Nutrition for Healthy Skin: Vitamin A, Zinc, Vitamin C | Chris Kresser

Nutrition for Healthy Skin: Vitamin A, Zinc, Vitamin C

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One of the biggest motivations to adopt a more nutritious diet is the desire to improve skin health. Many people of all ages struggle with skin conditions such as acne, rosacea, dry skin, wrinkles, and sun damage, among others. This can be very upsetting for those who have yet to find a solution to their problematic skin. While conventional medical professionals often discount the connection between skin health and nutrition, there is strong evidence to support the influence of our food choices on the health and vibrancy of our skin.

The consumption of certain vitamins, minerals, and other beneficial compounds in the diet is one of the most effective ways to treat skin conditions and improve the look and feel of one’s skin.

There are several nutrients that are known to play a role in the proper growth and immunity of the skin, and many people have found that their skin health has dramatically improved after making purposeful changes to their daily diet. For example, Liz from the blog CaveGirlEats has a great post about how eating a traditional diet has improved her skin health. As her story suggests, making simple changes to your diet can have a significant impact on skin appearance in a short amount of time.

In this series, I will discuss how vitamins and minerals from a nutritious whole foods diet can treat acne, wrinkles, and other problem skin conditions.

Vitamin A

Vitamin A, or retinol, is one of the most widely acknowledged nutrients for healthy skin. Synthetic retinoids have been used as effective treatments for severe acne and psoriasis since the 1980s, demonstrating how useful vitamin A can be in treating problem skin.

Vitamin A influences the physiology of the skin by promoting epidermal differentiation, modulating dermal growth factors, inhibiting sebaceous gland activity, and suppressing androgen formation. (1) As it promotes cell turnover in the skin, vitamin A is effective in preventing the formation of comedones that cause the most common forms of acne.

Lack of vitamin A causes the skin to become keratinized and scaly, and mucus secretion is suppressed. (2) Rough, dry skin is a common sign of vitamin A deficiency, which often first appears as rough, raised bumps on the back of the arms. (3) This condition is called hyperkeratosis pillaris, and is found in approximately 40% of adults. (4) Though dermatologists believe this is an inherited condition with no cure, I have successfully treated this condition in several patients by significantly increasing their consumption of vitamin A rich foods. While physicians prescribe synthetic retinoids to treat skin conditions including acne, eczema, psoriasis, cold sores, wounds, burns, sunburn, and ichthyosis, it is possible to obtain similar effects from consuming natural sources of pre-formed vitamin A. (5)

Preformed vitamin A, which is well absorbed by the body, can be found in a variety of traditional foods. The most vitamin A-rich foods are liver and cod liver oil, but other sources include kidney, cream and butter from pastured cows, and egg yolks from pastured chickens.

I recommend using cod liver oil if you wish to supplement, as this provides a balance of vitamin A and vitamin D that will reduce the risk of overdosing on vitamin A. Eating liver once or twice per week is a great dietary strategy for those looking to reduce and even eliminate stubborn acne.

Zinc

Zinc is an essential mineral that is an imperative part of many physiological functions, including structure in certain proteins and enzymes, and regulation of gene expression. It plays a role in immune function, protein synthesis, wound healing, DNA synthesis, and cell division. (6) In skin, zinc assists in the proper structure of proteins and cell membranes, improves wound healing,  has anti-inflammatory effects, and protects against UV radiation. (7)

Several studies indicate that dietary zinc may reduce acne, even as effectively as antibiotics such as tetracyclines. (8) This may be because it interacts with vitamin A as a component of retinol-binding protein, which is necessary for transporting vitamin A in the blood. (9) Zinc supplementation has been shown to significantly increase the level of vitamin A in the blood, indicating an interaction between the two nutrients that may explain its positive effect on acne. (10) In fact, men and women with serious acne are found to have lower levels of serum zinc than healthy controls. (11)

Dietary sources of zinc are best absorbed from animal sources, where it is not bound to phytates as in plant sources. Organs such as kidney and liver, red meat such as beef and lamb, and seafood such as oysters, scallops, and other shellfish are the highest animal sources of zinc.

Plant foods such as pumpkin seeds and other nuts can also be high in zinc as well, but are less bioavailable, as the zinc is bound to phytates if not properly prepared by soaking. To get the most zinc from your diet, include shellfish, organ meats, and red meat on a regular basis.

