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
Sources:
F. William Danby, MD, Nutrition and acne, Clinics in Dermatology (2010) 28, 598–604.
White GM. Recent findings in the epidemiologic evidence, classification, and subtypes of acne vulgaris. J Am Acad Dermatol 39(2 Pt 3):S34-7 (1998 Aug).
Lello J, Pearl A, Arroll B, et al. Prevalence of acne vulgaris in Auckland senior high school students. N Z Med J 108(1004):287-9 (1995 Jul 28).
Venereol 21(6):806-10 (2007 Jul).
Wolf R, Matz H, Orion E. Acne and diet. Clin Dermatol 22(5):387-93 (2004 Sep-Oct).
Magin P, Pond D, Smith W, et al. A systematic review of the evidence for myths and misconceptions’ in acne management: diet, face-washing and sunlight. Fam Pract 22(1):62-70 (2005 Feb).
Spencer EH, Ferdowsian HR, Barnard ND. Diet and acne: a review of the evidence. Int J Dermatol 48(4):339-47 (2009 Apr).
Bendiner E. Disastrous trade-off: Eskimo health for white civilization, Hosp Pract 9:156-89 (1974).
Adebamowo CA, Spiegelman D, Danby FW, et al. High school dietary dairy intake and teenage acne. J Am Acad Dermatol 52(2):207-14 (2005 Feb).
Adebamowo CA, Spiegelman D, Berkey CS, et al. Milk consumption and acne in adolescent girls. Dermatol Online J 12(4):1 (2006).
Adebamowo CA, Spiegelman D, Berkey CS, et al. Milk consumption and acne in teenaged boys. J Am Acad Dermatol 58(5):787-93 (2008 May).
Hoyt G, Hickey MS, Cordain L. Dissociation of the glycaemic and insulinaemic responses to whole and skimmed milk. Br J Nutr 93(2):175-7 (2005 Feb).
Kaymak Y, Adisen E, Ilter N, et al. Dietary glycemic index and glucose, insulin, insulin-like growth factor-I, insulin-like growth factor binding protein 3, and leptin levels in patients with acne. J Am Acad atol 57(5):819-23 (2007 Nov).
Cordain L, Lindeberg S, Hurtado M, et al. Acne vulgaris: a disease of Western civilization. Arch Dermatol 138(12):1584-90 (2002 Dec).
Smith RN, Mann NJ, Braue A, et al. A low-glycemic-load diet improves symptoms in acne vulgaris patients: a randomized controlled trial. Am J Clin Nutr 86(1):107-15 (2007 Jul).
Smith RN, Mann NJ, Braue A, et al. The effect of a high- protein, low glycemic-load diet versus a conventional, high glycemic-load diet on biochemical parameters associated with acne vulgaris: a randomized, investigator-masked, controlled trial. J Am Acad Dermatol 57(2):247-56 (2007 Aug).
Smith RN, Braue A, Varigos GA, et al. The effect of a low glycemic load diet on acne vulgaris and the fatty acid composition of skin surface triglycerides. J Dermatol Sci 50(1):41-52 (2008 Apr).
Zouboulis CC. Is acne vulgaris a genuine inflammatory disease? Dermatology 203(4):277-9 (2001).
James MJ, Gibson RA, Cleland LG. Dietary polyunsaturated fatty acids and inflammatory mediator production. Am J Clin Nutr 71(1 Suppl):343S-8S (2000 Jan).
Simopoulos AP. Essential fatty acids in health and chronic disease. Am J Clin Nutr 70(3 Suppl):560S-9S (1999 Sep). 26. Kaaks R, Bellati C, Venturelli E, et al. Effects of dietary intervention on IGF-I and IGF-binding proteins, and related alterations in sex steroid metabolism: the Diet and Androgens (DIANA) Randomised Trial. Eur J Clin Nutr 57(9):1079-88 (2003 Sep).
Fulton JE, Jr., Plewig G, Kligman AM. Effect of chocolate on acne vulgaris. Jama 210(11):2071-4 (1969 Dec 15).
Anderson PC. Foods as the cause of acne. Am Fam Physician 3(3):102-3 (1971 Mar).
Great article. I’m going through some of these issues as
well..
