The Snakeskin Medicine – Black Cohosh, Women, and Skin Care

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Many medications for acne fail people, particularly women. Learn how black cohosh is being explored and researched as an acne treatment, and how it works in both mainstream medicine and herbalism.
Black Cohosh (Actea racemosa), imperiled and replanted in Iowa City, IA – Photo Credit Mandy Garner-Dickerson, Moon in June Herbs

*Disclaimer* This article on black cohosh for skin care is meant to be a shared experience and insight by the author, not a suggested hormone therapy regime.  If you are curious about how certain hormone therapies and herbs could help treat your acne, please refer first to the guidance of a professional healthcare provider, your doctor, or a trained herbalist.

It’s a more interesting topic for the female half of the population: having healthy, glowing skin is a focus for many of us girls and women. Arguably, for the majority of us.

Females are most driven in our society to look good and appealing in the eyes of others.  Quite an unbearable pressure for some of us, but I won’t get into the whole feminist pickle that is here – and instead I’ll just stick to the herbalism.

Ironically, skin problems and acne tend to be the worse for women to deal with than men in our adult age.  Why?  Hormones.

As all of us females know, hormones control many aspects of our lives, and that is barely an overstatement.  Sometimes even our thoughts, feelings, opinions, and reactions during the day-to-day are governed by those crazy things.  Our only hope is to shrug off that idea, and pretend it isn’t true.

But if you ever find the time, sit down and have some tea with the closest woman to you in your life who has gracefully passed through menopause.  She is likely to agree with this sentiment, 100%.

The Hormone-Acne Connection

An herbal client of mine (and voluntary herbalist’s “guinea pig”) came and talked to me not too long ago on a completely non-herb related matter: her pretty much life-long struggles with acne.  What she ended up mentioning was that her doctor recommended she go on birth control pills to help control her skin problems.

I was honestly a bit flabbergasted, and as any herbalist with at least some handle on things would probably blurt out, I said “Why the heck would you do that?”

Followed immediately by “Why don’t you just start taking Black Cohosh?”

A little bit of science first: some women’s acne directly has to do with hormonal imbalance, as I stated earlier.  Thanks to a million different little factors in our modern-day existence, our estrogen gets screwed with – whether it be from “xeno-estrogrens” found in plastics all around us (packaging our food, for example), or from the birth-control pills that we think should be the standard for regulating our reproduction.

Through one way or another, the balance between estrogen and progesterone gets wacky.  This is especially noticeable right before menstruation- when estrogen levels plummet to give way to testosterone, one of the reasons why we get cranky and irritable.

Hormone Cycle | Iowa Herbalist
Graph of Average Hormone Fluctuations in Women – Women in Balance Institute – National College of Natural Medicine

When testosterone levels prevail over estrogen/progesterone in women’s bodies, that’s when acne erupts.  You get those big chin pimples, or zits on your chest, your cheeks, shoulders, or right underneath your shoulder blades.  Funnily enough, they pop up right where men usually have body hair.  The body secretes oils that it just doesn’t know what to do with.

It’s true – hormones don’t only affect our moods sometimes, but also the health of our skin. Fluctuations of female (but mostly – yes, believe it or not – male) hormones create excess sebum in the skin, which then lead to acne. For an excellent understanding of how it all works, check out this article here by the American Academy of Dermatology.

Back to the story about my client- her doctor told her just as much, that some women may not produce enough estrogen to counteract testosterone levels (this often has a lot to do with body type, genetics, or diet).  So he mentioned the idea of prescribing her birth control pills, something that is actually quite common. Even some dermatologists recommend it.

But what do you do if you want to take something natural, and moreover, if you aren’t sexually active or don’t even need contraceptives?  What if you are wary of the many side effects that birth control pills and I.U.D.’s might have?

Black Cohosh – Its History of Mimicking Estrogen

Black Cohosh (Actaea racemosa, formerly Cimicifuga racemosa), along with some other popular herbs out there, is beginning to be an experimental treatment for acne among professional healthcare providers all over the country – not just herbalists.

