SHOCKING: the lack of sebum in young children!!

Many of you have read my posts in which I argued in favor of the idea that not only is human sebum not really important as an alleged "moisturizing" agent, it may not be important for anything at all. Prominent among the material I've cited on these forums have been the views of Dr. Albert M. Kligman MD PhD, probably the most renowned dermatologist of all time. To help support his own views of the insignificance of sebum as a moisturizing agent, he has focused on the fact that young, prepubertal children produce virtually no sebum at all, yet somehow manage to get along just fine without it. To drive home this simple but important point, I thought I'd post the following material (including a nice graph showing the actual sebum levels of all the participants, including the group of children) from an independent study in which Dr. Albert Kligman didn't even participate. They say that "one picture is worth a thousand words", so maybe that one graph will impress people with how very little sebum young children actually produce!

This material is from the study: "The Androgen Control of Sebum Production. Studies of Subjects with Dihydrotestosterone Deficiency and Complete Androgen Insensitivity", Julianne Imperato-McGinley, Teofilo Gautier, Li-Qun Cai, Benetta Yee, Jane Epstein, Peter Pochi. J Clin Endocrinol Metab 76: 524-528, 1993. Following the chart is some of the text from the study, describing the experimental setup, subjects, and the results.

 sebum6.jpg ( 70.68K ) Number of downloads: 22


Subjects and Methods

Subjects

"Sebum production was evaluated in 12 subjects with inerited male pseudohermaphroditism due to 5a-reductase deficiency (MPH); 9 subjects were part of a large Dominican kindred, and 3 were from New Guinea. The mean age was 27 yr (age range, 19-40). Eight androgen insensitve (AI) subjects were evaluated with a mean age of 45 (age range, 15-78). Six AI subjects had their gonads intact when studied, and 2 subjects were on cyclic estrogen and progesterone replacement therapy after gonadectomy at the time of evaluation. Twenty-two normal adult Dominican males with a mean age of 28 yr (age range, 17-39), and 21 normal adult Dominican females with a mean age of 29.0 yr (age range, 18-37), normal menses, and no history of hirsutism or acne, were evaluated. Preadrenarchal boys and girls were also evaluated. This study group was comprised of 10 normal healthy Dominican boys ranging in age from 2-5 yr (average age was 3.7 yr), and 12 healthy Dominican girls ranging in age from 2-6 yr (average age was 4.3 yr). None of the children had clinical signs of secondary sexual development.

Procedures

"Measurement of sebum production was performed with Sebutape (Hermal Pharmaceutical Laboratories, Oak Hills, NY), a hydrophobic, polymeric film that measures sebum activity through the use of air-filled micropores. When sebum from the skin surface comes in contact with the tape, numerous tiny air cavities previously filled with air become filled with sebum. Consequently, sebum-filled pockets become transparent cavities forming a pattern of sebum droplet deposition.

"The test was performed in the following manner. The forehead of each subject was thoroughly cleaned with alcohol swabs. A Sebutape patch was placed on the forehead for 1 hr. The patch was removed and the amount of sebum measured on a scale of 0-5 using reference patterns provided in the kit. A zero (0) pattern was equol to no sebum production, whereas a five (5) pattern signified highest sebum output. The patches were read by the investigator (LC) who was blinded to the identity of the subjects.

Results

Sebum studies

"Ten normal boys and 12 normal girls between the ages of 2-6 years had no detectable sebum production by this methodology (Fig. 1), and had a sebum score of 0. Similarly, the sebum score of all adult subjects (with or without intact gonads) with complete androgen insensitivity was zero (Table 1) (Fig. 1)...

"The mean score for 21 control adult males was 4.4 +/- 0.6 which was significantly higher than the mean sebum score of 3.3 +/- 1.2, for 21 control adult females (P < 0.05) (Fig. 1).

"The mean sebum score of adult pseudohermaphrodites with 5a-reductase deficiency (4.5 +/- 0.6) was not significantly different from the mean score of normal adult males (4.35 +/- 0.6) (P < 0.05) (Fig. 1)."

More on the possible use of Nizoral shampoo for acne!

In past months I have recommended that people try washing their faces with Nizoral shampoo, on the theory that its main ingredient, ketoconazole (which has been shown to be an antiandrogen), may be able to reduce sebum production. Setting aside for the moment all the speculation that sebum production probably only plays an indirect role in acne, nevertheless, being able to reduce it would certainly be desirable.

