N-acetyl-cysteine (NAC) And Acne: Miracle Antioxidant Supplement Or Pointless Waste of Money?

According to state of the art scientific research, the cure for acne may be staring us in the face.

This common compound is handled by all doctors in their weekly duties, and administered to patients without a second thought as to the true extent of its powers. This compound was patented in 1960 and first approved for general usage by the FDA in 1968.

Today, this compound remains on the World Health Organisation’s list of essential medical tools. It’s the default compound for treating painkiller overdoses and extreme alcohol poisoning. This compound is about as nondescript as it gets.

The compound that secretly clears acne is N-acetyl-cysteine, a supplemental form of the amino acid cysteine found in eggs and dairy.

NAC has a well established tradition of curing virtually every medical condition under the sun. It might be the most extensively researched medical supplement in the world outside of the essential vitamins and minerals.

NAC has benefits for type 2 diabetes, decaying eyesight, and high blood pressure. It heals psychological problems like depression, schizophrenia, and anxiety, and possibly even cocaine and cannabis addictions. The latest on the ever-growing list is our old friend acne. 

 

NAC lowers acne by 50%

Unlike other acne supplements which are promising yet mostly indirect, NAC is a rare supplement to have studies directly on acne.

We’ve covered this amazing study before, in our 2015 milk thistle article. Scientists divided 56 male and female acne patients into four groups who took either 1) a placebo, 2) 200mcg of selenium, 3) 210mg of silymarin, an antioxidant found in the milk thistle herb, or 4) a 1200mg dosage of NAC daily. The patients were aged between 14 and 30, the prime years for acne.

Read Annihilate Your Acne – get the ultimate diet for clear and glowing skin!

The scientists tested acne itself, but also various bloodstream biomarkers such as malondialdehyde (MDA), a classic indicator of free radical levels. There was also interleukin-8, a pro-inflammatory chemical with unrivalled skin-inflaming abilities, which is proven in studies to be more prevalent in acne-prone skin (study, study).

With each passing week, the participants’ acne retreated further and further.

With the placebo pill, there were no noticeable chances. The selenium pill achieved a respectable 40% reduction, but with milk thistle and NAC, total acne lesions plummeted by a gigantic 50%.

The selenium performed admirably, and that’s why I recommend that all acne patients inspect their intake, but the NAC supplement won with ease. There’s many possible explanations, particularly that selenium takes far longer to accumulate in the body. With NAC, the benefits kicked in fast and only intensified thereafter; the reduction reached 15% after 2 weeks, 25% after 4 weeks, and 40% after 6 weeks.

Pro-inflammatory chemicals also retreated, with MDA and IL-8 falling 38.8% and 72% respectively in 8 weeks. Selenium also matched its rival NAC, with 35% and 71% falls, while silymarin was even better, achieving 39.2% and 80%.

Not only did a simple NAC pill have acne, it also beat the prestigious acne mineral selenium.

 

Precisely how does NAC clear acne?

The mechanism behind NAC’s greatness was also revealed in the study, as after 8 weeks of taking a 1200mg pill daily, bloodstream glutathione rose by 205%. 

What’s so special about glutathione? It’s the single most powerful antioxidant which your body makes itself. Glutathione has been dubbed the king of antioxidants and since 2000, the research floodgates have burst open.

Glutathione’s acne powers include 1) hoovering up vicious swarms of free radicals, 2) strengthening your skin against scorching sunlight, 3) preventing the pore-clogging squalene peroxide from being born, and 4) preserving delicate vitamin C molecules.

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N-acetyl-cysteine works its magic by replenishing your glutathione stores when they’re depleted. To illustrate, consider NAC’s main usage in hospitals worldwide – as an antidote to liver damage caused by painkiller overdoses. Countless painkiller brands such as Paracetamol use acetaminophen as the active ingredient. This compound does successfully cure pain in small doses, but acetaminophen overdoses are the number one cause of acute liver failure in the USA.

