Tuesday, April 2, 2013

Giving up grains and dairy and the (lack of) effect on acne


In October, Sam and I decided to stop eating grains and minimizing sugars to see how that went. It's been easier than I'd feared — much easier than my quite abounding fears! I was interested to see what effect it might have on our health, but truth be told, neither of us has any particular health concerns to monitor.

Except … my acne.

I was so hopeful that my adult-onset, hormonally triggered female acne (hate it, hate it, hate it) might react positively to the dearth of grains and sugars. There are a lot of paleo and low-carb types espousing the gospel of no-grains being the cure-all for acne. I wasn't sure how much to hope, but I was hopeful. Did I mention I'm in my mid-30s and have had this affliction now for over 15 years? It was both disappointing (how had none of my dermatologists suggested these dietary changes?) and encouraging to consider that making this relatively simple substitution in my eating might bring an end to my acne woes.

Turns out, my hope was misplaced. After giving up grains and sugars, my acne got … worse.

Yes, worse! It went from staying under control with one type of topical medication to needing extra topical treatments just to keep myself from despair at the constant large, red, painful mounds populating my chin.

Giving up grains and dairy and the (lack of) effect on acne == Hobo Mama
This picture is a few years old, back when I was doing the breastmilk-as-acne-treatment experiment.
Yeah, that didn't work, either. This serves to show you what my skin looks like
when I feel like crawling under a rock. It's downright painful and the oozing … oh, the oozing!
The zits I have right now are much larger than in this photo — joy! Click on it to see it bigger if you dare.

I've been waiting since October for a couple days when my skin is clear enough for makeup to hide the pimples so we can race and get some overdue family portraits done. Still waiting.

What's eating my skin?

I considered: Was there any possibility that not eating grains was bad for my skin? Or, to put it in the reverse, had eating grains somehow been good for my skin?

I did some research and reading and had to conclude: No. That really didn't make sense. The effect of grains on insulin levels, hormones, and bacteria couldn't have a beneficial effect of controlling acne unless I was some freak outlier (and let's assume I'm not). Populations eating traditional, low- or no-grain diets have had historically low levels of acne and other skin disorders, and those afflictions pop up consistently when grains (and other Western foods like sugar and dairy) are added.

Now, it could be that grains — present or not — have no effect on my skin, as seems to be the case.

But the fact remains that my skin got worse after giving them up in October, which led me to believe: There must be something I'm eating more of now that's exacerbating my acne. Sounds reasonable, right? (It could also be something I'm eating for the first time since October, but I couldn't think of anything that fit that criterion.)

I did some more reading through online forums, books on primal eating, and scholarly articles on acne and diet and identified some key targets:

  1. Dairy
  2. Nuts
  3. Coconuts
  4. Nightshades

I've listed them in order of likelihood, and in the order I determined to eliminate each one individually (until and unless one clicked) to see if my acne would diminish back to previous levels (or, please heaven) disappear completely.

To take each one separately, here was my thinking:

Dairy:

I've always been a big fan of dairy, particularly cheese. Growing up, I drank a glass of milk (or several) at every meal, but as an adult, Sam and I stopped that habit and used our (whole organic) milk mainly for cooking and baking. We used a lot of butter when we were eating grains but didn't find as much use for it once we stopped, and the same was true of milk. So I wasn't using more milk and butter after we went grain-free, and likely a lot less. But I fully admit I went cheese-happy. All those little grabby snacks that once had been grain-based (a cracker, a cookie, a tortilla chip) became cheese-based instead: String cheese and parmesan reggiano cut into little flakes were the main culprits. I also loved having a mini-meal at night of cottage cheese with fruit slices. Added to that, many meals contained or featured cheese as well, though that was equally true before going grain-free.

In my reading on paleo and primal diets, dairy was called out as an inflammatory and an unnecessary and potentially unnatural addition to human diets. I personally had been skeptical since, while it's true that cultures without a long history of dairy use (Asian populations, for instance) are more likely to be lactose-intolerant, the same cannot be said of cultures where dairy has been prevalent for many generations (such as mine). I'd never felt sick or otherwise indisposed from eating dairy in any form. But several research studies and anecdotal accounts of the link between dairy and acne convinced me that, sadly, it was worth giving an anti-dairy stance a try. So that became #1 on my list.

