What Is Known About Acne
Healthy Steps: Acne—First Steps
Healthy Steps: Acne—Full Program
Preventing Acne
From Dr. Deborah's Desk
Updated October 2017
Acne takes many forms, but even what a physician might see as mild acne can be a serious problem for the person suffering with it. Problem skin is generally considered an adolescent right of passage (albeit an unpleasant one), but the oily skin, clogged pores, and blemishes of acne plague many adults as well as teenagers.
What Is Known: The True Cause of Acne
Contrary to popular belief, acne isn't just the result of poor hygiene or eating chocolate - although dietary choices and skin-care habits do play a role in breakouts. The underlying cause of acne is a hormonal imbalance (specifically, too much testosterone), which stimulates excessive sebum production. Fertile ground for acne is created when excess sebum and dead skin cells clog hair follicles. Mix in bacteria that live on the skin, and the result is the inflammation and breakouts known as acne. Other contributing factors include environmental toxins and medications such as oral contraceptives and steroids, which upset hormone balance.
For decades, antibiotics and strong topical medications have been the standard prescription for treating acne, but recent research indicates the importance of good nutrition in overcoming this skin condition. In fact, it's best to always initiate acne treatment with dietary changes rather than medication. This means that with the proper diet, you may be able to avoid acne medication entirely or at least minimize your dependency on it.
Hormones are key to whether or not your skin develops acne: sex hormones are a bit outside of your control, but metabolic hormones respond well to a low-glycemic diet. Keeping insulin and its analogue hormones at a healthy low level is likely to reduce your acne outbreaks.
Individual foods can be individually problematic--or fine!--but it's definitely hard to sort out. Acne lesions develop over two to six weeks, so your dietary changes should be slow and spread out to make meaningful decisions about particular foods and your personal skin health.
Healthy Steps: Acne Treatment—First Steps
With any acne intervention, you are hoping to stop the formation of new lesions and can expect to see changes starting in 3 weeks.
- Enjoy wild Alaskan salmon 2 to 3 times a week.
- Eat a wide variety of vegetables, including dark greens with melted butter at least three times a week.
- For digestive and general immune support, Allergy Research Group, Synbiotics With FOS Powder. Start with 1/4 tsp and increase gradually to 1/2 Tbsp daily for 4 to 6 months.
- Keep your level of simple carbs low: no sweets or added sugars, limited grains and fruits--lots of vegetables!
Healthy Steps: Acne Treatment—Full Program
With any acne intervention, you are hoping to stop the formation of new lesions and can expect to see changes starting in 3 weeks.
Savor Helpful Foods:
- High-quality fats, including Omega-3 rich foods. Pasture-raised meats and wild Alaskan salmon are the best protein choices because they are excellent sources of omega-3 fatty acids. Clams, crab, crayfish, lobster, mussels, oysters, scallops and wild-caught shrimp are also rich sources omega-3 fats.
- Raw, whole-fat dairy products. Industrially raised cows are commonly treated with bovine growth hormone and milked while pregnant. They are also given drugs to allow insemination. In addition, all commercially bred cows produce milk that contains either DHT or IGF-1 hormones, both of which promote acne. Although it has not been evaluated for its effect on acne, raw milk from non-pregnant, non-treated cows is much healthier in general. It may be wise to avoid milk for three months to determine its effects on you.
- Vegetables, especially dark green leafy and allium family. Members of the allium family are mineral-rich and enhance mineral absorption. Garlic also has broad-spectrum antibacterial properties, especially raw garlic (try it stuffed in olives for a tasty treat).
- Zinc-rich foods and selenium-rich foods. A necessary building block for healthy skin, zinc is found abundantly in egg yolks, herring, lamb, liver, oysters, pumpkin seeds, sesame seeds, and sunflower seeds. Just 2-4 Brazil nuts provide ample selenium to meet daily requirements. Selenium is a powerful antioxidant and is essential for achieving healthy skin.
