Hiya Smarties!
Check out this super informative guest article by Mark Hyman, MD from my blog archives. If you or someone you know struggles with acne, the information and tips in this post could change your life.
Take it away, Dr. Hyman…
As our sugar and dairy consumption has increased over the last 100 years, so has the number of people with acne.
We now have over 17 million acne sufferers, costing our health care system $1 billion a year. Eighty to 90 percent of teenagers suffer acne to varying degrees. The pimply millions rely on infomercial products hawked by celebrities, or over-the-counter lotions, cleansers and topical remedies.
Recent research suggests that it’s not what we slather on our skin that matters most, but what we put in our mouth.
Many have suggested a diet-acne link, but until recently, it has not been proven in large clinical studies.
Instead, dermatologists prescribe long-term antibiotics and Accutane, both of which may cause long-term harmful effects. In 2009, a systematic review of 21 observational studies and six clinical trials found clear links. Two large controlled trials found that cow’s milk increased both the number of people who got acne and its severity. Other large randomized prospective controlled trials (the gold standard of medical research) found that people who had higher sugar intake and a high glycemic load diet (more bread, rice, cereal, pasta, sugar and flour products of all kinds) had significantly more acne.
The good news is that chocolate (dark chocolate, that is) didn’t seem to cause acne.
The dietary pimple-producing culprits—dairy and sugar (in all its blood-sugar-raising forms)—cause spikes in certain pimple producing hormones.
Dairy boosts male sex hormones (various forms of testosterone or androgens) and increases insulin levels, just as foods that quickly raise blood sugar (sugar and starchy carbs) spike insulin.
Androgens and insulin both stimulate your skin to make those nasty, embarrassing pimples. One patient recently told me he would give a million dollars for a pill to cure acne. He doesn’t need to. It seems that, for many, the cure to acne is at the end of their fork, not in a prescription pad.
While pimples are not as simple as too much milk or sugar in your diet, both have a significant impact.
Nutritional deficiencies, as well as excesses, can worsen acne.
Correcting common deficiencies, including low levels of healthy omega-3 anti-inflammatory fats, low levels of antioxidants such as vitamin E, zinc and vitamin A, and including an important anti-inflammatory omega-6 fat called evening primrose oil all may be helpful in preventing and treating unwanted pimples.
I will explain how you can correct and incorporate all of these nutritional elements of your diet and outline some supplements that will help you fight acne in a moment.
First it is worth taking a deeper look at milk and sugar.
Stay Away from Dairy and Avoid Acne
One scientist referred to milk as a “complex aqueous, suspended fat, liposomal, suspended protein emulsion.” What we know that milk is designed to grow things—namely, babies—and in the case of cow’s milk, calves. It is naturally full of what we call anabolic hormones (the same ones that bodybuilders and A Rod use to grow big muscles, and that cause bad acne). These are mostly androgens (like testosterone) and growth hormones, including insulin-like growth factor-1 (IGF-1).
There is no such thing as hormone-free milk.
Here’s a short list of the 60-some hormones in your average glass of milk—even the organic, raw, and bovine-growth-hormone-free milk:
- 20 α-dihydropregnenolone
- progesterone (from pregnenolone)
- 5 α-pregnanedione
- 5 α-pregnan-3 β-ol-20-one, 20 α- and 20 β-dihydroprogesterone (from progesterone)
- 5 α-androstene-3 β17 β-diol
- 5 α-androstanedione
- 5 α-androstan-3 β-ol-17-one
- androstenedione
- testosterone
- dehydroepiandrosterone sulphate acyl ester
- insulin like growth factors 1 and 2 (IGF-1 and IGF-2)
- insulin
This is what our government suggests we drink in high doses—at least three glasses a day for me, a healthy adult male, according to the choosemyplate.gov website. Those guidelines have been strongly criticized by many, including leading nutrition scientists from Harvard such as Walter Willett and David Ludwig.
