In a previous blog post we talked all about hormonal acne and some of the challenges associated with it. As a review, acne is due to stimulation of androgen hormones which increases sebum (oil) production. Sebum leads to a buildup of dead skin in our pores creating black and white heads. Acne forming bacteria thrives in this environment and mounts an inflammatory response that causes inflamed acne papules (pimples). As inflammation increases, inflammatory papules can increase in size resulting in nodular and cystic acne lesions. Other things that can affect sebum production includes, genetics, diet, cosmetics (oil-based products), stress, sleep, drugs, and abnormalities in other hormones in the body (insulin and IGF-1).
Traditional medical treatment of acne include various topical medications. Topical or oral antibiotic medications, benzoyl peroxide, clindamycin, and minocycline/doxycycline, treat the bacterial aspect of acne. Topical retinoids, such as adapalene, tretinoin, tazarotene, decrease sebum production and help to clear pores and reduce inflammation. Hormonal specific treatment includes options such as oral spironolactone, oral contraceptives, and a new topical called clascoterone. These medications alter the hormones that fluctuate and lead to increased acne.
Acne medications can work wonders for those with hormonal acne, but treatment can be complicated as there are many pieces to the puzzle of what is causing it. My patients often ask me what they can do to adjust their lifestyle to improve their acne. Obviously, if someone has an underlying medical condition that is leading to acne, treating that with the appropriate provider is first and foremost. Below, we discuss natural options and lifestyle changes that can potentially improve hormonal acne.
Historically, research has not been able to demonstrate significant evidence regarding the effect of diet on acne. However there have been recent studies that show an increase in acne in certain diet habits. High glycemic index (GI) foods spike glucose quickly, which increases insulin and androgens. This increases inflammation and oil gland size in the body, which can make acne worse. Dairy has always been a suspected culprit when it comes to acne, but research is showing milk may be the problem due to potentially containing hormones that stimulate oil glands. Certain fats and oils (omega-6 fatty acids) increase inflammation as well and can contribute to acne formation, as well as other health issues. Finally, alcohol disrupts the natural hormones in the body and slows liver detoxification of excess hormones that can contribute to acne.
Below is a list of beneficial lifestyle changes that can promote overall health and reduce acne formation.
- Nutrients that prevent acne: vitamin A, E, zinc, fatty acids, antioxidants
- Healthy fats: olive oil, walnuts, fish (tuna, salmon), flax and chia seeds
- Veggies: antioxidants and vitamins for skin nutrients
- Fiber: lentils, beans, nuts, seeds, quinoa
- Spearmint tea: decreases androgens
- Vitamin A & E: antioxidant vitamins, protect against free radical damage and inflammatory processes
- Omega-3 fatty acids: inhibits synthesis of proinflammatory molecules and decrease levels of IGF-1
- Zinc: anti-inflammatory
- Vitamin D: decreases inflammatory biomarkers and inhibits acne forming bacteria induced pathways and induce antimicrobial peptide production in sebum cells
- Exercise: assists in detoxifying excess hormones from the body
Chelsea Beer, PA-C