In this review I want to discuss some of the mechanisms on how acne can develop and also discuss what you might be able to do to help address acne.
Acne is one of the most common skin complaints that I see clients about. Unfortunately, we are lead to believe that our nutrition and lifestyle has little impact on such skin conditions, however this is far from the truth.
I am of the belief that our skin is a representation of what is occurring within our body and no matter what type of acne you are suffering with I strongly believe looking at what we eat, what we think and what we do on a day to day basis should make up the foundation of dealing with any type of skin condition.
The causes of acne
Testosterone and acne
Acne is most common in males, especially at the age when testosterone levels are surging during their teens, however as I will discuss later issues with testosterone imbalance are not limited to males going through puberty.
Testosterone has the ability to stimulate the production of keratin and an overproduction of this fibrous protein can result in skin pores becoming blocked which is thought to be one of the contributing factors to acne.
The reason this is not only an issue for males going through puberty is because in females mismanagement of a hormone called insulin which helps to lower blood glucose levels can also result in increases in testosterone. It is also a common reason why conditions such as PCOS are so prevalent these days.
Whenever blood glucose levels rise rapidly this results in a rapid increase in insulin levels. Continuous over stimulation of insulin amongst other reasons can then lead to a condition known as insulin resistance, whereby we need to make more insulin to get the sugars from our blood into our cells, further compounding the issue.
For females suffering with acne into adulthood this is a significant area of consideration and thus a foundation nutrition program that helps to manage blood glucose levels, prevent peaks in sugar and thus insulin is imperative to a holistic approach when addressing acne.
In some individuals this might mean a slightly lower carbohydrate protocol and potentially the use of insulin sensitising and anti-inflammatory herbs and nutrients to help address this primary area of consideration.
Increased testosterone to dihydrotestosterone (DHT) conversion
Increased acne has also been linked with a greater conversion of testosterone into DHT. This is the result of an enzyme known as 5-alpha-reductase. Interestingly some of the most effective natural approaches to acne such as zinc supplementation can act in a way of suppressing 5-alpha-reductase activity. With that in mind I will often run either a red blood cell zinc test or a serum zinc and copper test with my clients to determine if there is any zinc issues or imbalances. Another more common blood marker known as Alkaline Phosphatase also makes for a good indirect measure of functional zinc status and levels should be around 60-100IU/L, so if you have a recent blood test it may be worth looking at that as low levels (under 60) may be indicative of a zinc insufficiency.
For those of you interested in running blood tests I am able to offer my 1-2-1 clients significantly reduced rates for blood testing and this can be done as part of an initial consultation or for any of my current clients. If you are a current client you can email me or new clients feel free to fill out the contact form at the bottom of this page.
Digestive health, toxins and acne
It has previously been shown in studies that a high percentage of those with acne also have increased blood levels of toxins absorbed through the intestinal wall. Ever since the early 1900’s naturopathic doctors have been relating acne as a condition mostly associated with poor bowel heath.
Poor digestive health is the most common complaint that I deal with on a day-to-day basis. I’m shocked at how many people have significant digestive symptoms and just continue as if it is normal to feel that way and have those symptoms. Unfortunately along with skin health it is probably one of the most poorly dealt with complaints through conventional approaches, I believe because both of these issues are primarily nutrition, lifestyle and stress related.
It is said that a large proportion of acne sufferers also have low stomach acid which can result in the migration of bacteria from the colon into the small intestine, resulting in some level of small intestine bacterial overgrowth. This is probably why conventional treatment for acne often results in sustained periods of broad-spectrum antibiotics, something that may bring temporary relief but more often than not results in a more intestinal dysbiosis, other overgrowths and then an exacerbation of symptoms following the antibiotic course.
High stress, food intolerances, digestive infections and bacterial/yeast/fungal imbalances all have the capability of contributing to a condition known as intestinal hyperpermiability or leaky gut. To put it simply, this is where the intestinal barrier breaks down and substances that are meant to remain in the digestive system are allowed to enter the body and travel throughout the body, often resulting in inflammatory and immune responses.
How to help reduce acne
Diet
As mentioned earlier the primary goal should be to stabilise blood glucose levels, then second to that look at foods that are going to promote good gastrointestinal health and remove common food triggers to immune and inflammatory issues.
With that in mind I would promote the following simple guidelines
- Plenty of veg
- Adequate protein in each main meal
- Healthy fats in each meal and snack avoiding highly processed fats and vegetable oils
- Some starchy carbs but limited portion sizes and eat in their wholefood form
- Avoidance of highly processed carbohydrates such as those made from flour
- Avoidance of refined sugars
- Water & herbals teas initially
- Consider the elimination of dairy
- Consider pro and prebiotic foods
- Avoid deep fried foods
Regularity of meals depends on the individual. If you have a tendency to get low blood sugar between meals and experience symptoms like irritability, mood changes, lightheadedness etc when not eating for 4-5 hours then eat smaller meals and more often.
If you have no issue fasting for 4+ hours between meals then you might be okay on 3 meals or 3 meals and 1 snack per day.
I generally recommend a good starting point is a 12-hour feeding and 12-hour fasting practice with 4-5 meals/snacks within that 12-hour feeding period.
Stress Reduction
Stress can be a major contributor to poor digestive health and often results in us reaching for foods to sooth our emotions. Putting in beneficial activities to help reduce stress levels can be of real benefit to anyone with skin issues. I particularly like advising on the following activities:
- Diaphragmatic breathing
- Yoga
- Meditation
- Walking
- Listening to music
You can pick pretty much anything as long as you enjoy it and it adds to your health and energy rather than takes away from it.
Supplementation
There are certain key nutrients that I would look at supporting, most of which would be covered in a good multivitamin and mineral formula. Some of the most important nutrients for skin health and particularly acne are:
- Zinc
- Vitamin A
- Selenium
- Vitamin E
- Chromium
- Vitamin C
- Vitamin D
I would then also consider a decent probiotic, especially if there has been a history of antibiotic use and there are some digestive symptoms.
On top of that some fish oil and curcumin can be useful in suppressing immune and inflammatory responses.
If you also suffer with PCOS alongside acne which is a common association I would also utilise inositol at a dose of around 2-4g per day.
I hope you found this article useful. Of course we are all individual and in some people a more individualised approach is necessary. For those interested in 1-2-1 consultations please feel free to contact us using the form below.
