Contrary to what many conventional doctors and dermatologists may believe, nutrition plays a critical role in the health of your skin. Acne, rosacea, psoriasis, dry skin, and wrinkles are all affected by your diet, and eating the right types of foods is a great strategy for reducing and even eliminating these skin conditions.
The first article in this series on nutrition and skin health explained how vitamin A, zinc, and vitamin C can all help improve the appearance and health of your skin. In this second article, I will address three more important nutrients that can maximize skin health: omega-3 fatty acids, biotin, and sulfur.
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Omega-3 Fatty Acids
Omega-3 fatty acids are known to be anti-inflammatory, and the relative intake of omega-6 to omega-3 polyunsaturated fatty acids (PUFAs) may be a crucial dietary factor in the regulation of systemic inflammation. Our modern diets tend to be very unbalanced in essential fatty acid intake; the ratio of omega-6 to omega-3 fatty acids in Western diets is commonly at least 10 to 1, compared with ratios of 4 to 1 in Japan and 2 to 1 in hunter-gatherer populations. (1) This high ratio of omega-6 to omega-3 fatty acids in our modern diet likely plays a role in the prevalence of inflammatory skin conditions such as acne, psoriasis, and rosacea.
High levels of omega-3 fatty acids have been shown to decrease inflammation, and may reduce the risk of acne and other skin problems by decreasing insulin-like growth factor (IGF-1) and preventing hyperkeratinization of sebaceous follicles. (2) Conditions such as atopic dermatitis and psoriasis have been shown to be positively affected by supplementation with omega-3s from fish oil, likely due to competitive inhibition of arachidonic acid leading to a reduction in the inflammatory process. (3) Clinical results from omega-3 supplementation include an improvement in overall skin condition as well as a reduction in pruritis, scaling, and erythema. Omega-3 fatty acids have also been demonstrated to inhibit inflammation in the skin caused by UV radiation, and may even reduce the risk of skin cancer. (4)
Consuming foods rich in omega-3 fatty acids may lead to smoother, younger-looking skin with a visible reduction in inflammatory skin conditions like acne and psoriasis. These fats are especially abundant in cold water fatty fish such as sardines, salmon, mackerel, tuna, anchovies, and black cod, among many others. (5) There are many reasons I recommend eating fish rather than taking fish oil to get these omega-3s, as there are many other nutrients in fish that are highly beneficial to skin health such as vitamin D and selenium.
Avoiding industrial seed oils rich in omega-6 fatty acids can also help reduce inflammatory skin conditions; however, I have found in my clinical practice that limiting intake of omega-6 from whole foods like avocados, poultry, pork and nuts is usually not necessary. Following these recommendations and consuming adequate amounts of omega-3 fatty acids can greatly improve many inflammatory skin conditions and may help eliminate stubborn acne.
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Biotin
Biotin is a water-soluble vitamin that acts as an essential cofactor for enzymes that regulate fatty acid metabolism. Proper fat production is critical for the health of the skin, since skin cells are rapidly replaced and are constantly in contact with the external environment, and fatty acids in the skin protect the cells against damage and water loss. When biotin intake is insufficient, fat production is altered, and the skin cells are the first to develop symptoms.
A nutrient deficiency of biotin causes hair loss and a characteristic scaly, erythematous (red and inflamed) dermatitis around the mouth and other areas of the face and scalp. (6) In infants, biotin deficiency manifests as “cradle cap”, or scaly dermatitis of the scalp. This condition appears as crusty yellow or white patches on the scalp, behind the ears, and around the face. In adults, this condition is called seborrheic dermatitis and can occur in many different areas of the skin. Biotin deficiency can also be a cause of dandruff for some people.
