how to stay acne-safe with all the holiday meals to come!

 

check out this quick guide to navigating your holiday meals to stay on track and fresh faced during the holiday season!

remember that there are two different types of acne, inflamed and non-inflamed and either or both can be triggered by acne promoting foods. these start out the same way a tiny microscopic plug in the skin. we call this plug an acne seed. these little guys can quickly get inflamed and turn into the red spots that can sometimes be sore and almost look like a mosquito bite. these can pop up a few days after eating an offending food. non-inflamed acne takes 1-3 months to show up on the surface of the skin. this is the time it takes for that little seed to grow into a bump that hangs out under the skin or turns in to a blackhead. this means that the pumpkin pie that you eat on thanksgiving may not show up as acne until new years eve. what a bummer! so to ensure clear skin up to and through the new year, choose these acne safe alternatives during this fun and festive time of year.

 

TRADITIONAL HOLIDAY FOODS THAT CONTAIN DAIRY

 

pies contain butter in their crust and can contain sweetened condensed milk + heavy cream in their fillings (especially in pumpkin and pecan pies).

pie

instead ask if you can bring desert as your contribution to the meal! check out these paleo pumpkin pie and clean eating pecan pie recipes.

or just need a quick bite of something sweet? try to find a dried piece of fruit on a cheese tray, or fresh fruit or a square of dark chocolate instead. easy!

if you absolutely have to have something with dairy we think whipped cream is the safest option and here’s why; yes it’s cows’ milk but mostly air, so not as much dairy you’d consume if you were, say eating ice cream or cheesecake. still not recommended if you want your best chance for your clearest skin though.


mashed potatoes are traditionally made with lots of butter and heavy cream.

dairy free mashed potatoes

instead ask your host ahead of time to take some of the boiled potatoes out of the pan before adding butter and cream. add a little salt and pepper and mash your own bowl sans dairy! or how about roasted potatoes, a nice grainy bread or rice? or my personal favorites: roasted turnips (sub ghee for the butter) or roasted radishes – super yum!

or bring your own acne safe mashed cauliflower and turn your friends and family on to this delicious low carb dish.


green bean casserole can be made with butter, cream, and sometimes canned soups (like cream of mushroom) that contain dairy and soy.

green beans

instead skip the cassarole or ask your host to set aside some cooked green beans before they casserole them. you can also offer to bring a delicious paleo version that will be sure to please all of the foodies at the table.


gravy can contain cream, butter and white flour.

instead skip it or ask your host to set aside some turkey drippings for you before they add the thickeners. this recipe uses coconut milk and potato starch to make the worlds best paleo gravy.

our very own emily raves about this one which she made last year when her husband was still vegan. she says it was BOMB, even better than regular gravy if that’s possible.


bread usually contains dairy when made from scratch and can also contain soy if store bought.

dairy-free and soy-free bread

instead offer to bake the dinner rolls using this amazing dairy free recipe, this paleo recipe, or pick up a loaf at a local bakery where they can tell you which varieties are dairy free.

or impress everyone with these low carb keto buns. switch out the butter for ghee which is butter with the milk solids removed. ghee is a very anti-inflammatory fat and a step up from butter in acne safetyness.


salad dressing can contain dairy in the form of cream and cheese or soy as soy bean oil or soy lecithin.

make your own salad dressing

instead enjoy your salad without the dressing or make a simple vinaigrette like any of these.

so what if you can’t avoid eating these foods? your host is persistent that you try their lovingly prepared holiday offerings and you are absolutely starving and there are no alternatives in sight…(pause, deep breath, big sigh)….then OK, you can just have a literal bite. try sharing a non-safe food with someone if you really can’t avoid it altogether. or try eating around the obvious acne foes and discreetly throw the leftover cheese, sauce or tofurkey away.

what are some of your favorite holiday recipes? share them with us on instagram @skinsalvationacneclinic

the ins and outs of pcos and acne

pcos, or polycystic ovarian syndrome, is complicated. it’s an endocrine condition that affects 8-20% of women of reproductive age worldwide1 and it is characterized by at least two of the following three symptoms: cysts on the ovaries, elevated male sex hormones and/or absent or irregular periods. pcos is a highly misunderstood condition whose symptoms manifest differently among women. many women with pcos gain weight while others have thin body types, some have acne and regular periods while other haven’t menstruated in months. because almost all women with pcos test high in androgens (male sex hormones), many symptoms include infertility, male-pattern hair loss, oily skin and acne along the jawline, and facial hair growth. these symptoms can be frustrating to deal with because they are persistent and can often make women feel like they have no control over their bodies. but these symptoms appear for a reason. and usually that reason is that our bodies are chronically stressed and something about our lifestyles needs to change. women with pcos are at increased risk for developing type 2 diabetes, hypothyroidism and cardiovascular disease, so acknowledging these signals from our bodies is key to keeping ourselves healthy for a lifetime. 

