WAY TO CONQUER SLEEP DISORDERS WITH GENERAL AND HOMOEOPATHIC MEASURES

Abstract

A sleep disorder, or somnipathy, is a medical disorder of the sleep patterns of a person or animal. Some sleep disorders are serious enough to interfere with normal physical, mental and emotional functioning. Polysomnography is a test commonly ordered for some sleep disorders. This article review about causes, risk factors, different type, clinical presentation general management including some home remedies management and homoeopathic way of treatment of sleep disorder. Homoeopathy treats the person as a whole. It means that homoeopathic treatment focuses on the patient as a person, as well as his pathological condition.

Introduction

Sleep is an opportunity for the brain and body to rest and be restored. In addition, many functions important to good health take place during sleep at night. The amount of sleep that people need can vary widely. Infants may need up to twenty hours; many children need from ten to fourteen per night. The average requirement for adults is estimated at six to eight hours, but many people need much more than that feeling chronically stressed and compromised, both physically and mentally, because of insufficient sleep.

Disruptions in sleep can be caused by a variety of issues, from teeth grinding (bruxism) to night terrors. When a person suffers from difficulty in sleeping with no obvious cause, it is referred to as insomnia. In addition, sleep disorders may also cause sufferers to sleep excessively, a condition known as hypersomnia. Management of sleep disturbances that are secondary to mental, medical, or substance abuse disorders should focus on the underlying conditions.

'SLEEP HYGIENE' SOLUTIONS FOR BETTER SLEEP

From having occasional difficulty sleeping to insomnia, there is a lot can do to get a better night's sleep, feel refreshed when awake, and remain alert throughout the day. It's called "sleep hygiene".

There are four general areas important to sleep hygiene:

Our circadian rhythm, or 24-hour cycle

v  Aging

v  Psychological stressors -- those factors can cause difficulty falling asleep and disturb the quality of our sleep

v  Common social or recreational drugs like nicotine, caffeine, and alcohol

Circadian Rhythm

We all have a day-night cycle of about 24 hours called the circadian rhythm. It greatly influences when we sleep and the quantity and the quality of our sleep. The more stable and consistent our circadian rhythm is, the better our sleep. This cycle may be altered by the timing of various factors, including naps, bedtime, exercise, and especially exposure to light (from traveling across time zones to staring at that laptop in bed at night).

Aging

Aging also plays a role in sleep and sleep hygiene. After the age of 40 our sleep patterns change, and we have many more nocturnal awakenings than in our younger years. These awakenings not only directly affect the quality of our sleep, but they also interact with any other condition that may cause arousals or awakenings, like the withdrawal syndrome that occurs after drinking alcohol close to bedtime. The more awakenings we have at night, the more likely we will awaken feeling unrefreshed and unrestored.

Psychological Stressors

Psychological stressors like deadlines, exams, marital conflict, and job crises may prevent us from falling asleep or wake us from sleep throughout the night. It takes time to "turn off" all the noise from the day. One must develop some kind of pre-sleep ritual to break the connection between all the stress and bedtime.

Social or Recreational Drugs

Social or recreational drugs like caffeine, nicotine, and alcohol may have a larger impact on our sleep than we realize. Caffeine, which can stay in our system as long as 14 hours, increases the number of times we awaken at night and decreases the total amount of sleep time. This may subsequently affect daytime anxiety and performance. The effects of nicotine are similar to those of caffeine, with a difference being that at low doses, nicotine tends to act as a sedative, while at high doses it causes arousals during sleep.

Alcohol may initially sedate us, making it easier to fall asleep; however, as it is metabolized and cleared from our system during sleep, it causes arousals that can last as long as two to three hours after it has been eliminated. These arousals disturb sleep, often causing intense dreaming, sweating, and headache. Smoking while drinking caffeine and alcohol can interact to affect our sleep dramatically. These sleep disturbances may be most apparent upon awakening, feeling unrefreshed, groggy, or hungover.

