Why is Tea Tree Oil Still the Underdog of Acne Treatments?

By Seppo | Topical treatments

Tea tree oil, an extract of a tree native to Australia, has been used by Aborigines as an antiseptic and antifungal for centuries. In recent years, scientific research has shown it to be an effective treatment for acne.

Despite the evidence, though, it remains as the underdog of acne treatments and unlikely to get the respect it deserves.

Studies show tea tree oil as effective as benzoyl peroxide and topical antibiotics

Studies show tea tree oil is as effective as benzoyl peroxide or topical antibiotics

A recent article in the International Journal of Antimicrobial Agents reviewed scientific studies on the effectiveness of tea tree oil against acne. The authors looked at a series of scientific studies that were performed between 2005 and 2014. The studies showed that products containing TTO reduced acne lesions anywhere from 23.7% to 62.1%.

Taken together, these studies present strong evidence that tea tree oil’s effects are comparable to other commonly used anti-acne treatments, such as benzoyl peroxide and antibiotics. Though the authors claimed that some of the studies don’t meet the current methodological standards for a “rigorous, clinical acne study,” the majority of the data showed consistently positive results.

Many over the counter products have too little tea tree oil

The study authors looked at various anti-acne products containing TTO. They concluded:

Tea tree oil may be included as the active therapeutic agent or at lower levels that are unlikely to have therapeutic benefit but instead serve to increase the appeal or marketability of the product.

The authors concluded that a solution containing 5% or greater tea tree oil applied twice daily for several weeks would be enough to have an impact.

Side effects

TTO is fairly well tolerated but can cause some side effects. The studies that tracked side effects showed that TTO can cause some skin irritation and similar side effects than other acne treatments, including:

  • Itching
  • Burning
  • Sticking
  • Redness
  • Dryness

Studies that compared TTO to benzoyl peroxide or antibiotics showed side effects were milder and less frequent in the group using TTO.

In a nutshell: TTO can cause mild skin irritation.

How TTO works

Acne medications work by addressing one or more of the proximal causes of acne:

  • Bacteria (bacteria that colonize blocked pores turn small blackheads into painful pimples)
  • Inflammation
  • Excessive keratin production (keratin is a protein that binds skin cells together. Too much keratin prevents skin cells from separating, and big lumps of dead skin cells clog the pores)
  • Excessive sebum production

Studies have shown that TTO addresses 2 of the 4 proximal causes of acne. It effectively kills acne-causing bacteria. TTO also has anti-inflammatory effect in the skin.

Unlike vitamin C and green tea it’s not an antioxidant, rather it inhibits the production of pro-inflammatory cytokines in the skin. You could think of pro-inflammatory cytokines as fire alarm in the skin. The skin cells release them in response to injury. And if pro-inflammatory cytokines are the fire alarm then the immune system is the fire brigade. It responds to the cytokines and clears damaged cells. Alas, this causes further inflammation in the area.

This is a long way of saying that you’ll get much better results when you combine TTO with treatments that address the other proximal causes of acne. These include topical antioxidants and ‘peeling agents’ that open blocked pores (like salicylic acid and retinol).


Tea tree oil is one of the better researched natural treatments for acne. Studies show it can be as effective many commonly-used prescription treatments for acne, and yet causes fewer side-effects. Despite this, doctors still treat it as the underdog of acne treatments.


About the Author

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 page.

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