“Diet and acne are unrelated” is one of those frustrating medical truisms that just won’t die. Want to know something? This statement is based on ONE study, in the late 1960s, where they gave small groups of teenagers (around 40, if I recall correctly) real or fake chocolate bars to eat in addition to their regular diet, which was not described. Guess what, there was not a lot of difference between the groups in how many acne lesions they got. As far as the dermatologists were concerned, that settled the entire nutrition question, so patients should just eat whatever they want. Talk about junk science!
Acne is a multi-cause problem, and at least two of the causes respond to dietary intervention. If you’ve been reading this column regularly and have ever had a pimple, you probably can guess that one factor is inflammation, which can be triggered by inadequate good fats (fish, nuts, olives, avocados) and/or excessive bad fats (fried foods, trans/hydrogenated fats and things like soybean and corn oil) and/or inadequate anti-inflammatory foods like fruits and vegetables.
The other food-responsive acne trigger is elevated insulin levels (from a high glycemic impact diet) changing your production of zit-making androgens (the “male hormones”). The sugar-insulin link is just starting to emerge (finally!) in the literature. Australian researchers put a group of 25 young men on a low-glycemic-index diet for 12 weeks, counting their pimples before and after (the horror!). The low-glycemic diet resulted in significantly fewer acne lesions — plus the subjects lost some weight and had improved insulin sensitivity. Sugar and insulin are also both inflammation triggers. So, it’s not “chocolate,” it’s cookies and soda and white flour and … you know the list by now, and you know what to do.
Speaking of hormones, if you have acne, I recommend that you choose organic animal products (meats, butter, dairy products) to reduce your exposure to hormones that belong to someone else. And don’t forget water; since skin is one of your organs of detoxification and excretion, you want to keep the juices flowing. Try to break a sweat every day.
Zinc is a micronutrient that many folks with acne are missing. To get it, you need protein foods, with the best sources being meat, fish and poultry. If that grosses you out, try peanuts and beans. If you’re vegetarian or eat very little protein, you may have a zinc issue to explore.
Vitamin A is a powerful antioxidant and very important for healthy skin. It reduces sebum (oil) production, and helps skin cells turn over appropriately. You can overload on vitamin A if you take it in the fat-soluble (retinol) form as in some supplements and in liver (please do not ever eat liver). Beta carotene (the water-soluble form of vitamin A) you can consume in virtually limitless amounts without getting into trouble (not that you should). Welcome to the wonderful carotene-rich foods: dark leafy greens, yellow vegetables (carrots, pumpkin, sweet potato, winter squash), yellow fruits (apricots, cantaloupe, mango, papaya) and eggs. Gorgeous! Just like you!
Susan Fekety is a Yale-educated advanced practice nurse with special expertise in nutrition and dietary therapies. She provides women’s healthcare and coordinates the First Line Therapy program at True North Health Center in Falmouth. Contact her at sfekety@truenorthhealthcenter.org.