GENERAL TIPS TO GET BETTER SLEEP

In India, at least 10% of the people can’t sleep without the sleeping pills. In Mumbai the percentage of people suffering from insomnia is high. We believe that if this condition prevails for the next hundred years, not a single person will be able to sleep without medication.  Our whole being is totally connected to the sleep we have. Depression, heaviness, acidity, hypertension, tension all are related to the sleep problems.

A common concern of those who sleep poorly is that lost sleep will damage their health. Recent research demonstrated that the nightly loss of four hours of sleep over 10 days in healthy young adults reduced a number of measures of immune function. Two research papers described how sleeping less than five hours per night lowered the life span.

We all have trouble sleeping from time to time. But we can make it easier to get a good night's sleep every night with these simple steps.

v Cut caffeine. Simply put, caffeine can keep you awake. It can stay in our body longer than we might think – the effects of caffeine can take as long as eight hours to wear off. So if we drink a cup of coffee in the afternoon and are still tossing at night, caffeine might be the reason. Cutting out caffeine at least four to six hours before bedtime can help you fall asleep easier.

v Avoid alcohol as a sleep aid. Alcohol may initially help fall asleep, but it also causes disturbances in sleep resulting in less restful sleep. An alcohol drink before bedtime may make it more likely that we will wake up during the night.

v Relax before bedtime. Stress not only makes us miserable, it wreaks havoc on our sleep. Develop some kind of pre-sleep ritual to break the connection between all the day's stress and bedtime. These rituals can be as short as 10 minutes or as long as an hour. Some people find relief in making a list of all the stressors of the day, along with a plan to deal with them this can act as "closure" to the day. Combining this with a period of relaxation perhaps by reading something light, meditating, aromatherapy, light stretching, or taking a hot bath can also help us to get better sleep. And don't look at the clock! That "tick-tock" will just tick you off.

v Exercise at the right time. Regular exercise can help us to get a good night's sleep. The timing and intensity of exercise seems to play a key role in its effects on sleep. If we are the type of person who gets energized or becomes more alert after exercise, it may be best not to exercise in the evening. Regular exercise in the morning even can help relieve insomnia, according to a study.

v Keep bedroom quiet, dark, and comfortable. For many people, even the slightest noise or light can disturb sleep like the purring of a cat or the light from laptop or TV. Use earplugs, window blinds or curtains, and an electric blanket or air conditioner everything possible to create an ideal sleep environment. And don't use the overhead light if  need to get up at night; use a small night-light instead. Ideal room temperatures for sleeping are between 68 and 72 degrees Fahrenheit. Temperatures above 75 or below about 54 can disrupt sleep.

v Eat right, sleep tight. Try not to go to bed hungry, but avoid heavy meals before bedtime. An over-full belly can keep us up. Some foods can help, though. Milk contains tryptophan, which is a sleep-promoting substance. Other foods that may help promote sleep include tuna, halibut, pumpkin, artichokes, avocados, almonds, eggs, bok choy, peaches, walnuts, apricots, oats, asparagus, potatoes, buckwheat, and bananas. Also, try not to drink fluids after 8 p.m. This can keep us from having to get up to use the bathroom during the night.

v Restrict nicotine. Having a smoke before bed -- although it feels relaxing actually puts a stimulant into your bloodstream. The effects of nicotine are similar to those of caffeine. Nicotine can keep us up and awaken at night. It should be avoided particularly near bedtime and if wake up in the middle of the night.

v Avoid napping. Napping can only make matters worse if we usually have problems falling asleep. If we do nap, keep it short. A brief 15-20-minute snooze about eight hours after we get up in the morning can actually be rejuvenating.

v Keep pets off the bed. Pet sleep with us may cause us to awaken during the night, either from allergies or pet movements.

v Avoid watching TV, eating, and discussing emotional issues in bed.The bed should be used for sleep and sex only. If not, we can end up associating the bed with distracting activities that could make it difficult for us to fall asleep.

