*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.

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.
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.