Does Vitamin C Cause Pimples
Wendy Ouriel
Last week I had the honor of sitting on a scholarship panel for the University of California, Irvine medical school. This is something I have done for two years, and it is an excellent opportunity, not just to provide funding for great research, but to learn of what new biological research is being conducted.
Lately my research has been focused on skin care-related biology, which means I have tunnel vision and seldom get to venture out into other areas of scientific progress. Biology is a vast field and even if I were to spend 24 hours a day, 7 days a week reading, I could not even begin to scratch the surface of any developed field in less than 1 years time. Therefore, I look forward to such panels because I am able to read current research as it is developing, and often this is research I would never get the chance to explore on my own time.
One research paper that I was to assess for the scholarship was the research of a MD/PhD student who was exploring reactive oxygen species (ROS) and how they are regulated by a certain protein. The paper focused on how alterations in this protein can affect how much ROS is produced by the body, and when unregulated can lead to certain types of cancer. The cancer aspect of this paper was not interesting, nor was it novel. It has been well researched in a mountain of studies that ROS can lead to cancer. The negative of ROS wasn't interesting, what was interesting was a side buried in the introduction: The positive of ROS.
Reactive oxygen species have a necessary function in the body that I was previously unaware of: they act as a natural anti-microbial agent. Too much ROS, of course, is a bad thing, as the scholarship applicant's research (and many others) have supported, but the regulated amount of ROS naturally produced by the body is needed to prevent bacterial, fungal and other pathogenic invasion from infecting the body. And this is important in the context of skin care.
ROS and antioxidants have a healthy equilibrium in the body. When too much ROS is produced, disease can occur. However, the scale can tip the other way and when there are not enough ROS in the body, disease can also occur.
Source: Zhang FQ, Wang YS, Lou ZP, JunDe Dong JD (2007)
Your skin has a delicate microbiome of healthy bacteria that maintains a proper balance necessary for a disease-free environment. The biological properties that contribute to the healthy microbiome is well founded by research: proper moisture content, regular cell cycle, a healthy pH. When that balance gets disrupted, the skin gets sick. Sickness can include acne, dermatitis, folliculitis, and many others. The microbiome can get disrupted by raising skin's pH (through use of foaming and/or alkaline cleansers), by introducing an inflammatory agent to the skin (essential oils or fragrance), by mechanically damaging the skin (such as with a scrub, microdermabrasion, dermarolling, etc), all of which is well known. However, I believe we should consider adding one more to the list of skin damaging agents. One that has long been hailed as a panacea of human disease and considered a hero of skin care: antioxidants.
First and foremost, I hate to break it to any antioxidant fanatics out there, but the free radical theory of aging is not law in biology. And there is enough evidence to the contrary to support that the free radical theory is possibly an overgeneralization of how aging actually occurs, and that the aging process is much more complex than just: accumulation of ROS over time —> aging. This means that you can eat all the blueberries you'd like, you are still going to age. But keep eating them because of their vitamin content, low calories, fiber and other qualities that more likely contribute to longevity other than their antioxidant content.
So do antioxidants in skin care actually have any benefit? Yes and no. When you use skin care formulated with beneficial oils and extracts, I do believe that there are benefits. The oils and extracts themselves contribute to skin health because of their vitamin and mineral content, their fatty acid composition (for oils), and other factors that assist with maintaining the skin's healthy balance. When antioxidants are in oils and extracts, they are diluted and in low concentrations. In this case, they assist with anti-inflammatory action and have skin health benefits. They do not disrupt skin's microbiome and do not interfere with ROS doing its job of keeping bacterial pathogens away.
ROS is needed for normal, healthy function, from cell proliferation to keeping bacterial pathogen away. However, like anything, too much of something can be unhealthy. Too much ROS can lead to cell death and tumor formation.
Source: Galadari, S., Rahman, A., Pallichankandy, S., & Thayyullathil, F. (2017)
Antioxidants in skin care are bad when they are in concentrated form and disrupt the body's natural ability to fight off bacteria. When are antioxidants in concentrated form? In vitamin C serums.
When I wrote some time ago about how damaging vitamin C serums are to the skin, I received a mountain of responses of women and men telling me their stories of how vitamin C serums gave them acne and other skin diseases. I knew that it was because vitamin C serums broke the skin down because they discharged ROS due to their oxygenating effect in the skin. However, what I didn't know at the time was how antioxidants, when in concentrated form can take away beneficial ROS, leading to bacterial infection. The issue of vitamin C serums and their damaging effect on skin is much more complicated than I originally thought.
