My daughter and I were talking the other day about acne. She was asking me about products to wash her face with and which would be best for her skin. I realized that even though she listens to me go on and on about the importance of nutrition, she too thought that the products she was putting on her skin were the most important determinant to whether or not she was getting acne. No matter how many expensive face masks or scrubs you use, nothing will prevent breakouts more than cleaning up your diet.

When someone comes to me with acne, the first thing I do is fix their diet. First, I have the person cut way down on added sugars and refined carbohydrates. High-sugar foods and refined carbs cause spikes in blood sugar and insulin. This is associated with inflammation in the body, increased follicular hyperkeratinization, excessive sebum production (creating oily skin) and therefore acne. Follicular hyperkeratinization means that the cells in the follicle of the skin become stuck and do not shed normally. The skin follicles become stuck and acne can occur as a result.

I recommend a 6-week elimination of foods with added sugar and refined carbohydrates such as bread, crackers, and cookies. A simple place to start is eliminating desserts, but it is important to look carefully at what you are eating because sugar can sneak in. Added sugar is in 68% of all products in the grocery store. Make sure to read labels and check for sugar, but the easiest way to cut out added sugar is to just avoid all foods with labels on them. Remove prepared coffee drinks and sports drinks, which can also be full of added sweeteners, from your diet. It is also not a good idea to substitute artificial sweeteners or even low-calorie sweeteners (such as stevia) when you are working to cut down on sugar. This will only make you crave sugar even more. Eventually, you will be able to have a small amount of added sugar in your diet, but during this elimination phase, cut out as much as you can so that you can get a sense of how much of a difference it will make to your skin.

Another food I eliminate from a person’s diet is dairy. Dairy is a common culprit in acne. Even organic dairy is full of hormones that can trigger acne in some sensitive people. We see this when acne increases around a woman’s period or when a boy goes through puberty because of a spike in hormones. Cut out ice cream, animal milk, cheese, and yogurt. Instead of butter, you can cook with ghee, avocado oil, or coconut oil during this elimination period. Most people are able to add back small amounts of dairy, but for 6 weeks, avoid as much dairy as possible, and you will see just how much it impacts your skin.

The first week of cutting out sugar, refined carbohydrates, and dairy can be tough, and you will have a lot of cravings. But if you stick to it, you will feel better and many of these cravings will dissipate. If you need further details on how to cut out sugars and refined carbohydrates from your diet, read Dr. Mark Hyman’s The Blood Sugar Solution, 10 Day Detox Diet.  

If your skin has not improved after this 6-week elimination of added sugar, refined carbohydrates, and dairy, then you need to look deeper. A Functional Medicine doctor can help you do just this by examining areas of imbalances in the body, such as the microbiome and the detoxification system.

When I am working with someone whose skin is not better after the elimination diet described above, I investigate the microbiome, the microorganisms that line all surfaces in the body. When there are not enough good bacteria, bad bacteria in the gut or on the surface of the skin can overgrow and cause acne. Sometimes we find that we need to add in a probiotic or treat dysbiosis, an imbalance in the microbiome. This can be treated with herbs but occasionally the herbs are not helpful enough and I use a short course of prescription medication. I caution people against long term antibiotics for the skin. They may be very helpful at first, but often cause long term imbalances in the body that lead to a host of other problems, including further acne, down the road. Remember, a high fiber diet feeds the good bacteria in our microbiome. So reach for vegetables, beans, legumes, nuts, ground flaxseed, and true whole grains (such as whole buckwheat, quinoa, or millet) to support the good bacteria in our body.

I will also work to support the body’s detoxification system. Too many toxins or problems with processing and eliminating the body’s hormones will cause poor skin and outbreaks of acne. You can support your own natural detoxification system with a diet rich in cruciferous vegetables such as broccoli, Brussels sprouts, kale, cauliflower, and cabbage. Reach for a serving of these powerful vegetables every day. In addition, onions, garlic, and herbs such as cilantro give the body phytonutrients that aid in the body’s detoxification process. Don’t forget about the importance of exercise to support lymphatic circulation, encourage sweating, and naturally detoxify the body. Water is also instrumental in the process of detoxification, so make sure to consume eight 8-ounce glasses of water every day.

With these changes to your diet and lifestyle, your skin will become smooth and clear. It does not take expensive products to have glowing skin, only a healthy diet. Remember, if these simple tips are not helpful enough, visit a Functional Medicine doctor for more support.