Overview

Over the last few days I have compiled a lot of research surrounding the relationships between metabolic states, hormone imbalances, and acne. I am very excited to share these discoveries which are in fact very logical and simple yet often overlooked. If you have been suffering with acne and have tried everything such as adopting a remarkably clean diet, different facial cleansers, anti-biotics and so on, then your acne is probably attributed to a hormonal imbalance in which case reading this post will be highly beneficial to you. I can guarantee you that everything covered in this thread is backed up with scientific evidence and has been tested and proved through cause and effect methodologies including on myself -- a sufferer of mild to severe acne for 7 years.

In addition, the information in this thread has been gathered from various trusted sources and has been condensed and simplified in order to help aid comprehension. This thread will explain WHAT causes hormonal acne, WHY hormonal acne occurs, and HOW to eliminate hormonal acne from your life. If you do not wish to review the science explaining these findings and you solely wish to read how to eliminate hormonal acne then you can simply skip to the end of the thread where subheading Takeaways is located.

Carb vs. Fat Ratio

Regardless of what other sources may tell you, science constantly shows that dietary changes can significantly reduce the hormones known to cause acne. A major issue is that many long-term acne sufferers have in fact adopted a diet which has very commonly been misrepresented and actually promotes acne. Listed below are three different yet common diet compositions:

(Figure 1.1) - (Bernier, 2015), (Puusa, 2015).

The typical Anti-Acne Diet is a diet which many acne sufferers adopt and is saturated with many vegetables, fruits, lean meats, and whole grains, whereas oils, fat, sugar, and dairy tend to be greatly reduced or eliminated. The Anti-Acne diet is a diet of elimination rather than a diet of substitution or addition meaning that if you are to adopt the anti-acne diet, this generally involves removing or restricting common foods from you diet. The issue with the Anti-acne diet is that it is very high in carbohydrate sources such as vegetables, fruits, and whole grains, but it is very low in fat sources and generally follows the grounds of a high-carb-low-fat diet (Figure 1.1). Many sources on the web are inaccurate when it comes to beliefs behind fat consumption. Due to fat being largely misrepresented, acne-sufferers are highly likely to dismiss or reduce all fat and oil from their diets because they often associate fat and oil with junk food and they believe that all oily or fatty foods will induce breakouts. Or perhaps its the idea that consuming oily foods will produce more oily skin resulting in breakouts, however this idea is false as sebum causes breakouts and not oil (UCLA Health, 2015). What acne sufferers need to know is that scientific findings show that eating the proper amount of fat is highly beneficial.

Heres why the high-carb-low-fat diet is so controversial on the basis that it holds no sustainable long-term benefits unless you suffer with a condition which compromises your metabolic state. Stephen Phinney is an M.I.T. medical researcher and has disclosed that a carbohydrate-loading diet does not make sense since our bodies can only reserve 2,500 calories worth of carbohydrates at all times, whereas our bodies have the ability to store 50,000+ calories worth of fat (Schultz, 2015). Excess carbohydrates essentially all go to waste unless utilized right away. In contrast, by consuming less carbohydrates and more fat we are also training our body to pull from our fat reserves more effectively which also aids in blood sugar stability (Schultz, 2015).

Studies have shown that moderately reducing carbohydrate intake and replacing it with fat improved ALL the acne-relevant hormones (Puusa, 2015). The most notable hormones relevant to acne are insulin and testosterone. The results found in the study were as followed:

(Figure 1.2) justified by (Fabroccini, et al) & (Puusa, 2015).

If you do not fully understand what (Figure 1.2) is showing, essentially all you have to know is that higher amounts of testosterone (T) are shown to be more prevalent in people with acne (Mayer, 2013). A greater reduction in (T) is ideal for clearing skin, therefore the decreased carb diet is ideal and not the typical anti-acne diet. Your first phase insulin response represents how well your body is able to deal with spikes in insulin levels. Insulin is a hormone which is known for causing acne. Therefore it is ideal to have an INCREASE in your 1^st phase insulin response because it will help your body deal with the hormone insulin more effectively and therefore benefit your skin. The decreased carb diet also proved to be of much greater benefit for acne-sufferers due to greater insulin suppression and greater insulin response (Figure 1.2). Poor 1^st phase insulin response is one of the first signs of blood sugar problems. As a result of poor first phase insulin response, post-meal blood sugar levels increase too high and overtime this can cause further insulin resistance and damage to the pancreas (Puusa, 2015). In conclusion, reducing carbohydrate intake and increasing fat intake reduced the level of hormones known to affect acne. The reduced carb diet composing of about 41% carbs, 40% fats, and 19% protein will be most beneficial for acne-sufferers.

