by kerry watson
inflammation and inflamed acne is something that we talk about a lot here at sS. we’ve all experienced it at one time or another. you sprain your ankle or knee, and your joint gets swollen and painful. maybe when you are starting to feel under the weather, your lymph nodes start to swell. or, if you are reading this in the interest of skin, you wake up in the morning and something hurts on your face. you look in the mirror and there it is: a swollen, red, angry pimple. pain, redness (aka erythema) or imbalance, usually means that inflammation is present.
why does this happen to us? unfortunately, acne is (usually) genetic. but along with the tendency to have acne in the first place, our inflammatory ‘style’ is also largely genetic; which is further aggravated with certain triggers.
in a nut shell, acne is a disorder of the pores where an excess amount of skin cells are shed inside the pore. they clump together within the pore, underneath the skin, and cause breakouts. although the tendency for acne to become inflamed can largely be responsible by genetics, this doesn’t mean that we don’t have any control over it.
listed below are the main triggers that activate some level of inflammation in everyone. these things will turn on the inflammatory response more quickly and profoundly in people with the inherited tendency to develop inflamed acne.
– stress (all of it’s forms)
– lack of sleep
– certain foods and beverages
– hormonal fluctuations
stress is something pretty much everyone is familiar with. chronic stress is very common in this day and age but it should not be accepted as something normal or natural. our bodies need time to reset, rest and relax to stay healthy and well balanced.
it’s important to understand that there are different types of stress and that all stress, both chronic and acute, have the same inflammatory effect on the body. emotional stress is the most obvious. when we experience this type of stress we feel it, we know what’s happening and we know that we need to do something about it.
physical stress is less obvious. traveling is an example of physical stress. the dehydration and pure physics of being on an airplane (traveling hundreds of miles a minute), adjusting to a new climate, a new time zone, different (and probably likely unhealthy) food puts extra demands on our body. all of which translate to stress and inflammation.
we may not always have control over the things that cause us stress but there are measures that we can take to help us better cope with the stress of our daily lives. read a book, take a bath, meditate, go for a walk in nature. our blog post on stress management and our pinterest page will give you some other ideas.
getting 8-10 hours of sound, quality (not just quantity) sleep every night and waking up feeling refreshed and reenergized is one of the best ways to keep inflammation at bay. when we sleep, our hormones reset, our skin cells are regenerated, organs are cleansed and toxins are released for elimination. if you aren’t getting quality sleep you need to take action now. enforce a tech-curfew: put away the smart phone and computer and don’t watch tv for at least an hour before bed. read a paper back book for an hour, take a bath or do some relaxing yoga. you’ll also want to make sure your bedroom is completely dark to encourage the release of melatonin, the hormone that tells your body that it’s time for sleep. for more ideas, check out our “sleep better” blog post.
the foods we eat have an enormous effect on our body’s inflammatory response. when it comes to foods that contribute to inflammation, dairy, soy, sugar, coffee, top the list, with gluten, night shades, refined grains and other carbohydrates following close behind. these foods can have a particularly inflammatory effect if your digestive system is already compromised, which is often the case for those who have taken prescription medications for their acne over extended periods of time.
both dairy and soy have the potential to disrupt hormonal balance and anytime hormones are even very slightly thrown off inflammation can be the result.
thankfully, the practice of injecting cows with a genetically engineered growth hormone called rBGH to increase milk production is in decline. however, even without this hormone, cows, goats and sheep – like all mammals – have to be pregnant to produce milk. in turn, this milk, laden with hormones, naturally contain growth factors that help the baby calf triple its weight in a short amount of time. it is these same substances which can disrupt the human endocrine system and contribute to inflammation and the development of acne impactions. (you are what you eat + drink)
a common problem seen at dairy farms is mastitis, an inflammatory condition of the udders, which happens as a result of over-milking. mastitis is treated with courses of antibiotics. these drugs make their way our into finished dairy products. as a result, humans are ingesting antibiotics on almost a daily basis. among other things, this is contributing to the rise of anti-biotic resistant bacteria and the destruction of the bacterial balance in the human digestive tract. (according to the NRDC, 80% of US antibiotics are used for livestock and poultry! all the more reason to buy local + grass fed, pastured products).