DIET AND SLEEP

How much of a direct effect diet has on sleep is still unclear. Adjusting our eating routine may also help us to get a better night's sleep. Most people in our country eat a light breakfast, a moderate lunch, and a large meal in the evening. Yet leaving the largest meal to the end of the day may not be the best choice, since it can result in uncomfortable distention and possibly heartburn when we retire for the night. 

Pattern for a more sleep-friendly meal plan: 

v Eat a substantial breakfast. Because we are breaking our nighttime fast and consuming the nutrients will need for energy throughout the morning, breakfast should be our largest meal of the day. Whole-grain breads and cereals, yogurt, and fruit are just a few examples of good breakfast choices. 

v Opt for a moderate lunch. Choose brown rice, pasta, or whole-grain bread and a serving of protein -- fish, eggs, chicken, meat or beans. 

v Finish with a light dinner. It is particularly important to eat lightly for our evening meal in order to prepare for a good night's sleep. Plan to finish our meal at least two hours before going to bed, preferably longer.

HOMOEOPATHIC MANAGEMENT FOR SLEEP DISORDERS

Professional homoeopaths do not generally prescribe remedies to treat symptoms individually, as the symptoms are considered to be only the outward sign that your vital force is struggling to overcome disease. Instead a remedy is prescribed for the whole person. Accurate prescribing is essential to the success of homoeopathy. A miasmatic tendency (predisposition/susceptibility) is also often taken into account for the treatment of chronic conditions. The medicines given below indicate the therapeutic affinity but this is not a complete and definite guide to the treatment of this condition. The symptoms listed against each medicine may not be directly related to this disease because in homeopathy general symptoms and constitutional indications are also taken into account for selecting a remedy.

Reportorial rubric

[Kent] Sleep, Sleeplessness

Acon., Argen. Nit, Arsenicum album, Belladona, Bryonia, Cactus, Calcerea, Chamomilla, China, Cicuta v, Coffea, Cyclamen,Hepar sulp, Hyosyamus,Kali ars, Kali Carb, Lachesis, Mercurius, Merc. Cor, Nux.vom, Opium, Phosphorus, Plumbum, Pulsatilla, Rhus.tox, Sepia, Stannum met, Silicea, Staphy, Sulphur, Thuja

[Complete] Sleep, Sleeplessness, night

Arsenicum album, Causticum, China, Cina, Coffea, Conium, Ferrem met, Graphites, Hyosyamus, Mag.carb, Moschus, Nat.mur, Nit.ac, Nux.vom, Olendar, Opium, Phosphorus, Plumbum, Rhus.tox, Silicea, Spigelia, Squilla, Thuja

[Boericke] Nervous system, Sleep, Insomnia (Sleeplessness)

Absin, Acon., Anacardium, Arsen album, Avena, Belladona, Calcerea, Camph, Camph – monobrom, Cann ind, Chammomilla, Cimcifuga, Cinchona, Coca, Cocaine, Cocculus, Coffea, Cypripedium pubescens, Gelsimium, Hyoscyamus, Hyoscyaminum hydrobromatum, Ignasia, Kali brom, Lupulus hum, Nux.vom, Opium, Passiflora, Pulsatilla, Scutellaria  lateriflora, Sulphur, Sumbulus ferula

[Boenninghausen’s] Sleep, Sleeplessness

Aconite, Arsenicum album, Bryonia, Calcerea, Chamomilla, Coffea, Hepar sulp, Kali Carb,  Mercurius, Nux.vom, Pulsatilla, Sepia, Silicea