Your liver metabolises acetaminophen into a compound called N-acetyl-p-benzoquinone imine, which accumulates in the body. Ordinarily, glutathione-s-transferase binds to NAPQI and detoxifies it, but in overwhelmingly high doses, your bodily stores of glutathione become rapidly depleted, leaving the metabolites free to react with hepatic enzymes, destroy liver cells, and possibly even kill you.

This all-too-common tale is why doctors always keep a box of NAC pills on hand. NAC is the simplest and most effective way to rapidly spike glutathione levels and avert a medical disaster.

The mechanism couldn’t be simpler, as every glutathione molecule in your body is synthesized using the amino acids glycine, l-glutamine, and l-cysteine. An NAC pill simply supplies the cysteine portion.

The other ingredients of glutathione are sulphur and the minerals zinc, magnesium and selenium, which is why selenium performed so excellently above. A 2013 study found that severe acne patients had over 20% less glutathione in their skin cells, with moderate acne patients having just below 20% less.

 

NAC improves multiple root causes of acne

By sending glutathione soaring, NAC doesn’t only increase the antioxidants on your face.

Better still, the likes of vitamin E are relieved from their antioxidant duties elsewhere, such as protecting delicate eye cells and neurons. Vitamin E is the single most important antioxidant for clogged pores, and you want as much to be diverted to skin protection as possible. It’s a similar story for vitamin A, king of oily skin (or ending it anyway). Vitamin A is transported through the rough badlands of the bloodstream by retinol-binding protein, a delicate molecule which free radicals can shatter, sending your precious vitamin A spiralling into oblivion. Again, glutathione’s antioxidant functioning can stop this.

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The clearest real world example is NAC’s storied reputation for curing hangovers. The fatigue, lethargy, and sickness of a hangover don’t come from alcohol itself; they come from a by-product called acetaldehyde created when alcohol is broken down by the liver.

Like NAPQI from paracetamol, acetaldehyde pulls the plug on your glutathione containers, but NAC can bolster your defences before a hangover ever kicks in. One study found that 200mg worked excellently for hangovers, which is far below the standard NAC dose of 500mg.

The story doesn’t end there, as for acne, NAC can also benefit…

Chronic inflammation – higher glutathione will benefit inflammation itself, by keeping free radicals in check, but it doesn’t fundamentally alter a hyperactive immune system.

Nevertheless, this 2009 study gave 500mg of NAC to 24 patients with type 2 diabetes. After several weeks, levels of C-reaction protein (the most popular biomarker of inflammation) rose by 18% in the placebo group but fell nicely by 9% in the NAC group. The scientists concluded that NAC “may have some efficacy in reducing systemic inflammation”.

A mouse study, meanwhile, tested NAC, bromelain from pineapple, and the supplement alpha lipoic acid. All three reduced inflammation, which visibly translated to the mice’ skin, reducing their numbers of cysts.

In this 2013 study on rats, NAC reduced every inflammatory chemical under the sun, including IL-1beta, IL-6, and TNF-a, while increasing the antioxidants glutathione and superoxide dismutase. The authors dubbed it a “strongly anti-inflammatory” supplement. This study took it to the next level, calming IL-8, IL-6 and TNF-a in glutathione-depleted humans specifically.

This study on NAC found reduced systematic inflammation in the small intestine, as did a second NAC study published just this month (February 2016). That makes NAC promising for acne-causing digestive disorders such as leaky gut syndrome, where your intestinal permeability increases and too many inflammatory molecules flood into the bloodstream.

Insulin resistance – a feared disease where your insulin molecules no longer work properly, forcing your body to increases levels to compensate, and leading to oily skin (which insulin powerfully stimulates).

This 2002 study found that high doses of NAC, 1.8 grams daily to be exact, improved the insulin sensitivity of women with polycystic ovary syndrome after 5-6 weeks. Even better, blood insulin levels fell.