Nuts:

I definitely eat more nuts and seeds now that I'm not eating grains. And even more so now that I'm not eating dairy! (I need to find better snacks…) I try not to overdo it, but I'm pretty sure I fail. I know of no connection between nuts and seeds and acne, but it's certainly one of the elements in my diet that has changed since going grain-free, so I figured it was worth some exploration.

Coconuts:

This is another food item that's increased since going grain-free, particularly in the realm of (delicious, delicious) desserts. Same with nuts, actually, and coconut oil and flour and almond meal go hand in hand when doing no-grain baking, so I'm not sure which should be #2 and which #3 on the list — likely, I'd have to eliminate them together, honestly. Some people have great success with coconut oil, applied topically or taken orally, in treating acne. Still others complain that coconut oil is highly comedogenic (acne-causing) for them. I'm not certain whether it depends on the type of coconut oil, the type of application (oral vs. topical as well as how often it's applied or ingested), or simply the vagaries of individual human tolerance, but I do know it's something I eat more of now than before, so I suppose it's worth having on the list. I think it's more often called out as comedogenic when applied topically, so I'm not optimistic about any positive effect from eliminating it, frankly.

Nightshades:

This is one I'm including only because several people have mentioned that the nightshade family of edible plants exacerbates their acne. This seems odd to me, but there are enough people saying it that I suppose it's true for some people, and one of those people might just be little old me. Nightshades include potatoes (which I've stopped eating in any case since they're starchy), eggplants, tomatoes, peppers, and pepper derivatives such as paprika and various hot sauces. This category is last on the list because I truly don't think I've been eating more nightshades since October. I do eat a lot of the plants on that list fairly often, but not in markedly increased quantities since giving up grains.

So, for now, I've decided to give up dairy, and then I'll revisit my list if giving up dairy doesn't pan out.

The no-dairy experiment

So far, it's been a complete bust. Some of that has been user error, but some of it is my stubbornly stupid face.

I started trying to give up dairy at the end of February, but I kept forgetting. I certainly decreased my consumption, but I kept forgetting to stop eating it altogether.

Starting March 1, I said, "Ok, I'm going to be completely clean for two weeks," and then see how my skin reacted.

Now, various people told me two weeks is not enough. But the thing is, I love me some cheese. I knew if I said to myself, "Self, you can't have dairy forever," I would not follow through and instead would succumb to cheese-related despair. Plus, I'd just bought some lovely cheese at Costco (so, obviously, a big portion — smart planning, hey?), so I didn't want to feel like too much of a chump. I figured I'd reassess in two weeks — if my skin was clearer, then giving up dairy was helping. If it was not, then I needed to keep on the elimination (or give up, whatever my mood was at the time).

But … I was like one of those factories that kept resetting the sign to "0 Days Without an Accident." I couldn't believe how often dairy found its way into my mouth unintentionally. I'm a cheese magnet! It would be little things, like I'd be eating a salad at a restaurant and forget to specify not to sprinkle cheese on top. Then I'd spend half my meal time picking cheese shreds off the lettuce. Or Sam would bring me a spoonful (or bowlful) of his newest dairy-happy kitchen creation, completely forgetting that I'd foresworn the moo stuff. Or Mikko would run over with an ice cream and say, "Yum! Try this!" And I would … before remembering … Duh, dairy! There was an even bigger oh-duh moment when I realized the butter oil capsules I'd ordered and had started faithfully taking were … wait for it … butter oil. Ohhh … riiight. It was there on the label all along.

So there was no way I was completely clean from March 1, just — trying to be. I did, however, figure that occasional contamination was going to be a constant in my life, even if I concluded that dairy had an effect on my skin. There was no way I could behave as if dairy would send me into anaphylactic shock, so I was going to have to allow that, no matter what, I would be coming across traces of dairy in my diet here and there. If having clear skin required unwavering observance to the no-dairy (and no-grains and no-sugar) rule, then having clear skin was, quite truthfully, not worth it.

But I figured I'd still be able to tell if cutting back on dairy to minuscule accidental amounts had a beneficial effect on my skin. Maybe my skin wouldn't be clear, but maybe it would go back to pre-October levels of control, and I'd call that good enough.