Remedy	Individualizing  Symptoms
Aconite	Sleeplessness related to anxiety, shock, fright or grief. The sufferer is frequently troubled by nightmares and insomnia accompanied by physical and mental restlessness. Symptoms are worse from pressure of bedding, during menses and in a warm room. Better in open air.
Arnica	Sleeplessness associated with jet lag and overwork, the sufferer’s bed feels too hard and uncomfortable, and they may be overtired. Also useful for insomnia related to recent injury. Worse from least touch or wine. Better for lying with the head low or lying outstretched.
Arsenicum Album	Feel sleepy during the day but anxious at night. Restless in bed with anxious dreams and nightmares. Also for warmth, warm drinks, moving about, and sleeping propped up in bed.
Chamomilla	Sleeplessness related to restlessness, irritability, anger or the overuse of coffee. This is a well-used remedy for children suffering from insomnia who refuse to be calmed. Also handy for insomnia and restlessness during the first part of the night and insomnia related to nightmares. Worse for being covered but better for sweating.
Cocculus	Difficulty sleeping due to being overtired or exhausted. People needing this remedy are often emotionally sensitive, suffer from motion sickness and/ or depression. Symptoms are worse for touch, noise or cold, worse during menses and better for lying on the side.
Coffea c.	This is an excellent remedy for insomnia, particularly where the person is troubled by unwanted thoughts and the nervous system is over-excited, causing an over activity of the mind and body. Worse for cold and noise and better for warmth. Also useful for insomnia during pregnancy.
Gelsemium	Sleeplessness associated with anxiety related to impending events such as stage fright in people who tend to be dull and drowsy, who cannot get fully to sleep, or have a restless or overly heavy sleep. Worse in damp, humid weather or in spring and better for reclining with the head held high.
Ignatia	Sleepless from grief or sadness. Those who’ll benefit from this remedy are very light sleepers who often whimper while sleeping and have re-occurring bad dreams. Worse for cold open air and touch and better from pressure and warmth.
Kali phos	Sleeplessness related to anxiety, mental strain, muscular fatigue, night terrors, restlessness or sleepwalking. Worse for touch, cold or fatigue and better for leaning against something.
Nux vom	Sleeplessness associated with irritability, anger and gastrointestinal complaints in people who are impatient, fastidious and competitive. The person who’ll benefit from this remedy often wakes at around 3am, is worse for cold, dry weather, worse from eating and better for strong pressure and damp, wet weather.
Opium	If the person is feeling sleepy but unable to get to sleep, if the bed is too hot, or else sleep comes but it is so heavy that the person snores and cannot be roused.
Pulsatilla	The Pulsatilla type is restless in the first part of sleep and can’t decide if they’re too hot or too cold and they may wake up too early.  Insomnia may be related to sadness, fear or irritability. Symptoms are worse from eating bread, fatty or rich food before sleep, and symptoms are worse before or during menses. Better in the open air or cool weather.

MOTHER TINCTURES

Absinthium

            Sleeplessness due to nervous excitement

Avena sativa

            Insomnia with despondency

Passiflora Incarnata

            60 drops in a ounce of hot water at 8pm induces sleep

Thea

            For nervous sleeplessness with history of tea abuse

Piscidia

            Here cause of sleeplessness is mental worries

Hypericum

            The key actions are antidepressant, antispasmodic, analgestic, astringent, antiviral, sedative and it stimulates bile flow

Conclusion

The main outcome of Homoeopathic approach is to regains the body's natural healing and immune the body cells to treat the conditions that affect the body, prevent it and restore the good level of health and well-being. Along with Homoeopathic medicines, the lifestyle, personal habits & food habits modification may be useful for treatment of patients with sleep disorders. 

ACNE (PIMPLES) – A COMPLETE REVIEW WITH HOMOEOPATHIC APPROACH.

Abstract

Acne is one of the most common skin conditions of all age group individuals especially among the teenagers. The clinical presentation of acne can range from a mild comedonal form to severe inflammatory cystic acne of the face, chest, and back. Acne can occurs during a time of low self-esteem and high concern about appearance. This article review about causes, risk factors, different type, clinical presentation general management including some home remedies management and homoeopathic way of treatment of acne. Homoeopathy treats the person as a whole. It means that homoeopathic treatment focuses on the patient as a person, as well as his pathological condition.

Introduction

Acne, medically known as Acne Vulgaris, is a skin disease that involves the oil glands at the base of hair follicles. Acne, or the presence of pimples or blackheads, can be a problem on the face, chest, and back. Although it is most common during adolescence, acne can occur at other times in life. Acne is the common cause of spots. Boys are more commonly affected than girls.