 

what causes pcos? 

  • genetics – while pcos is not a genetic condition, per se, predisposition to pcos can be passed down through generations. those who are exposed to higher androgens by their mothers while in the womb are also at greater risk of contracting pcos later in life.

  • stress – both physical and emotional stressors can contribute to pcos. some examples of physical stressors include over-exercising, eating foods you are intolerant to, not eating enough and constant blood sugar issues. many women who suffer from pcos are stressed to the max in their everyday lives – they take on extra work at their jobs, juggle familial responsibilities, endure harrowing breakups and family stress and then often criticize themselves for not working or trying hard enough.

  • blood sugar imbalances – this is one of the most common root causes of pcos and often stems from excessive intake of refined sugars and carbs, or the standard american diet. it often leads to weight gain and involves chronically elevated blood sugar. these blood sugar imbalances cause systemic inflammation in the body and directly influence the production of testosterone, which then inhibits ovulation and fertility.

  • over-exercising and under-eating – our society places a tremendous amount of pressure on women to look a certain way. many women internalize the pressure to be thin and spend years of their lives under-eating while engaging in excessive (usually cardio) exercise. high-intensity exercise always causes testosterone spikes, but they are usually temporary, subsiding when we refuel our bodies with calories. but when women exercise for too long without replenishing their energy stores, their hormone balance starts to suffer.

dealing with facial hair growth and acne

if you struggle with facial hair growth, you are not alone. this can be particularly frustrating if it accompanies hormonal acne – they often show up in exactly the same places along the jawline and chin. because of the cultural expectation that women maintain hairless faces, this type of hair growth can be embarrassing – but there is absolutely nothing wrong with you, there is no reason to feel shame, and there is no reason for you to change in order to appease the people in your life. having pcos is hard enough without having to navigate gendered cultural expectations.

if you are a client here at sS and you to decide to undergo laser hair removal or electrolysis, we just ask that you wait at least two weeks between those treatments and our acne face treatments – we don’t want to stress your skin out too much! if you have hair on your face that you want to remove by shaving, try the tinkle razor, which we sell in the clinic. these razors are more gentle than conventional razors. as for waxing, we don’t recommend it! the heat can be irritating to the skin and who knows what kinds of comedogenic ingredients are lurking in those waxes! 

if your doctor diagnoses you with pcos, they will most likely send you home with a prescription for one or both of two medications: metformin for insulin regulation and spironolactone for decreasing testosterone levels. it is entirely up to you whether you decide to take these medications or not, and whatever your decision, here are a few herbal, dietary and lifestyle changes to implement to keep pcos symptoms under control (and, as always, ask your doctor before making any major changes to your health plan):

  • two cups of spearmint tea each day has been shown to reduce free testosterone levels in women with pcos and has resulted in reduced hirsutism with none of the side effects of pharmaceutical-grade drugs.2 

  • 400mg of saw palmetto, a plant native to the americas, has been found to inhibit the 5-alpha reductase enzyme. the inhibition of this enzyme helps reduce the conversion of testosterone to dht, which is the male sex hormone that leads to oily skin, hair loss, acne and facial hair growth.3

  • balance out your blood sugar by reducing your consumption of refined sugars and carbohydrates – ditch the morning cereals for eggs and greens; instead of a sandwich at lunch, try a salad with tuna or grilled chicken. and pasta for dinner? no way! zucchini noodles will do the trick. eat plenty of good fats and protein and aim for three square meals a day to get your blood sugar on track and to give your digestion a break.4 and supplementing with chromium picolinate has been shown to decrease insulin resistance in women with pcos.5

  • dial in your digestion. take a test to determine any foods you might not tolerate or try an elimination diet to get to the bottom of any digestive woes. this is hugely important because digestive distress is another physical stressor on the body that can ultimately contribute to elevated cortisol and testosterone levels. similarly, make sure your elimination is on track – we flush excess hormones out of the body through our stool, so eat your fiber!

