Written by: Emily Elliot
Edited by: Ali Cockerill

Many patients concerned with acne arrive at the naturopathic doctor perplexed and frustrated as they express, ‘I have tried everything and nothing works!’ While the number of ‘acne fighting’ products that line the shelves of drug stores and supermarkets are constantly growing and promises of clear skin are endless, the treatment of acne is complex and the exact science has not yet been discovered. While the exact pathogenesis of acne is still largely a topic of scientific investigation, the good news is that many lifestyle changes have well documented results. Additionally, acknowledging that as patients that their hormonal status is unique may be a starting place for answers. While expensive lotions and creams are an excellent addition to a proper skin care regiment, acne is truly a journey from the inside out. Our skin is a very important messenger that can offer us insight into what is happening internally. Let’s review some of the strategies that are effective for clearing up the skin.

Mastering your meals, the best diet for acne:
The debate on whether or not diet contributes to acne is longstanding. However, studies are finally identifying what dermatologists have always truly known – yes, there is definitely a link between diet and breakouts. It is no coincidence that some non- Westernized populations report almost zero occurrence of acne lesions! (1)
Specifically, studies have shown reduced acne lesions and the associated improvements in insulin sensitivity with the consumption of a lower glycemic diet (RCI) (1). A diet in higher glycemic foods will ultimately spike blood sugars leading to increased androgens and IGF-1, which increases secretion of oil and clogs pores.

A low glycemic diet for acne should include lots of healthy fats (olive oil, fatty fish, nuts and seeds), plenty of fibre (25 g for women and 38 g for men), lots of dark leafy greens and an appropriate protein calculation for one’s body weight (a minimum of 0.8g/Kg of body weight). The anti-acne diet should also minimize dairy products as they have also been linked to increased IGF-1 production.

Focusing on lymph is no waste:
Exercise recommendations for the patient with acne can be met with some resistance. Fears may emerge regarding how ‘sweat build up’ may detriment the skin. However, it is important to focus on the benefits that come from regular exercise and to promote proper hygiene practices before and after workouts. Many patients working with acne have issues detoxifying and may display signs of a sluggish lymphatic system like: allergies, itching, chronic fatigue etc. Recommendations like cycling, running, walking, yoga and ‘rebounding’ (trampoline jumping) have all been documented for their lymphatic benefits (2). Through daily movement and generating lymphatic flow, the body brings forth oxygen and nutrients to the skin’s surface as it works to eliminate cellular debris and waste products that can build up in acne (3). There really is no substitute for a healthy, active lifestyle. Explaining the mechanics of lymphatic detox may empower the patient to see how movement can positively promote their anti-acne efforts.

Tame hormonal havoc:
Once diet and lifestyle have been approached, hormonal status is a vital part of the acne investigation. Hormonal acne is often linked to the menstrual cycle and can appear around the region of the chin, hairline and back. High androgens (testosterone and its breakdown product dihydrotestosterone) are frequently cited as a hormonal cause of acne (voice changes, hair loss on the head, irregular menstrual cycles in women, weight gain etc.)(4). However, it is important to rule out other hormonal presentations that could use balancing. For example, are there signs of high progesterone (depression, weight gain and increased fat storage, poor blood sugar balance) or low progesterone (hair loss, anxiety, increased allergies, sluggish metabolism etc.) (4). Testosterone, estrogen and progesterone all keep each other in fine balance, so don’t forget to assess all three of these important hormones. (Note: high cortisol can be implicated in testosterone production as well, a quick check on cortisol status may be well indicated too).

Skin superstars: In general, improving skin vitality and health relies on a few key players. Typical recommendations are Vitamin A 25000-50000 IU (contraindicated in pregnancy), Vitamin C 1000-5000 mg and Zinc 15-25 mg, making Cyto-Matrix’s ‘ACEs and Zinc’ truly a ‘skin basic’ (5). Reduced levels of serum zinc have also been identified in patients with increased acne lesions making it an excellent addition to the anti-acne treatment plan (1).

Essential fatty acids are also crucial in maintaining that healthy skin glow we all long for. EFAs found in Cyto-Matrix’s Omega D3 liquid forte not only hydrate the skin and replenish the skin’s barrier but also offer anti-inflammatory properties that are highly beneficial in an inflamed condition like acne. An important focus in skincare is not just combating the condition but also promoting the formation of healthy skin in general.

Boosting bowel terrain:
Oral probiotics help to reduce systemic inflammation and oxidative stress that are characteristic of acne as well as modulate IGF-1, one of the primary proteins linked to acne proliferation. The benefits of supplementation have also been documented for patients who are taking antibiotic treatment and suffering from the side effects of these treatments. One study showed the synergistic benefit of taking probiotics with minocycline when compared to the antibiotic alone as the combination group showed the greatest reduction in acne lesions when compared to the other controls (6).

Mindful medicine for acne:
The emotional effects of acne can be intense and extensive. One important study revealed that even in patients with mild acne, there were feelings of low self-esteem, depression and suicidal thoughts (7). Checking in on one’s overall journey with acne and validating their frustration is a crucial part of patient care and may hold one of the final pieces of the puzzle. When mind, body and soul are all honored as part of the patient’s journey, the truest healing begins.

(1) Logan, C and Treloar, V. The Clear Skin Diet. Naperville, IL. Cumberland House Publishing.
(2) Exercise for the Lymphatic System. (2016). Retrieved from http://cancercompassalternateroute.com/detox/various-exercises-for-the-lymphatic-system/#
(3) The Lymphatic System. (2013). Retrieved from http://www.lymphnotes.com/article.php/id/151/
(4) Turner, N. The Hormone diet. USA. Random House.
(5) Natural Ways to Treat and Prevent Acne. (October 2012). Retrieved from http://www.huffingtonpost.ca/natasha-turner-nd/natural-adult-acne-solutions_b_1952491.html
(6) Kober, M and Bowe, W. (2014). The Effect of Probiotic on Immune Regulation, Acne and Photoaging: International Journal of Women’s Dermatology , 1 (85-89).
(7) Dunn, L. (2011). Acne in Adolescents: Quality of life, self-esteem, mood and psychological disorders: Dermatology Online Journal, 17 (1): 1.