The famous Nurses’ Health Study examining health habits of 47,000 nurses found that those who drank more milk as teenagers had much higher rates of severe acne than those who had little or no milk as teenagers. If you think it is the fat in milk, think again. It was actually the skim milk that had the strongest risk for acne. In other studies of over 10,000 boys and girls from 9 to 15 years old, there was a direct link between the amount of milk consumed and the severity of acne.
It appears that it is not just the anabolic or sex hormones in milk that cause problems, but milk’s ability to stimulate insulin production. It actually may be the lactose or milk sugar in milk that acts more like a soft drink than an egg.
Drinking a glass of milk can spike insulin levels 300 percent. Not only does that cause pimples, but it also may contribute to prediabetes. This is true despite studies funded by the dairy council showing that milk helps with weight loss. The question is compared to WHAT diet—a diet of bagels and Coke, or a healthy, phytonutrient- and antioxidant-rich, plant-based diet with lean animal protein?
Stay Away from Sugar, Refined Carbs and Pimples
If a glass of milk causes pimples, that may drive you back to your Pepsi. But not so fast. Recent studies also show that sugar and refined carbs (a high-glycemic diet) cause acne. More importantly, taking kids off sugar and putting them on a healthy, whole foods, low-glycemic load diet resulted in significant improvements in acne compared to a control group eating a regular, high-sugar American diet.
In addition to having fewer pimples, the participants lost weight and became more sensitive to the effects of insulin (resulting in less pimple-producing insulin circulating around the blood). They also had fewer sex hormones floating around their blood that drive pimples. We know that women who have too much sugar and insulin resistance get acne, hair growth on their face, hair loss on the head and infertility. This is caused by high levels of circulating male hormones and is called polycystic ovarian syndrome, but is a nutritional, not gynecologic, disease.
But the dietary influences don’t stop there. It is not just sugar, but the bad fats we eat that may also contribute to acne.
Get an Oil Change
Our typical Western diet is full of inflammatory fats—saturated fats, trans fats, too many omega-6, inflammatory, processed vegetable oils like soy and corn oils. These increase IGF-1 and stimulate pimple follicles.
Inflammation has been linked to acne, and anti-inflammatory omega-3 fats (from fish oil or a vegan source) may help improve acne and help with many skin disorders.
Balance the Hormones that Cause Skin Problems
The link is clear—hormonal imbalances caused by our diet trigger acne. Our diet influences sex hormones like testosterone, IGF-1 and insulin, which promote acne. The biggest factors affecting your hormones are the glycemic load of your diet (determined by how quickly the food you eat increases your blood sugar and insulin levels), and the amount of dairy products you eat.
The good news is that eating a healthy diet and taking a few supplements can balance those hormones. Exercise also helps improve insulin function.
How To Prevent and Treat Acne
Nine simple steps will help most overcome their acne problems.
1. Stay away from milk. It is nature’s perfect food—but only if you are a calf.
2. Eat a low glycemic load, low sugar diet. Sugar, liquid calories, and flour products all drive up insulin and cause pimples.
3. Eat more fruits and vegetables. People who eat more veggies (containing more antioxidants and anti-inflammatory compounds) have less acne. Make sure you get your 5 to 9 servings of colorful fruits and vegetables every day.
4. Get more healthy anti-inflammatory fats. Make sure to get omega-3 fats (fish oil, or a vegan source of omega-3).
5. And anti-inflammatory omega-6 fats (evening primrose oil). You will need supplements to get adequate amounts (more on that in a moment).
6. Include foods that correct acne problems. Certain foods have been linked to improvements in many of the underlying causes of acne and can help correct it. These include fish oil, turmeric, ginger, green tea, nuts, dark purple and red foods such as berries, green foods like dark green leafy vegetables, and omega 3-eggs.
