May 31 2011

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By Dr. Mercola

Your teen's months of prom planning are finally in place, complete with dinner reservations, the perfect gown, the dream date… and the dreaded last-minute acne flare-up! It's another crushing blow from this notorious villain that manages to crash every momentous adolescent event. If you're the parent of an adolescent, "heartbreak by acne" is an all-too-familiar scenario, making your emotionally fragile teen want to hide under his bed until semester's end.

Acne affects the majority of adolescents worldwide to some degree, and is a major source of embarrassment for many.

But it isn't just teens who are afflicted—one in five American adults also suffer from acne, for whom the psychological toll is no less significant. Acne affects about 85 percent of Americans at some time in their lives and is the most common skin disorder in the U.S.A. Experts report that many people underestimate the self-consciousness and social stigma that come with having acne.

Typically, those suffering from acne feel self-conscious, embarrassed and helpless. For many acne sufferers, the embarrassment can lead to low self-confidence, feelings of alienation and social withdrawal.

It's not hard to understand, then, why many people spend so much time and money trying to find a solution to their acne affliction. After trying a slew of ineffective over-the-counter products, many look to their physician for an answer. Most physicians quickly reach for their prescription pads. But acne medications have potentially harmful side effects, and attempt to treat acne's symptoms while completely ignoring its underlying cause.

Even though these drugs are strongly promoted and professed to be safe by physicians and drug companies alike, I am firmly opposed to using them as a first line defense against acne. The solution, moms and dads, is to take your adolescent to the farmer's market instead of to the drug store, because acne's biggest offender is the American diet.

Pharmaceutical Treatment of Acne is Big Business

Acne is one of the most common skin problems for which people seek the advice of a dermatologist. For such a common condition, it is astonishingly misunderstood and mistreated by medical professionals. One of the few things authorities can agree on is that most people get the type of acne called acne vulgaris, an inflammatory bacterial condition that commonly appears on the skin of your face, neck, shoulders, back and chest, sometimes leading to painful lesions.

But this is where the consensus ends.

When treatment after treatment fails and acne keeps reappearing, it's likely your doctor will call your acne condition "chronic." What this really means is, the treatments are the wrong ones! The underlying cause of your acne problem has not been addressed…

So, instead of addressing the cause your medical provider will likely adhere to the official government Guidelines of Care for Acne Vulgaris Management, put forth by the U.S. Department of Health and Human Services. This outlines the conventional acne treatment protocol, involving topical and systemic antibiotics, steroids and hormonal agents (including oral contraceptives), and Accutane—one of the most dangerous drugs ever developed.

The above recommendations have been fully approved by the American Academy of Dermatologyas the current roadmap for acne treatment—they are extremely influential, as they set the treatment standard at clinical, corporate, and governmental levels. It is astounding that the seventh and final item on their list of therapies is called "Dietary Restrictions (Not Recommended)"Their agenda is clearly NOT addressing the cause of your acne, but rather in merely managing it.

Managing it means ongoing visits to your dermatologist, and continued profits for the medical and pharmaceutical industry.

The consequences of these guidelines are as expected—aggressive promotion of drugs, backed by increased corporate spending, biased federal regulations, misguided medical practice, and continued public deception.

Overview of Conventional Acne Treatments

  1. Topical treatments (lotions, creams, and gels)—often the first thing a physician will prescribe
  2. Oral antibiotics (tetracycline, doxycycline, minocycline, and erythromycin)—usually prescribed for moderate to severe acne
  3. Accutane (isotretinoin) and its generic equivalents—reserved for severe acne cases

Topical treatments are claimed to reduce oil production, increase skin cell turnover, and kill off bacteria, which in combination supposedly reduce inflammation. Examples are tretinoin (Avita, Retin-A, Renova) and adapalene (Differin), which are all derived from vitamin A.

I am ok with topical Retin A, which is most likely beneficial and probably prevents and even reverses several types of skin cancers. However, I strongly urge you to avoid Accutane and its generic kin.

Avoid One of the MOST Dangerous Drugs Ever Made

Accutane is a highly controversial drug yet incredibly remains the industry standard for severe acne. Swiss drugmaker Roche Holding AG, manufacturer of Accutane, has spent most of this century in court defending itself against lawsuits from people whose health has been irreparably damaged by this menacing drug.

Roche has lost six out of six lawsuits and was recently ordered to pay $25.16 million in damagesto an Accutane user who developed inflammatory bowel disease as a result of the drug. Due to generic competition and the exorbitant cost of defending personal injury lawsuits, Roche stopped selling the drug in June 2009.

However, the generic form of Accutane (isotretinoin) is equally deadly and remains available in the marketplace under the names Claravis, Sotret and Amnesteem. More than two million people have taken Accutane, despite the fact that it is known to cause depression, suicide, inflammatory bowel disease, and 100 percent guarantee of birth defects if taken by a pregnant woman.