a common misconception amongst the health conscious population is that soy is a health promoting food. this couldn’t be further from the truth. not only does it mimic human hormones, soybeans are also a cover crop for corn. this means that soy is planted next to corn fields to soak up all of the pesticides and chemical run off that is used in the production of corn, 99% of which ends up in cattle feed lots. when we eat soy loaded with pesticide residues it can throw our entire endocrine system out of whack.
the soy of today is much different from even just 20 years ago. nearly all the soy grown in the US and China is genetically modified. this means that the plant’s DNA has been synthetically altered to be pest resistant and produce higher yields. unfortunately, the long term effects of consuming genetically modified organisms (GMOs) is not well researched. in fact, most countries have banned GMOs because of safety concerns.
soy also contains naturally occurring estrogen-mimicking hormones called phytoestrogens. these plant estrogens can interact with estrogen receptor-sites in the human body causing changes to our own, naturally circulating estrogen levels. because androgens like testosterone are responsible for the development of acne, one would think that actions on estrogen levels would either have no effect or be beneficial in preventing acne. this is not always the case. any disruption to natural hormone cycles can contribute to the formation of acne impactions and/or inflame existing acne seeds. (this is why even the copper-iud, which does not release any hormones, can still cause acne; it’s placement is disrupting your body’s natural hormonal rhythms).
for safer sources of vegetarian protein, look to beans, protein rich quinoa, pea protein powders and vegan nut and seed milks, or check out our pinterest page for recipe ideas like this chickpea ‘tofu’.
first, the bad news….unfortunately, that delicious cup of joe you look forward to every morning (and sometimes several times throughout the day) is keeping you broken out. coffee contributes to the development of acne seeds and inflammation in several ways.
to start, coffee magnifies the body’s stress response, essentially doubling the amount cortisol and epinephrine released by the adrenal glands. this, in turn, causes a spike in insulin which makes the skin to produce more oil and increases the number of skin cells shedding inside the pore. both of which start the acne seed formation process. insulin spikes also increase systemic inflammation and this causes tiny non-inflamed acne seeds to explode into big, red, swollen breakouts. these actions are caused by an acid found in coffee called chlorogenic acid. during the roasting process chlorogenic acid breaks down into quinic and caffetic acids. copious amounts of caffeine certainly don’t help the situation but these acids are the true acbe triggering ring leaders.
the acids found in coffee can also cause imbalances in the digestive flora. when the bad bacteria over take the good, the digestive system is no longer able maintain optimal function. b vitamins are no longer produced and important minerals and nutrients are not effectively absorbed or utilized. b vitamins are also depleted when stress is present in the body. deficiencies of all types can result. inflammation is commonly seen in the digestive tract when the health of the flora becomes compromised. this can lead to a condition called leaky-gut which causes low-level chronic systemic inflammation that also effects the skin. taking probiotic supplements would be an excellent way to start to heal this condition. keep in mind that so long as coffee is also part of the picture the probiotics can’t do their job effectively.
additionally, mycotoxins are molds that grow on coffee plants (and peanuts) – and the lower quality the coffee bean, the higher the mold content. this means that decaf coffe is the absolute worst. these mycotoxins have an estrogenic effect on the body that can mess with normal sex hormone balance, worsening acne. these toxic molds also weaken the immune system, potentially leading to an overgrowth of p.acnes bacteria inside the pores, promoting more inflamed acne lesions.