7. Take acne-fighting supplements. Some supplements are critical for skin health. Antioxidant levels have been shown to be low in acne sufferers. And healthy fats can make a big difference. Here are the supplements I recommend:
- Evening primrose oil: Take 1,000 to 1,500mg twice a day.
- Zinc citrate: Take 30 mg a day.
- Vitamin A: Take 25,000 IU a day. Only do this for three months. Do not do this if you are pregnant.
- Vitamin E (mixed tocopherols, not alpha tocopherol): Take 400 IU a day.
8. Try probiotics. Probiotics (lactobacillus, etc.) also help reduce inflammation in the gut that may be linked to acne.
9. Avoid foods you are sensitive to. Delayed food allergies are among the most common causes of acne—foods like gluten, dairy, yeast and eggs are common culprits and can be a problem if you have a leaky gut.
Following these simple tips will help you eliminate acne and have that glowing skin you have always dreamed of. It’s much cheaper (and safer) than expensive medications and dermatologist visits. Improve your diet and take acne-fighting supplements, and you will watch your pimples disappear.
Thank you so much for sharing your expertise with us today, Dr. Hyman!
Now I’d like to hear from you: Have you struggled with an acne or skin problem? Have you noticed any link between your skin? What seems to be a problem for you? Let’s share our collective wisdom in the comments below.
To Clearer, Healthy Skin
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And if being vegan alone doesn’t fix your acne, get a hormone test. You can be vegan, even long term, eat a whole foods diet, and still have skin problems!! But you are much less likely to! But get your hormones tested and see what’s going on. Testosterone is Ugly stuff if you have too much!! Or you may just be low in estradiol and so the androgens are taking over. That’s why women in perimenopause have acne all over again, those damn hormones! But if you want to supplement, then they do make prescription hormones from plants! Plants to the rescue for night sweats, YEAH!
I really wish I had access to this information 16 years ago; it would have saved me many many years of pain and suffering.
My skin started breaking out at age 12 and by age 14 I had a serious case of acne that lasted for the next several years.
Growing up, my parents fed me “well balanced meals” (usually consisting of meat, potatoes, and two different colored veggies) and there was always lots of fruit to snack on.
But I had a sweet tooth, I would live on sugary cereal if they had let me (great combo – sugar, carbs and milk…) I would eat if for breakfast, a snack, and before bed whenever I could.
I also LOVED milk – I used to drink 4 liters of skim milk a week!!! (Just for me – the rest of my family would drink about 2 liters a week between them) And what goes better with milk than cookies?
I was never overweight and appeared healthy other than the acne all over my face, back and chest.
I tried every medication and cream on the market – my doctor put me on Accutane at age 15 or 16, but that didn’t last long because I had some unhappy side effects with it (it messed up my stomach), not long after that, I was prescribed a topical cream that left my face so red, raw, dry and scaly that I remember holding cold cloths to my skin and crying because it was so painful.
Those are just two of the many experiences I had with prescription and over the counter acne ‘remedies’.
I was told repeatedly by doctors and dermatologists that diet did not impact acne, that my sweet tooth had nothing to do with my pimples and since I didn’t eat a lot of greasy foods I was fine.
They tried to convince me at a very young age (14 or 15) to go on birth control pills to help balance my hormones and combat the acne, but I knew enough to put my foot down – I didn’t want to start messing with my hormones at such a young age so I waited until I was 18 (right around the same time I moved to a vegetarian diet – but still drank lots of milk).
My skin cleared up for the first time since adolescence, but after about a year, I started having weird side effects so I decided it wasn’t worth it. My pimples came back, but not as severe as before.
A few years later, a vegan friend of mine told me that it might be my diet that was causing my constant breakouts. I got really offended and told her that the doctors had assured me that diet had nothing to do with it. I didn’t want to take the blame for my terrible skin.
Because she is a wonderful person she let it go, but over the next few years supported and educated me until I finally made the switch to a vegan diet about 2 years ago.