  • practice stress management. this is absolutely huge. take up meditation, improve your time-management skills, see a therapist to work through emotional stress, start a gratitude journal – do what you can to reduce chronic stress in your life as this is often the root cause of pcos.

  • cut the coffee. this is a double whammy – not only does coffee contribute to acne, but it also elevates cortisol levels and contributes to systemic inflammation. instead, try green tea, which has a healing effect on the skin due to its high anti-oxidant polyphenol content.

  • ease up on the exercise. instead of intensive cardio like running or hiit several days a week, switch these out for yoga, walking or light swimming. this will give your adrenal glands a break and will allow your body to more readily recover from stress. 

  • sleep. give your body a chance to do its healing work by getting a solid eight hours of restful and uninterrupted sleep each night. try to make this a priority – this can have a huge impact on the health of our hormones!

  • find a support group near you to work through your emotions around pcos. it’s a tough condition to deal with so finding support in different areas of your life can be a huge relief. 

 further reference:

8 steps to reverse your pcos by fiona mcculloch

paleo for women

pcos diva

pcos awareness association

soul cysters

footnotes

1. sirmans, s. m., pate, k. a. (2014). epidemiology, diagnosis, and management of polycystic ovary syndrome. clinical epidemiology. 6, 1–13.

2. grant, p. & ramasamy, s. (2012) an update on plant derived anti-androgens. international journal of endocrinology metabolism. 2012 Spring; 10(2): 497–502.
3. hudson, t. (2008) polycystic ovarian syndrome (pcos). dec 8, 2008.
4. liepa, g.u., sengupta, a & karsies, d. (2008) polycystic ovary syndrome (pcos) and other androgen excess-related conditions: can changes in dietary intake make a difference? nutrition in clinical practice. 2008 Feb; 23(1):63-71.
5. rabinovitz, h., et al. (2004) effect of chromium supplementation on blood glucose and lipid levels in type 2 diabetes mellitus elderly patients. international journal for vitamin and nutrition research. 2004 May; 74(3):178-82.

our favorite acne-safe restaurants in san francisco + the surrounding bay area

at skinSALVATION, we love to eat.

we love to grocery shop, cook meals at home and enjoy meals that are prepared for us by loved ones. we love to go to the neighborhood restaurants where they know us by name, and join year-long waitlists to have fine dining experiences. we love eating food that fuels our bodies and teaching our clients how to choose foods that will fuel theirs.

we consider cooking at home to be the most acne-safe option because it means that you have complete control of what goes into your food. often times when you eat out, there is hidden dairy, soy and cloggy cooking oils in dishes that you wouldn’t expect.

however, we recognize that we live in a mecca of some of the world’s most wonderful restaurants, so we’ve begun a list of some of our personal favorite places to eat acne-safe food. this list will be updated as we remember gems that we’ve experienced before and as we explore new restaurants.

note: not everything on these restaurant’s menus is acne-safe. make informed eating decisions by asking your server if dishes contain dairy or soy. they are happy to tell you and may be able to make substitutions to accommodate you.

pro tip: when a friend or a date asks you out to dinner, offer to cook for them or suggest a restaurant from this list where you know you’ll be able to find something to eat that fits your dietary restrictions. you can check out the menus online ahead of time and even call to ask about ingredients so that you already know what you’re going to order before you get there.

 

DINING OUT FOR DINNER IN SAN FRANCISCO

bar agricole has a seasonally based menu chock full of locally grown produce and sustainable meat options. all of their dishes can be made dairy + soy free and the “farm-to-table” restaurant just received another 3-star rating from michael bauer (esteemed food and drink writer for the sf chronicle for over 28 years!). be sure to try a handcrafted cocktail and the $1 pork sausages, served with gut-loving sauerkraut, during their daily happy hour from 5pm to 6pm.

trou normand is the sister restaurant of bar agricole and their made-in-house charcuterie selections are among the best the city has to offer! the protein-heavy menu favors us carnivores, but the citrus salad around this time of year is delicious and vegan, dairy + soy-free.

