Skincare with Friends Ep 67: Vitamin C for Acne? For Rosacea?

The subject matter for the first in person podcast since Covid ruined our social lives is whether Vitamin C could help with acne or rosacea, whether rosacea and acne sufferers should use Vitamin C for other things and my approach to using vitamin C as an acne sufferer. I’ve taken another deep dive into the studies to see if there is any evidence to help us decide whether we should try Vitamin C if we have Rosacea or Acne.

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Can Pure Vitamin C Help with Acne?

If I was hunting for an acne treatment, Vitamin C wouldn’t spring to mind, I’ve only ever found that it made my spots and blackheads worse but while I’m in the swing of researching, lets see if there are any studies on Vitamin C and spots? 

This quote stuck out to me-

“The integrity of the skin barrier may be related to the differentiation of keratinocytes, which affects the function of the skin barrier and causes skin diseases. Vitamin C enhances the late differentiation of keratinocytes, overcomes the differentiation-dependent oxidative stress, and maintains the integrity of the entire cuticle, which is an important prerequisite for the integrity of the skin barrier, ensuring the function of the skin barrier and preventing skin water loss, which in turn can lead to skin disorders.”

(Wang, 2018).

This essentially means that Vitamin C helps the skin turnover in a healthy way, this is something acne prone skin struggles with. It helps to keep the skin resistant to antimicrobial attack by strengthening the moisture barrier. This is a desirable effect for acne prone skin.

The other role that anti oxidants may play in acne is preventing oxidation of squalane. Squalane is one of the main lipids which the skin produces to moisturise itself and research has found that acne sufferers have higher content of Squalane oxides in their skin. Meaning that Squalane goes off and causes spots. Antioxidants like Vitamin C could in theory prevent this oxidation and help with acne. Acne sufferers may be better off choosing other anti oxidants like Azelaic Acid or EUK-134.

As an acne sufferer myself, after several experiments trying to incorporate pure vitamin C, I’ve pretty much found that it always flares up spots and blackheads on my chin. I’ve been using it on my upper face only for a short while and touch wood, it seems to be going ok. I use Azelaic Acid on my whole face twice a day and to my mind it is a better anti acne, anti oxidant skin brightener for problem skin.

Sodium Ascorbyl Phosphate- The Vitamin C Derivative that Might Help with Acne

While there are no studies looking into pure Vitamin C/ L-Ascorbic Acid as an acne treatment, there are some studies about the derivative Sodium Ascorbyl Phosphate. These studies on Sodium Ascorbyl Phosphate and acne look very promising. And since Sodium Ascorbyl Phosphate (aka SAP) is affordable, non irritating and easy to get hold of without prescription, it’s definitely worth exploring as an Acne treatment. Even if you only use it alongside your usual treatment as a bonus anti acne antioxidant.

Woolery-Lloyd et al in 2010 did a randomised double blind controlled study on 50 acne sufferers and treated them with a 5% Sodium Ascorbyl Phosphate. They saw up to 71% improvement in their acne. Very promising!

Another study (open this time so no blinding, therefore of poorer quality) showed SAP worked better than the doctor’s favourite Benzoyl Peroxide (Ikeno,2004). It’s an easy going ingredient which may have some limited anti aging effect, so definitely something to think about for acne sufferers, although I still suggest going to the doctor and getting prescription treatments.

Products with SAP to check out if you fancy trying Sodium Ascorbyl Phosphate for acne-

• Inkey List C50 Blemish Night Treatment 5% SAP, 2% Salicylic Acid £12.99 30ml
• Typology Vitamin C 11% SAP £21.90 30ml
• Facetheory has a few products with SAP but ? percentage
• Superdrug Vitamin C Booster £12.99 for 100ml ? percentage sodium ascorbyl phosphate and has fragrance

Is There Any Scientific Evidence that Vitamin C Helps with Rosacea

This came from a listeners question “Vitamin C and Rosacea, good to go? Not go? What about alongside prescription creams for said rosacea?” 

