Acne was ruining my life,” says Olivia Gilmer, who suffered from persistent blemishes on her face and chest in her early 40s. Over-the-counter topical treatments and prescription antibiotics offered only temporary relief. A dermatologist suggested birth-control pills to balance her hormones, but those didn’t help either. Worried about side effects, Gilmer (not her real name) resisted taking a prescribed acne medication.
Finally, after years of suffering, she consulted naturopathic physician Trevor Cates, ND, in Park City, Utah, who inquired about her dietary habits and digestion issues. Gilmer admitted she had a bit of a sweet tooth and often felt bloated and uneasy after meals. Cates suspected that Gilmer’s diet was the culprit behind her issues and recommended several changes.
In addition to limiting sweets to stabilize Gilmer’s blood-sugar and insulin levels, Cates recommended adding more fiber- and antioxidant-rich veggies to support her body’s detoxification systems and restore hormonal balance. She instructed her to eat foods high in amino acids to assist the synthesis of collagen (a protein that plays a vital role in skin structure) and to take prebiotics and probiotics to support gut health. Cates also suggested Gilmer eat two servings a week of wild-caught fatty fish to boost her intake of omega-3 fatty acids, which help minimize inflammation.
Within two weeks, Gilmer began to see improvements. Three months later, her skin was clear.
“Most traditional doctors dismiss the idea that what patients eat can significantly affect their skin,” explains Cates, author of Clean Skin From Within. In fact, the American Academy of Dermatology does not provide dietary guidelines; the organization recommends topical therapy, including retinoids (typically the first-line treatment for acne), antibiotics, and oral contraceptives.
“Treating the skin in this manner doesn’t address the underlying cause of skin problems,” Cates says. “As a result, the body remains inflamed and out of balance, and symptoms reappear in a vicious cycle.”
A growing body of research links diet to such skin conditions as acne, atopic dermatitis, psoriasis, and rosacea, as well as premature skin aging.
“The skin is a mirror of our internal health,” says Vivian Shi, MD, University of Arizona assistant professor of medicine and dermatology. “For example, psoriasis is an indication of a systemic inflammatory state. A topical cream alone often won’t solve the entire problem. You have to treat the person as a whole from both inside and outside.”
A whole-person approach addresses deeper issues that can affect the health and appearance of skin, including dysregulated blood sugar and poor digestive function.
If the digestive tract’s permeable lining is inflamed or has been damaged, for instance, bacteria and microscopic food particles can pass through, stimulating the immune system to attack them. This may result in systemic inflammation, which often manifests as skin problems. (Learn more at “How to Heal a Leaky Gut.”)
“When digestion is compromised, the gut is challenged to absorb nutrients and use them efficiently,” explains functional-medicine nutritionist Cindi Lockhart, RDN, LD, IFNCP. “Skin issues often indicate that we’re not getting enough nutrients — and we may be getting too many foods that cause problems. It’s more than the body can handle.”
For example, keratosis pilaris (which causes patches of rough bumps sometimes called “chicken skin”) can reflect deficiencies in key nutrients, including vitamin A and essential fatty acids, says Lockhart.
Sensitivity to foods such as dairy (low-fat dairy in particular) may pose skin challenges for some people. A study published in the Journal of the American Academy of Dermatology in 2016 found an association between the insulin-like growth factor 1, or IGF-1, in skim milk and increased production of sebum — an oily substance produced by the sebaceous glands — which, in turn, is linked with acne.
A diet high in refined carbohydrates and sugar increases insulin production, which stimulates sebum production as well. A high-sugar diet may also result in glucose binding to collagen, which reduces the amount of collagen in skin and leads to premature wrinkles and sagging.
Choosing health-supporting foods (see “Nourish Your Skin,” below) and eliminating harmful ones, including those at right, can provide therapeutic and preventive benefits for your skin and entire body.
Healthy skin thrives on a whole-foods diet that provides vital nutrients to support digestion, balance blood sugar, promote detoxification, and manage inflammation. Therapeutic levels of certain nutrients may be needed to nourish your skin as well. (For more on this, see “9 Supplements for Healthy-Skin.“)
Omega-3 fatty acids in fish oil — including EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) — are anti-inflammatory. Because inflammation is a root cause of acne, they’re an excellent choice for fighting it, as well as psoriasis and other autoimmune skin conditions. “EPA and DHA change the fatty-acid composition of cells, tamping down inflammation-instigating cytokines. They also help address inflammatory skin issues, including atopic dermatitis, eczema, and acne,” says Trevor Cates, ND. Omega-6 fatty acids, such as linoleic acid in flaxseed oil and gamma-linoleic acid in borage-seed oils, can also be helpful. (For more on essential fatty acids, see “The Omega Balance.“)
“Orange, red, yellow, and green vegetables and fruits are important in terms of skin health,” says Cindi Lockhart, RDN, LD, IFNCP. These foods boast antioxidant phytochemicals that can neutralize the damage free radicals cause and help protect the collagen in skin from oxidative stress. She recommends seven to nine servings daily.
A healthy population of microorganisms in the digestive tract protects the gut lining, improves the body’s ability to absorb nutrients, and guards against harmful bacteria. It also protects the microbial ecosystem on the surface of the skin by supporting the skin’s natural lipid barrier and immune system. Probiotic-rich foods build populations of healthy bacteria, while fiber-rich whole foods deliver prebiotics that gut microbes rely on to survive.
Collagen is a fibrous protein that maintains the structure of the body and elasticity of the skin. As we age, we naturally produce less, but we can support collagen synthesis through diet.
The body is always detoxifying itself: The liver neutralizes toxins, and the kidneys and digestive system filter waste. Keep your body nourished and hydrated to support proper detoxification — and promote clearer skin.
This originally appeared as “Healthy Skin From the Inside Out” in the January-February 2019 print issue of Experience Life.