The severity can range from mild to severe. About 9 in 10 teenagers develop some degree of acne. Often it is mild. However, it is estimated that about 3 in 10 teenagers have acne bad enough to need treatment to prevent scarring. Untreated acne usually lasts about 4-5 years before settling. However, it can last for many years in some cases. Good hygiene and diet play an important role in resolving this complaint. The acne vulgaris is perhaps one of the most dreaded problems many people face. The main cause behind the fear is obviously the degree of “loss of confidence” this problem causes in the population than the actual lesion.

Causes and Risk Factors of acne

Acne is a skin condition that occurs when hair follicles become plugged with oil and dead skin cells.

·        Androgen level - Nobody is completely sure what causes acne. Experts believe the primary cause is a rise in androgen levels - androgen is a type of hormone. Androgen levels rise when a human becomes an adolescent. Rising androgen levels make the oil glands under your skin grow; the enlarged gland produces more oil. Excessive sebum can break down cellular walls in your pores, causing bacteria to grow.

·        Genetic factor - Some studies indicate that a susceptibility to acne could also be genetic. Medications - Some medications that contain androgen and lithium may cause acne. Greasy cosmetics may cause acne in some susceptible people.

·        Pregnancy - Hormone changes during pregnancy may cause acne either to develop for the first time, or to recur.

·        Recent research narrates that everyone has acne-causing bacteria living on their skin, but researchers at the Washington University School of Medicine have identified that there are "good" and "bad" strains of the bacteria, which determine the frequency and severity of developing pimples.

·        High GI-diet and dairy intake linked to acne - A diet high in glycemic index foods and dairy products is now linked to acne, according to a new study published in the Journal of the Academy of Nutrition and Dietetics.

Other condition which worse acne includes

·        The progestogen-only contraceptive pill may make acne worse. In women, the hormonal changes around the monthly period may cause a flare-up of spots.

·        Picking and squeezing the spots may cause further inflammation and scarring.

·        Sweating heavily or humid conditions may make acne worse. For example, doing regular hot work in kitchens. The extra sweat possibly contributes to blocking pores.

·        Spots may develop under tight clothes. For example, under headbands, tight bra straps, tight collars, etc. This may be due to increased sweating and friction under tight clothing.

Classification and Clinical Manifestations

Whiteheads - remain under the skin and are very small

Blackheads - clearly visible, they are black and appear on the surface of the skin. (Remember that a blackhead is not caused by dirt. Scrubbing your face vigorously when you see blackheads will not help)

Papules - visible on the surface of the skin. They are small bumps, usually pink

Pustules - clearly visible on the surface of the skin. They are red at their base and have pus at the top

Nobules - clearly visible on the surface of the skin. They are large, solid pimples. They are painful and are embedded deep in the skin

Cysts - clearly visible on the surface of the skin. They are painful, and are filled with pus. Cysts can easily cause scars.

General Management

·        Wash your face about twice each day. Do not wash it more often. Use a mild soap and lukewarm water. (Very hot or cold water may worsen acne.) Do not scrub hard when washing acne-affected skin. Do not use abrasive soaps, cleansing granules, astringents, or exfoliating agents. Use a soft washcloth and fingers instead. Excess washing and scrubbing may cause more inflammation, and possibly make acne worse.

·        Don't try to burst the pimples. It may push the infection further down, causing more blocking and worse swelling and redness. Popping pimples makes scarring more likely.

·        Keep your hands clean, wash them regularly

·        Always wash your hands before touching your face.This includes before applying lotions, creams or makeup

·        Glasses should regularly be cleaned. They will collect sebum and skin residue

·        You skin needs to breathe. If your acne is on your back, shoulders or chest try wearing loose clothing. Tight garments, such as headbands, caps and scarves should be avoided - if you have to wear them make sure they are cleaned regularly

·        Hair collects sebum and skin residue. Keep your hair clean and away from your face

·        Too much sun can cause your skin to produce more sebum.

