If you want to clear your skin naturally – and to make sure it stays clear, then you absolutely must learn about topical antioxidants. I’m going to go out on a limb here and predict that they will be the next breakthrough acne treatment, and in this post I’m going to show you why.
In short, there’s completing evidence to show that inflammation in the skin is the trigger that sets off the acne formation process. And during the last 8 years several high quality studies have come out that show topical antioxidants can perform as well, or even better, than many of the established acne treatments.
The role of inflammation in causing acne
When people talk about causes of acne they usually talk about bacteria, sebum and blocked pores. All those are of course relevant, but science has shown that they are really secondary causes. There’s good evidence to show that inflammation to acne is like a starter gun for 100 meters sprinters. It’s the bang that starts the whole thing, be it a race or a new pimple forming on your face.
At the very beginning a pimple is all about inflammation. Bacteria and sebum enter the picture later, but at the beginning it’s all about inflammation. Studies have shown signs of inflammation at the very earliest stages of a pimple, far before you even become aware of it.
There’s also evidence that inflammatory cytokines (messenger molecules the immune system uses) are a bit like overzealous foremen in a factory, they like to whip the sebum and keratin producing cells into overdrive. Test tube studies have shown that when you expose those cells to inflammatory cytokines they produce more sebum and keratin. Inflammation is also linked to other hyperkeratotic skin conditions.
The consequences of that initial inflammatory damage then drive the pimple formation process. Excess keratin and sebum block the skin pores. Inflammatory damage to squalene (a fatty acid in sebum) consumes oxygen from the blocked pore, which then opens the door for P. Acnes bacteria to colonize it.
This initial ‘inflammatory insult’ can come from many sources. The skin is constantly exposed to potential sources of inflammation; such as UV radiation, ozone in air pollution, irritating chemicals in personal care products, harsh chemicals in acne treatment products, and even shaving.
Not to mention all the potential internal source, including stress, gut issues, improper diet, gluten, and so on. Those internal sources compete for the same antioxidants your skin needs for protection. And without sufficient antioxidants the skin cannot cope with all the ‘inflammatory insults’.
The power of topical antioxidants
Assuming this inflammatory theory of acne is correct; then you could think that topical antioxidants can prevent acne. And there’s good evidence to suggest that’s true.
For example, in 2011 Italian researchers published a study where they put topical clindamycin (antibiotic) head to head with a lotion that contained 4% nicotinamide (vitamin B3) and linoleic acid. Unfortunately the full-text study is behind a pay wall, but in the abstract the authors mention that the nicotinamide lotion was slightly more effective than the topical antibiotic in treating.
There was another topical antibiotic vs. nicotinamide study in 1995. In that study the 4% B3 lotion reduced acne by 60% vs. 43% reduction in the topical clindamycin group. So that study also showed nicotinamide to be more effective than topical antibiotics.
Vitamin B3 is of course an antioxidant, but it’s also been shown to repair the skin barrier function and suppress bacterial growth. So it’s no surprise it has an effect on acne.
Since 2005 there have also been a handful of good quality studies looking into sodium ascorbyl phosphate (SAP), a stable vitamin C derivate. In one study SAP was pitted against BP. Among the SAP treated group 76.9% reported excellent/good efficacy vs. 60.7% among the benzoyl peroxide group. In another study 5% SAP was tested against topical retinoids. SAP treatment reduced inflammatory pimples by 49% in 8 weeks. Interestingly, combining SAP with retinoids didn’t improve efficacy a lot, which just goes to show how well SAP worked. There are a few other SAP studies, all showing good effect, but I’m not going to go over them here.
And let’s not forget green tea. As I’ve written here before, topical green tea has shown good efficacy against acne. A part of that effect is due to DHT blocking effect of green tea, but a part of it due to its antioxidant properties.
Clearly there’s something to be said about using topical antioxidants for acne. There’s good science to show that inflammatory damage to sebum is the trigger that sets off the acne formation process. There’s even better evidence to show that topical antioxidants can be as effective, if not even more so, than the current gold standard topical treatments: benzoyl peroxide, antibiotics and retinoids.
But just because antioxidants show good efficacy doesn’t mean we should throw away benzoyl peroxide, salicylic acid and other established treatments. I believe in combining their forces. To use antioxidants to prevent acne, but at the same time using BP or salicylic acid to keep the skin pores open and wipe out those pimples that got started. This way you get the best of both worlds.
If this sounds like a smart way to treat your skin, then I recommend you check out Exposed Skin Care. It’s one of the few acne treatment kits on the market that meets this ‘best of both worlds’ approach. Please check out my review of Exposed to learn more.
- Clinical implications of lipid peroxidation in acne vulgaris: old wine in new bottles.
- Topical clindamycin 1% vs. linoleic acid-rich phosphatidylcholine and nicotinamide 4% in the treatment of acne: a multicentre-randomized trial.
- Topical nicotinamide compared with clindamycin gel in the treatment of inflammatory acne vulgaris.
- Efficacy and tolerability of topical 0.2% Myrtacine® and 4% vitamin PP for prevention and treatment of retinoid dermatitis in patients with mild to moderate acne.
- A topical lipophilic niacin derivative increases NAD, epidermal differentiation and barrier function in photodamaged skin.
- Sodium ascorbyl phosphate shows in vitro and in vivo efficacy in the prevention and treatment of acne vulgaris.
- Comparison of clinical efficacies of sodium ascorbyl phosphate, retinol and their combination in acne treatment.
- Sodium L-ascorbyl-2-phosphate 5% lotion for the treatment of acne vulgaris: a randomized, double-blind, controlled trial.
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