Biotin deficiency in the diet is usually only seen in individuals who are consuming raw egg whites, due to the protein avidin which binds with biotin and prevents its absorption in the gut. (7) Therefore, it’s not a good idea to eat raw egg whites, and if biotin deficiency is a concern, be sure to consume adequate amounts of biotin rich foods. The best sources of biotin are egg yolks and liver, and other good sources include swiss chard, romaine lettuce, almonds, and walnuts. Including these foods in your diet will prevent biotin deficiency and may help improve the production of fatty acids in the skin, returning moisture to dry skin.
Sulfur
Sulfur, the third most abundant mineral in the human body, is an extremely important dietary compound for both skin health and overall wellness. Yet we rarely hear about sulfur in mainstream nutrition, and many people do not even know which foods provide it. In fact, a large proportion of our population is likely eating a diet deficient in sulfur, which could be causing the initiation and progression of many inflammatory and degenerative diseases. (8) While the benefits of a diet rich in sulfur are numerous, I will focus on the effect consuming adequate sulfur can have on the health of the skin.
Animals fed a sulfur deficient diet produce less collagen than normal, demonstrating how a diet with inadequate sulfur can contribute to a reduction in collagen and subsequently cause an increase in skin wrinkling. (9) Getting enough sulfur in your diet can help maintain collagen production and keep your skin looking firm.
Sulfur is also required for the synthesis of glutathione, one of the most important antioxidants in the body. High levels of glutathione in the body can prevent damage caused by free radicals, which are thought to be the major cause of cellular aging. (10) The free radical theory of aging suggests that aging results from accumulation of cellular damage from excess reactive oxygen species that are generated as a consequence of oxidative metabolism. High levels of glutathione in the body can reduce the damage caused by these reactive oxygen species, helping to slow down the visible signs of aging. Glutathione also regulates the production of prostaglandins, reducing inflammation and possibly affecting symptoms of inflammatory skin conditions. (11) The level of glutathione in the body is greatly impacted by having adequate sulfur, specifically sulfur-containing amino acids, in the diet. (12, 13)
These amino acids are most abundant and bioavailable in animal foods such as egg yolks, meat, poultry, and fish. (14) Sulfur is also found in plant foods; good sources include garlic, onions, brussels sprouts, asparagus, and kale. Fermentation may make this sulfur more bioavailable, so foods like sauerkraut and other fermented crucifers are excellent sources of sulfur and an important component of a diet for healthy, youthful skin.
Next week, I will discuss another set of essential nutrients that can be beneficial in improving and maintaining the health and beauty of your skin.
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From article: “Acne, rosacea, psoriasis, dry skin, and wrinkles are all affected by your diet, and eating the right types of foods is a great strategy for reducing and even eliminating these skin conditions.”
Hmmm, you might want to change that to “acne, rosacea, psoriasis, dry skin, and wrinkles MAY be affected by your diet…” You said that they ARE affected by diet, but that is patently untrue. I have acne, severe dry skin, psoriasis-like patches of thickened skin, seborrhea, etc and they have been 100% completely and totally unaffected by diet. My skin has been unaffected by 16 years of dietary modifications including (but not limited to) vegetarianism, raw vegan, gluten-free, grain gree, sugar free, paleo, and other diets. This coupled with supplementation, including all of the supplements listed here- Vit A, C, Zinc, Selenium, Biotin, Omegas, borage,, sulfur (msm), and every pre/probiotic under the sun, as well as dozens and dozens of other supplements. So, no, these skin conditions are not all affected by nutrition and diet. Like I said, a more accurate way of stating this would be that for SOME individuals, diet and nutrition MAY affect CERTAIN skin conditions.
Hi Chris
Many thanks for a very resourceful website and podcast.
I am, as many other, suffering from seborrheic dermatitis and reached limited success with going gluten free / supplementing with biotin, zinc etc. Unsurprisingly, if I don’t watch my diet I often get some kind of minor gastric problem such bloating, gas etc – I previously was able to consume large quantities of sweet potatoes, but now also experience bloating when consuming these.