Vitamin C

Vitamin C has been known for decades to play a crucial role in the regulation of the structural protein collagen, which is necessary for the extracellular stability of the skin. Vitamin C nutrient deficiencies cause scurvy, which is first manifested as rough dry skin and corkscrew hair growth. Inadequate vitamin C is also known to contribute to the development of the common problem of hyperkeratosis pillaris, as the follicles become damaged when collagen formation is impaired.

Increasing the amount of vitamin C in the diet can contribute to improved skin health and faster healing. Observational studies have shown that diets high in vitamin C are associated with better skin appearance and less skin wrinkling. (1213) Vitamin C may also help prevent and treat ultraviolet (UV)-induced photodamage by acting as an antioxidant. (14) Higher intakes of dietary vitamin C have been correlated with a decreased level of dry skin, and ascorbic acid may have effects on trans-epidermal water loss. (15) Vitamin C has an important role in wound healing and can improve the proper formation of strong scar tissue. (16)

While true deficiency in the United States is uncommon, it is possible to be consuming sub-optimal levels, particularly in a diet with limited fruits and vegetables. The highest sources of vitamin C include bell peppers, guava, dark leafy greens, broccoli, brussels sprouts, kiwi, citrus fruits, and strawberries. Certain fresh herbs such as cilantro, chives, thyme, basil and parsley are also high in vitamin C. Consuming a wide variety of colorful plant foods on a regular basis is the best way to get adequate vitamin C in your diet. It’s important to remember that vitamin C is sensitive to heat, so lightly cooking these plant foods or eating them raw (if possible) is ideal to maximize your intake of this vitamin.

Keep your eye on the blog next week for three more nutrients that can greatly improve your skin health.

148 Comments

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  1. Chris,

    It seems that the Fermented Cod Liver Oil only has around 2000 IU of Vitamin A per serve. With that in mind, isnt it okay to also eat liver 2-3x/week? I just want to make sure I dont overdose. If I was to take FCLO, Liver & green veges on a daily basis, I feel like I could easily overdose.

  2. Probiotics absolutely. Kefir in the bath is a revelation.

    We are constantly washing off our beneficials with chlorine, soap, shampoos (detergent). I have had very dry flaky skin and scalp, and bumpy arms and legs since I was a young girl. I avoid fragrances and chemicals where possible since I am sensitive and generally use lots of moisturizers and don’t shower every day to try not to dry out (I’m in windy dry country).

    A few weeks ago I started making homemade kefir from kefir grains and it was awesome for my family (thanks kefirlady.com!). There was a suggestion to use kefir whey on the skin. I tried spritzing it on, it kind of gave my skin a sheen but made me feel rather itchy and dry. Thought I’d try a different approach.

    I added a cup or so of kefir to my bath along with a cup or so of Epsom salt (mag sulfate, good for what ails you), and soaked till I was good and pruney. Normally I wouldn’t soak long or hot, but I did this time.

    My skin felt amazing! I slathered on the Vanicream and I think I didn’t even apply any more moisturizer for a few days except face and hands. My skin is no longer flaky or tight feeling. The bumpiness of my follicles (skin cell buildup ) is also improved.

    The crazy thing is the effect lasts and lasts. I think I successfully colonized my skin with beneficial lactic acid microbes.

    I have been doing this about once a week for about 5 weeks. I can’t wait to show off my new improved skin to the dermatologist next time I go in for a mole check. An age spot on my hand even rubbed off and flaky scalp has cleared up too. (I’m 48).

    Search pubmed for kefir, it is truly great stuff. I added vitamin K2 drops and fermented skate liver oil recently to my regimen, but the kefir bath had already improved my skin texture tremendously. Maybe the microbes are generating K2 and B vitamins at the level of the epidermis, who knows. Kefir is known to inhibit pathogens and modulate immune response at the gut level, perhaps it does on the skin as well.

    My teenage daughter has miserable eczema on her arms (since a baby) and it responded temporarily to a Epsom / kefir bath by almost healing up, but it’s flaring again. I am starting to suspect salicylates.

