The 4 foods you actually need to avoid if you have acne

Figuring out which foods to avoid when you have acne is like trying to solve a puzzle blind with a team of hundreds of people giving you different information.  I remember getting conflicting information from EVERYONE about what I should and shouldn’t eat: My Mom told me I should eat lots of yogurt-which is advice I now know I absolutely should not have listened to.  Unfortunately, Mom does not always know best especially when it comes to acne. One blog said I just needed to eat raw vegetables and lean protein to clear my skin. An Acupuncturist told me I needed to avoid spicy foods.  A Dietician told me I should avoid gluten. An Esthetician told me not to eat sugar because it creates yeast in my gut that would contribute to candida overgrowth. And my Doctors wouldn’t even acknowledge that there is a link between diet and acne because most scientific, medical, and pharmaceutical research studies have failed to produce any reliable research on the matter.  Doctors also wouldn’t make any money advising us acne sufferers to make dietary and lifestyle changes so it makes sense that their approach to treating acne is largely based on prescribing pharmaceuticals. Needless to say, not one person actually gave me accurate advice until I came across the research of Dr James Fulton from his book Acne RX. His findings and methodology are part of what helped me finally get clear and they are largely what the dietary guidelines and the basis of our program are based on.

Dr Fulton is one of few people in medicine and science to say that diet absolutely has a connection to acne and both my personal experience and my experience as an Acne Coach have only validated his findings.  I mean, do we really need a double blind research study to figure out that what we eat has an effect on every part of our body? To be fair, it can be easy to miss the link between what we eat and our breakouts for reasons I mention in my blog If you have acne, changing your diet takes months to get clearer skin.  Also, everyone’s acne puzzle is different so each person’s triggers vary and even two people who are both sensitive to dairy might be triggered by different amounts. In our e-course, The 8 Steps To Clear Skin, we discuss these four potential dietary triggers that people with active acne should avoid until they get clear:  

Dairy
Soy
Excess iodine
High androgen foods

Once you are clear, you can perform a trigger test to determine which foods might actually be a trigger for you and in what amount and the instructions for performing a controlled test slowly enough that you don’t break out again is also taught in the e-course. 

You might also like…

Acne Mechanica: Pressure and heat might be breaking you out

Acne mechanica is a type of acne triggered by pressure, friction, occlusion, and heat on the skin.  If you have Retention Hyperkeratosis, the genetic disease that causes acne, you have little acne “seeds” called microcomedones that get created in your skin due to an overproduction of skin cells and the inability to effectively expel them out of the follicles.  These seeds are like fragile time bombs that when given a reason like stress, diet, or friction in the case of acne mechanica, can explode into full blown inflamed pimples.  

There are many potential sources of acne mechanica
Hand leaning or touching
Picking, pressing, touching, poking pimples
Tight headbands
Sunglasses
Hats
Helmets straps
Sports gear like chin straps
Tight fitting clothes and bras
Backpacks or anything else that has straps
Playing an instrument that presses against the skin (like a violin)
Steam, saunas, hot climates

That is right. Saunas and steam are NOT good for acne.
This deserves it’s own post because it’s such a huge misconception.  Check it out in my blog heat and steam are not actually good for acne.

Different acne triggers have different effects and acne mechanica is an inflammatory trigger
In my e-course, I talk about the different acne trigger categories and I divide all of the triggers into four pieces of a pie.  Each category of triggers has a different effect on the acne process and a different delayed reaction time. Dairy is in the dietary trigger category and most dietary triggers contribute to oil production which contributes to seed growth.  The delayed reaction time for dietary triggers is usually weeks to months so if you eat cheese, you likely won’t notice a visible breakout for months because it takes months for it to process through your body, contribute to seed formation, then move from the deeper layers of the follicle to the surface of the skin.  The effect of acne mechanica, on the other hand, is inflammation inducing and the delayed reaction time is only seconds to days because the inflammatory response is quick. If you sprained your ankle, it would get red and swollen right away because the inflammatory response is our body’s way of healing and protecting us so it needs to be able to respond quickly.  The same process happens when your acne becomes red, big, and swollen.

Is it acne mechanica or a comedogenic product or both?
Acne mechanica is a tricky thing because some of the things that come into contact with our skin can be a source of two different triggers: acne mechanica and comedogenic ingredients.  So your really tight sports bra could be breaking you out from the friction it creates and/or it could be breaking you out because it is washed with comedogenic detergent. Your sunglasses might be breaking you out on the ridge of your nose because it’s causing pressure and/or it could be breaking you out because you clean it with a wipe or solution that contains a comedogenic ingredient.  People usually think it’s bad to lean on their hands or touch their face because their hands are dirty but it’s the pressure and/or the hand lotion or hand soap they use that might contain a comedogenic ingredient that is clogging their follicles. “Dirtiness” in and of itself does not trigger acne so don’t worry too much about your workout clothes being dirty. Sure, dirty clothes don’t help but if you are using a comedogenic detergent then you are getting a fresh coat of pore-clogging ingredients on your workout clothes so you are more likely to break out from it being washed then from it being “dirty”.  To make sure you are not breaking out from both acne mechanica and comedogenic ingredients, wash anything that makes direct contact with your skin (sunglasses, workout clothes, head bands, helmets, hats, hands, instruments) with an acne-friendly product. We have a bunch of recommendations on our Pinterest.

