188 replies to this topic

[databased]

Usual disclaimer: I'm not a doctor, this is not medical advice, don't sue me, nobody has a cure for acne and I don't either, this discussion assumes you are an otherwise healthy person not taking any prescription meds and not suffering from any other pre-existing medical conditions.
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People need a model of acne that lets them make daily rational decisions that effectively help treat it.

Acne is clearly complicated, but if your model of acne is too complicated, then you end up in woo-woo land, doing liver flushes and unspeakable things in the bathroom, and compiling ever-expanding lists of forbidden food until all you can eat is bat guano gathered by virgins on the Isle of Crete in the month of September, and your bathroom contains more skin products than the local pharmacy.

Likewise, if your model of acne is too simple, then it simply doesn't work. Of course, anything works for someone simply because acne symptoms fluctuate over time (due to things you ignored in your too-simple model). Thus, the too-simple model simply adds to the enormous list of one-shot cures that has its own small set of prophets claiming "all you have to do is X", and if that doesn't work for you, then you didn't do X right, or hard enough, or with enough moral purity, etc.

The Zinc Hypothesis says that zinc is the factor that connects all the strange and weird things that make somebody have acne on some given day on the planet, everything from masturbation (losing zinc via semen) to eating bananas (eating copper-rich foods that can block zinc absorption). While it's exciting to think that it might be possible to connect all these many and varied dots, it begins to lead to woo-woo land, since zinc is so ubiquitous in the body it can be connected to anything, but what you need to know is what matters. After some tinkering, I'm ready to take a stab at defining priorities that matter, and hopefully making a model that's simple enough to be useful, but not so simple that it's ineffective.

Simplified Zinc Model of Acne

This model (trying to leave out any biochemistry terms) claims that much chronic acne can be treated successfully if only three things happen:

1. You have sufficient zinc available in your body.
2. You have a normal nightly melatonin cycle to drive the zinc to where it needs to be in the cells of your body.
3. You don't eat dairy unless you've proven you're one of the lucky folks for whom acne is not worsened by dairy.

That looks like a too-simple model (and it definitely is highly simplified), but it's not simply because a) having sufficient zinc is not as simple as just taking a pill and b) having a normal melatonin cycle is not as simple as just going to sleep. But, my hope is that tying all aspects of the regimen to these two simple goals can help someone have a coherent view of what works and why.

Why is dairy different? The mechanism by which zinc/melatonin treats acne probably, in part, involves dampening the production of some hormones. Milk is filtered cow's blood, so it can deliver hormones to you already 'rarin to go -- too late for zinc/melatonin to do anything about them. If you're not 100% sure dairy is no problem, just give it up and if the regimen makes you clear, you can always retest by adding it back in.

Having Enough Zinc
You would think that all you have to do to have enough zinc in your body is take a zinc pill. Indeed, I started down this path when I saw that taking a very large dose of zinc got me 100% clear for the first time in 30 years -- but I couldn't take a megadose of zinc forever, so I had to learn how to make a normal-sized dose work.

Unfortunately, science has not yet figured out the best way to get zinc in your body, or even how to test to see if you have "enough" zinc. It has figured out that just taking a normal zinc supplement might do you no good at all, due to other factors. Here's a list of tips for taking a normal dose of zinc and having it be effective:

• Don't be Vitamin D deficient. The Vitamin D Council can tell you how. It is a recent discovery that being Vitamin D deficient can keep a zinc pill from raising your serum zinc levels at all. This helps explain why taking a zinc pill seems to help some people, and doesn't seem to help others at all. It can take as long as 3 months to get your Vitamin D levels up to a reasonable level by taking pills.
• Get your Vitamin A by eating a carrot (or other carotenoid), not from a pill. Vitamin A pills can interfere with Vitamin D; that means forgetting the much-revered cod liver oil.
• Take the zinc with Vitamin B6. There's some indication B6 increases absorbability.
• Take the zinc on an empty stomach just before bed. That lowers the odds that something you ate that has a lot of copper in it will block absorption. Copper and zinc probably compete in the intestine to be absorbed. Don't buy the kind of zinc that actually contains copper, 'cause that's basically nuts. :-)

Have a Normal Melatonin Cycle
Every night, the pineal gland in your brain is supposed to notice that your eyes haven't seen any light in a while, and start cranking out melatonin into the bloodstream. The melatonin would make you sleepy and perform many, many other functions -- one of which probably stimulates the use of zinc. As the night goes on, the pineal gland is supposed to ramp up its production of melatonin to high levels. As the dawn comes, the light from the coming sunrise gets through your eyelids, hits your retina, and sends an ever-increasing signal to the pineal gland that tells it to start shutting down production of melatonin so you can wake up and not feel sleepy and groggy.

