Rather than wasting time with creams and benzoyl peroxide in a meticulous regimen, it’s better to just cheat, skip those steps and adopt the ultimate diet and lifestyle.
Overall, there’s two main internal problems behind acne: 1) a state of chronic inflammation, and 2) a systematic deficiency of antioxidants.
Make no mistake that in this civilisation of ours, the heroes and villains that can cause or improve acne are endless. Zinc is great for red and angry pimples, as is eating less sugar. Air pollution can cause acne, even shaking the hand of a woman who applied moisturiser that morning can wind up causing acne.
But what’s also true is that every single minor factor filters through to the two main factors, as well as the closely ranked in third factor, oily skin.
In particular, stacking up your bodily antioxidant supplies and the building blocks to build them is one the simplest and most effective acne strategies available…
…and one of the better researched antioxidant supplements is alpha lipoic acid.
Alpha lipoic acid is an antioxidant that is both found in foods and manufactured by the human body in small quantities. Red meat, spinach, broccoli and liver contain ALA, but the doses are tiny; hence ALA is mostly taken as an over-the-counter supplement. Small amounts are found in every human cell, with one function being helping to turn glucose into energy.
Alpha lipoic acid ranks alongside NAC, grass-fed gelatin, vitamin C and vitamin E as one of the more notable ways to crank up your blood antioxidant supply, and potentially cure acne. Is it worth the hype?
The answer is unknown. On one hand, alpha lipoic acid has extremely mixed results in testimonials from acne patients. On the other hand, ALA has a ton of indirect evidence for clear-skin benefits.
The antioxidant powers of alpha lipoic acid
The quality that makes alpha lipoic acid unique compared to say, vitamin E, is that it helps to regenerate other antioxidants as well. It can scavenge acne-causing free radicals by itself, but can also regenerate vitamin C, glutathione, vitamin E, coenzyme q, and more.
First let’s cover the studies directly on alpha lipoic acid. Alpha lipoic acid has free radical scavenging powers itself, but its properties mostly come from its reduced form, dihydrolipoate, produced during the first stage of metabolization.
Reduced alpha-lipoic acid becomes “a powerful antioxidant in its reduced form” according to this study. ALA was applied to cultured human cells and found to slash reactive oxygen species generation. This led the scientists to conclude that ALA can enhance antioxidant defences of human cells.
Then there’s this review from 20 years ago, in 1995. It claimed that ALA and its reduced form dihydrolipoate can deactivate free radicals like superoxide radicals, hydroxyl radicals, hypochlorous acid, peroxyl radicals, and singlet oxygen. In other words, alpha lipoic acid and related compounds can reduce an extremely wide variety of free radicals.
That was 20 years ago, and more evidence has accumulated since then. Some of the most interesting studies have been highly specific, on the brain condition of rats pumped up with arsenic. Arsenic is a deadly heavy metal, and when the rats in the studies were injected with it, brain levels of free radicals and lipid peroxides like malondialdehyde shot up and led to neuronal degeneration.
In this study however, ALA had a protective effect. It could 1) reverse the decrease in glutathione and related enzymes and 2) reverse the out-of-control malondialdehyde (one of the most dangerous fat soluble free radicals). The result was an increase in the rat’s cognitive performance (let’s hope they don’t get too smart).
This study was extremely similar, ALA reversed the decrease in glutathione from the rats and increased other antioxidants like catalase and superoxide dismutase as well. The relevance for acne? Arsenic isn’t just damaging to the brain; the onslaught of free radicals that it unleashes can show up vividly on the skin as well.
An interesting fact is that alpha lipoic acid is one of the few antioxidants with the ability to cross the brain blood barrier; a wide variety of benefits were observed for Alzheimer’s disease in this study. More relevant to acne, it’s also one of the few to be both fat and water soluble, allowing it to fight the countless different forms of free radicals on multiple fronts. This review of ALA’s brain benefits also remarked that combining it with plant based antioxidants like curcumin (from turmeric) or ECGC from green tea could enhance its power.
As those studies hint at, one of the biggest benefits of ALA is in restoring antioxidants that have already been used. Your average antioxidant functions by donating an electron to a free radical. Free radicals bombard and destabilise healthy tissues by attempting to steal their electrons to make up for the fact that they’re missing one.