  3. Great post. I never had acne until I went off birth control and my skin went crazy. After about a year and a half of clean eating, fermented foods, cleansing, healing my adrenals, and adopting a more traditional diet with lots of healthy animal fats, fclo, lypospheric vit c, etc. etc the acne on my chin/jaw line was improving but still there. It wasn’t until my hormones started getting back into balance that my acne started clearing up.

  4. In have just read an very intersting article named Pre- and Probiotics for Human Skin by Jean Krutmannbout (I am sure you can google it somewhere). It has a massive reference base of quality peer reviewed publications and seems to make good sense as well.

    The key items are that the microflora balance and general health of the skin are affected not just by internal aspects but also by what we do topically. The inference is that skin health is very much affected by what we ingest as well as what we apply to the skin, in particular, with regards to pre and probiotics. There are a many internal use probitoics ranging from yogurts, yokults, kefir, tablet lactobacilus and bifidus, etc,that are discussed and reccomended here.

    But it seems the best use of those and other paleo diet and nutrional supplements can be wasted it we use harsh cleansers and are to phyisicaly robust with our skin. I think Chris has made clear that the skin is a very complex and reactive organ.

    The layers should seen as including the layer of bacteria on the skin (the skin microflora) then the layer of dead skin that we are constantly sloughing off. The cutaneous layers start below that and should include the sebum or oil we are also releasing all the time.

    My feeling is that we have been trained to see oil and dead skin as bad and causing many problems like acne, etc. So you think the more you strip away the better. However, from my reading, the bacteria, the dead skin and the sebum are essential protectors of the skin. The good bacteria eat the dead skin in a slow natural way that is balanced with the sloughing process and which promotes healthly cellular turnover while preventing the growth of pathogenic microorganisms. The dead skin provides a physically protective layer against pathogens, UV and minor physical damage. The oil is also a protective mechanism. The use of harsh cleaners, and harsh cleaning processings can initially have a very positive effect making the dermis look fresher and healthier BUT it is a reactive organ. After a time the skin senses it is under attack and begins to overproduce oils, the natural process of dead skin breakdown is disrupted and the skin becomes vulnerable to pathogenic microgranisms so excess dead skin can be trapped in follicules with excess oil and P-acne bacteria. It also becomes susceptible to triggers that can cause ezcema, acne, etc. There is also some evidence that the skin microflora can activate the adaptive immune system.

    So gently does it for skin cleansing – be kind to your skin. Give your gut what it needs to boost skin immunolgy and health but you may also need to suplement the skin microflora. There are currently very few topical probiotics as only a few of the hundreds of bacteria in the skin boime can be cultured.

    Chrisal use a bacilus subtilius and http://www.chrisalaustralia.com.au is one site for a cosmetic version. They also have a version called Allergen & Odour Control at the cleaning product site for spraying on beds so you load up on topical bacteria while you sleep. At the same time, it also reduces dustmite allergens.

    A quick search of the internet has shown a few of the big cosmetic companies are already starting to move to include nutricosmetics and probiotic enhanced cosmetics in the lines. It is an emerging market direction. The Healthy Skin Blog has a number of articles on this matter which seem to compliment Chris’s approach to Skin Health.

  5. Hi I love your information have read a few of your blogs.

    I have hypothyroid, adrenal insufficiency, I have to follow a gluten free diet and candida type diet.

    I’m really struggling with snake shiny looking dry dehydrated skin, when I pinch the skin is goes very wrinkly I do have quite a lot of salt or I get headaches etc but I ve been reading a bout vitamin a.

    My diet is not high enough in vit a so I’m trying to correct that but I’ve also read that hypothyroid are lower in it any way, is this true?

    I’ve been getting conjunctivitis, very dry eye, skin very dry and wrinkly looking at 36 years old on my arms etc how much would I need to supplement do you think?

    I Aldo read that low vitamin a can cause low tsh level and my tsh is always low with low t4 and my gp said I should have pituitary MRI scan but maybe it’s due to low vitamin a, would love to know what you think.

    Thanks
    M

  6. I thank you for your knowledge on where the vitamins are used within the body… though you encourage meats far too much for my liking. I eat a plant based diet and most of your reccamendations for sourcing out these vitamins are in meats and dairy, red meat especially?? Have you explored the CHINA STUDY? Pretty much meat and dairy = Cancer.