Somebody just brought to my attention the following Web site article about that very same idea. Following the link is the article itself. Although it was written with bodybuilders (steroid users) in mind, it obviously still has implications for the typical teenaged acne sufferer. Although I have minor quibbles with some of the things the author says, I agree with the general thrust of his argument:

http://www.mindandmuscle.net/mindandmuscle...mp;artID=999412

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Steroid Side Effects: Fight Acne with Shampoo?
by Anthony Roberts

One of the most notorious side effects experienced with the use of Anabolic/Androgenic Steroids is the development of Acne. This is, for the more hardcore users, not too big of a deal. Granted, if you are three hundred pounds ripped, are balding with a permanent red face from high blood pressure, and develop a bunch of zits suddenly, that last part is probably the least of your concerns. Large oil filled zits just aren’t a pressing concern to the next Mr. Olympia. However, for most of us, and especially first time steroid users or females, zits are usually something we want to avoid. Acne is the most media-popularized side effect of Anabolic Steroid use, and (next to weight gain) the most outwardly recognizable.

Females especially, want to avoid this for aesthetic reasons, and it’s actually through interaction with one of the female moderators on a bodybuilding message board that I was most recently reminded of this point. She had been experiencing pretty bad acne from Anavar use, but she couldn’t find a suitable answer for how to get rid of it. The most typical answer to the question was “use Retin-A,” which was spouted by nearly everyone she spoke to. It is unfortunate that Retin-A, for many reasons, is a very poor choice for her purposes (one reason being it doesn’t address the cause of the acne appropriately, and it is also a prescription medication). In this particular case, I told her to take some Nizoral (Ketoconazole) Shampoo and rub it on her back and face as a body wash. Huh? What? Shampoo on your face and back? Shampoo is for your hair! Yeah, well that’s what everyone thought. Until now. Okay, I know: shampoo on your face is weird. But, I wouldn’t be writing for Mind and Muscle if I wasn’t three things:

a.) Weird (in the public’s eye)

b.) Creative

c.) Weird

Now, let’s talk about DHT and how it causes acne. We will then discuss why using Nizoral shampoo would be good for getting rid of acne. Development of AAS-related acne and the extent to which it is experienced can be due to a number of varying factors, with the steroids and dosages used being primary factors. It has been established that the receptors of the sebaceous glands have a particularly high affinity to Dihydrotestosterone (1)(2)(3). Anecdotally, it would also seem that DHT-derivations (Winstrol, etc…) cause more acne than others (Testosterone or 19-Nor derived steroids). Thus, we can also safely assume that steroids, which are affected by the 5-alpha-reductase enzyme and turned into DHT in the body, will also be highly probable to cause acne. Increased sebaceous gland activity causes oily skin, and this, in combination with bacteria and dead skin caused by normal wear and tear, then causes pores to become clogged more quickly than the body can deal with them (or than you can exfoliate or unclog them). This causes visible acne and generally terrible looking skin.

So DHT is a primary culprit in all those nasty zits, right? Well, stay with me here, because the next part may get slightly complicated. Nizoral shampoo (the chemical in it is Ketoconazole) is actually a topical anti-androgen. Remember, the catalyst for acne is initially DHT (an androgen) and the sebaceous activity it causes. When used topically, in shampoo form, this particular compound’s effects are limited to the skin/scalp and are not systemic (affecting the whole body) unless you take it orally (drink the shampoo). Ketoconazole’s pharmacokinetics have been studied with oral ingestion (they make a pill, you don’t drink the shampoo of course), and it has been determined that even orally, it is effective against acne, because oral ketoconazole has three delivery routes to the skin (4):

1. Passive uptake by keratinocytes in the basal layer

2. Excretion through the sweat glands

3. (The important one) A massive excretion through the sebaceous glands

In that same study, sebum levels compared with the plasma levels are very high, even with oral ingestion (4), which prompted researchers to simply create a shampoo from the base chemical (Ketoconazole) to prevent androgenic alopecia (balding) caused by DHT. Unfortunately, oral ingestion of an anti-androgen will cause an anti-anabolic effect as well. However, there is almost no effective plasma level to cause an anti-androgenic effect in your body when you topically apply it (4). So this should keep anyone from needlessly worrying about the possibility of an anti-anabolic effect to be had from topically applying Nizoral (even though it’s technically an anti-androgen).

Lets back up a bit and let me give you a little background on how I stumbled on all of this roughly 8 years ago.

I figured out that Nizoral would prevent acne when I had some acne on my forehead during my first cycle. I had been using Nizoral to prevent hair loss, and I always got some shampoo on the top of my forehead when I washed my hair. I soon noticed that the area the shampoo came into contact with was free of acne. So, long story short, I started using it as a topical acne treatment and my steroid-induced acne cleared right up. I tried it on my back acne, and it went away. My girlfriend at the time had some acne, and it cleared that up too. A few years ago, I actually looked for validation on my theory, and found it. The study I first found (4) examined the pill form, but the shampoo is the same active ingredient, and won't have a noticeable systemic effect, but rather will have a localized one wherever you apply it.

