What Is It?
Acne vulgaris, known simply as acne, is a common skin disease. Acne affects the areas of the skin that have the greatest concentration of sebaceous glands (or oil glands). These glands secrete sebum, an oily, waxy substance that helps to lubricate and protect the skin.
In normal skin, the oil produced by the sebaceous gland mixes with dead skin cells which are continually regenerated. The oil helps carry these skin cells out of the pore.
In people with acne, the oil and skin cells are produced at a faster rate than normal causing a buildup of dead cells. This buildup inside the hair follicle clogs the pore creating what is known as a comedone. An open comedone is known as a blackhead. A closed comedone is a whitehead. When a blackhead or whitehead becomes inflamed, it develops into a red bump, or papule. If it contains pus, it is called a pustule. Commonly, these are known as pimples or zits. In severe cases, a nodule or cyst develops that extends deep into the skin.
What Causes It?
There are a few contributors to the development and progression of acne. These include:
• Propionibacterium acnes
• Hormonal imbalance
• Leaky gut
• High-carbohydrate diet
• Dairy consumption
• Toxin exposure
• Cosmetic ingredients
• Poor liver function
• Low fiber intake
The excess sebum and dead skin cell build-up provides the perfect environment for the growth and reproduction of the skin bacteria Priopionibacterium acnes. This bacteria is found more frequently in people with acne, and it contributes to the inflammation that creates the red blemishes of acne.
Hormone imbalance, or, specifically, an increase in androgen hormones (like testosterone and DHEA), contribute to the development of acne primarily due to the increase in sebum production that these hormones induce. This is why women often experience acne break outs that occur in conjunction with their menstrual cycle; and also why acne is seen in male body builders who take hormones.
Inflammation underlies the development of acne. It is easy to see that a red and swollen acne pimple is inflamed. But where does this inflammation come from? One contributor to inflammation is the consumption of high-sugar foods, or more specifically, high-glycemic foods. High-glycemic foods cause a rapid increase in blood sugar, which, in turn, increases inflammation. Foods high in sugar and refined carbohydrates both contribute to increased blood sugar. High blood sugar leads to high insulin, which is the hormone that helps to transport glucose from the bloodstream into cells. High insulin levels are also known to increase androgen hormone levels and promote unregulated cell growth, which are both part of acne development. Indeed, consumption of a high-carbohydrate diet has been linked to acne.
Another contributor to inflammation begins in the gut. Leaky gut, or intestinal permeability, allows for the passage of larger than normal particles through the intestinal tract. These larger particles are then reacted upon by the immune system, creating inflammation in the blood stream, which circulates throughout the body. Inflammation that begins in the gut can manifest in any area of the body. Indeed, the skin is yet one more place that this inflammation may end up.
Another major contributor to inflammation is the Standard American Diet (SAD) which contains a high amount of omega-6 fatty acids that promote inflammation and a low amount of omega-3 fatty acids, which decrease inflammation. The high prevalence of omega-6 in vegetable oils and processed foods throws off the ratio of omega-3 to omega-6. More omega-3 is needed to decrease the inflammation of the SAD diet. One form of omega-3 that comes from fish oil, EPA, has been shown to block the production of a certain inflammatory molecule known as leukotriene B4. Interestingly, a drug that does that same thing has been found to decrease acne.
In cultures where diets are largely unprocessed, low-glycemic, and whole-food based, the people there have been shown to have an absence of acne. When these same cultures become westernized, consuming refined and processed foods typical of the Western diet, acne begins to develop.
Yet another dietary trigger of acne is dairy, especially milk. Milk consumption has been found to be associated with acne in teenagers. This is most likely because of the hormones that are found in milk. Milk from cows is naturally designed for the development of calves, not humans. Cow’s milk comes from pregnant cows that would not naturally be producing milk in the wild. This means that new hormones produced during the cow’s pregnancy are found in the milk. It is these hormones, in conjunction with the artificial hormones that the cows are given to produce even more milk, that are probably interacting with hormones in people with acne.
Toxins may also contribute to the development of acne. This may occur in conjunction with leaky gut, mentioned previously. Both bacterial and environmental chemical toxins travel to the liver after they are absorbed from the intestine. The liver functions to detoxify these toxins. If the liver is overburdened, or not functioning well (also known as sluggish liver), then some toxins will spill over in to the bloodstream and circulate throughout the body. The body then tries to get rid of the toxins another way. An alternate pathway of elimination is through the skin. Toxins may be released from the body through sweat. This release of toxins through the skin could contribute to the inflammation that leads to acne blemishes. One study found that 50 percent of patients with severe acne were found to have circulating endotoxins, which are bacterial toxins produced in the gut by dysbiotic bacteria.