Antioxidants have the ability to donate electrons to these loose cannons of molecules, but don’t become free radicals themselves…
…but what they do become is deactivated and totally useless. ALA can swoop in and regenerate lost antioxidants, particularly glutathione and vitamin C. Alpha lipoic acid also regenerates two lesser known ones called coenzyme Q10 and NAD (nicotinamide adenine dinucleotide). This study found that alpha lipoic acid supplementation increased cellular glutathione levels by 50% in healthy mouse lung cells. Glutathione is one of the best researched antioxidants for acne (which is why there’s a full article here).
All in all alpha lipoic acid is fairly potent antioxidant, though there’s some doubt about its effectiveness across the whole body, which you can discover if you scroll down to the analysis section.
The anti-inflammatory powers of alpha lipoic acid
Inflammation is a highly complicated topic. There’s countless different pro-inflammatory chemicals, in some circumstances it’s good to have an overdose of inflammation, and the complex interactions between chemicals don’t always guarantee that reducing one chemical will end up making your pimples calmer and less red.
No scientist alive or dead knows the ins-and-outs of the whole immune system…
…but alpha lipoic acid might bypass all that. It’s an interesting treatment, because it targets the master regulator of a vast swathe of these chemicals – NF-kappaB.
NF-KB is a protein complex, of which elevated activity has been associated with a plentiful selection of inflammatory diseases like arthritis, cardiovascular disease, asthma, and inflammatory bowel disease. In fact, NF-kappaB doesn’t transcript many pro-inflammatory chemicals… it’s even more dominant than that. It controls all the GENES that transcript the pro-inflammatory chemicals. Its influence on inflammation and acne is enormous, and ALA has been shown in studies to keep its activity at normal levels.
This study began by commenting on how important upregulated NF-kappaB is in chronic inflammatory diseases, claiming that high and poorly regulated levels with age were behind some diseases in the elderly.
Then it compared alpha lipoic acid to vitamin C and vitamin E on several immune system actors. Alpha lipoic acid “reduced NF-kappaB activity in these cells in a dose-dependent manner”. It also reduced a more specific pro-inflammatory chemical called TNF-a, and was superior to vitamin C and vitamin E for both functions.
This study, meanwhile, tested alpha lipoic acid against vitamin C in ascorbic acid and glutathione in human cells. Once again, alpha lipoic inhibited NF-kappaB in a dose dependent manner. Once again, vitamin C and glutathione did not.
Next we have a 1998 review of all the previous data. All you need to read here is the raw quotation: the benefits “include direct radical scavenging, recycling of other antioxidants, accelerating GSH (glutathione) synthesis, and modulating transcription factor activity, especially that of NF-kappa B”. The NF-kB restraint was responsible for the “sometimes dramatic benefits” of ALA.
Finally, we have a study on cells infected with AIDs, which obviously had some severe immune system abnormalities. NF-kappaB activity was out of control, and ALA was found to inhibit the excess activation in a dose dependent manner. What’s more, the required dose was very small; “the inhibitory action of alpha-lipoic acid was found to be very potent”.
If this all sounds like overly scientific jargon then it means this – alpha lipoic acid can control one of biggest regulators behind the pro-inflammatory chemicals which create, redden and swell the pimples you see in the mirror every day.
As long as these studies didn’t all arrive at the same false conclusion, the evidence shows that alpha lipoic acid might be an excellent remedy for inflamed acne.
NF-KB regulation isn’t the only factor either; there’s also research on benefits for T cell function. Those are types of white blood cells involved with immune system adaptivity, specifically in the tailoring of immune system responses to specific threats. If ALA improves T cell function then it might stop the inflammatory response to p.acnes bacteria from being so constantly brutal.
The bonus powers of alpha lipoic acid
It’s safe to say that lowered inflammation and increased antioxidant supplies are the main benefits of alpha lipoic acid, but if you read the article with a keen eye you’ll already have identified an extra one.
The answer is protection against heavy metals of course. The study on rat brains found that all the toxic damage from arsenic was reversed. Arsenic is a toxic heavy metal which was once used as a pesticide before being hastily banned. Significant quantities still contaminate crop fields, particularly former cotton fields, and are taken up into the root systems of plant species used to make apple juice, grape juice and rice.
Consequently, it’s in all of those foods, and it’s also in our bodies, causing problems like 1) overproduction of the skin protein keratin, and 2) glutathione depletion. Alpha lipoic acid could not only protect against the effects of arsenic, but also reduce levels of it: “lipoic acid treatment was effective in reducing brain regional arsenic levels”. Other heavy metals aren’t safe either, including mercury and aluminum.