Cleaning or washing isn’t the solution
As I mentioned above, cleaning and washing can actually make acne mechanica worse if you are being exposed to a comedogenic ingredient.  But I have seen a lot of tips to prevent acne mechanica mention that you should take a shower immediately after working out to prevent it.  But just like dirtiness doesn’t trigger acne, sweat itself doesn’t cause acne either: sweat can simply increase the amount of friction or heat between your skin and whatever tight fitting clothing or gear you have on.  So if sweat itself does not cause acne, washing it off after working out is not going to help because by the time you finish your workout the sweat has already contributed to the friction and heat. You should still take a shower because, well, it’s gross not to.  I just want you to be educated about WHY you are taking a shower.

How to get rid of acne mechanica
Use common sense and avoid the sources of acne mechanica that are listed above.  Wear loose, breathable cotton clothes when working out and under heavy gear to absorb sweat.  Avoid steam, extreme heat, and saunas. Become conscious of when you might be leaning on your hands or touching your face.  Unfortunately, it isn’t always possible or safe to avoid potential acne mechanica triggers. For example, you should not stop wearing a helmet if you play a contact sport or ride your bicycle.  And if playing violin is your jam then I wouldn’t advise you to stop playing it. So eliminating or reducing your exposure to the triggers that are safe and possible is the first step. If that gets rid of your acne, great.  For most us though, elimination or reduction might improve things but they won’t completely clear us because acne mechanica is usually a symptom of an underlying genetic condition (RH). So the second and most important step is to deal with the underlying cause of acne (in addition to managing the triggers) which is what the AES method aims to do.  Once we deal with the underlying issue, we don’t need to avoid triggers like heat and friction because the skin is cleared from the inside out so there are no seeds to blow up and become inflamed in the first place.

You might also like…

Heat and steam are actually terrible for acne so skip the sauna and the steam

Your Esthetician steams your face before extractions because she says it opens up your pores. You go into the sauna thinking that it’s expelling toxins and letting your pores breathe.  Sorry to burst your bubble but none of that is actually happening and you are likely causing more harm than good to your acne-prone skin. We never steam our clients before an acne facial or body treatment and we’ve had some clients get upset that they are because they think we are cheating them out of some essential part of the process.  But we don’t use steam because heat and steam are more likely to swell your pores shut than open them up! Also, we never perform extractions during the initial appointment precisely because we want clients to begin using the product kits which help break up congestion in the follicles so they are loose and easy to extract so even if steam did open up the pores, it wouldn’t be necessary anyways.

This is explained by basic physics people
Heat expands, cold contracts. Just think about wearing a ring on your finger-have you noticed that it might feel tight and swollen in the summer when the weather is warmer and a little looser in the winter when it’s colder?  This is exactly what happens to your pores. When you are exposed to heat or steam, your pores swell up and the congestion that is already struggling to be contained inside of our follicles can get squeezed so tight that the follicle wall might rupture and become more inflamed.  So if you are already struggling with an inflamed acne type, especially cystic acne, you should be avoiding saunas and steam because they can worsen inflammation. If you have a primarily non-inflamed acne type, you might be able to get away with heat and steam as long as you don’t notice an increase in inflammation symptoms such as redness, swelling, pus, and soreness.

Only oil can stretch the pores open or closed
Pore size is mostly genetic and there isn’t anything you can do to significantly change it.  Pores don’t actually get smaller or bigger on their own: How big or small your pores are depends on the amount of oil your sebaceous glands produce because oil is what flows through the follicle and stretches the pores open, making it appear larger or smaller.  And oil production is determined by testosterone levels because testosterone is the chemical messenger that triggers the oil gland to get pumping among many other things. Testosterone levels are primarily biological. For example, we are born with biological clocks that signal our testosterone levels to surge during puberty, pregnancy, and the menstrual cycle.  There are certain dietary and lifestyle factors that are within our control like dairy, soy, and stress that can impact testosterone levels so if we can reduce the levels of testosterone in the body, we can reduce oil production, and maybe cause the pores to appear smaller because there is less oil stretching the pore open. This is a big maybe though and it’s unrealistic to expect poreless skin because all of humans have oil glands that are constantly producing oil throughout our lives.  I know this is not good news if you are a pore-hater but remember that oil and pores serve really amazing life saving functions so if you really had the choice, you wouldn’t want to close them up!

