The Acne and Diet Connection: Or is it rosacea? A Nutritionist’s Story.
Things hit rock bottom when I needed to apologize to the makeup artist for the horrible state of my skin on the morning of a satellite media tour, when you appear in about 20 on-camera television interviews in the same morning. Fortunately, she was very skilled at her craft, and the not-too-close camera didn’t reveal to viewers what was happening on my face. But the acne (or so I thought) was incredibly embarrassing, and physically painful too. Would people think that I don’t take care of my skin? That I don’t wash my brushes? A dietitian is supposed to look healthy, after all.
Over the past year I have gulped down pills, slathered on expensive creams, endured facial peels, and seen three different dermatologists. I desperately tried different diets, from gluten-free (despite a lack of supporting evidence) to very low glycemic (with some evidence) in the hopes of clearing my skin. Nothing seemed to make a lasting, significant difference. My husband convinced me to try one more dermatologist.
The doctor looked at my skin and wrote a couple of prescriptions. I asked her if she believes that diet affects acne. Like most dermatologists she explained, “There’s no strong evidence to warrant me prescribing a certain diet for you.” But then she took a closer look at my face and dropped a bomb: “It looks like you might have rosacea.”
Rosacea!? The word conjures for me images of middle-aged men with Rudolph red noses and old ladies with flushed cheeks. She explained that it is commonly agreed, even in conventional medicine, that certain foods can trigger rosacea flare-ups. And in a semi-progressed stage, rosacea looks like acne. Because of my pregnancy, though, she was hesitant to prescribe a diet for fear that I’d get too restrictive. “Trust me,” I assured her, “I’m a dietitian.” She rambled off a few foods that can cause issues and when I begged her for additional reliable information resources, she directed me to the National Rosacea Society.
I immediately looked up rosacea do’s and don’ts. I became a NRS member to gain access to all of the information they had to offer. My new routine completely changed the state of my skin within a week. First, I stopped using the Clarisonic brush, “scrub pads” and salicylic acid, since anything but a soft washcloth (don’t scrub hard!) or cotton pad and the mildest face wash can wreak havoc on rosacea-prone skin. Almost overnight my skin looked less “angry”. By the end of the week, my skin even started to clear a bit. Within a few days, I began avoiding the common dietary and environmental triggers of rosacea, and a week later began using the prescriptions.
Over the past four months of food journaling and trial and error (because it can vary among individuals), I’ve concluded that my rosacea triggers are pickled and fermented foods (an olive or two is fine, but not five baby pickles!), anything piping hot (I let my coffee cool slightly first, or go with iced coffee), red wine (so I stick mostly to white wine, or have just a small amount of red) and spicy foods. Update 6/16: I’ve noticed that any alcohol can cause inflammation on my face, so I skip my favorite glass of wine at least a few days per week. And other culprits may exist. Following this diet at home is easy. Eating at good restaurants can get tricky, though, with their fondness for butter and cream (additional triggers, I think). While one good dinner out doesn’t cause too much trouble, throwing caution to the wind for a few consecutive days does.
The creams my dermatologist prescribed, Finacea and Clindamycin, seem to be working well. I wash my face and apply these religiously, followed by a light moisturizer and sunscreen. As usual and always. Four months later my skin is clear and I even will venture out in public sans makeup or huge sunglasses that cover my face.
Update 8/16: The stress of relocating to a new state is taking its toll on my complexion apparently. As much as I didn’t want to go on oral antibiotics, I recently started and it is helping big time. Doxycycline is the medication. You can help offset the antibiotics by taking a probiotic pill. VSL#3 is a well-respected one. And I’m using Soolantra gel/cream nightly, as well. My skin is looking gorgeous, in fact. I also read the book by dermatologist Debra Jaliman, MD, Skin Rules, and there are some good nuggets of wisdom in it about proper makeup removal and cleansing techniques. Check it out. It’s a quick and easy read. And I also started changing my pillow case every. Single. Night.
Update 10/16: Now I rarely take the oral antibiotics. I only take them when I’m having a flare up. I started using Aczone topical cream (prescription) when I start getting a new flareup. It’s been working! I still use the Soolantra in between when my skin is looking good. And clindamycin during the day.
Update 3/17: Here is another book to check out, Clean Skin from Within, by Dr. Trevor Cates. She has the approach of nourish from the inside to reduce inflammation.
If you have a skin problem, don’t delay. See a board-certified dermatologist who is patient in dealing with acne (or rosacea) patients. You’ll be glad you did. Have you ever experienced facial skin issues? Do you now? Are they food related? I want to hear about it.
Bonus tips: Since I wrote this post, readers have been asking me which products I use on my skin. I use Cera Ve cleanser in the morning. In the evenings, I remove eye makeup with Neutrogena makeup remover wipes and cleanse with Neutrogena Fresh Foaming Cleanser (since it also removes makeup and sunscreen well). In the morning I pat on Clindamycin, as well as Finacea before bed. If I have any dry spots I dab on Theraplex Hydro Lotion and Aquaphor for really dry or flaky areas. Often I pat on the Theraplex on the days I don’t have time to wait 30 minutes after washing my face before applying the prescriptions. For sunscreen (which I always wear before stepping outside) I usually use NARS Pure Radiant Tinted Moisture SPF 30. When I apply a full face of makeup I use Bobby Brown Skin Foundation Stick. Midday I apply Colorescience powder sunscreen on my face. And I wash my makeup brushes (almost) weekly, and concealer sponges after each use.
Update 6/16: I apply Theraplex Hydro Lotion after face washing before I apply the prescription creams. Every third day I use Metrodizonxale cream. If things start to get bad (from travel, vacation, going off the diet, stress, etc.), I take an oral antibiotic prescribed by my dermatologist. I noticed breakouts on the bridge of my nose. My dermatologist said that area isn’t a hormonal breakout area, but that swabbing all of your eyewear frequently with rubbing alcohol should resolve that. It did!
Disclosure: This post contains Amazon Affiliate links.
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