Interestingly, about the same year that I had discovered the use of a topical anti-androgen for use in preventing DHT-caused acne (steroid related in my case) scientists completed a study basically saying the same thing. Although I had discovered this use for topical anti-androgens in my shower, and they discovered it in a lab, it’s basically the same idea.

The study I found from that year examining a topical anti-androgen and its effects on the sebaceous glands was very interesting. When a topical anti-androgen was used on rodents, the scientists noted that sebaceous glandular and ductal regression was quite profound. This strongly suggests that a topical anti-androgen could effectively counteract endogenous androgens resulting in a suppression of growth of the sebaceous glands while leaving serum concentrations of both testosterone and dihydrotestosterone intact and not reduced (5). This means, for all intents and purposes, that Nizoral’s anti-androgenic effect on your skin will prevent acne, without it having a systemic effect on your body. In simplest terms, it will leave 100% of the muscle building effects imparted by the steroids you are taking totally unaffected.

Shampoo. It’s not just for hair anymore.

References

1. Am J Clin Dermatol. 2002;3(8):571-8.
2. Clin Dermatol. 2004 Sep-Oct;22(5):419-28.
3. Pol Merkuriusz Lek. 2004 May;16(95):490-2.
4. Int J Tissue React. 1988;10(2):111-3
5. Skin Pharmacol. 1997;10(5-6):288-97.

FINALLY: a more direct test of the "feedback theory".

Ok, several days ago in that earlier thread ("If you stop washing your skin, do you get LESS oily, or do you get MORE oily??"), I presented the results of my experiment which showed that my own forehead gets MORE OILY as the days go by without washing (for up to 12 full days, anyway). However, that's not quite the same as the general idea put forth in the notorious "feedback theory", so I promised that I would do a more direct test of it myself and post my results. Well, HOORAY, I can finally now do that! It's taken me this long because of the annoying amount of time I've had to spend in "grunge mode" and "intense washing mode". This is basically what I've done:

The first phase was in "grunge mode" again: I spent at least another full week (I think it was actually closer to 10 days) without washing my forehead at all, not even with water. No washing, no wiping (similar to what I did in the previous test). Then after that period of time, I de-fatted my forehead by thoroughly washing with Ivory soap, followed immediately by swabbing with 70% ethyl alcohol. Thereafter, I began a series of 9 Sebutape impressions, one every half-hour, for a total of 4 1/2 hours. I marked each test-strip with a "G", followed by the numbers 1 through 9, to indicate that those were made during the "Grunge" or "Greasy" period! The numbers indicate the amount of time in half-hours following the de-fatting that the impression was made. For example, "G5" is on the strip that was made at the end of the grunge period, 2 1/2 hours after the de-fatting.

The second phase was the period of intense washing: I spent over a full week (about 7 1/2 days) of washing my forehead THOROUGHLY with Ivory soap, 5-6 times per day, evenly scattered throught my waking hours. At the end of that period, I made another set of 9 Sebutape impressions, EXACTLY as I had done earlier: de-fatted my forehead by washing one last time with Ivory soap and swabbing with 70% ethyl alcohol, then made a Sebutape impression every half-hour for 4 1/2 hours. I labeled each test-strip with a "W" (for "Washing"), followed by a number 1 through 9, corresponding to which half-hour after the washing that I made it.

Here's the scan of all 18 Sebutape test-strips, G1-G9 and W1-W9, and I placed them side-by-side for your viewing pleasure and ease of comparison:

http://www.geocities.com/bryan50001/feedback_theory_test.htm

As usual, there's some inevitable fluctuation in those test-strips, even though they were made over a relatively short period of time. During some of those half-hours, the "Grunge" version might seem to be slightly oilier than the "Wash" version, and in other half-hours, the "Wash" version might seem to be slightly oilier than the "Grunge" version. But I think one thing is screamingly obvious: taken as a whole, THERE IS NO SIGNIFICANT OR OBVIOUS DIFFERENCE in the level of sebum production that occurred on my forehead during periods of intense washing, and periods of no washing at all. That's reflected by the fact that my forehead re-fatted itself AT THE SAME RATE after a single de-fatting after those periods. So my own experience with this simple test is right in line with what Kligman and his colleagues found, and what LabGirl81 reported about her company's testing: washing your skin doesn't stimulate it to produce more sebum as a "compensatory" mechanism.

All questions, comments, and flames are welcome!

Bryan

If you stop washing, do you get MORE oily, or do you get LESS oily??