Finally, we have the second big bonus benefit – an improvement in insulin sensitivity. This benefit is an offshoot of the antioxidant powers, because it functions by antioxidants protecting molecules involved with glucose energy metabolism and making it more efficient.
The end result is less insulin required to shunt the process along. The end result of that is less stimulation of sebaceous glands and less oily skin. What’s more, alpha lipoic acid helps to activate AMPK, which is a key regulator of cell energy metabolism.
All this data is promising stuff for the strategy of treating acne internally, with topical treatments used only as a bonus weapon.
The analysis of alpha lipoic acid
For that reason then, it’s disappointing to reveal that the testimonials of acne patients have been extremely mixed. There are certainly great stories, with one claiming that “it improved my acne instantly”. There’s plenty of scathing reports, with tales of red rashes and hives all over the body.
But by far the most common report is a total lack of visible benefits at all. No reduction in pimples, no redness, no effect whatsoever, leading to the patient discontinuing the supplement with disappointment. What’s the answer? Is there some factor that prevents alpha linoleic acid from working the aforementioned benefits when interacting inside the complex human body?
Here’s the most interesting explanation I’ve found – this study, the same one that raved about the benefits of its potent antioxidant properties, also found that ALA is not absorbed at all when taken at low constant levels.
The alpha lipoic acid molecules simply bind with fatty acid sites on albumin in the bloodstream instead. Only at high doses is the alpha lipoic acid roaming free and able to interact with cells across the body.
This makes perfect sense, because it’s almost guaranteed that our test subjects took low-to-moderate but constant doses. Humans have the old fear of the unknown, and particularly with an unknown supplement, only the experimentation fanatics would jump in with a high dose instantly.
This study on the antioxidant properties of alpha lipoic acid in vivo (so in living animals, not cells) was also revealing. In a test performed on rats, 98% of the lipoic acid was recoverable in urine 24 hours after administration. The ALA was rapidly metabolised and failed to accumulate in tissues. Compare that to vitamin E or vitamin A, which accumulate in the face to provide a direct shield against acne.
The study authors did comment that alpha lipoic acid has great benefits for a variety of diseases, and attributed them to fuelling an increase in glutathione. Nevertheless, alpha lipoic acid’s benefits just got cut in half.
Then there’s this study, which pointed out that as well as its undeniable antioxidant effects, alpha lipoic acid can also have pro-oxidant effects. It seems that alpha lipoic acid has highly complex interactions with the human body.
In my reckoning, the whole concept of alpha lipoic acid is suspect as well. If you can never obtain sufficient quantities through food, and the human body naturally manufactures extremely low levels, why is supplementation necessary at all?
ALA sounds like a very minor player. It’s not like glutathione which we are constantly depleted in due to toxin exposure. Compared with the essential nutrients vitamin C or vitamin E, and glutathione again, alpha lipoic acid seems to be more of a bonus antioxidant and one that is not yet guaranteed to work on acne.
There are also no direct studies on acne; compare that to NAC, which was found to slash acne lesions by 50% over the course of 8 weeks. Acne patients have 20% less glutathione in their skin than average. We have no such simplistic but telling statistics for alpha lipoic acid.
Then there’s the side effects. One person reported hives from an ALA supplement; that’s not an isolated incident. Some people in Japan have developed a condition called insulin autoimmune syndrome apparently.
For all the reasons above, I rank alpha lipoic acid towards the bottom half of the acne antioxidant hierarchy.
There’s a good chance that ALA will improve your acne, but there’s just so much uncertainty orbiting it that you might as well use vitamin C, vitamin E, or trusted old tools for skyrocketing your glutathione production first.
If you want a cheap acne supplement for aiding the manufacture of antioxidants, then NAC is dramatically superior, for its effect on glutathione. While alpha lipoic acid increases antioxidants through its regenerating capabilities, I highly doubt that it would beat taking more of the antioxidants themselves, vitamin C or vitamin E.
Nor would it beat taking the kingpin acne minerals for glutathione – zinc, magnesium and selenium. But alpha lipoic acid is not useless either, it has proven benefits for Alzheimer’s patients for instance, preventing further cognitive decline.
In reality, the anti-inflammatory benefits are far more convincing for acne than the more famous antioxidant ones. However, it’s possible that they won’t work their way into the flesh either. MSM or zinc are superior if you want lowered acne inflammation for low, low prices.
Overall, the testimonials speak for themselves – you can take alpha lipoic acid for an experiment and if the stars align perfectly, it might clear acne fantastically. However, you should not make it a top priority.
Thanks for reading!