Or, maybe you get up at 2am to go to the bathroom, flip on blinding makeup lights, and slam your pineal gland with a giant SHUT OFF signal just as it was really getting going. See how easy it is to not have a normal melatonin cycle? When Cordain studied primitive tribes and could not find a single zit on anybody, he made the plausible conclusion that this was because of their diet. But of course, another stark difference between those tribes and us is that they have no artificial light. They have to go to sleep at about the same time every day, they have to get a fair number of hours of sleep (nothing else to do!), and they have no artificial lights to interfere with their melatonin cycle (they probably also get more zinc in their diets, since they don't eat the results of industrialized farming). Notice that one of the biggest drug expenses in modern society is sleep aids; that should give you an idea of how common it is to not have a normal melatonin cycle. Easy rule of thumb: if you have to have an alarm clock to wake you up every morning, you don't have a normal melatonin cycle.

Tips for getting a normal melatonin cycle:

• Keep any light from reaching your eyelids when you sleep. Black out the bedroom. Wear a sleeping mask. Don't turn on lights if you get up in the night. Don't have things with glowing LEDs in the bedroom.
• Go to sleep at the same time every day. Your melatonin cycle will not immediately move over 4 hours just because you stayed up late on the weekend. That's what we call "jet lag".
• Get >= 8 hours of sleep per night. Sorry, that's how we evolved. The study showing significantly less breast cancer in women who slept 9 hours instead of 8 (and way more cancer in women who slept 7) should be a clue. We're supposed to be knocked out by melatonin for > 8 hours so a lot of maintenance can get done. If your life is just too hectic to get more than 6 hours sleep a night, I suspect this regimen is not likely to get rid of your acne.
• Cut off your caffeine 8 hours before bedtime. Caffeine can depress melatonin; that's part of how it keeps you awake (duh!).
• Cut off sweets 8 hours before bedtime. Tryptophan is the fuel for making melatonin. Excess fructose can bind with tryptophan and keep it from getting into the brain. Easiest way to rule that out is just eliminate sweet things ahead of the time of day when tryptophan is trying to get into the brain.
• Aerobic exercise in the evening on an empty stomach. Evening is when blood levels of tryptophan are peaking, but the trick is to get it across the blood-brain barrier into the brain. Exercise pumps more blood through the carotid and increases the amount of tryptophan that makes it into the brain. The "empty stomach" part is just a brute force method of making sure you didn't recently eat something else that can block the tryptophan from crossing into the brain.

Notice that this regimen doesn't care what the heck you put on your skin. This model of acne says that by the time you see a zit, the battle is over and you're just tending the wounded, so do whatever you can. But the proper place to fight the war is upstream, before any zit could get started.

Notice that this regimen, apart from dairy, has no list of forbidden foods -- and yet can help explain how foods can exacerbate acne. This model only cares about the effect that food has on zinc and melatonin, so it tries to keep you from eating zinc-blocking copper near the same time you take your zinc pill. And it tries to keep you from eating tryptophan-blocking fructose near the time tryptophan needs to be crossing over into the brain to make the night's supply of melatonin. But other than dairy, this regimen says that if you're going to bed at 10pm then eat whatever the heck you want until 2pm.

