Coming up on this episode of the Doctor’s Pharmacy…
Dr. Mark Hyman:
I often treat the face by treating the gut. It’s not what you put on your skin that matters, it’s what you put in your mouth that matters. That is determining a lot of what’s happening with our skin health. So beauty and skin health really comes from the inside out.
Hey, everybody. Welcome to the Doctor’s Pharmacy. It’s Dr. Mark Hyman, and this is a place for conversations that matter. Today I’m bringing you a new feature of the doctor’s pharmacy called Health Bites, to improve your health by taking small steps every day that can lead to big changes over time.
So today we’re talking about acne. Yes, acne, the number one skin condition in the United States affecting millions of people, 17 million, in fact, costing a billion dollars a year in treatments and other problems. It’s not just affecting teenagers, but also many adults. And the first thing we have to deal with when we think about acne is all the over the counter products, all the stuff on infomercial, all the things that we’re supposed to fix our acne with lotions, potions, creams and gels. But unfortunately, they’re not addressing a root cause. And that, my friends, is what we’re going to do from the framework of functional medicine.
What is the root cause of acne? Why do we get these inflammatory, pussy pimples on our face, and maybe other parts of our body? Well, there’s a lot of reasons. The biggest reasons, the biggest reasons are, today in our culture, dairy and sugar. Or I would say anything that turns to sugar like refining carbohydrates, bread, rice or pasta, bread, so forth. Bread twice, I said, because it’s really a problem. So basically we have a diet that is driving inflammation, that is driving acne. It also is a diet that destroys our gut microbiome with processed food, lack of fiber, antibiotic use, environmental chemicals, all destroy microbiome and lead to imbalances in the flora there that drive inflammation through the rest of the body and can cause significant skin issues.
Another big one, stress. Stress is a big factor, and that raises cortisol, messes up your hormones. Hormonal changes can happen in women particularly that are affecting their acne, such as polycystic ovarian syndrome. So we’re going to get into all that. But let’s sort of talk about the role of diet and what we know. And there are many, many studies, if you just Google acne and diet on the National Library Medicine website, you’ll see that there’s plenty of research about this. And in fact, there’s some great randomized control trials, there’s a lot of observational trials. But essentially, sugar races insulin, insulin promotes the production of testosterone, and testosterone can cause acne. And it also causes inflammation. Basically, sugar drives inflammation throughout your body, it also causes imbalances in your microbiome and flora. So if you really want to get rid of pimples, you should cut down or dramatically cut out sugar starch. And that’s bread, rice or pasta, flour products of all kind.
Dairy is another one. Dairy has so many different hormones in it. It has 60 different hormones naturally, even if it’s got hormone-free milk, you’re getting, or hormone-free dairy, it still has lots of hormones including insulin, many forms of testosterone, progesterone, so forth. And these all affect us. And particularly the A-1 casein cows, which are the modern cows that produce certain type of milk that’s more inflammatory, causes more problems. So there is another huge cause of acne, and the number of large controlled trials found cows milk increased the number of people with acne and the severity of the acne. So really bad news.
The other thing that is a big factor is fat, and certain kinds of fat, particularly trans fats, or fine oils, they can be driving more inflammation and cause more acne. But the big two are really dairy and sugar. And I would really encourage you, if you have acne to eliminate dairy a hundred percent, and also sugar and refined flours for a while, and see if it improves, because that often will take care of it, and without a lot of fancy doctor’s visits to the dermatologist, and some of the more toxic drugs that are used like accutane. We use topical antibiotics, we use oral antibiotics, we use accutane. These are not great drugs, and often cause secondary problems.
So the gut plays a huge role in overall health. And the microbiome plays a big role in our overall health. But it also plays a role with conditions like acne. And I had a patient once who had a really bad case of cystic acne, and she ended up having a number of parasites. And we cured her parasites and fix her microbiome, and her cystic acne went away. I often treat the face by treating the gut. It’s not what you put on your skin that matters, it’s what you put in your mouth that matters. That is determining a lot of what’s happening with our skin health. So beauty and skin health really comes from the inside out.
There’s also nutritional deficiencies that are big drivers of problems. For example, zinc, vitamin A, Vitamin E, are playing a big role. So Omega-3 fats really important in keeping inflammation down. Certain fats actually are really important, like evening primrose oil, which is an Omega-6 fat called gamma-linolenic acid, is actually a very effective anti-inflammatory, helps with gut repair. But also seems to be hormonally regulating in women and can help with reduction of acne. So I think it’s really important for women thinking about treatment to not just think about things like the oral birth control pill, which many doctors prescribe to regulate women’s periods. That can be helpful, but it also can cause secondary problems like impacting the microbiome, micronutrient deficiencies that are results from taking it, increasing overgrowth of yeast, and potentially even inflammation from hormones.
So I’m not a big fan of the birth control pill as a strategy for treating acne. I mean, it has other benefits, obviously, but I think it often can cause an exacerbation, or worsening of acne after you stop the pill. So it’s really important to get to the root cause, and to deal with the drivers of acne.
