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Your Diet, Your Skin

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 Nothing reflects the state of your diet better than your skin and hair. Clear, radiant skin doesn’t happen by accident; it is built by food choices you make daily.

Your skin’s structure is built from the food you consume.

When you think of it, skin is quite remarkable. Skin’s structure varies from one area of the body to another with changes in thickness and the specialized structures present (nails, hair, sweat glands, and sebaceous glands). Our skin protects us from UV damage through the presence of melanin, regulates our temperature by sweating or shivering, is a barrier to water loss, and is the largest sensory organ of the body.

What you might not appreciate is the link between the endocrine system and the skin. Not only are receptors for all the major hormones distributed in the skin, influencing skin’s appearance, but skin cells themselves produce hormones.

A key player in the relationship between skin and hormones is the sebaceous gland, located within skin’s epidermal layer.  The chief function of the sebaceous gland is to lubricate the skin through the production of sebum. In fact, sebaceous glands begin working in utero, producing the thick vernix caseosa which protects the embryonic skin from amniotic water. Sebum, in mature skin, in addition to its inherent moisturizing role, transports fat-soluble anti-oxidants to and from the skin surface and exhibits anti-bacterial activity. The sebaceous glands possess receptors for androgen hormones, which cause the release of sebum. During puberty when the androgen hormones sky-rocket, the higher amounts of sebum can clog pores, causing acne. This is the root of acne: acne will not develop without sebum and sebum will not be produced without androgen stimulation of the sebaceous gland.

Diet’s role in acne

While acne develops in 80% of American teenagers, it should be pointed out that acne is rare in non-Westernized societies. Recently, there has been a re-investigation of the influence of diet on the occurrence of acne. It has been found that there is a strong link between consuming a diet high in simple carbohydrates (sugar) and acne.  Eating foods high in sugar stimulates the release of the hormone, insulin. Insulin increases androgen production, resulting in increased sebum, and thereby, promoting acne development. On the contrary, eating foods low in sugar reduces androgen levels and lessens the severity of acne. A recently done study randomly assigned patients with acne to a control group or a low-glycemic-load diet and followed them for 12 weeks. Participants on the low- glycemic-load diet had significant improvements in their acne, as judged by dermatologists who were blinded to the groups.

By switching to foods that do not raise blood sugar excessively, acne will improve. The anti-acne diet plan is based on the glycemic index, or how much a given food will raise the blood sugar. Foods that are low or medium on the scale are recommended while high glycemic foods are to be avoided. Actually, making the shift to lower glycemic foods isn’t difficult because it means eating more fruits, vegetables and including lean protein.

Here’s what should be avoided: white bread, white rice, white potatoes, cookies, rice cakes, candy, cake, soda (including diet soda), fruit juices, cereals (even natural cereals with low sugar on the label) and pizza. It is necessary that you be very mindful of these as they all will raise insulin and cause androgen release.

Both milk and ice cream have been found to exacerbate acne. Milk and ice cream increase insulin production. But it should not be overlooked that milk produced by persistently pregnant cows will contain hormones which may amplify the hormone axis further. Yogurt and cheese do not cause excess insulin release or worsen acne. It is recommended that these be included in the anti-acne diet to satisfy calcium requirements as peak bone density has not been reached during adolescence.

I recommend that vitamins A and D as both independently benefit the skin and general health. Vitamin E reduces the inflammation present in acne – it is recommended until acne pustules resolve. Because the intestinal flora has been shown to be altered in acne, taking a probiotic like Align or Culturelle, is a good idea.

Here is a sample day of the anti-acne diet: Breakfast - Greek yogurt smoothie with blueberries. Lunch – Bowl of vegetable soup and chicken salad on whole grain toast. Drink water or brewed iced tea.  Afternoon snack – a piece of fruit (apple, pear, orange or 2 clementines) with string cheese.  Other options – 1 cup of edamane with a handful of nuts or guacamole with raw veggies. Dinner – Chicken or fish, simply grilled with quinoa or brown rice. Eat two vegetables, one of which is a leafy green vegetable. Drink water or iced tea with dinner. Drink 10 glasses of water daily.

Photographs of acne improvement in the low-glycemic-load group. A and B: subject A at baseline and 12 wk respectively; C and D: subject B at baseline and 12 wk, respectively; and E and F: subject C at baseline and 12 wk, respectively

Anyone who has suffered through acne knows how devastating the condition is.  Self-esteem can plummet. In teenagers, acne can lead to social isolation and depression.  But acne is curable – so take action now. Follow the plan I’ve outlined and see your dermatologist. There are new treatments which can quickly improve skin’s appearance; their effect will be amplified by following the anti-acne diet.

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