Preventing and Addressing Acne Naturally
In this post I'm diving into natural ways to prevent and address acne. I talked briefly about nutrition for addressing acne on New Day NW a few years back, and you can watch that segment here.
Many people tend to think that acne is a teenage problem but so many adults struggle with acne too, especially women in perimenopause. The hormonal fluctuations that take place in young people and perimenopausal women are different, but the outcome is equally frustrating, especially if you dealt with acne as a young person and thought that struggle was over.
This is a subject very close to my heart because I struggled with acne from about age 12 until my late 30's when I finally changed my diet. I was prescribed countless rounds of antibiotics and harsh topical treatments, all of which would calm things down a little and none of which ever made it go away. None of my doctors ever mentioned that my diet and food sensitivities could be contributing to my breakouts, so I went along with what they told me to do because I didn't know any better.
Eventually I resorted to Accutane and took two rounds of that (now only available in generic forms such as Isotretinoin and Absorica). If you’re not familiar with Accutane/Isotretinoin, it is a drug designed to shrink the oil glands with the goal of less oil = less clogging of the pores and ultimately less acne. The drug has been linked to birth defects if taken during pregnancy, and has also been suspected of causing psychological side effects including depression and suicidal ideology. Some of its’ other intense side effects include severely dry skin, eyes and lips, nosebleeds, back pain, dizziness, blurred vision, diarrhea and headaches to name just a few.
The result was that I had less severe breakouts but sadly it was at the cost of my gut health and even my mental health for several years. The drug companies are now claiming that the link between Accutane and depression/suicide is weak because people with severe acne are more at risk for depression because of the acne. I don’t buy this argument because my acne was pretty bad, but not bad enough that I was generally depressed because of it. I was a very upbeat, happy kid and it wasn’t until after taking Accutane that I began struggling with depression, eating disorders and suicidal thoughts.
Thankfully I had a supportive mom who got me into counseling and did her best to find doctors who knew how to help me. If it weren’t for her I’m not sure that I would be sitting here writing this today.
So let’s talk about what you can do to prevent and treat acne at any age. While the mechanisms causing acne may differ a bit depending on your stage of life, the principles for addressing it are the same: Optimize nutrition, reduce inflammation, regulate blood sugar, optimize sleep, and manage stress.
Acne is usually treated like an infectious disease when it is actually an inflammatory condition triggered by hormonal imbalances, food sensitivities, inflammatory foods, nutritional deficiencies, and stress. Using high quality, non-toxic skin care topically is essential, but your skin is a reflection of what’s going on inside your body, so a nutrient-dense, anti-inflammatory diet is crucial if you want healthy, clear skin.
In addition to reducing inflammation, it’s important to address blood sugar and insulin resistance. High glycemic foods (high starch/carb/sugar foods that spike your blood glucose) are very inflammatory by nature and they are problematic for your hormones and overall health. Eating these foods regularly can exacerbate hormonal issues like PMS, PCOS, and perimenopause symptoms. A high glycemic diet also leads to insulin resistance and eventually Type II diabetes, so cutting them out is a game changer.
Below I list foods to increase and foods to decrease or avoid. But your lifestyle is equally important because sleep and stress have a direct impact on your hunger and cravings, and if those are out of control it’s really tough to make food choices that serve you well.
Lifestyle Changes
Reduce or Manage Stress - Try to reduce stress as much as possible since the increase of stress hormones, especially cortisol, can increase inflammation. Inflammation which may show up on your skin. Hormonal fluctuations can increase inflammation and inflammation can increase hormone imbalances. Cortisol tends to be higher in perimenopausal women, so its even more important to take good care of yourself and manage stress in this stage of life.
Prioritize Sleep - Practice good “sleep hygiene” and try to get a minimum of 7 hours of sleep each night. Most of my clients find that they are less hungry, have fewer cravings, better energy and more mental clarity when they get enough sleep so it’s worth prioritizing.
Self-Care and Recovery - Practicing good self-care can help you be less stressed and more resilient. Intense workouts and heavy weight training are fantastic, but only if you’re recovering properly. Sleep is a huge part of this but so are rest days, stretching, and making sure you’re getting enough fun, creativity and fulfillment in your life (outside of your day job!).
Eat More Of This Stuff
Anti-inflammatory foods that are high in fiber, healthy fats, rich in antioxidants, vitamin c, zinc and magnesium are especially helpful. Here are a few of the things to eat more of:
Organic vegetables - Veggies are everything! They’re nutrient-dense, high in fiber, antioxidant, and anti-inflammatory. Get as many different colors as possible and try to eat 1 lb each day. In season, local produce is always the most nutrient-dense and delicious. The majority of your veggie intake should be from high fiber non-starchy veggies, with a smaller percentage coming from starchy veg like winter squash, potatoes and other root vegetables. Starchy veggies are nutritious but higher in sugars/starches, so you don’t need a lot of them.