A 2011 study also tested women with PCOS, this time using the diabetes drug metformin as a comparison. Amazingly, NAC matched effortlessly matched this powerful pharmaceutical drug, reducing insulin resistance and fasting insulin levels. The only thing missing was a mechanism for NAC.

This 2015 study found that NAC failed to reduce insulin resistance in the liver, but did succeed virtually everywhere else in the body. This 2003 study observed increases in insulin sensitivity and commented that lowered oxidative stress was probably responsible.

Which raises a question. Are NAC’s insulin powers unique, or are they solely down to glutathione? Antioxidants are vital to insulin sensitivity as they protect individual insulin molecules, making high bloodstream levels unnecessary. Nevertheless, NAC was powerful enough that a unique mechanism may well be lurking.

 

NAC – an impenetrable shield against environmental toxins

As a supplement, NAC has one particularly distinctive power – defending your skin against insidious heavy metals.

Whether this comes from boosting glutathione, which is also a stage 2 detoxification agent, or a special power of NAC itself is unconfirmed. What is known are the results:

LEAD: in factory workers with lead poisoning, n-acetyl-cysteine can reverse antioxidant depletion and lower blood levels of lead itself (study, study).

CADMIUM – a heavy metal which was formerly one of America’s most popular pesticides, only to be discontinued after reports of horrific side effects surfaced. NAC can accelerate recovery from cadmium toxicity (study) and protect against cadmium-induced liver damage in rats (study).

Luckily for acne, NAC can prevent the antioxidant depletion from cadmium (study), and also the uptake of cadmium into cells (study, study).

SODIUM FLUORIDE – NAC acts as a shield against the damage from toxic toothpaste and the water additive fluoride, particularly oxidative stress (study, study, study) and reproductive problems (study).

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ARSENIC – a uniquely dangerous toxin for acne. This heavy metal not only increases oxidative stress, but also the pore-clogging protein keratin.

NAC has successfully protected against arsenic-induced oxidative stress in three studies (study, study, study), and even saved one 32 year old man’s life after a failed suicide attempt using arsenic-laced ant poison (study). The man’s condition deteriorated for 27 hours and only recovered after doctors gave him a last ditch megadose of NAC. He was discharged 24 hours later.

MERCURY – there’s a big debate here, as many natural health gurus insist that NAC interferes with mercury detoxification, or allows it to be transported across the fateful brain-blood barrier. However, all the studies I’ve seen have been excellent.

NAC is a quick-acting antidote for mercury poisoning (study), can prevent mercury toxicity in mice (study), and can increase the urinary removal of methylmercury, the most deadly form in humans (study).

As for the brain fears, it’s highly unlikely, because this and this study found that NAC reduced mercury-induced neurotoxicity in the hippocampus of rat brains

 

NAC may improve depression

As for NAC’s wider benefits, this is a supplement of many talents, but the one that undoubtedly stands out is brain health.

First of all, NAC is spreading like wildlife as a simple yet effective treatment for depression. It’s widely popular on the internet, but this double-blind, placebo controlled trial supports it too: “NAC appears a safe and effective augmentation strategy for depressive symptoms in bipolar disorder“.

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Nor are other mental problems immune, as NAC supplements may banish schizophrenia, addictions, bipolar disorder, OCD, autism and possibly delay Alzheimer’s. NAC even affects impulse-related anxiety disorders such as nail-biting, hair pulling, teeth grinding, and lip licking.

None of this is surprising consider how NAC works. Glutathione has a dual function, acting both as a super antioxidant and a stage 2 and 3 detoxification enzyme. Taking NAC can increase the clearance of nearly every environmental toxin hiding in our world, and most heavy metals can shred your brain in some form. Aluminium accumulation accelerates the amyloid plaque formation behind Alzheimer’s, mercury is linked to autism, and fluoride can suppress IQ scores at all ages.

The less environmental toxins roaming around your body, the sharper your brain will be (not physically). The antioxidants of NAC will also prevent your neurons from getting frazzled.

