Acne

Acne is follicular inflammation with sebum, bacteria, and keratin plugging. Mainstream care uses topical antiseptics, antibiotics, and hormones. Ray Peat treated acne as a nutritional and hormonal skin-metabolism problem: puberty raises steroid demand and Vitamin A need; low Thyroid and PUFA imbalance worsen immunity and sebum chemistry.

In *Rosacea, inflammation, and aging*, Peat grouped acne rosacea with the same mitochondrial inefficiency, excess blood flow, and lactic-acid themes as kidney and diabetic fibrosis, arguing surface skin changes mirror deeper degenerative processes.

Diet and hormones

Vitamin A affects the differentiation of skin cells, the production of steroids, and resistance to infection and inflammation. The great increase in formation of the sex steroids at puberty increases the need for vitamin A, and makes its regulatory actions more important. Thyroid's important functions for the skin are the production of steroids and preventing their imbalance, and maintaining the immune function and production of sebum.

— Ray Peat

Peat listed liver, Eggs, oysters, fruits, and Milk as supporting vitamin A, thyroid, and vitamin E balance. Estrogen from contraceptives shrinks oil glands, which explains transient clearing but not long-term metabolic health.

Early high-estrogen oral contraceptives increased acne rosacea more than threefold in studies Peat cited on the rosacea page. Sensitivity to light can rise when porphyrin precursors accumulate; alcohol is often blamed without justification.

Topical treatments

Ten percent sulfur soap leaves an antiseptic skin residue; Peat preferred simple sulfur soap before salicylic-acid blends. A similar sulfur-based formulation, 10% sodium sulfacetamide/5% sulfur emollient foam, produced clinically significant improvement in an open-label case series of 8 rosacea patients. Sulfur lingers about a day and can smell. Flowers of Sulfur taken internally can help but long use may irritate the intestine.

Dissolved Aspirin on skin is anti-inflammatory and mildly germicidal. Topical Caffeine is antiseptic and anti-inflammatory in his notes alongside aspirin. Precipitated sulfur slurry with dissolved aspirin can be patted onto lesions; avoid benzoyl peroxide, which Peat suspected ages skin.

The excitatory metabolite glutamate, and nitric oxide, are both inhibited by aspirin.

— Ray Peat

Tetracycline antibiotics work partly through anti-inflammatory action, not germicide alone; over-the-counter neomycin lotion is an easy topical in his suggestion. Antibiotics should be avoided in Pregnancy. Diet changes during a course can make benefits permanent in his experience.

Supplements and metabolic context

Both Vitamin A and Zinc are essential for skin immunity in the right amount; excess of either disturbs immune function. Peat warned supplement batches vary and some Vitamin E products now carry significant PUFA. Adequate Thyroid is essential for skin steroid metabolism.

Rosacea-prone skin can show three to four times normal blood flow with impaired oxygen extraction in measurements Peat cited, suggesting mitochondrial defects as a shared driver with acne variants. Riboflavin, thiamine, and faster intestinal transit to lower Endotoxin appear in his rosacea nutrition themes and overlap acne care. See Harm reduction.

In a randomized double-blind trial of 80 patients with moderate acne, adding an oral probiotic to standard doxycycline treatment produced significantly better lesion improvement than doxycycline alone over 3 months, consistent with gut health playing a role in acne severity alongside direct antibacterial action.

See also

• Vitamin A
• Thyroid
• Rosacea
• Skin
• Inflammation
• Harm reduction