minas brazilian hosted the skinSALVATION team for our new years dinner and we pretty much ordered one of everything on the menu. they were very accommodating about making dishes dairy, soy and gluten-free for us.

llimon rotisserie has amazing roast chicken, sides + ceviche that are dairy + soy-free. they do have a few dishes on the menu that include soy sauce as indicated on their menu.

tin is a family-run restaurant that serves traditional vietnamese fare. we love to start with the fresh spring rolls, sans peanut dipping sauce, and follow it up with a steaming bowl of phō. perfect for these gloomy san francisco days we’ve been having!

turtle tower speaking of phō, turtle tower is know for this broth based soup, boasting some of the best freshly-made noodles. be sure to ask if they add soy sauce to any of the dishes that you order and if so, ask them to hold it.

*tip: bring your own bottle of coconut aminos in your bag when you dine at asian restaurants. you can add your own instead of soy sauce!

 

DINE IN OR TAKE OUT FOR LUNCH + DINNER IN SAN FRANCISCO

la taza has a huge menu including many great salads, which you can order without cheese. the kale con quinoa with steak is a staff favorite!

mateo’s taqueria is an upscale taqueria located downstairs from skinSALVATION. we love that they use organic ingredients and will make anything without cheese or crema, just ask for, “no dairy.”

staff favorites: guacamole (ask for no cheese!) + horchata made with almond milk. although horchata is a sweet cinnamon rice milk, it’s often mixed with dairy milk to make it creamy.

mau has delicious + nourishing broth as the base of many of their dishes. their staff is very knowledgable and can tell you if any of the dishes contain soy (a hard feat in many asian restaurants).

gracias madre takes a vegan approach to traditional mexican dishes. we LOVE that they use cashew cheese in their dishes, making them dairy AND soy-free.

burma love is a great burmese restaurant in the mission. some of their dishes contain soy so be sure to ask before ordering. staff favorite is their tea leaf salad (ask them to hold the peanuts to keep it acne-safe).

 

EAT IN THE EAST BAY

teni east kitchen makes an amazing burmese chickpea tofu for those of you who are missing the traditional soy dish.

burma superstar is the east bay mama restaurant of burma love. same rules apply.

mission heirloom is a beautiful paleo restaurant for meals and treats. their brazilian waffles (with cheddar cheese) and their coffee drinks are the only items on the menu to steer clear of. many of their dishes contain coconut oil, which can be problematic for many of us who are acne-prone but is okay in small amounts.

enssaro ethiopian is gluten-free, soy-free, dairy-free and you get to eat it with your hands! the meat sampler and veggies sampler are both amazing.

 

DELIVERY

darn good food

mealmade delivers delicious paleo meals for lunch and dinner in san francisco. a staff favorite is their orange chicken with cauliflower rice.

methodology is a subscription based paleo meal delivery service. their delicious + healthy meals are perfect for people who don’t have time to meal prep acne-safe food for the week. use promo code SKINSALVATION to get 10% off of your first week.

sprig lists all of their ingredients and nutrition information on the website + app so you can check if dishes contain dairy or soy before ordering.

munchery allows you to add filters for things like dairy, gluten and eggs. you have to double check ingredient listings to be sure that there’s no soy added.

good eggs delivers organic groceries, prepared meals and snacks from stores across the bay area.

instacart delivers groceries, prepared meals and snacks from stores in your area like whole foods, bi-rite, and rainbow grocery.

postmates delivers food from a TON of restaurants in the bay area. some of our favs are:

  • roam artisan burgers, which can be ordered without dairy, and even without a bun!
  • pica pica maize kitchen, which makes gluten-free peruvian style arepas. be sure to ask for yours without cheese!
  • project juice, which has a ton of great soy-free and dairy-free prepared meals. their coconut crepes with cashew cheese + blueberries are a staff fav!

 

SWEETS + TREATS 

wholesome bakery makes cookies + cupcakes free from the top allergens including: dairy, soy, gluten, and eggs. their thin mint cookie sandwiches are a staff fav!

dandelion chocolate makes beautiful dairy-free and soy-free chocolate.

sidewalk juice makes great veggie juices + smoothies. some of their smoothies contain dairy, soy milk or sherbet (super high in sugar!) but they will gladly sub almond milk for you! staff favs are the green energy juice (ask for it without apple + add extra lemon if you’re on candida cleanse!) and the blueberry almond smoothie (ask them to leave out the fro-yo).

boba guys will make any of their delicious boba drinks with almond milk instead of dairy!

