Though acne is usually seen as a male hormone excess concern called androgen-mediated acne, in many cases it’s actually driven more by insulin, which will also make the other hormonal based acne from thyroid hormones or estrogen issues worse. It directly stimulates skin cells to produce more sebum and keratin but it also increases the secretion and bioavailability of other hormones related to acne.
Insulin affects acne-relevant hormones in these ways:
• Increases androgen secretion.
• Increases androgen bioavailability by reducing sex hormone binding globules (substances that bind to sex hormones and inactivate them).
• Increases IGF-1 bioavailability by reducing IGF-1 binding proteins.
All of these factors contribute to more sebum and more acne.
To date scientists have been reluctant to investigate the connection between diet and acne. However, some studies that show reduction in acne include:
• Reduction of dietary glycemic index (GI).
• Simultaneous reducing dietary glycemic index and increasing protein intake.
• Higher risk of acne in people who drink more milk, likely due to the lactose (a dietary sugar) in cows’ milk.
Acne – Not Just About Insulin
By now it should be clear that insulin is an important factor in acne, but it is certainly not the only factor contributing to acne.
Acne begins with oxidative damage (inflammation) to squalene, a fatty acid in sebum (an oily secretion of the sebaceous glands). Oxidative damage converts squalene into squalene peroxide, which is highly comedogenic, or clogging. Research has quite clearly shown that there can be no acne without initial oxidative damage to sebum.
Sebum oxidation leads to blocked pores, allowing bacteria to colonize in the pores, thus setting the stage for acne.
Insulin stimulates sebum production and increases the proportion of squalene. A reduction in insulin does the opposite. More sebum on your face that is being constantly exposed to inflammatory damage from UV rays, air pollution, toxins, etc, means more acne. Without sufficient antioxidant protection, sebum will suffer oxidative damage resulting in acne.
Clearly there’s a case to be made for using ketogenic diets to treat acne.
That said, not everyone with acne is insulin resistant. In some cases, acne is linked to PCOS or other hormonal abnormalities, while in other cases, it not caused by hormonal issues at all, but has more to do with the gut, lifestyle and stress. In such cases, a low-carb diet may be part of the solution, but repairing the gut and correcting an out of balance lifestyle takes precedence.
Betty Murray, CN, IFMCP, CHC is a Certified Nutritionist & Certified Functional Medicine Practitioner with the Institute for Functional Medicine, founder of the Dallas-based functional medicine clinic Living Well Dallas and Executive Director of the the Functional Medicine Association of North Texas. A master of the biochemistry of the body, Betty teaches her clients how to utilize nutrition for autoimmune diseases, digestive disorders, MTHFR and weight loss. You can find her book “Cleanse: Detox Your Body, Mind & Spirit” on Amazon here.
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