How to reduce oily skin and prevent acne (2)

A mixture of plant extracts to fight acne

Part (1) of this series describes how nobelitin, an ingredient found in citrus fruits, reduces the amount of oil that is produced by the sebaceous glands surrounding the hair follicles. Less oil means fewer acne breakouts and better looking skin! This post describes an alternative treatment to improve oily skin. This treatment involves a mixture of three plant extracts, which we’ll call SKS:

COMPOSITION OF SKS

  • Sesame seed (Sesamum indicum)
  • Kernel oil (Argania spinosa)
  • Saw Palmetto Fruit (Seranoa serrulata)

How the study was done

A clinical trial with this mixture in an oil-free base was described in the Journal of Cosmetic Dermatology in 2007 (Ref 1). Test subjects applied SKS in an oil-free base onto their face twice a day for a period of 4 weeks. After that they were asked to score how much they thought their skin had improved. In addition to this subjective assessment, the scientists also actually measured the reduction of oil produced with a sebumeter and with sebum collection foils.

SKS significantly improves oily skin

SKS was generally very well tolerated and 95% of the test subjects felt that their oily skin condition had improved significantly.
The table below details the results:

Very Good Good Satisfactory
Reduces skin oiliness 45% 50% 5%
Refreshes skin 40% 60% 0%
Softens skin 45% 55% 0%
Overall efficacy 45% 50% 5%

The quantitative measurements correlated well with the subjective opinions and also demonstrated that the amount of oil on the forehead and cheeks was reduced by 20% and that the area covered by oily spots had been significantly reduced by 42% as compared to four weeks earlier.

How does SKS work?

As far as mechanism is concerned, it is thought that the SKS treatment interferes with the function of an enzyme called 5-alpha-reductase that is found predominantly in the sebaceous glands. Usually, this enzyme activates androgen hormones and changes them into more potent versions. These, in turn cause the sebaceous glands to secrete larger amounts of oil. By interfering with this enzyme, SKS reduces the production of sebum (oil). Less oil means healthier looking skin and less acne!

References

(1) Dobrev, H. (2007)
Clinical and instrumental study of the efficacy of a new sebum control cream.
Journal of Cosmetic Dermatology 6: 113-118 [Medline Link]

For further reading

How to reduce oily skin and prevent acne. Part (1)
How to reduce oily skin and prevent acne. Part (3)

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Posted in Oily skin, acne, treatments | 2 Comments

How to reduce oily skin and prevent acne (1)

Once you have treated an acne infection, how do you prevent acne from re-occurring? This post describes a research paper that shows how topical application of Nobiletin, an ingredient found in citrus fruits, can prevent acne by reducing the size of the sebaceous glands, by reducing the amount of oil at the skin surface, and by reducing the rate of cell division by sebocytes (the cells that produce oil). Check out the ”The Skinny on Acne” article for more information on the causes of acne.

Overproduction of sebum increases acne

Overproduction of sebum increases the likelihood of infections and acne out-breaks. Over-active sebaceous glands also cause an excessively oily facial skin. This feels unpleasant and is shiny and feels greasy. The pores are large and the whole situation feels unpleasant and ofcourse can result in inreased occurence of acne.

Retinoic acid reduces oil production but has side effects

Since an overproduction of sebum (oil) increases your chances for infections and acne, it makes sense that if you could reduce the amount of oil that is produced by the sebaceous glands, this should result in a reduction of infections and acne. Dermatologists have been looking for ways to reduce sebum production, but there are only a few known medications that are known to be effective for this. The best known are the retinoic acids such as Retin-A. Unfortunately these medications can have nasty side-effects such as severe skin dryness , flaking and blistering, as has been shown to cause birth defects and certain cancers in mice and rats. For more on Retin-A check out The Skinny on Retin-A. Obviously such medications are only available on prescription.

