Dr. Alan Logan, author of The Clear Skin Diet, came by the show to debunk some of the most popular acne myths and put you on the road to recovery!
Popular Acne Myths
1. Acne is caused by poor hygiene or "dirt" - not true, blackheads are not black from dirt - it is sebum, dead skin cells and immune cells reacting with air...and research shows that washing just twice daily with a mild facial cleanser is the way to go. Washing more often does not help and may even be harmful
2. Acne and diet are unrelated - new research, as discussed, shows this to be untrue
3. Acne and stress/sleep are unrelated - once again, new research shows otherwise
4. Acne is a just a "teenage" problem - not true, one in two women over the age of 26 will experience some degree of acne.
5. Acne is a "simple cosmetic" problem - not true, acne is serious business, rates of depression and clinical anxiety are much higher. Recently a bias was also reported showing that acne was a common reason for corporate recruiters to bypass them as candidates.
6. Acne can be "cured" by benzoyl peroxide and glycolic acid - despite the claims of Hollywood stars, the research on the ingredients as found in infomercial products show only half who use them will see even a modest improvement.
What is acne?
Acne is a disease of the "pilosebaceous unit"...the fancy medical jargon for the pore. Basically there is a buildup of excess sebum, the oily substance that can help block up the pore. Matters are made worse by an overproduction of cells that line the pore wall and then bacteria get into the mix and cause inflammation and the characteristic redness of acne blemishes (or "spots" as they call them in the UK). The blockage can spill over into the surrounding skin areas adjacent to the pore and cause even more painful acne lesions and even cysts.
You say acne is affecting more and more adults - why?
All arrows point to two factors... stress and diet. Overall adults rate themselves as highly stressed, and there have been major changes to the diet in association with the changing rates of acne... greater intake of sugars, vegetable oils, processed foods, high fructose corn syrup and fewer intakes of antioxidant rich fruits, vegetables and whole grains. The stress and diet issues go hand in hand, clearly we don't reach for Swiss chard when we are under stress, we go for the skin aggravating comfort foods high in sugar and the wrong types of fats. The adult acne rates are particularly high in women (one out of every two women over the age of 26 experience some degree of acne).
Why is it more common among women?
It may come down to the physiological gender differences in response to stress. Under stress we release the major stress hormone called cortisol, and cortisol is much more likely to elevate sebum production in females vs. males. The second issue is chronic stress and its influence on the acne-promoting androgens, or so-called male hormones. Under chronic stress a man's androgens will fall off, libido suffers etc, while in females if they are chronically stress with work deadlines, domestic issues and so on, the acne-promoting androgens will rise up steadily. Interesting studies do show that women's stress hormone cortisol levels are higher than men Monday to Friday, but they level off on the weekend and are indistinguishable from men. This supports the notion put forth by some researchers that work stress may be a culprit in acne.
What are the causes of acne?
Genetics and hormones play a major role, you can't have acne in the absence of androgens, those so-called male hormones. Stress and diet can influence how genes are "expressed" i.e. the degree of a genetically mediated condition can be significantly influenced by diet and lifestyle.
How does stress affect your skin? (and cause acne?)
Promotes sebum production, promotes production of inflammatory chemicals in the skin, and increases oxidative stress. Those with acne are already known to have lower levels of antioxidants, so further increasing oxidative stress only increases the burden.
Do people with acne have any nutrient deficiencies?
As mentioned, antioxidants are lower, including zinc and selenium which have important antioxidant and anti-inflammatory activity in the skin. Recent studies have also suggested that omega-3 fatty acids may be lower. Since these nutrients are in great demand in acne, that is to say that they are used up more readily, supplementation may be helpful.
Will the acne ever just go away?
Remissions of acne can certainly occur, although the likelihood of successful outcome will be greatly enhanced with appropriate dermatological care, dietary changes and some key supplements.
What foods should you avoid eating if you suffer from acne? Why?
The first food/beverages to pull out are dairy foods and drinks. There have now been three Harvard studies which have linked dairy, mostly milk, with acne... and it's a linear thing, more milk = greater risk of acne. Interestingly, while cheese and ice cream were implicated to a lesser degree, yogurt was not an acne-promoter in all three studies. Why? Milk can spike insulin levels, while yogurt, in head-to-head studies does not. Insulin, the hormones responsible for blood sugar regulation has now been linked to sebum production and skin inflammation when elevated. Then there are the growth hormones in milk and even organic milk has naturally occurring growth hormones which are theorized to promote acne... most milk is derived from pregnant cows so the natural growth hormone levels are high.
Next pull out the high sugar, processed foods and beverages that are devoid of fibre... this would include pop, high sugar cereals and baked goods with white flour like white breads, muffins and cake. Why? Not only do these foods contain very little nutritional value, they can spike blood sugar and insulin, and that takes us back to the insulin-sebum story.
Watch out for vegetable oils, we are currently over consuming omega-6 fats from corn, soybean, safflower and sunflower oils. Why? This type of fat can drive sebum production and inflammation right at the pore level.
What foods help fight acne?
It's really the flip side...more colourful fruits and vegetables, whole grains. Why? These do not spike blood sugar and insulin, they keep it stable...they also carry with them lots of antioxidants that are important for skin protection in acne.
More fish and seafood. Why? Research shows that those who eat the greatest amounts of fish and seafood have the lowest rates of every type of acne blemish...from blackheads to acne cycts. The reason is almost certainly because the omega-3 fatty acids help to turn off the acne inflammation and turn down the dial on sebum production.
Drink green tea. Why? In addition to all its other health benefits, green tea has a natural antioxidant chemical that can trurn down production of an acne-promoting hormone called di-hydrotestosterone.
Eat tomatoes or drink tomato juice. Why? Tomatoes contain lycopene, yet another antioxidant chemical that has been show to put the brakes on acne-promoting hormones.
The two recently published studies on diet and acne placed adults on a 3 month intervention with high intake of fruits, vegetables, fish seafood, very lean meats, whole grains and almost no processed grains, white flour. After three months, those in this "healthy diet" group had 22 less acne blemishes and lower levels of the acne-promoting hormones.
Tips for helping people cope through acne?
The stress connection is major, and adequate sleep is a cornerstone of keeping stress in check. So is exercise. There are also preliminary studies showing that mind-body medicine interventions, things like meditation, being mindful and biofeedback may have some benefit. If the depression or anxiety associated with acne start to interfere with quality of life and daily activities, it would probably be best to see a professional. There have been some reports of improvement in acne with medications that reduce anxiety and depression.