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Zits? Preventing Acne the Dr. Sara Way

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Acne sucks, yet it is preventable. There is a crucial link between how your eat and your complexion.

When it comes to breakouts and zits, DO NOT go for the antibiotics and harsh chemicals that can unnaturally thin your skin and make you burn in the sun. A few small tweaks to your food plan can make a world of difference. In fact, you can significantly improve your skin with how you eat and how you supplement. We know this from robust science, and from noting that people in rural Japan, Malaysia, and parts of Africa just don't get breakouts, as reported by Dr. Jonny Bowden, the Rogue Nutritionist, in The Most Effective Natural Cures on Earth: The Surprising, Unbiased Truth about What Treatments Work and Why.

I'm on a mission to change the world one hormone at a time, and today we are changing some of the hormones that drive acne, such as testosterone, IGF-1 (growth hormone) and insulin, when they are too high for both comfort and vanity.

Backstory on Acne

Acne is usually due to an imbalance in the family of hormones called androgens, which include testosterone and DHEA among others. We think of androgens as "boy" hormones, but women have and need levels in their blood (although only about one-tenth of those in men). We know that testosterone is crucial for women's maintenance of mood, sense of well-being and to see a decent response in the body to exercise. We're not talking Barry Bonds levels -- we're talking testosterone and DHEA in balance such that it is not too high and not too low.

Many of us find more zits on our skin as we enter peri-menopause, which can feel like puberty in reverse. It's especially fun when you are sharing your anti-acne skin care products with your kids.

I met a beautiful 40-something woman at a party last Friday who confided that she needs to do something about her acne besides the birth control pill that her GYN is offering. Honestly, I thought she was gorgeous, but I don't argue with women who fret about their skin -- I can relate.

She's not the only one who has a birth control pill on offer. I see them handed out like candy to girls who are nowhere near ready to have sex. I also see the Retin A products and the antibotics.

Don't do it, girlfriend! While sometimes there is a time and a place for a birth control pill, this is not one of them.

Causes of Acne

Step 1: Stimulation of the oil-making (sebaceous) glands by testosterone.
Step 2: The pores get plugged and trap the oil inside. Bacteria grow in the trapped oil, causing the production of irritants.
Step 3: Your immune system finds out. Like with most things in the body, this is good and bad news. Your army of immune cells fights the bacteria, and that renders the redness, swelling, pus-like fluid and later scarring. Pretty! This is the part we would all love to skip.

Most women notice that their acne is worse in the week before their period. We believe this is related to your testosterone peak at day nine, but the mechanism is not well understood.

If you have "bumps" (as my older daughter calls them) and are reading this post, it is likely that the standard approaches have not cleared your skin. Good news here: Treatments aimed at the hormonal cause often work when standard ones have not.

One specific type of hormonal imbalance associated with acne that deserves mention is the poorly-named polycystic ovarian syndrome or PCOS, a common disorder in reproductive-aged women. One of the main symptoms of PCOS is testosterone-induced skin and hair changes, which include acne, hirsuitism (increased facial and/or body hair) and sometimes scalp hair loss or thinning. Other symptoms are irregular periods or anovulatory (no ovulation to the rest of us) cycles, difficulty controlling weight and metabolic changes such as insulin resistance. Female acne can be a sign of PCOS. If you have some of these additional symptoms, consider getting evaluated for PCOS.

Eat This, Not That: The Food/Zit Connection

Turns out that acne often is a sign of dairy allergy, plus dairy products often contain hormones that aggravate your skin and cause zits. For the 411, check out my homegirl's book, uh... actually my classmate from Harvard Medical School, Dr. Jessica Wu, Beverly Hills dermatologist (super friendly and rigorous -- love that combo!). Her book is called Feed Your Face.

1. Kick dairy. Click here to learn more about why and how.

2. Eat this: Wild Alaskan Salmon. Fish oil and other healthy fats can help lower inflammation, which is one of the root causes of acne.

3. Cut sugar. Sugar aggravates acne. There's a link between eating sugar and androgen levels, particularly testosterone. High androgens can cause acne. Eat a low glycemic food plan and you can drop your testosterone levels by 20 percent within seven days! Click here for the study. And if you lower the glycemic index of your food for 12 weeks, you can reduce acne by more than 20 percent, according to a randomized trial (if you know me, you know this is the best quality evidence and what I favor). Click here for the study. And there's more where that came from.

Aim for foods that have a low glycemic index, as in 70 or lower (or even 55 if your skin is quite congested). Take it up one notch higher and go Paleo. Here's why: A study in the Archives of Dermatology tells us that Paleo can help reduces. What's Paleo? I've got a food plan for you right here.

4. Chocolate? Go ahead, but the high cacao variety. While some people fret that their love for chocolate might be aggravating their acne, there is no such link as long as the chocolate is low in sugar. In fact, one study showed that chocolate improves how your body uses sugar -- a measure called "insulin sensitivity."

5. Eat more green and yellow vegetables. They also help reduce inflammation, which will make your skin less inflamed, congested, and more attractive to others.

Dr. Jonny Bowden goes on to recommend Saw Pawmetto for acne, because it helps to reduce bad hormones that can aggravate your skin, such as dihydrotestosterone, the "son" of testosterone.

Many women, young and old alike, with hormonal acne have just simple acne, nothing else, and benefit from a hormonal assessment (usually saliva or blood testing), and balancing of any existing hormonal disorders with bioidenticals. While it is true that a birth control pill will lower your testosterone and make your skin more clear, it also lowers your libido and may have long-term risks associated with synthetic hormones. Start with your food as your first line of defense to improve your skin and decongest.

Now I'd like to hear from you...

Have you found a great way to reduce your acne?

Have you tried adjusting your food plan, and seen benefits to your skin?

Sara Gottfried, M.D., is a practicing integrative physician and author of the forthcoming book, The Hormone Cure (Scribner/Simon &Schuster, 2013). You can follow Dr. Sara on Twitter, connect with her on Facebook, watch her videos on Youtube, and subscribe to her newsletter.

For more by Sara Gottfried, M.D., click here.

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