So … how's it going?

Well, it's been a month of mostly compliance. As I said, I had a rocky start, so I'd give myself a good three weeks of being at least 90% (probably more like 95%) obedient to avoiding dairy. There are incidents like today when I was really thirsty when Mikko and I were out and I took a swig of his milk before realizing (this happens a lot, as you can see), "Oh, duh … milk." But I'm getting much better at remembering to ask for food at home or out without dairy additions or preparations, and I don't miss it as much as I'd feared. I will say I miss dairy more than I miss grains, strangely enough. I really do love cheese. I really miss cottage cheese and am half-hoping cutting out dairy has no discernible effect so I can get back to eating it!

In this month, my acne has definitely not gotten better. It hasn't gotten worse since the no-dairy experiment started, which is small consolation, but it hasn't improved, either.

On the one hand, I'm bummed that this wasn't the magic cure-all for my acne woes. I've had scattered daydreams that in a few short weeks I'd be walking around without any makeup and without any telltale bumps, bleeding scabs, and red marks. I also don't look forward to cutting out other foods in the hopes of finding the silver bullet, and it's possible I should continue to cut dairy even as I experiment with other eliminations, just to see if it's a combo, so that stinks.

On the other hand, it would be nice if I could start eating at least limited cheese again. I know of some people for whom elements of dairy are a problem, but not all of it — like, they can use raw milk, or sheep's milk cheese, or grass-fed butter but not milk, or whatever. So maybe eventually I'd get my cottage cheese back, but just live at more reasonable levels of cheesiness. Plus, and here's where I just live for a smug sense of self-superiority, I'd like to demonstrate that giving up dairy isn't necessary for everybody — that some people do just fine on it, thank you very much.

For now, I keep going, one uncheesy day at a time. I'm not sure how long to continue my no-dairy experiment. Any ideas? I've been through a cycle already, so I got to witness how that combination affected my acne (no real effect from my period, actually). I'm thinking I need to go at least six weeks in good faith but am wondering if going longer than that would be beneficial.

In full disclosure of confounding factors, I'm continuing my topical medications, because otherwise I wouldn't want to be seen in public. (I previously used only 2.5% benzoyl peroxide, which continues to work well on me, but I got irritated with all the fabric bleaching so switched to a high-quality 5% salicylic acid — actual brand I use, no affiliation — which was doing great on its own up till now.) I have in the past halted the use of chemical topicals and tried more natural methods, and that was terrible for me. (See photo proof above.) The only exception was pregnancy — pregnancy was awesome for my skin! But, no, I'm not going to get pregnant just for that reason… I'm also taking zinc supplements (this kind, and that's an affiliate link to Amazon), because some people said their acne cleared up once they cleaned up their diet and cured an underlying zinc deficiency. I don't think I actually have that, but it's cheap enough to try a bottle of zinc supplements in addition to giving up dairy and grains, so I am. I also continue to take a whole-foods multivitamin, cod liver oil capsules, probiotics, and vitamin D drops (no changes there). I don't wash my face with anything but water and occasional oil cleanses, and that's been just dandy for me for some time so shouldn't have anything to do with this recent population swell in Zit-topia.

So that's where I am for now, blemished and sick of it. Any advice or suggestions? Any personal stories of skin conditions cleared or worsened through diet?

20 comments:

Tree Peters said...

I have two sisters who are so sensitive to nuts that they get big almost cyst-like pimples when they eat them. Mostly peanuts, but could be any nuts or things with nuts in them.
I'd almost say get rid of the nuts first...
Also, do you think there's any chance your body is detoxing through your skin?
Are you eating only very organic meats? It's really important especially with hormonal issues. And organic cheese and dairy too. That will control your quantities since it's so expensive.
I'll keep thinking...

Heather in Oregon said...

