As an acne sufferer of over a decade, I understand how much acne impacts on your daily life. It effects your self-esteem, your moods, your social activities (any one else afraid of going to the beach without makeup?), how you interact with the world around you and so much more. But it has also allowed me to understand my clients that have acne and I am continually learning and researching on how best to support my patients who have this condition. Acne is a multifaceted condition and what works for one person might not work for someone else. And in my experience, not only do the symptoms and treatment vary from person to person, but it can vary for the same individual during their lifetime.
In an attempt to provide a variety of information, I've put together a summary of causes, triggers, home advice, professional treatments, nutritional information and anything else I could find to help you understand acne and all its components a little better.
What causes acne? (1)
There seems to be a general consensus that acne is caused by a combination of the following:
- Excess oil production (potentially from a hormone imbalance/excess androgens)
- Clogged hair follicles (can be from wearing makeup that clogs the skins)
- Hormonal imbalances (the balance of hormones is critical to skin health and can be disrupted easily)
What makes acne worse? (1)
- Hormones (again, excess androgens or hormone imbalances)
- Certain medications. Drugs that contains corticosteroids, testosterone or lithium can contribute to the worsening of acne. (1)
- Diet. There has been lots of debate about the relationship between diet and acne over the years. However, recent studies have suggested a close relationship between the two. Low glycemic index diets show beneficial results for people with acne as well as diets high in omega-3s. With this in mind, I usually recommend to clients to follow a low GI, mediterranean type diet. (4, 9)
- Stress. While stress doesn't directly cause acne, it can be linked to worsening of acne and/or new breakouts. This is because when we are stressed our cortisol levels rise which then increases oil production. If you are prone to stress then find ways to manage it. Regular exercise, meditation and even counselling can help you keep your stress in check. (2)
What can I do at home to help with my acne?
- Keep your makeup brushes clean and wash your pillowslips weekly. This has been drilled into me since I was a teenager. I'd like to add though that avoiding harsh chemical cleaners is best. Try using a natural shampoo to clean your brushes.
- Make sure you have a few makeup free days each week. The less we cover our skin with synthetic chemicals, the more chances we give the skin to heal.
Are there certain foods I should include in my diet to help my skin?
Yes! Here are a few of my general acne diet tips.
- Spearmint tea. Has anti-androgen properties as it reduces the level of free testosterone in the blood. (6)
- Green tea. Green tea may provide an anti-androgen effect as well. (6)
- Water. Minimum of 2L per day. This helps to keep us hydrated and support our elimination processes.
- Fibre. Making sure you are getting the recommended daily intake of fibre is important for your overall health as well as the health of your skin. 20-30g of fibre daily is recommended. (9)
- Fish. Fish contains omega-3 fatty acids which have anti-inflammatory properties. There is some research to show the benefits of omega-3s in people suffering moderate to severe acne. 1-2 serves per week is ideal. (12)
What foods should I avoid?
This answer varies from person to person, and my professional advice is to seek out a qualified health professional such as a clinical nutritionist, naturopath or Chinese medicine practitioner that works with skin to provide personalised advice. Here are a few general tips for what foods to avoid.
- Dairy. It's quite widely accepted now that dairy can contribute to acne. Look for dairy alternatives like almond milk or coconut yogurt, but be mindful of the added sugars (9)
- Refined sugar/processed foods including fruit juices. Eat the whole fruit instead. The fibre helps to slow the sugar being dumped into the liver.
- Limit caffeine. Coffee is a known hormone disrupter and if your hormones are out of whack, coffee could be exacerbating your acne. I limit my coffee to one per day, either black coffee or with a dash of almond or coconut milk. (11)
- Smoking. I feel like this one goes without saying but thought I should include it. Smoking is a nightmare for acne prone skin (plus so many other things).
What supplements should I be taking?
I always recommend seeking out professional advice before taking supplements, however as there is information all over the internet regarding this I thought it would be helpful to put a few of my favourite ones here.