Mother nature to the rescue

While it is desireable to reduce sebum production to improve and prevent acne and oily skin, retinoic acid based medications have many side effects and are only available by presrciption. Fortunately, mother nature comes to the rescue. In the recent scientific literature there are a number of papers that discuss botanicals that have been shown to also reduce sebum production. One of these papers is discussed below. Be on the look-out for another post on this topic soon!

Nobiletin prevents acne and reduces oily skin

In an elegant paper by Takashi Sato and co-workers (1), we can read about the beneficial effects of Nobiletin on sebum reduction. Nobiletin is a flavonoid that is present in the peel of many citrus fruits. It is especially prevalent in mandarines (Citrus nobilis). Medicinal flavonoids have been shown to have a variety of beneficial effects when taken internally or used topically. These include antioxidant, free radical scavenging and anti-inflammatory activities, as well as antitumorigenic and antitumor metastatic activities (1).

The researchers applied a mixture of 2% nobiletin in 95% ethanol and 5% glycerol to the ears of hamsters once a day for 14 days and then measured the amount of triacylglycerol on the skin surface. Triacylglycerol is the main constituent of mammalian fat and is a major component of sebum. They also made microscope sections of the skin and analyzed the size of the sebaceous glands. The treatment decreased the amount of triacylglycerol on the skin surface by 34% and also reduced the size of the sebaceous glands. The researchers were even able to show that nobiletin reduced the rate of cell divisions by sebocytes, the cells in the sebaceous glands that secrete sebum.

nobiletin-reduces-tg

Adapted from Sato et al. J Invest Dermatol 127 (2007) 2740

In another study, the researchers treated cultured hamster sebocytes with nobiletin. When these cells are treated with insulin, they respond by producing high levels of oil (triacylglycerol – compare the left two bars in the graph: “control” and “10 nM insulin”). By simultaneously treating the cells every 3 days with increasing concentrations of nobiletin, the researchers were able to force the cells to reduce the secretion of triacylglycerol almost back down to the low levels secreted in the absence of insulin (these are the three right bars in the graph).

In summary, this paper shows that nobiletin can effectively reduce the amount of oil produced by the sebaceous glands. Since less oil production means less predisposition to acne out-breaks, nobiletin should be a valuable addition to your acne treatment war chest!

Inspired by the scientific data above, Sana Fela is currently working on a new formulation of a Sebum Control cream based on Extracts of Tangerine. We will introduce this product soon. We are actively working on a complete line of botanical skin care products. If you would like to be notified about updates on our products or web site, please leave your contact information on our contact form

*** UPDATE***  November 2009 – Product development for Tangerine Anti-Shine Cream is now complete!  For details, see How to reduce oily skin and prevent acne part (3). Or visit our store to get your own!

References

(1) Takashi Sato, Aiko Takahashi, Mika Kojima, Noriko Akimoto, Masamichi Yano and Akira Ito (2007). A Citrus Polymethoxy Flavonoid, Nobiletin Inhibits Sebum Production and Sebocyte Proliferation, and Augments Sebum Excretion in Hamsters. Journal of Investigative Dermatology 127: 2740-2748

For further reading

How to reduce oily skin and prevent acne. Part (2)
How to reduce oily skin and prevent acne. Part (3)

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Can drinking milk cause Acne?

Professor Bodo Melnik of the Department of Dermatology, University of Osnabrueck, Germany, has published a thought-provoking perspective on a causal relation between cow’s milk consumption and Acne in Western societies (1).

Since the vast majority of adolescents will suffer from Acne, an environmental factor may be the cause. One of the pillars of the Western diet is the consumption of cow’s milk. The paper points out that a study of over 10,000 teenagers has shown a strong correlation between milk consumption (particularly reduced fat milk) and Acne in teen agers. In contrast, a study of inhabitants of Papua New Guinea and of hunters and gatherers in Paraguay that do not drink or eat dairy products, shows that not a single case of Acne is found. Obviously, such results suggest that milk consumption contributes to Acne in Western society.

