Someone on the internet is wrong. Nowhere is this truer than in the realm of natural health. Bloggers with more enthusiasm than critical thinking skills hype the miraculous healing benefits of various natural products.
Coconut oil receives more than its fair share of the natural health hype. But contrary to many other supposedly miraculous natural treatments, there are legitimate, science-based reasons to use coconut oil – and one very good reason not to use it.
Note that this post refers to topical application. Eating coconut oil is delicious, but I doubt it has any effect on acne.
Not surprisingly, coconut is great for moisturizing the skin. Or more accurately, it prevents the skin from drying. Skin becomes dry when the water that’s in and between cells evaporates, which happens faster during winter when the moisture difference between your moist skin and dry outside air is larger.
The layer of oil on your skin (sebum) creates a barrier that prevents the water in the skin from evaporating. Applying coconut oil, or any other oil for that matter, also creates such a layer and helps prevent moisture loss.
A 2014 study published in the International Journal of Dermatology tested coconut oil and mineral oil in children with atopic dermatitis (AD), basically a dry and itchy skin.
This image shows the improvements in AD score (SCORAD) and water loss through the skin (TEWL: transepidermal water loss).
Source: Evangelista, M. T., Abad-Casintahan, F. & Lopez-Villafuerte, L. The effect of topical virgin coconut oil on SCORAD index, transepidermal water loss, and skin capacitance in mild to moderate pediatric atopic dermatitis: a randomized, double-blind, clinical trial. Int. J. Dermatol. 53,100–8 (2014). http://www.ncbi.nlm.nih.gov/pubmed/24320105
As you can see, coconut oil was clearly better than mineral oil in reducing AD score and water loss.
TEWL is also important for acne because it indicates how well the skin barrier function works. Poor barrier function leaves the skin vulnerable to infections and colonization by microorganisms.
Coconut oil is strongly antibacterial, which, I believe, is the main reason it could reduce acne.
Lauric acid (LA) is the main fatty acid in coconut oil and accounts for roughly 50% of all the fat. A 2009 study showed LA kills acne causing bacteria 15 times more effectively than benzoyl peroxide.
Another study showed capric acid, another fatty acid in coconut oil, is also effective against P. Acnes bacteria – though weaker than lauric acid.
These studies clearly show that lauric acid is one of the best natural antibiotics against acne-causing bacteria.
However, I should point out that lauric acid in coconut oil is bound to triglycerides – it’s not free. Triglycerides in oils do not penetrate the skin deeper than the first few cells. Oils also have some free fatty acids and the bacteria on the skin can break triglycerides into free fatty acids. So it’s not unreasonable to say oils have some of the effects as their constituent free fatty acids – just nowhere nearly as strong.
Coconut oil contains several anti-inflammatory substances, including ferulic acid, p-coumaric acid, and other phenolic compounds. Ferulic acid is used as an antioxidant in many high-end skin care products. There’s some evidence to show these can protect the skin.
One study showed that applying coconut oil to rat ears protected against subsequent chemical exposure. Another study showed that topically applied coconut oil accelerates wound healing.
In the present study, we examined the influence of VCO [virgin coconut oil], applied topically for the healing of dermal wounds in rats. The results indicate a significant beneficial effect of VCO on intracellular and extracellular matrix components and the antioxidant profile during cutaneous wound healing in animals treated.
Nevin, K. G. & Rajamohan, T. Effect of topical application of virgin coconut oil on skin components and antioxidant status during dermal wound healing in young rats. Skin Pharmacol Physiol 23, 290–7 (2010). http://www.ncbi.nlm.nih.gov/pubmed/20523108
But let’s keep in mind that these are animal studies, and nobody can say for sure whether humans using coconut oil at home will get the same benefits.
Still, the anti-inflammatory properties of coconut oil come as a nice bonus, especially given the role inflammation plays in triggering acne.
For best results, use virgin coconut oil. A study showed it has somewhat stronger anti-inflammatory properties than processed coconut oil.
Coconut oil can also protect the skin against UV radiation. A 2012 study showed that coconut oil blocks around 20% of UVB radiation (and 0% of UVA radiation).
Just to be clear. Coconut oil is not a sunscreen replacement. It’s not strong enough. But as these studies show, it can protect the damage from occasional UV exposure, which can be helpful for acne-prone skin.
