N-acetylcysteine (NAC), a supplement that reduces hair pulling and skin picking
NAC – An Over-The-Counter Supplement That Works Better Than Medications
While I don’t believe there will ever be a pill you can take that will make you stop skin picking or hair pulling, there is a supplement that might help you reduce the behaviors, if you are one of the lucky ones for whom it works.
N-acetylcysteine (NAC) is an amino acid and a precursor to glutathione, the master antioxidant in the body. Low levels of glutathione in the body are implicated in numerous mental and physical health conditions and diseases. It is possible that glutathione is the most important molecule we need to stay healthy and prevent disease. Functional medical doctor Mark Hyman, MD says nearly all his chronically ill patients are deficient in glutathione and that the ability to produce and maintain high levels of glutathione is necessary for recovery from chronic illness.
While glutathione is expensive to deliver in an effective manner, NAC is readily available in capsule form.
Besides increasing levels of glutathione, NAC also modulates the amount of glutamate, an excitatory neurotransmitter in the brain. High levels of glutamate are thought to be involved in addiction cravings and OCD, so NAC may help reduce skin picking and hair pulling through lowering glutamate levels. Researchers disagree on whether the efficacy of NAC is due to antioxidant or glutamate effects. It could be both.
Study of NAC and compulsive skin picking
53 skin picking participants completed a double-blind placebo-controlled twelve week study ( . Of the group that received NAC, 47% were much improved or very much improved. Only 19% of the group receiving placebos were also much improved or very much improved, indicating that NAC does have a significant positive effect on reducing some people’s skin picking. Initial doses were 1200 mg / day increasing to 2400 and then 3000 by the end of the study. Not all participants increased to the full amount. Nauseousness was the most common side effect noted, but occurred in only 16% of those taking the NAC.
The reduction in skin picking behavior was found to be due to a reduction in the urge to pick. This suggests that NAC would help skin pickers with strong urges to do the behavior more than those who do the behavior automatically and unconsciously.
Study of NAC and trichotillomania (compulsive hair pulling)
A 12-week placebo controlled double-blind study published in 2009 in the Archives of General Psychiatry showed that 56% of the 50 participants taking 2400 mg per day of NAC experienced a significant reduction in hair pulling compared to only 16% of participants who were given the placebo. This makes NAC the most effective of all substances tested scientifically, including prescription medications, against trichotillomania. Frequently prescribed medications such as SSRI antidepressants have not proven nearly as effective.
Things to Know if You Want to Try NAC for Skin Picking or Hair Pulling
NAC helped only about half the people in these small studies, so there is no guarantee that it is going to help you. However, it is considered to be generally safe and is relatively inexpensive, so you might decide you would like to try it and see if it works for you.
Although widely available over-the-counter in drug stores, health food stores and on Amazon.com, it is always advisable to consult with your doctor or pharmacist before trying supplements, especially if you have other health conditions or take medication.
*** Update!: NAC is no longer available in Amazon and some other places. See my video explaining why and where can you get it now***
Keep in mind, it may take a few weeks to notice results. In the hair pulling study, it took nine weeks for significant improvement, although a couple of my skin picking clients reported it working for them after a much shorter period of time. It is also important to supplement with vitamin C and a multivitamin, because the body likely needs much more vitamin C and possibly also more selenium and other minerals when taking NAC. (NOW foods NAC contains selenium and also molybdenum.) It will also work better if you have adequate B-vitamins. I recommend a methylated B-complex like this one.
NAC is considered very safe, and even beneficial to health, without side effects. Nevertheless, you may experience some nausea (like I did) or other side effects, which may go away after a couple of days. It may be better with food, and nausea can be a sign that you’re not getting enough B vitamins.
I would start with 1200 mg / day and then increase to 2400 or even 3000, as they did in the skin picking study. You can divide the doses between breakfast and dinner.