Getting Rid of Acne Once and For All
The dreaded acne. It affects more than 85 percent of teenagers . But did you know that this skin condition has increased among adults? In fact, some eight million people visit the dermatologist every year for issues with their skin. We spend over a billion dollars for prescriptions and over-the-counter (OTC) products to cure acne, yet at best, these are short-term solutions.
Our first question of the week comes from Michael, a reader who has tried pretty much everything to get rid of his stubborn acne.
There’s got to be a way to deal with acne once and for all, right?
Yes, and it’s an inside out approach. What is going on inside your gut and your body affects your skin tremendously.
Rather than attack acne through superficial solutions, Functional Medicine  takes a roots-deep approach to acne and other skin problems. From that perspective, oxidative stress,  which triggers inflammation , contributes to acne and a host of other problems.
Major Causes of Acne and How to Treat Them
- Food Allergies, especially dairy. Hormones (including growth hormones) in dairy contribute to acne. Two large controlled trials found that consuming cow’s milk increased both the number of people who got acne and its severity. Other acne-triggering dietary culprits include processed fats like trans fats, which increase arachidonic acid levels and compete with omega-3 fats in the body, leading to more inflammation and acne. It’s important to remove dairy and trans fats from your diet.
- Sugar. Sugar raises insulin levels, which then promote the production of testosterone in women, as well as inflammation in general, causing acne. Large randomized prospective controlled trials (the gold standard of medical research) found people who had higher sugar intake and high-glycemic load diets (more bread, rice, cereal, pasta, sugar and flour products of all kinds) had significantly more acne.
- Gut challenges. Check for parasites, yeast overgrowth, and bacterial imbalances and treat these things with the help of a Functional Medicine practitioner. Taking probiotics  (such as lactobacillus), prebiotics, and digestive enzymes  can improve acne. I have seen serious cystic acne resulting from gut imbalances and parasites that resolve when the gut is fixed .
- Nutritional Deficiencies. Look for low levels of zinc , omega-3 fats  and some anti-inflammatory omega-6 fats, such as evening-primrose oil  – all of which can boost immunity, reduce inflammation and reduce acne. For women, try saw palmetto,  which is most often used for prostate health but is also found to reduce facial hair and acne in women.
- Cooling off inflammation. Foods like wild-caught fish, turmeric, ginger, green tea, dark purple and red foods such as berries, green foods like dark leafy vegetables, and pasture-raised eggs all help to reduce inflammation  that contributes to acne.
Click here  for my full blog on treating acne.
Eating Well When You’re a Busy Student
Our next question comes from a PhD student named Gretchen, who asks, “Do you have any cooking or meal prep advice for those of us who are PhD or med students?”
5 minutes for breakfast; 10 minutes for lunch; and 15 minutes for dinner. Yes, I made this happen when I was in med school, and you can too. I had to learn to cook quickly for myself while on a budget, and it took a little bit of practice, but it paid off.
Here are my steps to eating healthy when you don’t have a lot of time:
- Make a list. Take some time one day every week to sit down to plan a few simple meals that you can make quickly. Make a shopping list and head to the grocery store to purchase all the ingredients for those recipes in advance. Keeping a list and sticking to it saves time and money and keeps unhealthy food from “landing” in your shopping cart. Stock up on plenty of nuts, seeds and other healthy snacks to keep energy levels and blood sugar levels balanced. Here’s a list of my favorite snacks.  Another helpful hint: never go to the grocery store hungry!
- Develop a repertoire of a few cheap, easy-to-prepare meals. Have the ingredients available at home at all times so you don’t get stuck eating food that doesn’t make you feel well or help you create the health you want. This takes a bit of advanced planning but is well worth it. You can find recipes on my blog. 
- Go frozen. Frozen vegetables (preferably organic) become a real timesaver and last longer, especially if you already have some in your freezer and can avoid the need for last-minute grocery store stops. Ditto for frozen grass-fed beef, wild-caught salmon and organic berries. Shopping at warehouse stores can become a real time- and money-saver. Just buy the very best quality you can find. If you have the freezer space, you can take advantage of sales and coupons and stock up for weeks or even months with these essentials.
