Guidelines for Clear Skin

“You can’t be happy if you aren’t healthy.”  — James Altucher

One of the things that surprises acne sufferers most is how beautiful they look once their skin clears. Most never believed that having great skin was even a possibility. But it was. I once felt this way, and now I have perfect skin. And so can everyone.

The guidelines presented here are based on clinical research and the experiences of thousands of acne sufferers, including mine. They are not counterintuitive, but they do run counter to much of what has been taught to us by dermatologists and society at large. But they work.

If you follow all of the rules in this article, your skin will improve dramatically. I promise. If it doesn’t, feel free to yell at me on Twitter.

Acne is a treatable health condition. Researchers have found entire societies without a single case of acne. In those societies, people live by the guidelines recommended here, because they don’t have any other choice. You on the other hand have spent your entire life in a world full of acne inducing western temptations: caffeine, sugar, flour, alcohol, light bulbs, alarm clocks and cheap, processed food.

Clearing your complexion will take hard work and discipline. You must become a detective. Your mission is to find the nutrients your body is missing, and the lifestyle choices that it can’t tolerate. You won’t be disappointed when you are done. The psychological benefits of acne-free skin are immense. You will live a happier and more fulfilling life with clear skin. You’ll be more confident, and more attractive to the opposite sex.

The human body is a complex and interconnected system. To clear your skin, you must tweak every acne trigger you can identify, while striving to improve your overall health. Following the recommendations enumerated below will regulate your melatonin cycle, get your immune system under control, eliminate malabsorption problems in your digestive tract, reduce systemic inflammation, and ensure that your body and brain receive sufficient levels of vital nutrients.

I’ve broken the system recommended here into 6 relatively simple guidelines. If you follow each step carefully, you will see a significant improvement in your complexion within days.

1. Diet: Dramatically reduce consumption of sugar. If you have the willpower, you should also avoid flour, soy, dairy, and alcohol. Eat mostly vegetables, wild fish, limited amounts of fruit, and limited amounts of organic meat. Don’t eat anything cooked in canola oil, soy oil, palm oil, or sunflower oil. Instead, cook with extra virgin olive oil or coconut oil.
2. Sleep: Sleep more than 8 hours every night, on a regular schedule. If you need an alarm to wake up, you are going to bed too late.
3. Sunlight: Spend time outside during the day. In the shade, not in direct sunlight.
4. No Coffee: If you can’t cut out coffee altogether, do what you can to drink less, and drink it further away from bedtime. Stimulants induce stress and increase sebum production, as well as making it harder to get consistently good sleep.
5. Exercise: You should exercise every single day. Walk for 45 minutes if you can’t summon the motivation to do more.
6. Vitamins: Take zinc, vitamin D, vitamin B complex, and boron.

For more details about each step, and why they work, continue reading.

Step 1: Eat a low glycemic load, anti-inflammatory diet.

The best way to clear your skin is by with strict elimination diet. As your skin gets better, you can experiment with bringing some of these food groups back into your diet. Sugar, however, should never be welcomed back into your diet.

