Acne: is diet involved?

Where does acne come from and what can be done about it?

Among other roles, our skin is an emunctory, an organ that eliminates waste. So, it's hardly surprising that it's affected by toxins and can be a hotbed of inflammation. Acne cannot be reduced to a problem of diet. But some people are more sensitive than others to the mechanisms involved, which can be influenced, positively or negatively, by what we eat and drink. To fight acne, diet management, combined with other aspects (e.g., hygiene, stress management, sleep management, skin hydration), is a convincing and proven solution.

What is acne? Acne is the result of excess sebum and inflammation. Excess sebum is mainly linked to sex hormones. The inflammatory state, on the other hand, is mainly linked to lifestyle: diet, lack of exercise, etc. That being said, the production of sex hormones is itself the result of various processes within our organism, driven by what we provide it with, i.e., our food. So, we come back to diet, even if not everyone is equally sensitive to hormones. There are teenagers with a very poor diet and a perfect skin...

What dietary factors can promote acne, depending on individual sensitivity?

  1. An inflammatory diet: the most inflammatory foods are red meat, dairy products, fast sugars, salt, gluten, those containing toxic substances (e.g., certain additives) or those prepared in a toxic way (e.g., fried), alcohol and fructose and, in general, processed foods - given their content of saturated and trans-fatty acids, fast sugars, salt, additives, and so on.

  2. A diet that disrupts hormonal balance: a diet rich in fast sugars leads to frequent and high production of insulin, a hormone which in turn acts on the production of sex hormones, in particular androgens*, thus increasing sebum production. Consumption of dairy products is also involved, as milk contains hormones designed to make calves grow, hormones which are, among other things, precursors of testosterone. Non-organic milk also contains antibiotics, which can disrupt the intestinal microbiota, and pesticides, which are inflammatory.

  3. A diet that overloads the body with waste and toxins: processed food (additives, harmful heat treatments, etc.) and hormone-rich foods such as red meat and dairy products, hormones that the body must eliminate.

  4. A diet that weakens the skin's defenses: a diet deficient in vitamins and minerals, which are antioxidants, and/or omega 3 fatty acids, which are anti-inflammatory.

In summary, the following are unfavorable:

  • Red meat, dairy products, salt, gluten, industrial foods, fried and roasted foods, alcohol, fructose, fast sugars (e.g., cookies, cakes, pastries, fruit juices, refined cereal-based foods such as white bread and pasta).

  • The lack of omega 3 fatty acids (found in oily fish, vegetable oils and oilseeds), both in absolute terms and in relation to omega 6 fatty acids.

  • The lack of vitamins and minerals (the main source of which is fruit, vegetables, oilseeds and seeds, to simplify).

If you have acne, you should opt for a diet that's as natural and varied as possible and follow the recommendations for a good diet, which include a strict limit on fast sugars. Of course, this may seem daunting and unfair to the teenagers concerned, especially as some of their friends have no acne, even with a very bad diet. It's important to know and accept that we're not all equal in this respect.

In terms of micronutrients, a natural, diversified diet should provide everything you need, but you must ensure that you supplement your diet with vitamin D and take enough zinc. Vitamin D is anti-inflammatory. Zinc is also anti-inflammatory and improves healing.

You also need to pay close attention to the quality of your intestinal microbiota and, when in doubt or in the event of signs of dysbiosis, consider taking probiotics. Probiotics are dietary supplements containing bacteria that promote good intestinal health. A good microbiota also has a positive impact on stress.

Diet has a fundamental role to play in the fight against acne, for those who suffer from it, but it will often be necessary to act on other aspects of lifestyle as well:

  1. Skin hygiene: avoid touching your face without first washing your hands. I recommend using a turmeric soap morning and night. Turmeric is a natural antiseptic, successfully used as anti-acne treatment in certain populations. Smoking aggresses the skin and reduces its resistance to inflammation. Limit the use of cosmetic products and choose those that are non-comedogenic. Don't forget to moisturize your skin: even if acne-prone skin is rather oily, it still needs hydration to resist aggression.

  2. Stress management: in response to stress, our bodies produce more androgens. This explains why acne can be a permanent issue when we're under chronic stress. Acne usually disappears when you're on vacation, only to flare up again when you return to everyday life. Meditation, cardiac coherence (five minutes three times a day can already make a big difference), yoga, sport, etc., are interesting ways of reducing and better managing stress. If, for example, you walk for at least 30 minutes twice a day, this will also have a beneficial effect. Adequate dietary intake of magnesium (or supplementation, if necessary) also helps to modulate stress.

  3. Sleep management: lack of sleep and disruption of sleep/wake rhythms are damaging to the skin.

  4. Regular physical exercise: a sedentary lifestyle is also bad for the skin.

Menstrual acne is clearly hormonal acne, resulting from the disruption of the balance between androgens and estrogens and/or a poor balance between estrogens and progesterone, during the week preceding menstruation, when estrogen levels fall. This poor balance implies greater stimulation of the sebaceous glands and, consequently, higher sebum production. That said, not all women have the same amplitude of hormonal variations, nor the same sensitivity of their sebaceous glands to these variations.

As far as oral acne medications are concerned, I encourage you to use them only as a very last resort, after taking all the above into account. It may be tempting to resort to them, but they are not harmless. First of all, like all medicines, they must be metabolized by the liver, our detoxification organ, which is already under great strain from our Western diet. It’s also the liver that helps maintain our hormonal balance by eliminating excess hormones. Secondly, retinoids have undesirable effects (e.g., dryness of mucous membranes, including eyes and lips, and of the skin, photosensitivity reactions). They can also cause fetal malformations in the event of pregnancy. Finally, they can lead to lipid metabolism disorders with health risks and to serious psychiatric problems. Antibiotics, for their part, contribute to antibiotic resistance and alter the intestinal microbiota, while tetracyclines inhibit intestinal absorption of calcium and magnesium and increase urinary excretion of vitamin C.

As an alternative, some people take dietary supplements with, next to vitamin D, zinc and omega-3 EPA and DHA, also omega 6 gamma-linolenic acid (GLA) in the form of borage or evening primrose oil, which is also anti-inflammatory. Why not, but in my opinion not as a replacement for a good diet, but rather as a support, because they won't replace all the benefits of a good diet.

Even today, there are still dermatologists who claim that diet has nothing to do with acne. This is due to the difficulty of conducting robust studies and the discrepancy of certain data, on the one hand, and the pharmaceutical industry lobby, on the other. The fact that some people don't get acne, even with a very bad diet, may also contribute to this idea. Yet the evidence is there. People who fast for a week see a marked improvement in the appearance of their skin, and a clear reduction in acne if they have any. The same goes for those who switch to a meat-free, dairy-free diet based on vegetables, seeds, legumes, and oilseeds.

*Androgens are the male sex hormones (also present in women, albeit in smaller quantities): testosterone, DHEAS (dehydroepiandrosterone sulfate) and DHT (dihydrotestosterone). They stimulate the growth of sebaceous glands and thus sebum production

To find out more, also read these articles:

Young man's picture by Nikolay Vybornov