 

The downsides of NAC analysed

Now the part we all hate. N-acetyl-cysteine looks like a miracle judging by the scientific evidence, but there’s a few niggling flaws for acne.

Firstly, NAC has the same problem as milk thistle – that its central power is hardly unique.

If you’re deficient, then zinc, magnesium and selenium will increase glutathione levels just as strongly in the long run. In fact, they easily have priority over NAC due to their secondary acne benefits. Zinc is required to manufacture retinol-binding protein and control an overactive immune system, selenium can lower inflammation, and magnesium reduces stress and improves your sleep quality.

Even the amino acid cysteine is easily obtainable from eggs and dairy, and muscle-building whey protein is a particularly concentrated source, which could make NAC pills totally pointless.

Grass-fed gelatin provides the full spectrum of amino acids, and is probably an all-round superior supplement to NAC. Its glycine content boosts glutathione output, but also increases collagen by joining forces with its proline content.

Its possible that in the amazing 50% reduction study, the patients were eating such little glutathione-promoting nutrition that their skin was starving for something, anything, to send levels soaring. If your diet is packed with nutrition already, perhaps after reading this very website, then NAC’s true potential may be far milder.

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Then there’s the looming question of side effects, which even include skin problems such as flushing, red rashes and itchiness. One much feared consequence is that NAC forms a red blood cell-derived molecule called nitrosothiol which tricks your body into identifying an oxygen shortage. According to a mouse study, high doses of NAC can therefore cause pulmonary arterial hypertension (PAH), when the arteries in your lungs narrow and lung blood pressure rises dangerously.

Additionally, when pushing the boundaries of clear skin, the greatest strategy is always to focus on whole foods. Why? Because they have a far more complex profile of natural compounds.

For example, a daily NAC pill could send glutathione skyrocketing, while half a pomegranate contains an ORAC antioxidant score of 10,000 – an evenly matched antioxidant fest. However, the pomegranate also contains vitamin C and inhibits the formation of the stress hormone cortisol.

Choose dark chocolate for antioxidants and you’ll also nourish your friendly gut bacteria with healthy polyphenols. Get antioxidants from almost any fruit, even a humble apple, and you’ll acquire bonus vitamins, and fiber as prebiotic.

Then again, NAC supposedly has additional powers itself. The fate of NAC really hinges on whether glutathione is its sole speciality. If it isn’t, then NAC is far more worthwhile for acne.

 

Verdict – and the best product

Overall, the fact that NAC slashed acne counts by 50% speaks for itself. NAC beats selenium for increasing glutathione over the short term because selenium takes so long to accumulate in bodily tissues.

Essentially, while you should always cover the basics of glutathione first (the minerals, glycine, and dietary cysteine), NAC is superb if you’ve got money to burn on an extra weapon. You’ll particularly benefit if you’re vegan, because your skin will be hungry for extra cysteine.

In our article on milk thistle supplements, I recommend against them due to milk thistle not being unique, and commonly causing massively reduced libido and sexual function. Well, NAC isn’t unique either, but side effects reported above rarely happen. The lung-narrowing theory was only demonstrated once using enormous dosages. Plus, the danger zone is 2 grams daily, and to improve acne you only need 600mg.

NAC is also dead cheap as it’s produced on a mass industrial scale for hospitals. Compare eating a pomegranate every three days, which costs you about $15 per month, to taking the cheap Thorne Research NAC daily.

Speaking of which, Thorne Research N-Acetylcysteine (amazon link) is my current recommended product. It’s not only free from toxic fillers, but it’s a delayed digesting formula, giving you a whole day of nicely elevated glutathione. The dosage of 600mg is also optimal.

You should never skip whole, complex foods, but a tiny little NAC pill could take your skin to a whole new level. 

NEXT: get the full skin-clearing diet and wave acne goodbye forever

 

 

Thanks for reading!