Treatment

Follow these guidelines and you’ll have significantly improved skin within two weeks. These actions are geared towards lowering inflammation, improving insulin sensitivity, and reducing oxidative stress, which are the hallmarks of acne sufferers.

In the study pictured below, patients with severe acne had 3x the cRP (inflammation) as those with moderate acne.

inflammation acne study

Meanwhile, 81% of acne patients suffer from insulin resistance, according to this study. From another study: “These results suggest that insulin resistance may have a role in the pathogenesis of acne.”

And oxidative stress markers are all elevated in acne patients according to this study. From another paper: “The results obtained in this study clearly showed the existence of oxidative stress in patients with acne vulgaris, and that oxidative stress along with inflammation play a critical role in acne pathogenesis”

Acne patients suffer from insulin resistance, inflammation, and oxidative stress. These are all controllable by improving the following aspects of your lifestyle.

  • Diet: Nutritional choices have a profound impact on acne. Individuals consuming a natural, anti-inflammatory diet rarely suffer from acne. While nutrition is complex, the basics for an anti-acne diet are clear: Avoid sugars and processed foods entirely. Keep your net carb intake (total carbs minus fiber) under 30 grams per day until your skin improves. Steer clear of flour, dairy, rice, grains, and alcohol. Focus on a diet rich in vegetables, fruit, and wild fish, with limited meat. Exclude foods cooked in canola, soy, palm, safflower, or sunflower oil, opting for olive, avocado, and coconut oils instead. Processed foods should be avoided. Aiming for two or three meals a day can help minimize insulin spikes. Eating meals earlier in the day, during daylight hours, is also advised. Ketogenic, Paleo, and Whole30 diets are effective frameworks to explore. Limit meat consumption and avoid leftovers due to potential histamine and bacteria accumulation.

From a study documenting subjective assessments of dietary patterns and acne:

  • Take a 10-minute walk after every meal to combat insulin resistance and avoid blood sugar spikes. Walking after every meal can improve insulin sensitivity by up to 30%.
  • Eat meals in this order: 1st, vegetables and fiber. 2nd, proteins. 3rd, carbs. Combining this eating style with a walk after eating will dramatically lower insulin and blood sugar spikes and improve your insulin sensitivity. Over time, improved insulin sensitivity and lower insulin will reduce excess sebum production, which is a primary cause of acne. Glucose Goddess instagram account has amazing tips and information on this: https://www.instagram.com/glucosegoddess.
  • Supplements + medications: Research has demonstrated that Metformin, NAC, Zinc (75mg/day), Vitamin D, Turmeric/Curmumin, Milk Thistle, Selenium, Magnesium Threonate, a daily probiotic, and Vitamin B5 can significantly reduce acne. Avoid birth control and biotin. Biotin causes acne in many people. Metformin will require a prescription, but it is very effective so worth the effort. Agelessrx, joinfound, plushcare, and other online pharmacies will prescribe this for you. Take zinc with food or you will experience nausea.
  • Sleep with mouth tape to avoid mouth breathing at night. Mouth breathing causes oxidative stress, according to this study.
  • Drink lots of water and reduce salt intake. Dehydration and salt cause oxidative stress, according to this study.
  • Tretinoin + Azelaic Acid: Tretinoin will reduce acne but can worsen rosacea. For those suffering from red skin or visible red capillaries, use azelaic acid instead of tretinoin. It is equally effective in treating acne without the side effect of making skin red and irritated. With tretinoin, there will be an initial “purging” period in which you aggressively break out.
  • Sleep: Sleep more than 8 hours every night, always going to bed at roughly the same time and as early as possible. Alcohol is the most powerful disruptor of REM sleep known to man — even a single drink damages REM sleep. If you need an alarm to wake up, you are going to bed too late. Wear blue-blocking glasses after dark. Go to sleep as soon after sunset as is realistic and don’t sleep in past sunrise. Use an Oura Ring to track your sleep and tweak your lifestyle to maximize REM sleep, deep sleep, and the total length of your sleep. Other ways to improve sleep: dry sauna before bed, lots of daytime sunlight, meditate before bed, turn off electronics at 10 pm, avoid stress at night, keep the lights off at night, and don’t eat or exercise within 2 hours of bedtime.
  • Perfect oral health: Brush, floss, and waterpik. Use a tongue scraper. Get cleanings 3-4x a year. Poor oral health causes inflammation according to this study.
  • Maximize time outdoors: To regulate your melatonin cycle, spend more time outside during the day. Spend your time in the shade, not in direct sunlight. Go for a 30-minute walk as soon as you wake up and another at noon. Avoid exposing your skin to the sun — walk in the shade! Your eyes require exposure to unobstructed sunlight in order for your pineal gland to suppress melatonin during the day, which causes a melatonin spike at night and a corresponding surge in Zinc Superoxide Dismutase, an enzyme that removes ROS (reactive oxygen species). I also recommend blasting your body (cover your face) with direct sunlight at least once or twice a week.
  • No coffee, No caffeine, no nicotine: If you can’t cut out coffee altogether, do what you can to drink less, and drink it further away from bedtime. Green tea is less likely to cause acne and rosacea than coffee, and easier switch to switch to than a full decaf lifestyle. Stimulants induce stress and increase sebum production, as well as making it harder to get consistently good sleep. Many people simply cannot solve acne while drinking caffeine. This study shows that “Caffeine increases cortisol secretion in people at rest or undergoing mental stress”
  • Avoid stress. According to this study, “Cortisol causes an increase in sebaceous gland activity, and elevated levels of cortisol in stressful situations are manifested by increased sebum secretion
  • Reduce sebum on skin by lowering IGF-1, cortisol, and insulin: Acne and Rosacea patients produce 30-60% more sebum. Insulin and IGF-1 are both linked to elevated sebum production and acne. According to this study, “As expected, the subjects with acne had more (59%) sebum than the control subjects”
  • Monitor your prescriptions and don’t use drugs: If you can’t get clear, consider switching or stopping the medication you are on. A huge portion of this site’s traffic comes from people on new medications who experience new and prolonged acne outbreaks.
  • Birth control causes acne in an estimated 20% of users. Progestin-only birth control can have unpredictable effects on acne but it more often than not it increases it. Readers had switched from Kyleena to Mirena and experienced a dramatic reduction in acne. If you are taking birth control and experience acne, consider switching birth controls or pausing it altogether.
  • Water Fasting: Fasting does wonders to reduce inflammation and acne. 24-hour fasts can be done easily, and daily 16/8 fasts are beneficial. A 5-day fast is all but guaranteed to eliminate 100% of new acne. If you experience new acne after a 5-day fast, you are allergic to something you are putting on your skin, a medication you are taking, or something in your environment. Valter Longo’s work has shown that fasting can permanently improve biomarkers associated with acne such as inflammation (measured via C-reactive protein) and fasting blood glucose.