  7. Where you write about cod liver oil, could that also be replaced by “normal” fish oil? If they are very different, would you recommend to substitute the one for the other? It sounds to me as if it might be a bit too much to use both at the same time, but I could be wrong there.

    • Cod liver oil is primarily a fat-soluble vitamin supplement (A & D, with lesser amounts of K2, E and various quinones) with some EPA & DHA. Fish oil is primarily and EPA & DHA supplement, though some less purified forms like wild salmon oil have vitamin D. So it depends what your goal is.

      • Chris, with this is mind, would it be overdoing it to take both fish oil and cod liver oil, given that both fulfill a different goal? I mean, I might start growing gills or something…

  8. I am very glad to read this stuff and especially i want to give thanks to for this valuable and impressive quality content.Studies have shown that eating plenty of fruit and vegetables like carrots and plums enhances skin color. A survey was done and people preferred the natural colour which was the result of eating fruit and vegetables than spray tanning or tanning in the sun. Also, drink lots of water.

  9. Great site with great health tips!
    I also have keratosis pilaris and even asked my dermatologist if this could be a deficiency and he simply said no. I’m not going back to this guy.

    Doc, do you have any advice for people who have seborrhoic eczema?
    And I also notice that my skin is pretty saggy/stretchy and lacks tone. I’m 31 now and I have a scar on my cheek. This scar is now approximatively 1 inch deeper than it was originally when I got it! Anything I can do against this? My skin is generally stretchy and I asked my doc if this is abnormal and he said it’s still normal but I’m not sure. My brother has the same stretchy skin. I thought about EDS but I’m not hypermobile.

  10. Thanks for the information about “hyperkeratosis pillaris”. I’ve always had the bumps on the back of my arms, nice to know there’s a fix!

    I’m reluctant to use cod liver oil because of oxidation concerns. What do you think is the safest source? I’ll have to learn to cook liver in the meantime.

  11. So what if your skin doesn’t improve? I was diagnosed 15 weeks ago with candida albicans in my lower intestine. I was on a stricter diet than paleo. No sugar of any kind, including sugars from fruits, starches, sweet potatoes, etc. No dairy. No carbs really (no breads, corn, etc….I was gluten free to begin with any way). No molds (no coffee, no mushrooms, etc). Basically all I have been eating is a ton of veggies and meats and drinking a ton of water. All, or let me rephrase, 99% of my symptoms have vanished during treatment. I have dealt with the following symptoms for over 4 years: extreme anxiety/worry, headaches, extreme fatigue, acne, mental fogginess, shakiness, extreme moodiness (anger/weepiness), horrible stomach issues, the list goes on and on and on. All of those symptoms are gone and I feel like a new woman……all but my acne! I was always the classic 2-3 pimples before getting my period and then my face would clear immediately. Over the last 4 years, my once nearly clear face is constantly erupting, so I chalked it up to it being a part of the candida. I thought for sure when going on such a strict diet and seeing such an amazing change in all my other symptoms, that clearer skin would be one of them. Especially after 15 weeks. I just don’t get it?

    • Christine, After my first two months of going paleo, I experienced for 6 months, constant blemishes on my face, where previously i had a clear complexion. This was new and distressing. I have since determined that almonds are the culprit. Going paleo I was eating a lot of almond meal. Once I eliminated those, the blemishes (rashes) disappeared. Other nuts don’t bother me, just the almonds. Funny thing that I LOVE almonds, grew up with several almond trees on our property and ate them raw off the trees. Hope you find your culprits. I’m still trying to figure out a few of mine. 🙂

    • Please get blood work even if you must go out of pocket. Candida/Yeast – Women please check estrogen levels.
      Ensure profile covers all, although not limited to the following:
      Vitamin A, B2, C & E, Copper, Zinc, Sulfur & Blood Sugar Levels. Minimize Sugar, Fatty Proteins, Diary / Alcohol, Use of Antibiotics and Increase Soluble Fiber Intake. Stay Hydrated Love & Unstoppable Confident Energy to Each & All!

  12. Re Vitamin A – Weston Price Foundation advocate fermented cod liver oil. Unfermented quickly goes rancid.

  13. FYI, I learned through the Weston A. Price Foundation that another reason for getting zinc from animal foods is that if you try to get it from plants, the copper-zinc ratio is way off and you wind up with too much copper in your system.