Cohosh contains “phyto-estrogens,” or plant compounds that are thought to mimic estrogen.  When the herb is taken, the body reacts to it as if there was estrogen present – though it’s still not clear how.

Whatever goes on, human estrogen receptors are in some way affected by the plant’s constituents, making the body respond as if responding to estrogen.There are studies to support this use: here, and here.

Put two and two together – and you have yourself a possible alternative to birth control for acne treatment.

Traditional Use of Black Cohosh

Traditionally, Black Cohosh’s use is rooted in Native American medicine, used for female health and complaints long, long before its capsules have shown up on the shelves of natural food stores.

Bottles Apothecary | Iowa Herbalist

One of the other names for the plant was once “Black Snakeroot,” believed to have an affinity to snakes (and specifically rattlesnakes – the flowers of the plant look an awful like the rattle on this venomous serpent).  Eastern First Nation peoples also used the plant as a cure for snake bites.

Now, the plant has a modernized use that emulates its “spirit animal” – for the skin.  Like a snakeskin being shed, Black Cohosh is an herb that can be of immense help to certain individuals to put on a new skin, shed the old, and find a new-found sense of confidence and beauty in their appearance.

Needless to say, my client was grateful and happy that she discussed the idea of taking birth control with me before she went ahead and just did it– sight unseen.  At my suggestion, she decided to give Black Cohosh a try.  A week later she emailed me.  “My skin is beginning to clear up!”

A few months later, I saw her in person, and I had never seen her skin that clear in years.

Mainstream healthcare still dubs the use of many herbs as “experimental” or “unproven,” but this is one where I saw the results right before my eyes.

Please consult with a professional healthcare provider or physician before considering taking Black Cohosh for any reason.

Many medications for acne fail people, particularly women. Learn how black cohosh is being explored and researched as an acne treatment, and how it works in both mainstream medicine and herbalism.

Adrian White is a certified herbalist, author, organic farmer, and freelance writer on subjects of health, wellness, nutrition, herbalism, and agriculture. Her book Herbalism: Plants & Potions That Heal was published through Arcturus Publishing and is available wherever books are sold. She is a past contributor to Healthline with bylines in The Guardian, Civil Eats, Good Housekeeping, and Rodale's Organic Life. Adrian is owner of Deer Nation Herbs and Jupiter Ridge LLC, an organic farm growing diverse vegetables, mushrooms, and herbs. On any given day you can find her jumping between writing or researching, reading books, experimenting with a new food or herbal creations, or tending to herbs, vegetables, or mushrooms on her farm in the Driftless Region of Iowa. Visit her Resume/CV page, hire her as a freelancer (writing, marketing, social media) for your projects, or book her for an herbal educational health consultation.

13 thoughts on “The Snakeskin Medicine – Black Cohosh, Women, and Skin Care

  1. Could you give an idea of dosage or any specifics on the black cohosh please? I have suffered for years with miserable deep cystic acne, I have tried every lotion, potion, birth control, painful cortisone injections, horrific Accutane, DIM, every diet from raw vegan to paleo, most anti biotics, pro biotics, vitamins, minerals, oil cleansing,raw honey, lemon juice, Apple cider vinegar, yoga, meditation, prayer…… you get the picture!
    I have recently tried vitex agnus castus for four months and it has been worse than ever!
    I know from recent blood tests my progesterone is high but was not tested for androgens, I certainly seem more hairy over the past few years.
    Any help gratefully appreciated.
    Many thanks

    1. Thank you for writing Abbe, really sorry to hear of all these struggles you are facing.

      Unfortunately I can’t recommend any super specific dosage information – the most I can recommend is that you get hormone levels checked by a reliable health practitioner, preferably a blood panel or lab. If androgens are high and estrogen is low, then black cohosh capsules may work out for you.

      Dosage varies greatly depending on the supplement or tincture you get, all sorts of different companies create their products in different potencies. I can only suggest you read the directions on the label of any product you buy.

