Viral DIY Acne Treatments: What To Tell Your Patients
Did you know patients are using everything from diaper rash cream to table salt to try to treat acne?
“Official” estimates suggest that up to 50 million Americans suffer from acne. This number is likely an underestimate, as most patients are not seeking professional care. A Google search for “acne treatment” yields 191 million results, showing just how popular a topic this is. While some of these acne cures and treatments come from reliable sources, most do not. Yet, most patients obtain their medical information from these Google searches rather than from a dermatologist.
BY THE NUMBERS
50+ Million Americans are estimated to have acne
191 Million Google search results for acne treatments
85% Of young individuals worldwide are thought to have acne
Below, I will review the biggest fad acne treatments making their way across the beauty blogs as well as the available data on their effectiveness. As dermatologists, we need to recognize our patients are looking to the Internet for acne solutions, and we must be aware of what’s out there so we can properly educate our patients on best practices.
The latest buzz across beauty blogs reports that a $7 diaper cream is clearing faces around the country. The diaper cream is comprised of zinc oxide and white petrolatum, which, as we know, are commonly used as skin protectants. While oral zinc supplements have been reported to exhibit anti-inflammatory effects and may be useful as an adjunctive acne therapy, topical application of zinc oxide will not provide this benefit.
If we assume that the skin barrier overlying a pimple is inflamed and disrupted, then protecting it with a zinc oxide and petrolatum cream may be of benefit. However, these ingredients do not address the underlying abnormal keratinocyte proliferation, sebum production, P. acnes colonization, or inflammation that are characteristic of acne.
Aspirin is comprised of acetylsalicylic acid, which we use to reduce pain, fever, and swelling. After it is ingested, it is hydrolyzed by non-specific esterases in the stomach and liver and converted into salicylic acid. The Internet commonly confuses aspirin or acetylsalicylic acid with its cousin salicylic acid, and concludes that aspirin masks can help treat pimples.
We know that in acne, the skin produces greater levels of sebum compared to acne-free skin, as well as high levels of squalene. As that squalene goes through peroxidation in the skin, it leads to elevated lipoxygenase enzyme activity with inflammatory cell recruitment. As it turns out, acetylsalicylic acid has been shown to regulate lipoxygenase activity, which explains some of its anti-inflammatory properties. So theoretically this treatment may provide anti-inflammatory benefits.
SET THE RECORD STRAIGHT
It’s imposible to be aware of every viral acne trend, but you can help educate patients on the facts.
• Ask patients about anything they are using to treat their acne, including skincare, dietary supplements, topical spot treatments, etc.
• Recommend vetted and reliable online resources that patients can access for information.
• Consider providing comprehensive patient education on your own website.
• Educate patients about the pathogenesis of acne, as appropropriate to their level of understanding.
• Highlight common myths about acne causes and treatments and provide facts.
• Keep an open mind. Be firm but maintain dialogue, rather than be dismissive of patients’ questions or ideas.
• Provide rationale for using the prescription and non-Rx skincare you recommend.
• Advise patients that using additional or alternative agents may increase irritation and/or interfere with recommended products.
Made of sodium chloride, table salt is a commonly used food seasoning we all are familiar with. It is also included in personal care products as a thickening agent or may be used to help reduce moisture in the skin and hair. For this reason, it is added to some facial scrubs and drying creams.
Will a DIY salt spot treatment clear acne? The first challenge is getting the salt crystals to stick on the face. (The Internet suggests placing a bandage over the crystals to get them to stay put.) While salt may help dry out a pimple, it certainly will not take the place of our prescriptions. It is unclear whether it is more or less effective than topical salicylic acid.
Garlic has been used for centuries in traditional medicine for its anti-inflammatory properties. Garlic contains allicin, a compound that possesses broad anti-microbial activity. While data are limited, studies have shown that garlic juice does demonstrate activity against P. acnes bacteria. However, I would exercise caution, as garlic is associated with occupational contact dermatitis in cooks.
While most dermatologists are writing for prescription medications, we must be educated on the data (or lack thereof) about fad treatments disseminated on the Internet, many of which go viral.
When patients come to visit us in the office, it is important to dispel myths and ensure that our patients are being treated early and effectively with the best acne treatments available.
Joshua Zeichner, MD, FAAD is an Assistant Professor and Director of Cosmetic and Clinical Research in the Department of Dermatology at Mount Sinai Medical Center in New York.