- Green tea or green tea extract. A recent study suggests that components of green tea might help keep your skin clear.https://pubmed.ncbi.nlm.nih.gov/27062963/
Avoid Inflammatory Foods:
- Sugars. Sugar and sweeteners are a primary cause of inflammation and subsequent acne breakouts. Avoid candy, cookies, ice cream, sodas, and anything made with significant amounts of sugar or sugar substitutes.
- Chocolate??? The answer to the chocolate question continues to change from definite problem (when I was in school) to "absolutely fine" to the findings of a 2016 study showing an increase in acne lesions in acne-prone males who ate 99% dark chocolate (nearly sugar free) for two to four weeks. These study subjects were acne-prone and the results were "statistically significant," which always allows for individual variation.
- Grains. Gluten-containing grains (barley, kamut, rye, spelt, wheat) are common food allergens, but all grains (including corn, oats, and rice) should be considered suspect in acne cases. Avoid all grains and grain products for a period of 6 weeks, and then reintroduce them while carefully observing for return of acne symptoms.
- Dairy is a maybe. Sadly, even the healthiest dairy can increase levels of insulin and insulin-like hormones. Skim milk is the worst, but even cheese may be problematic. Going off dairy for six weeks and then re-introducing it might reveal whether it's a problem for you.
- Altered fats. Altered fats are highly toxic and trigger inflammation. Avoid margarine, shortening, and foods prepared with hydrogenated and partially hydrogenated fats. Also avoid deep-fried or high-heat fried foods.
- Commercially iodized foods. Avoid iodized salt and kelp. Note that milk, especially commercially produced milk, contains both iodine and hormones.
Supplements can Help:
- Probiotics enhance digestion by aiding in nutrient extraction and toxin elimination. They play a vital role in strengthening our immune systems. All sources of probiotics are valuable, including lacto-fermented vegetables such as sauerkraut, kefir, yogurt, and concentrated supplements.
- Start with Allergy Research Group, Synbiotics With FOS Powder. Start with 1/4 tsp and increase gradually to 1/2 Tbsp daily for 4 to 6 months.
- Thereafter, a low maintenance dose of 1/4 tsp daily or Integrative Therapeutics Probiotic Pearls, 2-4 daily-will be sufficient. Probiotic Pearls are tiny, easily swallowed, and packaged for slipping easily into a purse or pocket.
- Zinc. One of the most important skin nutrients is zinc, and it is particularly important for teenagers in general, and vegetarians in particular. Begin with Thorne Research Zinc Picolinate in doses of 30-150 mg daily, divided and taken with meals, for 1 to 3 months. (ALWAYS supplement prolonged zinc supplementation with copper: 1 mg for every 30 mg of zinc, up to a maximum of 4 mg daily.) Reduce zinc/copper supplements to 15-30/1 mg daily if no results are observed within 3 months.
- Pure Encapsulations Cod Liver Oil (FCLO). Take 5 capsules or 1 teaspoon liquid daily. FCLO provides valuable Vitamins A, D and cofactors.
Topical Skin Care:
- Clean skin twice daily with a transparent or moisturizing soap and warm water; avoid overly harsh products or treatments. Also wash if your skin becomes soiled by vigorous exercise or a sauna. Use white towels so you can see they are always clean.
- After cleansing, for persistent skin oil, apply a mild astringent such as witch hazel. If your clean skin feels at all tight or dry, apply a small amount of a gentle oil, such as coconut.
- In the absence of a skin-care specialist, Weleda products can be effectively used to treat acne with the following simple guidelines.
- Morning routine:
- Cleanse with a gentle cleansing lotion or cleansing milk. Both Weleda and Dr. Hauschka are excellent brands. Apply gently with a press-and-roll technique, without rubbing. Rinse.
- Apply toner after washing.
- Moisturize with a light moisturizer. Skin should feel slightly oily after moisturizer and dry slightly over a short time. Even if you think you have "oily" skin, moisturizing is an important step to keep the top layer of skin vibrant and resilient.
