Included among last week’s “Ask Me Anything ” responses were several requests for a Primal commentary on acne. A lot of people have asked for this kind of post over the years. The fact is, it’s a great question. Acne is a common problem that gives too many people too much grief. Our medical establishment’s prescription for acne generally involves dehydrating the skin into oblivion, sandblasting it with chemicals, or pumping hormones, antibiotics and potentially toxic meds into the patient. (If any of these methods have worked for you, I mean no offense. I just think people deserve better options than these.) Is there a healthier, more Primal method to a clear complexion? In a nutshell, yes. I’m not talking rabbit-in-a-hat trick but a lifestyle approach with natural options that minimize the systemic and external conditions associated with acne. Let’s look at the full picture.
The Systemic Root
Acne doesn’t have a single definitive cause but can be set in motion by internal and external conditions, all of which have some root in systemic functioning: inflammation, “excessive” sebum (oil) production, pore blockage and “bad” bacterial presence/infection. In large part, the condition of the skin is part and parcel of the body’s overall health. Systemically speaking, hormonal balance (or lack thereof) and associated nutrient levels strongly influence the production of oil, the skin’s vulnerability to invasive bacteria (and presence of “good” defensive bacteria), the natural production and turnover of skin cells, and (of course) underlying inflammation. As hard as it is to believe, the medical community is only this decade beginning to recognize the systemic roots of acne. (Then again, should we really be surprised?)
Now, we all know those folks who eat junk food, exercise once in a blue moon and keep a ridiculous sleep schedule – and yet by some bizarre miracle always have perfect skin. It can seem like a slap in the face to the earnest person who has to work for his/her complexion and still comes up short. (All I can say to this irony is the chickens come home to roost eventually. It’s not metaphysical karma but biological fact. Live a hard and sloppy life, and it will catch up with you at some point, in some way.)
I always say that we’re all cut from the same physiological cloth, and basic biological patterns hold. Nonetheless, subtle differences seem to exist from person to person. Some folks appear to be more vulnerable to acne – hormonal “stages” are a big part of that susceptibility – the teenage years being the most infamous example and early pregnancy or post-pregnancy/nursing being another. Hormonal shifts brought on by stress , exhaustive exercise  or medication side effects can also figure into our skin’s condition.
I don’t believe we’re 100% destined to have acne or not, but our susceptibility does appear to vary, and our modern Westernized environment seems to set the stage for that risk. As Loren Cordain’s (and others’) research  have shown, acne is ubiquitous in the Western world but limited in other parts of the world and practically unseen in traditional societies. Yet, even Primal folks are subject to acne. What gives exactly? I’d suggest it’s a constellation of influences in modern living that come back to taunt us in the mirror. We live a modern existence full of systemic traps: pollution, personal care products , stress, lack of sleep , and climate controlled living to name a few. Nonetheless, we needn’t sit home on a Friday night.
Let’s get down to the nitty gritty. What lifestyle factors actually make for healthy, clear skin? (We’ll get to other strategies later.) I’m sure you can guess what I’ll say first, and there’s good reason for this suggestion of course. Go Primal!  First, the obvious and then some additional tips.
Ding, ding! Eat an anti-inflammatory diet. As research  has shown, even conventional low glycemic diets make for better skin . Understand also that acne can be a manifestation of food related allergies or sensitivities (e.g. yeast, eggs, gluten, lectins). Dairy is a common culprit . (I’ve always said that milk is meant for baby cows.) Women in one study  who reported high dairy intake in teenage years were 44% more likely to have experienced severe acne. (Incidentally, full fat dairy isn’t as strongly implicated as lower fat dairy foods.)
Speaking of fat, I suggest that those vulnerable to acne eat plenty of clean fats, and do you can to avoid livestock hormones  (the basic reason to avoid milk , which is full of them regardless of organic status). Enjoy clean animal fat  and safe, non-oxidized plant-based fats like olive oil , coconut oil , etc. And be sure to load up on antioxidant-rich produce items as well, like garlic, onions, greens and broccoli that support cellular production and repair.
Beyond the power of a clean, anti-inflammatory diet, I suggest adding a good comprehensive supplement as well as extra zinc , vitamin B complex (especially vitamin B3 ), vitamin A and vitamin D  for added help in regulating oil production and further boosting the skin’s natural repair abilities. Research has especially supported the role of zinc deficiency in acne. Women who are pregnant , nursing  or have recently weaned are particularly at risk because of higher need for zinc. Of course, make sure you get plenty of omega-3s  for extra anti-inflammatory effect. Some folks report good experiences with adding evening primrose, an anti-inflammatory omega-6 as well. Finally, a good probiotic  can help your body (and skin) balance its own “good” bacterial defenses.
Chemicals like flame retardants, parabens, phthalates and other plastic-related chemicals are hormone disruptors, which can throw off even the best lifestyle efforts. Eliminate them  as much as you practically can (including the paraben-loaded conventional acne creams!).
Stress and Sleep
Stress causes a cascade of hormonal actions that over time deplete essential nutrient stores, especially minerals like zinc. They don’t call it beauty sleep for nothing! Consider it an investment in your appearance as well as overall health. Additionally, take up stress management methods  that support the relaxation response  to further support hormonal balance.
Topical, Hygienic and Commonsensical Ideas
Beyond systemic strategies, there are plenty of topical options that are effective for many but tend to be more hit and miss overall. I think it’s important to view their role as supplementary to systemic efforts. From a personal perspective, I understand people being willing to try anything and everything they find – at the doctor’s office, at the drug store, on the infomercials. From a Primal perspective, however, I’d suggest otherwise. The idea shouldn’t be to beat your skin into submission. Most people who have acne actually have very sensitive skin. Rather than looking for products that strip and dry the skin, I’d recommend choices that enhance the integrity of the skin and its natural defenses. There are plenty of natural options that won’t clean out your wallet and that promise fewer side effects to boot. Here are a few of Primal note….
- Manuka honey: All honey has antibacterial properties, but research shows  this New Zealand variety appears to pack more of a punch for acne and other skin conditions.
- Nicotinamide: A topical form of vitamin B3 can reduce inflammation and help acne  and improve skin’s overall condition.
- Willow bark: It packs an anti-inflammatory wallop.
- Tea tree oil: Consider it a more natural astringent that has a powerful antibacterial impact.
- Other botanicals like calendula and feverfew can be soaked and spread over the face with a cotton ball after washing in order to calm skin.
- Steaming: Visit the steam room at the gym or lean over a pot of hot water with a towel draped around your face to open pores for a good cleansing, natural oil extraction or absorption of botanical agents.
- Light exfoliants: Use baking soda or oatmeal to exfoliate and encourage skin turnover, but go gentle.
- Pure water: Those with the worst skin conditions like severe acne or rosacea can benefit from rinsing with distilled rather than tap water.
- Practical prevention: Minimize bacteria exposure to the face by keeping hands away from the face, cleaning phones, helmets, etc., and using fresh pillowcases (thanks, Shastagirl!)
The idea here is a holistic approach to supporting healthy skin. Although these suggestions might not serve as a magic bullet, they are the best way to get at the root causes of the physiological imbalances behind acne. Furthermore, the natural topical options can support your lifestyle efforts without depleting skin of its natural moisture or defenses and without creating product dependence. Finally, these suggestions can support the overall health and condition of your skin whether or not you have complexion issues. I hope the overview offers those with acne good food for thought and encouragement in their personal Primal regimens.
What say you, MDA community? How did going Primal change your skin? What other strategies and products (natural or otherwise) do you use that complement your Primal efforts? Thanks for reading and sharing your thoughts today.