Updated: Apr 29
Acne is a frustratingly common condition. In westernized societies, it afflicts 79% to 95% of the adolescent population! In men and women older than 25 years, 40% to 54% have some degree of facial acne, and clinical facial acne persists into middle age in 12% of women and 3% of men. (1)
As a functional medicine practitioner I would not consider acne vulgaris a disease, but a symptom of other underlying health concerns. It is commonly a sign of hormonal imbalance, nutrient deficiencies, poor diet and gut health.
In this article, I cover eight things that can be highly effective in addressing acne, and can in many cases provide a long term solution.
1. Avoid drying out the skin with excessive washing.
Many cleansers tend to promote oil (sebum) production by stripping the skin of its natural oils. The body tries to rebalance by increasing oil production which can lead to clogged pores and acne.
Over-washing can also break down the protective coating of our skin called the acid mantle. The acid mantle is made up of sweat, oil, and good bacteria and is essential for strong, healthy skin.
I'd recommend trying more natural moisturizing cleansers and nourishing oils before reaching for the harsher chemical-based formulas.
2. Increase your omega-3 fatty acids
Hormones like testosterone and Insulin growth factor (IGF-1) can increase oil/sebum production, so a careful balance is necessary.
The inflammatory hormone IGF-1 produced by the liver can also increase keratin, the structural protein of our hair, skin and nails. An overproduction of keratin can cause it to lump together with dead skin cells and block or surround hair follicles.
Furthermore, the EPA component of this essential fatty acid is converted in the body to powerful anti-inflammatory and antibacterial substances, soothing the inflammatory response.
High levels of omega 3 fatty acids can be found in oily fish, nuts, seeds, soybeans, and cold-pressed olive oil.
Top-quality fish or cod liver oil supplements would be my first choice if needing therapeutic benefits. Though, not all fish oil supplements are created equal. Many go rancid quickly, have not been adequately tested for heavy metals and impurities, and can actually do more harm than good. So please keep this in mind before purchasing any supplement from the supermarket or health food store.
Walnuts, pecans, chia seeds, pumpkin seeds and flax seeds are good choices of omega 3 fatty acids if vegan. Flax oil supplements are also available.
But, be wary of excessive nut consumption as they can increase omega 6 fatty acids in the body, imbalancing the omega 3:6 ratio. Omega 6 fatty acids tend to be more inflammatory and are also found in vegetable and seed oils, so it's best to skip processed foods containing these refined oils.
3. Avoid cow's dairy, refined carbohydrates and sugar.
These foods have been shown to increase insulin and IGF-1, potentially leading to increased sebum, keratin, and inflammation.
Foods rich in refined carbohydrates include:
Bread, crackers, cereal or desserts made with white flour
Pasta made with white flour
White rice and rice noodles
Sodas and other sugar-sweetened beverages
Sweeteners like cane sugar, maple syrup, honey or agave
Refined carbohydrates and sugar increase inflammation, by spiking blood sugars and insulin. Increased insulin makes androgen hormones, like testosterone, more active and increases insulin-like growth factor 1 (IGF-1). (6)
A number of studies have suggested a link between milk products and acne severity in teenagers. (7, 8, 9, 10). Plus, the 2005 Nurses' Health Study found that women who drink less milk were less likely to suffer from acne. (11, 12).
How can cow's dairy be an aggravating factor?
Well, firstly, dairy is a common allergen which can lead to a host of inflammatory reactions. Dairy increases insulin, independent of its effects on blood sugar, which can fuel inflammation. Plus, cow's dairy also contains amino acids that stimulate the liver to produce more IGF-1.
Certain cheeses are also high in histamines which can worsen acne in those with histamine intolerance. Other high histamine foods include chocolate, grapes, wine, bone broth, processed meats and fermented foods.
4. Eat real food!
In societies where people eat a non-Western diet, acne is virtually unheard of. In an article published in the Archives of Dermatology, a team of researchers studied 1,200 teens and adults in New Guinea and a remote part of Paraguay eating a diet of fruit, vegetables, seafood and lean meats and didn’t detect a single acne lesion in two years of study! (13)
5. Zinc should definitely be considered.
(Zinc gluconate used in this last study is a poor quality supplement and it still got results).
It's helpful to work with a holistic health practitioner when supplementing with zinc, as zinc toxicity and a zinc-copper imbalance can occur and this needs to be monitored.
Check out Three Key Nutrients You're Probably Lacking for more info on zinc.
6. Avoid touching the face frequently.
A sleeping position where a hand is touching the face can be a breeding ground for bacteria, leading to breakouts. Does the hand end up tucked under the cheek or chin while sleeping? Or is the chin rested on a hand while working? Is the pillowcase not changed regularly? If so, addressing these little habits may help.
7. Skip the harsh drugs and try a natural anti-biotic
Conventional treatment commonly involves the use of the oral contraceptive pill, broad-spectrum antibiotics, spironolactone (Aldactone) or isotretinoin (Accutane). But these drugs do nothing to address the root causes and can have dangerous long-lasting side effects.
Isotrention, in particular, has been associated with depression, inflammatory bowel disease, and osteoporosis. (17, 18, 19). Its mechanism of action is to alter DNA expression! I urge anyone with acne NOT to take it.
The estrogen component of hormonal contraceptives works to increase levels of sex hormone-binding globulin (SHBG), thereby decreasing levels of free testosterone which may help acne but lead to a host of other health issues. Coming off these pills can cause a post-pill type of acne that worsens for 6 months before it starts to get better.
Some may find a natural herbal antibiotic called berberine helpful for killing the bacteria that causes acne. Acne improved by 45% after just four weeks on berberine, in one clinical trial. It also reduces inflammation and IGF-1. (20)
However, like all antibiotics, it should not be used for long term use, and it should ideally only be used as part of a full gut healing protocol.
8. Address poor gut health and digestive issues.
Poor gut health is a common underlying cause of poor skin health. There are a host of issues that often need to be uncovered and addressed. Is irritable bowel or constipation an issue? How about low stomach acid? Could a food intolerance, sensitivity or allergy be an underlying cause? Or a small intestinal bacterial overgrowth (SIBO)? Is there a candida overgrowth due to excessive sugar, refined carbohydrate or alcohol consumption?
The gut is an important part of the detoxification process in the body. A healthy gut is essential for healthy hormones and healthy skin. There are no exceptions.
Addressing and healing the underlying causes of acne takes time and even with the best multifactorial approach, it can take 6 months to improve. But one must remember that an improvement in acne, usually means an improvement in one's overall health, and that should be the ultimate goal, not just beautiful glowing skin.
Keen to work with me to address your health concerns? Book a free discovery call.
Learn more about gut health in my IBS and gut healing Facebook group.