There are a lot of reasons to consider adding acne supplements to your arsenal, not least of which is the problems with conventional treatment and the fringe benefits of taking supplements that don't just improve your acne.
We're starting to discover from studies and first hand accounts that there are big problems with conventional acne treatment. Conventional treatment usually consists of either moderately effective topicals or harsh combinations of isotretinoin and oral antibiotics that obliterate your immune system along with the acne.
Studies have shown that acne can actually be caused by systemic inflammation. Unbelievably, conventional treatment actually increases systemic inflammation, which not only makes you dependent on treatment to stay acne free, but can also cause serious side effects that extend well beyond your face.
As more research reveals the risks and side-effects of conventional treatment a growing number of clinical trials have been focused on integrative approaches to acne. Integrative acne treatment considers the causes of acne from a whole body perspective where the human organism is an interconnected whole rather than discrete individual parts treated in isolation. Integrative treatment asks why the acne is present and tailors treatment accordingly.
Integrative medicine is not the same as holistic or homeopathic medicine. Integrative medicine combines the peer reviewed scientific rigour of conventional medicine with the focus on whole body health of holistic medicine to provide a comprehensive system for whole body health.
Integrative medicine is not about a magic pill to cure your problems, but a whole body approach that aims to maintain or restore proper function. A big component of integrative health is diet.
Research has found that diet is one of the biggest culprits in acne because a poor diet causes systemic inflammation [Ismail et al 2012; Veith et al 2011; Smith et al 2007]. A diet high in refined sugars and starches and low in fruits, vegetables, natural fibre, healthy fats and phytonutrients has been shown in multiple studies to correlate positively with acne as a result of systemic inflammation.
It's been shown a number of times across different demographics and countries that a low glycemic index diet reduces acne.
As an added benefit, systemic inflammation is implicated in the development of many diseases so when you treat your acne integratively you're not only treating your acne but maintaining whole body health. Remember conventional acne treatment does the exact opposite where instead of side-benefits there are side-effects.
Maintaining a healthy and diverse diet isn't easy. Though there is no supplement for a healthy diet, supplementation with vitamins, minerals, probiotics, phytonutrients and fatty acids are an easy way to fill the gaps in your diet and to help you benefit from a diverse range of acne-fighting compounds.
Quick Reference: Best Acne Vitamins & Supplements At a Glance
This is a quick reference guide for those that don't have the time to read the article in full. Try to at least skim through to make the most of the information provided.
Vitamins, Minerals & Fatty Acids
Phytonutrients & Probiotics
Vitamin A / Cod Liver Oil
Selenium & Vitamin E
Borage Oil GLA
More on these recommendations below.
Technology is advancing at such a fast pace that sometimes it's easy to forget how little we actually know. We can repair a damaged heart with our own bone marrow stem cells , but we still don't really know what causes acne.
A generally accepted definition is that acne is an inflammation of the sebaceous (oil producing ) glands of hormonal areas of the body (face, chest, back.) It can come in the form of black heads, white heads (closed & open comedones,) papules, pustules and nodules .
Until recently the cause of this inflammation was a mystery and topic of intense debate amongst acne researchers. Lately more research is pointing to the possibility that acne is just the visible result of invisible imbalance elsewhere in the body.
Acne & The Inflammatory Response
Until recently medicine tended to look at acne in isolation, simply as blemishes on the surface of the skin.
Luckily, science is beginning to understand that acne isn't just blemishes on the skin, but the result of what could be a much more significant systemic & chronic inflammation in the body.
Multiple studies link acne to a chronic inflammatory response in the body, which can result in anything from mild acne all the way to chronic inflammatory disorders like asthma, arthritis and celiac.
The Role of Diet
One of the most significant factors is diet, which can cause nutritional deficiencies, hormone imbalances and imbalances in skin and gut microbiota. All of this points to systemic inflammation.
Fun fact: we've come full circle. Ten years ago we thought acne was caused by eating greasy food and too much chocolate. Five years ago that was debunked. Now at present we've come back to that initial conclusion.
Acne & Stress
Stress can have a significant impact on acne, as shown in studies and by countless anecdotal accounts. Studies have also shown that the supplements that improve acne also improve mood disorders and overall stress levels [Bowe et al 2011; Rubin et al 2008].
Problems with Conventional Treatment
There's good reason to be wary of conventional treatment. Piecemeal solutions targeting a problem in isolation often present unexpected side effects (that can be worse than the original problem.)
Treating just the surface of the skin doesn't improve systemic inflammation and treating acne from the inside with antibiotics and tretinoins like Accutane can actually increase systemic inflammation along with a slew of other side effects.
However, oral acne treatments are often overprescribed by lazy or uninformed physicians. There are scientifically proven alternative therapies than can be just as effective and most importantly can provide side-benefits instead of side-effects.
Acne can be a socially debilitating disease. If you've suffered for a long time and you need professional help from a doctor, consider getting a second opinion from an integrative medicine specialist or a naturopath. Still, it's possible that pharmaceuticals are your only option (and there's no shame in that) but if that's the route you take get informed and stay informed on the drugs you're putting into your body.
Vitamins, Minerals & Fatty Acids
Vitamins play an important role in your antioxidant defence system [Abulnaja], which is one of the body's primary defences against the systemic inflammation which can aggravate acne [Rubin et al 2008].