The milk hypothesis says that the level of growth hormone (GH, somatotropin) and Insulin-like-Growth-Factor -1 (IGF-1), which already are increased at the onset of puberty, are further increased as a result of milk consumption. These hormones are powerful mitogens and play a central role in growth and homeostasis of the skin and various other tissues. It turns out that the levels of these hormones also correlate strongly with the occurrence of Acne.

IGF-1 (as well as insulin) stimulates sebocogenesis (2) and the production of oil by the sebaceous glands (3). It is this stimulation of the sebaceous glands that results in Acne when this coincides with infection.

Now, the problem in comparing different population groups is that it is just too much of an over-simplification to pretend that two groups only differ in the aspect that you are trying to study. There are a million other things that are different between them. And a number of these could be easily also be involved in whatever the reasons are that one group has acne and the other doesn’t. So, one always has to keep this in mind when comparing population groups. Never-the-less, this data points in the direction of a potential role of milk consumption in the development of Acne.

Should we counsel our kids to drink less milk? Maybe not. There are many reasons why milk consumption is a good thing. But a link between milk and acne is an intriguing concept that is worth thinking about.

References

(1) Melnik B. Milk consumption: aggravating factor of acne and promoter of chronic diseases of Western societies. J Dtsch Dermatol Ges. 2009 Feb 19.
(http://www.ncbi.nlm.nih.gov/pubmed/19243483)

(2) Deplewski D, Rosenfield RL. Role of hormones in pilosebaceous unit development. Endocr Rev 2000; 21: 363-392
(http://www.ncbi.nlm.nih.gov/pubmed/10950157)

(3) Smith TM, Cong Z, Gilliland KL, Clawson GA, Thiboutot DM. Insulin- like growth factor-1 induces lipid production in human SEB-1 sebocytes via sterol response element-binding protein-1. J Invest Dermatol 2006; 126: 1226–1232.
(http://www.ncbi.nlm.nih.gov/pubmed/16575389)

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Sugar and Acne

A nice review of the role of diet in the occurrence of acne was recently published by Dr. Elsa Spencer and co-workers from the George Washington University School of Medicine in Washington, DC. (Ref. 1)

They reported on studies that show the negative interaction between glycemic load, insulin sensitivity, hormone mediators, and acne. It goes something like this (see the schematic):

sugar_acne

How does sugar cause acne?

The regular consumption of foods with a high glycemic index causes an elevation of insulin levels in the blood. Chocolate and candy, but also foods that contain white flour, and soda with sugar are just a few examples of high glycemic foods. Apart from insulin resistance (which may result in diabetes), elevated insulin reduces the concentration of SHBG (Sex Hormone Binding Globulin) in the blood. This is a glycoprotein that binds sex hormones, in particular androgen (male) hormones, and keeps their levels in check. Consequently, if there is less SHBG, the levels of sex hormones go up. This, in turn, causes a stimulation of the growth of sebocytes. These are cells that secrete sebum (oil) in the hair follicles. Increased sebum secretion increases the chance for blockage and infection of the follicles which can ultimately lead to acne.

Conclusion: Chocolate and Acne don’t mix

There is more and more evidence that suggests that your diet is an important factor in how much acne you will develop. It is important to treat acne breakouts using a good tea tree oil based product before they have a chance to become more severe and result in acne scars. At the same time, scientific evidence such as presented in this post, suggests that you might want to reduce snacking on chocolate, candy, and other high sugar and high glycemic foods. Chances are that this will help reduce the number of future outbreaks.