Topical products might help 
Some active ingredients in acne products like benzoyl peroxide can help absorb oil on the skin which might make pores appear smaller.  Other ingredients like alpha hydroxy acids can exfoliate and break up congestion in the follicles so pores might appear smaller as congestion gets purged out of the follicles.  Our Clearing Treatment contains benzoyl peroxide and our serums and peels contain alpha hydroxy acids and other exfoliating ingredients that help cut oil and clear the follicles from the inside out.  The holistic aspects of our program include dietary and lifestyle recommendations that aim to target and reduce oil production. We don’t promise that our program or products will deliver smaller looking pores because, as I mentioned, it’s largely biological and the changes we might be able to achieve will be minimal.  There really is no program or product out there that will give you flawless poreless skin but if you have a chance at minimizing your pore size at all, our program is probably your best shot.

you might also like…

What causes pregnancy acne

You have probably already guessed or heard that hormones cause pregnancy acne.  But they don’t. All acne is caused by a genetic condition called RH that causes skin cells to get backed up in our follicles regardless of what triggers it, how severe it is, and at what age it’s dormant or active.  This causes a backup of debris that creates little seeds called microcomedones which then grow thanks to various triggers. One of hundreds of potential acne triggers is a hormone called testosterone which is responsible for signalling oil production.  So when testosterone levels surge, the sebaceous gland goes into overdrive, and if you already have follicles that are prone to get backed up due to RH then it’s like fuel to a fire. Acne is a genetic condition that is always present but it requires a trigger to become exacerbated or to go from a dormant to an active phase and vice versa.   And for some people, pregnancy is that trigger

Your acne might get worse and/or worse
Just because there is a surge of hormones during pregnancy doesn’t mean that your acne is going to get worse.  Even within the population of people who have the RH gene, there are many cases where their acne gets better or even completely goes away and never comes back.  Unfortunately, there is no way to predict how any person is going to respond to hormones and because acne is a multifactorial disease, there are so many other factors that come into play at any given moment.  Your hormone levels also shift throughout pregnancy, breastfeeding, and after breastfeeding so your acne might go up and down from conception to months after you stop breastfeeding as your hormones level out. The most common thing I see is that for those whose acne gets worse while they are carrying, their acne tends to get better once they stop breastfeeding.  And those whose acne gets better while they are carrying tend to get worse after breastfeeding.

Pregnancy might be your initial trigger or a subsequent trigger
Acne is a condition that typically morphs throughout our lives:  we may go through different stages where our acne switches from active to dormant, it might move or spread to a different location on our face, our sensitivity to triggers can change, and the type and severity of our breakouts might get better or worse.  Most pregnant women I see report that they had mild acne that manifested as an occasional pimple once in a while (this counts as acne by the way!) during puberty, it went away, then it came back with a vengeance during pregnancy. In this case, puberty was the initial trigger that caused their acne to go into an active mild phase, their acne went dormant after puberty, and then pregnancy was a subsequent trigger that caused their acne to reactivate into a more severe phase.   So if your acne reappears or appears for the first time during pregnancy, it’s completely normal.

Your triggers might shift during pregnancy
Acne is like a puzzle with lots of different pieces that make up the final pictures and getting and staying clear is always about trying to balance lots of potential trigger pieces at once.  If your hormones are improving your condition, you might actually have more freedom to be exposed to other triggers that would normally cause a visible breakout. For example, maybe dairy used to trigger you if you had it more than three times a week but now that your pregnancy hormones are part of the picture they might be “suppressing” the effects of dairy so you are able to have it everyday without seeing a visible breakout. Or vice versa: maybe your acne is way worse than it was before you got pregnant so the liquid makeup you used to use without a problem is now causing a breakout.  When you are pregnant, you already have a significant piece of the acne puzzle that you cannot control (hormones) so if you want to get clear, it is especially important that you manage the pieces of the puzzle that are within your control. Be flexible, don’t think that just because something didn’t trigger you before doesn’t mean it won’t trigger you now, and prepare to adapt to whatever changes you notice.

Pregnancy acne is not a separate type of acne so it should be targeted with the same approach
Pregnancy acne, like teen acne, is caused by and triggered by the same factors that cause and trigger all acne cases.  Hormone fluctuations are actually a potential trigger for everyone with acne and every human deals with fluctuating hormones throughout their lives: it just happens to be more exaggerated during pregnancy.  Because the underlying cause of acne and the majority of its triggers are the same, a comprehensive acne program will account for oil and hormones anyways regardless of whether or not you are pregnant because a good program will target the potential triggers AND the underlying cause of acne.

you might also like…

Biotin Breakouts: How your hair, skin, nail supplements might actually be making your acne worse

Biotin has been all the rage in recent years for those seeking glossier nails, glowier skin and fuller, more luxurious hair.  And why the heck would someone with acne think twice about taking something as natural as biotin that is specifically clouted as being good for skin?  Unfortunately, if you have acne, you SHOULD think twice or maybe even three or four times before taking a biotin supplement because it can potentially make acne much worse.

