Every acne patient has one question burning in their minds. How can I get rid of this? What can I do to get clear skin? Often dermatologists are powerless to help, and acne always comes back. The web is full of contradicting advice and leaves you just more confused.
So in this post I wanted to give you a brief overview of natural and drug-free ways to treat acne. The web is full of hype and exaggerations about natural acne treatments. So in this post I also want to talk a bit about what you can expect from them and what you can’t expect. Just so you don’t go in with too high expectations and end up disappointed later down the road.
Brief on what causes acne
Before we talk about treating acne, I want to briefly touch on what causes acne. It gives a bit of perspective on why the treatment suggestions are effective. First, we can’t ignore the role genes play in acne. Genes make acne-prone skin extra sensitive to hormones. They also put the skin immune system into hyperactive state. And because acne is so strongly genetic it’s incurable (at least with today’s technology).
All acne is to some degree hormonal. Because of genetic sensitivity certain hormones cause acne-prone skin to produce more sebum and increase the number of skin cells. This is the perfect recipe for blocked pores. Finally, inflammation damages the sebum and alters the environment in the blocked pore to be more suitable for P. Acnes bacteria. The bacteria multiply inflammation and cause the redress and swelling of the pimple.
As you can see acne is a complicated problem, and in many cases there are no simple solutions. You probably have to attack it from many angles, and especially so if you suffer from persistent adult acne.
So let’s talk about some things you can do.
Stabilize blood sugar levels
Despite the long-standing denial by dermatologists diet does affect acne. Studies have found that emphasize low glycemic index foods and where sugar and simple carbohydrates are avoided improve the skin. They are far from complete cures, but you can expect your skin to get better.
These diets work because they lower insulin and blood sugar levels. While acne is primarily affected by androgen hormones (male sex hormones) insulin and related hormones multiply the effect androgens have on the skin. They not only stimulate the release of androgens from the liver, but also increase the sensitivity of the skin to androgens. That’s why a diet that maintains steady blood sugar and insulin levels usually lead to improvements in acne.
Another thing you can try is to switch from saturated fats to monounsaturated fats (such as found in nuts and seeds and olive oil). Saturated fats can cause insulin resistance whereas most unprocessed plant fats reduce insulin resistance – and thus lower insulin levels.
So the overall best approach is to eat a balanced diet with somewhat reduced carbohydrate intake. A good ratio to start with is 50/30/20; meaning 50% of calories should come from carbohydrates, 30% from fat and 20% from protein, with emphasis on low glycemic index carbohydrates and healthy fats.
Studies have consistently found that inflammatory damage contributes to acne. Patients have lower levels of antioxidants and higher levels of inflammatory chemicals both in the blood and on the skin. This increased oxidative stress leaves the skin vulnerable to inflammation and makes it more acne-prone.
That’s why it’s important to take steps to calm down inflammation and increase the body’s antioxidant reserves. Here are some things you can do:
- Eat your fruits and vegetables. These foods are loaded with vitamins and antioxidants your body desperately needs.
- Omega 3/6 balance. Western diets in general are too high in omega 6 fats and too low in omega 3 fats. Because of the way the body uses these fats this imbalance causes inflammation. Reduce consumption of omega 6 fats and increase your intake of omega 3 fats (such as flax seeds and fatty fish).
- Manage stress. Chronic stress puts the body through a lot of inflammation. Do your best to manage your stress. Just 15 minutes of meditation or listening to relaxation CD can do wonders for your stress levels.
- Supplements. A handful of studies have shown that antioxidant supplementation helps acne. Most studies find that 30mg of zinc helps quite a bit. Selenium and vitamins E and B3 can also help.
Some alternative medicine proponents claim that all disease begins in the gut. While that counts more as hype than reality gut problems do play a role in acne. For example studies have found higher prevalence of gut and digestive problems among acne patients than controls with healthy skin. Gut problems increase inflammation levels in the body and may contribute to development of food allergies and sensitivities.
Not only studies show higher prevalence of gut problems among acne patients, but also that treating the gut problems also helps the skin. Again, this is not a complete cure, but another piece of the puzzle. You can try these things:
- Probiotics. Probiotic are the so-called healthy bacteria in the gut. In gut problems the bacterial balance has shifted towards harmful bacteria that also reside in the gut. Probiotics help to shift the balance towards the ‘good guys’. Supplements can help, but you should also consider fermented foods, such as homemade yogurt and kefir.
- Plant fiber. Plant fiber contains substances that feed the probiotic bacteria, also known as prebiotics. Eat a wide variety of fruits and vegetables ensure adequate intake.
- Remove irritating foods. Foods can trigger an immune response that causes damage in the gut. Gluten is perhaps the best known. Gluten is not a problem for every acne patient, but undiagnosed gluten sensitivity causes acne for some people. Trying gluten free diet for 3 to 4 weeks is a good idea to eliminate this possibility. Aside from gluten finding problem foods can be hard and take a lot of effort. That’s why I don’t recommend it only as the last option when you feel like you are really stuck.
No acne treatment is complete without topical remedies. Aside from certain prescription drugs no internal treatment can address the genetic sensitivity to hormones. Acne-prone skin not only has more hormone receptors than healthy skin, but enzymes that activate the hormones are also more active in acne-prone skin. There’s nothing we can do to cure this, but with smart topical treatments we can mitigate the damage.