I got very ill this winter and was diagnosed with celiac disease. As a result I chose to give up grains, legumes, starches (mostly), and all sugar other than a square or two of dark chocolate most days. My original intention was not to give up all of those forever but to have my body heal without those things that it is most difficult to digest or obtain nutrients from. Soon after giving all these up I got the WORST acne I've ever had and like you I've had adult acne since becoming an adult. However, in the past three months it has normalized and while not gone completely is the most minimal it has ever been in my adult life. That being said, I've noticed something of an upswing in it again this past month or so and I suspect that it is either because of an increase in my nut consumption in the form of flours and butters or my sugar, in the form of honey or maple syrup consumption, both of which have gone up because of birthdays and events. I'm planning on cutting back down to a (mostly) basic paleo diet again after my daughter's birthday this month(thankfully the last in our family for another 6mos)and see if it improves. I'm going to avoid eating any nut flours and nut butters for that time also. As for dairy, I don't notice a change in my acne but I have noticed a change in my digestion when I eat more of it. I too am a cheese lover and have been very sad to have to cut way down on my consumption although I recognize that it's probably better that way.

heathermhs said...

I've had good results using Crunchy Betty's suggestions. I bought her eBook and use her daily face scrub (with neem oil, calendula, and lemon essential oil) once per day and honey once per day to wash. I also use diluted ACV for a toner and a mix of jojoba and Tamanu oil for moisturizer. My face is more clear and more consistent than I remember it ever being.
http://www.crunchybetty.com/

Stacia R. said...

The ONLY thing that has helped my acne (and I still have some, but it's barely noticeable - way better than how it used to be) was doing the Oil Cleansing Method for washing my face. I tried breastmilk too and it just made my face sticky and feel tight.

I had to play with oils and amounts, but my sweet spot has been 70% sunflower oil and 30% castor oil. Cleanse at night when I've worn makeup that day and use coconut oil as a moisturizer. Get face wet in the shower in the morning and follow with more coconut oil.

Laura said...

Kudos to you on cutting grains. I've been trying for a year, but can't motivate myself to abstain for more than a few days in a row.

But my new discovery is iodine/iodide. The info is very confusing and controversial. There is a huge difference in some advocates recommended dosage vs the RDA. In some people too much can cause significant damage to the thyroid,in others it can fix a sluggish one. But maybe damage isn't caused by the iodine alone, maybe it is caused when the ratio of it and selenium are out of whack. It also is known to be required for proper breast function (my pet theory is perhaps lactation woes?) including fighting cancer. I've been meaning to do a blog post, but I have one thick, technical book I've been meaning to read first.

Anyway, I have been extremely cold for the past couple years. Wearing tons of clothes, snuggled with my kids under three blankets, in a heated house cold. I knew it is a symptom of a sluggish thyroid. I know I should go get it checked, but due to poor health insurance I try to avoid the dr.

From some research I knew iodine can help. I first tryed kelp powder in smoothies and soups for a few months but didn't notice a difference. I then decided if I used an iodine/iodide solution topically, and upped my selenium, b vitamins, vit c, and salt intake and take epson salt baths I could probably supplement safely without negative affect.

I put a quarter size spot of an iodine tincture on my stomach, when it disappeared I reapplied. After four days I was no longer cold. I did seem to get a bit of anxiety so I backed off, and started taking a thyroid multi which has just the RDA for iodine, and then use a quarter sized dosage of topical lugols iodine/iodide solution once every three or four days.

To get back on topic on skin care. The three organs that use iodine are your thyroid, your skin, and your breasts. After initially taking the iodine my skin broke out (some theory's are that this is caused by excess bromine and fluoride being released), but the acne only lasted a day or two and then went away. Overall my skin is a lot softer, less dry, and my acne seems to be a bit better, though not perfect.

I was also hoping that the selenium/iodine combination would get rid of my chronic sties and chalazion, but after a month my chalazion is still here and is actually worse. I am hoping that is because my body is trying to get rid of it, whereas before it wasn't even trying to fight the bacteria.




Inder-ific said...

Oh, man, this sounds brutal - both the skin issues and your massive dietary changes, which haven't made the difference you were hoping to see ...

I get hormonal pimples as well, although somewhat less as I get older, and my skin tends to clear up a ton when I'm pregnant or breastfeeding. Anyway, when it was bad in my 20s, I saw a dermatologist who just said flat-out that food was not a factor, it's just hormones. And while that was just one opinion (I don't think anyone knows it for sure) I took that to heart and have just never considered since that food might play a part in my skin issues. The fact that my skin clears up when I'm non-cyclical just seems to say "hormones" and that's the end of it. But it's intriguing to think that there may be more to it than that.