What is biotin?
Biotin (also known as vitamin B7)  is a B vitamin that plays an important role in many essential functions such as gene regulation, cell signaling, and metabolization.  It also plays a role in the functioning or your nervous system and, yes, your hair, skin, and nails. Although it’s an essential nutrient, most of us in developed countries ingest the recommended amount of around 30mcg a day from our regular diets since biotin can be found in a number of different foods including spinach, broccoli, whole grains, eggs, yeast, seeds, nuts, beef, dairy, pork, hamburgers, and sweet potatoes.  Most supplements contain an excessive amount of biotin that far exceeds the amount our bodies actually need to maintain healthy functioning.

How does biotin affect acne?
Acne is caused by a genetic condition called Retention Hyperkeratosis that causes an overproduction of dead skin cells.  When the skin overproduces skin cells, they clog up the follicles, mix with oil and other debris and set off a chain reaction that results in acne.  So if acne is caused by too many skin cells and biotin promotes the growth of skin cells then of course it can exacerbate acne!

Biotin may or may not make your acne worse
Nothing is ever black and white when it comes to acne because everyone’s acne is different.  Each person’s acne may different in terms of severity, type, location, and triggers so biotin may or may not be a piece of your unique acne puzzle.  In order to determine whether or not biotin is actually a trigger for you, you would need to test it much like you would test an allergy. Ingestible acne triggers like certain foods, supplements, and medications take quite a while to get processed through your body and show up as visible acne on the surface of your skin so it will likely take approximately 1-3 months for you to actually be able to determine whether or not biotin is actually triggering for you.

---

You might also like…

How to help your teen that is struggling with acne

I discussed in a previous post how adult acne and teenage acne are not two different things but there is one big difference between struggling with acne as an adult vs as a teenager: parents are largely still involved in how a teen processes and copes with their acne struggle.  Living with acne is hard no matter what but as the primary manager of a teen’s life, you have the power to mitigate or worsen their experience. Here are some tips to help you support your teen improve their condition inside and out.

Wash their clothes, sheets, pillowcases, and towels with acne-friendly detergent
Using detergent containing pore-clogging ingredients, fabric softener or dryer sheets can trigger breakouts.  When your teen puts their shirt over their face or sleeps on their pillowcase for 8 hours a night or uses a towel to wipe their face after the shower, you want to make sure that none of those things have pore-clogging residue on them when they make contact with their skin.  You can find some acne-friendly laundry recommendations on this Pinterest board.

Help them stick to an acne-friendly diet
Sticking to an acne-friendly diet is hard for adults but even harder for teens.  School, extracurricular activities, camp, travel, and friends’ houses are all places where their only food option might contain dairy, soy, and foods high in iodine and androgen. Try to make it easier for them by sending them with acne-friendly options or requesting an acne-friendly option (usually closest to vegan options) from their school or airline ahead of time.

Help them avoid acne triggers when they travel
When your teen goes off to summer camp or to their friends house for a sleepover, make sure they pack their product kit containing their skincare products and their toiletries (hair products, toothpaste, lip balm, etc).  Just a few days without using the products that are helping keep the follicles clear can allow seeds to form that don’t show up as visible acne on the skin for months. And using a comedogenic toothpaste just one time for one second can plant seeds in the skin that contribute to a breakout.  Also, make sure they pack a pillowcase and towel that is acne-friendly.  

Do not tell them “it’s not that bad”
The intention behind telling someone that a condition they are struggling with is “not that bad” is good. The impact though is usually not so good.  Your teen does not need you to minimize their experience and even if their acne is mild, it probably still affects their self-esteem, social life, and dating life.  So even if their condition doesn’t seem that bad on the outside, try to empathize with their internal experience and provide emotional support by validating their experience instead.  Rather than saying, “It’s not that bad, you look great and nobody notices those tiny pimples,” you can say something like, “I am so sorry you are struggling right now. It breaks my heart to see you feel so much pain and we are going to get through this together”.

Get them professional help if possible
Struggling with acne on top of navigating the challenging experiences that come from just being a teen in today’s world is really really hard.  And sometimes we just don’t want to talk to our parents. So if it’s possible and resources allow, finding a therapist that your teen enjoys seeing can be helpful.  The key here is making sure that you take the time to find someone they like and WANT to see every week. If they dread going to their therapist, it doesn’t mean that therapy isn’t working- it means that you need to look for someone else. I have a post about how to find a good therapist and a list of some great local therapists that might be a good start.