I am convinced about the gut-skin link and would deeply appreciate more details on how to combat this condition. For me, biotion supplementation etc. is rather a band-aid than resolving the underlying problem – I am sure I am consuming more biotin that most people but still experience this problem – i.e. rather a malabsorption issue.
I assume that your recommendation would be to:
1. Auto immune Paleo diet, if that not helps
2. GAPS diet
3. Bone broths
4. Glutamine
5. Fermented foods / probiotics
but any additional insight would be highly appreciated.
Kind regards,
John
John: that’s an excellent start. Let us know how it goes.
Great post and so timely as we are trying to sort out my husband’s nasty case of seborrheic dermatitis.
Looking at the studies Chris sited, it seems like omega 3s can be a double-edged sword. I have no doubt that in moderate levels they can protect the skin by reducing systemic inflammation and possibly modulating hormone levels.
But I noticed a worrying thing in one of the studies. They fed the participants 10g of fish oil per day. This was shows to offer very minor protection against UV light. But the worrying thing was that it increased lipid peroxidation in the skin, basically the fatty acids in the skin got damaged.
There’s now quite decent evidence that this kind of lipid peroxidation is the triggering factor in acne formation. Without this inflammation acne doesn’t form.
In the paper they noted that this happens probably because the PUFAs are so unstable and easily damaged.
So it’s probably wise to keep your fish oil and omega 3 intake at moderate levels.
Hi, it concerns me greatly that you recommend fish in one’s diet. This, despite the contamination of the Pacific Ocean with nuclear waste consequent upon the Fukushima event. There is info on the internet that eating fish from the oceans is not safe anymore. I stopped buying/eating ocean-aught fish as soon as I heard about Fukushima & I’m in New Zealand. The USA is much closer to Japan.
I’m open to reading any peer-reviewed, high-quality evidence that fish consumption isn’t safe because of Fukushima fallout. I haven’t seen any so far.
Also: scientists at UC Berkeley have been regularly testing samples of milk, produce and soil for radioactive isotopes and for the last several months the levels have been non-detectable.
Chris,
Awhile back I believe I heard another Paleo/Primal advocate, cant recall whom maybe Robb Wolf, said something to the effect that diary can be a culprit to skin problems such as acne. 1) Do you agree? and 2) Are there any Paleo/Semi Paleo foods that may cause skin complications?
Love the series so far. I hope the next one will also include avoiding sun burn and after care too.
Hi Chris,
Sorry for the mostly off-topic question, but I have a question about the Green Pastures FCLO/high-vitamin butter oil blend that you recommend. I got it because the reasons you recommend it totally make sense to me and I just use the dose the company recommends for myself. I have an almost-3 year old daughter (33 lbs) and I was wondering if you could tell me about what the right dose would be for her? I want her to get the benefits but don’t want to risk giving her too much. She likes it! Right now I just give her a tiny bit every few days but really have no idea how much to give! She is tall and thriving and eats very well in general–loves arugula, curries, cauliflower, meats, etc–but I don’t know how to cook organ meats and we live in a small town in Illinois without much access to decemt fish. I had been giving her the Nordic Naturals baby fish oil with clear dosing instructions for toddlers, but then after reading your blog I was concerned she isn’t getting enough K2 or A, so I got the Green Pastures. If you could let me know a good dose for toddlers or maybe include it in an article about children’s health I’d appreciate it so much. Thank you for your fantastic blog–so helpful!!!
I’m so jealous of pretty boy’s skin in your blog image.
Hoping to see future discussion on maintaining healthy gut ecology for healthy skin. I’m having good results with this approach, drinking homemade milk kefir, homemade water kefir, and kombucha (not homemade, but will soon).
My wife had perfect skin/facial complexion through to her late 30’s,not even getting the usual pimples during her teenage years; after breast cancer surgery,which included removal of lymph nodes,she developed rosacea- facial inflammation with pustules. This condition has persisted for decades and logically,as diet didn’t cause the rosacea,dietary changes/improvements haven’t helped.