Still, giving up cheese or grains, let alone BOTH ... wow, I would find that incredibly challenging. Good luck on this journey! If nothing else, you'll find out that food doesn't make a difference and you can eat whatever you want.

Rae said...

I commend you! I have also had adult acne and suffered for many years, however when I reached my thirties it began to clear up. One reason was pregnancy/breastfeeding but I also changed my diet. I have been vegetarian since I was 18 but once I hit 30 I became primarily vegan. I stopped washing my face with all sorts of "products" and I increased my water consumption and generally "detoxed" my system. At first I felt (and looked) worse but the body eliminates all the built up toxins in the beginning. The more you persist, the more improvements you will see. All the best to you!

Crunchy Con Mommy said...

I don't get zits but I get blackheads and the only thing that seems to help other than excessive exfoliation is coconut face fash I found at Walmart! But dietary changes don't seem to make any difference as far as I can tell.
I am going dairy and chocolate free right now though because they were bothing my newborn.
So of course I crave dairy and chocolate all day...

Kellie Barr said...

I went off dairy, soy and corn four and a half years ago, for Walter when breastfeeding. I did it just for him, but found that I am allergic to dairy as well. 2 years later, we went off gluten as well, and this year, we went off eggs, when my sensitivity turned into an all out allergy. I never did it for myself, but my skin cleared up significantly after getting all of the allergens out of my system. I break out immediately upon consumption of dairy, in painful spots. The more I eat, the worse the spots. Soy will do it too, but not to the same extent. And I noticed a breakout of small, non-painful bumps on my forehead after drinking a soda (a rare occurrence). With dairy, it doesn't have to be much to break me out. We bought new probiotics, which have no dairy ingredients in them, and says that the probiotics are from a non-dairy source, but there had to have been dairy in them somehow (cross contamination, perhaps). I broke out in painful spots all over my chin and mouth, while Walter had stomach cramps daily. And we were each only taking half doses of the probiotics.

Soooooo, my point/thought is that it may not be that "dairy makes people break out" but that if there is a food that is making you break out, it could be specific to YOU and it could affect you even in small quantities. My advice to everyone cutting out dietary components for things like this is to cut it out completely and then add it back in small quantities, if you see improvement after a few weeks of being completely clean. A really good example of why: when we were trying to figure out Walter's allergies, I cut out corn with no improvement, then realized a month later that I had not cut out soda when I was cutting corn, not thinking about the soda having corn syrup in it. When I tried again and cut the soda out, it made a VAST difference for him.

Good luck! Those spots look painful!

Kelli said...

I'm brand new to reading your blog but this post was very interesting to me. I give you a lot of credit for being able to eliminate different foods from you diet that takes a lot of self control! I have always had acne in fact I can't even remember when it started sometime in those lovely teenage years but it continued on into adulthood. I have tried, or at least feel like I have tried, every cream, lotion, wash, gel etc. that is out there for acne. I finally decided to take accutane even though I was very nervous to with all the horror stories out there about how bad it is for you but it really changed my life. It has been 3 years since I finished taking it (I took it for 6 months) and I have never had a pimple since. I had very little confidence and was extremely self-conscious about my acne before but since its gone away I feel much better about myself, stupid how something like acne can do that you. I also use Norwex clothes for washing my face with. I didn't start using them until after taking accutane but I just wet the cloth with water and do that morning and night and put on some lotion and thats my beauty routine! I hope your acne clears up soon for you!

Lauren @ Hobo Mama said...

@Tree Peters: Good call on the nuts. I think that will be next. Goodbye, paleo baking! {sigh}

I do try to eat only organic or (preferably) grass-fed/free-range meats and dairy. You're right about the expense, oy.

Lauren @ Hobo Mama said...

@Stacia R.: I do like the oil cleansing method (I do about 75% castor oil and 25% jojoba oil), but I haven't noticed a difference in my acne on it. I'm too scared right now to try out doing nothing but that, maybe once I get things more under control!

Lauren @ Hobo Mama said...