Give them space and don’t push your hopes for their skin on them
I have had parents bring their teens into our clinic and it’s clear that the teen doesn’t have the motivation or the discipline needed to get clear.  Getting clear takes a lot of work and time and acne usually appears worse before it gets better so if a teen doesn’t truly want it or they do want it but they do not have the discipline required, you have to be okay with that.  If a teenager is not sticking to the program, don’t scold or shame them. You can offer gentle reminders of what they should be doing if it’s helpful but if it just annoys them then let it go. They are not ready right now and if it’s not important enough to them at that moment then it shouldn’t matter anyways.  If you find that you are having trouble letting things go and leaving them alone, reflect upon why you want them to get clear more than they do and try to align yourself more with what is important to them.

you might also like…

Why algae like seaweed and kelp are terrible for acne

There are so many misconceptions about acne that I have to reeducate my clients on and one of the biggest is that just because it’s natural doesn’t mean it’s good for acne and algae like seaweed and kelp are the perfect example of that.  There are so many skincare professionals and products that tout the miracle of algae for skin but those people have not helped hundreds of people get clear because if they have, they would have seen firsthand just how acne-triggering marine plants can be.  

Why is algae triggering?
All types of algae can be incredibly triggering for breakouts because they contain high levels of iodine.  Iodine is an essential mineral that we all need some amount of in our bodies but in excess it gets excreted through our follicles where acne takes place and can be highly irritating for our pores.  The recommended daily value for adults is 150mcg and for pregnant women it’s 220mcg but most of us, especially in the United States, get more than enough through our daily diets because so many foods and beverages in the US are fortified with iodine.

Algae can be triggering if it’s consumed in food or applied topically
Algae can trigger breakouts whether it’s eaten or applied topically because iodine can irritate your pores whether it's coming from the inside out or the outside in.

It can take up to a few months to see an actual breakout
One of the concepts we stress in our e-course The 8 Steps To Clear Skin is that breakouts take time to surface.  It can take months for the food you consume to take effect in the body, contribute to the formation of an acne “seed”, then finally travel to the surface of the skin.  So next time you eat or apply something that contains algae, don’t think it’s not breaking you out just because you don't see a pimple the next day. You have to wait up to 3 months until you can judge whether or not a potential trigger is actually a trigger for you since everyone’s acne is different.

Algae has a lot of different names in skincare
There are so many different species of algae including seaweed, kelp, and spirulina.  But most species of algae that are used in skincare products are easy to miss because they are less commonly known.  There are also ingredients that are extracted from algae or byproducts of algae that can be easy to miss. These ingredients are all species of algae derived from our list of pore-clogging ingredients:

Ahnfeltia Concinna
Alaria Esculenta
Algae Extract 
Algin
Ascophyllum Nodosum
Black kelp
Bladderwack
Blue Algae
Blue Green Algae
Brown Algae
Carrageenan (okay in food)
Carrageenan Moss
Chlorella
Chondrus Crispus
Corallina Officinalis
Crithmum Maritimum
Dilsea Carnosa
Dulse
Ecklonia
Enteromorpha Compressa
Fucus Vesiculosus
Haslea Ostrearia
Himanthalia Elongata
Hydrolyzed Rhodophycea
Hypnea Musciformis
Irish Moss
Kelp
Laminaria Digitata
Laminaria Longicruris
Laminaria Saccharina/Saccharina Latissima
Lithothamnion Calcareum
Lola Implexa
Marine Algae
Mastocarpus Stellatus
Norwegian Kelp
Padina Pavonica
Palmaria Palmata
Plankton
Porphyra
Porphyridium Cruentum
Red Algae
Rockweed
Sargassum
Seaweed
Sea Whip
Spirulina
Ulva Lactuca
Undaria
Wakame

you might also like…

The differences between teenage acne and adult acne and why they are mostly similar

Any time I see another clinic or skincare product that claims to target “teenage acne” or “adult acne”, I know right away that they probably don’t know what they are talking about.  Or maybe they do know what they are talking about and they are just using those terms as a way to make money marketing to different demographics. But if they actually believe that teenage acne and adult acne are so different that they require different interventions, they don’t understand the basic physiology of acne.  There are a few differences between acne as a teenager and acne as an adult but they are fundamentally similar and require the same approach.

Difference #1: Teenagers have increased hormones which causes more oil production
The most notable difference between adult and teenage acne is that teenagers usually have increased hormone fluctuations which leads to excess oil production.  Some adults can also have significantly increased hormone fluctuations when they are pregnant, stressed, using certain medications, menopausal etc. Hormones don’t cause acne though and they don’t even directly trigger acne: hormones exacerbate acne indirectly by triggering the oil glands into overdrive which then triggers a genetic condition called RH that is at the root of all acne regardless of what age, what type, or how severe it is.  If someone has increased oil production whether they are a teen or an adult AND they have RH, their acne can be more stubborn and it can take longer to get them clear because it can be difficult to purge their follicles at a faster rate than they are being filled up by oil and other debris. The increase in oil production can also lead to more inflammation so teenagers might have acne that is more big, red, sore, and pus filled than adults. 

