Essential Oils in Alternative Acne Therapy
Acne, a common skin disease, affects people from adolescence through adulthood. Regardless of an individual’s age, primary and secondary acne lesions can have negative psychosocial effects. Complementary and alternative medicine (CAM) may offer benefits whether used in a complementary fashion or as an alternative to conventional treatments. CAM acne treatments have not been well-studied by Western methods, especially in children and adolescents. CAM approaches to skin problems include topical botanical extracts; plant essential oils (EOs) and aromatherapy; “herbal therapy”; and acupuncture. The author focuses on the use of EOs for acne management.
An opening section, “Clarification of relevant terms,” is rather less than clear. Winkelman writes that EOs may be mixed in gels, compounded into pastes or sprays, or applied via baths, massage, or inhalation. He defines aromatherapy as a therapeutic use of EOs. However, stating that EOs “is believed to be absorbed through the upper part of the dermis” ignores the defining pathway of aromatics: the nose and its limbic connection to the brain. Given the role of stress in acne, aromatherapy using calming, anxiolytic EOs could be of interest but is not mentioned. Nor are any EOs applied via inhalation mentioned in this article. The author discusses the United States’ (US) Food and Drug Administration (FDA) definitions of drugs and cosmetics. Products sold as cosmetics (e.g., perfumes, shampoos) may claim to promote attractiveness through fragrance, but those marketed “with certain ‘aromatherapy’ claims, such as reducing the number of acne lesions or improving acne, meet the definition of a drug.” Massage oils claiming to relieve skin irritation are also, he says, drugs under these rules. Making a drug claim requires specific evidence and procedures under FDA rules. A later reference to “cosmeceuticals” further clouds this discussion. Under “Mechanisms of action,” neither skin nor nasal absorption is mentioned, but theories, including “systemic effects (drug or enzyme), placebo effects, or general effective or ‘reflectorial’ effects that induce positive moods” are listed. EOs rich in ketones are associated with wound-healing properties; those high in alcohols, with antimicrobial/anti-infective activities. A table of types of organic compounds in EOs and their proposed therapeutic actions are useful and might have been further discussed.
Possible alternative acne treatments include tea tree (Melaleuca alternifolia, Myrtaceae) EO (TTO). Well-characterized and with an international standard, it has been used medicinally for many years in some nations. In the US, most TTO has ~100 terpenes, with 40% terinen-4-ol. TTO is used in many over-the-counter (OTC) acne products. An evidence-based review of botanicals in dermatology concluded that TTO could become a standard acne treatment. In a clinical study, 5% TTO vs. 5% benzoyl peroxide had a slower onset of effects but better tolerability. In a randomized placebo-controlled trial (RCT), patients with mild to moderate acne who used TTO 45 days had reduced total, inflammatory, and noninflammatory lesions compared to those using a placebo. A Cochrane analysis, however, found the evidence for TTO of low methodological quality.
Hinoki false cypress (Chamaecyparis obtusa, Cupressaceae) steam-distilled leaf extract is widely used in cosmetics. Fermentation with Lactobacillus fermentum yields an extract, LFCO, that strongly inhibits Propionibacterium acnes. In an eight week, randomized, a split-face study in 34 patients with mild to moderate acne, LFCO produced faster effects than TTO (P<0.05), greater effect on inflammation and inflammatory markers, and 65.3% reduction of inflammatory lesions compared with 38.2% for TTO-treated skin. LFCO reduced sebaceous gland size and sebum production. Authors of that study compared LFCO’s effects on retinoids and antibiotics, with fewer adverse effects (AEs). Copaiba (Copaifera spp., Fabaceae) oleoresin from tree trunks, eponymously called “copaiba,” is a traditional South and Central American medicine for wound healing. It is anti-inflammatory, antiseptic, and promotes healing. Active compounds are diterpenes. In a 21-day double-blind study, copaiba EO and placebo both reduced inflammation and lesions, but nonstandard measures made results difficult to compare with other studies.