In 2004, brain scans showed that people taking Accutane suffer a 21 percent decrease in frontal brain activity, the part of the brain that plays a critical role in mood and social interaction. These brain changes may explain the depression, suicidal and aggressive behavior, and psychotic reactions reported by some Accutane users.

Is reducing your acne worth that?

Even official regulation policy acknowledges the real danger of Accutane. The U.S. Food and Drug Administration (FDA) has warned physicians and consumers about reports of "depression, psychosis, and rarely suicidal thoughts and actions" related to the use of Accutane. Patients using Accutane reported to the FDA that these psychological symptoms improved after stopping Accutane therapy, but worsened with re-start of the drug.

In light of this evidence, the labeling of Accutane was changed to strengthen the warning about its risk for causing depression.Isotretinoin now has the strongest warning available for any drug category—and given a FDAPregnancy CategoryX rating..

If you are taking isotretinoinand become pregnant, you are virtually guaranteed to be damaging your baby. Accutane is extremely teratogenic (causing damage to a fetus).

According to the Mayo Clinic:

"Isotretinoin is associated with severe birth defects, so it can't be taken by pregnant women or women who may become pregnant during the course of treatment or within several weeks of concluding treatment. In fact, the drug carries such serious potential side effects that women of reproductive age must participate in a Food and Drug Administration-approved monitoring program to receive a prescription for the drug."

In addition to teratogenic and psychological adverse effects, Accutane (isotretinoin) users have reported the following negative effects:




Increased levels of triglycerides and cholesterol in your blood

Increased liver enzyme levels and liver damage

Erectile dysfunction

Headaches and brain swelling

Disturbances of your central nervous system


Damage to skin and mucous membranes Premature epiphyseal closure

Hyperostosis (excessive bone growth) and bone demineralization

Neutropenia, agranulocytosis, and rhabdomyolysis (blood disorders)

Development of inflammatory bowel disease

Damage to your eyes including cataracts

Hearing impairment


Heart attack and stroke

Allergic vasculitis


Antibiotics for Acne: Doing More Harm than Good

Many dermatologists prescribe long-term antibiotic treatments for acne. Even though oral antibiotics are widely promoted, I suggest you avoid these medications, as they will inevitably cause more problems than they solve.

Every time you take an antibiotic, you kill your beneficial bacteria along with the problematic ones. This can set the stage for yeast infections, as well as resistant bacterial strains.

Antibiotic resistanceis a serious and growing problem today. This includes the antibiotics prescribed for acne, such as erythromycin, which is becoming increasingly ineffective as more strains of bacteria have adapted to it. Increasing numbers of physicians are beginning to pull away from treating acne with antibiotics, or at least limiting the duration of their use. Besides antibiotic resistance, antibiotics are not without risks themselves.

For example:

  • Erythromycin can cause damage to your teeth or skeleton.
  • Doxycycline is associated with photosensitivity.
  • Minocycline is known to cause pigment deposition in your skin (most often in acne scars), mucous membranes and teeth, and occasionally autoimmune hepatitis (a lupus-like syndrome) and serum sickness-like reactions.

And ALL oral antibiotics are associated with vaginal candidiasis, as most women will attest. The problem with all of these drug treatments is, they don't correct the underlying reason you have acne—which is why relapse is so common. Acne occurs when your body falls out of balance, so the goal must be to regain homeostasis. This can be achieved through simple lifestyle modifications.

The Truth is, Acne is one of the Easiest Problems to Treat Naturally

Just like other chronic diseases running rampant in Western society (like diabetes, heart disease, and obesity), acne is primarly a disease of the Western world.

More proof is continuing to emerge that the root cause of acne is not bacteria or genetics, but environmental factors—particularly your diet. Acne is much less of a problem in non-Westernized societies, where refined carbohydrates and sugarare consumed in much lower amounts. Solid evidence exists that diets high in sugar and refined carbohydrates are the primary CAUSE of acne.

We now know that a low-grain or no-grain dietwill very likely clear up your skin, permanently! Antibiotics are unnecessary because correcting your diet creates an internal environment that does not ALLOW bacterial overgrowth to occur.

After diet, the other major factor is stress.

Part of a holistic plan for preventing acne flare-ups is managing your stress. We know that stress is a major factor in infectionsof any kind. So why aren't physicians lining up to give you the good news? Well, they can't "sell" you a healthful diet. The only one who will reap the benefits from that is you!

Grain-Free Diets Can Clear Up Your Acne FOR GOOD!