An Actual Day in the Life

• 08:00am Wake up. No alarm clock. Even though there's tin foil on the windows, you just can't keep the sun out completely, so the light wakes me up naturally. Can tell I've been doing this a while because I'm not a morning person, so I normally wake up groggy, and only respond to questions with grunts until lunchtime. But after working on having a normal melatonin cycle for a week, I actually wake up feeling pretty alert, and can form complete sentences.
• 08:10am Skin care. Which consists of washing my face with a bar of Dove soap while I'm taking my shower. That was easy! Cheap, too!
• 08:30am Breakfast What to have? ANYTHING I WANT! (except dairy) Today, it's bacon and eggs (eggs scrambled with a bit of water, no milk) and a few blueberries (blueberries ought to have a decent zinc/copper ratio, but I'm just eating them 'cause they taste good).
• 12:30pm Lunch Heading to McDonald's. But first, I'll pop my first zinc pill of the day, along with the first of my 2-a-day Vitamin B pill that contains B6. I used to take all my vitamins right after lunch, but because I know the rules for zinc, I'm giving the zinc and B6 a running headstart to my intestines so that, if my lunch has foods with a lot of copper in it, the copper won't have a chance to block the zinc absorption. For the record, this is a 30mg zinc picolinate pill. I suspect the form of zinc doesn't matter nearly as much as the fact that I've been taking enough Vitamin D for enough months to know I'm not deficient. What's for lunch? 2 hamburgers, the enormously large fries, and a 32-ounce Coke jam-packed with lovely, lovely caffeine and high-fructose corn sugar. I feel only pity for anyone who has to eliminate all sugar from their diet to fight acne. Yummy! For dessert, I'll have a big chunk of my favorite chocolate bar (real chocolate, no milk/dairy product in there). Life is good!
• 06:00pm Exercise Time to try to move some tryptophan into the brain. Punch 35 minutes into the treadmill and hop on. The goal is to get blood moving, so I crank the incline and speed until I'm out of breath, then drop it to a fast walk and watch TV until I've totally recovered and am breathing normally. Then, I crank it up again and repeat. After about 3-4 cycles of this, I'm sweating and can feel the blood moving pretty good. After 30 minutes, I hit the 5-minute cooldown button, and 5 minutes later I'm done. Even couch potato me can work hard for a mere 30 minutes!
• 07:00pm Supper Haven't eaten anything since lunch, but this time I have some rules to observe. No Coke, no fruit, no sweets. Oh well, I have a Chicken Burrito Grande with black beans, big enough to choke a horse, and a bag of chips and salsa on the side. Yum! Ooops, dang it there's cheese in there! That's OK -- this regimen is not about food obsession. Maybe I'll pay for it tomorrow with a little zit. A little slip here and there is not the end of the world. I'll take my evening vitamin pills with supper, but not my 2nd zinc and Vitamin B tablet.
• 11:00pm Bedtime My normal tendency is to stay up to 1am, but after a week of working on my melatonin cycle, I'm starting to get sleepy earlier. So, I pop the 2nd 30mg zinc pill and the 2nd of my 2-a-day Vitamin B pills that contains B6, and go to bed. I used to read to fall asleep, but I'm starting to be able to just get in bed, turn out the lights, and be asleep in a few minutes. All the shades in the house are drawn, I have tinfoil on the bedroom windows, and if I could find my crappy nightmask I would wear that on my eyes, but I lost it. Oh well. If I get up in the night, I won't turn on any lights. I notice it seems like I'm less likely to get up in the night on this regimen.

[AltaPGT]

Very good writeup. Just out of curiosity, did you not get completely clear on zinc + bag of miscellaneous supplements?

I just noticed you seemed to go from trying to identify what other supplements + zinc were making you clear to what other lifestyle factors + zinc are making you clear...

[UKLady]

Thanks Database. You write so well, I really enjoy reading your stuff!

My sleep cycle is a big problem for me....I get tired during the day and sometimes go to sleep for hours in the afternoon (on days I'm not working) and then can't sleep at night! It's just a struggle to get good sleep 'hygiene' when I don't have work 5 days a week...when i was working f/t I HAD to have a regular sleep pattern and went to sleep at 11pm every night, slept straight away, up at 8 every morning.

I wonder how I can discipline myself to that.

My acne has changed since I started on the supplements. Rather than getting frequent smaller zits, I am getting just one or two really bad ones (as in large painful closed nodules that hang around for ages).

When I was on BCP, I noticed the same...less oily skin, far fewer zits, but the ones I got were way worse.

It must be some sort of effect on my hormones?

I really will try to cut out *or at least cut down, on the dairy. Milk no problem but cheese and butter are hard!

Oh, I have a question. Where does stress fit into the zinc model? I think stress is quite a factor with my skin. Do stress hormones deplete zinc levels?

[pb101]

Who are you trying to convince zinc is related to acne? Yourself or me? Seriously, just take the pill and monitor the progress.

[databased]

did you not get completely clear on zinc + bag of miscellaneous supplements?

Only if megadosing zinc. And I did not know enough at that time to keep melatonin a constant, so it's a crapshoot what I was really testing. But since things are looking good on 2x30mg zinc/day with this regimen (and may work with less, I'm working my way down), I haven't gone back to that line of testing.

you seemed to go from trying to identify what other supplements + zinc were making you clear to what other lifestyle factors + zinc are making you clear...

It's really all about zinc and the simplest, longest-standing scientific observation about acne: it correlates with low serum levels of zinc. No one can just say "zinc cures acne", since we know it doesn't. At modest doses, it produces modest improvement in a significant percentage of patients. Well, that's not that interesting ("look pretty lady -- I used to have 10 zits, but now I only have 5!":-). So the question is, if zinc was the key to curing acne, what are the things that make taking a zinc supplement partially or completely ineffective for most patients?