    I wonder if zinc might be my missing puzzle piece. I have reason to believe I’ve got too much copper in *my* diet most of the time. I get a decent amount of vitamin A but am still plagued by keratosis pilaris.

  14. My skin began breaking out at puberty, and still has not stopped now that I am 56 and one year of having no periods. When I was a kid the fam took me to a derm who put me on tetracycline for a few years (horrors when I think about that now), as well as ultraviolet light on my face. Of course it didn’t work. I became a healthy food “organo” person in high school, so it’s been most of my life sans crap (no junk, fast food, processed foods). I’ve basically tried it ALL (except Accutane) and nothing has ever changed. Diet, supplements (all the ones Chris suggests), natural hormone-replacement, no hormone replacement, candida diet. Low on nuts. 2.0 salicylic acid kind of helps to dry out breakouts but doesn’t prevent them. Three years ago the skin on my shoulders began breaking out as well, something that had never happened before. 🙁 A couple years ago I became almost totally Paleo (hard as I have never like red meat since I was kid) and totally gluten-free and very low dairy (half and half in morning coffee) because I hoped it would help with allergies and the recurring sinus infections I’ve also had in the past few years, one so bad last winter that I did take an antibiotic and prednisone so I could freaking breathe! Soy free, nightshade free. Eggs yes or no doesn’t mater. I lost the 20 lbs. I had tried to lose since age 40 (yay!) but no change in skin or allergies. I’ve tried Chris’ suggestions for sinus infections, no dice. I am stuffed up a lot of the time. Have air filtration in the house. I eat so incredibly well with high quality food and supplements, and yet see people who eat crap, wheat, dairy, smoke, etc. and have no acne or allergies or sinus infections and it is beyond frustrating. I meditate (and actually teach meditation) and my stress levels are not high. I really don’t know what else I can do except accept it – yet I wish I had a “cure.”

    • Zannie,
      It doesn’t matter how good you eat if you don’t digest and assimilate the nutrients. Adequate stomach acid is essential to the proper digestion of proteins. Proteins are broken down into amino acids, the building blocks of antibodies, hormones, enzymes, and hemoglobin. Have you had your stomach acid levels tested? It is a common problem and may be related to your dislike of red meat.

      Proper digestion of fats can also be an issue. Fats are essential for cell membrane construction and function and the delivery of fat soluble vitamins. Stools that float are a sign that fats are not being assimilated. Supplemental bile salts can help in this area.

      Just some ideas of other things to look at. Don’t give up.

      • Thanks Peter, I do take HCL/pepsin and digestive enzymes with each meal, plus strong probiotics. Just never liked meat. I eat eggs, chicken, turkey, fish, seafood and eat protein at every meal. No floaters!

        • Zannie you might look into the GAPS diet, it’s a very specific full detoxification and then healing regimen. The GAPS Guide is particularly helpful in navigating the Intro part of the diet, which might help you cleanse out any lurking baddies in your gut. Anyway it’s worth a look, for a lot of people who have tried everything, GAPS ends up their skin & health savior, us included.

          • Thanks Christine. 🙂 My diet is close to GAPS as it is but I’ll look into it more. The meat stock is the biggest challenge for me.

            • Have you gone through Intro? Intro is tough but following it to the letter and slowly moving into the full GAPS diet was the way to go for us. I suggested the GAPS Guide by Baden Lashkov because it’s the most straightforward explanation of Intro that I’ve found. Dr. McBride doesn’t outline Intro in her book.

        • Zannie,
          I’m glad to hear you’re on to the HCL/pepsin and fat digestion is working.

          Another idea you might try is the Coca Pulse Test to determine the source of the allergens. This can be done on a mini-scale as opposed to the procedure described in Dr. Coca’s book. Take a seated pulse for a full minute, chew but don’t swallow a suspected food for 30 seconds, retake a full minute pulse. If it rises by more than 6 beats per minute the food is likely a problem. You can also test personal care products with this method (although I’m assuming you’ve already cleaned those up along with your diet, still they should be tested). Environmental toxins can also be tested (cleaning products, off-gassing from upholstery, carpets, etc)

          Don’t discount foods you really enjoy. The body can release endorphins in response to foods we are very allergic to. Essentially giving us an injection of feel-good chemicals whenever we ingest something toxic to our system.