 

 

 

 

this article was written for you by liesse + chelsee.

acne-safe ranch dressing

here’s a recipe that we found for acne-safe ranch dressing. check out the video below of chelsee whipping it together!

ingredients
1 can full-fat coconut milk or coconut cream, refrigerated overnight (do not use light coconut milk)
2 tablespoons minced shallots
1 garlic clove, minced
2 tablespoons apple cider vinegar
3 tablespoons chopped fresh chives
1½ tablespoons chopped fresh parsley
1½ tablespoons chopped fresh basil
1 tablespoon chopped fresh dill
1 teaspoon sea salt
black pepper, to taste

instructions
1. open the can of coconut milk or coconut cream. scoop the coconut cream off the top of the can and add it to a large bowl, leaving the coconut water within the can.
2. add 4 tablespoons of the coconut water into the coconut cream and whisk until smooth (reserve the leftover coconut water, as you may need to whisk in an extra tablespoon or two after refrigerating your dressing depending on your desired thickness).
3. add in the shallots, garlic, apple cider vinegar, chives, parsley, basil, dill, sea salt, and black pepper. stir to combine and refrigerate dressing for at least 30 minutes to let the flavors meld together.
4. enjoy this dressing over your favorite salads or dip your favorite vegetables into it!

cocktails 101: for the acne-safe diet

when living the acne-safe lifestyle and adhering to the acne-safe diet, limiting your sugar intake is key! sugar, even in its simplest form, can cause inflammation. processed sugars like white bread, pasta and common table sugar can be some of the biggest culprits. here is a good article that breaks down to effects of sugar on the body.

so you’ve already vowed to leave the sugar out of your black tea every morning and cut down your late night pantry raid for dark chocolate to one night a week (or two)! however, there might be one thing you’ve yet to consider: those pitchers of margaritas, glasses of sangria and delicious summer shandy’s!

photo-1444728399417-08d2aa39e6f4
while alcohol itself is made through the process of distilling sugar, there is no actual sugar left in the spirits once they have been distilled. FUN FACT: you can make alcohol out of ANYTHING that contains sugar, like this carrot eau de vie which would make for a deliciously vegetal bloody mary! so as long as the producer hasn’t added any sugar after distillation to reach a desired taste or color, drinking spirits straight is the best way to avoid the high sugar intake. however, the cocktail trend is on the rise and there are so many awesome cocktail-driven bars and restaurants, especially here in san francisco.  we’re here to tell you that you don’t have to give up a friday night out with friends for healthy skin!

there are plenty of delicious cocktail recipes that call for little to no sugar at all! even the notoriously sweet, and beloved, tiki drinks can be made to fit in with the acne-safe diet. you can still get the toy umbrella without the break out!

here are the most important things to keep in mind before you actually start drinking:

  1. EAT! eating before you drink is so good (and mandatory) for so many reasons. and we mean eat a MEAL, not snacks. chips and salsa for dinner before a night of scorpion bowls is not going to cut it, trust. the more protein and carbs you have in your belly, the less chances of you needing to have a friend hold your hair back while you puke up the whole night. kim’s favorite is to eat and drink at the same time at the many fabulous restaurant bars in the city – what other way is best than to socialize while sitting, drinking and eating delicious food at the same time?!
  2. HYDRATE. you definitely want to plan ahead and start drinking lots of water the day of (as well as during and the day after) drinking. the more hydrated you are, the less hungover (and sick + inflamed) you will be overall.
  3. REST. it’s important that you set your body up the best you can to get ready to receive the abuse that’s about to ensue (sounds rash, but it’s the truth). try to rest up the several nights prior to (and after) your night out. if you party too many nights in a row, you’ll likely get rundown, and combined with the stresses of everyday life (and the cold weather in winter! or SF summers for that matter), will almost guarantee a cold – and having to call in sick-to-work days.
  4. PLAN. like how we address your acne in-clinic, plan holistically. think about how many drinks you want to max out at (or how much money you want to spend) to avoid drinking too much. decide what drink of choice you’ll go with and stick to, to avoid mixing alcohols = nausea. and if you are going to go home with someone you meet at the bar, try and have in your bag (or car) at the very least, travel sizes of your acne-safe face wash and moisturizer so you can do your walk of shame with a clean face (sans slept-in-makeup-face) the morning after. and of course, your designated driver situation so that, you know, you arrive alive!