Difference #2: Teenagers have unhealthy lifestyles (not that it matters anyway)
Some professionals say that teenagers have more acne because they lead an unhealthy lifestyle that includes lots of junk food, fried foods, and lack of sleep.  I know adults who live terribly unhealthy lifestyles and teens that live healthy lifestyles but, to be honest, it doesn’t really matter because living or eating “unhealthy” does not cause acne and living or eating “healthy” does not cause clear skin.  I know a lot of teens who eat like crap and never get a pimple and I know a lot of adults who meditate, get good sleep, eat clean and still have acne. In my experience working with teens, their biggest barrier to getting clear is not usually their hormones or their lifestyles: it’s their lack of discipline.  Teenagers usually have a harder time sticking to the guidelines that living an acne-friendly lifestyle requires. They also tend to be less motivated because they are not usually the ones paying for our program and they have a harder time conceptualizing that there is a delayed reaction between trigger exposure and breakout.  So while they are away at summer camp, they might think it’s okay to eat potentially triggering foods like cheese because they won’t actually experience a breakout for 1-3 months. On the other hand, adults tend to be more disciplined and they are usually so fed up with acne by the time they are in their twenties and thirties that they are willing to do whatever it takes to get clear.  Of course, there are exceptions to every rule and I have had some teenage clients who are more disciplined than some of my adult clients but adults are more likely to be able to get away with a lack of discipline because they don’t have the excess oil production to account for. It’s important to note that there are certain foods that need to be avoided such as dairy, soy, and peanuts but the reason they need to be avoided is not due to the fact that they are unhealthy but rather because they can lead to an increase in hormones.

Difference #3: Teenagers tend to breakout in different areas than adults
Teenagers tend to breakout primarily in their t-zone and adults usually breakout on the lower half of their face and the perimeters (forehead, temples, cheeks).  This is another generalization with lots of exceptions and the location of someone’s acne can have a lot to do with which products they are using. For example, an adult might break out on their forehead because they are using a pore-clogging shampoo and a teen might break out on their cheeks from using a pore-clogging blush even if that is not their typical breakout area.  There are lots of misconceptions about what causes acne to show up on different areas of the face and I mostly blame the face maps that are found all over the internet nowadays. When my clients tell me, “I think my acne is hormonal because it’s along my jawline and the lower half of my face,” I cringe. If acne along the jawline was due to hormones then why do most teens get acne on their t-zones?  It’s bullcrap. Forget those stupid face maps. The areas that we tend to breakout shift throughout our lives in a wave that starts on our t-zones during puberty and migrates towards the edges and bottom half of our face as we move into our twenties and thirties because our oil glands tend to get more activated in those areas.

Hormones, oil, and lifestyle only matter if you are born with RH
Why do you think some teenagers get acne and others don't despite the fact that they all tend to have hormonal fluctuations and an “unhealthy” lifestyle?  It's because only some teens are born with Retention Hyperkeratosis (RH) which is a genetic disease that causes a dysfunction in the hair follicles that leads to an overproduction of skin cells and an inability to wash them out of the follicle effectively. So an increase in oil production doesn’t create acne for a teen who isn’t born with RH because they have a natural cleaning system built into their follicles that is able to wash the excess oil out.  Teenagers who are born with RH essentially have a backed up plumbing system so even just a little increase in oil can cause their follicles to completely overflow.  

Why teenage acne and adult acne are still more similar than different
Despite a potential difference in hormones, behavior, and breakout location, the underlying cause of acne and the majority of its triggers are the same for teens and adults.  Acne is a multifactorial disease and hormones and oil are just two of dozens (if not hundreds) of potential puzzle pieces. A good acne program will account for oil and hormones anyways regardless of your age by having you eliminate certain foods, supplements, lifestyle factors and products that may be contributing to hormonal fluctuations and/or oil production. A good acne product plan will also include ingredients and instructions to fight inflammation whether you have severely inflamed acne, mildly inflamed acne, or no inflammation at all.   And, most importantly, a good acne program will target the potential triggers AND the underlying cause of acne and once those factors are managed the location of your breakouts is obsolete.

you might also like…

You don't have to avoid sugar, caffeine, fried food, alcohol, or gluten if you have acne

I cannot stand when skincare professionals tell people with acne that in order to get clear skin, they need to eat clean and avoid sugar, caffeine, fried food, alcohol, and gluten. I have even heard that some “specialists” recommend avoiding certain vegetables like tomato and eggplant!  During my acne struggle, I got so much advice about what I shouldn’t eat from the internet, Doctors, Estheticians, and even “Acne Specialists” that at one point, my diet was reduced to nearly nothing. I had a client once who was basically living off of boiled chicken and greens because she read so much bullshit online that she was convinced that everything else made acne worse.  I actually made her eat a cookie before she left my office because advice like this is unnecessary, irresponsible, and just cruel! Acne is such a difficult condition to live with to begin with so telling someone with acne that they also need to severely restrict their diets and abstain from things that they might find great pleasure in like their morning cup of coffee or a bar of chocolate can compromise their mental health. People with acne are also desperate and will pretty much do anything they are told will improve their condition so I consider it my responsibility to only recommend the guidelines that are absolutely necessary to get clear and no more so that their lives aren’t taken over even more by acne.