    • And also check out http://www.acne.org (and the products he sells at http://www.danielkern.com). Not to sound like a shill (I’m not), but I just wish after 15 years of prescription acne meds and 2 courses of accutane that I had discovered Daniel Kern’s regimen sooner. He has done so much research and I am now completely clear.

    • Zannie, everybody is different, so this may or may not help. I had mostly eliminated my sinusitis when I gave up dairy, but I still continued with grassfed butter and heavy cream. Even that was enough to keep my sinuses sub-optimal, and it wasn’t until I stopped with even butter and ghee that I stopped having that stuffy feeling, especially waking up in the morning, and my ears stopped ringing. It is possible that the highly allergenic casein is a culprit for me. I really miss butter and cream, but I do NOT miss blocked ears and stuffy nose.

    • This could also be a histamine problem…I had similar issues – no matter how clean I ate, and I suspect it may be a histamine issue. I read Chris’ article about histamines elsewhere on this site. I used the suggestion of adding enzymes (I take NOW brand (bromelain with quercetin) to break down histamines…it can’t hurt, and if it doesn’t help you can just stop. The effect was immediate! I now take two with each meal, and I can breathe, have more energy, and no sinus infections. I have shared this info with others who had apparent food allergy symptoms no matter how clean they ate, and they have had similar results.

      • It should be noted however that bromelain is high in salicylates, which can cause severe reactions in those with salicylate intolerance. Quercetin is an antihistamine, but not bromelain.

  15. While the article mentioned crucial vitamins it failed to give dosage information making it problematic for majority of people to follow your guide. I would suggest at least 25k-35k IU retynol per day, 50-100mg Zinc and 2-10g of vitamiin C per day to get good skin.

    There is no mention of probably crucial factor – shower. Cold shower protects skin oil and chlorine doesn’t evaporate. Furthermore, since many people like to think in therms of paleo style, anything but cold shower is definitely not paleo.

  16. Hi Chris,
    I think you have some of the health writing out there and wondered if you will cover intertrigo in this series?

  17. Chris, you write “It’s important to remember that vitamin C is sensitive to heat, so lightly cooking these plant foods or eating them raw (if possible) is ideal to maximize your intake of this vitamin.”

    Isn’t fermenting an even better way to maximize the nutrition you can get from vegetables and fruit as that actually raise some of the vitamin levels especially vit. C among many other things that makes fermenting a very beneficial approach?

  18. For those with psoriasis, you may need to look into supplementation in addition to dietary changes. My Dad’s psoriasis is much much better with zinc supplementation and evening primrose oil. Not advocating that this applies to everyone, but it certainly would to many considering acceptance of the need for zinc and fatty acids for skin health.

    It’s important when looking at food sources of zinc, to take into account the copper levels those foods have as zinc and copper must be in balance. This is a very very common nutritional imbalance, so for anyone with an excessive copper:zinc ratio, certain foods such as organ meats may not be ideal to promote zinc levels as there is a lot of copper in those foods too which will just block the action of the zinc where it’s needed.

    • I am also suffering psoriasis and i agree it is both dietary changes and supplements. In some cases you should also consider changes in your lifestyle to reduce stress. I have been totally grain-free few months and it makes me feel so much better. I consider my diet as an autoimmune paleo (i am still eating some quality sausages). I hope I can see the good feeling soon on my skin..

      I see that zinc is essential along vitamin D and vitamin C. I am not so sure about evening primose oil because of high omega-6 content. I think cod liver oil is better. Next thing I am going to try is curcumin capsules.

      I hope Chris would write an article about psoriasis soon. I believe he has a lot to say for this annoying disease.

    • It is interesting to note that cortisone and hydrocortisone deplete zinc levels. I used hydrocortisone for years on my psoriasis and I’ve been struggling with low zinc levels. Howevert, the diet changes cured the 30 year bout with psoriasis even with low zinc levels(see earlier comment). Maybe my zinc levels were dramatically improved by the diet even though they are still below optimum.

      It’s easy to test your zinc levels by taking a tablespoon of aqueous zinc and holding it in your mouth for 20 seconds. If you experience no bad or metallic taste, your zinc levels are very low.