I had lots of problems with acne as a teenager, I am now 22 and I’ve found a couple of things have improved my skin greatly. Firstly, I started using Simple moisturiser everyday, as my skin can get a little dry. I also use a homemade tea tree oil and aloe vera gel face mask about once a fortnight, or whenever I am going somewhere where I want my skin to look extra good. Recently I have started taking a skincare supplement (Zare beauty) which has a good selection of vitamins, alongside iron tablets (for anaemia) and it has made a massive difference, I now moisturise every other day (still using Simple) and my face looks less red and flushed than it used too!
Hi there, the whole thing is going well here and ofcouirse every one iis shyaring facts,
that’s in fact excellent, keep up writing.
Yeah Nice post, this is what I wanted.
Thanks for sharing this post.
All 9 ways are awesome and l loved 6th one.
Keep it up!!!!
awsome tip
Beautiful info there. The veggies insight is great. It is the high time that parents taught kids on veggies importance considering that there are many acne cases in teenagers these days. In addition, no one wants to put their teenage kids on strong acne treatment creams at their tender ages.
very nice blog!! This blog is right on target thus instructive for the individuals who are not mindful of the impacts that eating regimen has on our skin and pimple inflammation.
Thank you so much for this wealth of knowledge. I stopped dairy for about 6 months now I saw great improvement. I started getting acne in my early thirties now I’m almost forty and still battling acne. I believe coffee and cooking oil are my culprits in addition to dairy. I drink at least 4coffees and I cook alot with oil. I am definitely making an oil change.Thanks
Cannot believe these simple changes would work so well. Have suffered acne for 25+ years and just in last week have nearly flawless skin. I am in awe. Thanks for sharing this!
Best,
Adam
Eating highly processed foods such as refined breads and cereals, which are easily digested, leads to a chain reaction in the body. When breads and cereals are digested, it leads to an increased amount of sugar. In turn, this excess sugar allows the body to produce high levels of insulin and insulin-like growth factor (IGF-1). Elevated insulin levels lead to an excess of male hormones, which cause pores in the skin to secrete sebum, a greasy substance that attracts acne-promoting bacteria.
Does anyone have any ideas, comments, suggestions on healing acne scars and discoloration?
very nice posting………thankx for sharing such nice tips to prevent acne. it is very helpful information to every one to protect our skin.
Could you suggest some acne fighting smoothies please Kris? Axx
**HELP** I cannot find a non-synthetic vitamin A. Can anyone recommend a good Organic brand?
Thanks!
Same here Gia! I cant find most of these supplements, Vit A in particular, that dont/doesnt contain soy or other fillers. And no one will answer our questions!!!!! FRUSTRATED!!!!!!! I want to get these supplements already but dont want to spend my very tight budget on crap!
Great Article. At the age of 49, after years of struggling with Rosacea and Reactive Airway Syndrome, I delivered a baby who was diagnosed with a dairy allergy. So I went on a dairy free diet so that I could nurse her. It took 10 months, but my Rosacea disappeared, and only flares up when I eat dairy. I can feel the sting, and my chin and cheeks turns red. I also start to cough within 10 minutes and my lungs hurt – the Reactive Airway Syndrome kicking in.
I had acne from about age 13 through about age 27, when I discovered the cause of it for me. btw–I had that very kind of cystic acne where a big bump would form under the skin (fortunately I would only have one or two, sometimes a couple more — but I always had one somewhere). There is no doubt that my diet was high in milk products at that time, as well as sugar; that did not appear to be the cause of my acne. The problem was elimination. I went on a low-dose antibiotic Erythromycin (sp?) (wish I wouldn’t have, but that’s another story) for a year to treat the acne. It did lessen my acne quite a bit, and what I noticed is that I was having more b.m.s (probably because the antibiotic messed with my digestive system?). When I went off it, the acne started to come back, but then I realized that I needed to eliminate more regularly and so I just started making more of an effort to make sure I did, and lo and behold they started going away for good. The only time the acne would come back is if I was constipated.
This has proven true for me. I have struggled with acne since being off birth control and have PCOS. Even eating a very clean, plant-based gluten free, vegan diet did not help my acne. I recently cut out all grains (even gluten free ones), all sugars and sweeteners and really limited fruit consumption for 30 days. I couldn’t believe how much my acne improved. After the 30 days, I started introducing some things back in my diet like brown rice, quinoa, dates and other ‘healthy’ foods and sure enough my acne started coming back right away. While eating grain free and no sugar/ sweeteners is so hard (way harder than vegan was for me), it definitely seems to help me. Unfortunately, it didn’t help me lose weight in that 30 day period, but hopefully it will eventually.
