) aerial parts (Dass, 2013).

Safety: Manjistha is not suitable for those with a
vata imbalance or a strong vata constitution.

Dose: Decoction: 3-9 g dried root/day (Dass,
2013); Tincture: 1-4 mL (1:3, 25%) 3x/day (Pole,
2013).

Managing Vata Skin Issues

Skin issues that are caused by vata dosha tend to show up as dry, scaly, and possibly itchy skin.
Constipation may be present as well. In general, the suggested course of action is to eat foods that are
moist, warm, oily, and grounding. External applications of sesame oil may also be helpful (Frawley,
2000). Commonly used herbs include the classic ayurvedic formula, triphala (fruits of Terminalia bellirica,
T. chebula, and Phyllanthus emblica), which helps to regulate bowel movements and provides a gentle
cleansing effect. Also, demulcents such as marshmallow (Althea officinalis) root, shatavari (Asparagus
racemosus) root, and licorice (Glycyrrhiza glabra) root are suggested. For vata skin imbalance, the
approach is to nourish and build rasa, and to alleviate dryness from the inside out.

Managing Kapha Skin Issues

Kapha-type skin imbalances are characterized by water retention, oozing or weeping sores, and skin
that feels damp. Cold and moist temperatures will make kapha skin conditions worse. To address the
underlying imbalance, one should eat kapha-reducing foods, which are hot, light, and dry. Hot, dry
weather and sweating are also helpful. Herbal formulas such as triphala guggulu, described below, are
supportive.


Triphala Guggulu

This traditional formula is a channel clearer and skin detoxifier (Frawley, 2000).

Ingredients

5 parts guggul (Commiphora mukul) resin powder
3 parts triphala powder (1 part bibhitaki (Terminalia bellirica) , 1 part haritaki (Terminalia chebula), and 1
part amalaki (Phyllanthus emblica) fruits)
1 part long pepper (Piper longum) fruit powder

Directions

● Combine all powders and mix until evenly distributed.
● The suggested dosage can vary quite a bit, depending upon the individual. Thus, it is helpful
to consult with a qualified herbalist or ayurvedic practitioner. In general, ⅛-¼ teaspoon of the
powder 2x/day is a good starting point.


Visit the course to download the Balancing The Doshas to Support Skin Health worksheet as a PDF.

TOPICAL APPROACHES TO SKIN HEALTH

Abhyanga (Skin Oiling)

Abhyanga is an important component of dinacharya (daily ayurvedic self-care practices). Abhyanga can
be performed daily, but even done a few times a week, it is a soothing, nourishing, grounding, and
immensely helpful practice. It is best to use oil that is slightly warmed, and the ideal oil varies based
upon one’s constitutional type. For vata dosha, sesame oil is best. Sunflower or coconut oil works well
for pitta dosha, and safflower or almond oil is generally recommended for kapha dosha. Abhyanga not
only keeps the skin elastic and moist, it also helps to provide a subtle, energetically protective barrier,
strengthening the immune power of the skin.

While many common oils, such as sesame and sunflower, work well for abhyanga, added benefit can be
derived by using herb-infused oils. These are commercially produced by various ayurvedic and botanical
product suppliers, but herbal abhyanga oils can also be prepared at home, and making your own infused


oils adds intention and potency. This abhyanga oil is tonifying, anti-inflammatory, and pacifying for both
vata and pitta doshas.

Vata-Pitta Abhyanga Oil

Adapted from Brenda Igler (Igler, 2016).

Note that the following recipe provides instructions on the traditional way to make an ayurvedic oil, but
the recipe can also be made using a standard oil infusion, as demonstrated in Unit 3.

Ingredients

1 tsp licorice (Glycyrrhiza glabra) root
1 tsp valerian (Valeriana officinalis) root
1½ tsp ginger (Zingiber officinale) rhizome
2 tbsp bala (Sida cordifolia) root powder
1 tsp amalaki (Phyllanthus emblica) fruit powder
1½ tsp guduchi (Tinospora cordifolia) stem powder
1 tsp manjistha (Rubia cordifolia) root powder
1 ½ tsp St. John’s wort (Hypericum perforatum) aerial parts
½ cup (4 fl oz) sesame oil
2 cups (16 fl oz) water

Directions

● In a medium-sized pot, bring the water to boil and add the licorice, valerian, and ginger. Turn
down to a simmer and cook until the water is reduced by 50%.
● Remove from heat and add the bala, amalaki, guduchi, manjistha and St. John’s wort. Cover
and let steep for 30 minutes.
● Add the sesame oil, put on a very low simmer, and stir occasionally until all of the water has
cooked off. These are some ways to determine when all of the water has evaporated and you
only have pure herbal oil left:
– The bubbles in the mixture become smaller (oil creates smaller bubbles than water).
– Oil becomes clear as the water evaporates. You may be able to see through to the bottom
of the pot more clearly.
– Hold a dry glass over your pot. This will help detect condensation if water is still present.
– Finally, when you strain the mixture, you should end up with 4 fluid ounces of oil (the original
amount you put in).
● Strain through several layers of cheesecloth. Label, store in a glass bottle for up to 1 year, and
enjoy as a lovely skin oil!


