Is Your Acne Caused By What You're Eating?

I think it's important that we have to recognize that we're all individuals and the cause of acne is not just one problem. It depends on your individual story. Hi, I'm Kao, one of the producers.

Of the Doctors Pharmacy Podcast. We have a tendency to think that glowing skin can be achieved as a result of what we put on our skin as opposed to what we put in our bodies. In fact, we spend over a billion dollars collectively on prescriptions and over-the-counter products to cure acne. but eliminating acne is best approached as an inside job. Dr. Hyman recently spoke about this with his colleagues at the Ultra Wellness Center.

Dr. Todd LePine and Dr. Elizabeth Boham. The skin is contiguous with the gut. So if I draw a line on the skin and I keep drawing a line and go down my tongue and I go into my esophagus, down to my stomach and my intestine, I'm still.

On the same surface.

So oftentimes, and you know this, Mark, is that- that's true. I just thought of that. Yeah, it's kind of a cool thought. That's how I explain to patients. so the skin is contiguous with the gut. It's an ectodermal tissue. And when their skin issues think gut.

It's really a tube. It's outside your body. Here's your gut. Yeah, it's true. I mean, when I have a patient with psoriasis, eczema, acne, rosacea, I treat their gut.

Yeah.

And I don't put stuff all over their face or on their body.

Exactly.

To suppress the inflammation, I get rid of that. And it's like a. It's like, really an American miracle. I mean, dermatology is not. something that I'm an expert in, although I was trained as a family doctor in dermatology. But I feel like we get the most amazing results just for something as simple as fixing the gut and changing the diet.

I remember I was having a conversation with my daughter about skincare products and okay, what's the best thing to use for my skin? And all of a sudden I realized even though she'd lived with me her whole life, I don't think I ever said this. I said, what you're eating is so much more important than what you're putting on your skin. You know, the food that you're putting in your mouth is so much more important than what topical things you're putting on your skin. And so it made us start to have this conversation, which I thought I was saying all the time, but that I think sometimes people don't realize or understand or the connection is not made, that how important what you're choosing to eat every minute of the day, how much that impacts your skin.

Yeah, I mean the traditional medicine focuses on the outside in. What stuff you can slather on your face, what creams, potions, lotions, or maybe taking antibiotics, which is a whole problem we're gonna talk about in a minute. But most of our skin health comes from the inside out. Yes. so if you want great skin, if you want glowing skin, if you want clear skin, if you wanna get rid of your acne, if you wanna get rid of your eczema, if you wanna get rid of your psoriasis, if you wanna get rid of rosacea, all these things come from the inside out. And traditional dermatology focuses on the outside in. And it doesn't really work that well most of the time, even when you work on the outside in. And it's difficult, it's expensive, these medications are absorbed. My rule is if you wouldn't eat it, you shouldn't put it on your skin.

And a lot of times with the topical treatments, whether it's steroids for eczema or topical antibiotics for acne, they can work in the short term, but in the long term, they disrupt your skin and make you more prone to getting it in the future.

We know now in functional medicine and in medicine in general, if people paid attention to the research on acne, is a lot of it starts in the gut. Yes. So if I see someone with skin problems, the first thing I think of is what's going on in their gut? Absolutely. What's going on with their food that they're eating? Yep. With inflammatory foods, with food sensitivities, with foods that trigger hormonal responses, with foods that increase something called insulin resistance. So tell us about the pathology and the pathophysiology of acne. Acne because it's very interesting because we often just think it's like a topical thing but it's really not.

Yeah, I mean one of the things we know with foods is that when you eat foods that are really refined and processed, foods that are high in sugar and refined carbohydrates, you'll get a spike in your blood sugar and you'll often get that spike in insulin after you get a spike in blood sugar, right? So you eat food, your blood sugar goes up, the body makes a lot of insulin and that spike in insulin and blood sugar will cause a follicular hyperkeratosis.

Wow, that's a big word.

