The Acne Diet

September 18, 2009 Written by JP       [Font too small?]

I’m entirely open to seeing a doctor and having appropriate medical tests conducted. I’m even willing to judiciously use medication if it’s truly warranted. But there are many conditions that effect quality of life without threatening mortality. These are the types of health concerns that are often best addressed by natural means. A good example is a common problem that afflicts a large segment of the adolescent population. Acne vulgaris is a skin condition that’s a major cause of both physical and psychological harm. It just so happens that there is an all natural, inexpensive and safe treatment plan that may help abate the suffering.

A newly published study examined the dietary patterns of 3,775 “late adolescents” (18 -19 years old) who reside in Oslo, Norway. This same evaluation also looked at the connection between acne prevalence and “mental health problems”. Food frequency questionnaires and a psychological test referred to as the Hopkins Symptom Checklist were used to compile the data on the teenagers.

  • 14% of the young men and 13% of the young ladies reported suffering from acne.
  • The degree of psychological distress was higher in those with more severe skin symptoms.
  • In the young men, the consumption of potato chips and sweets appeared to be associated with acne.
  • The young women who ate the largest amount of raw vegetables were least likely to exhibit skin inflammation and lesions.

Based on these findings, the authors of this population study determined that, “self-reported acne is significantly associated with mental distress and, among girls, with infrequent consumption of raw vegetables”. (1)

My three-part system for improving acne involves the following steps: 1) eat a low-glycemic diet that’s rich in healthy fats and high in fiber; 2) test to see if dairy-based foods are contributing to your symptoms; 3) include select nutritional supplements in your daily routine.

Step #1 – The Role of Diet

Diet is by far the most important aspect of my proposed plan of action. If you do nothing else, change this one factor and I think you’ll likely find some degree of positive change in your skin’s condition. The concept behind this type of diet is very simple:

  1. Emphasize natural, whole foods and avoid processed grocery items. In most cases, this will naturally reduce your blood sugar, insulin production and systemic inflammation.
  2. Avoid fake fats (hydrogenated/trans-fats). Instead, use organic coconut oil, extra virgin olive oil and organic butter for cooking and flavoring foods.
  3. Skip the starches and sweets. Focus on fresh fruits and vegetables that are appropriate for low carb diets and limit desserts to special occasions.
  4. Stay well hydrated. The drink of choice is pure water. But herbal teas are also highly recommended. These medicinal brews often calm the inflammation that plays a role in the severity of acne symptoms.
  5. Don’t be afraid of healthy fats. The only way to succeed on such a diet is to enjoy liberal amounts of fatty sources of protein, such as grass fed beef, nuts, omega-3 eggs, salmon and seeds.

It’s important to note that I didn’t pull these concepts out of thin air. I’m basing these recommendations on the preponderance of recent scientific evidence relating to the connection between food choices and acne. (2,3,4,5,6)

Step #2 – Eliminating Dairy

Three recent studies have looked at the association between milk intake and acne occurrence. A 2008 trial published in the Journal of the American Academy of Dermatology examined the eating patterns of over 4,200 teenaged boys. A “positive association” was found with respect milk, in general, and skim milk in particular. Adolescent females also appear to be sensitive to dairy. A 2006 study from Harvard investigated the milk consumption of over 6,000 girls (aged 9 – 15). It likewise found a similar connection between milk use and acne. The acne/dairy connection may extend to the adult population as well. In 2005, Harvard researchers theorized that this may occur due to, “the presence of hormones and bioactive molecules in milk”. This point of view is supported by more contemporary research as well. (7,8,9,10)

Step #3 – Nutritional Supplements

Consider adding a high quality multivitamin/mineral, fish oil and green tea to your wellness program. A small trial from October 2008 found that the daily use of a multi-nutrient product significantly reduced inflammation and lesion counts in a group of 5 patients with “mild to moderate acne vulgaris”. 3 males and 2 females (aged 18 – 23) were asked to take a supplement containing a daily total of 1,000 mg of EPA (a fatty acid in fish oil), 200 mg of EGCG (a component of green tea), 200 mcg of chromium, 200 mcg of selenium and 15 mg of zinc. 4 out of the 5 patients showed a reduction in problematic skin symptoms. On average, the total number of lesions dropped from 63 to 40 over the two month trial. There was also a reduction in inflammation and redness in the acne prone areas. The “average inflammatory lesion count” registered as 21 at the start of the study. After two months, it declined to 7. An improvement in “mental outlook” was also reported by the patients. More research is certainly called for, but these preliminary findings offer reason for hope. (11,12,13)