So the path that got me here was really a pretty straight line. Zinc, zinc, zinc, and what could make zinc work in one person and not another? Once you know that a pinealectomy in rats drops their zinc levels, it's a small leap to suppose that suppressing your normal nightly melatonin surge is going to work at cross-purposes to taking a zinc supplement. My guess: melatonin directly stimulates cells to express anti-oxidant genes, which then require zinc to create zinc enzyme superoxide dismutase. Obviously there's some magic step in there I don't understand that blocks acne, but it's a plausible line of thought.

Like cholecalciferol (Vitamin D3), melatonin is clearly a powerful sun-related immune system hormone that directly tinkers with our genes, and whose importance has been largely overlooked until recent years. With respect to its effect on acne, I currently believe it needs zinc to do its job just as, say, Vitamin D probably needs folate in the colon to prevent colon cancer. To me, manipulating the sleep cycle is not a lifestyle factor -- it's the only way I have to tinker with a powerful cyclical hormone. If I could just take a pill, as with Vitamin D, I would definitely go that route. But trying to tinker with your cycle via supplemental melatonin is something that seems to still be on really shaky scientific ground.

Of course, it's possible that melatonin is also directly dampening androgen production, independent of any affect on zinc -- or even decreasing acne via two independent means. That's OK -- if it works for the wrong reasons, I can live with that.

I get tired during the day and sometimes go to sleep for hours in the afternoon (on days I'm not working) and then can't sleep at night!

Boy, that sure sounds like me! Just a week ago, I rarely made it through a day without a nap. It would be really interesting to see if you followed this regimen if that didn't change for you in about the # of days it takes to get over being jet-lagged. I'm not much on discipline myself, but after sticking to it for a few days, my night sleep got sounder and more refreshing, and my desire for the lengthy daytime siesta has pretty much vanished. OTOH, if you're on anti-depressants, then that's a wildcard in the equation since, despite much colloquial assumption that they "raise serotonin levels", it's really not that clear what many of them are doing in the brain. Since the cascade goes tryptophan->serotonin->melatonin, it's a reasonable bet that anti-depressants that claim to do something with serotonin may also affect the melatonin cycle.

I really will try to cut out *or at least cut down, on the dairy. Milk no problem but cheese and butter are hard!

I really wouldn't sweat the butter; I don't. I don't drink milk, and I don't eat ice cream, but if some cheese pops up in my food 3 times a week, it's not a big deal. If I get a pizza, I choose one that's easy on the cheese, not the Cheese Lover's Delight. Who knows how much dairy you could get away with if this regimen happened to work for you?

Where does stress fit into the zinc model?

Who knows, but I can wave my hands as well as any scientific kibitzer. Melatonin and cortisol (aka "the stress hormone" <cue the creepy organ music>) do a little dance of opposition everyday. As you wake up, melatonin levels go down and cortisol levels come up to get you going in the morning. So, if you want to give your body more hours of more stress hormone, just do the opposite of this regimen: sleep <8 hours every night with lots of light around, eat fructose in the evenings, etc.

What I'm really saying is that stress isn't causing your acne, it's a potential indicator that you don't have a decent melatonin cycle, leading to the zinc in your body not doing you much good, and that causes your acne (well, "causes" is a loaded word, try "lets happen" maybe instead).

I find it really fascinating that someone has already published a paper pointing out that the supplements implicated in improving acne greatly overlap those implicated in improving depression. The psychologists in the Human Givens project (who may or may not be whackadoodles) believe that poor sleep is depression and vice versa (more or less). IOW, you give me a normal person, let me sleep deprive him often enough, and I'll hand you back someone who meets the DSM definition of depressed. Likewise, they think curing your sleep problems is at least one route to curing depression.

So this hypothesis postulates that if you succeed at treating your acne, you'll have decreased stress (not external factors, but your reaction to them) just as an incidental side-effect.

It must be some sort of effect on my hormones?

Unfortunately, I only get one patient to experiment on, and I'm not female. For me, cystic and nodules seemed to be reliably dairy related. I don't know if that's likely to be true for a significant percentage of other folks. I would be really interested to see what happens if you could do this regimen for a couple of weeks. I pretty much can see results in a matter of days, but then I have the most wonderfully reliable acne that rarely fails to deliver on a daily basis if I do nothing about it, so it doesn't take long to know something's not working :-).

[UKLady]

Thanks for the reply! Maybe you could become a part time therapist LOL!

