Most acne patients suffer from oily skin. Excess sebum produced by the skin causes clogged pores and acne – not to mention looking ugly. In this post I’ll share some scientifically proven remedies that can cut down sebum production by 50% or more.
Genes make acne-prone skin sensitive to hormones, and those hormones boost sebum production in the skin. Lucky for us science has given us effective treatments for oily skin. These include topical treatments that mitigate genetic sensitivities, and diet and lifestyle changes that reduce the levels of acne-causing hormones.
Brief intro into what causes oily skin
Let’s start by understanding the problem. In acne patients sebum production hinges on two things: genes and hormones. Genetics make acne-prone skin more sensitive to androgen hormones.
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These hormones then act on the skin and increase sebum production. What happens is that the skin converts free testosterone from the blood into much more potent DTH. DHT can be up to 10 times more potent on the skin than testosterone. This conversion happens through an enzyme called 5-alpha reductase, which is over-expressed in acne-prone skin, thanks to genetics!
As with acne, you have to attack oily skin from two sides. Topical treatments can reduce the effect of hormones, and with smart diet and lifestyle changes you can reduce the levels of these hormones.
You can fight oily skin at the skin level with substances known as 5-alpha reductase inhibitors. These substances inhibit the enzyme 5-alpha reductase that increases the conversion of testosterone to DHT, and that way increase sebum production.
Here are some natural 5-alpha reductase inhibitors:
- Green tea is perhaps the best one I know. In one study green tea lotion reduced sebum production by 70% after 8 weeks of use, see the green tea and acne page for more info. Unfortunately this study hasn’t been replicated, and that’s why we can’t say for sure yet.
- Fatty acids. Quick search found several fatty acids that inhibit 5-alpha reductase. The most potent are gamma-linolenic acid (GLA) (found in evening primrose oil and many seed oils), alpha-linolenic acid (omega 3) and that lauric acid (in coconut oil) and oleic acid (in olive oil). Though many of these need to be confirmed by good quality human studies.
- Minerals. Certain minerals can inhibit the enzyme. We have best evidence for zinc (addition of vitamin B6 and azelaic acid can increase inhibitory power). Other minerals that show promise are cadmium and copper.
- Saw palmetto. There’s a lot of talk about saw palmetto at hair loss forums. It’s also been found moderately effective in a handful of studies. Hair loss is also linked to DHT and 5-alpha reductase, so what helps with hair loss could help with acne also.
Studies that measure effect on sebum production in humans
Most of the above mentioned studies are in vitro (test tube) studies. While useful many substances that show effect on test tube turn out to be useless in live humans. So let’s look at studies done on humans that measure sebum production.
Saw palmetto, sesame seed and argan oil combination
I already mentioned the study with green tea. Another study showed good reduction with cream containing saw palmetto, sesame seeds and argan oil. The study showed 20% reduction in overall sebum levels and 42% reduction in oily areas after 4 weeks. The green tea study showed similar results, and had they continued this study for another 4 weeks the results would have likely been better. In the green tea study the results really kicked-in after week 4.
When you look at the ingredients in the cream these results are not surprising. Argan oil is high in GLA, linolenic and oleic acids, sesame seeds contain GLA and saw palmetto itself is effective inhibitor.
Java tea extract
I also found a report of two studies using java tea (Orthosiphon stamineus) leaf extract. The paper says 2% java tea leaf extract reduced sebum more than formulation containing 1% zinc gluconate (ingredient frequently used in oily skin care products). Unfortunately I don’t have access to the full-text report and they didn’t mention percentage reductions in the abstract.
Conclusion on topical treatments
Because of genes acne-prone skin is extra sensitive to androgen hormones. You can mitigate this with topical treatments that contain 5-alpha reductase inhibitors. Some of the most promising are green tea extracts, gamma linolenic acid, saw palmetto and zinc. Studies have shown over 50% reduction with these ingredients.
As a disclaimer I have to mention that the evidence for these things is still fairly weak. Not too many human studies have been done, and even fewer have been replicated. So while these results are promising we should take them as preliminary.
Diet and lifestyle remedies for oily skin
You can also fight oily skin with diet and lifestyle changes that reduce the levels of acne-causing hormones. I covered this in detail in the hormonal acne page, so just a quick summary here. Sebum production is affected by hormones androgens, insulin and insulin like growth factor 1 (IGF-1).