@Laura: I was just reading a recommendation to eat more kelp — I didn't realize there was a tincture available. Very interesting results!

Lauren @ Hobo Mama said...

@Inder-ific: Ah, the food & dermatologist conundrum. So, there was one study in 1969 that tested chocolate — just the cocoa part — by giving two groups daily candy bars, one with cocoa and one without, but all else the same. There was no difference in acne at the end of the study, so the conclusion: Chocolate doesn't cause acne. And for some unknown reason, that was extrapolated and handed down as: Food has no relation to acne. Kind of weird, but I've heard that so many places, and clearly so have you. But there are actually several studies showing that there is a relationship between food and acne (such as this about dairy and this about glycemic load), although it's obviously a heck of a lot more complex than just saying X food causes acne in anyone, full stop.

I agree about the challenging nature of eliminating foods. I was actually doing just fine on no-grains, fats and protein being so filling and satisfying. But stopping dairy, and then considering stopping nuts or eggs (another potential allergen) and who knows what else … makes me sad.

Lauren @ Hobo Mama said...

@Kellie Barr: That's a good point! Too bad I'm so crap at avoiding contamination. But I can see why you'd be more cautious!

Lauren @ Hobo Mama said...

@Kelli: I started Accutane in my 20s, but after a month my liver count was so high my doctors suspected hepatitis or worse and called me in a tizzy. I had to stop taking the Accutane and have a gazillion more blood tests as it left my system and my liver (thankfully) recovered. So I'm one of the people who can't tolerate it. I'm bummed, because it did a really good job at drying me out for just that single month. I wish there were something else on the market like that that maybe wasn't quite … so … extreme. ;)

Luxe Little said...

Sorry to hear you are suffering in this way. I have the same issue and it is horrible.

I have found so much useful information at


http://www.acneeinstein.com/

Good luck

Laura said...

For me, a 35 year old who has suffered from acne since 14, this is what finally worked for me. A completely plant based diet with very limited grains (like on the weekends). After trying everything, for so long, it feels so damn good to have clear skin. I still plan on trying to figure out if i can tolerate some grains more than others though, cause man I love them.

Suzanne said...

Nuts are very much related to acne in that they high in omega 6, which triggers sebum production in the skin. If you already have oily skin, you want to try to keep your omega 3 and omega 6 at a 3:1 ratio. If you are not oily, try to keep it at 2:1. This will help your acne for sure. Also, I will say that I don't think 3 weeks was enough time to see if dairy effects your skin. I have done many diet cleanses where my skin didn't clear up for weeks. Sometimes my skin would get worse before it got better because it was purging. Myself, after suffering with moderate and at one time sever acne for 15 years, I am now paleo with very minimal sugar. (only fruits) I try to eat low GI foods too. For the first time ever, my skin is glowing and clear and the tone is even. Even my scars are diminishing. Honestly, my diet is well worth it. I forgot how good I could feel with clear skin. Haven't had it in so long. Even some of my fine lines are going away. Crazy! I say, try the dairy thing again. You might not know how bad you feel until you really feel so much better. Great article! My best to you!

Rhonda Leilani said...

I wish I had the magic answer for you (and myself.) Same thing-acne since high school now 35 and still a battle. The only times it's cleared is being on the pill, during pregnancy and breastfeeding otherwise I have been really aware of my oily skin and painful new pimples. I currently use a benzoyl peroxide wash followed up with clindamycin topical and then lotion so no dry skin to cause clogged pores. Then I frequently use an alpha beta hydroxy acid pad type thing which really helps in exfoliating and getting rid of a new pimple quicker than usual. Also do "dermaplaning" maybe once or twice month for exfoliation too (which is a new thing - will see how it goes.) I love dairy too. I feel like upping my green veggies helps...like spinach and kale (not too much kale) but I try to eat spinach daily in smoothies along with my normal veggie with dinner. I also remember trying green tea for a month and my skin seemed less oily and reactive. Might try again. Sorry this sounds like im brainstorming here! But just wanted to add my 2 cents. I also feel that it is very hormonal and wonder how much food really affects the skin? And wonder if the skin goes through a bacteria phase and is then very oily and reactive to foods ... like having blood sugar spike and whatnot.

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