Not all carbohydrates are created equal. Carbohydratescan be categorized into the following types:

  • Simple carbohydratesare sugars, such as those found in candy, soda, and baked goods. Your best bet is to strictly limit those in your diet—working toward eliminating them completely. Be especially careful to avoid all high fructose corn syrup, which is a major component of sodas and processed foods.
  • Complex carbohydratesare found in natural whole foods such as beans, nuts, whole grains, and vegetables. Although beans, nuts and grains contain more nutritive value than simple carbohydrates, you will need to limit them if acne is a problem for you.

Your body "prefers" the complex carbs found in vegetables to the complex carbs found in grains, because your body handles their digestion differently. Vegetable-carbs are slow to break down into simple sugars, with minimal insulin impact, whereas digestion of grain-carbs raises your insulin and insulin-like growth factor (IGF-1).

Higher IGF-1 levels can lead to increased male hormones, which cause your pores to secrete more sebum, a greasy substance that traps acne-promoting bacteria. IGF-1 also causes skin cells (known as keratinocytes) to multiply, a process associated with acne.

This is why most grains should be avoided if you have acne issues.

The research holds this up.

In a 2007 studypublished in the American Journal of Clinical Nutrition, young men (ages 15 to 25) with acne problems were placed on low-glycemic diets for 12 weeks, showing significant improvements in acne and insulin sensitivity.

Similar findings were shown in this 2002 study.

Simply eliminating grains, sugars (particularly fructose), cereals, potatoes, corn, rice, pasta, processed foods, etc., radically improves acne for most people. Fruit contains a fair amount of fructose, so it should be consumed in very limited quantities if you are predisposed to acne. And fruit juices should be strictly avoided since the sugar is very concentrated in them. (Vegetable juices are great, though, especially green juices.)

So, how many carbs is too many? Nutritional Typingcan give you your answer.

Knowing your Nutritional Type will help you determine the ideal amount of carbohydrates you should be eating with each meal. By learning to analyze your reactions to the foods you eat, you can begin to fine-tune each meal to the ratios of proteins, fats and carbs that are just right for you. For a simple FREE tool to help you determine your Nutritional Type, see this link.

If you incorporate these dietary changes, not only will your acne subside, but also your complexion will become more radiant and youthful.

Can Gluten Make Your Acne Worse?

Glutenin wheat and other grains may be contributing to your acne symptoms if you have a gluten intolerance, which many people do. This is a separate issue from the insulin effects already discussed. Gluten is a prime suspect if you have rosacea, a growing problem, especially for Baby Boomers.

According to The Gluten Free Diet:

"A person who is gluten intolerant cannot digest gluten, so the body will not recognize it when it is eaten and therefore treats it as a foreign body when trying to digest it.

Because the body of a gluten intolerant person cannot process gluten properly, the small intestines become damaged slowly over time causing digestive issues. The gluten intolerance can produce other symptoms and push the toxins through the skin such as acne."

Since gluten sensitivity is so pervasive anyway it would make loads of sense to try a a gluten-free diet for one month and see if your acne or any other health symptoms improve. This shouldn't be too difficult if you are already implementing a low-grain or no-grain diet, which minimizes sources of gluten.

The Milk-Iodine-Acne Connection

You may already know that I am an advocate of raw milkfor its vast nutritional benefits in general. However, there is a cautionary statement for you, IF you are an acne sufferer. Milk generally contains a fair amount of iodine, although there is less in raw milk than pasteurized milk. Iodine is known to aggravate acne.

Several studies document this relationship as farmers often feed their cows iodine-fortified feed to prevent infection.

Therefore, if you drink milk, you should seek to choose raw over pasteurized—this is true, regardless of whether or not you have issues with your skin. Since raw milk naturally contains iodine at healthier levels, it is less likely to aggravate your acne than pasteurized milk—but the potential still exists for even raw milk to trigger flare-ups. In the interest of eradicating your acne once and for all, then, it seems wise to eliminate milk and other dairy products from your diet altogether.

There are no studies of which I am aware investigating the relationship between raw milk and acne. If you want to test it out for yourself, you can try consuming raw, organic, grass-fed milk, and if it seems to be making your acne worse, then eliminate it from your diet.

Many Skin Care Products Only Contribute to the Problem

What you put on your skin is as important as what you eat. In fact, what you apply topically is readily absorbed through your skin, which is really a semi-permeable membrane through which substances pass directly into your body.

Many of today's skin care products and cosmeticsare nothing more than a toxic mélange of harsh chemicals, which cause more skin problems than they solve. And when it comes to acne, these chemicals can seriously inflame an outbreak, or prevent one from healing.

Why do so many cleansers, lotions and potions contain these potentially hazardous ingredients?

Because they're cheap, readily available, and easy to dilute.

When it comes to the skin care industry, anything goes. The Environmental Working Group estimates 99 percent of personal care products contain more than one ingredient that has never been evaluated for safety. It's a self-regulated industry—an industry that operates on "the honor system" but has a multitude of dishonorable players.

So you have to be a meticulous, well-educated label reader to know what you're getting.