Abhyanga Video Demonstration

Visit the course to download the How to do Abhyanga video transcript as a PDF.

Soothing Skin Irritations

When dealing with both chronic and acute skin issues, it can be helpful to take a multi-pronged
approach. Working with diet and lifestyle as well as taking herbs internally is a great long-term plan.
However, it can also be helpful to apply herbs topically, especially for short-term soothing. This paste is
helpful for soothing eczema and other skin irritations that present with redness, itching, and
inflammation.

Skin Soothing Paste

Adapted from Brenda Igler (Igler, 2016).

One of the chief ingredients in this skin paste is neem (Azadirachta indica) leaf. Neem has many
applications for balancing skin issues, and may be used both internally and externally to that end.

Ingredients

2 parts neem (Azadirachta indica) leaf powder
2 parts echinacea (Echinacea spp.) leaf powder
2 parts comfrey (Symphytum officinale) leaf powder


1 part yellow dock (Rumex crispus) root powder

1 part burdock (Arctium lappa) root powder
1 part turmeric (Curcuma longa) rhizome powder
Aloe (Aloe vera) leaf gel or sesame oil (adjust amount as needed to achieve desired consistency.)

Directions

● Define your “part” based on how big of a batch you want to make—for a small batch, 1 part
could equal 1 teaspoon; for a larger batch, 1 part could equal 1 tablespoon or ¼ cup.
● Combine all ingredients in a bowl and stir until thoroughly mixed.
● Mix 1 teaspoon of powder with either aloe (Aloe vera) leaf gel or sesame oil. (Sesame oil is
preferred if there is significant dryness in the skin.)
● Apply to affected area and cover with a bandage. This paste can remain on the skin for
several hours.

Neem – Azadirachta indica (Meliaceae) – Bark, leaf, fresh twig

The neem tree is native to the Indian subcontinent, and thrives in hot weather, but has adapted to a
range of climates and regions and can be found throughout Asia, Africa, Australia, and Central and
South America. Dry, stony, shallow soils are ideal terrain for neem. It takes 10 years for the tree to
reach full maturity, but it will produce fruit at about 2-3 years old and has a productive life span of
150-200 years (Neem Foundation, 2014).

Actions: Alterative, anthelmintic, anti-inflammatory, antimicrobial, antipruritic, antipyretic, antiseptic,
antiviral, bitter, hypoglycemic, vulnerary

Energetics: Cooling, drying

Use: Neem possesses extremely cool, bitter,
and purifying qualities, which make it a popular
choice for soothing skin irritations, acne, chronic
skin conditions such as psoriasis and eczema,
liver and blood disorders, parasites, and a
number of other maladies that benefit from
strong purification. Neem particularly targets the
liver, spleen, blood, and lymphatic systems. Its
anti-inflammatory, vulnerary, antipyretic, and
antimicrobial properties are helpful for skin
issues, and for this reason it is common to find
soaps, shampoos, skin oils, and other topical
products made with neem. Topical applications
of neem are particularly useful for bacterial and
fungal infections of the skin (Dass, 2013).

Neem decreases pitta and kapha doshas, but increases vata dosha. Its cool, bitter qualities are
strongly pitta-reducing and it is especially useful for skin conditions that are a result of pitta or rakta
imbalance. This holds true when the herb is taken internally to cool the gastrointestinal tract, as well


as when it is applied topically to calm skin inflammations and irritations. Neem combines well with
turmeric (Curcuma longa) rhizome, gotu kola (Centella asiatica) leaf, guduchi (Tinospora cordifolia)
stem, and rose (Rosa spp.) petal for inflammatory skin conditions (Pole, 2013).

The alterative and astringent qualities of neem aid the body in removing ama and its anthelmintic
action makes it useful in avoiding the contraction of parasites and malaria. It is therefore an ally for the
world traveler—a small amount of neem can be taken daily when traveling to places where parasites
and malaria are common (Dass, 2013).

Safety: Neem is not suitable for those with a vata imbalance or a strong vata constitution. Neem is
best used short term or at low doses (Pole, 2013).

Dose: Infusion: 0.5-5 g leaf/day; Tincture: 1-5 mL (1:3, 25%) 3x/day (Pole, 2013).