I’ve heard it said that vitamin C is a good ingredient for rosacea. I googled it and there’s loads of articles from blogs, clinics and brands about how well fit C works for rosacea. I was bowled over to find out that there are no studies on this pairing. Not one decent study and maybe one crappy study with 8 participants that is not available on the internet to see. These are some mentions that I found in favour of the idea of using Vitamin C for rosacea-

“Although the pathophysiology of rosacea is multifactorial and incompletely understood, there is increasing consensus that inflammation is a central process in rosacea. This inflammation is linked through a variety of mechanisms to other processes including UV damage, vascular changes, and oxidative tissue damage.”

Jones, 2009

This quote acknowledges the role of Ultraviolet radiation in the Rosacea disease process and the importance of anti oxidants in its treatment. There is no mention of Vitamin C in this study though it does recommend Azelaic Acid or Metronidazole-

“The most effective agents against rosacea have anti-inflammatory properties. As with topical metronidazole, Azelaic Acid demonstrates significant anti-inflammatory activity in established in-vitro assays, and is able to inhibit neutrophil metabolic function and the release of ROS.”

Jones, 2009

Vitamin C doesn’t have anti inflammatory properties and indeed might be quite irritating. We talked about why Vitamin C has to be irritating to work in one of our earlier podcasts. This is the only direct mention I could find of Vitamin C for Rosacea in the research-

“Barrier repair, resolution of dysbiosis (meaning an upset in the skin microbiome), and maintenance of a healthy microbiome are critical in rosacea patients. To that end, topical products formulated with niacinamide, feverfew, green tea, coffeeberry, aloe vera, soy, oatmeal, and vitamin C have all been shown in small studies to repair and replenish barrier function in rosacea-prone skin.”

Marson, 2019

The study this quote is based on is very small indeed and I can’t seem to get hold of a copy to read it.

So, in theory vitamin C could help with rosacea because it is an antioxidant and protects against sun damage but considering that rosacea causes a lot of inflammation and vitamin C in it’s correct formulation is pretty irritating, it might not be the best pairing. And there is literally no evidence to show that vitamin C works for rosacea, so while it’s not an absolute no go I would be cautious using it while suffering rosacea. You might be ok, you might not, science has no information for us. 

In Summary- For Acne and Rosacea sufferers, you are better off seeing a doctor and getting prescription treatments for your condition. If you are looking for an ingredient which helps with aging and brightening, you can’t go wrong with Azelaic Acid, it’ll also help with spots and redness, use the code NIAP2 to get money off Dermatica’s 20% Azelaic.

References

Ikeno, H., Ohmori, K., & Monma, T. (2004). An open study comparing efficacy of sodium 5% L-ascorbyl-2-phosphate lotion versus 5% benzoylperoxide cream in the treatment of acne vulgaris. Journal of the American Academy of Dermatology, 50(3), P18. doi:10.1016/j.jaad.2003.10.076 

Jones D. A. (2009). Rosacea, reactive oxygen species, and azelaic Acid. The Journal of clinical and aesthetic dermatology, 2(1), 26–30. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2958186/.

Marson, J. W., & Baldwin, H. E. (2019). Rosacea: a wholistic review and update from pathogenesis to diagnosis and therapy. International Journal of Dermatology. doi:10.1111/ijd.14757 

Ottaviani, M., Camera, E., & Picardo, M. (2010). Lipid Mediators in Acne. Mediators of Inflammation, 2010.

Wang, K et al (2018) Role of Vitamin C in Skin Diseases Front. Physiol. 9:819 https://www.frontiersin.org/articles/10.3389/fphys.2018.00819/full

Woolery-Lloyd, H., Baumann, L., & Ikeno, H. (2010). Sodium L-ascorbyl-2-phosphate 5% lotion for the treatment of acne vulgaris: a randomized, double-blind, controlled trial. Journal of Cosmetic Dermatology, 9(1), 22–27. doi:10.1111/j.1473-2165.2010.00480.x