Painkiller medications are easily one of the most heavily consumed drugs in the western world, so if they did cause acne, the potential would be huge.
There’s been no significant surge or downswing in paracetamol and NSAID usage; the only real trend is the epidemic of opioid abuse spreading from state to state. As expected, many acne patients are questioning whether painkillers cause acne, but unexpectedly, some are wondering whether they might clear it.
These acne patients are in the first stage of truly clearing acne. They’ve failed with normal treatments and are searching for alternatives, but haven’t stumbled across the natural strategies yet.
Have they uncovered a secret in this instance? Seeing as this article is about commonly prescribed medications, here’s a medical disclaimer: I’m not a doctor, and the content of this article is entertainment only.
Let’s get started:
Painkillers can deplete your glutathione levels
Acetaminophen, also known by its brand names Tylenol or Paracetamol, is one of the most popular painkillers around. It works without a doubt, specifically by inhibiting the activity of COX-2.
Cyclooxygenase-2 is one of the most important pain mediators in the body. In the immune system, there’s multiple subsets of chemicals. Nf-KappaB controls acne-related chemicals like TNF-a and interleukin-8, while COX-2 controls many chemicals related to pain. These include prostoglandins and thromboxanes.
These chemicals can actually make your pimples more painful, but have a huge role in neck pain, back ache, brain throbbing; you name it. NSAIDs inhibit COX-2 sites widely, while paracetamol inhibits it only in the central nervous system, but still succeeds.
So what’s the connection to acne? The connection lies with paracetamol’s metabolisation in the liver.
Despite its safety at low doses, paracetamol is a painkiller with a huge risk of overdosing. Paracetamol overdoses kill 100-200 people a year in the UK and in the US, sent an average of 78,000 to the emergency room from 2006-2007. They’re the single most ubiquitous overdose and account for 48% of all UK poisonings per year, much more than alcohol.
Every doctor in the land carries a bottle of NAC pills to prevent death by paracetamol. Why? NAC is the fastest known way to increase glutathione levels, and paracetamol is one of the fastest ways to decrease it.
The process of metabolising and detoxifying paracetamol in the liver uses an abnormally large amount of glutathione compared to other drugs. It’s been proven to decrease overall glutathione levels. The high toxicity is mainly due to glutathione depletion…
…and glutathione is one of the most important antioxidants for acne. Acne patients have 20% less glutathione in their skin than people with clear skin.
Glutathione is needed to deactivate destabilising free radicals, protect vitamin C and E from oxidation, prevent clogged pores, and much more. The warnings about paracetamol come with outright overdoses – intakes so high that your glutathione declines to nothing and you reach the brink of death.
But for acne, chronic overuse is just as damaging, even if you don’t wake up in hospital. Using too much paracetamol daily will result in chronically low glutathione supplies, more clogged pores, and more acne.
What about other painkillers?
NSAIDs: ibuprofen – ibuprofen is among the safest painkillers, primarily because its detoxification pathway doesn’t involve glutathione at all. In phase 1, ibuprofen is detoxified by two cytochrome P450 enzymes, while in phase 2, glucuronidation comes into play. Therefore ibuprofen does not decrease glutathione and may slightly increase it according to some studies. It does have another downside: increasing photo-sensitivity slightly.
Aspirin – the official pathway of aspirin detoxification does not include glutathione. But the pathway does involve conjugation with glycine, the amino acid used to make glutathione. Negative effects of aspirin overdoses can be caused by glycine depletion, and glutathione depletion may be one of them. This study found that aspirin overdoses could impair the body’s glutathione systems. The difference is far slighter than paracetamol, but nevertheless noteworthy.
Indomethacin – also metabolised via the p450 pathway, but this study found that indomethacin is able to decrease glutathione and another antioxidant, superoxide dismutase. It’s one of the harsher NSAIDs as well, even decreasing blood flow to the brain.
Naproxin – evidence is thin, but naproxin was found to decrease glutathione levels in the the brain of rats.
Opioids: hydrocodone – no obvious role for glutathione here. Hydrocordone is metabolised by a p450 enzyme to norhydrocodone and to hydromorphone by another enzyme. Both metabolites actually produce some of the pain relief, but according to this study on many opioids, hydromorphone reduces liver glutathione levels. Small doses caused a decrease, as did morphine and pethidine. Therefore morphine itself, the oldest opioid, is in the same boat.
Codeine – this was found to have no effect in the study above, but then again, codeine is a much weaker opioid.
Oxycodone – the data is scarce on oxycodone’s connection to glutathione, but like hydrocordone, it metabolises to hydromorphone, which is known to be connected. I would just about recommend it over Krokodil though.
With other painkillers, the glutathione reducing properties are less strong, but still significant. With regular usage, they can easily take a toll on your precious, acne-clearing supplies. For acne, ibuprofen is the safest painkiller you could take.
Why are people taking them for acne?
Most acne-clearing enthusiasts are intelligent enough to realise that painkillers are just a temporary fix for their skin, but acne patients are still taking them in droves. The most popular is ibuprofen.
Believe it or not, the science is solid, and easy to understand. Seeing as NSAIDs inhibit part of the immune system, the section responsible for pain, they also inhibit much of the inflammatory response to acne. Aspirin and ibuprofen can decrease redness and swelling of pimples and presumably the pain. The benefits are limited given that COX-2 has no remit over inflammatory chemicals like IL-8 and TNF-a, but enough to prevent a swathe of new pimples. Studies on premenstrual acne have found that inhibiting COX-2 leads to improvement.
The problem, however, remains the same. Initially, you might see strong improvements from aspirin, as your inflammation levels will evaporate before your eyes, and with it the redness and swelling. But the glutathione decrease takes days to properly intensify, and it will be a steady downward spiral thereafter. That is the most likely scenario.