I know, right? Which just means that there's extra, that in the follicles of the skin, the skin's not turning over as well as it should. And so cells get stuck in the skin, and then those stuck cells can get more inflamed, and you can get acne can get produced. So one of the major things we always start with is pulling away the refined and processed foods and the sugary foods.

And starchy foods.

And starchy foods, right? Anything that's gonna cause that insulin spike. We know that when we pull away those refined and processed foods and the sugary foods, most of our patients, so many of our patients see great improvement in their acne right away. Right away. Right away.

So sugar, starch, processed foods, they gotta go. And then there's another food that is really common in this country. and it is a huge driver of acne. Yeah, the dairy.

Yeah, yeah. Dairy.

Dairy, I mean, 'cause dairy is, you.

Know, all of our dairy food, our milk, our cheese, our ice cream, you know, all of that is very high in hormones. There's 60 different hormones in milk and.

These are not added like growth hormone. These are just naturally occurring hormones. Why? It's a growth food for calves. It helps them grow.

It makes them grow, right?

So it's got a lot of factors that are hormonally active that drive growth.

Yes. And we know that those growth factors can stimulate acne in some people. You know, not everybody, but for some people, they're more sensitive to them and they definitely will cause more acne. Actually, I'm one of them.

I'm one of them. If I have dairy, I get pimples. So if I know I'm going on a TV, I can't eat dairy. I don't usually eat dairy, but if I have sheep or goat, it's a little different. It's not as inflammatory for some reason. But if I have regular dairy, you.

Can count on me getting pimples. And I'm like 60 years old to get pimples from dairy. Absolutely, and I think it depends, like the question of sheep or goat, I think it depends on the person. There's some people that it really, all types of dairy bother their skin and for other people there's some that is better than others. And what we know is sometimes the testing, like the food allergy testing or food sensitivity testing, doesn't always pick it up. I mean, we do it often, but there are times when we get a negative test result, but even if we still pull it away and people's skin improves.

So this isn't like a, an allergy necessarily.

Not necessarily. It could be.

And like you said, all the hormones in dairy too. But there's another category of things which are food sensitivities that do drive inflammation and drive leaky gut and can drive acne that are independent. So we've got sugar, we've got dairy, and we've got this other category which.

Is sort of more amorphous, but it is a factor in a lot of people. Absolutely, absolutely. So there's so many ways, and I always say this, there's so many ways that somebody can react to food. But I think it's important that we have to recognize that we're all individual. and the cause of acne is not just one problem. It depends on your individual story. Food sensitivities might affect you immediately, or.

It might take a few days. This can make it difficult to determine what foods might be causing acne or other problems. Eliminating common food triggers like gluten, dairy, grains, sugar, alcohol, and caffeine for a period of time can be a great way to assess how these foods are impacting your body and your skin. Dr. Hyman spoke about this with another colleague of his from the Ultra Wellness Center, dietitian Lisa Drayer.

There are two things I really like to emphasize with my patients, and one is it's not just about what you can't eat. I know it's easy and it's very natural to see this list of foods, whether it's a short list or a comprehensive elimination diet where we have a ton of foods that we take out like corn, soy, wheat, gluten, dairy, all these things. And then they're left thinking, well, what can I eat? Well, the reality is there's a lot more you can eat than you can't eat in this situation. But it's so easy because food isn't just calories and fat and protein. It's also what connects us. It's part of the community and emotional connection we have. So if you're used to eating these foods all the time, it's a big shock to some people. So then that's all they can see, is what they can't eat.

But it's really- you-'re taking away my cheese.

I've got a story about that.

Wait.

Yeah, exactly. But it's also about what you can add in, not only in terms of whole foods that are rich in polyphenols, these things that protect and heal the lining of the gut, But it's like getting more diversity in your diet, learning how to get into the kitchen, cook with all these different flavors and textures, sort of like reconnecting.

Spices.

With foods. Exactly.

And then you get to add stuff back, right?

Right.

