Acne – Nutritional Solutions
We all long to have clear, glowing and vibrant skin. Great skin radiates health and vitality, boosts our self-confidence and often reflects a healthy body within. For many the impact of blemishes, blackheads, and scars runs more than skin deep. While acne is typically thought of as a condition of our teenage years, the fact is millions of adults are also afflicted. Acne is estimated to affect more than 50% of women aged 20 – 29 and more than 25% of those aged 40 - 49 years.
Contrary to popular belief, acne is not due to poor hygiene but results from a number of underlying imbalances within the body. By targeting these triggers with specific treatments, nutrition and lifestyle changes you can improve the appearance of your skin long term.
How Does Acne Develop?
Blemishes arise when hair follicles in the skin become blocked with oils and particles such as dead skin cells and bacteria. Sebaceous glands attached to hair follicles secrete an oil-based substance known as sebum. Sebum normally helps moisturize skin and keep it supple. However, when there is excess sebum produced, the follicle can become blocked. Sometimes, bacteria called Propionibacterium acnes that normally reside in the skin interact with the sebum trapped in a clogged follicle and lead to inflammation. So anything that clogs pores, leads to the rapid division of skin cells, and/or creates or worsens infection and inflammation will contribute to blemishes.
What Makes Acne Worse?
Hormone imbalances and in particular excess production of testosterone can increase the amount of sebum. This is one of the reasons why acne is more common in adolescence. It also explains why women may notice an outbreak just before their monthly period as levels of hormones fluctuate. Stress can also play a role. Cortisol, one of our stress hormones interferes with blood sugar and causes the sebaceous glands to produce more sebum. Stress can also lead to hormonal imbalances worsening ongoing symptoms.
The food we eat and our body fat cells also play a role in sebum production, hormones, and inflammation. There has been much debate about the role of diet and development of acne. However a number of studies suggest certain types of food can worsen or improve acne. So if you are undergoing treatments for your skin maximise the benefits by making some changes to your diet.
The first thing to watch is foods high in carbohydrates. In particular quick releasing carbs (e.g fruit juices, cakes, alcohol, biscuits, sweet foods, refined white grains) and processed foods as these lead to a sudden rise in blood sugar and the production of excess insulin. This results in the production of certain growth factors particularly insulin like growth factor (IGF-1) that stimulate sebum production, encourage skin cell manufacture and exacerbate hormone imbalances that underlie acne. So switch to slower releasing carbohydrates like wholegrain rice or quinoa or starchy vegetables such as sweet potato, carrots and beetroot.
For some people dairy produce is known to aggravate acne. Milk is a direct source of hormones and a number of growth factors including IGF-1 which can stimulate sebaceous glands, promote more insulin in the body and alter skin cell production. Simply switching to a milk alternative such as almond or coconut may lead to improvements.
The type and quantity of fat in your diet is equally important. Certain fats particularly saturated and hydrogenated fats; such as those found in red meat, dairy products and processed foods are known to promote inflammation. Conversely a diet rich in omega 3 fats (found in oily fish, certain seeds and nuts) can lower inflammation and improve overall skin health.
On top of this, a high toxic load can clog up the liver, putting extra pressure on the detoxification function of the skin, as well as interfering with your liver’s ability to do its other jobs, such as processing hormones. This may explain why there appears to be a link between a healthy gut and good skin. Having an optimal level of beneficial bacteria supports digestion, detoxification and prevents harmful bacteria to flourish which can promote inflammation. By removing processed foods and adding in fermented foods like kefir, sauerkraut and kimchi you will not only support a healthy gut flora but also help improve your skin too.
Another group of foods to consider is gluten grains (wheat, barley and rye). These are known to promote inflammation and cause the production of insulin and insulin-like growth factor called IGF-1. The result is the production of more male hormones, which cause your pores to secrete sebum, that attracts acne-promoting bacteria. Simply removing gluten grains for a month may lead to noticeable improvements in your skin.