The best choice of action is to target insulin levels. Because IGF-1 follows insulin, and insulin and IGF-1 acts as androgen boosters (they stimulate androgen release from the liver and increase the effect androgens have on the skin). Since insulin follows blood sugar levels your goal is to maintain steady blood sugar levels.
Diet is perhaps the most important determinant of blood sugar and insulin levels. So let’s start with diet tips:
- Eat balanced diet. Eating carbohydrates stimulates insulin release (as does eating protein but to a lesser degree). That’s why it’s important to somewhat limit carbohydrate intake. Studies show that ratio of 50/30/20 (50% of calories from carbohydrates, 30% from fat, and 20% from protein) is effective in reducing insulin and stabilizing blood sugar levels.
- Low carbohydrate diets. Low carb diets are another way to go. They are effective but in my opinion unnecessary. The problem with low carb diets is that you have to eat a lot of fat to compensate for missing carbohydrates. This excess fat consumption causes insulin resistance, so when you eat carbohydrates your blood sugar and insulin levels go through the roof. So low carb diets work as long as you stick to them, but sticking to them can be a problem and cause a lot of stress and inconvenience. So they work, but not recommended in my books.
- Focus on complex carbohydrates. Not only the quantity but also the type of carbohydrates matters. Eating carbs with high glycemic index (GI), such as sugars and processed (white) grains, increase insulin levels much more than complex, unprocessed carbohydrates. So focus on whole grains, beans, brown rice and other complex carbohydrates. Use glycemic index as guideline.
- Moderate saturated fat intake, avoid trans-fats. When it comes to fats causing insulin resistance trans-fats are the worst. That’s a reason alone to avoid them as much as possible. When eaten in excess saturated fats can also cause insulin resistance. As far as possible limit saturated fat intake to 10% of total calories.
Other lifestyle factors
How you live your life also affects insulin levels. Pay attention to these things:
- Sleep enough. Sleep deprivation has been shown to cause insulin resistance. So make sure you get your sleep.
- Manage stress. Stress is another proven factor behind insulin resistance and high insulin levels. Do your best to manage stress. One way is to listen to relaxation or meditation CDs. 15 to 20 minutes a day can make a big difference on your stress levels and skin.
- Exercise and weight loss. If you carry extra weight do your best to drop it. Being overweight is perhaps the most important cause of insulin resistance. Consequently, pretty much all studies show that regular exercise reduces insulin resistance and insulin levels.
Oily skin is just one of the struggles we acne patients have to go through. Not only oily skin causes blocked pores and acne but it also looks ugly and feels nasty. It’s caused by combination of genes and hormones. Luckily science has uncovered effective remedies for oily skin.
Topical treatments can mitigate genetic sensitivity to hormones. Studies have shown over 50% reductions in sebum production after 8 weeks of topical treatment. Some effective remedies include green tea extracts, gamma linolenic acid, saw palmetto and zinc.
You can also reduce the levels of hormones that put the skin glands into overdrive. One way is to moderate carbohydrate intake and focus on low GI, complex carbohydrates. Regular exercise, proper sleep, and stress management also helps.
There’s no getting over the fact that as acne patients we were dealt a bad hand in the genetic lottery, and oily skin is one of the consequences. But you don’t have to remain a victim of your genes. By putting into action the tips covered in this article you can take a big step towards healthy and beautiful skin.
- Inhibition of type 1 and type 2 5alpha-reductase activity by free fatty acids, active ingredients of Permixon.
- Anti-androgenic activity of fatty acids.
- Inhibition of steroid 5 alpha-reductase by specific aliphatic unsaturated fatty acids.
- Inhibition of 5 alpha-reductase activity in human skin by zinc and azelaic acid.
- Cations inhibit specifically type I 5 alpha-reductase found in human skin.
- Effect of a topical erythromycin-zinc formulation on sebum delivery. Evaluation by combined photometric-multi-step samplings with Sebutape.
- On the effects of a plant extract of Orthosiphon stamineus on sebum-related skin imperfections.
- Novel agents for the treatment of alopecia.
- A Randomized, Double-Blind, Placebo-Controlled Trial to Determine the Effectiveness of Botanically Derived Inhibitors of 5-α-Reductase in the Treatment of Androgenetic Alopecia
- Clinical and instrumental study of the efficacy of a new sebum control cream (PDF)
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