Is anyone aware of any specific recommendations for people who have seborrheic dermatitis, keratosis pilaris and rosacea? ie. foods to avoid, nutrients to consume, etc.?
From what I’ve gathered, biotin, omega-3’s, vitamin A/D/E/K, magnesium, zinc, sulfur, vitamin B12, thiamine and nicotinamide all seem to be helpful for those conditions.
Apparently there has been a link observed between SIBO (small intestine bacterial overgrowth) and rosacea. Now considering seborrheic dermatitis, keratosis pilaris and rosacea are all inflammation related disorders and the great importance of gut health to total wellbeing, it seems likely that addressing the SIBO would result in a cessation of symptoms related to any of the aforementioned conditions.
I’ve seen some recommendations for the GAPS diet, a book called Breaking the Vicious Cycle: Intestinal Health Through Diet, the Specific Carbohydrate Diet, an autoimmune paleo protocol and an anti-fodmaps diet. (At this point I still have yet to look into all of these thoroughly)
At this point I’m kind of overwhelmed with all of this info and maybe a little dissatisfied with the truth that a lot of this comes down to self experimentation as there is a lot of individuality when it comes to these conditions and food sensitivities, etc.
I’m pretty strict paleo as it is and have already cut out most of the major pro-inflammatory ‘players’ if not all of them, I suppose a closer look at my diet based on foods mentioned in the recommended texts above combined with some smart supplementation and quite possibly a gut healing protocol may be necessary. I guess what I’m wondering is if there is a single dietary protocol that has already been formed for the 3 skin conditions I have mentioned which I can immediately begin to follow or if I am best off starting with some gut healing protocol.
If anyone has any advice or experience with any of this I would love to hear from you. Thank you.
Hi Ishan,
I also have KP and have tried various dietary protocols to get rid of it. While I’ve had improvements here and there, nothing I’ve tried has eliminated it permanently. I think even with the “perfect” supplement and dietary regimen, it would still come right back if you stopped. There is likely some underlying condition leading to various nutrient deficiencies internally and externally (with an obvious “chicken skin” manifestation in cases of KP).
I’ve also looked into SIBO as a possibility and have often wondered about the reasons for its development. I know there are some theories out there. A while ago I theorized that if bacterial populations in the large intestine aren’t adequate (i.e. good species diversity), maybe they migrate and populate the small intestine so that the host (that’s us humans) may benefit from the added breakdown of nutrients. At the same time, these bacteria consume a number of nutrients themselves (from the foods we eat). But perhaps even with the “overgrowth” the host may end up with more nutrients than they would without the “overgrowth.” Ehhh that was hard to put into words, do you get what I mean??
2 of my family members have very minor KP, but none as severe as mine. I also received the most antibiotics as a child (for ear infections) compared to family members. I was not born with KP but developed it in early childhood, which makes me wonder if the antibiotics had a role in it.
I’ve read that in the absence of Vitamin A, the epithelium cells (which line the skin, intestines, etc.) will release keratin instead of the mucus that would ordinarily protect the skin…. so it could be a defense mechanism. While it would seem that addressing a Vitamin A deficiency would help KP (and maybe it does for some), I believe the issue is more complex for many of us.
Hi Evan,
You made some pretty interesting points and I certainly agree with your conclusion that the issue is more complex for many of us. It seems to me that dealing with conditions such as KP require a great deal of self experimentation and even then I suppose we are really just looking at keeping it under control rather than eliminating it. While I still believe that the answers are out there, they appear to be far from easy to obtain.
Yea it’s disappointing that there’s hasn’t been more research into it, being that it’s a “benign” condition. I’m hoping to be able to participate in the American Gut Project and get a little insight into my gut microbiology (http://humanfoodproject.com/american-gut/). Maybe there will be some answers there.
Great article!