There is little question that genetics play a significant role in skin condition. Many of us know this both from personal experience and what we’re frequently told by dermatologists. But, I believe that the program outlined above can help improve skin quality and, more importantly, overall quality of life for many adolescents and adults who feel destined to suffer with acne or other inflammatory skin issues. If you decide to try out my 3 step program, please let me know how it works out for you.

Note: Please check out the “Comments & Updates” section of this blog – at the bottom of the page. You can find the latest research about this topic there!

Be well!

JP

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25 Comments & Updates to “The Acne Diet”

  1. Kellie Says:

    My son had acne and was told to avoid dairy based on all the ‘studies’. Such studies are usually done on the man made versions of foods, such as processed dairy, milk in this case. So the results should conclude ‘avoid processed dairy’ not ‘avoid dairy’. I just wanted to mention this because quite often the studies are flawed, or based on man made processed versions of real food, and a conclusion is drawn that doesn’t quite reflect the whole truth. One bad apple does not mean the whole barrel is bad, as they say! My son went back to the basics, thanks to Weston A Price’s work. He drinks raw milk and eats raw dairy products frequently. He has not had acne since we changed his diet to natural, real, foods. Love your blog by the way!!

  2. JP Says:

    Thanks for sharing that, Kellie. You make a very good point, IMO.

    I agree that there can be a different reaction to raw, grass fed dairy. The live enzymes and naturally occurring probiotics set raw dairy apart from most store bought products.

    If someone wants to continue to use milk but knows they don’t respond well to the conventional (homogenized + pasteurized) forms … a switch to well produced, un-pasteurized versions may be a viable alternative.

    I’m thrilled to hear your son is doing well. He’s lucky to have your guidance and support!

    Be well!

    JP

  3. Nina K. Says:

    My sister has pretty bad skin, but its not acne vulgaris – thank god! – only lots of pimples, but sometime so bad that it looks like acne.

    what her helps: cut everything processed out, starting with fasting for a few days, after that, soups of veggis, no dairy, but eggs, fish and meat are ok. fat from dairy or butter have an great negative impact.

    that cleanse her from within, she says.

    Nina K.

  4. Anonymous Says:

    Thanks for mentioning grass-fed beef specifically in your discussion of healthy fats. Most people don’t realize the increased levels of omega-3s and simply think that all beef is the same.

  5. JP Says:

    Thanks for sharing that, Nina. I think it’s encouraging for people to read such accounts. I know it is for me!

    Be well!

    JP

  6. Bianca Says:

    Nicotinamide (also known as Niacinamide) applied topically, is beneficial for reducing Acne, Skin hyper-pigmentation (acne scars), increasing skin moisture and reducing fine wrinkles. Scientists at NY University College of Medicine have shown that Niacinamide is superior to antibiotics such as Clindamycin in controlling acne.

  7. JP Says:

    I do think the more desirable fatty acid profile of grass feed meat can be helpful. It’s certainly closer to the way nature intended us to eat. The fact that fewer antibiotics and growth stimulants are (generally) given to grass fed cows may also factor into the equation. This was mentioned by the Harvard group and would likely apply to meat as well as milk.

    Be well!

    JP

  8. JP Says:

    Thank you, Bianca.

    I agree that topical niacinamide is a promising aid for those with acne. I chose to focus on the dietary aspects of this condition because they’re frequently not emphasized. But there would likely be an added benefit to address the symptoms externally as well.

    Be well!

    JP

  9. Iggy Dalrymple Says:

    When I was a teenager (about 55 years ago) I went to a dermatologist for my acne. He had me stop eating all candy, chocolate, iodine, and fried food. He applied dry-ice packs to my face to cause the skin to peel, and he had me mega-dose on vitamin A. It worked. Later I read that mega-dosing on vit A can cause a growing child’s legs to stop growing. Today, my legs are less than 28″ long but I have as long a torso as a tall man. My short legs caused no problems and I excelled as an athlete, but impossible to wear pants off the retail rack.