- Zinc. Zinc is a potent immune modulator, helps to fight viruses and bacteria and produces anti-inflammatory effects. Zinc is an effective, low cost, low side effect addition to any acne treatment. (8)
- Probiotics. There is growing evidence to support the use of probiotics in the treatment of acne as certain strains directly inhibit the acne bacteria through the production of antibacterial proteins. (15)
- A hormonal balancing product. This will every much depend on your individual presentation. Some women are oestrogen dominant and would require an oestrogen-clearing products while others are progesterone deficiency or have high testosterone. Men can also experience hormonal imbalances including high or low testosterone. Your health care provider will be able to assist you in determining your particular hormonal issue.
Should I seek professional support for my acne?
If your acne feels out of control and is affecting your daily life then I would definitely recommend seeking support. I find the combination of a good skin therapist and a qualified holistic health practitioner works well. Your qualified skin expert will be able to provide advice for a daily, at home treatment regime, as well as providing you with regular treatments to help clear and calm your skin. I found my lovely skin lady through a mutual friend and she has been helping me so much! Her knowledge of the skin is incredible and her treatments, while therapeutic, are also incredibly relaxing. Sarah, owner of Glow Skin Studio, you are a life saver.
When selecting your health professional to help you with your acne, you have a few options. Over the years I have found that Chinese medicine, acupuncture and naturopathy have been of assistance, not just with my acne but with many of the other contributing factors including stress and digestion. My biggest mistake was not sticking to the treatments. Usually a minimum of 3 months is recommended, followed up with ongoing check ins to make sure everything remains in balance.
How can Acupuncture and Chinese medicine help acne?
While further research in this area is still needed, there are some research papers that support the use of acupuncture and Chinese medicine for the treatment of acne. The research has found that there was no significant difference between acupuncture and pharmaceutical drugs, however the acupuncture treatments reported less side effects. (13, 14)
The main benefit that I find with acupuncture is that its holistic approach means your treatment will be specific to you. Any supplements, herbal prescriptions, dietary advice are all based entirely on YOUR body.
Your skin is a reflection of your internal health. Look after your insides like you would your outside.
4. Pappas, A. (2009). The relationship of diet and acne. Dermato-Endocrinology, 1(5), pp.262-267.
6. Grant, P. and Ramasamy, S. (2012). An Update on Plant Derived Anti-Androgens. International Journal of Endocrinology and Metabolism, 10(2), pp.497-502.
7. Tolino, E., Skroza, N., Mambrin, A., Bernardini, N., Zuber, S., Balduzzi, V., Marchesiello, A., Proietti, I. and Potenza, C. (2018). Novel combination for the treatment of acne differentiated based on gender: a new step towards personalized treatment. Giornale Italiano di Dermatologia e Venereologia, 153(6).
8. Cervantes, J., Eber, A., Perper, M., Nascimento, V., Nouri, K. and Keri, J. (2017). The role of zinc in the treatment of acne: A review of the literature. Dermatologic Therapy, 31(1), p.e12576.
9. Kucharska, A., Szmurło, A. and Sińska, B. (2016). Significance of diet in treated and untreated acne vulgaris. Advances in Dermatology and Allergology, 2, pp.81-86.
10. MacKenzie, T., Comi, R., Sluss, P., Keisari, R., Manwar, S., Kim, J., Larson, R. and Baron, J. (2007). Metabolic and hormonal effects of caffeine: randomized, double-blind, placebo-controlled crossover trial. Metabolism, 56(12), pp.1694-1698.
12. Khayef, G., Young, J., Burns-Whitmore, B. and Spalding, T. (2012). Effects of fish oil supplementation on inflammatory acne. Lipids in Health and Disease, 11(1), p.165.
13. Mansu, S., Liang, H., Parker, S., Coyle, M., Wang, K., Zhang, A., Guo, X., Lu, C. and Xue, C. (2018). Acupuncture for Acne Vulgaris: A Systematic Review and Meta-Analysis. Evidence-Based Complementary and Alternative Medicine, 2018, pp.1-12.
14. Cao, H., Yang, G., Wang, Y. and Liu, J. (2013). Acupoint Stimulation for Acne: A Systematic Review of Randomized Controlled Trials. Medical Acupuncture, 25(3), pp.173-194.
15. Kober, M. and Bowe, W. (2015). The effect of probiotics on immune regulation, acne, and photoaging. International Journal of Women's Dermatology, 1(2), pp.85-89.