General Advice

DIET

The link between diet and acne has become a lot clearer in recent years.

Acne is a disease of modern societies and is almost non-existent in hunter gather societies.  For example in Eskimos, acne only appeared when they adopted a Western diet of highly processed and refined foods.

A recent university study has suggested that the right diet can reduce acne by more than 50% in only 12 weeks.  The recommended dietary changes were simple and included eating more lean protein (e.g. lean red meat, fish and chicken) and low Glycaemic Index (GI) foods (e.g. wholegrain bread, basmati rice, baked beans, fresh fruits, vegetables) and keep to a minimum takeaway and processed foods.

Carbohydrates

Carbohydrates play an important role in supplying energy however certain carbohydrates are absorbed more quickly than others and the quicker the carbohydrate is absorbed the quicker the blood sugar level increases and the more insulin the body needs to release to control the blood sugar level.

The Glycaemic Index (GI) is a score to measure the rise and fall effect specific carbohydrate foods have on blood glucose (it is based on a 50 gram serve of carbohydrate).

High GI foods with a score of 70 or more are more quickly digested and absorbed causing blood glucose levels to rise rapidly.  This sudden blood glucose spike triggers the pancreas to produce high levels of insulin.  High levels of insulin are associated with hormonal imbalances that contribute to acne.  Examples of high GI foods are sugary ready to eat breakfast cereals, white bread, potatoes and biscuits.

Low GI foods with a score of 55 or less are slowly digested and absorbed causing blood glucose levels to rise slowly over time and have a lower insulin response.  Reduced insulin levels help to control hormonal imbalances associated with acne and can reduce acne.  Examples of low GI foods are oats, wholegrain bread, basmati rice, baked beans and fresh fruit.

Different types of the same food can have quite different GI values.  For example white potatoes are 90, whereas sweet potatoes have a GI of 44.  White calrose rice is 83 whereas basmati rice is 58.

There are various publications that provide information on choosing low GI foods.  One excellent book is “The Low GI Shoppers Guide to GI Values” Author: Jennie Brand-Miller, Publisher: Hachette, Cost: Approximately $12.95.

Chocolate

Chocolate was for many years suggested as responsible for bad skin, however, starchy foods such as white bread and potatoes are much more likely to blame as they have a higher GI.  Whilst chocolate doesn’t need to be totally avoided nor should you go overboard as it contains a lot of fat and therefore kilojoules.  Dark chocolate has a lower GI than milk chocolate and there are other health benefits attributed to consuming high cocoa content chocolate (over 70%) in moderation (e.g. 30-40 grams/day).

Protein

Protein rich foods such as lean red meat, fish, eggs and chicken do not increase blood glucose levels, helping to keep insulin levels, hormones and acne under control.

Lowering the amount of insulin the body produces helps to reduce excess testosterone and this lessens the likelihood of acne.

Adequate energy needs cannot be sustained simply by switching from a high GI to a low GI diet and hence protein rich foods are necessary to help control acne as well as playing an essential role in providing the body with a wide range of nutrients essential for health and vitality.

Red meat (beef, lamb and veal) is the richest supplier of well-absorbed iron, which helps to move oxygen around our bodies and is essential for normal brain development and function.  Red meat is also rich in zinc, which helps to keep the immune system strong.  Our bodies absorb both zinc and iron more effectively from meat than from plant foods.  Red meat, poultry, fish and eggs are excellent sources of vitamin B12, a nutrient not found in plant foods.  Vitamin B12 has a special role in protecting our DNA and nervous system.  Fish and seafood are packed with healthy omega-3 fatty acids, with the second largest sources in our diet being beef and lamb.  Omega-3s help protect the health of the heart.

Helpful Diet Hints

Follow these helpful hints to boost levels of protein-rich foods and low GI carbohydrates:

1. Power up with protein

• Include lean beef, lamb or veal at least three to four times a week and fish twice a week for dinner.
• Eat lean protein (red meat, poultry or fish) for lunch daily.
• Aim for three serves of low-fat dairy foods each day.
• Remember to include eggs.

2. Go low GI

To ensure carbohydrate choices are low GI:

• Start your day with high-fibre breakfast cereals, such as porridge, natural muesli or wheat biscuits.
• Swap white bread for wholegrain and rye varieties.
• Choose pasta and basmati rice instead of white rice.
• Add legumes, tofu, lentils or chickpeas to stews and salads.

3. Get Fresh

• Aim for three serves of fruit a day.
• Eat at least 2½ cups of vegetables a day, preferably non-starchy ones, such as broccoli and capsicum, which have a lower GI value.

4. Have an Oil Change

• Use olive oil in cooking.
• Choose a monounsaturated margarine.
• Sprinkle nuts and seeds on cereal.
• Add avocado to a sandwich or salad.

5. Limit processed foods

• Avoid sugary breakfast cereals and ready-to-eat snacks.
• Drink water instead of soft drinks.
• Keep quick meal options at home so you don’t send out for takeaway.
• Limit refined white foods, such as bread, cakes and biscuits.

EXERCISE

Regular exercise is also important to maintaining skin health by reducing insulin levels which in turn lowers hormones that kick start or exacerbate acne.

Exercise improves the body’s sensitivity to insulin so that less insulin is needed to maintain blood glucose levels.

In addition exercise increases our circulation during and after exercise helping the bloodstream to deliver more oxygen and nutrients to the skin, enhancing skin repair and cell growth.

The National Physical Activity guidelines recommend engaging in 30 minutes of physical activity on most days.  This should be of moderate intensity where you have enough breath to talk but not to sing.  This can be in three 10 minute bursts of activity.

OTHER BENEFITS

Diet and exercise that encourages a beneficial reduction in insulin levels and insulin resistance are not only beneficial to acne but other health benefits such as reduced risk of weight gain and reduced risk of type 2 diabetes later in life.

ORAL CONTRACEPTIVE

The typical oral contraceptive is what is called a combined pill as it combines two types of hormones namely an oestrogen (e.g. ethynyl oestradiol) and a progestogen (e.g. levonorgestrel).

The progestogen component of the oral contraceptive can have androgenic actions which in some women can result in stimulation of oil production in the skin and hence exacerbate acne.

If women develop acne when on a standard dose combined oral contraceptive pill (e.g. MICROGYNON 30ED or NORDETTE) then it is usually beneficial to reduce or change the progestogen component of the pill to a less androgenic formulation such as YASMIN (drospirenone) or VALETTE (dienogest)

If more severe acne or hirsutism (excess hair growth) then it may be necessary to change to a more strongly anti-androgenic oral contraceptive such as DIANE 35ED (cyproterone acetate).

OTHER HORMONAL TREATMENT

In some women who do not want to be on the oral contraceptive there are other medications which work by helping to switch off the natural androgenic hormones that increase sebum production and cause acne.  These include ANDOCUR (cyproterone acetate) and ALDACTONE (spinonolactone) however, they are not compatible with pregnancy so are not suitable for women who are pregnant or attempting to fall pregnant.

Related Items

• About Acne
• Skin Care Advice