Within the last year, I have been exclusively focusing on the root cause of acne internally with clients, but topically I have not given this much thought until recently. I am so thankful to have recently found skinSALVATION Acne Clinic in San Francisco. Kimberly Tan, owner and esthetician of skinSALVATION is a wonderful resource when it comes to treating acne topically. Initially, I was attracted to the clinic because of the holistic approach in addressing acne, which aligned with my philosophy perfectly.
My first visit there I knew I had found something great as I noticed some familiar books in the waiting room, such as Nourishing Traditions and other diet and detox books, which naturally I was excited about. In my first visit with Kimberly, she touched on the importance of diet and stress management in the cause of acne, and particular foods that can aggravate it. This is also where I discovered the term comedogenic, which refers to the ability of something to produce or aggravate acne, usually tending to clog pores on a topical level. Products that contain comedogenic ingredients continue to cause pimples for acne prone skin, no matter the nationality or gender of a person. This really sparked my interest, as it was completely new information since my focus is more on internal causes. So I began to look into this further.
What kinds of things impact comedogenicity?
According to the scienceofacne.com:
Comedogenicity is a complicated process that can vary from individual to individual. One interesting observation is that human sebum is itself comedogenic. A substance can be comedogenic for several reasons:
- It can contribute directly to the formation of a plug in the follicle (pore). This could potentially occur with a substance that triggers the coagulation (increases the “stickiness”) of free sebum. Plugged pores make it easier for P. acnes bacteria to grow in the follicle, which leads to inflammation.
- A substance can be comedogenic because it triggers an allergic reaction and/or inflammation. For example, substances like SLS (sodium lauryl sulfate) are common ingredients in topical preparations. However, SLS can cause allergic reactions in some individuals and is generally considered comedogenic.
- A substance can serve as a direct food source for the bacteria responsible for most responsible for acne vulgaris, P. acnes. P. acnes bacteria eats fatty acids as its primary food source and certain substances like olive oil or other vegetable oils could potentially serve as food sources and encourage bacterial growth. The increased bacteria can in turn stimulate increased immune response, inflammation and comedogenecity.
- Some substances that are normally non-comedogenic can be converted into allergens by the enzymes present in the skin, or even by UV light.”
Like many terms that are used freely for marketing purposes, products that claim to be “non-comedogenic” “oil-free” “dermatologist tested/ approved” does not necessarily mean it is free of clogging ingredients. Just like the supplement industry, beauty and personal hygiene products are not regulated, so there is no standard or truth to what a company has to comply to when labeling. Therefore, like everything else you choose to put in and on your body, understanding what ingredients to look for is vital to know if it is truly acne safe. Just one comedogenic ingredient alone in a product is enough to cause pimples in someone who is acne prone.
I am definitely reaping the benefits of this knowledge. I eat what I consider a very high quality, clean and anti-inflammatory diet, and naturally in my line of work, am very aware of other causative factors, yet still break out pretty consistently. I couldn’t figure out why, until I began to take a closer look at what I was applying to my skin. Even within my “natural” and practically edible products I was using, many of them contained coconut oil, and to my surprise, the fat in coconut is one of the highest scoring comedogenic ingredients (as shown below).
Many will say that if the comedogenic product is lower on the ingredient list, you don’t need to worry, but again, if you are acne prone, why risk it? Eliminating these ingredients completely is the best plan to prevent acne on a topical level.
Below you will find a comprehensive list of common ingredients found in beauty and personal hygiene products. This table is taken from the original comprehensive comedogenicity testing done by Dr. Fulton (Author of Acne Rx) , et al. In these lists, comedogenicity and irritancy are graded on a scale of 0 to 5, with 0 being no effect and 5 being highly comedogenic. Products with a rating of 3-5 are the most dangerous by far, as you can see here. I highly suggest checking all your products against this and switch to products that are acne safe to prevent future breakouts.
Alternatively, you can also see skinSALVATION Acne Clinic’s guide to comedogenic ingredients here.
Comedogenicity of Common Substances List Part 1 (Fulton, et al)
Comedogenicity of Common Substances List Part 3 (Fulton, et al)