Causes of acne vary between individuals but there is considerable evidence that poor blood-sugar control and resulting hyperinsulinaemia have a role to play in the skin condition.
Other causes of acne can include reactions to dairy and other allergens, bacterial infection and dysbiosis, and even stress and depression, along with nutrient deficiencies. (All of which I discuss in Eat to Beat Acne!)
Hyperinsulinaemia (persistently elevated insulin levels) is increasingly common, causing a variety of symptoms such as lethargy, irritability, poor concentration, fatigue, weight gain, and hormonal disruption leading to acne. A low-carb diet, including foods that are low in the glycaemic index (GI), may, therefore, be of benefit for acne sufferers and could address other complications of hyperinsulinaemia before a condition such as diabetes develops.
Chronically high levels of insulin in the blood imply that the body is struggling to deal with the amount of circulating sugar, often from simple carbohydrates in the diet or excessive carbohydrates. Switching simple sugars for unrefined, wholegrain products, and simply cutting back on carbohydrates may allow acne sufferers some relief as well as protecting their general health.
Many of those who achieve weight loss on diet plans such as the South Beach Diet or Atkins Diet also note improvements in their complexions when cutting down on carbohydrate intake. While there are other problems associated with the high intake of protein and fat on such diets, the advice to restrict simple sugars remains worthy of attention.
Diet and Acne – Chocolate, Dairy, and Refined Carbs
Diet and acne have been strange bed-fellows for a number of years, with myriad myths regarding connections of spots to food. In most cases there is little evidence to support the idea that foods such as chocolate increase acne. The problem is that in cases where chocolate consumption is part of a generally unhealthy diet full of fat and sugar and low in wholefoods, vitamins, minerals, and phytonutrients, the skin (and the rest of the body) is not getting the nutrition it needs to be healthy and look beautiful.
Most acne sufferers react to the fat and sugar in chocolate rather than the chocolate itself, as studies comparing carob and chocolate demonstrate. However, dairy chocolate could prompt a skin reaction, including acne, eczema, or psoriasis as many people are intolerant to dairy or even allergic to cow’s milk products.
To find out more about the links between acne and chocolate, as well as what foods can be of benefit for acne flare-ups, pick up a copy of Eat to Beat Acne!
Standard Acne Treatments
Unfortunately, despite the evidence stacking up in favour of dietary changes to beat acne, the standard treatments for acne remain palliative, using over the counter medications or prescription medications, that can have nasty side-effects, to manage symptoms. Salicylic acid cleansers are popular OTC remedies for acne, with a benzoyl peroxide product also favoured by dermatologists to help dry out oily skin.
Harsh cleansers and peroxide treatments may simply induce further skin damage and make the skin angrier, redder, and less able to function as an effective barrier as it should. The use of these treatments may also lead to acne scars. Where these treatments fail to resolve acne a dermatologist may prescribe antibiotics and/or isotretinoin, a form of vitamin A.
Problems with Accutane
Isotretinoin (Accutane) has been popular for treating acne for a number of years but has considerable side-effects and is extremely ill-advised in pregnancy as it can cause severe birth defects. Women of child-bearing age with a chance of become pregnant are unlikely to be prescribed the vitamin A treatment for this reason, and other patients who are using isotretinoin may develop cognitive problems and experience depression, hallucinations, and become suicidal.
Antibiotics and Oral Contraceptives for Acne
Other treatments for acne, such as laser treatments for acne and scarring, and the use of oral contraceptives or antibiotics carry their own risks. Long-term antibiotic use increases the risk of damage to the liver and the possibility of candida overgrowth (thrush). Imbalances in intestinal flora also pose their own risk of acne developing, and some researchers have even linked stress, acne, gastrointestinal distrubance, and even depression, with bacteria in the gut.
In cases of chronic stress the environment in the gut can change considerably, thus affecting the bacteria residing there and their ability to synthesise vitamins, eliminate toxins, protect the gut wall, and carry out other essential symbiotic functions. Maintaining good bacteria in the gut, through diet, and probiotics in some cases, is key for many acne sufferers to control symptoms and keep skin healthy. Antibiotics for acne also raises the possibility of antibiotic resistance developing, with serious consequences if an infection then occurs.
Long-term contraceptive use, particularly from an early age, is also thought to increase the risk of breast cancer (although some studies have shown no change in this risk). Oral contraceptives also have the unfortunate effect of depleting the body of a variety of nutrients, including several B vitamins, and upsetting the copper-zinc ratio. As zinc is essential for healthy functioning of the skin, the immune system, and the healing process, any deficiency in zinc will likely result in problem skin, increased scarring, and higher risk of infection, as well as affecting mood.
Simple Dietary Changes for Acne Treatment
Acne sufferers would do well then to take a look at their diet in general and see if they can make some simple changes in a few areas. Ensuring adequate water intake and reducing stimulants such as caffeine, tea, and sugary caffeinated drinks, is a good start, followed by an all-round reduction in simple sugars and a switch to unrefined organic wholegrains which have lower pesticide residues and are more nutrient-dense.
It is also helpful to ensure that you eat enough protein, essential fatty acids from nuts, seeds, and even algal oils (which is where the omega 3 in fish oil comes from), and maintain a low carbohydrate diet. These steps offer both a simple and effective natural acne treatment, with added benefits for all round health.
For more on the connection between diet and acne, pick up a copy of Eat to Beat Acne!
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Bowe WP, Joshi SS, Shalita AR., Diet and acne. J Am Acad Dermatol. 2010 Jul;63(1):124-41. Epub 2010 Mar 24.
Adebamowo CA, Spiegelman D, Danby FW, Frazier AL, Willett WC, Holmes MD., High school dietary dairy intake and teenage acne. J Am Acad Dermatol. 2005 Feb;52(2):207-14.
Bowe WP, Logan AC., Acne vulgaris, probiotics and the gut-brain-skin axis – back to the future? Gut Pathog. 2011 Jan 31;3(1):1.