So that's so important. And that's what people don't realize. And a lot of people come to me and either they've already tried an elimination diet, let's say they've done gluten and dairy free. My first question always is, Did you have any help? Did you do this on your own? Did you go online? Did you find something? Or did you have a professional who knows how to guide you through this? First question. Second question is, how do you reintroduce?

What do you do? When you give people a chance to stop the foods that are problematic and add in the good foods, then their body's gonna tell them. They don't need you or me or a doctor or anybody else to tell them what works. They see the difference. Their sizes clear up, their headaches go away, their skin clears up, they feel better, right? Their digestion improves.

And you had another case of a.

A young man with depression and anxiety and acne.

Yeah, he was 20 years old. It was very, very sad. The depression was debilitating for him for many years. Anxiety, as you said, acne, cystic acne. And so he was a bit more complicated. He had been struggling for a while. So we did a comprehensive elimination diet. So we took out all the heavy hitters, of course, like we said before, all the processed foods, but corn, soy, even shellfish and tree nuts. And we took out major alcohol. caffeine, all of that. And that's the diet where people are like, what should I be eating then if I have to give up all these foods? That's the question.

What am I gonna eat?

I know, what am I gonna eat? What the heck should I eat? That's like your book.

So it's-- My food group is pizza.

All the things you can't eat. It's devastating. But number one, that's why it's so important to work with somebody that you can have guidance. You have ideas for meals, snacks, and that's what every patient walks away with is a very individualized meal plan that provides what should they be eating. RecipeS, resources, all that. But so going back to this case, we knew that it was going to be a little bit longer term. I knew that he was going to feel better to some degree, but I thought it was going to take a little bit longer. So after four weeks, which is a typical amount of time between when somebody first comes to see me and the follow up, he started to feel a clarity that he hadn't had in a while. He still had the depression, he still had the anxiety, the acne was still there, but he said, I feel well enough that I'm motivated and I want to keep doing this. And that was going to be my recommendation anyway. So I was like, okay, great, we're.

On the same page.

Another month goes by. Because it doesn't take a long time. It's not like you do this for six months and see how you feel. Literally, the first few days are hard because you want to withdraw. And then after three or four days, by day five, six, seven, you start to see such dramatic changes.

Exactly. It's pretty remarkable. Yep, and the people that I would least expect to be on board with these types of diets are the ones that do the best, to be honest with you. And so after a month, He said, okay, I've got this clarity. I do want to continue on. The second month, the acne was next to gone. It was so consistent.

Consistent acne is a big deal. It's like you have big giant welts on your face.

It really was devastating his confidence. And so that was very clear. Then by the third month, he was in much better spirits. He was having much more awareness of his, just his emotional reaction to things. depression was much less overwhelming. And so we started to do the reintroduction process because that is so important. People don't realize how important it is to do the reintroduction process in a structured way. We have to be very structured. And that's what I help people with is how do you do this in a way that we can really identify which foods might you need to stay off of a little bit longer. But as we're working to heal the gut, as we talked about before, how can we bring these foods back in so that you can start having more variety and more diversity? So with him, by the third month, we reintroduced one food at a time. It usually about three days each food. We found that when he had cow's milk and gluten and I think it was corn, those three triggered his symptoms to get worse. So we kept those out, but he was able to have a variety of pretty much all the other foods. We're talking whole foods here. And it was remarkable to see the difference and to watch him be able to eat these foods again without problem.

For the majority of people, cleaning up your diet and addressing food sensitivities will lead to huge improvements with your skin. Better sleep and stress management techniques may also help reduce acne. If you're not having success in these areas, consider working with a healthcare practitioner to determine if nutritional deficiencies, environmental toxicity, hormonal dysfunction, or any other problems are at the root cause of your skin issues. Thank you for tuning in to this episode of the Doctor's Pharmacy. If you'd like to learn more about anything you heard today, I encourage you to check out Dr. Hyman's full-length conversations with Dr. Todd Lapeen, Dr. Elizabeth Boham, and Lisa Dreyer. If you enjoyed this episode, please consider sharing it with a friend and leaving us a comment below. Until next time.