Recent evidence suggests that free radicals and oxidative stress play a role in the initiation of acne. Some vitamins act as natural antioxidants, protecting the skin from oxidative stress. Interestingly, markers of oxidative damage are higher in blood samples taken from patients with acne, whereas antioxidants are lower. Not only are cellular antioxidants low in patients with acne, but levels of antioxidant vitamins like vitamins A and E are also significantly lower in acne patients as compared to controls. It appears as though these antioxidants are being consumed at a faster rate in patients with acne.
Vitamin E is thought to have antioxidant properties. When ingested by eating food rich in vitamin E, or through oral supplementation, vitamin E makes it way to the skin by becoming incorporated into the oily secretion known as sebum. Not only are vitamin E levels in the blood of acne patients lower than controls, but vitamin E levels in the sebum of acne patients are lower as well.
So, theoretically, it would make sense that supplying acne patients with more vitamin E (topically or systemically) might help prevent (or even treat) acne. Vitamin E in the form of alpha-tocopherol was tested in high doses topically to measure antioxidant activity, and the results were published in a prestigious dermatology journal called the Journal of Investigative Dermatology. Long story short: the authors were underwhelmed. The form of vitamin E that was applied topically might not have been sufficiently converted to the active form. Although I’m not giving up on topical vitamin E, given the data we have thus far on topical vitamin E, oral supplementation may be the way to go.Nuts, seeds, and vegetable oils are among the best sources of alpha-tocopherol, and significant amounts are available in green leafy vegetables and fortified cereals. Dietary supplements containing vitamin E sometimes contain doses well above those recommended. Since high levels of vitamin E consumption have been associated with bleeding problems, I recommend that my patients try to get the vitamin E they need from their diets. If they don’t like to eat nuts or seeds, then I suggest either taking a supplement with a very conservative amount of vitamin E, or taking a vitamin E supplement only once or twice a week.
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