Many people don’t realize that damage caused by UV radiation (among other things) to sebum is the trigger that kicks off the acne formation process.
Following UV exposure, squalene undergoes massive photodegradation. Upon oxidative challenge, squalene is readily oxidized giving rise to different squalene peroxidation by-products exerting harmful activities in skin..
Squalene peroxide has been demonstrated to be comedogenic: in animal experiments, comedones have been triggered by exposing rabbit ears to irradiated squalene. A positive correlation was found between degree of squalene peroxidation and size of the comedones elicited.
Picardo, M., Ottaviani, M., Camera, E. & Mastrofrancesco, A. Sebaceous gland lipids. Dermatoendocrinol 1, 68–71 (2009). http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2835893/
Which is one of the reasons I recommend everyone with acne to use topical antioxidants. Protecting sebum against oxidative damage is one of the keys to preventing acne.
As promising as these results sound, there’s a caveat. In some cases, coconut oil may also cause acne.
It’s highly comedogenic, rated at 4 at the comedogenicity scale (5 being the maximum rating).
Normally I don’t pay much attention to comedogenicity ratings. They don’t accurately predict whether an ingredient causes acne. In 2006, Greek researchers tested 10 products containing moderately comedogenic ingredients against negative (nothing) and positive (a highly comedogenic ingredient) controls. This graph shows the increase in comedones for each test.
Source: Draelos, Z. D. & DiNardo, J. C. A re-evaluation of the comedogenicity concept. J. Am. Acad. Dermatol. 54, 507–12 (2006). http://www.ncbi.nlm.nih.gov/pubmed/16488305
None of the products containing supposedly comedogenic ingredients caused any more comedones than the negative control. The increase in the graphs is due to the skin being covered with patch testing tape.
Why aren’t comedogenicity ratings useful?
The problem with comedogenicity ratings is that the tests used to derive them just don’t reflect real world usage. In comedogenicity tests, the ingredients are used at very high concentrations, whereas they are used in much lower concentrations in skin care products. Dose matters.
Coconut oil delivers a hefty dose of lauric acid
It’s a bit different when we talk about coconut oil. Earlier I mentioned that coconut oil is about 50% lauric acid, so quite a hefty dose.
It still doesn’t mean coconut oil would cause acne for everyone who uses it. That’s clearly not the case. But it wouldn’t surprise me if it would cause acne to a not insignificant percentage of people.
Beyond that coconut oil seems to be very safe and unlikely to cause contact allergies or other negative reactions.
None of the patients in the VCO group developed adverse reactions. This is concurrent with the findings of our literature search, which showed no published reports of contact dermatitis caused by VCO.
Evangelista, M. T., Abad-Casintahan, F. & Lopez-Villafuerte, L. The effect of topical virgin coconut oil on SCORAD index, transepidermal water loss, and skin capacitance in mild to moderate pediatric atopic dermatitis: a randomized, double-blind, clinical trial. Int. J. Dermatol. 53,100–8 (2014). http://www.ncbi.nlm.nih.gov/pubmed/24320105
Coconut oil stands as an exception among many supposedly highly effective natural acne cures. There are valid, science-based reasons to try applying coconut oil on the acne-prone skin.
Being a relatively heavy oil, it forms a barrier that prevents moisture from escaping and protects the skin. It does this better than dermatologists-favored mineral oil.
Coconut oil can kill acne-causing bacteria. Coconut oil also contains antioxidants and has been shown to offer some protection against UV radiation (but it’s not a substitute for sunscreen!).
On the flip side, coconut oil is highly comedogenic. Comedogenic ingredients are normally not a problem, but given the high dose of lauric acid, coconut oil may cause acne for some people. So I suggest you start carefully and only apply a little bit on a small area of the face.
Coconut oil is an interesting option for people who like ‘all natural’ skincare options. I still believe that properly formulated skin care products that combine antioxidants (vitamin C, green tea, etc.) with antibacterials (tea tree oil), and perhaps salicylic or azelaic acid will prove to be more effective than coconut oil.
Seppo Puusa, a.k.a. AcneEinstein shares rational advice about natural and alternative acne treatments. Read more about me and my acne struggles at the about me page.