A Dietitian’s Guide to Anti-Inflammatory Nutrition for Acne
Acne sucks. As a dietitian who struggled with hormonal cystic acne for almost a decade, I get it. You probably get a ton of (unwanted) advice about diet and acne, and you’re wondering if any of it is legit. So I wanted to put together a comprehensive guide to anti-inflammatory nutrition for acne so you can separate fact from internet fiction.
Honestly, nutrition for acne is just as complex as acne itself…so there is a LOT of information here. While reading through the whole thing will help you see the whole picture, I also know you might be a wee bit impatient so here’s a table of contents to help you skip to the part you need.
- What Causes Acne?
- What is Inflammation?
- How does Diet Affect Skin?
- Foods to Control Acne
- 5 Foods to Heal Acne
- Foods to Avoid for Acne Prone Skin
- Does Dairy Cause Acne?
- Nutrients + Supplements for Acne
First things first: what causes acne?
Despite what the internet will tell you, diet is not the sole cause of acne. It’s super complex and pretty individualized. So while your best friend may have cleared her skin by ditching dairy, it might not be the thing for you.
Any number of things could be contributing to your breakout, like:
- Hormones: my own experience with hormonal acne began with my first pregnancy, but hormone shifts at any age can initiate breakouts
- Microbiome: the bacteria living in your gut can influence your skin as well as your gut, nervous + immune systems. So, how you feed your gut microbiome matters
- Genetics: did your parents have horrible cystic acne? You’re more likely to get it too
- Diet: the connection between diet and acne is still kinda controversial, due to poor quality research and quite frankly, not enough research. A recent 2021 review confirmed that there does appear to be a link between diet and acne, particularly for higher glycemic foods + fast food, low vegetable intake, dairy and chocolate (although some state that the evidence doesn’t back up the chocolate fear)
- Inflammation: acne is considered an inflammatory condition, which isn’t always on everyone’s radar. So let’s talk about what inflammation actually is and why anti-inflammatory nutrition for acne is a good thing.
- Stress: stress = inflammation = acne. It’s definitely a biggie for me. It is thought that stress doesn’t cause acne, but if acne is present, it will exacerbate it.
What is inflammation?
Inflammation is an integral part of the immune response. We need acute, or short term, inflammation to help protect us from germs or any tissue damage, like when you cut yourself in the kitchen.
However, chronic inflammation occurs via a different pathway than acute inflammation, and it represents an imbalance between action and tolerance in the immune system, generally due to some chronic aggressor such as chronic stress, gut dysbiosis or diet. Chronic inflammation is associated with many chronic conditions, everything from rosacea to lupus to irritable bowel syndrome. So managing chronic inflammation is a potential strategy in getting acne under control and anti-inflammatory nutrition is one way to do that.
How does diet affect skin?
Food is not just an assortment of nutrients. Although eating nutrient-dense plant foods and foods rich in fibre are both important for nourishing your immune system, food is also information. And over long periods of time, sending the wrong kind of information to your body can stoke the flames of inflammation.
What kinds of information can food send? Well, food can raise blood sugars quickly or slowly, which is known as their glycemic impact. When our blood sugars rise sharply, we get larger spikes of insulin, the hormone that our body needs to get that sugar into our cells. Frequent large spikes of insulin have been shown to increase oil production in the skin as well as foster chronic inflammatory responses. Research suggests that higher glycemic, “Western-style” dietary patterns are associated with with acne lesions.
So an anti-inflammatory dietary pattern can help regulate inflammation – and anti-inflammatory nutrition for acne is a solid first step for a healthier body and clearer skin. I have a whole cookbook on anti-inflammatory nutrition called Eat More Plants.
What does an anti-inflammatory diet look like? At its simplest, it means choosing more whole plant foods like vegetables, nuts and legumes that are high in nutrients + antiinflammatory phytochemicals as well as fibre to feed the gut microbiome. It means eating fewer animal products to keep saturated fat intake lower and fewer hyper-processed and fast foods to avoid hyperglycemic effects on blood sugars.
The types of fats we eat can also contribute to inflammatory responses. While we need to eat omega 6 fatty acids from plant foods such as grains, nuts and seeds, it is thought that eating excess omega 6 and saturated fatty acids (which is common in a Western-style diet of meat and hyper-processed foods) can drive pro-inflammatory pathways while a diet rich in omega 3 fatty acids and monounsaturated fats such as avocado and olives may be supportive of healthier skin.
So let’s get into what to eat more of and less of, shall we?
Foods to control acne
Before I get into this what to eat/what to avoid for acne section, I have to remind you (just in case you skipped the first half of this blog!) that diet is not 100% responsible for acne. You have to consider skincare + stress + hormones and all the other things too. Some folks will have excellent responses to diet changes, and others, not so much.
The other thing to note is that pattern always matters more than plate. Drinking a beauty smoothie a couple of times a week while still being stressed and eating bags of candy daily probably won’t move the needle. Instead, what you can do consistently everyday – such as having a green smoothie, getting zinc-rich foods etc – is going to have a larger effect on your acne.