It’s pretty interesting when you look at the signs behind this, and you see that a lot of the challenges that we see because of our diet are really driven by the poor quality diet we have, and all the things that are going on with milk. Now, the dietary guidance in America say to drink three glasses of milk a day as an adult, two glasses as a kid. There’s very little data on showing that this is actually good, or effective, or healthy. In fact, there’s plenty of data is showing the opposite. And I’ve reviewed this before on the podcast, but I encourage you to check out an article called Milk and Health by doctors David Ludwig and Walter Willett from Harvard, which reviewed all the evidence of milk, and presented a case for why it’s not nature’s perfect food, and may actually be harmful and not something that we should be having mandatorily recommended to us in our dietary guidelines, or in school lunches, which is really incredible, actually.
I was with a Native American and recently and he said, “We are mandated to have milk with every school lunch for our kids. And most of us are lactose intolerant and can’t drink it.” So it’s unfortunate. So we want to basically get really a strategy to deal with this. The first thing you want to do is get rid all the dairy. That’s nature’s perfect food, but only if you’re a calf. Make sure you eat a very low glycemic, low sugar, low starch diet. So liquid sugar calories, flour products, sugar, just cut them out if you’re really having problems.
Eat an anti-inflammatory diet. Lots of fruits and vegetables, antioxidants, anti-inflammatory compounds, they really, really help. So get those plenty, well, five to nine I think is just minimum, but plenty of servings, probably eight to 10 or 12 servings of fruits and vegetables a day. Also, get more anti-inflammatory fats like Omega-3 fats, really important. Also, you can try evening primrose oil, which is an Omega-6 fat. You might need to get those as supplements. And include antiinflammatory foods. Things like turmeric, fish oil from eating fish, ginger, green tea, nuts, dark, purple and red foods like berries, green foods like dark leafy vegetables, Omega-3 eggs, also, really helpful. And there’s certain supplements can be helpful, evening primrose oil, maybe a thousand to 1500 milligrams a day. Zinc, about 30 milligrams a day. Vitamin A, maybe five to 10,000, you want to do it under supervision because it basically can be toxic when taken for a long time. Vitamin E as well.
And probiotics. Probiotics would be very helpful for the gut. Certain probiotics can prevent acne, lactobacillus and others. And the other thing that we didn’t really touch on too much is that food sensitivities can be a big factor. So you may not have a true allergy, but different foods may just trigger inflammation. For example, mentioned dairy, but also gluten. Eggs can be a factor, even though they’re healthy. Different foods you might want to do an elimination diet, like the Tendee detox diet, to actually see what happens when you clear out all the inflammatory, potentially inflammation triggering foods that you might be sensitive to.
So there’s really a lot of things you can do to fix your acne. And in addition to the dietary cleanup, in addition to getting sorting out the nutritional deficiencies, dealing with your gut is really important. So a gut reboot, we’ve talked a lot about this on the podcast, but how do you do a gut reboot, it may require work with a functional medicine doctor. I call it the weeding, sitting and feeding program. That’s where we weed out the bad guys, see the good guys with probiotics, and then feed the gut to get it healthy, and support the growth of healthy bacteria. Also, make sure you deal with stress, which can be a triggering factor. High levels of cortisol and inflammation from chronic stress can drive more skin issues. And also, be careful what you’re putting on your skin. A lot of the products out there are full of all kinds of chemicals and additives.
Checkout Skin Deep, which is the Environmental Working Groups guide on how to use products that are not full of toxins and crap on your face. So make sure if basically my theory for what you should use topically is, if you could eat it, you can use it on your body, because everything goes through your skin. You don’t want to actually have a topical set of compounds that you’re putting on your skin that are causing more systemic issues.
So there’s a lot we can do to resolve acne. I’ve had such great luck with it with so many of my patients, young, old, at all stages of life. And if you focus on the root causes, get rid of the dairy and sugar, fix your gut, optimize your nutrient status, deal with stress, you’re going to do fine. So that’s my little health bite on acne. If you want to share us with your friends or family, please go ahead. We’d love to hear from you how you cured your acne with diet, or lifestyle, or supplements and the right things that actually help balance your system out. And if you love this podcast, please subscribe, and we’ll see you next week on the Doctor’s Pharmacy.
Hi, everyone. I hope you enjoyed this week’s episode. Just a reminder that this podcast is for educational purposes only. This podcast is not a substitute for professional care by a doctor or other qualified medical professional. This podcast is provided on the understanding that it does not constitute medical or other professional advice or services. If you’re looking for help in your journey, seek out a qualified medical practitioner. If you’re looking for a functional medicine practitioner, you can visit ifm.org and search their Find a Practitioner database. It’s important that you have someone in your corner who’s trained, who’s a licensed healthcare practitioner, and can help you make changes, especially when it comes to your health.