References

(1) Spencer EH, Ferdowsian HR and Barnard ND (2009) Diet and acne: a review of the evidence. Int J Dermatol 48: 339 – 347
http://www.ncbi.nlm.nih.gov/pubmed/19335417

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Low carb diet can reduce Acne

If you read the article on how sugar consumption can cause an increase in amount or severity of acne, it stands to reason that a low-carb diet should result in less acne, and this is in fact the case. It has been shown that foods with a low glycemic index increase SHBG and reduce androgen levels, resulting in lower acne severity. See the figure below [adapted from (1)].

low_carb_acne

Robyn Smith and co-workers reported in 2007 on a clinical trial performed at RMIT University (Melbourne, Australia). They compared the amount and severity of acne in people that were on a low-carb diet with a control group. Participants attended a baseline appointment in which extent and severity of acne were evaluated and then randomly assigned to either the low-carb or the control group. The participants in the low-carb group were put on a diet that was achieved by modifying the amount and type of carbohydrates. They were instructed to substitute high-carb foods with foods higher in protein ((e.g. lean meat, poultry and fish) or with lower glycemic index foods (e.g whole grain breads, pastas and low sugar fruits). Every month the participants were scored for changes in inflammatory lesion counts (papules, pustules and nodules) and total lesion counts. The graph above shows some of the results. After three moths, the LGL group had a much larger reduction in amount and severity of acne lesions as compared to the control group that did not control its sugar intake.

The take-home message is clear: If you eat a lot of candy or otherwise consume a lot of sugar, you increase the occurrence and severity of your acne. We all know that there are many other reasons why it is bad idea to eat a lot of sugar, but if you are plagued by acne, you better think twice before indulging in high sugar foods!

References

(1) Smith RN, Mann NJ, Braue A, et al. (2007) A low-glycemic-load diet improves symptoms in acne vulgaris patients: a randomized controlled trial. Am J Clin Nutr 86: 107–115.
Abtract at http://www.ncbi.nlm.nih.gov/pubmed/17616769
The full text of this article is available for free at
http://www.ajcn.org/cgi/reprint/86/1/107

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Tea Tree Oil is effective against Acne

Tea tree oil (Melaleuca alternifolia) has a long history of use as a natural treatment against bacterial infections, and has been the subject of a large number of research studies. Many of these studies were performed on bacterial cultures [e.g. see (1)]. In its most basic form, different kinds of cultured bacteria are exposed to tea tree oil and the toxicity of the tea tree oil to the bacteria is evaluated. One of the easiest ways to do this is to look at the replication rate of the bacteria. This is a measure for how quickly the bacteria can reproduce in the presence of the tea tree oil. While from such studies it is clear that tea tree oil is effective against bacteria in the lab, such experiments are not necessarily indicative of it’s effectiveness to fight infections in patients.

There are a few published clinical studies that have looked at the effectiveness of tea tree oil to treat infections in humans. Particularly relevant for the treatment of acne is a study that was published in 2007 by Enshaieh and co-workers (2). They studied a group of 60 patients with mild to moderate facial acne vulgaris. The patients were randomly divided into two groups of 30 patients. One group was treated twice daily with a 5% tea tree oil gel and the other with a placebo (the gel without tea tree oil).

tea_tree_oil_efficacy

The tea tree oil and placebo gels had the same color, texture, and packaging. Neither patients, nor medical staff knew which patients had active gel and which patients had placebo gel. Treatments were continued for 45 days and patients were evaluated every 15 days for changes in acne severity and total number of lesions.
Some of the results are shown in the figure [adapted from (2)] . The tea-tree oil treated group clearly showed dramatically increased efficacy against all three types of acne lesions (comodones, papules and pustules) as compared to the placebo group. Studies like this show the promise of tea tree essential oils n the treatment of acne.

Sana Fela has developed a new acne treatment cream that is based on tea tree oil.
Please visit the Acne Treatment Page or the Web Store

References

(1) Raman A et al (1995) Antimicrobial effects of tea-tree oil and its major components on Staphylococcus aureus, Staphylococcus epidermis and Propionibacterium acnes. Lett Appl Microbiol 21: 242-245
(http://www.ncbi.nlm.nih.gov/pubmed/7576514)

(2) Enshaieh S et al. (2008) The efficacy of 5% topical tea tree oil in mild to moderate acne vulgaris: A randomized, double-blind placebo-controlled study. Indian J Dermatol Venereol Leprol 73: 22-25
(http://www.ncbi.nlm.nih.gov/pubmed/17314442)

(c) Sana Fela 2009

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