From Valter’s website:

  • Exercise: Excercise every day. Walk for 45 minutes if you can’t summon the motivation to do more.
  • Blood tests Ask your doctor for a blood test of inflammation markers (C-reactive protein), along with testosterone, estrogen, vitamin B, vitamin D, IgG, IgE whatever other biomarkers he/she finds appropriate. Fix any that are out of sync. Inflammation markers are particularly relevant to acne and easy to improve with diet and fasting.
  • Take lukewarm showers Hot showers are inflammatory, irritating, and cause your body to release histamines. They turn skin red and trigger rosacea.
  • Air filter: Buy the best air filter you can justify. Particulates in the air cause inflammation. With my air filter off, my air quality monitor shows a particulate count of 15-30 inside my home. Within an hour of turning on the air filter, the count drops to 4. This study concluded that urban air pollution is associated with inflammation, oxidative stress, blood coagulation, and autonomic dysfunction simultaneously in healthy young humans.

  • Eat earlier in the day, in sunlight if possible. Eating later in the day and at night doubles the thing of time your blood sugar stays elevated after a meal.

  • Wear a continuous glucose monitor. The Dexcom G7 is the most accurate. The Freestyle Libre is a more affordable option. Keep your blood glucose low and stable. Avoid meals that spike your blood sugar. You can get a CGM via SigNos.com
  • Improve your insulin sensitivity or lower your insulin resistance. Fasting and low-sugar diets can do this. In this controlled study, those with insulin resistance had significantly worse acne.
  • Meditation and stress avoidance Become aware of when you feel stress. Daily meditation will make you less stressed. A continuous blood glucose monitor can help monitor stress. When cortisol (the stress hormone) rises, blood sugar rises with it. The morning before I had to deliver bad news in an all-hands talk to my company, my blood sugar was extremely elevated for 3 hours. Cortisol and elevated blood sugar lead to acne and other health problems. If you manage stress, your skin, sleep, and overall health will improve.