5 Foods to Help Heal Acne
Omega 3-rich seeds: we all need omega 3s everyday, and omega 3 foods have been associated with fewer acne lesions. So enjoy 2-3 tablespoons of ground flax, ground chia or hemp hearts daily. I’ve got plenty of recipes using omega 3 seeds for you to try.
Fruits + Veggies: antioxidant rich fruits and vegetables help keep your immune system nourished, lower inflammation and are associated with fewer acne lesions. Whenever you can, make half your plate fruits and vegetables at every meal. They’re also rich in vitamins A and C which are important for skin health, including collagen protection. Yes, all F+V count, including onions, sweet potatoes and frozen veggies.
Lower GI foods: Because of the association with glycemic spikes and acne, a lower glycemic dietary pattern has been shown to be supportive in acne. However, I want to caution against using glycemic index as your only barometer for healthy eating. Because it doesn’t tell you the whole story. For example: an oatmeal cookie has a lower GI than oatmeal. UM….instead, let the principal inform your choices: eat whole plants most often, and always pair with protein and healthy fats for better balance.
Non-dairy foods: you may find ditching dairy worthwhile, so you’re going to need healthy non-dairy alternatives such as unsweetened plant-based milks. You might also have fun making your own nut-based cheeses and cashew cream-based recipes…you’ll never miss the dairy!
Legumes: beans and lentils are tops when it comes to high fibre, microbiome-boosting foods because you don’t want to neglect your gut health! Legumes are also rich in minerals such as zinc to support healthy skin.
You do not need to go on a gluten-dairy-sugar detox to heal your acne. You do need to be mindful of how you eat…but that typically means a focus on MORE. More plants. More cooking at home. You don’t have to fear food. Doing an elimination diet for acne should be a last resort…not the first response. Why? Because elimination breeds food fear and makes it harder to nourish yourself.
Foods to avoid for acne prone skin
Let me repeat: pattern over plate. It’s the foods you eat consistently that make the biggest difference to your skin. So an ice cream on a sunny afternoon? Totally fine. But drinking two sweetened coffee drinks and a mid-afternoon candy bag daily? We probably need to shrink that sugar intake.
So let’s talk about foods + dietary patterns associated with acne.
High glycemic foods: foods that are hyper-processed, made primarily of refined flours and added sweeteners with little fibre can raise blood sugars and cause inflammation/oil production spikes. Don’t fall for the ‘no refined sugar’ health washing. Sugar is sugar, even if it’s maple syrup or coconut sugar.
Hyper-processed, “Western-style” diets: the diet we typically eat in North America is high in added sugars, meat, saturated fat and refined flours and low in fruits and vegetables and fibre. It’s okay to grab a pizza every once in a while, but as much as it is within your ability and affordability to do so, cooking simple meals at home from whole plant foods like grains, legumes and vegetables will help you be better nourished.
Does dairy cause acne?
“Just ditch dairy and your skin will clear!” said every blog post ever. Now, I will share that I have had clients who have had their skin improve post-dairy but others for whom it did not work (I’m in that unlucky category!).
So what does the science actually say? It’s still kind of controversial, but it would appear that the strongest evidence is for milk (particularly lower fat) itself, not dairy products as a whole. Why? Dairy can contain naturally occurring hormones that can increase oil production and acne lesions, such as insulin-like growth factor 1 (IGF-1).
Do you need to ditch dairy for your skin? If generally increasing the nutrient-density of your diet doesn’t work, it’s worth a shot. Make sure you’re getting your calcium and vitamin D from non-dairy sources so you protect your bones + nervous system.
Specific nutrients + supplements for for acne
Zinc: Zinc is critical for immune and gut health. In acne, it is thought that zinc may help reduce inflammation and even counter P.acnes bacteria in the skin. Studies have shown that zinc supplementation is effective in acne. However, studies typically use doses of zinc you’ll want to ask your doctor about, particularly because high doses long term can cause side effects like nausea and can alter your levels of copper. Enjoy more zinc-rich plant foods such as pumpkin seeds, hemp hearts, cashew and chickpeas.
Omega 3: Omega 3 fatty acids are thought to be anti-inflammatory and specifically in acne, may help to decrease the production of acnegenic leukotriene B4 (LTB4) and moderate levels of IGF-1. In one trial, omega 3 and GLA, a unique omega 6 found in hemp and borage, decreased acne lesions. I would recommend starting with food sources of omega 3 fatty acids first, then add an algae-based omega 3 if you want more support.
Probiotics: given the theoretical connection between the gut microbiome, inflammation and skin health it would seem that probiotics are of promise in acne treatment but there is very little research so far exploring this. In one trial, using a Lactobacillus rhamnosis strain, probiotics did in fact improve acne appearance. However, this is just one trial and there are a lot of crappy probiotics on the market so you have to know what to look for when buying a probiotic.
Vitamin D: Vitamin D is known to be an important factor in immune health and recent research suggests that those with acne have lower vitamin D levels than those without. So taking your daily vitamin D might also be supportive of clearer skin.
WHEW!!! That was a lot to digest…ha! I hope you learned something new and if you have any questions, drop them in the comments!