NicotinamidesmallNicotinamide (AKA niacinamide or nicotinic amide), a vitamin B3 derivative, may be a welcome adjunct ingredient in an acne sufferer’s arsenal. I say adjunct because it is unlikely to produce adequate levels of clearing on its own, but may help boost otherwise lacking treatment protocols. It has a fairly good track record over the years and two recent studies further corroborate its acne fighting prowess. The first of the two studies compared 5% nicotinamide gel against 2% clindamycin (a topical antibiotic) and found them to be equally effective, with no side effects seen from the nicotinamide gel. The second study pitted 4% nicotinomide against 1% clindamycin. The researchers of this study came to a similar conclusion: “The efficacies of 4% nicotinamide and 1% clindamycin gels are comparable in treating moderate inflammatory facial acne vulgaris.”

Nicotinamide is available over-the-counter but is not found in many products. This may changes as more evidence surfaces showing its efficacy. I am personally going to look into the possibility of adding it into Acne.org products in the coming years.

References:

  • Shahmoradi Z, et al. “Comparison of topical 5% nicotinamid gel versus 2% clindamycin gel in the treatment of the mild-moderate acne vulgaris: A double-blinded randomized clinical trial.” Journal of Research in Medical Sciences. 2013; 18(2): 115–117.
  • Khodaeiani, et al. “Topical 4% nicotinamide vs. 1% clindamycin in moderate inflammatory acne vulgaris.” International Journal of Dermatology. 2013; 52(8): 999-1004.

Pacific_oysters copyOver the years, evidence continues to mount that adequate levels of zinc help reduce acne symptoms, on average by approximately 40%. While zinc will likely not completely clear anyone’s skin, this is still significant and is more than placebo.

It turns out that oysters contain far more zinc than any other food. In fact, 3 ounces of oysters (about 6 cooked or raw oysters) contain about 74mg of zinc, almost 500% of the daily value for zinc. However, because high levels of zinc can be toxic, be sure to keep your total zinc intake below 100mg per day.

If you are not fond of oysters, supplementing with a 30mg zinc gluconate pill per day should be plenty to get the benefits.

While there is still not enough compelling evidence to conclude that diet and acne are in fact related, in this one instance, perhaps indulging in a few oysters could be a fun way to provide some extra insurance against breakouts.

responsive-2We’ve been working on a new acne.org design for a few months now. It uses what they call Bootstrap 3, which basically means it should work pretty flawlessly on all devices, desktop, tablet, and mobile.

It’s also super clean looking and should appear more crisp on retina screens like the iPhone, iPad, or MacBook.

A big thanks to Paul for being in charge of the design and taking acne.org solidly into 2014 and beyond.

If you guys find any bugs or even just things you think could be done better, please comment here and let me know.

cr_logo_homeConsumer reports recently tested some popular acne treatments. They pitted Proactiv against AcneFree and found no difference in efficacy. “After eight weeks, acne was never wiped out completely, but in half to two thirds of volunteers, the number of blemishes was reduced by an average of about 40 percent.”

My 2 cents: 40% efficacy is nowhere near good enough. Over the many years that I have been researching both over-the-counter and prescription treatments, this 40% mark is often where treatments land. Keep in mind that when you give people a placebo, their acne clears up on average about 30%. I think any acne treatment should aim to completely clear acne. Having 40% less acne still means you are broken out, and who wants that? People who closely follow The Regimen almost always get completely clear. I would like to see these large brands give people much larger sizes of 2.5% benzoyl peroxide and instruct their users exactly how to gently cleanse and apply the benzoyl peroxide in order to get completely clear.



Consumer reports also tested zappers which use heat to supposedly shrink acne lesions. They tested Zeno as well as No! No! Skin. The authors of the test concluded, “Both devices shrank most acne lesions but eliminated only about 13 percent of them.”

My 2 cents: I am surprised at Consumer Reports conclusion on heat devices. Our team here at acne.org did our own test on Zeno and ThermaClear heat therapy devices on volunteers in our office. In our small, anecdotal study, neither device visibly shrunk or eliminated any lesions. More on heat devices here.

References:

  • “Acne treatments come out a wash.” Consumer Reports. 2012; 77(1): 9.

inoutnew
I have been saying for years that if benzoyl peroxide is so good at killing bacteria on its own, then why do we need topical antibiotics like clindamycin, which do not work nearly as well as benzoyl peroxide in clearing acne, and have contributed to creating massive amounts of resistant bacteria across the world? It is a simple question and I have yet to meet anyone who can give me a compelling reason why a doctor would prescribe topical antibiotics for acne.

Perhaps the medical community is finally seeing what I am seeing. In a recent article in The Journal of Drugs in Dermatolgy, Dr. Kircik from Mount Sinai Medical Center in New York shows that ears and eyes are perking up to the massive over-prescription of topical antibiotics, especially when a better and safer alternative exists: “…we have recently noticed BP’s benefits as monotherapy in the treatment of acne. Benzoyl peroxide works rapidly on P. acnes (bacteria) without causing antibiotic resistance. Hence, we may have to reconsider the role of topical antibiotics such as clindamycin in the treatment paradigm of acne vulgaris.”

Halleluiah.

References:

  • Kircik LH. “The role of benzoyl peroxide in the new treatment paradigm for acne.” The Journal of Drugs in Dermatology. 2013; 12(6): s73-4.

1-5new3

The Regimen calls for waiting 5-15 minutes after cleansing before you applying benzoyl peroxide. For the past few weeks, I’ve been eliminating this wait. I have been cleansing my skin, patting dry, and then immediately treating with benzoyl peroxide. I’m questioning the waiting time after cleansing for a couple of reasons:

• People often simply do not have the time
• It may not be necessary

I want The Regimen to be as easy as possible to follow. Eliminating the waiting between cleansing and applying benzoyl peroxide could be a good step in that direction.

So far, my skin is still perfectly clear even though I am not waiting the prescribed 5-15 minutes after cleansing.

My question for you guys: Have you experimented with not waiting after cleansing like I’m currently doing? How did it go?

We took a trip to the lab recently to double check a new machine we’re using to manufacture our benzoyl peroxide. Here’s Kent (my business partner) and I in front of one of the tanks where Acne.org Treatment is made. Why Kent is posing like an automaton I really don’t know :)

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One of the worst things anyone can do for acne is to harshly wash the skin. Unfortunately, people with acne tend to default to scrubbing their skin. A recent study published in the International Journal of Dermatology found 42.7% of people washing their face “excessively,” 28.7% washing “vigorously,” and 14% washing “until I cannot detect sebum (skin oil) at all.” The researchers concluded, “This study showed that our patients may be making a great deal of errors…To effectively treat and prevent further breakouts, appropriate skin care is imperative in patients with acne.”

It is hard for me to read results like this because I just know that these people are doing themselves much more harm than good by washing in a harsh manner. Acne-prone skin is sensitive to irritation, and over-washing the skin, or scrubbing the skin when washing, produces high amounts of irritation which can keep people firmly stuck in a vicious cycle of acne.

Do yourself a huge favor and wash extremely gently with your bare hands for 10 seconds or less.