REVIEW OF RELATED LITERATURE

This chapter presents the related Literature and studies both Local and
Foreign sources.

FOREIGN LITERATURE
It's unclear when lemon became a popular home remedy for acne or what its origins
were.Still, it's clear that lemon and lemon water for acne are considered well known
acne treatments. The question is whether or not they work.

Because lemon is such a simple idea, and because rarely are any research dollars
spent on natural remedies, there is no current evidence that acne and lemon interact
in any way. That said, it's possible that lemon has an effect on acne. Most likely – if
lemon affects acne at all – it would be with regard to acne scars. There is evidence
that vitamin C is beneficial for speeding up the wound healing process. Since acne
scars are a type of wound, leaving vitamin C on the face could be a beneficial way to
reduce scarring and ultimately reduce the appearance of acne (although acne itself
will still be present).

It's also possible that lemon has some type of either antibacterial properties. Lemon
has a very low pH balance, indicating that it may damage and ultimately reduce the
amount of bacteria on your face. Essentially, lemon is an acid that may be safe for
skin, and since most bacteria cannot handle that type of acid it's possible that lemon
is killing off the excess bacteria that cause acne. That same acidic content may help
dry out the skin as well. That dryness would essentially mimic what other acne
treatments do – reduce oil buildup on the skin to help pores breath and prevent
bacteria proliferation. Once again, it's not necessarily clear what the link between
lemon and acne is, if there is a link at all, because there are no scientific studies of
the effects of lemon for acne. But there is logic behind the idea that lemon could be
effective as an acne treatment. (www.progressivehealth.com)

Acne vulgaris, or acne, occurs in 40 to 50 million individuals in the U.S. and is the
most common skin condition, according to the American Academy of Dermatology.
Acne occurs from excess oil buildup, clogged pores, inflammation and bacteria.
Over-the-counter products are available to treat acne breakouts, but they can be
pricey. Lemon juice is a home remedy for acne treatment and is inexpensive
compared to the acne products at stores. Lemons contain a natural astringent and
antibacterial agent that acts as an exfoliant to help remove dead skin cells faster and
prevent clogged pores. Lemon juice is not a substitute for medical treatment; consult
with your health care provider to discuss any potential risks or if your condition
worsens. (Carolyn Russell-Delucas, Blogger, 2017)

According to Aleena Sooban, MB BS from UOL - University College of Medicine

& Dentistry (2017), lemon extract has citric acid and other ingredients, including vit
C. In her view, it can act as an astringent just like salicyclic acid though a bit milder.
Might take a longer amount of time too as compared to salicyclic acid. Ofcourse it
should never be used on dry skin, but if you have an oily skin it will work wonders,
just don’t use it excessively. This is considering you have occasional breakouts, if
you have frequent ones, you need a check up. Acne has multiple causes from
hormones to stress to poor sleep pattern to chemical etc.

According to a blogger named Rashedul Islam, Many believe that lemon juice is the
miracle cure for acne, so they looked into the details of using lemon juice as an acne
treatment . Lemon juice does have some acne fighting qualities and can be a cheap
way to try and clear your skin. Here are the primary benefits of lemon juice and acne:
Reduces oil: The acid in lemon juice has mild astringent qualities. The astringents
work by constricting the body tissues and pushing the oil out of your skin. Kills
bacteria: The citric acid of lemon juice also acts as an antiseptic. Since bacteria have
a difficult time adjusting to acidic environments, the lemon juice can help reduce the
number of bacteria that are living inside or on top of your skin. Cheap: All it costs
you is a couple of lemons and some cotton balls to apply it. Reduces redness: Many
find that applying an astringent like lemon juice greatly reduces the redness caused
by acne. Scar therapy: Some believe lemon juice is a natural way to reduce scars
caused by acne.

According to a Thai blog Onlymyhealth (2014) Not many like the sour taste of
lemon and don’t prefer it for its extreme tartness; though, the sour fruit has various
health uses. The benefits of lemon extract range from losing weight to controlling
blood pressure, to skin benefits and more. Acne is a skin condition in which hair
follicles become clogged with oil and dead skin cells. Lemon extract reverses the
damage and prevents it. One of the main ingredients of lemon extract is citric acid,
which has been found effective against a number of skin problems such as acne. It is
because of the presence of vitamin C in this citrus fruit that promotes healthy,
glowing skin. Besides, the alkaline nature of the citric fruit kills some types of
bacteria known to cause acne.

Lemon juice is known for its bleaching properties. And if you’re someone who likes
to use nature’s remedies, you may have wondered whether or not you could use
lemon juice to fade acne scars.

If you’ve been searching online for how to fade acne scars, you probably already
found websites that included testimonials from people who tried lemon juice for this
purpose. Does it work? If so, how would it work? Is it the best solution? Is lemon
juice good for anything else?

Lemon juice and other citrus fruits are full of all types of medicinally active
substances. Besides vitamin C, citrus fruits contain limonene, alpha-hydroxy acids
(AHA), hesperidin, quercetin, naringenin, and others. And these components are
quite active when it comes to the application on skin.

In one Chinese study, a citrus extract was found to be beneficial for a red scar. The
scientists determined that the extract worked on the scar by preventing extra cell
growth in the scar and degrading the collagen buildup of the scar.

The essential oil of lemon allows vitamin E, vitamin C, vitamin B6 and vitamin A to
penetrate the skin better for healing, according to Italian researchers. They also found
anti-inflammatory actions in skin from citrus fruits. This is potentially good for acne
scars.