As for opioids, they have a less known relationship to acne: they reduce testosterone levels strongly compared to other drugs. 34% of men taking short acting opioids had low testosterone in this study, versus 74% for long acting opioids. They’re believed to function by lowering pituitary gland secretion of leutinising hormone and follicule stimulating hormone, both of which signal the balls to manufacture testosterone. After several weeks it can completely end oily skin and clogged pores, but I recommend against lowering testosterone for acne, to maintain vitality and health.
Some dangers which aren’t connected to acne (or directly connected) include heart attacks, gastrointestinal bleeds, and kidney damage. It’s clear that taking painkillers to clear acne is a very foolish move.
I definitely do not recommend trying aspirin or other painkillers to clear acne, whether as a short term scorched earth approach or a long term strategy. Requiring painkillers for back ache or a bullet wound is one thing, a necessary evil. Overdosing purposefully is another.
Painkillers are not the doom of your skin, but to summarise, use them as intended. There’s much more depth to this topic than that though.
If you do take painkillers regularly, and even notice an improvement in acne when your back or neck is particularly bad, don’t get tempted to take more. There’s plenty of other acne strategies anyway.
Secondly, plenty of supplements and everyday foods can also relieve pain, particularly those that lower inflammation. Scientists often test foods against NSAIDs in studies, and some, including ginger and turmeric, were discovered to be equally as effective at reducing inflammation as these pharmaceutical weapons.
However, any moderately anti-inflammatory food will work, with pain relief accumulating as you include more. Many function in the same way: by inhibiting immune system chemicals like COX-2, and with it their pain signalling. Anti-inflammatory foods and supplements which inhibit COX-2 include…
Resveratrol – the heart healthy phytonutrient found in red wine. Many phytonutients are anti-inflammatory, but resveratrol is one of a handful proven to inhibit COX-2 and prostoglandin release specifically. Take a resveratrol supplement: red wine is not recommended in these circumstances, while red grapes are not concentrated enough.
Onions and kale – another such phytonutrient is quercetin. Other fantastically healthy phytonutrients, including epigallocatchin-3-gallate in green tea, have been shown to have no effect. Quercetin is one of the strongest natural COX-2 inhibits and onions and kale are extremely rich in it.
Sweet potatoes – Peruvian purple sweet potatoes were proven in one study to significantly inhibit COX-2 levels. Will normal sweet potatoes work? They’re sparser in the miracle compounds, anthocyanins, but they also contain high amounts of quercetin. You’ll learn the truth quickly enough if you adopt them as your main carb source.
Dark chocolate – recommended for a very different reason. People reach for chocolate at times of stress, and the sweet sugar isn’t the only cause. Cocoa contains a bliss compound called anandamide, a mood boosting substance called phenylethylamine, and releases natural opiates when eaten. This study took people with the painful peripheral artery disease (PAD) and ordered them on a long march. Those eating 40 grams of 85% dark chocolate were able to walk further before they couldn’t bear the pain any longer.
Dark chocolate is like a natural opioid. Dark chocolate has anti-inflammatory properties of its own, however, as beneficial gut bacteria feast on its polyphenolic antioxidants and churn out ” waste products” of anti-inflammatory molecules.
Turmeric – this spice was proven to soothe the pain of post-operation patients in this study. 200mg concentrations of curcumin, the main antioxidant in turmeric, have been shown to inhibit pain strongly. Always use black pepper with your turmeric.
Extra virgin olive oil – contains a compound called oleocanthal which was shown to inhibit COX-2. Just 3.4 tablespoons of olive oil contained enough oleocanthal to equal the anti-inflammatory properties of ibuprofen; add it to your salad or potatoes daily.
An added benefit is that this war on pain will become a war on acne too, having the same anti-inflammatory benefits as painkillers. Just without the shocking side effects.
To keep using them, build your defences
Depending on your pain severity, natural dietary strategies probably won’t replace your painkillers completely. However, and this is just important, they could allow you to cut down substantially. If eating sweet potatoes and ginger every day allows your to slash your paracetamol dosage to just 20% of what it was, that’s a massive victory.
Strategy two is repairing and defending against the damage from painkillers. The main problem is depletion of glutathione, so you need to supply the ingredients. Selenium is the baseline mineral used to manufacture glutathione, with 5 out of 8 forms being seleno-proteins. Magnesium and zinc are also vital, as are the amino acids glycine and cysteine. Ensure that these basic factors are corrected and the occasional paracetamol will bounce off your skin.
Thereafter you can enter the expert realm, eating secret foods with glutathione-boosting properties. These include grapes, ginger, basil, turmeric, garlic, and onions. Coincidentally, many are also COX-2 inhibiting foods. The principles are similar to alcohol abuse, which also wreaks havoc by decreasing glutathione.
It also goes without saying that if you suffer only minor pain or not even chronic pain, yet still pop painkillers constantly (or know somebody like this), it’s time to cut down.
Glutathione is one of the most important antioxidants for preventing acne and painkillers can reduce it. Therefore your strategy is simple: keep painkillers restricted.
For acne, ibuprofen is the safest painkiller overall, although it can increase photosensitivity when abused and has unrelated side effects. There’s absolutely no advantage to using painkillers to treat acne. The only theoretical advantage is as an extreme short term solution for calming existing pimples down.
Maybe you’re going on a date or heading to a business meeting, or on trial in a kangaroo court where all the jurors happen to hate acne. But using honey or avoiding sugar, or dunking your face in cold water is far superior for rapid acne reduction.
Follow the natural steps here and you may even become impervious to pain, maybe too much so.
Thanks for reading!