Acne can be such a miserable affliction that it can call for desperate measures - a fact that attracts a lot of snake oil peddlers to the acne cure market. In recent years it has been claimed that oxygen (or 'pure' oxygen) effectively treats acne by killing the bacteria that cause those unsightly eruptions. Oxygen? But that's air. How can it be a killer?

Some bacteria are aerobic (and that doesn't mean they are addicted to Jane Fonda workout videos) and thrive in the presence of oxygen, indeed require it for their continued growth and existence. Other bacteria are anaerobic, and cannot tolerate gaseous oxygen, such as those bacteria which live in deep underwater sediments, or those which cause bacterial food poisoning. The third group are the facultative anaerobes, which prefer growing in the presence of oxygen, but can continue to grow without it.

The bacteria that causes acne is propionibacterium and it is anaerobic. It doesn't like oxygen one bit and, hurrah for acne sufferers, it can die in its presence. This still wasn't making much sense to me. Since, unless, you are on the top of Mount Everest, most of us are exposing ourselves and our microbes to a fair amount of oxygen every second of the day. However, it seems that the amount of oxygen exposure is critical. According to one study, growth inhibition becomes effective in propionibacterium, only when the amount of oxygen present exceeds the oxygen-consuming activity of the cells and so cannot be removed by them.

So now we've established that oxygen can be your friend in the fight against the acne, the next question is how get enough of it to satiate the cells and zap the bacteria? One way might be to get an oxygen facial at a salon, where pure oxygen is hosed onto the skin. This would require more than a monthly visit and could start to get expensive (and not everyone can have their own private oxygen machine like Madonna).

There are creams and gels that purport to treat acne by touting oxygen. However, they aren't terribly convincing. Take Liquid Oxygen Acne Wash with Salicylic Acid by Neaclear. The active is clearly marked as 3% salicylic acid, which makes it like, well, just about any old acne product. It does, however, also come with oxygenated water. Indeed, most 'oxygen' products that I turned up in researching this post are made with oxygenated water. So what are we to make of that?

Oxygenated water came to fame a few years ago when it was billed as a source of energy and a boon for sporty types. It has been mostly discredited by medical professionals who pointed out that any oxygen added to a bottle of water would disappear into the atmosphere on opening.

The other way that acne cream manufacturers tackle the oxygen issue is to use hydrogen peroxide, which isn't exactly oxygen, but that doesn't stop them putting oxygen on the label. It is a weak acid with strong oxidizing properties. So strong that it is considered to be a reactive oxygen species (ROS). These are ions or very small molecules that include oxygen ions, free radicals, and peroxides. They have important roles in cell signaling. But, during times of environmental stress (such as for example, UV or heat exposure) ROS levels can increase dramatically, which can result in significant damage to cell structures. Hydrogen peroxide has (unsubtle) bleaching capabilities and has been used in the past to whiten skin and bleach hair - think 'peroxide blonde'. As an anti-bacterial, hence, its use in acne creams. Anything higher than a 3% dose is considered hazardous. Benzoyl peroxide, another anti-acne active, can decompose to become hydrogen peroxide and can be very irritating to the skin.

On balance, unless you can sit around in an oxygen mask, your time is likely better spent looking for other options. And even if it is possible to undergo some kind of oxygen therapy, too much of it would definitely be a bad thing since it could cause oxidative stress: aging by any other name.