Possible complementary acne treatments use EOs from sandalwood (Santalum album, Santalaceae), rosemary (Rosmarinus officinalis, Lamiaceae) extract, Jeju EO from thyme (Thymus quinquecostatus, Lamiaceae), found on the island of Jeju, South Korea, and EOs from kinkoji (Citrus obovoidea, Rutaceae) and amanatsu (Natsudaidai orange, Japanese summer orange; C. natsudaidai). Sandalwood EO is used in Asia for skin eruptions. It inhibits Staphylococcus aureus and P. acnes. Synthetic sandalwood induced wound healing in human keratocytes. In an eight week open-label trial, 89% of 42 patients with mild to moderate acne who used 0.5% salicylic acid with sandalwood in a 4-part cleansing regimen saw global improvement, with 37% mean decrease in inflammatory, 25% in noninflammatory, and 31% in total lesions compared to baseline. Products were mostly well-tolerated. Three rosemary compounds modulate cytokine production via different mechanisms. While rosemary extract in “cosmeceutical” or dermatologic products may boost their anti-inflammatory effects, its “injection… is not associated with… irritation or inflammation in the mouse model.” Jeju oil may be active against P. acnes. The other two EOs are characterized as “Korean citrus” despite the apparent Japanese origin of at least one. Tested against P. acnes and S. epidermidis, they reduced P. acnes secretions of interleukin-8 and tumor necrosis factor α.
No studies have reported on psychosocial outcomes of botanical acne treatments, cost-effectiveness or other advantages, or possible effects on hyperpigmentation. Clinical evidence is sketchy to nonexistent. Nonetheless, dermatologists should be familiar with CAM options in order to respond to patient interest.
Winkelman WJ. Aromatherapy, botanicals, and essential oils in acne. Clin Dermatol. May-June 2018;36(3):299-305. DOI: 10.1016/j.clindermatol.2018.03.004.
Can Honey and Cinnamon Help Treat Acne?
Acne is more than just a skincare concern. It can also be painful, persistent, and uncomfortable with the person who develops it.
While prescription and other medicinal treatments can work, they may also contain harsh ingredients that can dry out the surrounding skin. Those looking for more natural remedies or for something that will clean the skin more deeply may turn to mask applications.
One such mask that is rumored to treat acne is made from honey and cinnamon. While there are some things to bear in mind when creating this mask, the treatment can be very soothing and work well as a cleanser.
Benefits of honey and cinnamon for the skin
Honey is a solution that is made from sugar, mostly fructose, and glucose. These sugars contain proteins, amino acids, vitamins, minerals, and enzymes.
For centuries, people have used honey as a medicinal treatment. The compound has been used to treat dandruff, psoriasis, burns, and fungal infections. Honey is also added to many skin care products.
The main reason for using honey and cinnamon to treat acne is because it can help to kill the bacteria that contribute to inflamed pores.
The Proionibacterium acnes or P. acnes bacteria have been found in many red and inflamed pimples. The bacteria feed on sebum, which is the waxy substance that can build up and clog pores, further contributing to acne.
Honey has several chemical properties that enable it to kill bacteria. Examples include:
- A high concentration of sugar, which puts pressure on bacterial cells, making them less likely to multiply.
- An acidic environment where bacteria cannot easily grow.
- The compound propolis that bees use to seal their hive has antimicrobial properties.
Cinnamon also has antimicrobial properties. According to an article in the International Journal of Pharmaceutical Science Invention, cinnamon can kill or suppress the E. coli, Staphylococcus, and Candida albican microbes.
Cinnamon also has astringent properties. Astringents help to shrink pores, which can make the skin appear smoother and evener.
Research regarding honey and cinnamon’s benefits
The benefits of using honey and cinnamon together as a face mask haven’t really been studied. The two have been separately studied, but the research is mixed on whether or not they are effective.
Studies remain inconclusive on the effectiveness of honey and cinnamon as an acne treatment.
A study published in BMJ Open investigated the application of a 90 percent medical-grade manuka honey and 10 percent glycerine (honey-derived) treatment after washing the face with an antibacterial soap compared with washing the face with the same soap but not applying the honey.