I saw a dramatic improvement in my skin within a few weeks/months, especially when I juice and eat really well. My skin still isn’t perfect but neither are my eating habits (it’s shocking how many vegan sweets are available…) but I can really see it in my skin if I’ve been a little off track in my diet.
Thank you, Dr. Hyman, for all of the tips in your article, I’ll try to cut sugar out of my diet for good and maybe by my 30th birthday I’ll have pimple free skin!
Thanks for all the help..my sons acne can’t be detox after 6 months of veganism( I don’t think)he says he feels better than ever…just looks terrible ) ; I will check out Dr. Perricones book and cut back on some of the gluten products in the meantime. My son doesn’t have any symtoms of having a gluten intolerance other than severe and worse acne. Confusing!
I love this article! I wish I knew this information in High School and just after when I had serious acne issues. I have been vegan for about 4 years now and still battle some acne at age 37. My face has never looked better since going vegan but it’s not perfect. I’ve also had annoying acne on my chest for some reason and I was determined to figure out the cause before summer. I experimented by removing bananas from my diet which I had an intuition about but refused to believe for a long long time (bananas are awesome). Well, I stopped putting them into my green smoothies and my chest cleared right up. I researched bananas and found that they have inflammatory properties along with all that sugar as they ripen. I also noticed that when I boosted my zinc intake to thwart of an oncoming cold, my complexion became clearer also. So between the two I have had amazing luck with very little to no acne on my chest this summer! Yay for sporting tank tops confidently! My face still has a few breakouts now and then and I believe it’s from sugar and gluten. Gluten is hit or miss with me, certain grains make me lethargic and tired after eating and some don’t. This is my next experiment, along with agave. I consume a bit too much agave and it could be a culprit as well. It’s all about being intuitive with our bodies! Thanks for the great article!
So, so, so TRUE! I’ve had acne since starting high school. During that time, I recently became vegetarian and later vegan. I never knew what was causing my skin to breakout but then I looked at my food to see what was going on. I realized I was consuming way too much sugar (like an entire box of cookies a day) and not eating my fruits and veggies like I was supposed to. I’d go to dermatologists and tell them about my discovery but they would nod their heads and tell me that it isn’t sugar that’s causing my breakouts. Somehow a part of me rejected them when they wanted to put me on Accutane and from there my journey to healing my acne begun. While my acne hasn’t healed completely, I’m hopeful for the day it will. So thank you so much Dr. Hyman for this article. It really was a a godsend!!!
I am one of those people who had a very strong link for terrible acne caused by dairy. I started getting it when I was just 11 years old, and on a ‘good day’ , would only have 20 pimples. They were painful and scarring, and I dealt with them as graciously as I could. When I was 21, ( 10 years later!!!) I tried giving up dairy ( for different reasons) completely, and was amazed when within 2 weeks, my decade of acne was down to 5 or 6 pimples. Now, 3 years later, I have remained vegan ( I was a vegetarian already) and dont’ miss milk or milk products, even though at one time I loved them. I rarely get a pimple at all, and if I do I know it’s because of some insidious milk product that’s been snuck in somewhere. I wish more kids would know about this, and save themselves alot of emotional and physical scarring.
Some of that vegan acne is probably detox. Detox can last for a couple of months if there was a lot of garbage in the diet before. Also it would be a good idea to consider food allergies. Whenever we change diets we will end up eating a lot of something unfamiliar to the system.