  • Avoid sugar at all costs. You should even avoid eating more than a little bit of fruit. Many, many studies have linked high sugar diets to acne. Human beings were never meant to eat much sugar, and in fact it only entered the diet of most people around 300 years ago with the advent of globalization.
  • Quit eating all processed foods. If it comes in a box, it’s probably bad for you.
  • Only consume extra virgin olive oil and extra virgin coconut oil. Do not consume any other oil. Do not eat anything cooked in vegetable oil, soy oil, or any other kind of oil. When eating at restaurants, be careful to research the type of oil they cook with, or stick to meals without oil. Many restaurants will claim that canola oil mixed with olive oil is pure olive oil.
    [Soybean oil increased blood pressure and impaired endothelial function, compared to olive oil]
  • Eliminate flour and other grains from your diet. Limited amounts of rice are probably fine, but we recommend avoiding that as well. As with sugar, human beings did not evolve to eat grains. Humans have only been eating grains for about 12,000 years, since the start of the agrarian era. Compare this to the million years our so humans and our hominid ancestors spent eating a hunter / gatherer diet in the plains of Africa.
  • Eliminate soy.
  • Eliminate dairy including eggs.
  • Eat cooked tomatoes in olive oil. This boosts lycopene levels, which in turn reduces your skins sebum production. Eating raw tomatoes is healthy, but won’t provide you as much lycopene.
  • Go to Whole Foods and buy everything in the produce department. Make salads with green peppers, yellow peppers, red peppers, red onions, white onions, avocados, tomatoes, broccoli, spinach, mixed greens, zucchini, garlic, carrots, and asparagus. Buy the ‘no salt turkey’ from the Whole Foods deli. Feel free to drench your salad with extra virgin olive oil. [Olive oil and salad combined 'explain' Med diet success]. These nutrient rich foods are anti-inflammatory and very helpful to your body’s fight against acne.
  • Eat lots of carrots. Carrots are full of carotenoids, which the body uses to produce vitamin A.
  • Eat a low glycemic load diet. Glycemic load is different (although related) to glycemic index. Visit nutritiondata.com to get the glycemic load facts on foods you eat. Studies link high glycemic load diets to acne.
  • Lots of water is good, but stop drinking in the early evening. You don’t want to have to wake up to go to the bathroom and disrupt your sleep cycle.
  • Red meat may cause issues. Organic chicken and turkey, in moderate amounts, are fine to eat.
  • Try to eat wild alaskan salmon or other deepwater fish at least three times/week. Do not eat farmed salmon.
  • Read about the foods you regularly eat. The more you learn, the better equipped you will be to make decisions on any given day.

Don’t take my word for it. Here is a list of studies showing a connection between diet and acne:

Read more about inflammation:
Scientific American: Is Chronic Inflammation the Key to Unlocking the Mysteries of Cancer?
The Wall Street Journal: The New Science Behind America’s Deadliest Diseases
DrWeil.com: Does inflammation cause heart disease?

Step 2: Sleep for more than 8 hours every night, in complete darkness.

Japanese scientists tackled the issue of sleep and acne reduction in a questionnaire based study, and found a strong correlation between acne and lack of sleep. Other studies have demonstrated that sleep deprivation increases stress levels and reduces immune system function, while diminishing the appearance of physical beauty. Sleep loss has also been proven to lower testosterone levels in young men. This study showed that stress, a proven result of sleep deprivation,leads to acne.

The body of science on the sleep-health connection is vast, and makes a compelling case about the importance of sleep.

Here are guidelines for getting high quality sleep, based on clinical sleep research.

  • Sleep for more than 8 hours every night.
  • Try to be outside for several hours during the day. The closer to noon, the better. Being outside during the day resets your internal clock, making it easier to sleep at night.
  • Sleep in a completely dark room. Use aluminum foil to darken windows if necessary.
  • Go to sleep at the same time every night.
  • Don’t rise to an alarm. Schedule your life so that you can wake up naturally.
  • Exercise daily. A 30 minute walk at noon and another one at dusk will do wonders for your ability to sleep well.
  • Set the bedroom temperature to a crisp 67 degrees. A low body temperature aids falling asleep. A cold shower before bed is another effective way to lower your body temperature.
  • Eat foods that contain tryptophan, a melatonin precusor that helps you sleep.
  • Avoid alcohol, which inhibits sleep and can lead to nighttime awakening.
  • Avoid caffeine and other stimulants, although if you cannot completely abstain, take them first thing in the morning.
  • Do not take vitamins at night. They can keep you awake.
  • Eating a healthy diet helps you sleep. This study found concrete links between a variety of nutrients and sleep duration.

Step 3: Let your eyes see unfiltered natural light for as many hours per day as possible.

This extraordinarily well-researched post on acne.org explains the melatonin cycle in great detail.

Human beings evolved to spend all day outdoors, then go to sleep soon after the sun went down. In today’s world, being outside all day would be an extreme lifestyle. So just do the best you can to see sunlight. If you can work near a window, do it. If you can open it, even better. When the weather is good and I don’t have to go into the office, I work on my back porch. I always sleep great on those days. At a minimum, you should be able to go for a long walk around noon.