Unfortunately for me diet wasn’t enough. I been suffering with adult acne, eczema and dandruff for over 18 years. While diet did reduce the symptoms. It didn’t go away complely. Even with autoimmune protocol of Paleo. So I had to resort to prescription creams along with Paleo diet.
What do you people think about pork and psoriasis connection? I am suffering psoriasis despite AI paleo and supplements. I think my next move could be to cut down eating pork. I was not eating pork when I was on Paganos diet and my skin was better then. But I think Pagano did not give enough energy and calories.
Pork has been the culprit of dermatitis breakouts for me…especially around the eye area and wrists. Pigs are “dirty” animals (they eat feces) and all those toxins get passed onto you. As a child I always had flare-ups when I ate pork, and sometimes still do. It took years before I made the connection. My 80 year-old aunt who raised pigs for a living on her farm was the one who suggested I might be “allergic” to pork, and that’s when I started to see the correlation. Haven’t touched pork in years.
Acccording to heartfixer.com (a cardiologist dealing with MTHFR cases) people with a CBS mutation or SOUX mutation cannot tolerate sulfur contating drugs or food.
http://www.heartfixer.com/AMRI-Nutrigenomics.htm
I have read on other mthfr websites that you can order sulfur strips and test your urine to see if you have a problem with sulfur. Would be interested in Chris’s take on this.
I have rosacea-pretty controlled right now but I cannot handle sulfur rich foods anymore. I am very frustrated with this and am trying to figure out if it is temporary or if I will have to stay away from them forever. Onions and garlic have always bothered me to a certain extent but is so much worse now than before. I need to try sauerkraut (it’s been awhile) to see how I handle it but it seems like most fermented foods don’t agree with me.
Sara – just noticed your comment. You beat me to it 🙂
Have you tried molybdenum to help with the sulfur tolerance? Have you read Amy Yasko’s vooks and had the testing done? I am heterozygous for CBS699T and am now eating low sulfur diet (though to be honest, never really felt any problems eating high sulfur foods but did react to yucky sulfites in wine or cider).
vooks = books 🙂
Excellent article, Chris!
I was diagnosed with guttate psoriasis 8 years ago. After my initial major flare where I broke out all over my body, I now only get the occasional red lesion. However, I have chronic dry, scaly patches on my scalp and behind my ears that are not clearing, despite being on the AI Paleo protocol. I always thought this was psoriasis, but after reading this article, its sounds just like seborrheic dermatitis- although Im sure they are related. I feel like I need more biotin in my diet, as I dont consume the foods you listed, per recommendations for the AI protocol (no eggs and nuts) and yours about cutting down on fibrous veggies for people with IBS, which I also suffer from.
What other foods could I consume that would provide biotin? Or is it ok to take it in supplement form?
,
I am always pleased to see your posts. This one is of particular interest to me. I recently found out I am type 1 diabetic and with all my research I believe that along with a genetic predisposition perhaps my diet contributed to the disease. I am much more conscience of what I eat now. however I remember being a little girl and breaking out in hives from sulfa drugs. Is this the same or different. I am also allergic to zinc. I have always purposely stayed away from sauerkraut for this reason. Can you shed some light on this for me?
Sulfa is not the same as sulfur, though that’s a common misconception.
I’m not Chris obviously but I hear a lot about people being “allergic” to things like sulfur and iodine–the zinc thing is a new one but I suppose it fits in that category. And I don’t understand. You need sulfur and iodine and zinc or you’d die. How can you be allergic to any of them?
Could it be that your intolerance is to a compound that contains zinc, and that it’s something else in the compound to which you are reacting, rather than the zinc?
Dana, you don’t become allergic to things because they are optional or even bad for you. You can be allergic or sensitive to anything, including vitamins, minerals, enzymes, your own hormones even. I have been succefully treated for all of the above and the difference is astounding.
Hi Dana
There are some genetic mutations which mean people are ultra sensitive to any sulfur – CBS and SUOX are two of the known ones. CBS is an upregulation – meaning that the enzyme works overtime. People in this case do need sulfur but need to limit it until they get the mutations under control.
