Ray Peat on Skin, Acne and Rosacea

Short answer: Ray Peat's main article on the skin is about rosacea, which he explained as an energy problem of the small blood vessels. He also wrote about why skin stiffens with age, the effect of cortisol and estrogen, and substances that can be applied directly.

What Ray Peat wrote about the skin

Rosacea becomes more common after 30 and shows up where the sun hits most. He took that to mean aging and irritation are its essential causes. Source: Rosacea, inflammation, and aging: The inefficiency of stress

His mechanism: excess excitation produces nitric oxide and lactic acid, which lower the energy of the cells in the vessel wall until they cannot hold their tone, and the vessels dilate. Source: Rosacea, inflammation, and aging: The inefficiency of stress

Estrogen makes it worse. Early high-estrogen contraceptive pills increased acne rosacea more than three-fold. Source: Rosacea, inflammation, and aging: The inefficiency of stress

Antibiotics such as tetracycline help partly through an anti-inflammatory action and partly, he suggested, by reducing endotoxin from the gut. Source: Rosacea, inflammation, and aging: The inefficiency of stress

Coffee is often avoided by people with rosacea, but he called it a very good source of niacin and magnesium, with caffeine acting somewhat like niacinamide. Source: Rosacea, inflammation, and aging: The inefficiency of stress

Cortisone-type hormones thin the skin. Vitamin A is needed for skin cells to differentiate properly, and he suspected that light on the skin raises its own steroid production. Source: Blocking Tissue Destruction ↗

Aged skin does not lack collagen. Collagen builds up and stiffens with age, cross-linked by the breakdown products of unsaturated fats, and that stiffness is what shows as wrinkling. Source: The Cancer Matrix

He described pregnenolone as having a face-lifting action, through better circulation and the contraction of muscle-like cells in the skin. Source: Progesterone Pregnenolone & DHEA — Three Youth-Associated Hormones ↗

What he suggested in practice

• Applied to the skin: niacinamide, progesterone, vitamin K and coenzyme Q10, which he says can improve the metabolism of the local tissue.
• Aspirin and saturated fats can also be protective topically.
• Vitamin K when antibiotics are used.
• Check for low thyroid function, vitamin A deficiency, protein deficiency and lack of sunlight behind a chronic skin problem.

Where he wrote about it

This topic comes up in 54 of the articles on his site. These are the most relevant ones:

• Rosacea, inflammation, and aging: The inefficiency of stress · original on raypeat.com ↗
• Stem cells, cell culture, and culture: Issues in regeneration · original on raypeat.com ↗
• Blocking Tissue Destruction ↗ · original on raypeat.com ↗
• Membranes, plasma membranes, and surfaces · original on raypeat.com ↗
• Progesterone Pregnenolone & DHEA — Three Youth-Associated Hormones ↗ · original on raypeat.com ↗
• Oils in Context · original on raypeat.com ↗
• Hot flashes, energy, and aging · original on raypeat.com ↗
• Diabetes, scleroderma, oils and hormones · original on raypeat.com ↗

My take

A weak skin barrier is where most acne starts, the same way a weak gut barrier is where most gut problems start. Niacinamide and full-spectrum vitamin E are what I use on that side.

Quick answers

What did Ray Peat say about rosacea?

That it is caused by an energy failure in the small blood vessels of the skin, driven by nitric oxide, lactic acid, estrogen, sun damage and endotoxin.

What did Ray Peat suggest applying to the skin?

Niacinamide, progesterone, vitamin K and coenzyme Q10, and he noted that aspirin and saturated fats can be protective topically.

What did Ray Peat say about acne?

His articles mostly discuss acne rosacea. He connects it to estrogen, pointing to early contraceptive pills that tripled its frequency.