  10. Angie Says:

    Acne can be downright crippling to self-esteem, especially for teens.

    I have a face mask recipe (all natural) that I’ve been wanting to try… and both the mask and the toner recipe call for cold green tea… It seems that green tea is quite the little health wonder… perhaps topically?

    It’s good to see that again, using a holistic approach of the body and not just some topical cream… It makes sense, really.

  11. JP Says:

    Iggy,

    I wonder if the effect of vitamin A was due to it’s negative impact on vitamin D levels?

    I think the chocolate connection likely has to do with the fact that most chocolate is loaded with sugar and stripped of the naturally occurring antioxidants. Pure cocoa appears to be a powerful antioxidant/anti-inflammatory in many circumstances. That *should* be a positive effect in inflammatory skin disorders.

    Thanks for sharing your experience. Your life certainly is unique and interesting learn about! :)

    Be well!

    JP

  12. JP Says:

    Angie,

    I would think that green tea would be an excellent addition to any homemade skin care recipes.

    I try to brew some organic white tea every day. I use the spent tea bags as a “facial toner”. I just press (virtually) all the liquid out of the tea bags and then rub them on my face and forehead. I figure the antioxidants can only help. Plus, I like to stretch my health care dollar to the maximum. :)

    Be well!

    JP

  13. Per | Healthification.net Says:

    This is very interesting :) I’ve written a post about it at my blog.

    What’s even more interesting is that acne is not found among hunter-gather tribes, who are not a part our wester culture. Except, of course, among those who have changed to a more western diet and lifestyle…

    Per

  14. JP Says:

    Per,

    Thanks for sharing that interesting observation. I do believe that acne is, in part, a manifestation of the typical modern diet and lifestyle. Fortunately, it’s a modifiable risk factor. :)

    Be well!

    JP

  15. Julie Says:

    I liked the comments re: Adult acne perhaps connected to Hormones in milk.
    I’ve started buying my meat from a local butcher that only buys from farmers who don’t use hormones and preservatives etc…but I think I will switch to Organic milk. I don’t know if I’ll go as far as Raw milk yet. If I see an improvement, I’ll definately stick to it for all of my family. I don’t want my daughter to start puberty any earlier either.

  16. JP Says:

    Julie,

    I think that choosing healthier/more natural sources of dairy and meat is one of the best dietary decisions we can all make.

    I’m confident and hopeful that this simple change will help you and your family achieve better overall health.

    Be well and happy holidays!

    JP

  17. Linda Says:

    I have been plagued with adult onset acne since menopause. Through trial and error, I have found that the most helpful thing for me is eliminating dairy that is labeled Rbgh/Rbst free on the package or eating only organic dairy. This means also cutting out dairy in most candies, such as milk chocolate, and in other processed foods as these products would not normally contain Rbst/Rbgh free dairy.
    Thanks for the great service you provide with this website. I happened upon it researching Umcka. The article was very informative. I can’t wait to read some of your other articles.
    Linda

  18. JP Says:

    Thank you for sharing your experience with us, Linda! It’s very valuable to know what techniques have worked for others. :)

    I’m happy to know that you’re enjoying the site. Please feel free to stop by often and ask any questions that may come to mind.

    Be well!

    JP

  19. JP Says:

    More evidence supporting the use of essential fatty acids:

    http://www.medicaljournals.se/acta/content/?doi=10.2340/00015555-1802&html=1

    Acta Derm Venereol. 2014 Feb 18. doi: 10.2340/00015555-1802.

    Effect of Dietary Supplementation with Omega-3 Fatty Acid and gamma-linolenic Acid on Acne Vulgaris: A Randomised, Double-blind, Controlled Trial.

    Jung JY1, Kwon HH, Hong JS, Yoon JY, Park MS, Jang MY, Suh DH.