I agree with Lilli – I know lots of people who are very sensitive to different foods and supplements. Even healthy food is problematic for many people, due to things like amines, salicylates, phenols, thiols for example (all of these are naturally occurring chemicals). If people have leaky gut or genetic mutations, then they are more susceptible to these “oddities”. The word “allergy” is not correct in some cases, “intolerance” may be a better term to use (though reacting with hives to a sulfa drug sounds more like an allergy than an intolerance).
In other cases, people are sensitive to the fillers found in supplements – such as mag stearate or cellulose for example. These poor folk need to pay through the nose for more expensive, purer supplements or get them compounded by a pharmacist.
Hi Alexis
There is a genetic defect (SNP) in the methylation cycle called CBS 699T that may be playing a part in your reaction to sulfa drugs. Do you react to high sulfur foods like garlic, onions, eggs, spinach, cabbage? Another sulfur related SNP is SUOX which is also on the link below.
Here is some more info about CBS (written by an Ohio heart doctor who uses the Amy Yasko methylation protocol): http://www.heartfixer.com/AMRI-Nutrigenomics.htm#CBS:%C2%A0%20Cystathionine%20Beta%20Synthase
Also what type of zinc do you react to? Picolinate is a great form of zinc that is highly absorbable. Otherwise, you may need to bypass the digestive tract and try a cream based delivery.
Good luck!
I sometimes use a prepackaged lemon juice for sparkling water and cooking. They include sulfur dioxide as a preservative. Is that a helpful form of sulfur from a glutathione production perspective?
Perhaps more emphasis should be put on “sulfur-containing amino acids” such as Cysteine (which happens to be one of the precursors to Glutathione), or the various beneficial sulfur-containing compounds such as those found in garlic.
You’d do much much better with garlic, onions, and raw goat’s milk rather than a toxin such as sulfur dioxide… 🙂
Chris, I appreciate and read all of your articles! I am a dermatologist and maintain a Paleo diet, along with being a triathlete. I feel strongly that avoiding grains and sugars are essential to avoiding all aspects of inflammation in the body, but of course, am especially interested in the direct effects of the skin. I do a lot of local and national lecturing and am working on a lecture that delves in to the effects of grains and sugar on inflammatory skin diseases. I know you are hugely connected with many of the folks in the research arena and would appreciate any links you may have to articles on this subject or any specific folks that you’d recommend I connect with so I can put together a meaningful lecture. I feel strongly that our colleagues in the medical profession need to grasp and at least understand the aspects of this reality that so many doctors unfortunately have no clue about.
Keep up the good work!!!!!
I’ve found that “nutrient-seeking” has been the absolute best solution for my problem skin. Egg yolks, adequate vitamin D, sulfur-rich foods, liver and sardines, as well as bone broth, a bit of red palm oil, and the Blue Ice cod liver oil-butter oil blend are staples for me. My skin has never been brighter or better – after years of using medicines (topical sulfur, retinoids, and antibiotics) that served as poor substitutes for what real food (and better digestion) can do.
Liz,
Can you explain what it is about red palm oil that is so helpful for skin (as opposed to the myriads of other types of oils that are also supposed to be good for skin)? Do you take it orally or topically? Also, I was taking 5000 iu of vit d3 daily (pure encapsulations) after finding that my levels were on the lower side (41ng/ml) and after 2-3 months of that I started taking 1/2 – 1 tsp of the green pastures fclo/bo blend. My understanding is that there is some vit d in that but not tons, and wonder what an optimal maintenance dose may be. I’m assuming it would be helpful to get my levels checked again.
Red palm oil is the richest source of beta caroten on the planet which a) is good for the skin per se b) converts to vitamin A. It is probably the dominant nutrient responsible for the effect.
Red Palm oil also has vitamin E
Great Post, Chris. Very informational. I appreciate it very much as a plastic surgeon. This is great info!