My friends, for quite some time now, a few individuals who post on this site have been trying to convince everyone that you actually produce MORE oil if you wash your skin/face more than a certain very minimal amount. The main proponents of this concept are "AlexAlmighty", who started that huge thread a year ago entitled "An Experiment (Long)", and my pal "ballaballa". I've heard the same claim from two or three other posters, too; namely, that their skin gets LESS oily if they stop washing it. I believe "ballaballa" recommends washing your face no more often than perhaps once or twice a week (if I am incorrect in that, he can feel free to correct me). The idea behind this, of course, is the old-fashioned "feedback theory", which held that washing sebum off the skin only stimulates the sebaceous glands to produce more oil. Therefore (according to this notion), if you stop washing your face, your glands will soon "normalize" and stop producing so much sebum.

However, the "feedback theory" is FALSE, as I've taken great pains to explain over the last year. Sebum keeps oozing out inexorably, whether you wash it off your skin or not! I think many of you will be interested in seeing some simple but convincing evidence that the skin continues to pump out and even ACCUMULATE sebum on the surface, for at least as long as 12 days after you stop washing.

I've been talking about Sebutape test-strips for quite a while on this site, so it shouldn't be all that surprising that that's what I used to measure sebum on my own face in a scientific manner! What I did is this: I stopped washing my face ENTIRELY (not even water, absolutely nothing at all) from Thursday, December 8, to last night, Tuesday, December 20. Starting on Sunday, December 11, I began taking roughly daily Sebutape measurements of a smooth area on my forehead, as a SCIENTIFIC way of measuring the casual level of oil/sebum on my face. During that 10-day period, I made 9 impressions. I've scanned all 9 of the test-strips, and I want everybody to see them, side-by-side, and judge for yourselves whether you think oil INCREASES or DECREASES when you stop washing your skin or face! Oil/sebum shows up as dark spots on the test-strips. The more oil, the more spots. It's as simple as that.

First of all, however, you should take a look at the chart they provide with Sebutape test-strips....it explains how they're used, and gives some sample impressions of "Low", "Medium", and "High" levels of sebum. The following is a scan of that chart, and I've put an actual clean, blank Sebutape strip above the chart, just so you can see what one looks like in its pristine condition:

http://www.geocities.com/bryan50001/sebutape_chart.htm

Ok, now we've come to the real deal...here's a scan of all 9 of the actual Sebutape impressions I made on my forehead, from Dec. 11 to Dec. 20 (in other words, on a roughly daily basis), during a period of absolutely NO WASHING OR WIPING WHATSOEVER....I labeled each strip on the right side with a pen from 1 to 9, so that you can see the slow progression from one day to the next (left to right, top to bottom):

http://www.geocities.com/bryan50001/sebutape_test_strips.htm

It's pretty obvious, isn't it?? While there's a bit of typical and expected fluctuation from one day to the next, there's an obvious slow INCREASE in oiliness, all the way from Day 3 of no washing, all the way to Day 12 of no washing. 'Nuff said for the theory that your skin gets LESS oily if you don't wash.

Bryan

What really constitutes a good "moisturizer"?

Many of you here are too young to know anything about the enormously popular book "Life Extension", written more than 20 years ago by Durk Pearson and Sandy Shaw. Below is an excerpt from the chapter "Looking as Young as You Feel". I took the liberty of putting the first sentence of the second paragraph in bold, to emphasize the obvious relevance to what some of us have been discussing here lately (whether or not sebum really has anything to do with skin moisturization):

"Skin appearance can be markedly improved by using Na-PCA, the sodium salt of 2-pyrrolidone-5-carboxylic acid, the principal natural humectant (moisturizer) in your skin. The ability of skin to hold moisture is directly related to its Na-PCA content. The ability of Na-PCA to pull water out of the air is amazing. If you put out a small amount of dry Na-PCA in the Sahara Desert, in a few hours it will become a puddle because of the water removed from the very dry air there! Older people have about 50 percent less Na-PCA in their skin than young people, thus contributing to a dry, hard skin condition. Bathing and swimming can lead to dry skin because your natural Na-PCA is leached out. Na-PCA can be found in some premium quality skin-care cosmetics. Look at the labels to see if it is listed as an ingredient.

"Here's a simple experiment you can do that will demonstrate the fact that it is water, and not oil, that keeps skin soft and supple. Cut some small pieces of hardened leather from an old shoe, and soak one piece overnight in baby oil, another piece in water, and a third in a 15 percent solution of Na-PCA in water (see Appendix I for a supplier of Na-PCA). Next day, remove the pieces of leather from the liquids, dry them off with a paper towel, and compare them for flexibility and softness. The pieces soaked in the Na-PCA and water and the water alone will both be soft, whereas the oil-soaked piece will be much less soft. Now hang the pieces up to dry. The piece soaked in plain water will rapidly dry out and harden, whereas the piece soaked in the Na-PCA solution will remain moist, soft, and supple."