Tea tree oil







Where does it come from?

Tea tree oil is an essential oil extracted by distillation from the Australian plant Melaleuca alternifolia. Australians have used this plant for a long time as antimicrobial.


There is increasing evidence that support the utility of this essential oil for acne. A recent study from an Australian group investigated commercially available gel (200 mg/g) and face wash (7mg/g) in participants with mild to moderate acne. They found a reduction of 54% of lesions at 3 months.

Side effects

Overall these products are well-tolerated. Some patients might experience dryness, scaling or peeling

Main recommendation

If you like to use natural products, this particular essential oil is a good option to use. It is a complementary option in cases of mild to moderate acne. If you experience any side effect, discontinue.



  1. Malhi HK, Tu J, Riley TV, Kumarasinghe SP, Hammer KA. Tea tree oil gel for mild to moderate acne; a 12 week uncontrolled, open-label phase II pilot study. Australas J Dermatol. 2017 Aug;58(3):205-210 

    No publisher ID given





What are my options when isotretinoin is not for me?

Many adult women suffer from acne beyond their teenage years. This can be very bothersome. Flare-ups occur most frequently in this group before menstruation. Skin is oily, with comedones and inflammatory lesions.

For those women who cannot use isotretinoin, there is an option. According to researchers from the University hospital of Nantes, France, spironolactone is associated with remission or positive outcomes in up to 70% of the patients.

Why does acne occurs in adult women?

Women with adult acne may suffer from a hypersensitivity to androgens in sebaceous glands and skin cells.

How does spirnonolactone work?

Spironolactone works by inhibit dihydrotestosterone even with low doses of the drug.

According to their study if you have mild acne, the chances are that you will improve with this treatment. You would have further improvements if you are using third or fourth generation oral contraceptives.

Ask your dermatologist if this treatment would be suitable for you.


Diet can elevate acne – hormones

Recently, researchers have discussed a lot the role of diet in the development of acne. In special, they have discussed the role of carbs because they  stimulate the secretion of two hormones directly implicated in the development of acne. These hormones are: insulin growth factor 1 (IGF-1) and androgens.

If you were figuring out where does your acne come from, these substances play a big role in the development of new lesions.

What kind of food are we talking about?

According to this, eating food like bread, milk, popcorn, potatoes, cookies, spaghetti, soft drinks, and corn,  may precipitate acne. On the other hand if you trade them by things like meat, chicken, quinoa, tuna and Greek yogurt could reduce the number of lesions.

What is my personal view about low-carb diet in acne up to this day?

My recommendation would be to try this 3-4 times a week and give a break with a regular healthy carbs-based diet. There are things to consider such as the calculation of calories and macros per day so it would be smart to  educate yourself on that or contact a nutritionist.

This type of approach is interesting and it might help to some extent in cases that are not too severe. I think that combining this approach to topical treatment could increase the chances to improve the number of lesions.

Warning: you will lose weight, therefore, it is not a good idea to try it if you are underweight.



Paoli A, Grimaldi K, Toniolo L, Canato M, Bianco A, Fratter A.
Nutrition and acne: therapeutic potential of ketogenic diets. Skin Pharmacol Physiol. 2012;25(3):111-7.



Reading at a magazine while waiting at the doctor’s office I found an article that talked about chocolates and acne. The article explained how a group of teens were put to eat chocolate while another group ate a similar product that didn’t contain chocolate. The results: teens that ate chocolate group didn’t have any significant worsening of their acne condition.

I was actually 15 by the time I read that article, since then I have elaborated the idea, I have read other people’s opinion about it, and I have commented the results with my patients.  However once in a while I have found people emphatically telling me that they would always get more pimples after eating chocolates or other high caloric food.

The truth is that in the past couple of years, there has been an increased interest on the effects of diet in acne. Results suggest that low glycemic index diets can actually decrease the size of the sebaceous glands. Regarding chocolate itself, investigators have communicated they may actually trigger the immune system to release mediators that may cause inflammation on the skin.

These findings are still accumulating but in the meantime it is good to get become familiarized with the high and low glycemic index food in order to choose the best type of food that help you get less lesions and actually have a healthier lifestyle.

According with the American Diabetes Association carbs with high glycemic index include sugar, white bread, white rice, corn flakes, bran flakes, bagels, pumpkin, pretzels among others. That’s the type of carbs you want to stay far from. Low glycemic index food include dried beans, corn, yam, oat meal, all non-starchy vegetables, sweet potatoes, most fruit, and many whole grain breads and cereals. That is the good carbs you want to choose.