    This study was undertaken to evaluate the clinical efficacy, safety, and histological changes induced by dietary omega-3 fatty acid and γ-linoleic acid in acne vulgaris. A 10-week, randomised, controlled parallel dietary intervention study was performed in 45 participants with mild to moderate acne, which were allocated to either an omega-3 fatty acid group (2,000 mg of eicosapentaenoic acid and docosahexaenoic acid), a γ-linoleic acid group (borage oil containing 400 mg γ-linoleic acid), or a control group. After 10 weeks of omega-3 fatty acid or γ-linoleic acid supplementation, inflammatory and non-inflammatory acne lesions decreased significantly. Patient subjective assessment of improvement showed a similar result. Heamatoxylin and eosin staining of acne lesions demonstrated reductions in inflammation and immunohistochemical staining intensity for interleukin-8. No severe adverse effect was reported. This study shows for the first time that omega-3 fatty acid and γ-linoleic acid could be used as adjuvant treatments for acne patients.

    Be well!

    JP

  20. JP Says:

    Updated 09/04/15:

    http://www.ijaaonline.com/article/S0924-8579%2814%2900345-8/abstract

    Int J Antimicrob Agents. 2015 Feb;45(2):106-10.

    Treatment of acne with tea tree oil (melaleuca) products: a review of efficacy, tolerability and potential modes of action.

    •Tea tree oil products reduce lesion numbers in patients with mild-to-moderate acne.

    •The tolerability of tea tree oil products is similar to other topical treatments.

    •Efficacy may be attributed to antimicrobial and anti-inflammatory activities.

    Be well!

    JP

  21. JP Says:

    Updated 1/4/16:

    http://onlinelibrary.wiley.com/doi/10.1111/ijd.13188/abstract

    Int J Dermatol. 2015 Dec 29.

    Dark chocolate exacerbates acne.

    The effects of chocolate on acne exacerbations have recently been reevaluated. For so many years, it was thought that it had no role in worsening acne. To investigate whether 99% dark chocolate, when consumed in regular daily amounts, would cause acne to worsen in acne-prone male subjects, twenty-five acne prone male subjects were asked to consume 25 g of 99% dark chocolate daily for 4 weeks. Assessments which included Leeds revised acne scores as well as lesion counts took place weekly. Food frequency questionnaire was used, and daily activities were recorded. Statistically significant changes of acne scores and numbers of comedones and inflammatory papules were detected as early as 2 weeks into the study. At 4 weeks, the changes remained statistically significant compared to baseline. Dark chocolate when consumed in normal amounts for 4 weeks can exacerbate acne in male subjects with acne-prone skin.

    Be well!

    JP

  22. JP Says:

    Updated 08/16/16:

    http://onlinelibrary.wiley.com/wol1/doi/10.1111/jdv.13835/abstract

    J Eur Acad Dermatol Venereol. 2016 Jul 16.

    Acne and dairy products in adolescence: results from a Norwegian longitudinal study.

    BACKGROUND: Acne is a very common skin condition, and it is of great interest to elucidate lifestyle factors that may contribute to its occurrence. In the last decade, the acne-diet connection has been brought back to credibility.

    OBJECTIVE: To examine whether high intakes of dairy products in early adolescence is associated with moderate to severe acne in later adolescence.

    METHODS: The study is a longitudinal, questionnaire-based population study of Norwegian adolescents. Students attending the 10th grade (15-16 years old) of compulsory schooling in Oslo in 2000-2001 and the 13th grade (18-19 years old) 3 years later, in 2004, were invited. Dairy product consumption was self-reported at age 15-16 and acne severity was self-assessed and reported at age 18-19.

    RESULTS: The overall prevalence of moderate to severe acne was 13.9%. High intakes (≥2 glasses per day) of full-fat dairy products were associated with moderate to severe acne. In boys with exclusively high intakes of full-fat dairy products, the odds ratio for acne was 4.81 (1.59-14.56). A high total intake of dairy products was associated with acne in girls (OR 1.80, 1.02-3.16). No significant associations were found between acne and intake of semi-skimmed or skimmed dairy products, and not with moderate intakes of any fat variety of dairy products.

    CONCLUSION: This study shows association between high intakes of dairy products and acne in adolescence. Our findings support a hypothesis suggesting that dairy consumption may be a factor contributing to acne. The study is based on multiple hypothesis testing, and the methodological limitations must be considered when interpreting the results.

    Be well!

    JP

  23. JP Says:

    Updated 09/01/16:

    http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0161162

    PLoS One. 2016 Aug 25;11(8):e0161162.

    Comparison of Vitamin D Levels in Patients with and without Acne: A Case-Control Study Combined with a Randomized Controlled Trial.