- Choose pre-prepped. If chopping doesn’t fit your tight agenda, choose fresh pre-washed organic leafy greens – like spinach, kale, arugula\ and Romaine lettuce. Pre-cut produce is also available at many markets, which drastically reduces kitchen work. They might be a bit more expensive, but if you’re short on time and space, they’re worth it.
- Don’t be afraid of canned foods. Carefully chosen canned and jarred foods, such as vegetable or chicken stocks, sardines, wild Alaskan salmon, artichokes and roasted red peppers, make it easy to toss together last-minute meals. Always choose lower-sodium versions and read labels carefully to be sure that gluten, dairy, sugars and other unwanted ingredients aren’t inadvertently sneaking into your diet. If choosing canned food, opt for PBA free cans whenever possible.
- At the very least – go healthy. Even when you do your best, you’ll have days where everything falls apart and even throwing together a simple salad topped with pre-cooked wild salmon becomes impossible. Because you prepared, you’ll have nuts, seeds and other healthy snacks to steady blood sugar levels so you’re not ravenous by dinner. Many grocery stores now have hot bars with healthy selections. Stopping by Whole Foods Market on your way home for a rotisserie chicken along with sautéed pre-cooked vegetables makes a simple “fast food” meal without the sugar and damaging fat found in drive-thru foods. Always do the best you can under the circumstances rather than aim for perfection.
Eating well doesn’t have to be expensive or time consuming. In the morning, when I’m rushing out the door, I usually have a shake with greens, almond milk, nuts and seeds, and maybe some berries. For lunch, I eat a big, fat salad with arugula, avocado, nuts and seeds, a can of wild salmon, and some tomatoes. All of this is pre-washed to save me on time. For dinner, I’ll make a simple piece of protein with some veggies on the side.
Don’t let the food industry trick you into convenience meals. With these strategies, you’ll be ready to make a healthy meal anytime, anywhere.
Gaining Weight on a Low-Carb Diet
Most of the time we hear about individuals who can’t seem to lose weight, but sometimes I’ll get patients who can’t seem to gain weight, especially when they transition to a low-carb diet. This is the subject of our next question which comes from Jennifer who tweeted, “Can you give advice on how to gain weight on a Paleo diet?”
Well, the truth is, when you cut out starch and sugar, you’re not activating the insulin hormones which could mean you might have a tough time gaining weight.
We must remember that every body is different. Personally, I need a little bit of starch in my diet because I’m pretty skinny. So, keep your body type in mind and keep a food journal to monitor how your body reacts to different foods. You might find that you need more carbohydrates than you thought you did.
To boost healthy carb intake, include sweet potatoes squash or other starchy vegetables at dinner. You can also try incorporating nuts and seeds, because they contain a little bit of carbohydrates, in addition to protein and fat.
There are many reasons you might be unable to gain weight. You might have an infection or other gut imbalances, which might make it difficult to gain weight. An overactive thyroid can cause you to lose weight. And if you’re under a lot of stress, you might be losing more weight than you’d like.
If you suspect any of these are an issue for you, I highly recommend working with a Functional Medicine practitioner who can provide the right tests to identify the true cause(s) of your weight loss and treat you appropriately.
For the most part, tweaking the diet can solve this challenge. So, my first recommendation for Jennifer is to experiment with adding some more healthy carbohydrates like starchy vegetables into her diet and see how that affects her weight.
Now I want to hear from you. Are you dealing with acne? Do you have tips for feeding yourself when you’re out of time? What about gaining weight? What has worked for you and what hasn’t? Comment on my Facebook page. If you liked this video be sure to share it with your friends and family on Facebook  and Twitter, and, submit your questions to drhyman.com, and maybe next week I’ll make a House Call to you.
Wishing you health & happiness,
Mark Hyman, MD