Tea tree oil. Snail mucin. Beef tallow. Red light therapy. Sulfur-based spot treatments. Can these skin care products and others made famous by social media actually treat acne like “skinfluencers” claim they do?
It’s complicated, say researchers from the University of Colorado School of Medicine.
While many users may find some success in some of these products, they don’t often align with the American Academy of Dermatology (AAD) guidelines for acne treatment, according to a new literature review authored by second-year medical student Natasha Barton, Cory A. Dunnick, MD, professor of dermatology, and their research colleagues.
“I was interested with the rise of people posting on TikTok and other platforms about nontraditional products like snail mucin and beef tallow as skincare. Acne has a big societal impact for people, so I wanted to look into these products and see what evidence was there to support them,” says Barton, lead author on the paper, which calls for improved dermatologic literacy and more collaboration between dermatologists and the online content creators who endorse a plethora of products that haven’t been as rigorously tested as many dermatologist recommended products.
Even though a gap persists between many of the products in the researchers’ review and AAD acne treatment guidelines, Barton and Dunnick say they see room for additional research and the possibility that some of these skin care products may have a place in treatment regimens, even if they aren’t necessarily written into guidelines yet.
Marketing vs. research
Research can be slow, but trends are fast.
“A lot of the marketing of these products outpaces the research,” Dunnick says. “Obviously, the American Academy of Dermatology is going to recommend treatments that are evidence based, but the TikTok trendsetters tend to recommend what’s popular and what generates views. Often, these content creators even get paid to do so.”
The AAD guidelines emphasize an individualized approach to treating acne and underscore the effectiveness of ingredients such as benzoyl peroxide, retinoids, antibiotics, hormonal therapies, and isotretinoin.
“We practice personalized medicine in dermatology. When I see a patient, I first try to assess the type of acne. If it's more comedonal, which is like blackheads and clogged pores, we might feature tretinoin or one of the topical retinoids to unclog the pores. If it's more inflammatory, which is like red papules and pustules, then we might need to emphasize more topical antibiotics and anti-inflammatory treatments,” Dunnick says.
In cases of adult acne or rosacea, there may be a need for azelaic acid, which is safe for use during pregnancy. For hormonal acne in women, a hormone modulating medication may be effective, and in scarring cystic acne, oral antibiotics may be used.
Finding a regimen that works
Some popular skincare trends are closer to the AAD recommendations than others.
Pimple patches, for example, tend to align more closely with the guidelines because some brands may incorporate ingredients that are foundational in acne treatment, such as benzyl peroxide. Tea tree oil, on the other hand, has gained popularity for treating acne because of its antibacterial and anti-inflammatory properties. Some research shows it can reduce acne lesions but deviates from AAD guidelines due to a lack of large-scale clinical trials to support its efficacy and safety.
Beef tallow, which has gained popularity for being natural, lacks substantial clinical evidence supporting anecdotal claims that it can reduce inflammation and promote clearer skin.
“Dermatologists generally advise caution,” the researchers said of this treatment.
Researchers also investigated clean beauty, Korean skincare, probiotic skincare, CBD-based skincare, cryotherapy, and other hot trends, and while there were obvious differences between what’s popular online and what experts recommend, the researchers say it’s not all bad news.
“As dermatology continues to evolve, integrating patient preferences with scientifically supported treatments will be essential to providing comprehensive, personalized acne care,” the researchers conclude in the paper. “Bridging the gap between medical recommendations and skincare trends may lead to improved adherence, better patient outcomes, and more accessible treatment options.”
Dunnick and Barton say it’s important for research to continue to examine these products because it could lead to better understanding of popular products and whether they have a place in a skincare routine for treating acne. It’s also important to access vetted sources for medical information and consult a dermatologist when needed.
“It takes time for medical guidelines to update,” says Barton, who sees herself becoming a dermatologist after medical school. “I’m sure we could probably update this paper in five years and there would be 10 new trends that are popular. At the end of the day, we should remain curious about the treatments that are making a splash and do our best to find whether they can play a part in maintaining healthy skin and treating acne.”