Nutrition: What Can Help?
One of the easiest and cheapest ways to make improvements to your skin is to look at what you pile on your plate. In addition to topical creams and lotions and salon treatment, there are a number of foods known for their skin clearing properties that, added to your diet over time, may help to improve the appearance of your skin. Eating the right foods combined with a good skin care regime and treatments can make all the difference.
Go for Whole Foods
Base your diet around unprocessed whole foods to help reduce blood sugar levels, insulin and growth factors which influence sebum production. Think loads of vegetables, wholegrains like rice and quinoa, nuts, seeds, lean protein and some fruit. Remove the refined sugary foods mentioned above, skip the dairy and add in plenty of colourful antioxidant rich vegetables and fruits to protect the skin, support healing and lower inflammation.
Here are the top foods and nutrients for great skin
- Oily Fish
Nourish your skin with plenty of anti-inflammatory omega 3 fats. Studies have shown that individuals who consume a Mediterranean style of eating, or a more plant-based diet rich in omega-3s, are less prone to acne that those who follow other dietary patterns. Omega 3 fats are beneficial for overall skin health and found in oily fish (sardines, mackerel, trout, salmon, herring, prawns), walnuts, leafy greens, chia seeds and flaxseed. Try and include oily fish 3 times a week and 1-2tbsp of seeds daily.
Avocados are rich in anti-inflammatory monounsaturated fats and plenty of vitamin E to keep the skin looking glowing and fresh. A good source of vitamin C which supports the production of collagen helping to improve the texture of your skin. Add in some olives too - another good source of monounsaturated fats.
- Fermented Foods
Our gut is home to countless bacteria and if these are out of balance it can promote inflammation and poor detoxification. This is especially relevant if you have taken antibiotics recently. By including fermented foods naturally rich in beneficial bacteria you may notice a healthier skin. Examples include raw sauerkraut, kimchi, kefir, kombucha, yogurt, miso and tempeh.
- Herbs and Spices
Not only do they add a wonderful flavour to dishes, many herbs and spices are packed with protective antioxidants and have potent anti-inflammatory and anti-microbial properties. Try and include turmeric, ginger, garlic, cinnamon, oregano, rosemary and other herbs to your daily meals.
- Green Tea
Green tea especially matcha green powder is packed with antioxidants known as catechins. Known for their anti-inflammatory properties; try to include 3-5 cups daily. Topical applications of green tea extract may also have potential in treating acne.
Berries are loaded with antioxidants to protect our skin and lower inflammation plus vitamin C which is essential for collagen production and gives our skin a fresh glow. Berries are also packed with soluble fibre which helps support our digestive health and feed beneficial bacteria keeping our gut healthy.
- Leafy greens
Greens such as kale, spinach, broccoli, watercress, collards, spring greens, romaine lettuce are all rich in antioxidants and nutrients important for the skin including vitamins A and C plus soluble fibre to support digestion and detoxification. It also supplies omega 3 fats which can improve the skin’s appearance as well as lowering inflammation. Try to include at least 1 cup of greens daily in your diet.
- Don’t forget water
Clear skin starts from within, and one of the best, cheapest and most effective ways to get there is to help your body flush out toxins by drink plenty of water. Drinking water through the day will help replenishes water in the cells and keep your skin looking plump and fresh looking.
- Include protein
If you suffer with scarring and are embarking on treatments to support healing it is important you get sufficient protein in your diet. Protein is essential to support healing so aim to include a palm size portion with each meal – poultry, fish, seafood, beans and legumes, eggs are all good examples.
- What about Chocolate?
There doesn’t seem to be an association between chocolate (in its most unprocessed form) and acne. In fact raw cacao and dark chocolate is a good source of antioxidants and may actually be protective. But avoid processed, sugary confectionary.