Ayurvedic Pregnant Belly Mask

This recipe is based on a traditional ayurvedic belly paste used to ease the itchy skin that is so
common in pregnancy as well as to minimize stretch marks. Some of the herbs in the traditional
formula have sustainability issues or are difficult to find, and have been replaced with more common
herbs.

Ingredients

1 tbsp licorice (Glycyrrhiza glabra) root powder
1 tbsp manjistha (Rubia cordifolia) root powder
1 tbsp triphala (Terminalia bellirica, T. chebula, and Phyllanthus emblica) fruit powder
1 tbsp gotu kola (Centella asiatica) leaf powder
1 tbsp rose (Rosa spp.) petal powder
1 tsp nutmeg (Myristica fragrans) seed powder

Directions

● Combine powders in a glass jar. Label, and store in a cool, dark place for up to 1 year.
● Combine 2 teaspoons herbal powder with enough milk or water to make a smooth paste.
● Apply to belly and chest approximately 20 minutes before showering/bathing.
● Rinse in shower/bath.
● After shower/bath, apply moisturizer.

Garshana (Dry Brushing)

In some ways garshana is the antithesis to abhyanga. Whereas abhyanga is nourishing and moisturizing,
garshana is purifying and somewhat drying. It is a helpful practice in instances of water retention and
feelings of sluggishness. Therefore, it is supportive for kapha imbalances and is also indicated for most
individuals during late winter and spring—the kapha time of year. Dry brushing can be done with either a


special body brush or with silk gloves or even a dry washcloth. It is best to do dry brushing before
bathing in the morning. Since this practice helps to move sluggish lymph, it is done using circular
motions in the direction of the heart. Garshana should be avoided on areas of the body that are inflamed,
and the practice may also be contraindicated for individuals with sensitive skin, psoriasis, or eczema.

CONCLUSION

Radiant skin comes from within and is a reflection of the health of one’s immune system, rasa (plasma
and other fluids), rakta (blood), liver, and mamsa (muscle tissue). General self-care practices, such as
maintaining good digestion, practicing abhyanga and garshana when appropriate, and internal and
external use of herbs can all assist in cultivating healthy skin. However, it is important to have at least a
general understanding of one’s individual constitution in order to tailor skin care practices to better meet
your specific needs. Ayurveda is one approach that looks at skin health from a holistic perspective and
teaches the importance of addressing underlying imbalances associated with skin disturbance.


Ayurveda: A Life of Balance by Maya Tiwari
Ayurvedic Healing: A Comprehensive Guide by David Frawley
Ayurvedic Herbology East and West: A Practical Guide to Ayurvedic Medicine by Vishnu Dass
Ayurvedic Medicine: The Principles of Traditional Practice by Sebastian Pole
The Everyday Ayurveda Cookbook by Kate O’Donnell


LESSON 5: SKIN CARE IN CHINESE

MEDICINE

In the following video tutorial, acupuncturist and herbalist Brendan Kelly discusses skin health from a
Chinese medicine perspective. Note that because Brendan Kelly is a licensed acupuncturist, he is
licensed to use terms such as treat, diagnosis, prescribe, and medicine when he is referring to herbs.
Without a license in acupuncture, or other medical license, an herbalist is not legally able to use these
terms with clients.

Visit the course to download the Skin Care in Chinese Medicine video transcript as a PDF.


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LESSON 2

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LESSON 3

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LESSON 4

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Botanical Skin Care Course Unit 2

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LESSON 1: THE SKIN AS AN

Leafy Alterative Tea

Rooty Alterative Tincture

Blushing Blossom Shrub

Gingery Green Juice

Beet and Carrot Salad

1 tsp lemon zest (optional)

Kale and Shiitake Soup

Spiced Burdock Bitters

Roasty Reishi Roots Tea

● Combine all ingredients in a slow cooker; cover with 5 cups water.

LESSON 2: NUTRITION FOR HEALTHY

NUTRITIONAL SUPPORT FOR THE SKIN

Bone Broth Three Ways

LESSON 3: DIGESTIVE HEALTH AND

Happy Tummy Infusion

LESSON 4: SKIN CARE IN AYURVEDA

Skin Health and ​Rasa​ (Plasma and Other Fluids)

MANAGING DIGESTION FOR HEALTHY SKIN

Vata-Pitta Abhyanga Oil

Abhyanga Video Demonstration

Skin Soothing Paste

1 part yellow dock (​Rumex crispus)​ root powder

Ayurvedic Pregnant Belly Mask

LESSON 5: SKIN CARE IN CHINESE

Pedersen, M. (2010). ​Nutritional herbology.​ Warsaw, IN: Whitman Publications.

Das könnte Ihnen auch gefallen

Skin Health and Rasa (Plasma and Other Fluids)

1 part yellow dock (Rumex crispus) root powder

Pedersen, M. (2010). Nutritional herbology. Warsaw, IN: Whitman Publications.