Melatonin is a naturally occurring compound produced by the pineal gland of the brain. Melatonin levels fluctuate based on a daily cycle, regulating the circadian rhythms of several biological functions. During the day, the brain produces less melatonin and at night the brain produces a melatonin surges. Unfortunately, modern lifestyles wreak havoc on this cycle. When indoors, the human body isn’t exposed to bright light, so its internal clock assumes that it’s near dusk, and produces excess melatonin prepare for sleep. At night, a combination of too much light, not going to bed at a regular time, sleeping in past sunrise, and too much melatonin wasted during the day prevent the brain from producing a proper melatonin surge. There is good reason to think that a broken melatonin cycle causes a variety of illnesses, including insomnia, depression, acne, cancer, and dementia.

Steps necessary to achieve a properly functioning melatonin cycle:

  • Go to sleep at the same time every night, preferably around 10pm. A consistent bedtime makes it easier for your body to begin the biological processes necessary for sleep.
  • Sleep >8 hours in a pitch black room.  Any type of light (blinking light on a phone, computer, or smoke detector) can potentially disrupt your melatonin cycle.
  • Make sure that you are out and about as much as possible during the day.  Your eyes need exposure to natural sunlight, without sunglasses or other filters obscuring the light.  When the eyes are in natural sunlight, the brain’s pineal glands suppress melatonin production. All day melatonin suppression is necessary for a proper nighttime melatonin surge.  You don’t want to be in direct sunlight. Sit in the shade. Ideally, you will spend 10+ hours outside per day. When you spend time indoors, the indoor lighting convinces the brain nightfall is coming, leading the brain to produce melatonin.
  • Avoid caffeine and other stimulants within 10-12 hours of when you go to bed. You can drink caffeine first thing in the morning, but any time after that is more likely to disrupt your sleep.  Eliminating caffeine altogether is probably the single best thing you can do to improve your skin.
  • Depending on the time of year and latitude/longitude, get enough direct sunlight on your body to produce Vitamin D.   You may want to cover your face and allow the sun to hit only your body.  Vitamin D deficiency is highly correlated with various cancers, and there are some indications that it is associated with acne. If you can’t get in the sun, it’s an absolute must that you take a Vitamin D supplement.
  • Don’t drink alcohol. Alcohol might help you fall asleep, but it disrupts the second half of your sleep cycle.
  • At night, try to keep all the lights off in your house. Spend the last hour or two you are awake in the dimmest light you can function in. We are trying to emulate nature here. If you use a computer, turn the brightness all the way down.

You can control your circadian rhythm by getting outside during the day and sleeping in complete darkness

There is a strong correlation between clear skin and your body producing large amounts of melatonin at night.

Step 4: Avoid central nervous system stimulants, including caffeine, Adderall, Ritalin, taurine, green tea, Red Bull, 5 Hour Energy, and all others.

This one is easy on paper, but hard in practice. Stimulants affect acne in so many ways. They increase sebum production, raise stress levels, and make it harder to get a full night’s sleep. Caffeine has a half life of 8 hours. That means if you drink a large coffee at 8 am (400 mgs), 25% of it (100 mgs) is still floating around in your bloodstream when you try to go to sleep. You will sleep better and have better skin if you cut stimulants out of your life. It’s not just acne, either. Your skin will look smoother, younger, and less blotchy.

If you can’t cut caffeine and other stimulants out of your life altogether, try to use them in moderation, and only early in the morning.

Step 5: Work out!!!

Work out for at least 30 minutes, every day. No matter how busy you are, you can find the time to go for a pair of 30 minute walks.

Exercise makes you smarter, happier, and less stressed. It also helps you sleep better.

Ideally, you should work out strenuously enough to get your heart beating. Don’t exercise within 3 hours of bedtime, as you risk setting off the fight or flight instinct in your body and producing anti-sleep hormones that it thinks are necessary to survive. Why else would you be exercising at night other than to run for survival? Humans can’t hunt or do much of value at night; we don’t have night vision. Nighttime is when we are meant to sleep.

If you exercise daily, you’ll sleep better and you’ll have better skin.

How does exercise prevent acne?