Dr. Hyman, you are a mind reader! I was just saying yesterday that I have hit a dead end with my acne problem and would love to know where to turn next. Granted, my acne is relatively mild. However, throughout the summer, I have not been able to get rid of it, and this has caused stress and unhappiness on my end. To paint a picture for you, I eat a largely plant-based vegan diet. The supplements I take are vitamin D3, vitamin B12 and digestive enzymes with every meal. In addition, I cleanse, tone, spot treat and moisturize my face with all natural and organic products and incorporate omega-3 fats into my diet everyday via flaxseed. For the most part, I exercise everyday, too, and despite all this, I still battle some acne! While I refuse to go back to the days of using chemical-based products, it is very hard to live with all the pimples and blemishes on my face even with cover-up. Your article couldn’t have come at a better time for me! After reading your suggestions on further supplements to take, I am very excited to get them and start using them in my everyday routine. I couldn’t agree with you more that acne like any other ailment is caused by what we put into our bodies, so I am very relieved to know that there is more I could be doing in terms of dietary changes! Thank you!
Great article. Just wondering, how do you know you have a leaky gut? You mentioned that when you said to avoid gluten, dairy, yeast and eggs. I am gluten, dairy and yeast free but occasionally have eggs. So I’m wondering if that’s contributing to my acne issue now. Would love to hear back from you.
We need to start stating things like… pasturized cows milk is bad for acne.. becuase you cannot lump raw in with dead, or cow in with goat, and sheep or breast for that matter. Raw goat milk has healed my son’s autism and has restored good health to our whole family…however pasturized dairy ruined my sons gut and contributed to malabsorbtion of nutrients that contributed to his previous poor health. The facts need to be disseminated .. milk is not the bad guy… its what commercial food production has done to milk that makes it bad. We have a duty to get the information out there. Raw milk can change peoples lives.. and these articles miss the boat. Stepping off my soap box now. will link my sons recovery story that was published in our local newspaper
I have had acne since my teens and I’m now 41. I went vegan a year ago, and suffered more acne, due to detox, but after doing the crazy sexy diet cleanse, my skin is clear. The healthier I eat, the better it is. When I slip up on sugar and junk, I break out again. Cindy, your son may be going through detox also.
Eliminating all sweets from my diet has cleared up my skin. I was a raw vegan and sill getting big painful pimples until I cut out the fruits. Since then I have been reading the Body Ecology Diet which made clear to me that my ecology had previously been out of whack and by eating sweets I was feeding yeast in my body. Sweets include most fruits, most grains, and all sweeteners except stevia.
Hi Cindy- Yes there is a test that can detect if he has celiac’s disease but the test is not 100% accurate. The test will not be able to tell you if you are gluten intolerant though (just celiac’s which is an autoimmune disorder of the small intestine). From my own experience, I took the test and it came back negative. I then resorted to eliminating gluten completely from my diet because I still had pretty severe symptoms from gluten. I took gluten out for about a week and I immediately felt like a different person and a lot of my symptoms cleared up right away. When I ate gluten again after about a week, a lot of discomfort started happening again and my symptoms were in full swing. Also, not all whole grains have gluten but it might not be a bad idea to try an elimination diet with your son. Just be careful because gluten can be hidden in foods such as soy sauce, so just make sure to check all labels. Good luck!!
I completely agree! I was suffering sever acne for years. I’m now 25 and I’ve gone through Accutane , several topical, anti-biotics, etc… I recently changed my diet to vegan with a lot of raw foods. My Acne cleared up fairly quickly and now I’m dealing with healing and preventing scars. Thanks so much for posting!
I’ve also experienced issues with my skin since moving to a vegan diet… perioral dermatitis. Unfortunately nothing cleared it, so I’m on a three month antibiotic trial to see if that will clear things up. None of the “usual” triggers (steroids, fluoride toothpaste, heavy moisturizers, etc) can be blamed for my condition either, which is really frustrating. It seems the vegan diet isn’t the answer for everyone looking for glowing, clear skin.
Just realized…maybe its gluten thats the problem because we do eat alot of whole grains. Is there a test that confirms if that could be the problem?
