Last Updated on January 6th, 2020
By Dr. Jaggi Rao, MD, FRCPC, Double board-certified dermatologist
Every few years grapefruit is either praised as a miracle diet food or panned as denounced for its interference with medications. The fact is, grapefruit can be helpful in controlling appetite, because it can fill up at the cost of very few calories, and grapefruit juice neutralizes enzymes that the liver uses to detoxify some, but not all, medications. But what about acne? It turns out grapefruit, especially grapefruit seed, can be incredibly useful in treating acne as well.
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In the 1970’s an immunologist named Dr. Jacob Harich started gardening in Florida. He fertilized his plants with compost, which breaks down very quickly in Florida heat and humidity. The one food scrap that did not break down in his compost pile, Harich observed, was grapefruit seed.
Harich took some grapefruit seeds back to his lab and started testing. He found that the grapefruit seed extract neutralized hundreds of different strains of bacteria and fungus. The extract also killed many kinds of single-celled parasites.
Grapefruit seed extract contains vitamins A, B, and C, as well as the plant compounds naringen, neohesperidin, dihydrocampherol, quercetin, campherol, and apigenin rutoside. Laboratory studies over the last 30 years have found that grapefruit seed extract kills Streptococcus, Staphylococcus, E. coli, Salmonella, Helicobacter pylori, Giardia, and yeasts.
There are two different ways of making grapefruit seed extract. The cheaper way is to soak ground-up seeds and pulp in ethanol (the kind of alcohol in alcoholic beverages) and then to distill the extract from the mixture. This produces more of the naturally occurring antimicrobial compounds in the extract.
Another way of making grapefruit seed extract is grinding the seeds and dehydrated pulp and mixing them with virgin coconut oil. The coconut oil does more than just remove the antimicrobial compounds. It creates them by interacting with chemicals in the grapefruit. This method liberates fewer healthy compounds from the grapefruit seeds and pulp but produces more kinds of healthy compounds than soaking the fruit in alcohol.
Regardless of how you make it, grapefruit seed extract is not effective in killing p. acnes, the type of bacteria most closely associated with acne, but because of its success in killing Helicobacter pylori, it may be able to help reduce acne rosacea.
Acne rosacea is a misleading name because technically, it is not acne. Acne vulgaris is the medical term for common acne caused by clogged pores, excess oil, p. acnes bacteria, and inflammation, while acne rosacea is the medical term for an entirely different condition. The exact cause of rosacea is still unknown, but it is a condition characterized by frequent blotchy, red outbreaks on the skin. It can be differentiated from acne vulgaris in several ways. First, rosacea often has clear triggers, like eating spicy foods or being exposed to especially hot or cold weather, though not everyone has the same triggers. Acne vulgaris breakouts may occur because of a trigger, but it usually isn’t as immediate and severe.
Second, if you look closely at a rosacea breakout, you will not notice that the pores don’t appear clogged. With acne vulgaris, you can trace each individual lesion back to a clogged pore. Finally, rosacea often looks more like a rash than acne vulgaris, which typically involves individually clogged pores and acne lesions. If you’re still having difficulty determining whether you have acne or rosacea, we recommend seeing a dermatologist, because the causes (and thus the treatments) for the two conditions are very different.
Although researchers aren’t sure what causes rosacea, they have found that many people who have rosacea also have an infection with a strain of bacteria known as Helicobacter pylori. These bacteria colonize and form a film on the lining of the stomach. They keep from being dissolved by stomach acid by secreting urea, which kills cells in the lining of the stomach. The Helicobacter pylori bacteria then take over the space where the stomach cells used to be. The stomach attempts to get rid of the infection by secreting even more acid, which can cause ulcers of the stomach and duodenum.
Antibiotics (and antibacterials like grapefruit seed extract) are often useful for treating rosacea. When the Helicobacter bacteria in the duodenum are killed, the immune system in that part of the intestines no longer has to stay on high alert all the time. This information seems to transfer to the skin, where the immune system produces less of a reaction to allergy-causing substances.
According to a study that examined 872 patients with a Helicobacter pylori infection, 167 of which also demonstrated signs of rosacea, bringing the infection under control often cures rosacea. In fact, 92% of the participants were completely cured. Because grapefruit seed extract can kill Helicobacter pylori, and killing this particular type of bacteria seems to cure rosacea, grapefruit seed extract could be an ideal rosacea treatment.
If you have rosacea, you probably should not start eating large amounts of grapefruit to try to clear blemishes. Your skin might react to the acid in the fruit, plus, to get the benefit of 5 grams (a little over a teaspoon) of extract, you would need to eat 1,000 grams (a little over 2 pounds) of fruit. However, you should try taking grapefruit seed extract, using the amount of extract recommended by the manufacturer.
There is no 100% guarantee that grapefruit seed extract will work. Because rosacea is believed to be caused by a combination of factors, treating only one aspect (the Helicobacter pylori infection) is unlikely to cure the problem entirely. Still, it’s worth a try. Be sure to buy products from a company that offers a money-back guarantee, and allow at least 4 weeks for results.
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