Home Remedies:

1.      Ice can be used to quickly reduce the redness, swelling and inflammation of pimples. It helps in improving blood circulation to the affected area, and in tightening the skin pores and removing dirt and oil accumulated on the skin. You can use ice cubes or crushed ice, whichever is convenient. Wrap the ice in a piece of cloth and hold it on the affected skin area for a few seconds. Wait a few minutes and repeat the process.

2.      Another quick way to get rid of pimples is the use of lemon juice, which is rich in vitamin C. Lemon juice helps pimples dry up faster. Be sure to use fresh lemon juice and not bottled juice, which has preservatives. There are a couple of ways to apply this remedy. Dip a clean cotton swab in fresh lemon juice and apply it to the pimples before going to bed. You can also mix one tablespoon of lemon juice with one teaspoon of cinnamon powder and put it on the pimples overnight. In the morning, wash the skin well with lukewarm water. However, this particular remedy is not suitable for those with sensitive skin.

3.      The toothpaste that you use every morning to clean your teeth also can be used to treat pimples quickly. It is most effective when used following the ice remedy. You must use white toothpaste; avoid using gel toothpaste. The toothpaste that you use every morning to clean your teeth also can be used to treat pimples quickly. It is most effective when used following the ice remedy. You must use white toothpaste; avoid using gel toothpaste. Apply some white toothpaste over the affected skin area before going to bed. In the morning, wash your face with water and you will see a significant improvement in the swelling.

4.      Garlic is an antiviral, antifungal, antiseptic and antioxidant agent that can help in the fast treatment of pimples. The sulfur in garlic also promotes quick healing of pimples. Cut a fresh garlic clove into two pieces. Rub the garlic on the pimples and leave it for five minutes before washing the skin with lukewarm water. Repeat the treatment several times a day. Eating one raw garlic clove daily can also help purify your blood. But do not to eat too much raw garlic as it can upset the stomach.

HOMOEOPATHIC MANAGEMENT

The homeopathic medicines are selected after a full individualizing examination and case analysis, which includes the medical history of the patient, physical and mental constitution etc. A miasmatic tendency (predisposition/susceptibility) is also often taken into account for the treatment of chronic conditions. The medicines given below indicate the therapeutic affinity but this is not a complete and definite guide to the homeopathic treatment of acne. The symptoms listed against each medicine may not be directly related to this disease because in homeopathy general symptoms and constitutional indications are also taken into account for selecting a remedy.

Some Homoeopathic remedies for Acne are Sulphur, Sanguinaria, Kali bromatum, Antimonium crudum, Asterias Rubens, Belladonna, Hepar Sulphur, Calcarea Silicata, Nux vomica, Arsenicum iodatum, Causticum, Chelidonium majus, Graphites, Psorinum, Sabina, Calcarea phosphoricum, Ledum palustre, Nitricum acidum, Bovista, Tuberculinum