i already know your next question…. no caffeine? at all? what about tea? well, here’s the good news, tea contains less caffeine, more antioxidants and none of the troublesome acids found in coffee. of all the different teas, white and green tea (including mate) are the best. they have the highest anti-inflammatory activity and the highest anti-oxidant content and the lowest caffeine content. black tea is also a suitable alternative with less caffeine than coffee and no acids. there are also several acne-safe coffee alternatives. personally, i really like these yerba mate drinks from guayaki.
sugar & refined carbs
dairy, refined carbohydrates and sugar all stimulate the release of insulin, a hormone that controls how our cells use glucose for energy. chronically high levels of insulin in the body can cause cells to become resistant to it’s messages which can have a devastating effect on many of the body’s systems creating, among other things, a state of chronic systemic inflammation.
the refined sugars and carbs you’ll want to avoid are pretty much anything white – white sugar, white flour, white breads, white pasta. generally, for grain-based products, the darker, the better (as in, whole grains vs ‘enriched’ wheat products – for more information, read here and here). however, ‘brown sugar’ or agave are just as bad as refined sugars and high fructose corn syrup – you can find out more here.
in other words, look for ‘whole grain’ or ‘sprouted’ grains, check the ingredient listings to make sure ‘enriched flour’ is not listed, and choose stevia, monk fruit or, in small amounts, natural sweeteners like dates or honey.
gluten & other processed grains
prolamins are specific types of proteins that are found in all grains. the one that most people are familiar with is gluten, however, gluten is not the only pro-inflammatory compound found in grains. prolamins are troublesome because our digestive enzymes are not able to properly breakdown these proteins into amino acids. this causes inflammation to the lining of the small intestine which prevents it’s ability to accurately monitor what passes into the blood stream. larger undigested food particles end up in the blood stream and because the body is unfamiliar with these particles it mistakes them for foreign invaders. inflammatory compounds are released by the immune system leading to chronic systemic inflammation so long as the prolamin containing foods are consumed.
grains (even whole grains) contain phytates which bind to minerals like zinc, calcium, magnesium and iron in the digestive tract blocking their absorption into the cell. this is another reason why reducing or eliminating grains is often recommended for those who struggle with inflammation. it’s important to eat enough carbohydrate containing foods to maintain a healthy metabolism.
starchy vegetables like sweet potatoes, yams, turnips, rutabagas, carrots, parsnips and winter squash are great sources of healthy carbohydrates that don’t contain phytates or prolamines. low glycemic fruits like berries, melons and apples are also excellent alternatives.
night shades are vegetables that contain pro-inflammatory alkaloids which increase inflammation in the body. in some cases of stubborn inflammation avoiding these vegetables is recommended. the most common night shades are potatoes (white), tomatoes, peppers and eggplant. many people who are sensitive to night shades notice other signs of inflammation after eating these vegetables like joint pain or even headaches.
the acne-safe diet that we promote at sS is designed to control inflammation internally. not only does it prevent the inflammation and development of new acne seeds, it helps to prevent other imbalances and conditions brought about by chronic inflammation and poor dietary choices. check out our pinterest page for a listing of acne-safe recipes.
we already know that any disruption to our natural reproductive hormonal cycles presents a risk for inflammation. even normal hormonal cycles will kick up an inflammatory response during certain phases. for example, many women see acne flare-ups right before the onset of their period when progesterone spikes or during ovulation. this can happen month after month like clockwork. these breakouts aren’t new seeds forming, they are old seeds that are being brought back to the surface by inflammation. if we can get the inflammation under control and extract the seeds, the hormonal flare-ups will eventually decrease and even stop happening.
eating a low inflammatory diet as outlined above will help keep hormones in balance and inflammation at bay. other things that can control hormonal imbalances include taking birth control pills at the exact same time each day and getting regular acupuncture treatments to correct any hormonal irregularities (like irregular, long or heavy cycles).
and for both sexes, some may benefit further from a naturopathic approach by having your hormones actually tested by a lab, to determine a more precise, scientific approach to rebalancing.