When citrus extracts were examined for their flavonoid content, scientists found that
a flavonoid called hesperetin protected the skin against damage from the sun and the
accumulation of melanin pigments. Another good thing about citrus for the skin.(
http://scarsandspots.com)
LOCAL LITERATURE

Today the quest for natural remedies is widespread, regardless of the intensity of the
health problem. And, acne is no exception. The severity of this annoying skin
condition varies for each person, but everyone goes through the problem at some
stage of their life. Of course, adolescence is associated with acne, but a few people
suffer from acne even in their adulthood. It may also leave mild to severe scars that
can last throughout your life. Fortunately, there are natural treatments that work.
Lemon juice is one such natural product known for its remedial properties. But, have
you heard of it in the context of treating acne scars? If not, read on to see the benefits
of this inexpensive product that you’ve probably used in delectable recipes.

Usually, acne lesions heal in a day or two, but they leave reddish scars or dark
spots. Mild acne scars will fade away over a period of time. But what if they are
severe? They will push you to start looking for scar removal products in the market,
but you can try lemon juice before you decide on them. Its natural bleaching property
has the potential to reduce the visibility of scars and hyper-pigmentation. Citric acid
is the key ingredient in lemon juice that destroys the acne-causing bacteria when
applied on your skin. So, it not only treats the scars left by acne, but also prevents the
development of acne, such as pimples and papules. Citric acid comes under alpha
hydroxyl acids or AHAs, which have exfoliating properties. It simply means that
when you apply lemon juice on your face, the external layer of dead skin is removed
and the underlying cleaner layer is exposed, and new skin cells will start developing.
As a result, your skin will look younger and lighter, i.e. dark and discolored spots
will start vanishing. Slowly, say in a few weeks, you can notice positive changes in
your skin.
 The concept is interesting, but how do I use lemon juice on my skin? Clean your
face, dab the lemon juice with a cotton ball and wash it off after about 15 minutes.
It’s as simple as that. You can also leave it overnight. The only caution is that you
may have to dilute the juice with a little water if your skin is very sensitive. If you
use it excessively, dryness and irritation may occur. Usually, lemon juice will cause a
burning sensation when applied topically, but only for a few minutes. Still, if your
skin is sensitive, it is better to dilute it. Mix it with honey if you have dry skin and
with cucumber juice if you have oily skin. Drinking lemon juice is also beneficial as
it improves digestion and detoxifies your body. Other than that, check your diet and
habits to make sure that your intake of vitamins, water, fiber, etc. is proper. Clearade
reviews explain how your intake affects the oil metabolism in the skin. Application
of lemon juice on your skin produces a radiant tone, by removing acne scars and
preventing future breakouts. Citric acid acts as an acid peel and astringent, and also
has antibacterial and detoxifying properties. It is one of the most inexpensive acne
home remedies that can work wonders if used consistently. So why wait? Perhaps,
your quest for acne solutions has come to an end! Get rid of acne scars and live with
confidence.

MIJ Sadique is specializing in skin issues and has made several studies about acne
and acne remedies. He has more resources about scientifically proven acne home
remedies, including Clearade acne treatment. (http://filipinonurses.org)

Philippine lemon, which is widely known as calamansi, is a fruit with that distinct
sour and acidic taste.Lemon can grow in a tropical country like Philippines.
Philippines have two weathers such as wet and dry season.

According to Urological Association and Annals of the Rheumatic Diseases,

Calamansi or Philippine Lemon has vitamin C which enhances your beauty, by
rejuvenating skin from within and thus bringing a glow on your face. That’s because
vitamin C, also known as ascorbic acid, is key to the production of collagen, a
protein that aids in the growth of cells and blood vessels and gives skin its firmness
and strength. One of the natural benefits of calamansi juice is it acts a natural skin
bleaching agent. It is also a popular ingredient for facial cleansers and tones
nowadays.The extract reduces oiliness in skin, thus clearing up skin problems such
as pimples, acne, blackheads and freckles. It also moisturizes and increases skin
hydration. Being a natural antiseptic medicine, can also cure problems related to the
skin. The juice can be applied to reduce the pain of sunburn and help to ease the pain
from bee stinks as well. It is also good for acne and eczema. It acts as anti-aging
remedy and can remove wrinkles and blackheads. Drinking calamansi added with
water and honey brings a healthy glow to the skin.

Danielle (2013)said on her blog, "I’m one of those people that suffer with acne
though I must say that my acne problem is not that bad compared to others that get so
many breakouts and those that need to get intense treatments like Accutane. I get a
maximum of around 5 breakouts all at the same time during my bad days. One bad
habit I have is that I tend to pop my zits (which is a huge NO NO), and that results to
scarring or dark spots. There are several drugstore and high end treatments that target
the dark spots caused by pimples, but I won’t be dealing with those now. Today, I’ll
be taking about a natural ingredient for fading acne scars – pure calamansi
juice.Many have attested to the effectiveness of lemon juice in lightening dark spots.
Lemons, in tropical countries like the Philippines though, are quite expensive. So
instead of using lemon juice, I used a relative of it which is calamansi (aka
calamondin). Both belong to the family Rutaceae and contain high amounts of
vitamin C. The acidity and the vitamin C are the main factors responsible in helping
fade acne scars & lighten dark spots. Basically, what I did was I juiced out the
calamansi fruits and stored the juice (good for 1 week application) in a small plastic
bottle that I stored in the refrigerator. Every night, I would put some juice on a cotton
pad and gently pat it on my clean face, leave it on for 30 minutes and then rinse with
water. After that, I put on my moisturizer. There is a stinging sensation when I have
the juice on my face which is caused by the high acidity of the calamansi. The
stinging subsides as the juice dries so it’s not much of a big deal. I did this nightly for
3 weeks (though there were some instances where I got lazy, and didn’t put the
calamansi juice treatment, oops!) As you can see, the scars are still there but have
lightened a little bit. The process may take a few months to see dramatic results. "