      If your doctor, physican, practitioner, or whosoever deems it safe to do so, you could try the black cohosh supplement on your own. It is incredibly safe and has virtually no reported dangers or side effects, just make sure to obtain the supplement from a highly reputable company – HerbPharm is great.

      The client I worked with had very deep prolific acne since she was a child, and her skin has been permanently restored since taking it. I really hope it works for you too, it’s life changing! I wish you the best of luck!

  2. Hello thank you for your blog and wonderful information. I have a couple of questions. Do you do online consultation ? or have a location that I can visit ? The person that you recommended the black cohosh did you use a tincture or capsule form and and how much did you recommend toe friend to take? I got my levels checked both siliva and blood which both says different things. My blood test says everything was Normal but my siliva test says that my estrogen was low my testosterone was normal range and my progesterone was slightly low. I have been working with a herbalist. But so far it hasn’t really been working . Please can you answer my questions above it would be gladly appreciated.

  3. Also I forgot to mention that I have severe acne on my cheeks forehead and chin and I am usually drenched with Mcintosh sweats 2 weeks before my period. Please help.

    1. Hi Anne! Thank you for reading and writing in. I sure do wish I was doing consultations currently, but I am not, neither in person or online (yet). My client who I suggested black cohosh to has used mostly capsules I believe, and may have switched to tincture at times. I believe she simply followed the dosage instructions on the bottles. It does sound like you may have a strong collection of signs that *could* indicate low estrogen. I would recommend talking with both your current physician and herbalist to see if taking something that would boost your estrogen levels would be right for you (if you are taking an estrogen birth control for example, black cohosh would definitely not be right for you), and to make sure you track your cycle and take it on and off for two weeks at a time (don’t take it during times when estrogen peaks in your cycle, usually the two weeks following menstruation). You’ll know for sure after talking with your doctor. Otherwise, taking black cohosh yields no side effects in people who don’t have potential health interactions with it or who take it two weeks on, two weeks off – other than if overtaken in high doses over a long period of time.

      I wish you the best of luck, Anne, if you decide to give it a try. It really did change my client’s life positively.

    1. Hi Dorothy! Thanks for reading. I don’t think taking black cohosh supplement will make your skin oily, but everyone reacts differently to a single herb. If you think your skin issues may be estrogen-related, I can say that black cohosh will likely help correct an imbalance rather than make your skin more oily. I’d definitely talk with your doctor, herbalist, or dermatologist about this but also to watch how your skin reacts if you decide to safely give black cohosh a try! Best of luck!

  4. Hi Adrian,
    I read your article with interest about black cohosh and its possible utility in treating acne. I was wondering if you had any thoughts on using black cohosh topically for treating skin ageing due to estrogen loss postmenopausally? There is at least one skin product (Empelle) that uses non-hormonal estrogen mimics to treat signs of age in skin of post menopausal women. Just wondering if it is possible to use black cohosh the same way.

    1. This is a good question – I’m curious if it would work too. I really don’t know! My guess would be yes, as there are topical progesterone products. I would suspect however that there would need to be other ingredients added (carriers, collagen, etc.) for there to be any progressive anti-aging effect however, my guess is plant estrogen could not achieve that for skin alone.

  5. Hi Adrian, thanks for the article. I recently started taking black cohosh to improve estrogen and help with acne. You mention in a comment reply it shouldn’t be taken following menstruation. Does this mean it should only be taken in the second half of my cycle, after ovulation until menstruation? Thank you so much

    1. Hi Rosie! Thank you so much for your inquiry or question. For inquiries like yours, especially on the topic of natural hormonal imbalance and how herbs can help (and that being a matter that is different for everyone), I’d be more than happy to address these in an herbalist consultation. For information on these consultations visit the “Consultations” link above and click on “Herbalist Consultations” in the dropdown menu. You can also visit the Online Shop to purchase and book one with me.

      If you do purchase a consultation booking I will be in touch with you as soon as I can about the best time for this to take place, and what format you would like it to be: write-up protocol, phone call, or Zoom session.

      Thank you so much for your interest!

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