Acne research is flawed and unreliable
I am not saying that “unhealthy” foods are good for acne or your body and that there is no connection to breakouts.  I am saying that there is no reliable research that proves there is and over the many years I have been closely monitoring acne sufferers as they get clear and stay clear using our method, I have never once had to make someone eliminate or even reduce their “unhealthy” food or beverage intake.  

Inflammation is a very manageable symptom
Most of the professionals that recommend avoiding unhealthy food and beverages cite an increase in inflammation that can occur.  But even if certain foods increase inflammation, inflammation isn’t the cause of acne and it’s not even a trigger: it’s a symptom.  And it’s a symptom that can easily and very effectively be managed through icing and the proper use of an acne-friendly product with the right amount of benzoyl peroxide like our Clearing Treatment.  

IF eating unhealthy makes your acne worse, you have bigger fish to fry
I have had a few clients swear that sugar or greasy foods or caffeine makes their acne worse before they start our program and I still don’t bother making them avoid those things because IF that is actually the case, I know it’s merely a symptom of a whole lot of other underlying issues that need to be managed.  I even had one client get upset with me because she truly thought the reason she had acne was because she ate too many sweets and I wouldn’t agree with her. But I gave her this analogy: imagine you had a broken back that you weren’t getting professional help for or properly taking care of. So every time you bent down to grab your purse, your injury flared up and you got a shooting pain that went down your leg.  You wouldn’t then blame your purse or bending down or your leg for giving you pain, would you? No. You would blame your back because your back is the underlying issue, bending down is a trigger, and shooting pain down your leg is a symptom. So if someone told you they wanted to avoid their purse because it was causing them pain down their leg, you would think they are silly because you know logically that once they fixed the underlying issue (your back), bending down to get their purse wouldn’t trigger pain.  Well think of the connection between unhealthy food and acne the same way: acne is caused by a genetic condition that is triggered by a number of different factors including oil and hormonal fluctuations and inflammation is merely a symptom that appears as a result of those triggers flaring up an underlying condition. So if unhealthy food is causing an increase in inflammation, it’s just a sign that there are a myriad of underlying issues that need to be dealt with.

A sustainable acne program balances enjoyment and mental health with stress
You know what increases inflammation levels?  Stress. And you know what’s stressful? Living with acne. And you know what’s also stressful?  Living without chocolate. Or chips. Or cake. So even if eating something unhealthy raises inflammation levels, so does significantly restricting your diet and a sustainable acne-friendly lifestyle balances our quality of life with what we need to do to get and stay clear.

There are foods and drinks that you should avoid if you have acne
There are certain foods and drinks that should be avoided if you have acne-at least until you are clear and can test which things actually are a trigger for you.  Dairy, soy, excess iodine, and high androgen foods can all trigger acne but not just because they are “unhealthy” or inflammatory but because they have a direct link to some part of the hair follicle where acne takes place. 

---

you might also like…

How to find a good therapist when you are struggling with acne

I love therapy.  Therapy has been one of the most crucial aspects of my self-care practices and I have been lucky enough to have had a few great therapists that have helped me tremendously through many challenges in my life.  I have also seen a few terrible therapists and a few mediocre ones so I know that not all therapy is good therapy. But I wish more than anything that I could have had a good therapist when I was going through my roughest times with acne because the acne struggle IS a mental health struggle.  Sure, at its core acne is a physical condition but the physical symptoms of acne are not life threatening and we don’t technically need to treat it for the sake of our physical health: it is the internal emotional, psychological, social, and relational aspects of acne that make it such a torturous condition to live with.  So if you are living with acne and looking for some relief or if you are just a human living on this earth and dealing with all the existential struggles that we humans have to deal with, here are some tips for finding a good therapist that I have learned through the years.

WHAT TYPE OF THERAPY IS BEST?