Healthy Fats, Especially Omega-3’s - I know people with oily skin and acne tend to shy away from fats, but you need enough healthy fats to prevent your oil glands from overcompensation for lack of oil and internal hydration. Here are the winners: Olive oil, avocado oil, cold water wild caught fish (like salmon, sardines, and mackerel), purified fish oils (I like Metagenics), fresh and organic nuts and seeds, coconut (in moderation). Luckily many of the foods containing healthy fats are also high in zinc and magnesium.
Plenty of Protein - Ideally you’ll be eating 1 gram of protein per pound of your ideal body weight daily. Yes, this is a lot of protein, but even if you get close to this target you’ll be better off. I recommend sticking to “clean” protein sources as much as possible which include wild caught fish (the smaller/lower on the food chain the better), organic pasture-raised poultry and 100% grass-fed beef and lamb, and organic plant-based proteins like nuts and seeds. Soy should always be organic and kept to a minimum since high soy intake can trigger acne in some individuals.
Organic berries and low-sugar fruit such as grapefruit, apples and moderate amounts of whatever is in season locally. Berries are particularly high in antioxidants and they’re my personal fave when in season. When not in season I keep frozen organic berries on hand for smoothies.
Vitamin C-Rich Foods - Vitamin C is a powerful antioxidant and it helps to preserve collagen which keeps your skin nice and plump. Hello anti-aging! If you’re eating enough colorful veggies and fruits you should be getting enough vitamin C.
Zinc Rich Foods - Zinc deficiency has been shown to cause acne and make it worse. The winners are: Pumpkin seeds, hemp seeds, grass-fed and pasture-raised lamb/beef, chickpeas, lentils, cacao powder, cashews, mushrooms and spinach.
Magnesium-Rich Foods - We tend to breakout when stressed and magnesium helps to support your adrenal system and regulate your body’s response to stress. The winners are: Avocado, dark leafy greens, cacao, nuts and seeds, especially almonds, pumpkin seeds, and spirulina.
Probiotic Foods - Fermented foods with live cultures are very beneficial for your microbiome and gut health (read more about this below). A healthy gut has a positive effect on every aspect of your health, and it can’t be ignored when it comes to skin health! Try to incorporate probiotic foods like sauerkraut, kimchi, and fermented pickles and other veggies as often as possible. I am not including yoghurt or kefir here because I don’t recommend dairy, but you can try using low to no sugar plant-based versions. Hint: Probiotic foods are not shelf stable, so you’ll find these in the refrigerator section of the grocery store. You may also talk with your health professional about taking a high quality probiotic supplement.
Drink More of This Stuff
Water, water, water! If you’re dehydrated your skin will suffer. Dehydration causes your oil glands to overcompensate for the lack of moisture by producing more oil. You also need enough water to detoxify properly which is crucial for healthy skin and hormones. Invest in a high quality water filter and drink from a glass bottle as tap water and plastics contain toxic, hormone disrupting chemicals. Warm lemon water first thing in the morning is particularly helpful for alkalizing your body and promoting detoxification.
Nettle Leaf Tea - Nettles are loaded with minerals and vitamin c and they help with detoxification. They also block DHT, which is the active androgen that causes acne.
Dandelion Tea - Dandelion is wonderful for detoxifying the liver. Happy liver = happier skin, hormones, everything!
Spearmint Tea - Spearmint (not peppermint) reduces testosterone, and in turn, help reduce acne in women
Green and White Tea - These are both loaded with antioxidants and help to reduce inflammation, balance hormones, and regulate blood sugar. EGCG, the antioxidant polyphenol found in green tea also increases sex hormone binding globulin which works to bind up the excess androgens that can cause acne. These teas can both be effective when used topically as a toner or spritz. However, both green and white tea contain caffeine so if stress is contributing to your breakouts, opt for a decaffeinated version instead.
Tulsi or Holy Basil Tea - Holy Basil is a wonderful adaptogenic herb that helps balance blood sugar and reduces anxiety.
Avoid This Stuff (Except for the Occasional Indulgence)
Dairy! Dairy products may be the most problematic foods for people struggling with acne. Dairy is also one of the most common food sensitivities/allergies/intolerances and is cross-reactive with gluten; This means that if you react to gluten, dairy may cause the same symptoms. The naturally occurring hormones and milk protein (casein) in milk are to blame here, not the milk fat or sugar (lactose) which used to take the blame. Milk is naturally high in androgens and dihydrotestosterone (DHT), both of which make the skin oilier and more prone to clogged pores an ultimately, breakouts. After suffering with acne for nearly 25 years, I finally cut out dairy and my skin cleared up in just 2 weeks!
Sugary, High Glycemic Foods - These include all of the “empty calorie” foods that cause your blood sugar to spike. Think bread, pastries, pasta, refined grains, sweets/candy, soda (both regular AND diet!), ice cream, alcoholic drinks, fruit juice, and white potatoes. Sugar comes in many forms so read your labels and check out this article for a list of what to lookout for. Artificial sweeteners should also be avoided as they can still cause blood sugar spikes for some people.