photo-1448832529029-aca2dfcaf7c9

WHEN MAKING COCKTAILS AT HOME:

lots of classical cocktail recipes call for simple syrup, a solution of sugar and water, as the primary sweetening agent. when making cocktails or other non-alcoholic drinks at home, try making your own simple syrup using stevia or coconut sugar instead of refined sugar! agave syrup can also be a good alternative to sugar due to it’s slightly lower glycemic index. you can also try cutting the simple syrup by 1/3 or 1/2, in most recipes it should work out ok.

here are some of our favorite at-home cocktail recipes that call for little to no sugar!

– a real homemade piña colada (not from a mixer that comes in a plastic bottle) either frozen or served over crushed ice, is sure to transport you straight to the island of puerto rico (even if it’s just in your head!)

the skinny margarita made with un-aged tequila (reposado and añejo tequila may have sugar added in the form of caramel coloring so always be sure to check the labels! FYI, this is common in whiskey as well) and this organic apple cider vinegar limeade drink with 0 grams of sugar makes for a deliciously tart margarita that won’t throw off your diet!

– this kombucha “moscow mule” has only 1g of sugar in each drink, PLUS tons of gut-healthy probiotics, so you can afford to have more than just one, or two, or..

– you can also keep it suuuper simple by mixing 1 part spirit and 2 parts sparkling water (plain a lá soda stream, perrier, etc or la croix!), with a squeeze of lemon or lime

photo-1470338745628-171cf53de3a8
WHEN ENJOYING COCKTAILS AT A BAR OR RESTAURANT:

EAT. and DRINK WATER. (see above).

sugary ingredients, like juice and flavored syrups, can be over-used in some bars to appeal to the masses. additionally, these ingredients are more than likely masking a cut-rate spirit (aka well spirits, aka almost always the lowest quality stuff) that may be economic, but not very nice to sip on when served “neat.” (on their own, without ice or mixers),

– to avoid this, opt for the simpler cocktails on the menu, i.e. the ones without a million ingredients that are certain to have less sugar!

– always ask if the bar carries agave syrup and can substitute it for any use of simple syrup or raw sugar in your preferred cocktail. you can always ask if they can just use half the sugar, or make it less sweet.

– and when all else fails, beer is almost always the safest bet, sure to have less than a few grams of sugar in each serving!

whereEVER and whenEVER you are consuming alcohol:

it is always important to stay hydrated, but even more so when consuming alcoholic beverages! your skin, and tomorrow morning ‘you,’ will thank you for it. a good rule of thumb is one glass of water for every alcoholic drink consumed (we call these, “water bumpers.” try mixing it up with sparkling water instead of regular tap water, or soda water with a dash of bitters and lime juice. the combination is simple, hydrating and delicious!

ADDITIONAL RESOURCES:

here’s a great post on drinking from nerdfitness.com, with a paleo- and carb-watching edge.

K & L wine merchants in SF and redwood city are kim’s favorite purveyors of high-quality spirits. if you are going to drink poison, you might as well get the good shit!

bar agricole in san francisco is one of, if not the, best place in san francisco to get an education on spirits. any of the bartenders there are super knowledgeable and can help you discover a new spirit, drink or mocktail. and they are CRAZY about quality: for starters, they make their own bitters using local biodynamic grape spirit. (their sister restaurant trou normand is also fab, and are more charcuterie-centric).

the cavalier also in san francisco is a great place to imbibe while downtown. the bartenders are super friendly, and the food is great. the beef tartare is divine, and paleo! (when you eat it with the lettuce cups and skip the toast, that is).

yuzuki restaurant is one of kim’s restaurants that features an awesome selection of sake, which is a japanese spirit derived from rice. owner yuko and sake-sommelier yoshi will teach you the wonders of lovingly hand-crafted sake, which is worlds away from the hot sake that most think of. (if you have no clue about sake, watch the documentary ‘the birth of sake‘ – it’s beautifully filmed and really shows you the hard work that goes into to truly hand-crafted sake).

happy sipping!