  • Improves the quality and length of your sleep.
  • Improves blood circulation, reduces stress, balances your hormones, and stimulates hundreds of systems in your body.
  • When you exercise, stress hormones are flushed from the body and you become more relaxed and less anxious.
  • Helps your body absorb the nutrients in food, and pushes tryptophan, a melatonin precursor, into the brain.
  • Excellent for your overall health, short term and long term.
  • Acne is heavily linked with depression, and exercise is an effective treatment for depression.

A massive Dutch study of 19,288 twins and their families published in 2006 showed that exercisers are less anxious, less depressed, less neurotic, and also more socially outgoing. A Finnish study of 3,403 people in 1999 showed that those who exercise at least two to three times a week experience significantly less depression, anger, stress, and “cynical distrust” than those who exercise less or not at all. [read more]

 

Step 6: Take the following four supplements

  • Zinc (75mgs / day)
  • Boron (6mgs / day)
  • Vitamin B Complex (do not take this at night!)
  • Vitamin D

The following supplements are anti-inflammatory, and many people find them useful for controlling acne. 

  • Fish Oil (1000 mgs/day. Helps ward off heart disease and inflammation, both strongly correlated with acne
  • Selenium (200mcg/day — do not exceed this)
  • Alpha-Lipoic Acid (100 mgs)
  • ECGC (Green Tea Extract)

Advanced Steps:
Food Sensitivity and Allergy Testing

Low grade food allergies, often called food sensitivities, are believed by some to cause inflammation. An IcG food sensitivity test will identify food sensitivities. Avoiding foods you are allergic to may make a difference in the way you look and feel. See my attached IcG test results. I tested to be extremely sensitive to eggs, and when I cut them out of my diet I quit getting pimples around my temples.

Despite my personal experience with food allergy testing, I must mention that there is a great deal of skepticism in the scientific community about the value of IcG test results. A scientist emailed us the following:

“From what I have learned at national and international allergy meetings, IgG testing is of no clinical value. IgG can be positive just because you eat a particular food. So, milk-specific IgG may just indicate that you eat dairy products. In my opinion, avoidance diets should not be predicated on IgG. The one exception is celiac disease which is now legitimately diagnosed by looking for very specific IgG antibodies in sera (anti-tissue transglutaminase).”

Other thoughts on treating acne:

  • Review your prescriptions. Medicine you take for other health conditions may affect your skin.
  • Don’t use topical medications, creams, or take acne medications. These just kill good and bad bacteria alike, damage your skin, and make your body more sensitive to the sun.  I’m sure you are terrified of the idea of quitting your topical medications, but you must do it eventually.  You don’t want to put bleach on your face every day for the rest of your life, do you?
  • I don’t wash my face at all. But if you must, wash twice/daily with the most gentle face wash you can find. Acne.org recommends Clean & Clear Foaming Facial Cleanser.  Wash and shower with lukewarm or only slightly warm water.  You don’t want to irritate and dry out your skin with hot water. Believe it or not, there is absolutely no evidence showing that washing your face every day does a thing to improve acne.
  • If your skin is dry, moisturize using jojoba oil or another moisturizer you are comfortable with.  Use as little as you can get away with.
  • If you use sunscreen, attempt to find one that uses Zinc Oxide as the primary ingredient. This blocks both UVB and UVA. Avobenzone is an effective sunscreen ingredient, but it breaks down in sunlight, and some people find that it causes breakouts.
  • Excellent oral hygiene will help. Poor oral hygiene causes all sorts of health problems, including heart disease, a condition that like acne is highly correlated with inflammation. Get your teeth professionally cleaned every 6 month, brush after every meal, floss at least twice/day, and use a Waterpik twice/day.
  • Make sure your home air ducts are clean. You don’t want to spray dust all over your face all day long, which is what happens when air filters don’t get changed every month. If your air ducts haven’t been regularly changed, you should hire a professional to clean out the entire system.

The steps presented here represent a major lifestyle overhaul for most people. They aren’t easy to abide, and the changes can’t all be made at once. But you can slowly build these habits, and the rewards will be never ending. You’ll experience less anxiety, look better and feel happier. You are just a few changes away from having a better life. Don’t delay and longer. Get started now. And if you need a coach, you know where to find me.

Please send questions and suggestions to david@acneresearch.org! I’d love to hear from you.