Indicated Remedies	Indications
Asterias rubens	Considered as one of the chief dugs for treating acne, Itchy acne, Skin seems less elastic, Acne eruptions with fetid pus, Acne rosacea, Acne affecting back, shoulders, sides of nose, chin, Flabby patient with lymphatic constitution, Sycotic diathesis, Sexual excitement in both sexes, Fear of bad news in adolescent girls, Worse coffee, left side
Belladonna	Red, hot facial skin,  Scarlet rash like acne, Suddenly spreading acne lesions, Alternate redness and dullness of skin, Pustular eruptions on skin, Skin feels smoothly red but burns, Acne leading to swelling of glands of neck, chin, Bluish, red acne lesions, Shiny red eruptions
Sulphur	Is perhaps the remedy most often indicated in this affection, especially if chronic. The skin is rough and hard and the acne is associated with comedones and constipation; great aggravation from water is the characteristic leading to Sulphur in skin affections. Face is Pale, sickly color. Heat and spotted redness of face. Black pores. Itching intensely in evening and from warmth. The acne punctata is the variety corresponding most nearly to Sulphur. Simple forms yield to Belladonna or Pulsatilla. Acne rosacea yields to Arsenicum iodatum or Sulphur iodide.
Kali bromatum	Acne on the face, neck and shoulders. We frequently find acne in Epileptics who have been maltreated by bromides. This remedy is especially adapted to the acne simplex and the acne indurata, especially in hyperaesthetic, nervous females. Face flushed. Acne of face, pustules. General failure of mental power, loss of memory, melancholia, anesthesia of the mucous membranes. Suicidal mania with tremulousness. Itching of skin worse on chest, shoulders, and face. Anesthesia of skin. This remedy may be given if Asterias Rubens fails. Dr. J.H.Clarke says, “I know of no remedy of such universal usefulness in cases of simple acne as Kali bromatum 30,” and the late Dr.A.M. Cushing recommended Arsenicum bromatum 4x as very efficacious. Thuja is one of our best remedies for acne facialis. Calcarea picrata is also a useful remedy for acne; clinically it has been found one of the good remedies. Calcarea sulphurica is indicated where the pimples suppurate.
Antimonium crudum	Small red pimples on face, acne in drunkards with gastric derangements, thirst and whitecoated tongue. Face with sad expression Fat, fretful, cross and peevish; cries if looked at, touched or washed. Ecstatic, dreamy, sentimental. Pustules.
Natrum muriaticum	It acts especially on the sebaceous glands, and is a very helpful remedy in acne. In this affection attention must be directed especially to the patient’s type, temperament and tendencies and the general symptoms are far mores important than the local ones.
Radium brom	Acne rosacea with red pimply rashes, Small eruptions with itching, burning, swelling, and redness, Excessive itching with burning of skin as if on fire, Painful pimples, Acne with scars that take long time to heal, May be associated with itchy dermatitis of skin and/or trophic changes in fingernails, Acne seem worse after getting up in the morning, Better, in open air and hot bath
Bovista	Acne in sensitive girls, Crusty eruptions around mouth and nostrils Acne from overuse of cosmetics, Swollen look of cheeks, Sensitive skin with tendency to leave deep impression with blunt instruments Itchy eruptions, May have had an attack of urticaria or tendency to recurrent urticaria, Pimples covering the entire body, Acne always worse in summer
Hepar Sulphur	Papules prone to suppurate and extend. Acne in youth. Suppurate with prickly pain. Easily bleed. Unhealthy skin; every little injury suppurates. Cannot bear to be uncovered; wants to be wrapped up warmly. Sticking or pricking in afflicted parts. Great sensitiveness to slightest touch. Constant offensive exhalation from the body Face, Yellowish complexion. Suits especially scrofulous and lymphatic constitutions that are inclined to have eruptions and glandular swellings. Unhealthy skin. Great sensitiveness to all impressions. The lesions spread by the formation of small papules around the side of the old lesion. Chilliness, hypersensitiveness, splinter like pains, craving for sour and strong things are very characteristic.
Calcarea Silicata	Pimples, comedones. A deep, long acting medicine for complaints which come on slowly and reach their final development after long periods. Hydrogenoid constitution. Skin Itching, burning, cold and blue, very sensitive. very sensitive to cold. Patient is weak, emaciated, cold and chilly, but worse from being overheated; sensitive generally.
Merc sol	Syphilitic acne, Earthy, puffy, dirty looking face, Pustular acne, Constantly perspiring skin, A big pimple surrounded by many small pimples, Itchy eruptions worse from the warmth of bed, Eruptions in private parts, buttocks. Skin and mucus membranes affected at the same time, Yellowing brown or greenish pus from Pustular acne, may be streaked with thin blood. Extremely fetid suppuration Worse extremes of temperature, night, dampness, perspiration

Conclusion

The main outcome of Homoeopathic approach is to regains the body's natural healing and immune the body cells to treat the conditions that affect the body, prevent it and restore the good level of health and well-being. Along with Homoeopathic medicines, the lifestyle, personal habits & food habits modification may be useful for treatment of patients with acne.