Most of us have someone in our life who has absolutely flawless skin. Inevitably, it’s achieved through a very complicated and expensive facial care regimen consisting of water. Curses! But wait, there’s something to this trend!
When it comes to achieving acne-free skin, your regimen should likely be a bit more minimalistic than you think. It’s about using gentle products that are less drying and irritating, avoiding toxins in your diet and skincare products, and making a concerted effort to de-stress. Follow this guide to ensure your lifestyle, nutrition, and product selection are all skin-friendly, and abolish acne for good!
What causes acne?
Acne forms when trouble brews in your skin’s “pilosebaceous units”. These units include: your skin’s hair follicles which are made from keratin, and their oil glands which produce sebum. Sebum is an oily, waxy substance that protects and lubricates the skin. The openings to these units are your pores, which are just barely visible on normal skin.
Here’s what happens behind the scenes to cause acne:
- Hormones, including testosterone and insulin, signal your oil glands to produce sebum. Insulin!? The hormone released in response to eating sugary or high-glycemic index foods? You bet. Too much of these hormones can produce sebum at problematic levels. Dry skin also signals a ramp-up in your sebum production.
- Sebum mixes with keratin to plug pores, forming whiteheads (blocked, closed pores) and blackheads (blocked, open pores).
- The bacteria, Cutibacterium acnes, which normally colonizes the skin in low levels, gets trapped inside pores and multiplies.
- Inflammation takes place, causing redness and swelling inside your pores. With enough inflammation, your hair follicle can rupture causing large, painful lumps and even scarring.
What you’ll feel
When acne strikes, whiteheads, blackheads, pimples, and deep, painful cysts can all grace your face, chest, shoulders, and back. Acne goes more than skin deep, and can also cause scarring, and have detrimental effects on mood and well-being. Wait, you’re past your teenage years— your skin should be clear, right? Wrong. Not only can acne persist from adolescence into adulthood, it can also start anew once you’re #adulting.
What conventional medicine offers
When it comes to treating acne, there are a multitude of over-the-counter and prescription options. Remember your physiology lesson and choose products and follow strategies that, together, cover all of your bases to craft an acne-fighting plan:
- Dampen sebum production
- Break down keratin
- Fight bacteria
- Reduce inflammation
- Salicylic acid: dissolves built-up keratin, helping unclog pores. Look for a 0.5-2% concentration, and apply once or twice daily. Risks? Skin irritation.
- Benzoyl peroxide: oxidizes and kills bacteria within your pores. It also helps ensure your skin’s acne-forming bacteria don’t become resistant to any topical antibiotics you use. Risks? Skin irritation and bleaching of clothing and hair.
Topical prescription medications:
- Topical retinoids including tretinoin (Retin-A) and adapalene (Differin): reduce inflammation, scarring, and even wrinkles, by sloughing skin cells and encouraging new ones to grow. This process also pushes debris out of your pores that’s keeping them clogged. Risks? Redness, itching and stinging. Adapalene is also available in combination with benzoyl peroxide as a 2-in-1 (Tactupump).
- Azelaic acid (Finacea): reduces production of keratin, fights bacteria and reduces inflammation. Risks? Irritation.
Oral prescription medications:
- Hormone therapies, such as oral contraceptives or “birth control pills” and spironolactone can help combat acne by rebalancing hormones and dampening testosterone.
- Isotretinoin (Accutane, Epuris) is an oral retinoid that severely reduces the size of your skin’s oil glands, and thus its sebum production.
These latter options aren’t without serious risks and side effects, but can be utilized if you’ve failed topical treatments or have severe acne.
A side note on antibiotics
Antibiotics, both in pill and cream form, are also widely prescribed for acne. However, overusing antibiotics can cause resistance (eg. the bacteria will learn to fight these antibiotics, and they become less effective) amongst both acne-causing bacteria and bacteria that play a role in other infections. Antibiotic use can also deplete your body’s good bacteria stores, also known as probiotics, and contribute to other health serious health concerns. As such, first consider alternatives to antibiotics when treating your acne.
Integrative medicine: a holistic approach to treating acne
Integrative medicine is about combining lifestyle, nutrition, herbal and mind-body remedies with the best of conventional medicine to help you be your healthiest self!
Whether you’re looking for help treating acne naturally, or hoping to reduce your reliance on the chemicals so often present in medications, focus on these integrative “prescriptions” to make your skin shine, and reap the overall health benefits too!
Remember to get the “ok” from your doc if you have any health conditions, or if you take regular medications before making significant lifestyle changes or trying new supplements or herbs.
Dr. Ross’ Integrative Medicine Prescriptions
- Skip the sugar and eat a low glycemic-index (GI) diet, such as the Mediterranean diet. This can help keep the hormones responsible for acne in check. Diets low in GI and refined sugars improve acne and reduce the need for acne medication. Plus, you reap other health benefits, too.