You should spend five minutes every day cleansing your face, which removes the impurities that collect on your skin during a typical day and clog up your pores. And ladies, please never sleep in your makeup. It's also advisable to exfoliate your skin once or twice per week. But do so gently, especially if you are experiencing an outbreak, and never pull or rub your skin aggressively.

You should use pure, safe, natural skin care products—preferably organic ones. Apply your skin care products to warm skin, which maximizes absorption.

And once you've cleansed, exfoliated and moisturized, take a deep breath and… rela-a-a-a-x.

Relaxing Your Way to Clearer Skin

Stress can potentially worsen just about every condition, including acne. It's important to learn how to manage your stress, BEFORE it becomes overwhelming. It is even more important to teach your children how to do this when they're young, before stress accumulates unabated and begins to take a toll on their health.

Recent studies substantiate the hypothesis that stress can aggravate acne.

One study involving college studentsfound a connection between acne flare-ups and stress from final exams. Researchers found that subjects who had the most stress during examination periods also had the worst acne outbreaks, suggesting emotional stress from external sources is a significant factor.

While it has been argued that the stress associated with acne is an effect of acne rather than a cause, the above researchers believe this new evidence proves otherwise—that it's the stress that is exacerbating the acne, not vice versa.

Additionally, stress and fatigue can lead to adrenal burnout, where your adrenal glands become depleted. This can worsen your acne as well and perpetuate higher stress levels.

So how do you deal with the ever-present stress in today's demanding world?

My favorite tool is the Emotional Freedom Technique, or EFT. EFT involves tapping your body's energy meridians with the tips of your fingers to clear emotional blocks, thus restoring balance to your mind and body. EFT is a powerful de-stressing technique that is easy for adults and children to learn. It can even relieve physical complaints such as chronic pain, allergy symptoms, and more.

You could also add in other proven stress-busters, such as yoga and meditation.

You Can Take Control of Your Skin Health

Remember, your complexion is a reflection of your overall health. Don't forget to incorporate these essential factors into your acne-busting plan:

  • Sugars and Grains: This is probably the single most important step you can take to improve your skin health.  If you can eliminate all sugars and grains for a few weeks there is a major likelihood you will notice rapid improvement in your complexion.
  • Water: Drink plenty of fresh, pure water every day. Hydrating your body facilitates cell growth and regeneration, elimination of wastes, and sloughing away dead skin cells. Hydration will also improve your skin tone.

Every day, drink enough water so that your urine is a pale yellow color. If your urine is bright yellow, you probably need to drink more water (unless you take B vitamins, which themselves turn urine bright yellow).

  1. Exercise: Getting plenty of high-intensity exercise helps your body flush out toxins, including those in your skin's pores. Plus, exercise is vitally important to all other aspects of your heath. If you happen to have access to an infrared sauna, this can be helpful, because the more you sweat, the more you flush unwanted debris and contaminants out of your pores.
  2. Sleep: Did you know that a good night's sleep can decrease your stress and lead to clearer skin? Your body's time for healing and rebuilding is at night while you sleep, and this applies to your skin. Sleep is also required for good energy and mood.
  3. Proper balance of bacteria: This is especially important if you have been on antibiotics, because those drugs indiscriminately kill off the beneficial bacteria in your gut, without which you cannot have a strong immune system. You can reestablish your bacterial balance by taking a high quality probiotic supplement, and by incorporating naturally fermented/cultured foods into your diet.
  4. Vitamin D: This important nutrient is crucial for maintaining a healthy immune response, and most people are deficient in it. Without adequate vitamin D, your body cannot control infection, in your skin or elsewhere. Exposing large areas of your skin to appropriate amounts of sunshine is the best way to optimize your vitamin D levels, or use a safe tanning bed. You should expose your skin until you just barely begin turning pink, which indicates you've generated the optimal amount of vitamin D for the day.

If you don't have access to regular UV exposure, the next best thing is an oral vitamin D supplement, accompanied by regular monitoring of your vitamin D levels with a blood test.

If you change your diet and lifestyle in the ways I've recommended, you can expect significant improvement in the health and appearance of your skin. Plus, those same strategies will lead to improvements in your overall health, as well as relieving your bank account of expensive acne drugs that don't offer any real or lasting solution to your skin's woes.

Remember lifestyle changes are not a "quick fix," but over the long run, they reap endless rewards!


  Acne Resource Center

  Guidelines of Care for Acne Vulgaris Management

  Mayo Clinic

  Bloomberg February 16, 2010

  Drugenquirer May 28, 2010

  Arch. Dermatol. December 2002

  Amer J Clin Nutr July 2007

  Archives of Dermatology 2003

Related Links:

  Simple Ways to Stop Acne Naturally

  No-Grain Diet Clears up Acne for Good

  Natural Solutions for Acne