Well, my mother swears that the anti-depressants I have taken on and off for the past 16 years make me tired. So, there could be something in that. My GP OTOH says that day time fatigue is a symptom of depression. No matter how much sleep I get, it seems never enough. Yesterday, I slept 12 hours overnight, felt very upset and down (work related/relationship stuff)and after walking dogs went back to bed at 3pm and didn't wake up till 8.30pm! Then bed again at 2am, up at 10.30. Still feel tired. When I feel down, I just want to crawl into bed and sleep...so I think with me it's all tied up with depression and the melatonin/sleep cycle being out of whack too.

Dairy...I am quite naughty and don't pay any attention to it! But, come to think of it, I did have two four cheese pizzas the other week and then got these 2 horrible nodules!

OK. Time to try this properly. I'll print this thread off when I'm at work and pin it on my fridge (just in case there are any pizzas in there!)

ETA when I was showing my friends at work my neck nodules (in explanation as to why I was wearing a scarf!) they all thought they looked like an allergy of some sort (not that they are derms, just that with the size of the big lump I have right now on my neck, it looks like an allergic reaction to something).

[blueboys]

Hi Databased,

I am a 25 year old male and I have been battling, neck back and shoulder acne for about 7 years now, It has been a lot better recently since I changed my diet (green smoothies and low GI) and started a high dose of Vitamin C along with topically applied mandelic acid (Mama lotion)

My back is still in a bit of a mess and I am determined to beat this!! I have just ordered some zinc picolinate (solgar), b complex, (solgar) and vitamin D (biolife)

I will start the supplements this week and hopefully this will be my key!

I am also going to take an ELISA test from York test to see if I have any food allergies and if this doesnt work out I think I may be going down the anti candida / colon / liver cleanse program,

wish me luck!

[Daisy456]

Today for the first time in 26 years I am wearing only mascara and no cover up make up! My skin looks fine and I am thrilled.

I just finished a month of mega dose zinc (180 mg.day) and have dropped back to 130 and am on my way down. I also take 2 B complexes, a couple of D's, a multi, chromium pic, no dairy, plenty of water, and sleep plenty and hard.

This is the first time I can remember (including Accutane) that my skin feels healthy from the inside out.

All I can say is thanks for all the thorough thinking on this evasive subject. Seems inadequate. Never would have thought of zinc without this board.

[databased]

Daisy456: that's great! I hope it comes with lots of benefits for you; I know I'm just more social and happy around other people now that I can have clear skin.

In my journey to get the same 100% clear that megadose zinc gave me with just normal-dose zinc, I've come to believe that melatonin is the key. I suspect melatonin turns on the specific gene in cells that makes them generate the enzyme that makes use of the zinc. Right now, I can stay 100% clear on 50mg zinc/day -- but I have to make sure I follow the part of the regimen devoted to having a full melatonin cycle (no sugar in evenings, aerobic exercise when tryptophan levels are rising, etc.). I'm working on ways to move tryptophan into the brain that don't require exercise -- 'cause I'm a giant slug! As a side benefit, I can't believe how productive I'm becoming in the mornings, now that my sleep cycle is changing.

The thing that really gives me hope that I might know what I'm doing is that evidence is growing that I can predict in advance what's going to happen to my acne. So, one day when I had some cheese and didn't have time for 30 minutes evening aerobics, and couldn't get to bed on time or for as long, I thought "OK, this will show in my skin tomorrow." Sure enough, there was one non-inflammatory zit the next day. That's another thing that's making me believe I'm getting in the ballpark of understanding the acne mechanism: small deviations from the regimen result in small penalties. I suspect that when we chase ideas like "food allergies" and get a massive outbreak that we "trace" back to some tiny amount of forbidden food, we're probably just fooling ourselves.

I'm also pretty happy that, unlike megadose zinc, I can now point to a regimen that no doctor is going to scream about. Nobody is going to argue against dropping sugar/caffeine in the evenings, or 30 minutes of aerobic exercise, or sleeping >=8 hours/night in the dark :-).

[databased]

It has been a lot better recently since I changed my diet (green smoothies and low GI)

AFAICT, people make green smoothies with fruit, which means fructose, which in turn means you can't really do the zinc regimen, at least not unless you avoid them after, say, 2pm.

started a high dose of Vitamin C

This theory predicts that won't help a bit, but won't hurt either (except maybe your pocket book, especially if you're pissing most of the Vitamin C away by taking more than the gut can possibly absorb -- about 1 gram a day)

I have just ordered some zinc picolinate (solgar), b complex, (solgar) and vitamin D (biolife)

If you're just starting an increased (or first-time ever) dose of Vitamin D, allow a couple of months for it to matter. Also, hopefully you read and grokked the things you have to do to raise the odds that the zinc you take will actually have any effect on your skin. It's easy to take zinc and have it fail to cure your acne, even if the cause of your acne is zinc metabolism.