- Detox from dairy. Dairy both contains and stimulates the hormones that play a role in acne, and those who eat dairy suffer more acne. Try a dairy elimination diet. Skim milk, in particular, has been associated with more severe acne.
- Eat more omega-3s. These fatty acids help combat acne, likely through reducing inflammation, one of the final steps in the acne pathway. Wild salmon, sardines, mussels, rainbow trout and Atlantic mackerel are sustainable choices, and low in mercury. Not into fish? Opt for flaxseed, walnuts, or supplement (see below).
- Don’t wash your face. What? Sounds counterproductive, I know. But, no matter how much washing and scrubbing you do, you can’t get the sebum out of your pores; you’re still only removing surface oils. All your skin needs to help maintain its normal balance is a gentle rinse with warm water twice daily. Now, if you’re applying sunscreen or makeup in the morning, it’s best to wash it away nightly with a gentle, non-soap cleanser with a pH close to that of normal skin (about 5.5). Then, gently rinse your face with warm water in the morning. If you’re usually product-free, just rinse with warm water twice daily or use a very gentle cleanser.
- Don’t use toners or astringents. These can dry out the skin, signalling to your oil glands that they need to produce more sebum, thus further contributing to acne.
- Moisturize. Use a non-toxic moisturizer that’s labelled “non-comedogenic” which means it won’t clog pores. Keeping your skin moist can help signal to your oil glands that things are in balance and you don’t need more sebum, thank you very much. Pro tip: avocado, olive and jojoba oils all make mean natural nightly moisturizers, plus they’re cheap!
- Don’t pick, squeeze or pop. Don’t go for the (very) short-term reward: it’s far-outweighed by your risk of long-term scarring.
- Apply SPF. OK, this is less about acne and more about wrinkle-prevention and protection from cancer, but it’s really a must. Look for a product that’s “non-comedogenic” to ensure it’s approved for acne-prone skin.
Remedies from the Garden
- Tea tree oil is a great topical acne remedy and has minimal absorption beyond the skin. Evidence shows it can treat mild to moderate acne in a similar way to benzoyl peroxide 5% gel, but with less burning and dry skin.
Pro tip: Make your own “Natural Tea Tree Acne Serum” with just jojoba oil (avocado or olive are great, too) and 100% tea tree essential oil. For a 5% solution, Add 20 drops of tea tree oil to 20 mL of jojoba oil, shake well and store in a well-sealed amber or cobalt bottle. Test on a small patch of skin, then apply to freshly-washed face nightly as needed. Wash or rinse your face in your normal morning routine.
- Green tea lotion is another great natural remedy, and studies suggest it can reduce sebum production, improving both acne and patient satisfaction. Plus, it’s safe to use, with no serious side effects reported. Look for a product that contains 2-3% green tea and apply twice daily for at least 8 weeks before judging whether it’s the best option for you.
- Omega-3 fatty acids. If you’re not getting what you need through your diet, consider supplementing to reduce acne, and associated inflammation. Take 1-2 grams of EPA/DHA combined.
- Nicotinamide (Niacinamide). This topical Vitamin B3 is available as a serum, cream, or gel. Studies have shown it to be effective in combating acne, even when pitted against topical antibiotics. It works through multiple ways: boosting your skin’s barrier, combating bacteria, and reducing inflammation. Bonus? It may also fight some of the damage induced by the sun’s UV rays: oral Nicotinamide has been shown to reduce skin cancer. To emulate the studies, aim for 4-5% nicotinamide in your product.
- Zinc. This mineral is essential for skin and immune function, and can also reduce inflammation. In studies, supplementing with zinc for 6-12 weeks improved acne. If you’re eating a mostly plant-based diet, it can be tough to get enough through diet alone. How much is enough? Review your diet and see if you can optimize your zinc. For most people, a good place to start is by adding 30 mg of elemental zinc each day. Or, look for a multivitamin that contains zinc as well as other minerals important for your skin including: vitamin B3, B6, copper, folic acid
Acne can have a huge impact on your mental health. Conversely, stress can flare acne, too. Consider boosting your acne-fighting routine by adding stress-reduction techniques such as exercise, yoga, meditation and mindfulness practice.
A side note on when to see a doctor for your acne
If you have more severe acne that’s not clearing up with the above regimen, or you have scarring, visit your doctor. Mood concerns or anxiety arising as a result of your skin? Time for a check-in.
To help you find products that are good for you, and Mama Earth, check out these resources.
- The Environmental Working Group (EWG) has database you can search to ensure you’re getting safe, non-toxic products. Look for soap-free cleansers, moisturizers and sunscreens approved for your health, and the environment.
- The Canadian Dermatology Association gives their seal of approval to brands and products, if you’re looking for skincare that’s dermatologist-approved.
Congratulations on taking this step toward achieving your best health! Enjoy the journey. (I’m honoured to be one of your humble guides).
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