Hey Kristina,
I watched a video on youtube of two twin sisters Ronda and Nina who cleared their acne on a vegan diet by eliminating fats, not sugars. They were vegan for years and suddenly started having terrible acne. Eventually they discovered that it was soy and fat causing it. So instead of removing fruits, try to remove ALL fats. Good luck!:)
I am a 33 year old woman who suffered from SEVERE acne for over 20 years. It started at 10. I had boils and cystic acne ALL OVER my face. My face was so covered with acne that I could barely see my skin. It was humiliating. My doctor gave me everything to try and nothing worked that he recommended me to a dermatologist at 18 years old. The dermatologist assured me that acne had NOTHING to do with food. I was addicted to chocolate milk for most of my life, having 3-4 glasses a day, and (looking back), my diet consisted of many sugars. Although my parents fed me many organic vegetables since I was a baby, I was sneaking cookies and candy all day, every day! My dermatologist told me to use Spectro Jel as my face wash. He prescribed every cream you could imagine and tons of different medications and nothing worked. He then gave me such a high dose of the antibiotic Erythromycin, that I would up in anaphylactic shock, was rushed to the hospital and nearly died.
The last resort was Accutane. I didn’t care about the risks. I was desperate. took it. It worked. For a few years that is…..
Then it came back a few years later. There I was nearly 30 years old with a face full of cystic acne again. I went to a new dermatologist who prescribed Accutane again and I was so tempted to try it again but I was older and wiser and was really scared.
My nutritionist, Grace Van Berkum (http://www.gracevanberkum.com/) told me to take diary out of my diet for 2 weeks and see what happens. Guess what? A massive change happened! My skin was clearing up. That was 4 years ago and I am still dairy free. Also removing dairy from my system, magically cured a number of stomach problems I was having AND I started losing weight! This was great.
I still had some problems with my skin, but it was getting better. I went to see a holistic allergist Daniel La Coste (http://www.hhccentre.com/team/daniel-lacoste/) for some environmental allergy issues. He was testing and holistically clearing me from pollen, dust etc. He told me he may be able to help with my skin. He asked me to bring in my face soap, laundry detergent and any skin products I used. I bought Spectro Jel which both dermatologists and my family doctor had told me to use for years. Daniel tested me and guess what? I WAS SEVERLY ALLERGIC to the prescribed face was I was using for YEARS! I was also allergic to my laundry detergent and as it turns out ALL chemicals that are used in cleaning products.
I now use all natural plant based face wash, laundry detergent, cleaners and moisturizer (which I was never was able to use) and I only get a single pimple once a month!
So it was a combo of dairy, sugar and soaps (with chemicals) I was instructed to use by doctors. Sounds a little fishy to me!
Cutting out dairy had the biggest impact on me. I have to admit it was difficult at first – I think we are conditioned to believe that dairy is the best source of calcium and we know how important calcium is….. Now I focus on getting my calcium from plants and paying attention to my Vitamin D levels more so than worrying only about my calcium. I added a zinc supplement (I knew mine was low from bloodwork) at the same time I eliminated dairy, so I believe it was likely a combination of the two.
The most recent thing I incorporated to help keep my skin clear always (since I was still having some hormone-related breakouts, albeit mild compared to my dairy days) was an Ayurvedic approach – I try to stay away from foods that can aggravate Pitta (my main constitution and since Pitta aggravation is believed to play a role in skin issues, including acne) during times when I’m already feeling spicy and feisty enough, and also use a daily herbal supplement containing Pitta-balancing herbs, most notably neem. That seems to have rounded out the story for me and having clear skin.
I suffered with mild to severe acne from my early teens through my late 20s. I even took Accutane my senior year in high school, which has such harmful effects on the body I had to have monthly liver function tests! My acne cleared up temporarily, but returned a few years later. Birth control temporarily helped my skin, but once I went off birth control because of migraines, I experienced horrible rebound acne. Lo and behold, reducing dairy, sugar, and wheat, and eating more fruits and veggies and omega 3s, and I have the best skin of my life in my 30s. I remember asking my dermatologist as a teenager if diet had any affect on acne and he told me that’s just a myth.