We already have good scientific studies to show that zinc doesn't produce dramatic improvement in most acne patients. This regimen is about all the things you have to do in addition to just popping the pill to raise the odds it will give you dramatic improvement.

Good luck!

[Daisy456]

Yes, happy, confident, normal feeling. A little jealous of people who've never felt otherwise, seeing as how this has taken 25 years for me. I just saw The ShawShank Redemption and feel like I was robbed of 25 years of normal life. Well, let it begin.

[AltaPGT]

Databased - can I ask your opinion on melatonin supplements? They are readily available and affordable, and some people swear by them for really good sleep.

I know thats not the "natural" or most optimal route, but for people that can't optimize their sleep schedule easily, couldn't you take melatonin with zinc right before bed and get a synergistic effect?

Just interested in your input on it.

[oldschool]

Hi Folks,

It's been a couple of weeks now since I started taking vitamin D, and after a slow start, I'm now taking 15,000IU/day. I think my body is so deficient in it that it will take a while for me to get a proper therapeutic effect, but it seems to have helped already. I've had much clearer skin since I started, and it seems to be continuing to get better. It looks loads more healthy, I've had progressively less new stuff coming through. Mainly old stuff slowly disappearing. I'm also on zinc, vit B and a couple of others.

Just want to say a big thanks to databased, who inspired me to have a proper go with my supplements. It's definitely the additional of vitamin D that has turned the corner for me.

Old School

[bran88]

Hi Databased,
nice write up...this might be slightly off topic, but you seem fairly knowledgeable so I hope you don't mind if I pick your brain...I have found that dairy definitely effects my skin and have (for the most part) cut it out. I've been researching goat's milk and it's derivatives to try and figure out if it's safe to eat or not. I've done a couple of minor experiments but am not sure that I can say anything for certain...what's your stance on this issue?

I think it's so important to sleep in the dark and to sleep early...I try to do that too. I don't know if it really effects my skin, except that i have noticed that after 2 or more nights of sleep deprivation I usually break out.

I only take 15 mg of zinc per day but am considering changing my supplements around a bit...right now i'm taking a&d so i might switch that to just vit. d since i eat tons of fruits and veggies and am sure i get enough vit. a. Maybe i'll increase my zinc a little too. I am 95% clear right now but am still reliant on topicals to keep me clear

As far as stress goes, i am positive that it makes me break out. I have been very clear since july now BUT there have been a couple of times that i've been extremely stressed out and that has caused a break out. When you respond to a stressor by becoming really stressed, your cortisol levels become elevated, so i think that works with your theory. BUT I disagree with you in the sense that i think controlling stress levels actively can help to prevent acne.

i hope things continue to go well for you!

[nicolemarie]

i started taking zinc 50mgs per day sometimes 100... haven't noticed much of a difference. is it safe to take more? how much should i take for moderate and very hormonal acne?

did you not get completely clear on zinc + bag of miscellaneous supplements?

Only if megadosing zinc. And I did not know enough at that time to keep melatonin a constant, so it's a crapshoot what I was really testing. But since things are looking good on 2x30mg zinc/day with this regimen (and may work with less, I'm working my way down), I haven't gone back to that line of testing.

you seemed to go from trying to identify what other supplements + zinc were making you clear to what other lifestyle factors + zinc are making you clear...

It's really all about zinc and the simplest, longest-standing scientific observation about acne: it correlates with low serum levels of zinc. No one can just say "zinc cures acne", since we know it doesn't. At modest doses, it produces modest improvement in a significant percentage of patients. Well, that's not that interesting ("look pretty lady -- I used to have 10 zits, but now I only have 5!":-). So the question is, if zinc was the key to curing acne, what are the things that make taking a zinc supplement partially or completely ineffective for most patients?

So the path that got me here was really a pretty straight line. Zinc, zinc, zinc, and what could make zinc work in one person and not another? Once you know that a pinealectomy in rats drops their zinc levels, it's a small leap to suppose that suppressing your normal nightly melatonin surge is going to work at cross-purposes to taking a zinc supplement. My guess: melatonin directly stimulates cells to express anti-oxidant genes, which then require zinc to create zinc enzyme superoxide dismutase. Obviously there's some magic step in there I don't understand that blocks acne, but it's a plausible line of thought.

Like cholecalciferol (Vitamin D3), melatonin is clearly a powerful sun-related immune system hormone that directly tinkers with our genes, and whose importance has been largely overlooked until recent years. With respect to its effect on acne, I currently believe it needs zinc to do its job just as, say, Vitamin D probably needs folate in the colon to prevent colon cancer. To me, manipulating the sleep cycle is not a lifestyle factor -- it's the only way I have to tinker with a powerful cyclical hormone. If I could just take a pill, as with Vitamin D, I would definitely go that route. But trying to tinker with your cycle via supplemental melatonin is something that seems to still be on really shaky scientific ground.