Processed Foods and Inflammatory Oils - Refined “vegetable oils” like canola, corn, soybean, peanut, safflower and sunflower oil are all highly inflammatory and can make acne worse. These oils are found in many processed foods and are used in restaurants because they are cheap and have a high smoke point (they don’t burn up at high heats), so they are tough to avoid if you eat out a lot. Try to eat at home most of the time and use the healthy oils mentioned above, especially avocado oil and coconut oil for higher heat cooking, and increase your omega-3 rich foods to help offset the times when you do eat out.
Alcohol - No one wants to hear it, but when it comes to your hormones and your skin, alcohol is NOT your friend. It’s highly inflammatory, high glycemic, increases cortisol production, disrupts sleep/circadian rhythm, and is dehydrating. If you must drink, avoid alcohol on an empty stomach and try to limit it to one low-sugar drink per week.
Caffeine - I swear I’m not trying to ruin all your fun by taking away your coffee and booze. I just want you to be strategic about your use of them so you can feel your best! Caffeine also increases cortisol and messes with your hormones and circadian rhythms / sleep quality. During perimenopause caffeine use is linked to increased vasomotor symptoms such as hot flashes and night sweats. And like alcohol, caffeine is a diuretic so it contributes to dehydration which makes your skin more prone to premature aging.
Alternatives to Antibiotics
Antibiotics are responsible for saving countless lives and there is definitely a time and a place for them. However, they do come with side effects and doctors have grossly over-prescribed them over the last few decades. Just one course of antibiotics can wipe out certain types of gut bacteria forever; and since we have yet to identify all the beneficial bacteria that live in our bodies, we may not know if the strains that we killed are even replaceable through diet or probiotics.
To say that my gut health was compromised after taking years and years of antibiotics would be the understatement of the century, and the resulting health problems were definitely not worth the marginal improvement I saw in my skin.
According to this article in sciencedaily: Prolonged use of antibiotics can affect the microbiome (the trillions of bacteria, viruses and fungi that inhabit our bodies) in areas other than the skin, resulting in disease. The report noted that people who use topical and oral antibiotics were three times as likely to show an increase of bacteria in the back of their throat and tonsils compared with non-users. Long-term use of antibiotics in acne treatment also is associated with an increase in upper respiratory infections and skin bacteria and was shown to affect a user's blood-sugar level.
An interesting alternative is guggul (gugulipid/guggulsterone) which is made from the sap or gum resin of the guggul tree. The guggul tree is native to India, Bangladesh and Pakistan and has been used in Ayurvedic medicine for centuries. Traditionally it was used to treat atherosclerosis but recently studies showed it to be as effective if not slightly more effective in for treating acne than tetracycline. Guggul contains plant steroids that lower cholesterol and triglycerides. One of these substances also decreases the redness and swelling that occurs in some types of acne.
I recommend making dietary changes first and if you are still having breakouts after at least 6-12 weeks of eating according to the above guidelines, give the guggul a try. Your gut and your complexion may thank you!
Other Basics for Better Skin
Don’t sleep with makeup on. Cleanse your skin with a gentle cleanser that doesn’t leave your face feeling stripped. Follow up with a hydrating serum and/or moisturizer that allows your skin to breathe and avoid harsh chemical acne treatments.
Switch to clean, non-toxic skin care, hair care, and makeup. Credo Beauty (this is my referral link) and Beauty Heroes are great resources for these products and they carry acne-specific products that won’t damage you skin. Mineral sunscreen (zinc or titanium dioxide) is also important for overall skin health and to prevent acne scarring.
Change your pillowcase often. Your pillowcase can harbor all kinds of bacteria, dust mites and other stuff that can contribute to breakouts, so change it out every 3-4 days at most. Wash your bed linens in unscented non-toxic laundry detergent because chemicals in conventional detergents can also be irritating.
Move your body! Movement is essential for good lymphatic drainage, digestion, detoxification and hormone health and it’s also a great stress reliever. Try to get those 10,ooo steps in daily and avoid sitting for long periods of time. Sweating regularly with exercise or sauna use can also help prevent acne. Initially you may experience more breakouts when you first get started, but this usually doesn’t last.
I know this is a lot of info, but I hope you’ve found it helpful! If you’re interested in customized nutrition coaching, I would love to help you. Click here to schedule a complimentary 30-minute Coffee Talk and let’s chat about your unique goals and challenges.
References:
Isotretinoin (Oral Route) Side Effects
Doctors Turning to Antibiotic Alternatives to Treat Acne
Nodulocystic acne: oral gugulipid versus tetracycline.
The Link Between Milk and Acne
How to Address Hormonal Acne With Changes to Your Diet by Dr. Jolene Brighten