Mitigate genetic disposition
Dihydrotestosterone (DHT for short) is a key hormone behind acne. It stimulates sebum production and skin cell growth far more potently than other hormones. The skin converts DHT from testosterone with the help of an enzyme called 5-alpha reductase, and this conversion is overactive in acne patients. Substances known as 5-alpha reductase inhibitors can hinder the conversion and mitigate the damage genetic sensitivity. Here are some:
- Green tea, or more specifically the epigallocatechin gallate (EGCG) found in green tea
- Saw palmetto
- Gamma-linoleic acid (GLA), found in evening primrose oil and many seed oils
Note that you have to apply these remedies topically on your skin for them to be effective.
Until recently it was thought that it’s the bacteria that trigger the acne formation. But recent research has called this into question. New studies show that inflammation is present even at the earliest stages of the pimple formation process and that inflammation of sebum changes the environment in the blocked pore to be more suitable for P. Acnes bacteria.
What this means is that if you can protect the skin from that initial inflammation you may be able to prevent the pimple from ever forming. This is where anti-inflammatory topical remedies can help. Things like:
- Vitamin E is the primary antioxidant protecting sebum.
- Vitamin C is another antioxidant and works together with vitamin E.
- Zinc is another important antioxidant in the skin.
- Green tea has high antioxidant potential and studies have found green tea creams to be as effective as benzoyl peroxide in treating acne.
Many acne patients shy away from moisturizing the skin. The rationale being that the skin is already too oily. But the problem is that extra sebum isn’t doing what moisturizer should do.
Weakened skin barrier function is a feature in many skin conditions, acne included. The skin acts as a barrier between you and the outside world. It regulates moisture and protects the vital organs from drying. It also bars bacteria and pathogens from entering the body. Weakened skin barrier function makes the skin more sensitive and susceptible to inflammation.
Moisturizers bind water into the skin and help to repair the skin barrier function. That’s why a good moisturizer is essential for clear and healthy skin. Choose a moisturizer that’s formulated for facial skin. To kill two birds with one stone you can also find a moisturizer with green tea, vitamin E or some other anti-inflammatory substances.
Standard acne treatment advice
So far we haven’t talked much about standard acne treatment advice. Not because it doesn’t work, but because you probably know much of it already. It bears saying that you should still do the following:
- Antibacterial treatments with careful use of benzoyl peroxide, salicylic acid or tea tree oil.
- Keeping the skin pores open with salicylic acid or other anti-keratolytic agents.
- Occasionally using scrubs to prevent the skin from clogging.
Putting it all together
I realize that after reading this you may feel like you need to spend half of your life in bathroom with different creams and lotions. But fear not, thou shall have a life outside the bathroom also.
You probably have to go beyond just a basic cleanser, but there’s no need to fill your bathroom with countless bottles. You should be able to get away with the following:
- Cleanser, preferably something with benzoyl peroxide, salicylic acid or tea tree oil to control bacteria.
- Serum or leave-on lotion to apply after the cleanser. This should include some anti-inflammatory ingredients and possibly salicylic acid.
- Anti-inflammatory moisturizer.
- Scrub to use once or twice a week.
This should be a good acne treatment kit to start with. As you choose your products mind what your skin can handle and what it cannot handle, especially when it comes to medications and chemicals.
The web is full of outlandish claims with little basis on reality. I think it’s important that you get into this with realistic expectations. To avoid disappointment and quitting because of ‘lack of results’. So let’s first acknowledge the fact that acne currently can’t be cured. Because of genetic tendencies acne-prone skin is sensitive to hormones and prone to excess inflammation. No treatment can fix that.
What we can do is manage and mitigate. Proper dietary and lifestyle choices help to keep hormones and inflammation under control. And smart topical treatments mitigate the sensitivities in the skin itself.
How far these will take you? That I can’t say for sure. It’s likely you’ll see a significant reduction in the number of pimples and severity of acne. It’s not uncommon for severe cystic acne to be reduced to the occasional pimple. But it’s unlikely that these are enough to get you completely clear. And it’s highly likely that you will get occasional breakouts – especially during stressful times.
We covered a lot of ground in this. So let’s pull out the important messages for take-home pointers.
- Because of genes acne-prone skin is extra sensitive to hormones and inflammation. These hormones cause excess sebum production and abnormally high rates of skin cell growth leading to blocked pores.
- Initial inflammation in the skin pore makes the environment within the pore ideal for P. Acnes bacteria. The bacteria stimulate further inflammation and turn the blocked pore into a pimple.
- A balanced diet with emphasis on low glycemic index carbohydrates and healthy fats help to balance the hormones.
- Regular consumption of fruits and vegetables and balancing omega 3/6 fatty acid intake provides much needed antioxidants. Zinc supplementation has also been shown to help as it further boosts the body’s antioxidant potential.
- Gut healing may be the missing link from many acne treatment programs. Studies show that acne patients have higher rates of bacterial overgrowth and other gut problems. These cause systemic inflammation and contribute to development of acne. Consumption of probiotics, either from supplements or fermented foods, and prebiotic plant fiber is highly recommended.
- One part of your topical treatment regimen should focus on mitigating genetic disposition with ingredients that inhibit DHT hormone, such as green tea, and provide much needed antioxidants to the skin. Traditional anti-acne advice (antibacterial treatment and keeping the skin pores open) completes your topical treatment regimen.
So that’s it. I hope you found this post useful. If you have questions, please use the comment form below or connect with me in Facebook, Twitter or Google+. And remember to check my website AcneEinstein.com for more information.