Of course, it's possible that melatonin is also directly dampening androgen production, independent of any affect on zinc -- or even decreasing acne via two independent means. That's OK -- if it works for the wrong reasons, I can live with that.

I get tired during the day and sometimes go to sleep for hours in the afternoon (on days I'm not working) and then can't sleep at night!

Boy, that sure sounds like me! Just a week ago, I rarely made it through a day without a nap. It would be really interesting to see if you followed this regimen if that didn't change for you in about the # of days it takes to get over being jet-lagged. I'm not much on discipline myself, but after sticking to it for a few days, my night sleep got sounder and more refreshing, and my desire for the lengthy daytime siesta has pretty much vanished. OTOH, if you're on anti-depressants, then that's a wildcard in the equation since, despite much colloquial assumption that they "raise serotonin levels", it's really not that clear what many of them are doing in the brain. Since the cascade goes tryptophan->serotonin->melatonin, it's a reasonable bet that anti-depressants that claim to do something with serotonin may also affect the melatonin cycle.

I really will try to cut out *or at least cut down, on the dairy. Milk no problem but cheese and butter are hard!

I really wouldn't sweat the butter; I don't. I don't drink milk, and I don't eat ice cream, but if some cheese pops up in my food 3 times a week, it's not a big deal. If I get a pizza, I choose one that's easy on the cheese, not the Cheese Lover's Delight. Who knows how much dairy you could get away with if this regimen happened to work for you?

Where does stress fit into the zinc model?

Who knows, but I can wave my hands as well as any scientific kibitzer. Melatonin and cortisol (aka "the stress hormone" <cue the creepy organ music>) do a little dance of opposition everyday. As you wake up, melatonin levels go down and cortisol levels come up to get you going in the morning. So, if you want to give your body more hours of more stress hormone, just do the opposite of this regimen: sleep <8 hours every night with lots of light around, eat fructose in the evenings, etc.

What I'm really saying is that stress isn't causing your acne, it's a potential indicator that you don't have a decent melatonin cycle, leading to the zinc in your body not doing you much good, and that causes your acne (well, "causes" is a loaded word, try "lets happen" maybe instead).

I find it really fascinating that someone has already published a paper pointing out that the supplements implicated in improving acne greatly overlap those implicated in improving depression. The psychologists in the Human Givens project (who may or may not be whackadoodles) believe that poor sleep is depression and vice versa (more or less). IOW, you give me a normal person, let me sleep deprive him often enough, and I'll hand you back someone who meets the DSM definition of depressed. Likewise, they think curing your sleep problems is at least one route to curing depression.

So this hypothesis postulates that if you succeed at treating your acne, you'll have decreased stress (not external factors, but your reaction to them) just as an incidental side-effect.

It must be some sort of effect on my hormones?

Unfortunately, I only get one patient to experiment on, and I'm not female. For me, cystic and nodules seemed to be reliably dairy related. I don't know if that's likely to be true for a significant percentage of other folks. I would be really interested to see what happens if you could do this regimen for a couple of weeks. I pretty much can see results in a matter of days, but then I have the most wonderfully reliable acne that rarely fails to deliver on a daily basis if I do nothing about it, so it doesn't take long to know something's not working ).

i started taking zinc 50mgs per day sometimes 100... haven't noticed much of a difference. is it safe to take more? how much should i take for moderate and very hormonal acne?

[databased]

couldn't you take melatonin with zinc right before bed and get a synergistic effect?

Modestly educated opinions that might change over time:

• Not clear you can significantly affect area-under-curve with supplements.
• It is clear some brands are ineffective -- who knows which?
• Not sure how to time the dose so it's not counter-productive.
• Rheumatoid arthritis researchers are quite emphatic that people with auto-immune disease should not take them; I agree, but believe this is related to failure to suppress daytime melatonin, not the nocturnal surge.

Just like a short run of 200mg zinc/day, I don't think trying to use melatonin for a few weeks to adjust your melatonin cycle can hurt you (assuming no pre-existing medical conditions), but I would be really surprised if it can make up for things like sleeping few hours, having light/noise disturbed sleep, etc.

I have tried sublingual melatonin several times. In my limited experience, techniques to increase tryptophan in the brain were significantly more effective at inducing drowsiness and sound sleep, but I'm still doing lots of tinkering there to find what works best/easiest for me. I see there's a patent out on removing the oil from gourd seeds (stripping the fat from the tryptophan) and combining with the right stuff to maximize flow across the blood-brain barrier. If a pill of that stuff came out, I would rather bet on that than melatonin supplements.

