Therapeutic Interventions for Acne: A Functional Approach

Acne is a common condition that affects many people not just in their teens, but well into adulthood. Although often perceived as a self-limited disease, its prolonged presence can have a significant effect on self-esteem.

Acne is an inflammatory condition characterised by excessive sebum production, follicular hyperkeratinisation, and inflammation. Research has shown that androgens and microbial colonisation with Propionibacterium acnes contribute to its pathogenesis.

Sebum production and hyperkeratinisation

Sebum is an oily secretion used to lubricate skin. Excessive production, often stimulated by testosterone and insulin, can block pores. Hyperkeratinisation, where skin cells don't shed normally, further exacerbates this blockage, leading to comedones (the primary sign of acne).

Poor blood sugar regulation increases insulin and IGF-1, which are associated with increased sebum and hyperkeratinisation. Stabilising blood sugar is therefore a key therapeutic intervention.

Bacteria

Propionibacterium acnes is a bacteria naturally found on skin that can overgrow in blocked pores. Recent studies suggest a link between the gut microbiome and skin health. Imbalances in gut bacteria (dysbiosis) may contribute to inflammatory skin conditions.

Inflammation

Inflammation is a major factor in acne. Stress can induce pro-inflammatory mediators like substance P, which can disrupt the skin barrier. Interestingly, acne pathogenesis shares similarities with atherosclerosis, involving inflammation and oxidative stress.

Nutritional interventions

A functional approach focuses on:

• Supporting skin health directly (e.g. Vitamin A, Zinc).
• Regulating blood sugar to control sebum.
• Reducing systemic inflammation.
• Supporting a healthy microbiome.

Key Nutrients for Skin Health

• Vitamin A: Reduces sebum production and hyperkeratosis.
• Vitamin C & E: Antioxidants that protect the skin.
• Zinc: Involved in tissue regeneration and hormone activation.
• Selenium: Supports glutathione production (often low in acne patients).
• Vitamin B3 (Nicotinamide): Anti-inflammatory.
• Berberine: May decrease lipogenesis in sebaceous glands.
• Omega-3 (EPA/DHA): Anti-inflammatory.

Practical Steps

Regulate Blood Sugar: Avoid refined sugars, eat protein/fat with meals, and consider intermittent fasting (12h overnight).

Support Microbiome: Eat fermented foods (kefir, sauerkraut) and plenty of prebiotic fibers.

Reduce Inflammation: Increase Omega-3 intake from oily fish or seeds, and use anti-inflammatory spices like turmeric and ginger.

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The Better Health Beat Team