Zinc is a mineral with several properties that may help relieve acne. It is known for its anti-inflammatory and antioxidant actions and antibacterial effects against P. acnes. It also helps balance hormones and reduces the production of sebum. Good sources of zinc include seafood, nuts and seeds especially pumpkin seeds and mushrooms. Zinc is also effective when added to topical solutions for acne.
Niacinamide is a compound derived from niacin (vitamin B3). It is known for its anti-inflammatory action within the skin and appears to reduce spots as well as improve healing. Niacin rich foods include fish, seafood, poultry, peanuts and beef.
- Vitamin A
Vitamin A is often used topically in creams to improve skin health and is a crucial vitamin for improving skin health and lowering inflammation. Try and include vitamin A rich foods such as liver, eggs and tuna and those rich in beta carotene a precursor to vitamin A. Good sources include sweet potato, butternut squash, pumpkin, carrots, apricots, leafy green vegetables.
Selenium is an important antioxidant mineral involved in the production of another potent antioxidant called glutathione. Poor levels of selenium in the soil, inadequate intake can all lead to minor deficiencies which can affect our skin health. Selenium can be helpful for healing scars and lowering inflammation. Fish such as cod, tuna, halibut, sardines, and salmon are excellent sources, along with eggs, liver and meats like turkey and lamb. Brazil nuts are also a rich in selenium, and just two brazil nuts a day will give you the 200 micrograms necessary for an adequate intake.
- Vitamin E
Vitamin E is the most abundant fat-soluble antioxidant found in the skin. It is secreted on the skin surface through the sebum and is important for protecting our skin. It’s also a potent anti-inflammatory agent. Good sources include nuts and seeds so try and eat a handful each day.
- Panthothenic Acid
Pantothenic acid, a B vitamin has been shown to support wound healing, especially when applied topically, by improving the regrowth of cells when injured. It can be particularly useful for improving appearance of skin if you suffer with scarring.
As well as your diet there are some simple steps you can take to help your skin look its best.
Excess oils on the skin, either naturally-produced or derived from oil-based moisturizers, cosmetics, or hair products can exacerbate acne – so switch to oil free products.
Scrubbing or rubbing your skin is not recommended, as it could spread the bacteria making your skin worse. Scrubs however can be more of a preventative measure to ensure follicles stay free of sebum and dead skin cell debris
As stress may lead to a breakout or worsen your acne it is important long term to make changes to your lifestyle to address ongoing stress.
- Wash face gently with unscented, oil-free cleansers and keep skin clean.
- Use only oil-free moisturizers.
- Use cosmetics sparingly. Use only hypoallergenic, oil-free cosmetics.
- Resist the urge to squeeze, scratch, or pick at acne lesions.
Treatments to consider
Medical Microdermabrasion, which involves removal of the top layers of skin with an abrasive material or tool to allow new, smoother skin to regrow, may be used to reduce the appearance of acne scars especially if there are only a few areas affected.
Laser therapy and laser resurfacing are now very popular treatments. Lasers are very high-intensity light sources and work by removing a thin layer of skin with minimal heat damage. Some lasers treat acne by destroying the P. acnes bacteria and damaging the sebaceous glands, causing them to produce less oil.
'Chemical peeling' involves the application of various types of chemicals (usually acids) to affected skin in order to remove the top layers of skin and potentially improve superficial scarring
Alpha hydroxy acids (AHAs) are often used in skin conditions; at high concentrations they act like chemical peels. Examples include lactic acid and glycolic acid which you may find in lotions and creams and they can be effective in reducing outbreaks.
- Hyaluronic Acid
Hyaluronic acid has become very popular in skin treatments and products. It may be effective as an injected treatment for acne scars, as scars are the result of abnormal formation of collagen structures that are associated with skin wound healing. It may also help in the improving the appearance of acne scars.
- Light Therapy
The bacteria P. acnes, which play a major role in acne-related inflammation, are sensitive to certain wavelengths of light, especially blue and red light. Using light therapy can be effective in reducing acne with minimal side effects.
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