    BACKGROUND: Vitamin D plays an important role in the immune system, and its deficiency has been implicated in various skin diseases, including atopic dermatitis and psoriasis. Acne is a common inflammatory skin disease; however, the association with vitamin D remains unclear.

    OBJECTIVES: We evaluated vitamin D levels in patients with acne to determine the effect of vitamin D supplementation.

    METHODS: This study included 80 patients with acne and 80 healthy controls. Serum 25-hydroxyvitamin D (25(OH)D) levels were measured, and demographic data were collected. Vitamin D-deficient patients were treated with oral cholecalciferol at 1000 IU/day for 2 months.

    RESULTS: Deficiency in 25(OH)D was detected in 48.8% of patients with acne, but in only 22.5% of the healthy controls. The level of 25(OH)D was inversely associated with the severity of acne, and there was a significant negative correlation with inflammatory lesions. In a subsequent trial, improvement in inflammatory lesions was noted after supplementation with vitamin D in 39 acne patients with 25(OH)D deficiency.

    LIMITATIONS: Limitations of the study include the small number of patients in the supplementation study and the natural fluctuation of acne.

    CONCLUSIONS: Vitamin D deficiency was more frequent in patients with acne, and serum 25(OH)D levels were inversely correlated with acne severity, especially in patients with inflammatory lesions.

    Be well!

    JP

  24. JP Says:

    Updated 09/14/16:

    http://www.wageningenacademic.com/doi/abs/10.3920/BM2016.0089?url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org&rfr_dat=cr_pub%3Dpubmed&

    Benef Microbes. 2016 Sep 6:1-6.

    Supplementation with Lactobacillus rhamnosus SP1 normalises skin expression of genes implicated in insulin signalling and improves adult acne.

    Systemic supplementation with probiotics is increasingly being explored as a potential treatment strategy for skin disorders. Because both the gut-skin axis and dysregulation of insulin signalling have been implicated in the pathogenesis of adult acne, we designed the current study to evaluate the effect of supplementation with the probiotic strain Lactobacillus rhamnosus SP1 (LSP1) on skin expression of genes involved in insulin signalling and acne improvement in adult subjects. A pilot, randomised, double-blinded, placebo-controlled study was conducted with 20 adult subjects (14 females and 6 males; mean age: 33.7±3.3 years) with acne. Over a 12-week period, the probiotic group (n=10) consumed a liquid supplement containing LSP1 at a dose of 3×109 cfu/day (75 mg/day), whereas the placebo group (n=10) received a liquid lacking probiotics. Paired skin biopsies – one obtained before treatment initiation and one obtained at the end of the 12-week treatment period – were analysed for insulin-like growth factor 1 (IGF1) and forkhead box protein O1 (FOXO1) gene expression. The clinical criterion for efficacy was the investigator’s global improvement rating on a five-point scale. Compared with baseline, the probiotic group showed a 32% (P<0.001) reduction, as well as a 65% increase (P<0.001) in IGF1 and FOXO1 gene expression in the skin, respectively. No such differences were observed in the placebo group. Patients in the probiotic group had an adjusted odds ratio of 28.4 (95% confidence interval = 2.2-411.1, P<0.05) to be rated by physicians as improved/markedly improved (versus worsened or unchanged) compared with the placebo group. We conclude that supplementation with the probiotic strain LSP1 normalises skin expression of genes involved in insulin signalling and improves the appearance of adult acne.

    Be well!

    JP

  25. JP Says:

    Updated 01/09/17:

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5183780/

    Postepy Dermatol Alergol. 2016 Dec;33(6):416-420.

    The possible role of diet in the pathogenesis of adult female acne.

    Acne in adults is a chronic, increasingly common disease, especially among women. It differs in pathogenesis and clinical presentation from adolescent acne. Acne in adults is associated with Western diet, defined as high consumption of milk, high glycemic load and high calorie intake. Metabolic signals of this diet result in a significant increase in insulin/insulin growth factor 1 serum level and consequently in the molecular interplay of mammalian target of rapamycin complex 1 kinase (mTORC1)/forkhead box protein 1 (FoxO1) mediated nutrient signaling, leading to increased proliferation of keratinocytes, increased lipogenesis and sebum production and finally to aggravation of acne.

    Be well!

    JP

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