There are lots of different therapeutic modalities but the type of therapy that has been the most helpful for me and the one that I think is crucial if you are struggling with acne is somatic therapy.  Somatic means relating to the body so somatic therapy is mind-body therapy and a somatically informed therapist has an integrative approach to healing that includes the body. Acne is obviously a mind-body issue but every “mental health” issue we deal with is actually a mind-body issue so finding a therapist who includes the body in their approach is essential regardless of what you are dealing with in my opinion.  Somatic therapists are trained in modalities like Somatic Experiencing, Hakomi, Mindfulness, and Sensorimotor Psychotherapy so look out for those words on their website. Internal Family Systems (aka IFS or parts work) has also been a life changing modality that has helped me tremendously so I highly recommend finding a somatic therapist with at least a knowledge of IFS or an IFS therapist who integrates somatic modalities.

HOW DO I KNOW MY THERAPIST IS GOOD?

Finding the right therapist should feel like finding "the one"!  You should have no doubt that they are meant for you and you should look forward to and even excited to meet with them every week. If you are dreading seeing them or even just feeling “meh” and not looking forward to it, they are not the right therapist for you so keep looking. Finding a good therapist takes work and trial and error but if you put the time and effort into finding someone that feels right, it can pay off tremendously.  

WHAT KIND OF THERAPIST SHOULD I SEE?

There are different kinds of therapists with different acronyms after their names.  My favorite therapists have all been Marriage and Family Therapists (MFT or MFTi) and my least favorite ones have been Psychologists (Psy. D).  In my experience, MFTs tend to be warmer & have a more human approach than Psychologists who have been trained in a more academic setting that focuses on clinical diagnoses and research. At the end of the day, you are looking for a person you feel connected to and it doesn’t matter what abbreviations they have after their name but the days when a therapist was just a cold person who would sit and listen to you are over!  Nowadays, therapists can be warm, friendly, and human so make sure you choose someone who feels like they are on your side and more of a friend than a Doctor looking to diagnose and treat a patient.

HOW MUCH IS THERAPY?

The current average fee for therapy in the SF Bay Area is between about $200 a session but do not be deterred by the fee listed on a therapists website.  Most reserve some sliding scale spots so if you feel called to someone and their full fee is outside of your budget, don’t hesitate to ask if they have any sliding scale spots available.  If you need a fee that is even lower, there are lots of sliding scale clinics in the Bay Area that I list in my post A list of some great Bay Area Therapists and clinics.

HOW OFTEN AND HOW LONG SHOULD I GO TO THERAPY?

Therapy sessions are typically once a week and most therapists will require weekly sessions so that you are going often enough (just like working out requires a certain level of consistency and frequency).  If you can’t go once a week, there are some therapists who are flexible and might be willing to do sessions every other week but I would recommend sessions at least every other week at a minimum. Regarding how long you should go to therapy for, I think that is the same as asking how long you should exercise for.  Therapy is for my mental wellness what exercise is for my physical wellness. Both should be done regularly and they should be done not just when things are bad but when things are good as well. Exercise should be done even when your body is in shape to maintain optimal wellness and therapy is no different so if you are lucky enough to have access to therapy, you should go!

WHAT IS THE PROCESS FOR FINDING A THERAPIST?

Finding a therapist is like dating: finding the one is based on a combination of intuition, qualifications, and chemistry.  You might see someone whose qualifications you like but when you talk to them, there is no chemistry. Or you might find someone who doesn’t have the qualifications you are looking for but that you might be intuitively drawn to.  I have broken down the process I use into a few steps:

1. First, browse therapist profiles and see you are intuitively drawn to.  I list a few of my favorite therapists in my post A List Of Great Bay Area Therapists And Clinics If You Struggle With Acne but if none of them call to you, Psychology Today has a great therapist finder where you can filter by location and modality so you can select Internal Family Systems, Somatic, and/or whatever else you are drawn to under the “types of therapy” filter.  For me, I often get a gut feeling based on their picture so if I see someone’s picture and I just don’t like them, I don’t bother reaching out. Notice who you feel drawn to, read their websites, and collect as many names as possible to reach out to so you can compare and contrast.  

2. Once you’ve collected names, start by emailing them logistical questions like, “Are you accepting new clients?”, “What days/time slots do you have available,” and “What is your fee,” so you don’t waste your time if those things aren’t a fit.  Then ask them to set up a phone call because most of them offer a free 15-20 minute phone consultation.

3. During the phone consultation, feel into how comfortable you feel with them on the phone but also have a few questions ready.  Some of the questions I ask are: “What does a session usually look like with you?” and “How engaged are you during sessions?”. You can also ask how they work with the particular issues you are wanting help with.  

4. I always commit to meeting with at least two or three therapists even if the first one feels like a good fit just so I can really compare who I feel the most connected to.  Again, when you find the right therapist it should feel like finding “the one”. You should feel connected to them, comfortable with them, and look forward to seeing them every week.  If you begin therapy with someone who feels right at first but they start feeling less than helpful down the line, I encourage you to bring it up to them. If the issue doesn’t get resolved or if you ever stop look forward to seeing your therapist, I also encourage you to trust your gut and find someone else.

you might also like…