other important measures that we can take to keep inflammation down include:
- treating the skin gently and avoiding abrasive ingredients and scrubbing the skin (either with your hands, a towel, clarisonic brushes, or products that contain abrasive particles)
- the topical application of benzoyl peroxide
- taking anti-inflammatory supplements like fish oil and cod liver oil, opti-zinc and/or zyflamend
- and, of course, icing.
as dr. fulton says, ‘don’t forget the ice! it’s the poor man’s antibiotic.’ icing is the best way to control inflammation topically. just as we would ice a sprained ankled or broken arm, we can ice the face to bring down and prevent inflammation. inflamed acne can quickly be reduced by icing at least twice a day for up to 30 minutes at a time. in addition to it’s anti-inflammatory action, icing the skin creates temporary micro fissures, that allow the active ingredients in skin care products to penetrate deeper into the pore where acne starts to form.
benzoyl peroxide (bp), which was stabilized for the treatment of acne by dr. fulton, is a cornerstone in the treatment of inflamed acne. by pushing an oxygen molecule into the pore it neutralizes the p. acnes bacteria that can overgrow in inflamed acne lesions. this specific type of bacteria is present on all skin but can over grow in and around areas that have a build up of sebum (the skin’s oil). the irritating waste products of these bacteria are what causes inflammation. in addition, bp causes exfoliation inside the pore which helps to loosen impactions.
zyflamend is a popular anti-inflammatory supplement developed by new chapter, a great company based in brattleboro, vermont. it is mostly used for treating joint and muscle pain. however, we have found it to be very useful in calming the inflammation of acne. in most cases, a significant decrease in visible inflammation is seen within two weeks of use. the recommended dosage is two capsules a day taken on an empty stomach if tolerated (taking with food is ok too). you can increase the dose to up to 5 caps a day slowly as needed. the ingredients consist of a blend of anti-inflammatory herbs including turmeric, rosemary, green tea and holy basil. however, this supplement is not recommended for pregnant or nursing women. as with all supplements, speak to your doctor before taking zyflamend, especially if you are on other medications.
zinc has been shown to reduce the inflammatory response of acne in the more severe cases. this particular form is a highly absorbable form of zinc, as researched by dr. fulton. it is commonly sold as opti-zinc and it contains copper as well as zinc because these two minerals compete for the same receptor-sites. supplemental copper is needed when taking zinc to prevent a copper deficiency . dr james fulton recommends taking 100mg a day for up to four months at a time. it can take a month or longer to see a reduction in the inflammatory response with zinc. this supplement should always be taken with a full meal to prevent stomach upset. we recommend that clients start with one tablet a day and work up to the max dose slowly and only as tolerated. then, when inflammation is under control (and as the acne starts to clear), reduce your intake. zinc levels should be monitored by a qualified health practitioner to ensure they stay in the normal range.
essential fatty acids (EFAs)
EFAs are “good” fats that the body needs for proper hormone synthesis and health prostaglandin formation. healthy hormone synthesis is important in hormonal balance which is vital in keeping inflammation levels low. prostaglandins are lipids that have hormone-like actions with the ability to turn on or off inflammatory messages in the body. quality sources of cod liver oil contain significant amounts of vitamins a and d. these vitamins are converted to their active forms retinoic acid (vitamin a) and calcitrol (vitamin d) in the body. both are precursors to active hormones that regulate gene expression.
nordic naturals cod liver oil is a superior product that we recommend over others. we also love their pro omega 2000 and pro EPA with GLA products.
inflammation triggers are specific to individuals and this is why we have new clients eliminate all possible triggers and reintroduce them one at a time once their skin is clear. if you have already gone through this process with us you may already know what some of your triggers are. identifying and avoiding triggers is an ongoing process, so whether you are learning about this for the first time or the tenth time, we all need reminders, support and new information to keep us on the path to clear skin.
just remember that the power to control inflammation is in your hands. by following our anti-inflammatory guidelines you’ll able to keep your skin and body looking and feeling it’s best.