Ingredients in cosmetics and beauty products may also contribute to acne formation. This occurs for a number of reasons. First, many different chemicals are used in beauty products, some of which have been shown to affect hormones. Others are known to clog pores, and block the normal flow of sebum out of the skin. Still others are known to enhance the porousness of the skin, allowing other chemicals to pass through the skin and promote inflammation.
A diet low in fiber also contributes to a buildup of toxins. When fiber is lacking in the diet, constipation develops, which can affect acne development. One effect is that excess toxins are produced and absorbed when bowel movements are slowed in the colon. Fiber helps to regulate bowel movements, binding toxins and carrying them out of the body more rapidly. Additionally, fiber helps to lower blood glucose levels, which can help to control acne, as mentioned before.
Stress also contributes to the development or worsening of acne. Excess cortisol, the main stress hormone of the body produced by the adrenal glands, is known to be elevated in adults with acne. The acne itself may also produce stress in people who develop self-esteem issues surrounding their appearance. This can create a vicious cycle that makes it difficult for the acne to heal.
Genes also play a role in the development of acne, most likely in conjunction with some of the environmental factors above. In about half of the people with acne, at least one parent was also affected by the disease.
What Are the Signs and Symptoms?
When the more severe nodules or cysts form, scars may remain on the skin. People with acne may also suffer from low self-esteem or even depression.
Brenda's Better Way
The gut-acne connection involves increased intestinal permeability due to dysbiosis, toxins, or food sensitivities. The resulting upregulation (increase) of inflammation often includes the entire body. Symptoms may include fatigue and malaise, joint and muscle pain, depression, headache, and skin eruptions including acne. There are genetic factors with acne that can be triggered by stress, a diet high in saturated fat and sugar and a lack of vegetables, fruit, and probiotics. These triggers promote intestinal dysbiosis that can contribute to acne. The high saturated-fat and sugar diet will also increase insulin resistance which can increase obesity and androgen production, both of which can lead to acne.
So once again we see that lifestyle, stress management, diet, hormone balance and beneficial bacteria may be the cornerstones of treatment for acne, as they are for so many other conditions.
Acne is treated by conventional doctors as a condition of the skin and only of the skin. I have a different viewpoint. The skin is a major organ of elimination. Toxins are released from the body through sweat. Imbalances inside the body can ultimately manifest through the skin. In my experience, people with skin conditions have underlying toxicity that needs to be addressed. Supporting liver function, the main toxin-processor of the body, is essential.
Gut imbalance plays a big role in conditions of the skin. Interestingly, antibiotics are often used to treat acne. Antibiotics reduce the inflammation of acne and may help to rid the skin of the Propionibacteria acnes that is associated with acne. But I give a huge caution here. Long-term antibiotic treatment is NOT the answer. Antibiotics disrupt the bacterial balance of the gut which serves as an essential foundation of good health. When antibiotic treatment is stopped, acne often returns in addition to a host of other conditions, including antibiotic resistance.
Addressing gut imbalance and poor diet is the best way to get to the underlying cause of acne. Natural approaches for acne treatment go much further than skin deep. The following recommendations encompass a whole-body approach for people with acne.
• Follow The Skinny Gut Diet for optimal health when dealing with acne.
• Eliminating dairy from the diet may be helpful for some people with acne.
• Other foods that may need to be avoided include alcohol, coffee, chocolate, saturated fats, trans fats, spicy foods, and refined carbohydrates (sugar, white flour, white rice, etc.).
• Do not squeeze blemishes, as this can introduce infection to the area.
• Avoid cosmetics that contain harsh ingredients that may irritate the skin.
• Chew food well for best digestion.
• Exercise regularly.
• Apply tea tree oil to blemishes to inhibit bacterial growth.
Complementary Mind/Body Therapies
• Colon hydrotherapy is helpful to remove toxins from the body.
• Stress can be a major component of this disease, so find ways to reduce it with therapies such as meditation, yoga, deep breathing, massage, biofeedback, or music therapy.
• Acupuncture is helpful for people with acne.