- Evening routine:
- Cleanse with a gentle cleansing lotion or milk. Apply gently with a press-and-roll technique, without rubbing. Rinse.
- Apply toner.
- Do not apply any moisturizing products to the skin after the toner in the evening, leaving the skin clean and free to heal overnight.
- Morning routine:
- Alternatives to Weleda choices are available over the counter.
- Salicylic Acid helps unclog pores by encouraging the shedding of dead skin cells from within the follicles, effectively reducing pore blockage and acne breakouts. Clean skin as usual, then spread a thin coat of 2% salicylic acid evenly over your skin.
- Benzoyl Peroxide. Benzoyl peroxide helps eliminate the bacteria that cause acne by flooding the pores with oxygen (bacteria cannot live in an oxygen-rich environment). Used on its own or in combination with salicylic acid, benzoyl peroxide is effective for mild to moderate acne. Dryness is the most common side effect. Avoid overuse because damaged, dry skin is also acne-prone.
- Sulfur. Included in many over-the-counter products, sulfur helps to reduce excess oil and dries comedones (blackheads).
- Niacinamide applied topically has been found to be as effective as some topical antibiotics in acne treatment.
Homeopathic Treatment
The homeopathic approach to acne is most effective with individualized treatment with a professional homeopath.
Acne Prevention: What Can You Do?
A sound nutritional approach to healing acne involves eliminating inflammatory foods (particularly sugars and toxic fats) from your diet, while simultaneously emphasizing anti-inflammatory and skin-nourishing foods such as salmon and dark green leafy vegetables. It's also important to drink at least 6 to 8 glasses of pure, filtered water every day to keep your skin hydrated and help flush out toxins.
Of course, it's also necessary to take proper care of your skin from the outside. Daily cleansing is essential for removing surface impurities, but avoid over-cleansing, which can worsen the acne problem by causing dry, flaky skin. When cleansing, use a gentle touch and avoid harsh cleansers. Extra washing is indicated if you exercise profusely, touch your face frequently, or sweat on your face.
Along with good nutrition and topical treatments, adequate sleep, regular exercise, and techniques for managing stress are necessary steps toward attaining healthy, glowing, and blemish-free skin. It's important to understand that acne healing first occurs in the deeper layers of the skin. Because it takes 4 to 6 weeks for skin cells to mature and make their way to the surface, changes in the appearance of your skin can take over a month to fully register.
Unless scarring is occurring or acne is causing severe emotional disturbance, antibiotics should be avoided. If antibiotics must be used, think of them as a temporary control measure rather than as a long-term solution. Topical antibiotics should always be tried prior to systemic antibiotics, which you may never need for your acne if you take advantage of the abundant alternative therapeutic options. If you do take antibiotics, institute the lifestyle and nutritional measures mentioned above and simultaneously take probiotics. The best choices include Allergy Research Group, Synbiotics With FOS Powder and Allergy Research Group or Klaire Labs Saccharomyces Boulardii (3-6 daily). These are not destroyed by antibiotics as are other probiotics.
From Dr. Deborah's Desk
Teenage acne is common enough that most practitioners have their own approach to the problem. Although personally I opt for the simplest of moisturizers (pure coconut oil), I don't hesitate to recommend Dr. Hauschka products for teenagers with acne. Countless times I have seen acne fade to minimal or none promptly with 3 simple steps and switching to the gentle and skin-nourishing face cleansers made by Dr. Hauschka. The 3 simple steps? Eat less sugar. Eat zinc-rich foods (meat) or take zinc supplements. Take cod liver oil or eat good dietary sources of vitamin A: eggs and liver. More severe or persistent acne requires the full program listed above and often professional homeopathic treatment for resolution.
This information is provided for educational purposes only, and any individual diagnosis or treatment should be determined by you and your doctor. See Additional Information.