In general, I use to view melatonin as pretty much harmless. But then, I began to suspect that longterm failure to suppress daytime melatonin induces auto-immune disease. And then, I began to see that melatonin unmasks the genome just like Vitamin D, and every year brings new discoveries about what genes it affects. So now, I view melatonin with great respect and would much prefer to manipulate it via tryptophan and retinal light, which doesn't bypass any of the body's builtin rate limiting systems.

[databased]

I've been researching goat's milk and it's derivatives to try and figure out if it's safe to eat or not. I've done a couple of minor experiments but am not sure that I can say anything for certain...what's your stance on this issue?

Why can most people drink cow milk and not have acne? Why can some acne patients drink cow milk and not see their acne get worse? If the link from milk to acne is via hormones, then you have to explain the great per-patient variability. Since I've never personally seen a "phase" when it was OK for me to eat dairy, I wouldn't take genetics off the table. Maybe most people have an enzyme that just chops up whichever chemical in the cow milk is the problem, and I just don't have that gene or else it's turned off.

Whatever the case, even without understanding any detailed mechanism, I think the evidence says you'll just have to test goat's milk and see. That's a lot easier to do if you're starting from a clear state and you just change that one thing, of course.

I think it's so important to sleep in the dark and to sleep early

Necessary, but not sufficient, in this model. You need the number of hours, but if your melatonin is not peaking, then it won't do the trick. No easy way to measure that except by going to a sleep lab, unfortunately. That's why I focus on getting tryptophan to the brain before bedtime.

i eat tons of fruits and veggies

Eat those fruits within 8 hours of bedtime, and you may manage to render your sleep ineffective by having fructose bind with the tryptophan in your blood, leading to less raw material for the tryptophan->serotonin->melatonin cascade in the brain that night.

i think controlling stress levels actively can help to prevent acne.

Could be -- certainly it's a Good Thing to avoid stress either way.

[databased]

i started taking zinc 50mgs per day sometimes 100... haven't noticed much of a difference. is it safe to take more? how much should i take for moderate and very hormonal acne?

One thing we know from studies by Real Scientists with Beards is that most acne patients won't see much improvement from taking a lot more zinc than you're taking right now. If taking a zinc pill worked for most of us, there would be no need for a "regimen" -- just take a pill! Hence, the need for all the other stuff.

Have you:

• taking that zinc on an empty stomach just before bedtime with Vitamin B6?
• been taking a meaningful (>= 1000IU) dose of Vitamin D (cholecalciferol, D3) for at least 6 weeks?
• been cutting off fructose/caffeine 8 hours before bedtime?
• been doing at least brief aerobic exercise 2-4 hours before bedtime?
• sleeping in the dark, >=8 hours, able to wake without an alarm clock?

I wouldn't bother taking more than 100mg zinc/day if you haven't focused on all the other things designed to try to actually make the zinc effective against acne.

One of the many remaining mysteries is the pharmokinetics of zinc. How long do you have to be taking a daily zinc supplement for zinc levels to reach a new stable value in your body? When I initially took ~200mg zinc/day, it took about a week to see results. But you would expect a faster move with a larger dose. In the Alzheimer's study, it took 6 weeks to move zinc serum levels (not clear serum levels are a meaningful measure of zinc status) -- but that was only when Vitamin D was involved, and 6 weeks is a plausible delay for Vitamin D to become effective.

[Paco]

Databased,

I appreciate your empirical, although personal, analysis of your acne regimen and zinc. This kind of approach is sorely needed.

[bdot1]

Database


Thanks for all the info its been really eye opening. Im on the path to starting your regimen I just have a few ?'s.

I know for a fact that I am Vitamin D dificient as I recently had some blood work done. You've mentioned that Vitamin D is crucial in the absorption of Zinc so I am starting the zinc 50 mg X 2, b complex X 2 and the vit D X 2. Where in your regimen should I include the vitamin D (what time of day and with what other supps? With or without food? How many times a day? How many IU's?

Also since I am Vitamin D dificient will I have to wait the whole course of 6 weeks in order to see improvement with the zinc and my acne? Or should I see results earlier than this?

And lastly I am using a chelated zinc gluconate (natures bounty), which I have heard is good, rather than the pincolate. Not sure if this is an acceptable replacement? And I have virtually eliminated dairy since I know for I fact that I am highly sensitive to it. I'm going to get on the proper sleep schedule and have been trying to exercise and limit late night sweets as you recommend.

Thanks in advance