Acne is not a life threatening disease but the discomfort and embarrassment it causes should not be under-estimated. Both teenage and adult sufferers often develop poor self-esteem, depression and social anxiety due to the unsightly and often painful skin lesions. Should those with acne just accept their ‘bad luck’ or is there more that can be done? Standard treatment usually involves topical creams, face washes, antibiotics, birth control pills for women and, sometimes, even stronger medication with the potential for adverse side effects. While these offer symptomatic relief, are they dealing with the root cause?

Until fairly recently the diet/acne connection was considered a myth by many in the medical community. A systematic review of 21 observational studies and 6 clinical trials, done in 2009, found clear links between diet and acne. Acne sufferers who successfully treated their problem by cleaning up their diet are testimony to this truth. They have experienced for themselves that food is medicine – even for one’s skin. The internet is full of their anecdotal success stories, some after many years of mental and physical discomfort.

Dr Mark Hyman, a physician and best-selling author, says acne is an inflammatory condition inside the body and that proper treatment of the skin must involve healing the body from the inside out. The biggest driver of inflammation is food. He explains that a diet high in sugar, dairy, gluten-rich grains and processed food is likely to promote acne. Dr Hyman believes that, for many, the cure to acne is at the end of their fork, not in a prescription pad.

Did you know that acne was nearly unheard of in hunter-gatherer cultures? The moment these tribes veered away from their traditional diet and started eating Western food, acne became more prevalent. This fact speaks volumes about the unquestionable link between our modern diet and the rise of skin disorders.

Every pimple starts with inflammatory damage to sebum, which is an oily substance produced by the sebaceous glands in the skin. Diet is a key factor for creating the conditions for sebum damage to occur. Therefore, to appropriately deal with the root cause of acne one needs to cut out the foods that cause hormonal imbalances and inflammation in the body.  This is an important step towards a more permanent cure.

Inflammation – the true trigger

Inflammatory foods, if consumed on a regular basis, cause all sorts of health problems. Sugar and dairy are the main culprits when it comes to acne. There are many mechanisms by which they cause inflammation and aggravate acne. They raise insulin, cause hormonal imbalances, trigger food sensitivities and induce leaky gut syndrome.

Dairy is a very hormonally active substance. The purpose of cow’s milk is to grow baby calves into big cows and is therefore full of anabolic and sex hormones. People mistakenly think organic milk is hormone-free but there is no such thing as hormone-free milk.  The hormones are mostly androgens, like testosterone, and growth hormones such as insulin like growth factor 1 (IGF-1). When one considers the manner in which commercial milk is produced, with added antibiotics and artificial growth hormones, it is little wonder our human body’s delicate hormonal balance can be upset by ingesting the milk meant for another species. Our skin glands are put into overdrive, resulting in excessive sebum production and skin cell growth –  the ideal recipe for blocked pores. The blocked pores become a breeding ground for bacteria that continue to grow in number, and start to irritate the skin –  causing more inflammation that eventually leads to acne.

Another issue with dairy is the ‘insulin response’. Insulin is very inflammatory to the body. Drinking a glass of milk can spike insulin levels 300 percent, further aggravating the inflammatory reaction. One might think it is the fat in milk causing the problem but studies have shown that skim milk users had the strongest risk of acne. It is actually the milk sugars that are eliciting such a strong insulin response. So basically, it is the hormones in milk and the excessive insulin response that stimulates your skin to make those nasty pimples. The fact that some people may also be intolerant to dairy is another factor aggravating the inflammatory reaction.

 Sugar is a big driver of inflammation in the body. Consuming the occasional soft drink or chocolate bar is unlikely to be too problematic but if you are consuming sugar or processed carbs at almost every meal be prepared to suffer the ill effects. Sugar, like dairy, raises insulin and increases oil production in your skin glands which clogs up your follicles.

Excess sugar in your diet also makes it more likely that you’ll develop insulin resistance. The way your body responds to insulin resistance is by producing androgen hormones, like testosterone, which worsen acne breakouts.

The gut connection

There is reliable evidence to suggest a connection between skin issues and the gut. All of us have around 100 trillion bugs residing in our digestive system. Some are good and some are less so. Having the good and bad bugs in balance is essential for optimal health. If the bad guys take over, due to too much stress, a bad diet or the use of antibiotics, this can cause major health issues. Digestion is interfered with and toxins are produced. The gut wall becomes damaged and molecules, which would normally be kept inside the digestive tract, enter the blood stream.  This is called leaky gut syndrome or intestinal permeability. How does this fan the flames of acne? Leaky gut increases chronic inflammation. The sad reality is that many acne patients are prescribed repeated courses of antibiotics that, literally, wipe out a significant portion of their good gut bacteria and create the imbalance referred to above. Antibiotics, at best, offer a short-term solution but cause much bigger problems in the long-term. The good news is that one can heal from a leaky gut and is an avenue well worth exploring in the fight against acne.  The first step is to eliminate gluten from your diet.

The ideal acne diet

Acne is caused and aggravated by systemic inflammation in the body. An anti-inflammatory diet should therefore be an important part of any treatment plan. Chris Kresser, a globally respected doctor of functional medicine, recommends a Paleo approach for the following reasons:

• Paleo eliminates refined flour, gluten, excess sugar, dairy and industrial seed oils, that provoke inflammation.
• Paleo encourages regular physical activity and getting adequate sleep, which reduces inflammation and strengthens immune function.
• Paleo is a very gut-friendly diet, which is important given the strong connection between the gut and the skin.
• Paleo corrects the many nutrient deficiencies that lead to skin problems due to its focus on nutrient dense meats, vegetables and healthy fats.

The take-home message is that more CAN be done to help those with acne find a permanent solution to their unwelcome condition. A simple dietary intervention together with maintaining good topical skin hygiene, could put sufferers on the road towards beautiful, healthy-looking skin from the inside out.

Article written by Nicky Perks for Lose It magazine (Volume 20)

References:

• Does diet really affect acne? https://www.ncbi.nlm.nih.gov/pubmed/20361171
• Acne, a disease of Western Civilisation? https://www.ncbi.nlm.nih.gov/pubmed/12472346
• Dr Hyman: Do milk and sugar cause acne http://drhyman.com/blog/2011/02/11/do-milk-and-sugar-cause-acne/
• Pills or Paleo? Preventing and Reversing Acne and Other Skin Problems https://chriskresser.com/pills-or-paleo-preventing-and-reversing-acne-and-other-skin-problems/
• Acne Einstein: https://www.acneeinstein.com/dont-know-how-to-get-over-acne-let-me-help/
• Dr Mercola: Foods to avoid if you have acne http://articles.mercola.com/sites/articles/archive/2014/06/16/food-causing-acne.aspx