High GI carbs rise a hormone called insulin in a way that may be dangerous for your skin and your health in general in the long term. Eating low GI carbs not only may help to reduce the number of pimples but it certainly prevents other diseases such as diabetes.

GI food



Napolitano M, Megna M, Monfrecola G. Insulin Resistance and Skin Diseases. ScientificWorldJournal. 2015;2015:479354.

Melnik BC, John SM, Plewig G. Acne: risk indicator for increased body mass index and insulin resistance. Acta Derm Venereol. 2013 Nov;93(6):644-9.



Blue_Light_Acne_TreatmentDifferent light-based therapy have been used to treat acne, specifically targeting Propionibacterium acnes (P. acnes) and modulating the body’s defense response.

P. acnes naturally produces porphyrins, substances that strongly absorb light. The role of light devices is to activate porphyrins and ultimately produce singlet oxygen which will result in bacterial death but also destroy sebaceous glands .

Photodynamic therapy has been available for around 15 years. Its effectiveness has been well demonstrated, the main disadvantage has been its side effects which include pain, erythema an hyperpigmentation. In the past years, several protocols have been adjusted to provide better tolerance and more effectiveness.

New devices using narrow band ultraviolet light (NB-UVB) has proved to inhibit P acnes with a relatively low dose. We have also previously known that NB-UVB modulates the body defense response mediated by cells creating a synergistic effect.

We expect promissory results from short courses of NB-UVB therapy in combination with other local treatments available depending on the severity of acne lesions.


Propionibacterium acnes or P. acnes, is a bacteria involved in the development of acne lesions. For years topical antibiotics such as erythromycin or clindamycin have been recommended as a part of acne therapy to combat this bacteria; however increased concern has risen due to the emerged resistance of P. acnes to this type of drugs.

Topical benzoyl peroxide is an alternative of topical antibiotics, it is not expensive and doesn’t create resistance. However some people cannot tolerate its side effects which include skin irritation, peeling, itching, and redness.

The development of topical nitric oxide may provide with an alternative to topical antibiotics. Nitric oxide is naturally synthesized by the human body in response to bacteria, it has a low propensity for resistance and it could even reduce sebum production.

Results of studies made with this component are going to be presented in the World Congress of Dermatology this year.


1. You will outgrow acne.

Reality: acne is oftentimes a chronic disease and not just a self-limiting disorder of teenagers.

2. The more I wash my face, the cleaner it will be.

Reality: actually the more you clean your face the greasier it will get. When you remove fat from your face too often your sending a signal to your sebaceous glands to secrete more sebum.

3. A good suntan will help me get rid of acne

Reality: excessive sun exposure damages skin cells, as a result it will make you look older and it will increase your chances of getting skin cancer.

4. The latest products in the store will cure my acne.

Reality: whereas some acne products sold over the counter have proven benefits, they might not be sufficient for your particular type of acne.

5. You don’t have to worry about acne. It’s a self limited condition.

Reality: moderate and severe acne might lead to scarring which can very hard to treat.

6. Sulfur soaps are ideal for acne.

Reality: some of them are smelly and they might cause irritation on your skin.

7. I’m an adult, I shouldn’t have acne.

Reality: as we have explained in other sections, getting older is not a guarantee to get rid of acne.

8. I cannot wear make up.

Reality: many makeup products now in the market that are non-comedogenic, that could be used.

9. I don’t have to visit the dermatologist.

Reality: most dermatologist can give you a better insight and recommendations to help you overcome and cure acne.


Acne is a common condition that affects 80% of adolescents and young adults from the ages of 11 to 30. However the common belief that you will soon outgrow the disease is not always correct. It’s been reported that around 42.5% of men and 50.9% of women continue to suffer from this condition into their adulthood.

It’s location upon the face is apt to be a possible source of great annoyance and embarrassment, not only just to teenagers but also to young adults.

Although acne lacks the urgency of a life-threatening condition, it produces long term ramifications that can be coming up with cutaneous and emotional scars lasting lifetime. It debilitates an individual’s confidence causing physical, social, and psychological sufferings and reduces self-esteem.

What causes acne?

Certain facts are known about acne: the primary factors involved in the onset of acne are increased sebum production, abnormal keratinization, inflammation, and bacterial colonization by Propionibacterium acnes. However it is considered that acne is not an infectious disease, it’s more an inflammatory process and the role of P. acnes is more inflammatory than infectious.

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