In one 2015 study acne severity was linked to low levels of vitamin D in the blood. Researchers went to far as to conclude that "vitamin D would be a prominent factor in acne." [Toossi 2015]
Acne induces the release of compounds called cytokines, cell signalling compounds implicated in the development of disease. Research has found that vitamins A and D mediate the release of cytokines, suggesting a relationship between low levels of these vitamins and the development of acne. [Agak et al 2014)
Vitamin A / Cod Liver Oil
Vitamin A is well known for it's role in skin health. Low levels of Vitamin A have even been found to aggravate acne [Al-Akawi et al 2006].
One of the best sources of Vitamin A is cod liver oil, which is also a rich natural source of fatty acids with their own potent anti-acne properties [Rubin et al 2008].
Fatty Acids & The Omega 3-6 Ratio
Preliminary research suggests that the EPA in fish oils like cod liver oil can improve acne as much as a proposed acne drug [Rubin et al 2008]. Fish oils are also potent natural sources of Vitamin A, which has long been known for it's skin health benefits including anti-acne activity.
Zinc is probably the original anti-acne supplement. Likewise, the anti-acne properties of zinc are well documented. A recent study showed definitively that acne severity correlates with lower levels of zinc in the blood [Mogaddam et al 2014].
The question isn't whether zinc is effective, but what kind of zinc is effective. Not all zinc is created equal because zinc is notoriously difficult for the body to absorb and many supplements are a waste of time and money. To make the most of supplementation and optimize bioavailability always choose a zinc orotate supplement like Now L-OptiZinc.
Selenium + Vitamin E
Selenium has also long been known for it's role in the fight against acne.
In one study from 1984 participants suffering from moderate to severe acne saw improvements in their acne when given 200mcg selenium twice per day [Michaelsson et al 1984]. This treatment was especially effective for severe acne.
In this study the selenium was given with 10mg of vitamin E twice daily to optimize bioavailability and absorption. That bodes well for acne treatment because a 2006 study determined that vitamin E supplementation improves acne [Al-Akawi et al 2006].
A very close formulation to that in the study is Now E-400 Selenium + Vitamin E.
Chromium picolinate has long been used as a weight loss aid said to help curb carbohydrate cravings and reduce insulin sensitivity. Although the jury is still out on weight loss claims, the skin care benefits of chromium are well documented. A 1984 study found that 400mcg a day improved acne [McCarty et al 1984]
Acne Probiotics & Phytonutrients
Acne & Probiotics
A lot has been written recently about gut microflora and disease prevention. Disruptions in gut health has been implicated in a wide variety of ailments from simple allergies to severe autoimmune conditions. Of course, given that the skin is the body's largest elimination organ it was just a matter of time before the gut and skin relationship was discovered.
"The lines of communication, as mediated by gut microbes, may be direct and indirect - ultimately influencing the degree of acne by a systemic effect on inflammation, oxidative stress, glycemic control, tissue lipid levels, pathogenic bacteria, as well as levels of neuropeptides and mood-regulating neurotransmitters."
Gut imbalance can effect acne through a variety of pathways. What is clear is that "we can now see an undeniable link" [Bowe et al 2011]. This is one of there main reasons that conventional acne treatment is problematic: it can actually make skin conditions worse in the long term by killing off healthy gut bacteria.
As such gut care is a must in any acne treatment regimen, whether it's achieved by eating a diverse variety of fermented foods on a daily basis or through probiotic supplementation.
As far as supplements are concerned, a high quality probiotic with a variety of strains should be chosen. Generally anything over 50 billion cultures isn't necessary and can cause digestive upset. Even lower doses can cause digestive upset so care should be taken to gradually phase in supplements even if it means taking half or quarter doses at first.
There's a really long history of turmeric being used in the treatment of acne and other skin disorders, most notably through Ayurveda. In addition to having well-documented antimicrobial properties, research has now confirmed age old wisdom finding that turmeric has significant anti-inflammatory and inhibitory effects on acne bacteria [Jain et al 2003].
ECGC (epigallocatechin-3-gallate) polyphenol from green tea has well documented anti-inflammatory benefits [Rubin et al 2008]. ECGC has also been shown to have a role in acne treatment due to it's anti-inflammatory and antioxidant properties. Studies have also shown that these properties may be especially beneficial for hormonal acne [Shaw 2000].
Standardized extracts of EGCG are widely available online and in stores. Supplementation can also be through simply drinking green tea. Traditionally brewed green tea has 20 - 40mg of EGCG per gram while matcha green tea has 50 to 55mg of EGCG per gram.
Be aware that although a lot has been made of the claim that matcha has 137 times the EGCG of green tea (especially by advertisers) the truth isn't quite so dramatic. Matcha does have a higher concentration of polyphenols than regular brewed tea, but it isn't significant enough to be worth the extra cash unless you also like the taste more.
In any case, both are still a delicious way to supplement EGCG.
Borage oil is derived from the seeds of the borage flower. The oil provides the highest natural source of GLA (gamma-linoleic acid), even higher than more well-known sources like evening primrose oil.
Borage oil has a wide variety of benefits stemming from its potent anti-inflammatory and immune system regulating effects. In one study researchers determined that the GLA in borage oil could be as effective for acne treatment as proposed acne drug zileuton.
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