Acne is the most common skin disorder affecting adolescents and young adults(1). Acne can cause significant anxiety and psychological stress, and may lead to disfiguring scars that are life long. Acne occurs when cells produce too much keratin (a protein), too much oil, unwanted bacterial buildup, and inflammation.
Conventional treatments include: topical retinoids, peroxides, and antibiotics that can leave the skin dry, red, and peeling. Oral medications like retinoids are teratagenic (cause fetal deformity) and can cause liver damage. Oral antibiotics can lead to dysbiosis and drug resistance. There are various diet and lifestyle recommendations that are supported by evidence to have a positive effect on acne, and with better side effect profiles.
Let’s begin with the diet. Inflammation plays a role in acne, and our diets contribute our overall inflammatory load. There is convincing evidence that dairy consumption is linked to acne. First of all, dairy consumption stimulates the hormone insulin-like growth factor 1 (IGF-1), and just as its name implies, this hormone makes things grow; like acne. IGF-1 also stimulates androgenic hormones, and these hormones stimulate oil production, which is one of the factors associated with acne production. The dairy itself contains hormones known to stimulate oil production and acne formation (2). The mechanisms connecting dairy and acne are convincing enough to recommend the elimination of dairy in acne treatment.
Acne treatment should include a diet that has a low glycemic load and glycemic index. This means that you need avoid sugary, starchy, white colored foods. When we eat foods that raise our blood sugars, our pancreas releases insulin and elevated blood levels of insulin stimulate androgenic hormones. Androgenic hormones stimulate acne. Elevated insulin also stimulates IGF-1, which we already know is involved in the process of acne formation (3). Work by Cordain et al, supports the notion that high glycemic diets contribute to acne production. Looking at 1,315 people of non-western societies in Papua New Guinea and Paraguay, NOT ONE single case of acne was observed! Compare this to 79-95% of westernized teenagers suffering from acne! This dramatic difference cannot be contributed to genetics alone, and it is reasonable to attribute, at least in part, this outrageous acne occurrence to the western diet, high in cereals, packaged, and starchy foods.
Now let's talk nutrients. Zinc is a micronutrient that been shown to be an effective acne treatment in several trials(4). In a double blind study, 91 participants were given either 400 mg of oral zinc sulphate or placebo for 12 weeks. Significantly better results were demonstrated in favor of the zinc group (5). Zinc is an essential nutrient for the development and function of human skin and it has been shown to be effective at killing the bacteria associated with acne (2). Consider zinc in your acne plan, and keep in mind that zinc should be taken with food to avoid nausea. When we are exposed to toxins and stress our cells undergo oxidative stress and this plays a key role in acne progress (6). Exposure to free radicals happens from eating too much sugar/refined carbohydrates, exercising too little or much, drinking too much alcohol, smoking, air pollution, stress, etc. Since oxidative stress is implicated in acne, then treatment of acne warrants anti oxidants. And in fact, when given vitamin E and selenium for 12 weeks, both of which are antioxidants, skin improved (7).
Fish oil is abundant in essential fatty acids and benefits acne, especially mild to severe types (8). Consuming a lot of omega-3 fatty acids, as found in fish oil, can stop inflammation, and inflammation is foundational in acne production.
Acne sucks, and the majority of us have, at least at some time in our lives, experienced it. Eating a dairy-free, whole foods diet that consists mainly of veggies, fruits, whole grains, legumes, and quality-sourced proteins and excludes packaged, sugary, and starchy foods are key to regulating the hormones involved in acne. Several nutrients are worth trying, such as zinc, omega 3 fatty acids, and antioxidants before using antibiotics, hormones, or Accutane.
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