So now it seems, from an oxidation standpoint, vitamin C serums damage the skin in two ways:
- Their oxygenating effect creates ROS in the skin which breaks the skin down, creating inflammation, and leading increased susceptibility to pathogenic infection
- Their antioxidant effect destroys the healthy ROS created by the body to prevent bacterial infection.
The two together creates a storm that disrupts the body's ability to maintain a healthy balance which is why vitamin C serums have destroyed so many people's skin.
So if you used a vitamin C serum and it gave you acne, redness or any other skin issue, it is because the serum took away your body's ability to fight off bacteria, and weakened it, inviting pathogens to infect your skin.
The killing of healthy ROS and creating unhealthy ROS reminds me of when people use scrubs, face brushes and/or harsh cleansers on their skin and get acne as a result: You scrub off the healthy, balanced oil that your skin produced. The skin becomes stripped and imbalanced. Then your body makes more oil in haste to replenish what was lost. But this time the oil is inflammatory, and your skin has all the hallmarks of acne: redness, closed comedones etc.
Vitamin B12 has been implicated in its ability to cause acne when in excess in the body, however this has been noted for injections of the vitamin, and not when topically applied. What is important to note is the term excess, and how this relates to vitamin C serums. There is also research that suggests that when antioxidants are in excess in the body, this contributes to virulence and oxidative stress.
Vitamin C serums are clumsy in their formulation. The vast majority of serums have a haphazard and dubious amount of the vitamin in the serum, formulated by no scientifically justifiable standards (the presence of vitamin C itself in a topical product to up-regulate collagen is not scientifically justified). And coupled by the fact that the vitamin is in isolated form in your serum means you are getting too much to be good for you. Vitamin C serums are excess that you are imposing on your body and you will disrupt your skin by using them. Maybe not now, but certainly over time.
Vitamin C serums are not a product born of scientific research and rigorous methodology and experimentation. Vitamin C serums are a product born of clever marketing, the misrepresentation of results, and profitable conflicts of interest. It is a bottle whose exterior is cloaked in the trustworthy guise of science, and its contents a nostrum potion.
I believe that less is always more in skin care and that we shouldn't go for quick fixes, fall for marketing hogwash, or bathe in pseudoscientific snake oil. I believe in tried and true methodology and taking a scientific, modern take on long-held skin care practices. That means exfoliation, light and natural serums, and gentle cleansing. Once I stopped listening to the fads and started taking a pragmatic and empirical approach to skin care, my acne disappeared and clear skin took its place. Vitamin C serums are one of those fad products that I hope will disappear with time, and I am certain that we will see adult acne disappear with it too.
References:
Brescoll, J., & Daveluy, S. (2015). A review of vitamin B12 in dermatology. American journal of clinical dermatology, 16(1), 27-33.
Dinakar, C., Abhaypratap, V., Yearla, S.R. et al. Planta (2010) 231: 461. https://doi.org/10.1007/s00425-009-1067-3
Fang, F. C. (2011). Antimicrobial actions of reactive oxygen species. MBio, 2(5).
Galadari, S., Rahman, A., Pallichankandy, S., & Thayyullathil, F. (2017). Reactive oxygen species and cancer paradox: to promote or to suppress?. Free Radical Biology and Medicine, 104, 144-164.
He, W., Kim, H. K., Wamer, W. G., Melka, D., Callahan, J. H., & Yin, J. J. (2013). Photogenerated charge carriers and reactive oxygen species in ZnO/Au hybrid nanostructures with enhanced photocatalytic and antibacterial activity. Journal of the American Chemical Society, 136(2), 750-757.
Hébrard, M., Viala, J. P., Méresse, S., Barras, F., & Aussel, L. (2009). Redundant hydrogen peroxide scavengers contribute to Salmonella virulence and oxidative stress resistance. Journal of bacteriology, 191(14), 4605-4614.
Paiva, C. N., & Bozza, M. T. (2014). Are reactive oxygen species always detrimental to pathogens?. Antioxidants & redox signaling, 20(6), 1000-1037.
Scales, B. S., & Huffnagle, G. B. (2013). The microbiome in wound repair and tissue fibrosis. The Journal of pathology, 229(2), 323-331.
Zhang FQ, Wang YS, Lou ZP, JunDe Dong JD (2007) Effect of heavy metal stress on antioxidative enzymes and lipid peroxidation in leaves and roots of two mangrove plant seedlings (Kandelia candel and Bruguiera gymnorrhiza). Chemosphere 67:44–50
Source: https://www.oumere.com/blogs/news/how-vitamin-c-serums-cause-acne-in-healthy-skin
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