Cindy, a couple of years back I did a blood test for food intolerance. Eggs, wheat and dairy showed up (as well as sunflower seeds, red kidney beans). I had cut all that stuff out, but continued to get acne. Also, years before my food intol test I had taken antibiotics, the contraceptive pill and accutane. what a mistake! Anyway, fast forward to 3 weeks ago, my nutritionist suggested I cut out gluten (I was eating rye bread and other stuff with gluten in it, just not the wheat). and guess what, it’s working! I’m shocked at the difference. I also increased my water intake at the same time.
http://www.doctoroz.com/article/gluten-sensitivity-self-test
^ Dr. Oz has a great Gluten Intolerance Self Test because there is a blood test for Celiac Disease – it is more difficult to diagnose the intolerance. If you are a defective then you can diagnose yourself. Good luck
Unfortunately my son seems to be the rare child that got severe scarring acne after going to a healthy vegan diet. I had no choice but to put him on antibiotics and even that isn’t helping yet. It was so strange but we eliminated all dairy and introduced more and more vegan meals and then we were almost fully vegan and his skin went nuts. We do have a pretty balanced diet…definately way better than we had before…but my heart is broken that our new diet seems to have scarred his face at 16. I wanted to avoid the extremes with medicine but felt helpless after trying alot of the recommended natural ways to help with no results at all.
I have a very similar story… Have you ever tried estroblock. It may just do the trick for him if her still struggles. You can read all about it on their website. All four of my children have been on Accutane (last resort for me to make that decision) # of them… Acne returned. I found Estroblock and my kids face is clear! It’s all natural no side effects and from cruciferous veggies… Anyway I hope I can be of help.
Great article! I was in my late 20’s when I had a cystic acne on my face, I was also anorexic too, so my body was not getting any nutrients to heal my skin and now I have these scars on my face which I desperately want gone I am obsessed…. I was on accutane and it did get rid of my large cysts but I was left with the scars. I have changed my diet so much, I rarely eat cheese and never drink milk. I juice and eat alot of veggies! and when I keep to that my skin glows, I am not perfect I do give in to some junky food sometimes and when I do my skin automatically response with acne! I think dermatologist need to expand their practice, If my dermatologist at the time really asked the right questions, get to know my diet (which had zero nutrients) I may be scar free today! but in the long run I do take full responsiblity for my own actions, I should have been more in tune with myself!
Moving to a vegan diet really helped clear up my skin all of the way. However, as of a few months ago, I began to experience more problems again– and I feel like these problems began when I moved to a very high raw diet and started eating a lot of fruit. I have only recently realized that this may be the problem, can anyone cite some good resources on links between eating large amounts of fruit as a cause of acne?
Hi, I am no expert of any kind however I was thinking that maybe high intake of fruit may cause acne because of all of the fructose (sugar) in them.
Could be a couple reasons for that, one being the high sugar content. I went raw vegan for 8 months, and while my skin was totally clear during that time, I lost an unhealthy amount of weight and had a high fasting blood glucose level, probably from eating so much fruit sugar. Here’s a study showing that high carbohydrate intake worsened acne:
http://www.ncbi.nlm.nih.gov/pubmed/25059055
Could also be nutrient deficiencies, in animal-source vitamin A (retinol), B12, zinc, etc., that tend to be low on vegan diets.
This article is spot on and so informative for those who are not aware of the effects that diet has on our skin and acne. I was one of the many who had no idea there was a correlation between what we eat and acne. Therefore I succumbed to accutane when I was a teen because I was told it would be the answer and a quick fix to heal my acne after years of struggling with topical ointments. Although accutane did heal my acne, I suffered with depression while taking it. Fast forward almost 10 years later and I found myself suffering with mild acne once again. This time I got down to the root of the problem, but only after I went to the dermatologist and the topical treatment she prescribed did not work. I found out that the culprit was dairy and gluten. Now that I have been off of both dairy and gluten for 7 months I have not had an acne breakout since and my skin has never looked this good.
The steps I took to fight acne was to perform an elimination diet. This led me to discover that I have a gluten intolerance and soon after I found out that I was lactose intolerant as well.