Importance of Dietary Balance

Balance in diet is something which is constantly represented in an incorrect manor. My biggest mistake when I was an acne-sufferer was that I always thought of a balanced meal in terms of meat grains and veggies when I should have been thinking of a balanced meal in terms of protein fat and carbs. This simple alteration in thinking results in a greater emphasis on food quality and macro-nutrients which is more beneficial and is also less restricting. It is important to understand that you will not receive as much benefit if you consume a meal which is very high in fat and nothing else, then you consume a meal which is high in carbohydrates and nothing else, then you consume a meal which is only high in protein and nothing else. When attempting to stabilize hormone imbalances,the greatest benefit will be received by those who consistently eat balanced meals accurate to the caloric ratios of 41% carbs, 40% fat, and 19% protein. As already identified, fat reduces acne better than carbs for the following reasons:

High-fat meals supress testosterone (T) levels longer than high-carb meals (Puusa, 2015).

Eating fat doesnt cause an increase in insulin or blood sugar levels. Insulin levels are especially important because insulin can stimulate the liver to release androgen hormones (DHEAS, a precursor to T and other androgens) and make your skin more sensitive to androgens (Puusa, 2015).

It is also important to note that eating animal fats result in less suppression of (T) than plant fats (Puusa, 2015). Therefore, acne sufferers will notice the greatest benefit from consumption of higher amounts of plant based fats rather than animal fats. In addition, people who have developed insulin resistance or other blood sugar problemswill probably also benefit from moderate carbohydrate consumption, HOWEVER, there are certain limitations as restricting carbohydrates to much can also cause implications. There is some degree of competitive inhibition between how your body uses fat and glucose (sugar) as a fuel source. When your body burns fat it reduces burning of glucose and vice-versa. Meaning, if you reduce carb intake too much, you over-train your body to burn more fat so the next time you eat carbs your body doesnt know what to do with them, resulting in abnormally high blood sugar and insulin levels (Puusa, 2015). It appears that an adequate intake of carbohydrates is required for normal glucose tolerance (Fabroccini, et al).

Takeaways How to get rid of hormonal acne

Replace bad carbs (high-glycemic index, low fibre) carbs with good carbs (Low-glycemic index, high fiber)

Decrease your consumption of carbohydrates and replace them with healthy fats to match a ratio or a similar ratio of 41% of total caloric intake coming from carbs, 40% of total caloric intake coming from fat, and 19% of total caloric intake coming from protein. Essentially, there is a balance which has to be met between total calories coming from carbs and total calories coming from fat. If you consume to many carbs this will induce breakouts, contrastingly if you consume to much fat this will also induce breakouts. Restricting carbs to much can also cause insulin resistance and cause problems when you eat them (Puusa,2015).

Get rid of trans-fats and other processed fats. Emphasize unprocessed fats mostly from plant sources such as oils, nuts, and seeds. Data on animal fats is still inconclusive, but there is no need to overly restrict animal fat (Puusa, 2015). In addition, ensure that you are consuming a BALANCE of both omega-3 (sources such as seafood, walnuts and flaxseed) and omega-6 fatty acids (sources such as natural oils other than olive oil and eggs) as this will also aid in regulation of acne relevant hormones. An ideal balance of omega-6s to omega-3s falls somewhere in the range of 2:1 to 4:1 (Pick, 2015).

Dairy is a debatable subject, I personally eat small amounts of dairy, but for the duration of experimentation with this diet I would recommend eliminating/reducing dairy consumption. Once you feel comfortable you can gradually add dairy back into your diet.

I know it sounds contradictory because of how we have conditioned ourselves through all of the misrepresentation from various sources, but increasing fat intake actually relieves hormonal imbalances, subsequently relieving acne-sufferers (Figure 1.2). It takes an open-mind to change your diet for the benefit of your health and if your current diet is not working, no matter how clean you think it is, I really encourage you to give this a try. For me personally, it was my obsession with eating clean which meant limiting all forms of oil and fat which actually caused my breakouts. The typical anti-acne diet has conditioned people to think that all fat and oil should be avoided, but there are actually so many forms of healthy fats which are necessary for proper bodily functions and maintaining a strong immune system. In addition, many vitamins vital to skin health such as vitamin A, D, E, and K are fat soluble vitamins and require adequate fat in order to be properly absorbed and stored in the body (Doctors response archive, 1999).