The researchers concluded that adding the honey combination to the acne regimen only improved 4 out of 53 patients’ acne.
Another review looked at 70 articles about cinnamon and found that cinnamon has antimicrobial properties as well as wound-healing properties. The researchers also suggested that cinnamon may have anti-aging properties in the skin.
A review published in the Asian Pacific Journal of Tropical Biomedicine found that honey contains enzymes that create hydrogen peroxide, which has antimicrobial properties.
However, not all honey types have this property. An example is Manuka honey. However, Manuka honey still displays antimicrobial effects because it has a low pH level and high sugar content.
An article published in the Journal of Microbiology, Immunology and Infection found that some types of honey from Iran had as much antimicrobial activity as certain antibiotics. However, the study’s authors pointed out honey hasn’t been studied widely for its ability to kill the P. acnes bacteria that tend to thrive in pimples.
Like many natural treatments, honey and cinnamon as a skincare remedy haven’t been widely researched. People seeing a dermatologist for their acne should always check with them before using the cinnamon and acne mask to ensure it won’t affect current treatments used.
How to make a face mask
Some people who opt to make a face mask with cinnamon and honey will leave it on their skin for 30 minutes.
Others will use the mask as more of a “spot treatment,” applying it as a paste to pimples and acne blemishes. The options are truly up to the user, their skin concerns, and their skin type.
People intending to make a face mask can take the following steps:
- Gather 2 tablespoons of honey and mix it with 1 teaspoon of cinnamon until it forms a paste-like substance.
- Do a patch test on their hand. Apply a dime-sized portion of the mixture to the back of the hand. The user should wait at least 10 minutes to ensure that itching, redness, and swelling don’t take place.
- Apply to skin, either to individual blemishes with a clean fingertip or cotton swab or to the entire face.
- Rinse with warm water after leaving on overnight or rinse 30 minutes after application. People should avoid using excessively warm water as it can be drying to the skin.
One consideration is what type of honey to use. Medicinal-grade honey is available at many health food stores. These honey have been purified and are generally free of additives. They are often compounds used in skin care applications.
Two examples of medicinal-grade honey brands include Manuka honey and Revamil honey.
Some people prefer to use local honey, which is honey produced by honeybee farmers in their area. The idea behind using local honey is that it has compounds that may fight off illness when ingested. Some people will eat spoonfuls of local honey as a means to fight allergies.
Potential risks and alternatives
Honey is often safe when applied to the skin. It is possible that a person may have an allergic reaction to honey, however. Examples of allergic side effects can include hives, itching, swelling, and wheezing.
Cinnamon can also be highly irritating to the skin. For this reason, it is important to always use a test patch on the hand before applying the honey and cinnamon face mask to the entire face.
Other tips to help control acne
When it comes to treating acne, the goals are to keep the skin clean, moisturized, and free of pore-clogging oils and bacteria without over-drying the skin.
Many natural treatments for acne exist that can be used in addition to honey and cinnamon masks. Examples include:
- Tea tree oil: A 5 percent tea tree oil solution can help kill acne-causing bacteria
- Green tea extract: Applying a 2 percent solution of green tea extract lotion may help to reduce mild to moderate acne
- Alpha hydroxy acids: These natural fruit acids can help unclog pores and encourage skin cell growth but may increase the skin’s sensitivity
An acne treatment plan can include the following steps:
- Washing the skin twice per day with mild cleansing soap and warm water.
- Applying an acne spot treatment or product to any individual pimples. People who have a lot of acne blemishes may wish to apply lotion over the entire face.
- Applying an oil-free moisturizer to the skin, if desired. During the initial weeks of treatment, spot treatments may be particularly drying to the skin.
- Applying an oil-free sunscreen to the skin in the morning.
- Applying a skin-clearing treatment mask, such as a honey and cinnamon mask, once or twice a week.
Many people cannot control their acne with over-the-counter products. In this instance, they may need to see a dermatologist for a prescription for stronger medications that can fight acne blemishes.