This recommended diet has not only benefited my skin, but it has also greatly improved my energy levels, my mood, muscle gains, and I am a lot less prone to anxiety. You have little/nothing to lose with trying out this diet and so much to gain. I would recommend this diet to anybody, not just people on this forum, because it so incredibly healthy and there is scientific evidence to justify it. This diet is extremely simple to adopt as adding healthy fats to meals is very easy, affordable, and will make your food taste so much better. The Mediterranean diet is regarded as one of the healthiest diets on the planet and it is known for its emphasis on large amounts of healthy fats from plant sources. I encourage you to do more research on the Mediterranean diet as it is a great representation of the caloric ratios discussed above (41% carbs, 40% fats, 19% protein).

Here are things which I have noticed with people who claim to have cured their acne through following an extreme diet plan such as eliminating X foods, juicing every day, hyper-dosing vitamins, only eating X amount of calories, no sugar, no caffeine, no alcohol etc. These forms of clean diets are too extreme and science proves that dieting in such an extreme way is not sustainable for long-term health benefits. I am not doubting the fact that you may have found a solution, but if you have to restrict yourself that much and maintain such a strict schedule then I wouldnt necessarily say that you have your acne under control. Furthermore, those who are on extremely limiting and customized anti-acne diets find that when they do consume something which goes against their dietary restrictions they find that they begin to breakout right away or they still struggle with occasional blemishes even when they do follow their ultra-restricting diets. The reasons for this have been explained above (applies to hormonal acne primarily). In contrast, there are those who have absolutely no regard for what they consume yet they have a flawless complexion. For example, many people will frequently consume fast foods which contain high amounts of fat yet breakouts remain irrelevant. It would appear (this I do not have any evidence to refer to, so I can only hypothesize) that consumption of some fat, even if its trans-fat or saturated-fat, is still more beneficial for hormone regulation than greatly reducing/eliminating fat which is common in anti-acne diets.

Many other acne regimens also involve making you wait weeks or months before/if you start to see results. With adoption of a decreased-carb, higher-fat diet you should actually begin to see results much more quickly. I personally saw measurable results within a week and I physically felt much better within a few days its exactly what I needed.

I know it seems like a lot of information, but it really isnt and this diet is extremely simple. If you read the entire passage then I applaud you for actually taking the time and approaching your acne concerns with an open-mind.

Id love to keep this thread going and help spread awareness about hormonal acne. You shouldnt have to live with it and its actually a lot easier to get rid of than you think. So let me know about your experiences and any questions that you may have.

Puusa, S. (2015). Carbs Vs. Fat For Hormonal Acne. Acne Einstein. Retrieved From: [removed]

Schultz, R. (2015). The Truth About the Low-Carb High-Fat Diet. Shape. Retrieved from: http://www.shape.com/weight-loss/weight-loss-strategies/truth-about-low-carb-high-fat-diet

Fabbrocini, G. et al. Low glycaemic diet and metformin therapy a new approach in male subjects with acne resistant to common treatments. CED Clinical and Experimental Dermatology. Retrieved from: http://www.readcube.com/articles/10.1111%2Fced.12673?r3_referer=wol&tracking_action=preview_click&show_checkout=1&purchase_referrer=onlinelibrary.wiley.com&purchase_site_license=LICENSE_DENIED_NO_CUSTOMER

Doctors Response Archive. (1999). MedicineNet.com. Retrieved from: http://www.medicinenet.com/script/main/art.asp?articlekey=10736

Mayer, M. (2013). Acne & Testosterone. Livestrong. Retrieved from: http://www.livestrong.com/article/77411-acne-testosterone/

UCLA Health.(2015).Does skin oil cause pimples?Sharecare - response from UCLA health. Retrieved from: https://www.sharecare.com/health/acne-skin-pimples/does-skin-oil-cause-pimples

Bernier, J. (2015). The Complete Anti-Acne Diet. Elephant Journal. Retrieved From: http://www.elephantjournal.com/2015/02/the-complete-anti-acne-diet/

Pick Marcelle. (2015).Balancing Your Omega-3and Omega-6 fatty acids- Essential for Health and Long Life.Women to Women. Retrieved from: https://www.womentowomen.com/inflammation/balancing-your-omega-3-fatty-acids-essential-for-health-and-long-life/

Figure 1.2 - Source of Study: Favourable metabolic effects of a eucaloric lower-carbohydrate diet in women with PCOS.